Meningitis, arteritis and choroiditis in a child the subject of congenital syphilis : gummata on cranial nerves; disease of cerebral arteries; cicatrices of liver and spleen in a case of congenital syphilis / by Thomas Barlow.

  • Barlow, Thomas, 1845-1913.
Date:
[1877]
Catalogue details

Licence: Public Domain Mark

Credit: Meningitis, arteritis and choroiditis in a child the subject of congenital syphilis : gummata on cranial nerves; disease of cerebral arteries; cicatrices of liver and spleen in a case of congenital syphilis / by Thomas Barlow. Source: Wellcome Collection.

Provider: This material has been provided by UCL Library Services. The original may be consulted at UCL (University College London)

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    nystagmus of both eyes. It was rather coarse, and it was not constant. Both eyeballs were generally directed towards the left. The pupils were equal and of moderate size. I failed to detect anything abnormal with the ophthalmoscope. There was paresis of the muscles of the face. It was general, but not equal in amount. There was now and then a very slight frown on the left half of the forehead, but much less than on the right. The right eyelid was observed to be shut on more than one occasion, whilst the left remained open. When the child cried the left cheek remained flat. There was no distortion when at rest. There were frequent fine tremors of the facial muscles of the right side at the corner of the mouth and the orbicularis palpebrarum. To a considerably less extent they were observed on the left side of the face. My impression is that the reaction of the face muscles on both sides to the constant current was greater than normal, and that the reaction to Faradism was diminished. Comparing the two sides with one another, the left responded a shade better to the constant current than the right, and very much less to Faradism. As to the other cranial nerves I am not able to give any positive information. The child had frequent slight laryngeal spasms, which may or may not have depended on some morbid condition of the vagus, and once or twice he had some odd gasping attacks, in which he became very blue. The vomiting may have been central in its origin, but I rather thought it was dependent on gastro-enteric disturbance, because of the other signs, and because also it seemed to be controlled somewhat by bismuth, and subsequently by small doses of brandy. He had no convulsions, and was not particularly irritable. The diagnosis of this case appeared to be conclusive in favour of a tumour or tumours, situated at or near the base of the braiu, pressing on the cranial nerves subsequent to their deep origin. I inclined to the belief that it was tubercular and not syphilitic, and the child was not treated by any antisyphilitic remedies what- ever. It is doubtless due to that fact that these specimens are brought before the Pathological Society. At the post mortem which Dr. Lees and I made at the patient's home we found that the diagnosis was quite incorrect. There was no tubercle anywhere. On the upper surface of the liver there were four more or less stellate patches of thin cicatricial tissue. Three of them were about the size each of a shilling ; one was not