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MAny have to this day enquired, but as yet as farre as I know it hath not * 1.1 bin sufficiently explained, why a convulsion in wounds of the head seazes on the part opposite to the blow. Therefore I have thought good to end that controversie in this place. My reason is this, that kinde of Symptome happens in the sound part by reason of emptinesse and
drynesse; but there is a twofold cause, and that wholy in the wounded part, of this emptinesse and drynesse of the sound or opposite part; to wit, paine; and the concourse * 1.2 of the spirits and humors thither by the occasion of the wound, and by reason of the paines drawing and natures violently sending helpe to the afflicted part.
The sound part exhausted by this meanes both of the spirits and humors, easily falls into a Convulsion.
For thus Galen writes; God the creatour of nature, hath so knit together, the triple spirituous substance of our bodies, with that tye, and league of concord, by the pro∣ductions * 1.3 of the passages; to wit of Nerves, Veines, and Arteries, that if one of these forsake any part, the rest presently neglect it, whereby it languisheth, and by little, and little dyes, through defect of nourishment. But if any object that nature hath made the body double, for this purpose, that when one part is hurt, the other re∣maining safe and sound, might suffice for life and necessity: but I say, this axiome hath no truth in the vessells and passages of the body. For it hath not every where doubled the vessels, for there is but one onely veine, appointed for the nourishment of the braine, and the membranes thereof, which is that they call the Torcular, by which when the left part is wounded, it may exhaust the nourishment of the right and sound part, and though that occasion cause it to have a convulsion, by too much dry∣nesse; Verily it is true, that when in the opposite parts, the muscles of one kinde are equall in magnitude, strength, and number, the resolution of one part, makes the con¦vulsion of the other by accident; but it is not so in the braine.
For the two parts of the braine, the right and left, each by its selfe per∣formes that which belongs thereto, without the consent, conspiratiou, or commerce of the opposite part; for otherwise it should follow, that the Palsie properly so called, that is of halfe the body, which happens by resolution, caused either by mol∣lification or obstruction residing in either part of the braine, should inferre together with it a Convulsion of the opposite part. Which notwithstanding dayly experience convinces as false. Wherefore wee must certainely thinke, that in wounds of the head wherein the braine is hurt, that inanition and want of nourishment are the cau∣ses, that the sound and opposite part suffers a convulsion.
Francis Dalechampius in his French Chirurgiry renders another reason of this que∣stion; That, (saith he) the truth of this proposition may stand firme and ratified, we * 1.4 must suppose, that the convulsion of the opposite part mentioned by Hippocrates, doth then onely happen, when by reason of the greatnesse of the inflammation in the hurt part of the braine, which hath already inferred corruption; and a Gangraene to the braine and membranes thereof, and within a short time is ready to cause a sphacell in the scull, so that the disease must be terminated by death; for in this defined state of the disease, and these conditions, the sense and motion must necessarily perish in the affected part, as we see it happens in other Gangraenes, through the extinction of the native heate. Besides, the passages of the animall spirit must necessarily bee so ob∣structed by the greatnesse of such an inflammation or phlegmon, that it cannot flow from thence to the parts of the same side lying there under, and to the neighbouring parts of the braine; and if it should flow thither, it will be unprofitable to carry the strength and facultie of sense and motion, as that which is infected and changed by admixture of putred and Gangraenous vapours. Whereby it cometh to passe, that the wounded part destitute of sense, is not stirred up to expell that which would be troublesome to it, if it had sense; wherefore neither are the Nerves thence arising seased upon, or contracted by a Convulsion.
It further more comes to passe, that because these same nerves are deprived of the presence and comfort of the animall spirit, and in like manner the parts of the same side, drawing from thence their sense and motion are possessed with a palsie; for a palsie is caused either by cutting or obstruction of a Nerve, or the madefaction, or mol∣lification thereof by a thinne and watry humor, or so affected by some vehement di∣stemper, that it cannot receive the Animall spirit.
But for the opposite part and the convulsion thereof, it is knowne and granted by all, that a convulsion is caused either by repletion which shortens the Nerves by distending them into bredth, or by inanition, when as the native and primitive
heate of the Nerves being wasted, their proper substance becomming dry is wrinck∣led up and contracted; or else it proceedes from the vellication, and acrimonie of some vapour, or sanious and biting humor, or from vehemencie of paine. So wee have knowne the falling sicknesse caused by a venenate exhalation carried from the foote to the braine. Also wee know that a convulsion, is caused in the puncture of the Nerves, when as any acride and sanious humor is shut up therein, the orifice thereof being closed; but in wounds of the Nerves when any Nerve is halfe cut, there happens a convulsion by the bitternesse of the paine.
But verily in the opposite part, there are manifestly two of these causes of a con∣vulsion; that is to say, a putride and carionlike vapour, exhaling from the hurt, and Gangraenate part of the braine; and also a virulent acride and biting Sauies, or filth, sweating into the opposite sound part, from the affected and Gangraenous; the malig∣nitie of which Sanies, Hippocrates desirous to decipher, in reckoning up the deadly signes of a wounded head, hath expressed it by the word Ichor; and in his booke of fractures he hath called this humor Dacryodes et non Pyon. [that is, weeping and not di∣gested.] Therefore it is no mervaile if the opposite and sound part endewed with ex∣quisite and perfect sense, and offended by the flowing thereto of both the vaporours and sanious matter, using its own force, contend and labour as much as it can, for the expulsion of that which is trouble somethereto. This labouring or concussion is follo∣wed (as we see in the falling sicknesse) by a convulsion, as that which is undertaken in vaine, death being now at hand; and nature over-ruled by the disease. Thus (saith Da∣lechampius) must we in my judgement determine of that proposition of Hippocrates and Avicen.
But he addes further, in wounds of the head, which are not deadly, practitioners observe that sometimes the hurt part is taken with the palsie, and the sound with a convulsion; otherwhiles on the contrary, the wounded part is seazed by a Convulsion and the sound by a Palsie; otherwhiles both of them by a convulsion or Palsie; and somewhiles the one of them by a convulsion or Palsie, the other being free from both affects; the causes of all which belong not to this place to explaine. Thus much Dale∣champius.
A convulsion is caused by drynesse.
A twofold cause of con∣vulsisieke drynesse.
Lib. 4. de usu partium.
Opinion of Champhius.