Excerpt from Lectures on Clinical Medicine, Vol. 35: Delivered at the Hotel-Dieu, Paris
Gentlemen, - The patient lying in bed No. 7, St. Agnes ward, affords me the opportunity of raising a question of the highest clinical importance, namely, the contra-indication of bloodletting in cerebral h?morrhage, and more generally in apoplexy. I will at the same time draw your attention to the semiotic value of facial paralysis when it occurs in connection with a lesion of the opposite hemisphere of the brain, and not as a consequence of disease exclusively limited to one of the facial nerves. Lastly, I will say a few words respecting the differential diagnosis between softening of, and h?morrhage into, the brain.
The patient, whom I mentioned just now, was admitted into the hospital for a chronic pulmonary catarrh, which had not caused any notable disturbance of his general health. He was under treatment for that complaint, when he was suddenly seized with symptoms which caused me some anxiety, although he did not himself complain of them.
Without any premonitory headache or giddiness, he found a few days ago that his tongue was embarrassed, and that his speech was thick.
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