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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    The occurrence of convulsions is, without exception, preceded by many different movements, most of wliich have been more fully described in Kussmaul's above-mentioned treatise.' We will here only briefly allude to some of them:— I. Immediately after stoppage of the blood the various sphincter muscles of the face contract, especiaUy, and in a very striking manner, those of the iris and eyelids; then, in the order of their distmct- ness, the concha of the ears, the nostrils, and the mouth. The jaws, which are generally akeady closed, become spasmodically ■locked. Then, usually a Httle before but sometimes simultaneously upon the occurrence of general convulsions, the pupHs, and the fissures of the eyelids, ears, and nostrils are mdened, sometunes the mouth also very distinctly. The adductors of the under jaw seem also for a few moments to become paralysed, but dunng the attack the jaw becomes locked, either uninterruptedly or in broken succes- sion, by the alternate occurrence of spasmodic and more feeble abductions and stronger adductions. 2 Convulsive efforts are almost invariably made to turn the pupils towards the internal angles of the eyes; after which, the eye- balls generally roll abovit, first inwards, forwards and downwards, then outwards, backwards and upwards, until at length the pupi^^s are turned towards the external angles of the eyes, and are wholly or partially concealed by the upper eyehds. , . . • 3. The eyeballs are first drawn back into the sockets, and agam become prominent as the pupils dilate. , ^ . 4 Eespiration is at &st accelerated, but shortly afterwards, a little while before the approach of general convulsions, it becomes prolonged ^^^^^^^^^^'^ ^^^^ generaUy become paralysed and unable to bear the weight of the head, which sinks down upon the breast or side, the animals afterwards faUing down in a swoon on their fore feet occasionaUy on their hind ones. These symptoms of paralysis t t~ distinct and constant the greater the time that elapses before eeneral convulsions come on. . ^ . • The signal for general convulsions is given by a tonic contraction of the muscles of the neck. Then commences a terrible scene, the more surprising by contrast if preceded by swooning. The head is drawn violently backwards; the pupil becomes uncommonly enlarged; 1 Vide ' Zeitschrift des Wiirzburg. Pbys. Med. Vereins.'