Medical Jurisprudence, Volume 2 (of 3)Paris, John Ayrton
Science
Medical Jurisprudence, Volume 2 (of 3)
Paris, John Ayrton
Medical laws and legislation -- Great Britain
We have deemed it necessary to offer these few remarks upon the
relations which subsist between the functions of the heart, lungs, and
brain, in as much as the propositions which have been thus established
respecting them, can alone lead to a correct pathology of those
diseases, by which life is suddenly extinguished, or suggest a rational
and effectual plan of treatment, in cases of suspended animation.
SYNCOPE:
In which the pulsations of the heart cease, before the action of the
respiratory organs.
The heart may cease to beat either from organic lesions in its own
structure, or in that of its vessels; or from being sympathetically
affected by injuries in other parts[20]; or from the operation of
certain poisons; or from a shock of the general nervous system, as
experienced in paroxysms of certain passions.
In ordinary fainting it is evident that some slight and feeble motions
of the heart still continue, although insufficient to produce a sensible
pulsation in the more distant arteries; and where this has continued for
an unusual period, and the respiration has been so obscure as to escape
common observation, the phenomenon has been eagerly seized by the
admirers of the marvellous, and credulity has attached to its history,
under the name of _Trance_,[21] circumstances of extravagance and
mystery, to which it can hardly be necessary to allude on the present
occasion. But the motions of the heart may have ceased altogether, and
in such cases it becomes a question, no less interesting to the
practical physician than to the physiologist, whether they can ever be
restored, and if so, we have to inquire under what limitation, as to
time; under what circumstances; and by what means? The views which have
been already offered respecting the pathology of Syncope will afford us
considerable assistance in the solution of a problem, so intimately
connected with inquiries of forensic importance. It would appear that
where the heart has ceased to pulsate, _in consequence of the cessation
of respiration, it can never again be set in motion_; but that where it
has stopped from other causes, as from the operation of certain poisons,
its muscular irritability not having been exhausted, its action may be
occasionally revived. Where Syncope arises from hemorrhage, we shall
find, on dissection, that the heart and its great vessels are either
empty, or contain only a small quantity of blood in their cavities; but
where Syncope arises from other causes, the heart is seen distended to
an unusual magnitude, and the blood in the left auricle and ventricle is
generally of a more or less florid colour, and has not the hue of venous
blood; a circumstance which depends upon the pulsation of the heart
ceasing before the function of respiration, and which is the very
reverse of what happens in death from suffocation, as we shall hereafter
explain.
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