Daily Kennebec journal. [microfilm reel] (Augusta, Me.) 1870-1975, 1875-12-22

ERRORS ABOUT APOPLEyY.

recent medical writer makes the fol-
lowing suggestions, which correct some
prevalent notions regarding apoplexy:
"ln conversing with several persons
about Vice President Wilson's death and
its cause, have noticed that few have a
right conception Of the symptoms of apo.
plexy. The conditions constituting an at
tack are the rupture of cerebral blood
vessel. and consequent hemorrhage or ex-
travasation of blood into the brain. The
effect of an extravasation of blood into the
brain substance is the same as compression
by depressed portion fthe skull, because
the brain is inclosed in hard, unyielding,
bony case. Under these circumstances the
pressure caused by the extravasated blood
interrupts the circulation in the substance
of the brain, and the apoplectic phenome-
ma. such as stupor, insensibility. etc., are
in fact due to deficiency of a proper sup
ply OF blood to the nervous mass. The
mechanism is practically the same when
apoplexy depends on sudden and intense
congestion, or the plugging of cerebral
artery by blood clot.
The symptoms Of the disease and imme.
diate cause of death are, therefore, due to
a lack OF proper supply of blood to the
brain, and not, as is generally supposed,
to an accumulation or rush of blood to the
head 1t may appear paradoxical super
tluous quantity of blood within the crani-
um should destroy life by depriving the
mass OF brain of sufficient supply of ar
terial blood, yet the fact is sufficiently
clear. The rupture Of the cerebral blood
vessel is due to the weakness of its coats,
which is the result of general debility or
previous i'll health. In the great majority
OF cases there are no premonitory symp-
toms. The attack may be preceded, in
certain instances, by sense of weight or
fullness, vertigo, flushing OF the face, ETC..
but these symptoms are never of sufficient
significance to warrant the prediction ofan
attack. Statistics show that of 63 cases
analysed with reference to premonitory
symptoms by Rocheaux, they were pres
ent in only 9, less than 10 per cent. of the
whole number. The liability to an attack
increases progressively from the age OF
20 years upward, occurring most frequent
ly after 60 years of age, which is due to
the increased weakness of the coats of the
blood-vessels in old age, and hence their
liability to rupture.
1t is generally supposed that an attack
is usually preceded by strong mental ex-
citement OF violent physical exertion. This
does not seem to be the case. Although
attacks sometimes follow severe muscular
exercise or mental excitement, in the large
proportion of cases the affection is not in
duced by any obvious exciting cause. Gen.
drin analysed 176 cases, and found that 81
(over So per cent, occurred during sleep.
and large share of the others when the
patients were comparatively quiet. An
other popular error is the supposition that
Il certain class of persons who have short
necks, florid faces, with what is known as
a full habit, with considerable embonpoist,
are peculiarly liable to a so-called apo
plectic constitution. Recent researches
and analyses of large numbers of cases
have developed the facts that no reliance
is to be placed on these or any other ex-
ternal characters as denoting predispo-
sition to apoplexy, and that the majority
of persons attacked are either spare or Of
ordinary habit of body. After patient
has suffered one attack and partially re-
covered, the conditions which induced it
are likely to remain or to return, and
hence there is considerable liability to a
recurrence. Physicians therefore conclude
that unless one attack has occurred, there
are but few if any physical signs or pre-
monitory symptoms which will warrant
the prediction of an attack in any case