The Redwood gazette. [volume] (Redwood Falls, Minn.) 1873-1940, 1876-02-17
1ntoxication and An0plexy..

IN several articles we;have insisted On
thu difficulty there frequently is in tho
daAknosis between intoxlcation and fatal
s&6plexy. In particulafswe have stated
= 6at apoplexy from cerebral hem0rfhage
initiates not only the comatose stage of
drunkenness, but occasionally what we
call the 4ssuproariousn stage. ARGENT
case exemplifies this remark. A gentle
man Was found lying In a gutter BY =
policeman; and, d. Tie gentleman sang
"Tommy, make way for your uncle"
!, and also said, part Of the Lords prayer,
he was supposed to be drunk, and was
taken to the police Office. Later on, as
he seemed to be in fit, he was sent to q
hospital, and died there next morning of
apoplexy from disease Of the brain.
Whether that apoplexy was owing to
cerebral or meningeal hemorrhage or not
we do not know. The difficulty is, of
course, the greatest when there is no his
cases. The apoplectic patient, from the
text books point of view, is taken ill at
home, and under circumstances in which
the diagnosis, 60 far as to exclude drunk
enness, is ready made. In hospital and
police practice, the history is too often
like that of this poor gentleman; he is
found in gutter insensible and uproar-
ious. But not only may patient be vio-
lent in cases of apoplexy to be speedily
fatal, but he may, when otherwise appar-
emily deeply insensible, perform elaborate
actions. We must be on our guard, and
not be misled by these cases. Let us
mention one or two cases of automatic
actions occurring during coma. We have
never seen actions so striking as that of
singing comic song in q case of apo
plexy. The =" suggestion Of the particu-
lar action often seems to be given by what
the patient was doing when his illness
set in. Thus, o woman, who had
fractured her skull by falling down stairs
while she was laying down some oil
cloth, kept arranging the counterpart
when partly insensible; she died in few
hours. We have seen q lady who during
otherwise deep coma would elaborately
sponge her face when the sponge was put
into her right hand, and this only few
hours before her death. BY the way, this
'lady's symptoms at the outset were to the
popular mind SO like those of drunken
ness, that she was hailed by the street
boys, "See the drunken lady!' when she
was brought out of the house where she
was first taken ill. Sometimes the auto
matte action is the survival of a deeply
organized habit. DR.. Hughlings jackson
has recorded the case of man who, dur
ing fatal coma, deliberately twirled his
mustache. It was afterwasd found that
this was very common trick of his. He
had been a soldier. We consider it
great misfortune that such cases are often
looked on as mere scientific curiosi,ies,
and, again, that a comparative study is
not made of the effects of alcohol, epilepsy
and other comatizing agents. Wenow in
sist, again, that-the performance Of very
elaborate actions may be seen in cases of
apoplexy to be speedily fatal; they occur,
too, after epileptic seizures, and after
drinking. Hence, difficulties in diagno-
sis. The cases are illustrative of Lay
cocks doctrine of the reflex function Of
the brain. A careful study of automatic
actions occurring IN numerous cases of
insensibility from various causes, by the
light of several principles enunciated long
ago hy Laycock, would be very profitable,
not only as the means of investigating i'm
portant problems in that which is COM
monty called the physiology Of mind"
but for the directly utilitarian purposes of
diagnosis and prognosis. '-British Aedi-
cal Journal.