Strogue

“ What are the Signs of the Fracture of the two Tables of the Skull, and of the overflowing of the Blood upon the Membranes of the Brain?
They are the loss of the Understanding at the very Moment of receiving the Wound; an Hæmorrhage or Flux of Blood thro' the Nose, Mouth, or Ears; drowsiness and heaviness of the Head, and more especially Vomitting of Phlegm; from whence may be inferr'd the necessity of making use of the Trepan. ”

“ The almost stagnant blood beginning to circulate again through nearly collapsed veins and arteries, inflicts tortures upon every nerve—tortures unheard of in the cruelest inquisition. Red-hot needles seem to be piercing every nerve of the body and pore of the skin. It is an agony that even the torpor of the brain does not overcome. ”

“ Another very important reflex upon the heart is that which is effected through the solar plexus and the sympathetic nerve. A stroke upon the belly will through these nerves stop the heart, dilate the vessels, and induce the most serious conditions of shock, killing the patient, or at any rate bringing him down to death's door. ”

“ Little child, if you go to hell there will be a devil at your side to strike you. He will go on striking you every minute for ever and ever without stopping. The first stroke will make your body as bad as the body of Job, covered, from head to foot, with sores and ulcers. The second stroke will make your body twice as bad as the body of job. The third stroke will make your body three times as bad as the body of Job. The fourth stroke will make your body four times as bad as the body of Job. ”

“ If a fracture, then, occur in the head, it is discovered by the sharpness, weight, hardness, or violent force of the body which struck it, and by the symptoms which supervene upon the person who has been struck, such as vertigo, loss of speech, and sudden prostration, more particularly if it be a fracture with depression, or contusion, or expression, or the internally-arched fracture, owing to the compression of the brain. ”

“ For the third, we are to consider first, that upon every great agitation or concussion of the brain, as it happeneth from a stroke, especially if the stroke be upon the eye, whereby the optic nerve suffereth any great violence, there appeareth before the eyes a certain light, which light is nothing without, but an apparition only, all that is real being the concussion or motion of the parts of that nerve. ”

“ Compression of the brain may be the direct and immediate result of a head-injury, a piece of the vault of the skull being driven in, and a local or a general paralysis of muscles being at once observed. In addition to the muscular paralysis, which may enable the surgeon to localize the spot at which there is pressure upon the brain, there is the grave symptom of coma or insensibility. And, as in deep sleep, there is often loud snoring, due to the vibration of the paralysed soft-palate. ”

“ When the first kind of this Disease exists in its most violent Degree, it is then sometimes termed, an apoplectic Stroke, or thundering Apoplexy, which kills in a Moment or instantaneously, and admits of no Remedies. When the Assault is less violent, and we find the Patient with a strong, full and raised Pulse, his Visage red and bloated, and his Neck swelled up; with an oppressed and loud hoarse Respiration; being sensible of nothing, and capable of no other Motions, except some Efforts to vomit, the Case is not always equally desperate. ”

“ Thus when inflammation occurs in the finger, as in a whitlow, the pain is not only constantly severe, but it is increased by every pulsation of the heart, and thus has a throbbing character. By raising the hand nearly to a level with the head both the constant pain and the severity of the throbs may be relieved, as the blood is not sent with such great force into the arteries and returns more readily through the veins. ”

“ If it be pricking, the Wound is deeper, but of small Moment: If it be a battering or bruising Instrument, the Wound is accompany'd with Contusion, producing a great Suppuration, besides the Concussion and Commotion of the Part, which are inseparable, and often cause very dangerous Symptoms. {151}
Inferences may be made also from the disposition of the wounded Person; for a strong robust Man may better bear the Stroke than a weak one ”

“ The blood poured out upon the brain from an apoplectic stroke, must, and does, prove fatal, save when the vis medicatrix is able to interpose in time, by encircling the fluid, enclosing it with a sac, and subsequently by absorption removing the extraneous pressure. All these are vital processes, over which the sufferer has no control—of which he is not even conscious. ”

“ When so induced to move, the agonizing pain to which the patient is subjected may be gathered by noting his countenance and manner of progression.
With each movement forward, muscular tremors affect the limbs; each step is short, jerky, and convulsive; the respirations and pulse are almost immediately greatly quickened, and the lower lip is hung pendulous, and moved almost unconsciously up and down with a flapping noise against the upper. A patchy perspiration breaks out about the body and quarters, and the tail is outstretched and quivering. ”

“ Immediately a dull, sickening pain becomes apparent at the base of the neck, and insensibility rapidly ensues. This arises from the affection of the respiratory nerve centre. In a short space of time the face becomes dark and congested through the veins being gorged with blood, and the heart ultimately ceases to beat. ”

“ In acute Diseases, when the motion of the Blood is very rapid through the whole Body, the Brain must suffer greatly, on account of the horizontal position, to which people in such cases are confin’d; because, the Blood rushing violently into the Arteries of the Brain, and its return being retarded by the Jugular Veins, will remarkably contribute to produce delirious symptoms, so frequent in acute Disorders, which might be in some measure prevented, by raising the Head ”

“ If we could go into the causes of false strokes in work or play, we should doubtless find that each has its antecedents, and that the false stroke often has a more or less definite meaning and is the expression of some trend which does not lie on the surface. Such occurrences are readily explicable as failures of adjustment due either to weakening of control or disturbances in the controlled tendencies to movement. ”

“ Since a moderately strong pulse, when the patient is in a recumbent posture, and not hurried in mind, seldom exceeds 120 strokes in a minute; whereas a weak one often exceeds 130 in a recumbent posture, and 150 in an erect one, in those fevers, which are termed nervous or putrid. ”

“ For treating a stroke on the head unto the brain, a stroke in the body unto the bowels, and the breaking of one of the four limbs, the wounded person was to receive three pounds from the one who wounded him ”

“ There are years of patient scornful persistence in every line. A man who had swum with the current could never have learned that mighty up-stream stroke....
“I turned back to my work, and went on groping and muddling; then I looked at the donkey again. I saw that, when Stroud laid in the first stroke, he knew just what the end would be. He had possessed his subject, absorbed it, recreated it. When had I done that with any of my things? They hadn’t been born of me—I had just adopted them....
“Hang it, Rickham, with that face watching me I couldn’t do another stroke. ”

“ The sun beat oppressively on his head and blistered his shoulders through his net undershirt. The warm water soaked the energy out of limbs and arms. He changed from breast to over-arm stroke, then he shifted to the crawl and trudgen stroke. ”

“ It is for the same reason that to cry out with bodily pain, how intolerable soever, appears always unmanly and unbecoming. There 28 is, however, a good deal of sympathy even with bodily pain. If, as has already been observed, I see a stroke aimed, and just ready to fall upon the leg, or arm, of another person, I naturally shrink and draw back my own leg, or my own arm: and when it does fall, I feel it in some measure, and am hurt by it as well as the sufferer. ”

“ Localizing to the pre- and post-central convolutions. Injury to the pre-central or motor area usually leads to the development of definite symptoms—twitchings, convulsions, or paralysis of the face and extremities on the contra-lateral side. In the earlier stages reflexes are abolished. Later on, as the result of degenerative changes in the pyramidal tracts, spasticity, contractures, and rigidity, with increased reflexes will be observed in the affected limbs. On the other hand, the muscles do not show any reaction of degeneration. ”

“ The upper part of the brain may bear pressure to a considerable degree without bad consequences ensuing, but compression at the origins of the nerves is always highly dangerous and generally fatal. Bleeding from the nose, mouth, and ears, when attended with other circumstances and symptoms evincing a violent injury and consequent cerebral disturbance, has been considered as decisive of fracture at the base having occurred. ”

“ All the muscles of the arm, forearm, and hand are paralysed, and, as a rule, also the pectorals and spinati, but the rhomboids and serratus anterior escape. There is paralysis of the sympathetic fibres to the eye and orbit, with narrowing of the palpebral fissure, recession of the globe, and the pupil is slow to dilate when shaded from the light. ”

“ The strong kind.—These cases mostly occur in stout, strong, short-necked, bloated-faced people, who are in the habit of living well.—Symptoms. The patient may or may not have had headache, sparks before his eyes, with confusion of ideas and giddiness, for a day or two before the attack. When it takes place, he falls down insensible; the body becomes paralyzed, generally more so on one side than the other; the face and head are hot, and the blood-vessels about them swollen; the pupils of the eyes are larger than natural, and the eyes themselves are fixed ”

“ Throbbing, to a greater or less degree, is always felt in an inflamed part by the patient; and it is frequently so distinct as to be readily perceived by an attentive examination. This arises, probably, from the stagnation of blood in the vessels of the part over-excited, and principally affected by the disease or injury, causing an increase in the collateral circulation; and it is this rapidly increased action around that gives rise to the signs and symptoms, and constitutes, in point of fact, what is known and recognised as inflammation. ”

“ Pressure on brain—pain, spasm, nausea, dullness, blindness, stupor, coma, palsy. Congestion and anæmia synchronous. Lesions of cortex. Encephalic lesions—hemiplegia, with spasms, increased reflexes, spasms follow cranial nerves, vertigo, apoplexy, epilepsy, dementia, coma, little muscular atrophy, or dermal sloughing. Spinal lesions, paraplegia without spasm, reflex reduced or nil, follow spinal nerves, head symptoms less, much muscular atrophy, bed sores. Sensory and motor tracts, in crus cerebri, respiratory centres—inspiratory expiratory, inhibition. ”

“ One would like to know for what nerves and whose nerves, since strangers who reside here for any length of time generally find that any constitutional tendency to ailments in which the nerves are principally involved is increased, instead of lessened; and among the natives themselves brain diseases, strokes of all kinds, fits and cramps, are frequent and fatal, while the enemy which they fear the most, and which presses them the hardest, is known by them as "nervous fever," The air is too stimulating for any but the most robust constitutions ”

“ The down and up strokes are compound movements—the termination of the down stroke embracing the beginning of the up stroke, and the termination of the up stroke including the beginning of the down stroke. ”

“ Convulsions are an involuntary contraction of the muscles. Consciousness is wanting, while the limbs may be stiff or in spasmodic action. (See p. 261.)
3. Locked-jaw is a disease in which there are spasms and a contraction of the muscles, usually beginning in the lower jaw. It is serious, often fatal, yet it sometimes follows as trivial an injury as the stroke of a whip lash, the lodgment of a bone in the throat, a fishhook in the finger, or a tack in the sole of the foot. ”

“ When there is great disturbance of the arterious system, with throbbing, there is always acute pain. In common whitlow of the finger, how the arteries of the arm, the brachial in particular, throb, is well known. In proportion as arteries are excited to vehement action, some difficulty occurs to the transmission of the blood into the veins. ”

“ The wise men in these islands have invented a theory that headache, neuralgia, vertigo, and other affections of the head, arise from a crack in the skull, or from pressure of the skull upon the brain. ”

“ When a fit comes on, the muscles of the face twitch, the body is stiff, immovable, and then in a short time, in a state of twitching motion, the head and neck are drawn backwards and the limbs violently bent and stretched. Sometimes these movements are confined to certain muscles or are limited to one side, and I may add that such cases are of more importance as far as the state of the brain is concerned than those in which the convulsions are general. The eye is fixed and does not see ”

“ In order to make the stroke, the foot is first drawn forwards, when the toes close together and the webs fold, so as to offer to the water the least possible resistance; but when the back stroke is made, the toes spread out, while the action of the limb is at the same time, in most instances, obliquely outwards. ”