58 
PARTURIENT APOPLEXY. 
which attend upon sanguineous discharge into the cerebral sub¬ 
stance, and parturient apoplexy meant such discharge during the 
parturient state. There never would, indeed, never could have 
been any controversy touching the essential nature of this disease 
had not the march of pathological science brought to light facts 
which were at variance with received opinions. 
The scalpel disclosed this pregnant truth—namely, that the 
phenomena of the so-called apoplectic condition in the paturient 
state were not due to what was then understood by apoplexy, 
viz: a sanguineous discharge into the cerebral substance. With 
this vital fact clearly demonstrated, it became obvious that even 
though hemorrhagic extravasation may be present in a case of 
parturient apoplexy, it by no means fnrnishes proof that the 
essential condition upon which the phenomena of the disorder 
depends is cerebral congestion. It is a mooted question even now 
with neurologists and pathologists whether actual hemorrhage 
into the cerebrum can take place without antecedent and con¬ 
comitant disease in the blood-vessels themselves. MM. Charcot 
and Bouchard have declared that cerebral hemorrhage almost 
invariably followed arteritis, and Hammond accepts the same 
opinion. The liability to cerebral hemorrhage is not diminished 
by pregnancy, and its occurrence during that, or the parturient 
state, attended with the phenomena of paturient apoplexy, by no 
means affords evidence of its connection in a sequential relation 
with either of the above-named conditions. Some authorities 
record examples of parturient apoplexy where death ensued, and 
where post-mortem examination disclosed blood-clots in the brain. 
How these cases can have no great importance in their bearing 
upon the subject, as it is not shown that they were not ordinary 
cases of cerebral hemorrhage occurring during the parturient 
period. In the several autopsies we have made in cases where 
death resulted from well-defined parturient apoplexy, every evi¬ 
dence of congestion was wanting. We may quote here the lan¬ 
guage of Fleming: “ The examination of the brain has not 
yielded very satisfactory or constant results.” Regarding the 
morbid anatomy of cerebral congestion, Hammond says: “ There 
are certain appearances seen in the brains of those who have died 
