Three cases of acute anterior polio-myelitis (acute spinal paralysis) in adults / by W. Allen Sturge.

  • Sturge, William Allen, 1850-1919.
Date:
1879
Catalogue details

Licence: Public Domain Mark

Credit: Three cases of acute anterior polio-myelitis (acute spinal paralysis) in adults / by W. Allen Sturge. Source: Wellcome Collection.

Provider: This material has been provided by The Royal College of Surgeons of England. The original may be consulted at The Royal College of Surgeons of England.

    12/14 (page 10)
    lO <leltoid was q\iiie j^one, as she could not remove her arm from lier side. She was aide, however, to head the elbow fully, hut her jiower of re- sisting forcible extension of the joint was very small. There seemed to be no power whatever in the triceps, which had almost completely dis- appeared. The muscles of the forearm, both flexors and extensors, were very much wasted, the greatest circumference of the limb below the elbow being eight inches and a quarter, as opposed to nine inches and a half on the right .side. The hand was in the “ main-en-griffe” position, typical of wasting of the interos.sei and himbricales ; the tendons of the flexor muscles were sharply defined under the skin of the palm, and the metacarpal spaces were sharply defined on the back of the hand. The thenar and hypothenar eminences had almost completely disappeared. The patient was able to flex her wrist fairly well, though with only slight ]iower of resistance. She had great difficulty in producing ex- tension of the joint. She could squeeze a little with her fist, but could not bend the first and third phalanges, nor extend the second phalanx of the fingers. She could hold a fork in the hand, but could not make use of it. Sensation appeared to be wholly unaffected. Examined electrically, the muscles presented the reaction usually found in old cases of acute atrophic paralysis, namely, more or less complete loss of reaction to the induceil current, complete loss of re- action to voltaic electricity applied over the nerves, and marked diminu- tion to the voltaic current applied over the muscles. I need .scarcel)'^ repeat what I have already said, that this last peculiarity is only found in the later stages of this malady, and that in the early stages there is almost invariably an increase of irritability in the affected muscles to voltaic electricity when the poles are applied over the muscles them- selves Her general health was good, and none of the other limbs were affected in any way. There was likewise no affection of the serratus magnus, rhomboidei, or pectoral muscles on the left side. Under treatment, which consisted mainly of tonics, voltaic electricity to the affected limb, and the use of Junod’s boot to increase the circulation in the arm, there was some little improvement; the metacarpal spaces became somewhat more filled up ; she was able to extend the wrist considerably better ; and she regained the power of doing many little things which were im- possible to her when she first came into hospital. Case hi is that of a girl aged 19, single. She had generally lived at home in the country under fairly good circumstances ; but for some little time before the onset of the present illness she had been acting as shopwoman in a confectioner’s shop, where she was a good deal exposed to draught. There is no other history of exposure to cold or wet. The family history was good, her father and mother and ten brothers and sisters all being alive and in good health. The patient was never very strong, and since the establishment of the menstrual func- tion, about four years before her present illness, she had been subject to