The Lumleian lectures on the muscular arterioles : their structure and function in health and in certain morbid states : delivered at the Royal College of Physicians / by George Johnson.

  • Johnson, George, 1818-1896.
Date:
1877
Catalogue details

Licence: Public Domain Mark

Credit: The Lumleian lectures on the muscular arterioles : their structure and function in health and in certain morbid states : delivered at the Royal College of Physicians / by George Johnson. Source: Wellcome Collection.

Provider: This material has been provided by The Royal College of Surgeons of England. The original may be consulted at The Royal College of Surgeons of England.

    50/60 (page 46)
    peded flow of blood through the lungs into the systemic heart and arteries, as explained in my first lecture. The epileptiform convul- sions which often result from the inhalation of nitrous oxide gas admit of the same explanation. It is quite certain that, in Kussmaul and Tenner's rabbits, with closed carotids and subclavians, no black blood could reach the brain, yet the convulsions were apparently identical with those which result from suddenly fatal apncea, whether in the lower animals or in the human subject. A few years since, the following case came under the observation of my friend Dr. Lavies and myself. A gentleman, about sixty years of age, had been confined to his bed for three weeks with symptoms which pointed to great feebleness of the heart, and probably to fatty degeneration of its walls. There was dyspnoea on exertion, and some- times on awaking after a long sleep ; the heart's impulse and the radial pulse were feeble ; there was some oedema of the legs, and over the bases of the lungs there were moist crepitating sounds, probably the result of oedema there. He awoke in the middle of one night, told the nurse that he felt quite comfortable, asked the time, and began to re- peat her reply Oh, half-past , when he suddenly stopped, and the nurse, turning to him immediately, saw that his face was livid and he was in strong convulsions. In a few seconds, and before any one could answer her call for assistance, the patient was dead. The body was examined, in the presence of Dr. Lavies and myself, by my friend and former colleague Dr. Kelly. The walls of the heart were thin, soft, and fat. The right ventricle was dilated and contained a firm de- colorised thrombus extending from the apex of the ventricle through the tricuspid orifice into the auricle, to the outer wall of which it had evidently been attached and moulded, but, becoming separated from the auricular wall, it had fallen over the tricuspid orifice and completely closed it. Thus, the circulation must have been completely and in- stantaneously arrested. The result was lividity of the face from venous fiilness, and epileptiform convulsions from cerebral arterial anaemia. In this case, as in the case of the rabbits with ligatured arteries, it is evident that the convulsions were caused, not by black blood, but simply by the absence of circulating blood in the cerebral vessels. When animals are killed by air being forcibly blown into a vein, the breathing becomes hurried, the animal suddenly falls down, and usually dies in convulsions ; the contents of the bladder and rectum being fre- quently expelled at the time of death. Dr. John Reid states that, in