Some disorders of the cerebral circulation and their clinical manifestations / by Alfred E. Russell.

  • Russell, Alfred E. (Alfred Ernest), 1870-1944.
Date:
1909
Catalogue details

Licence: In copyright

Credit: Some disorders of the cerebral circulation and their clinical manifestations / by Alfred E. Russell. Source: Wellcome Collection.

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

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    stability and the same physical and mental relation- ships. Dr. James MacKenzie discusses these abnormal circulatory disturbances under the very non-committal title of the “X Disease.”* Pal has ably demonstrated the importance of vascular changes in relation to clinical symptoms in an exhaustive monograph — giving these changes the suggestive name of “ Gefasskrisen ”—vessel crises. It is difficult to decide in each case whether the coldness of the skin is due toactivevaso-constriction, or whether the skin vessels are merely narrowed down just enough to accommodate the diminished amount of blood available for them. On general grounds vaso-dilatation in a large vascular area which would cause lowering of blood-pressure is compensated for by active constriction in other regions. The tightening of the skin described in one case was- possibly due to a contraction of the hair’muscles. Whether there is a very active vaso-constriction of the cutaneous vessels, it is clearly ineffective against the splanchnic dilatation, for'it can scarcely be doubted but that the blood-pressure must usually be very low in these attacks. The pulse is usually extremely feeble. With a great accumula- tion of blood in the splanchnic region the pulse of necessity becomes small, and the common physio- logical accompaniment of a lowering of blood- pressure is an acceleration of the heart. But in * Diseases of the Heart,’ 1908, p. 56.