On the Treatment of Dropsy of the Gall-Bladder by Operation, with Notes of a Successful Case

G. Brown
1878 BMJ (Clinical Research Edition)  
9I6 THE BRITISH MEDICAL _O URNAL. [Dec. 21, 1878. extended up the whole of the cord, and eventually to the medulla oblongata. Schroeder van derKolk (Ot the Proximate Causeand Rational Treatment of Epilepsy, Sydenham Society, 1859, page 223) has shown that the medulla oblongata contains, in addition to numerous groups of ganglia both for sensitive and motor nerves, special auxiliary ganglia, possessing the property of exciting, even in the healthy condition, on the application of any stimulus,
more » ... merous reflex phenomena in different groups of muscles. Hle affirms that, as a consequence of augmented irritability, this capacity for reflexion is greatly increased, and in epilepsy rises so high that the reflex phenomena manifest themselves spontaneously and without external irritation. "Moreover", he adds, "what is most important, these phenomena are not constant; but, as Brown-Sequard expressly observes, the fit does not last long, but is often repeated." In reference to the nature of the spinal irritant, it is interesting to notice the result obtained by Kussmaul and Tenner, in their experiments on the production of epileptic convulsions by profuse hmmorrhage. Rapid abstraction of blood from the nervous centres situated within the cranium produced general convulsion; but the sudden production of anaemia of the spinal cord was followed by paralysis of the hinder part of the body. In only three of the animals experimented on, a slight tremor preceded the paraplegia, and in these the trembling movements lasted only for a few seconds, and were immediately followed by total paralysis of both hind legs. The fact that, in the case detailed above, the convulsions first manifested themselves eight days after the injury, points to some hyperaemic or inflammatory condition having been developed in the cord-a view which the experiments of Brown-Sequard favour, and the experiments of Russmaul and Tenner tend to support.
doi:10.1136/bmj.2.938.916 fatcat:45syh5ol4vcupd73ttaxxfbez4