Selected monographs.

  • Kussmaul, Adolf, 1822-1902.
Date:
1859
Catalogue details

Licence: Public Domain Mark

Credit: Selected monographs. Source: Wellcome Collection.

Provider: This material has been provided by UCL Library Services. The original may be consulted at UCL (University College London)

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    least partially balanced, without the animals having fallen into real epileptic convulsions.^ These experiments are in remarkable accordance with the above- mentioned observation of Romberg, that epilepsy in plethoric subjects has an apoplectic character and is attended by feeble con- ^nllsions. VVe feel, therefore, induced to express our doubts as to whether these so-called epileptic affections in plethora are to be at all ascribed to true epilepsy, or whether they are not rather to be set down among the series of apoplectic affections, and those which have in common with each other, unconsciousness, insensibility, and even the appearance of clonic spasmodic movements of the Hmbs, although in a sKght degree; but which differ in their symptoms with respect to the state of the respiratory muscles, and are, in par- ticular, accompanied by paralysis of the glottis, wliilst epilepsy is distinguished by spasm of the glottis. The results of our researches are accordingly decidedly at variance with any theory which offers sudden congestion of an active, passive, or mixed character, as the cause of an epileptic attack. We have, on the contrary, proved that the sudden appearance of arterial anaemia of the brain gives rise to epileptic attacks; and we are, therefore, fully justified in propounding the question, What is the value of the theory which explains them by a spasm of the muscular elements of the vessels of the brain, especially of the smaller arte- ries containing many muscular fibres ? If at any time we can observe that fright is capable ''of expelling the blood from the cheeks, it cannot be denied that it is possible for the same cause, one of the most frequent of epileptic attacks and affections as is well known, to contract the smaller branches of the carotids and vertebral arteries. We know that anaemia, the most fruitful source of epilepsy, renders the nervous system very irritable and very accessible to the influences of fright; that anaemic and chlorotic persons possess a small and compressible piilse, and readily tui'n pale and swoon away. Numerous and accurate observers, such as Georget, Watson, Copland, Trousseau (De IMpileps., 'Gaz. des Hopit.,' 1855, No. 49), and others, expressly mention that at the commencement of the attack the face is always pale, and only turns red and blue subse- quently. Nevertheless, the carotids and the heart pulsate strongly; indicating the existence of an impediment to the circulation in the ' A more detailed account of Ihe results of these experiments, which are not entirely completed, shall be given at some future time.