Diphtheria and antitoxin / by Nestor Tirard.

  • Tirard, Nestor Isidore Charles, Sir, 1853-1928.
Date:
1897
Catalogue details

Licence: Public Domain Mark

Credit: Diphtheria and antitoxin / by Nestor Tirard. Source: Wellcome Collection.

Provider: This material has been provided by King’s College London. The original may be consulted at King’s College London.

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    momentarily checked, becomes thoroughly and easily re- established. Paralysis of the laryngeal muscles sometimes gives rise to a good deal of trouble after tracheotomy. In one of my cases, after all urgent symptoms had passed off, every effort to remove the outer tracheotomy tube was followed by an arrest of respiration, and we had ultimately to intu- bate. In this case sensation was ultimately regained, and we were able to dispense with the tube. In a similar case there was reason to believe that the arrest of breathing resulted from sheer nervousness, as when one of my colleagues enlarged the tracheal opening and the larynx was viewed from below, the movements of the vocal cords were found to be under normal control. Sometimes the tongue, the lips and the face exhibit indications of paralysis. Facial paralysis is not very common as a sequel of diphtheria, but in 1893 I had a child under my care at the Evelina Hospital with this condition, and the diphtheritic origin, which was at first a matter of inference, was subse- quently confirmed by affection of the palate, the extremities and the diaphragm. In the following case the paralysis of the face was unilateral and incomplete, resembling that seen in hemiplegia rather than the more complete form of Bell’s paralysis. Diphtheritic paralysis of face and palate.—Harry M , aged five years. Admitted November 22, 1893. Six weeks previ- ously had diphtheria ; four weeks later had paralysis of left side of face, and fluids began to return through nose, and he lost power in Ids legs. On admission the soft palate was seen to be paralysed ] he spoke with nasal voice. There u as maiked paralysis of facial muscles ; orbital muscles were affected, but not to any marked extent, as the child was able to shut his eyes well. There was no squint ; the knee jerks were absent. Three days after admission, paralysis of external rectus and inferior