A case of rapid "wasting palsy" from structural disease of the spinal cord / by J.L.W. Thudichum. The investigation of the nervous centres with comments / by J. Lockhart Clarke.

  • Johann Ludwig Wilhelm Thudichum
Date:
[1863]
Catalogue details

Licence: Public Domain Mark

Credit: A case of rapid "wasting palsy" from structural disease of the spinal cord / by J.L.W. Thudichum. The investigation of the nervous centres with comments / by J. Lockhart Clarke. Source: Wellcome Collection.

Provider: This material has been provided by The University of Glasgow Library. The original may be consulted at The University of Glasgow Library.

    24/40 page 22
    23 described in Guy's Hospital Reports, vol. viii. 18G2. There was progressive paralysis and flexion of several -fingers of both hands, with subsequent wasting of their muscles. At this stage of the disease the patient sickened with typhus fever and died. On examination after death there was found in the cervical enlargement of the spinal cord considerable dis- tention of the central canal, from accumulation of fluid within it, with consequent atrophy of the grey substance. In certain parts of this region there appears to have been absorption of nearly the whole of the posterior portions of the grey substance, only a certain extent of the anterior cornua remaining. The fourth case is that which forms the subject of my present communication. It is worthy of note that in thie second case the symptoms began soon after a sun-stroke received in Australia. On ex- amining the brain (which before I received it was reported as healthy) I found one portion of the marginal convolution of the longitudinal fissure to be much softer than the rest, and closely adherent to the membranes. In the present case also it has been seen that the symptoms made their appearance soon after a severe fall and blow on the back of the head, which rendered the patient unconscious for some time. It is not improbable that in both cases the shock to the cerebral centre may have been the exciting cause of the morbid changes which were found in the medulla oblongata and spinal cord. However this may be, it would be well in all futui e cases to note any acci- dental shock which the brain may have received, and examine this organ carefully after death. In cases also, occurring after fever, it might be important to inquire whether the attack was accompanied with severe cerebral, or other nervous symptoms. Indeed, in taking clinical notes, and making out the history of the disease, we should be careful to observe every circumstance that can possibly afiect the case; for it is only by this close and minute investigation during life, with an equally searching and complete examination after death, that we can hope to ari'ive at definite and exact conclusions in both a pathological and physiological point of view.
    digitised image 1
    digitised image 2
    digitised image 3