Vascular bronchocele and exophthalmos / [J. Warburton Begbie].

  • Begbie, James Warburton, 1826-1876.
Date:
1882
Catalogue details

Licence: Public Domain Mark

Credit: Vascular bronchocele and exophthalmos / [J. Warburton Begbie]. Source: Wellcome Collection.

    12/32 (page 178)
    affection of the heart, which may indeed give rise to organic cardiac disease, but does not necessarily do so; to attempt to demonstrate the source of the affection would, as we cannot find it in anaemia, with our present materials, be a fruitless labour, and would lead us far into the region of hypothesis.’- It is now four years since Koeben expressed the opinion that a lesion of the sympathetic best explained the entire phenomena; and in i 860, the late M. Aran, having diligently studied the dis- ease, and having brought the subject under the attention of the Imperial Academy of Medicine, concluded that, in all probability, the primary seat of the disease was in a lesion of the grand sympa- thetic. M. Trousseau, who has of late had considerable clinical experience of exophthalmic brouchocele, and whose views on the subject may be found at length in the discussion before the Impe- rial Academy, in which, as “ rapporteur,” he took a very promi- nent part, as well as in the second volume of the Clinique Medicale de FHotel-Dieu de Paris, rejects the anaemic theory as to its causation, and regards the anaemia as secondary to the cardiac palpitation, the arterial pulsations, and the phenomena connected both with the eye and thyroid gland. “ Anaemia,” he says, ‘‘ is an epiphenomenon ; it is secondary, sometimes tardy in its development. The morbid cause acts primarily on the heart, and it is not till the lapse of a certain time, more or less con- siderable, that the blood is modified in the constitution of its elements. The woman in bed 34 of the ward St Bernard presents at this time the features of anaemia; these features were not, however, in existence when she came under our care, although the disease had then continued for nine months. A neurosis of the grand sympathetic had preceded the anaemia.” Again, the same distinguished physician observes, “ The disease is, in my opinion, a neurosis with local congestions, having its proximate cause in a modification of the vaso-motor apparatus.^ There may, then, be said to exist, at the present time, two theories respecting the origin of the singular and interesting ailment we are considering. The one, that it depends upon anaemia, a blood impoverishment; the other, that it results directly from a disorder of the nervous system, is a neurosis 1 “ On the Cachexia Exophthalmica of Authors.” Translated hy Dr. W. D. Moore, ‘ Dublin Hospital Gazette,’ July 13th, 1839. 2 ‘ Clinique Mddicale de I’liotel-Dieu de Paris,’ tome ii, p. 645.