Observations on cerebral apoplexy at different periods of life / by Richard Quain.

  • Quain, Richard, 1816-1898.
Date:
1849
Catalogue details

Licence: Public Domain Mark

Credit: Observations on cerebral apoplexy at different periods of life / by Richard Quain. Source: Wellcome Collection.

Provider: This material has been provided by The Royal College of Surgeons of England. The original may be consulted at The Royal College of Surgeons of England.

    15/20 (page 13)
    18 MENINGEAL HAEMORRHAGE. Years. Cases. Males. Females. 1 and 1^ 4 1 3 2 and 2J 8 6 2 4 3 0 3 5 to 7 4 4 0 11 to 14 4 1 3 Total, 23 12 11 CEREBRAL AND VENTRICULAR HAEMORRHAGE, Years. Cases. Males. Females. 2 2 1 1 3 2 2 0 4 and 5 3 0 3 7 2 2 0 9 and 10 3 3 0 12 to 14 3 1 2 Total, 15 9 6 The preceding facts will show that the earlier periods of life are not as exempt from these lesions as has been generally supposed; and they will serve as a nucleus for future observations. Their present number, however, is scarcely sufficient to justify any conclusion as to the precise age, in children, most liable to apoplexy, except that it appears to occur frequently between the second and third years of life. III. RELATIVE FREQUENCY OF CEREBRAL APOPLEXY AT DIFFERENT PERIODS OF LIFE SUBSEQUENT TO THE AGE OF PUBERTY. In this portion of our inquiry I propose to avail myself of the statistics of forty-nine cases of apoplexy which came under my notice during the time (above five years) that I was house-physician at University College Hospital.1 The age was ascertained as accurately as possible in every case; and in every instance there was either a post-mortem examination, or a fit in which insensibility, followed by paralysis, oc- curred, which justified the case being considered as one of apoplexy. The record has this peculiarity, that the date of the first fit (if there has been more than one) is that which has been retained. The conclusions thence derived are therefore necessarily as to the period of life most liable to apoplectic seizures, and not as to the age at which death by apoplexy occurs. I believe this to be a distinction of some importance; for, as it must be always a matter of doubt whether a fit will be fatal or not, our inquiries should tend to illustrate the date of its probable occurrence rather than that of its probable fatality. It is this date (that of the probability of the apoplectic seizure) which is of importance in our prophylactic, as well as in all other, considerations. Table i shews, that of the forty-nine cases, twenty-seven occurred in males and twenty-two in females. The relative frequency of the disease in the sexes, thus shewn, corresponds with the generally-received opinion, that apoplexy more frequently attacks males than females. As the num- ber of females living is greater than that of males, the difference is in reality somewhat greater in favour of the latter. The entire number of cases of every description received into the wards of the hospital cotemporaneously with those of apoplexy, just referred to, amounted to 3665 ; of these, 1834 were males, and 1831 females. When we thus take all diseases, and find the proportion of the sexes nearly identical, we may safely conclude that the disproportion shewn in the cases of apoplexy is not due to any accidental or special disturbing causes, hut that the liability to the disease is in reality greater in males than in females. 1 I have pleasure in acknowledging the assistance of my friend Mr. Wilkes (late physician's assistant at the hospital) in preparing the table of ages.