Disturbances of the Heart: Discussion of the Treatment of the Heart in Its Various Disorders, With a Chapter on Blood PressureOsborne, Oliver T. (Oliver Thomas)
Science
Disturbances of the Heart: Discussion of the Treatment of the Heart in Its Various Disorders, With a Chapter on Blood Pressure
Osborne, Oliver T. (Oliver Thomas)
Blood pressure; Heart -- Diseases
Cadwalader, [Footnote: Cadwalader, W. R.: A Comparison of the Onset
and Character of the Apoplexy Caused by Cerebral Hemorrhage and by
Vascular Occlusion, The Journal A. M. A., May 2, 1914, p. 1385.]
after considerable investigation, has come to the conclusion that
large hemorrhages into the brain are the rule in apoplexy, and that
small hemorrhages are rare, and he is inclined to think that even
small, as well as large hemorrhages, are more frequently fatal than
supposed. In other words, he thinks that many of the nonfatal
hemiplegias are caused by vascular obstruction and softening and not
by hemorrhage. He finds that sudden death, or death within a few
minutes, does not occur from hemorrhage, even if the hemorrhage is
large, though a rapidly developing and persistent coma usually
indicates a hemorrhage. If the coma is not profound and is slow in
its onset, with symptoms noticed by the patient, and cerebral
disturbance, he believes it to be caused generally by softening of
the cerebral center, due to some obstruction of the blood flow, and
not to hemorrhage. While occasionally a slowly increasing loss of
consciousness may be due to hemorrhage, he thinks it is doubtful if
real hemorrhage ever occurs without loss of consciousness, while
softening of some part of the cerebrum may occur without
unconsciousness. He thinks that the size of the hemorrhage is of
more importance than its situation in causing the profoundness of
the symptoms, but he repeats that nonfatal cases of hemiplegia are
generally caused by vascular occlusion and subsequent softening, and
not by hemorrhage.
TREATMENT
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