Clinical memoranda : being selected cases from the wards of Dr. M'Call Anderson.

  • Thomas McCall Anderson
Date:
1894
Catalogue details

Licence: Public Domain Mark

Credit: Clinical memoranda : being selected cases from the wards of Dr. M'Call Anderson. 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.

    25/34 page 19
    bowels were at first costive, but have become somewhat loose since 16th April, when he took a dose of medicine. The joints have not swollen at any time, but have been very painful on movement, and the pain has gradually travelled from the legs up the body. He has perspired freely during the illness, but the odour of the perspiration presented no niarked peculiarity. On 14th April he was wakened in the early morning by very severe pain in the frontal and occipital regions, which made him dazed and stupid, and caused temporary impairment of vision. Later in the day he had several attacks of vomiting preceded by sickness. He does not recollect the details of this part of his illness, but was afterwards told by his wife that he had been delirious. Since the 14th he has constantly suffered from stiffness of the back of the neck, preventing motion of the head to either side. Any attempt at rotation caused a pain which shot up the sterno-mastoids, and was worst behind the ears. He also felt pain along the costo-vertebral joints, though not directly over the spinous pi'ocesses, but he has had no palpitation, d^-spncea, or pain on the left side of the chest. There is no cough. When a lad, after exposure on his van, he had a fever which lasted three weeks. Beyond that his feet and legs swelled, he remembers nothing of the illness, and from that time till now his health has been good. There is no history of rheumatism in the family. On admission he had a dazed appearance, and his eyes were dull and lustreless. There was tenderness of the muscles at the back of the neck, and also of the costo-vertebral joints, but none over the spinous processes. He perspired freely, and seemed very weak. The pulse was 88, regular and soft. The right border of cardiac dulness was at the left margin of the sternum, the upper border at the lower margin of the third rib, and the left in the nipple line. There was no murmur, but the first sound was slightly muffled. The lungs and liver were healthy. 33rd Aiyril.—Patient has had attacks of violent delirium throughout the day, attempting to get out of bed, &c. His pupils are rather sluggish in response to light, the right being rather more dilated than the left. The temperature has been generally above 100^, the highest being 101'4' at 4 p.m. yester- day. Pulse remains regular (88). He never asks for food, but does not refuse fiuids. The evacuations are not passed in bed. '2ot]t Ajyril.—Temperature still slightly over 100^ He lies on his side, sunk in the bed, with his knees a little drawn up. He recognises nobody, and is quite delirious. The pupils are
    digitised image 1
    digitised image 2
    digitised image 3