Epilepsy : its symptoms, treatment, and relation to other chronic convulsive diseases / by J. Russell Reynolds.

  • Reynolds J. Russell (John Russell), Sir, 1828-1896.
Date:
1861
Catalogue details

Licence: Public Domain Mark

Credit: Epilepsy : its symptoms, treatment, and relation to other chronic convulsive diseases / by J. Russell Reynolds. Source: Wellcome Collection.

Provider: This material has been provided by the Royal College of Physicians of Edinburgh. The original may be consulted at the Royal College of Physicians of Edinburgh.

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    existence we may not be able to say whether the muscles, the nerves, the spinal cord, or the brain, is primarily affected; but we are certain that, inasmuch as contractility and innervation are vital acts, and depend upon nutrition-changes in one or the other of the muscular or nervous organs, this spasm is due directly to some excess, or modification of those nutrition-changes. The difierence, then, between negative and positive symptoms is this,—^that whereas the former may depend directly upon some such rough lesion as a solution of continuity, the pressure of a tumour, or other mechanical conditions, the latter (positive symptoms) must always depend directly upon minute, inter- stitial changes, which are the necessary conditions and proxi- mate causes of vital acts. Distinct leisons of organs may be the remote causes of positive symptoms; a tumour may cause spasm; but such causes are remote always: the immediate cause is the change of nutrition, the modification of the inter- stitial process. § VII. Convulsions are modifications of vital actions, and therefore depend upon modifications of physical conditions. It is no objection to this general proposition, that frequently, post mortem, we can discover no organic change in the brain or spinal cord, for convidsions belong to the second categoiy of symptoms, and depend upon modifications of nutrition. We may find a tumour in the brain, or tubercular deposit in its meninges; we may find disease of the kidnej'^s, or such general derangement of the organs as scrofula or rickets can produce; but wherever we may find these easily-discovered physical changes, they are not the immediate causes of convul- sion, for convulsion is a modified vital act of mxiscvdarity and nervous force, and its proximate cause is in the nutritive con- dition of the nervous centres. § VIII. Convulsions depend directly upon nutrition-changes in the nervous centres. So long as spasm or paralysis, pain or an£esthesia, are confined to one muscle, or to a limited surface, it is possible, and often probable, that the lesion exists in the periphery, or in some channel of communication between the peripherj'- and the centre ; but when the disturbance involves aU the muscles of a limb, of one side, and a fortiori, when aU the mxiscles of the