Diphtherial nerve-affections / by Edward Headlam Greenhow.

  • Edward Headlam Greenhow
Date:
1863
Catalogue details

Licence: Public Domain Mark

Credit: Diphtherial nerve-affections / by Edward Headlam Greenhow. 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.

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    All! Tlie urine was free from albumen. 2G//(. The patient had lost all nower of walkiii.!^, and could not even stand by the bedside, the left leg being mani- festly stiU_ weaker than the right. No material change in the other synijjtoms. 12//; April. Sensation and motor power of the soft palate still impeHect. Sight perfect, so that the patient could read ordinary type Ijoth at the normal distance and also at a distnnce of three feet from the eyes. Power of grasping ■with the hands much impaired ; numbness and formication of the arms and junnbness and loss of power in the legs have receded from the .shoulders and hips downwards to the elbows and knees, but the numbness of the feet has rather increased. Patient luiable to stand, but could lift liis feet from the ground when seated. The right leg was now worse than the left; the right arm had throughout been more atfected than the left. Muscles of the hands, arms, and legs mucli shrunken and emaciated. Sense of constriction round the abdomen diminished ; tenderness in the vertebral region nearly gone. On moderate ])ressure of tlie feet between the finger and tlnnnb, near the junction of the first and second metatarsal bones with tlie tarsus, there was tenderness and spas- modic retraction of the legs, especially of the left. There was also consider- able tenderness on pi'essure over the sciatic nerves. 25fh. Patient's appearance much improved ; had gained flesh ; had acquired considerable conunand of the left hand and arm, and somewhat increased power in the right hand and fore- arm ; there was also some return of sensation in the fauces, and of motor power in the soft palate. Numbness of legs and feet, and hyperaesthesia and jerking of the limbs, on pressure of the instep between the finger and thumb, continued. 6th May. Patient had gained strength in both arms, could stand with great difficulty, but was imable to walk. The sense of constriction round the abdomen was nearly though not quite gone, but there was now the same feeling in the arms from the shoulders doumwards to the wrists. 12th. Patient could now grasp firmly with both hands, th.e left being still the strongest, and could likewise raise himself from his chair, and stand without assistance. The lower limbs were free from fomnication while at rest, but when they were moved it was felt from the feet upwards to the hips. There was still tender- ness on pressure over the sciatic nerves, but none in the vertebral region. 16///. Sensibility of the fauces appeared to be perfectly restored, but the motor power of the velum in articulation was still imperfect, especially on the right side. The sense of tightness in the arras remained, but in a less degree, and the patient had for the last two days experienced the same sensation in both legs from tlie knees downwards anteriorly to the toes and posteriorly to the heels. Formi- cation of lower extremities on movem.ent still considerable. 20th. Patient much improved in colour and general appearance, and was this day for the first time able to walk across the Avard. 26lh. Decided improvement in all respects, but patient still complained of the sense of constriction in both arms and legs as though they were bandaged. He coidd now walk, but un.steadily, and while doing so, required to look to his feet in order to direct their move- ments by the eye. 4th June. Had walked a mile and a quarter tliis day, but his limbs were still feeble, and his gait unsteady. Was gaining flesh, the muscles of the hands and arms especially having become stouter and firmer. The sense of constriction in the arms and of constriction and numbness in the legs greatly diminished during the last ten days. The tenderness on pre-ssiire over the sciatic nerves and the hypera!sthesia of the feet quite gone. Dis- charged to the Convalescent Asylum at Walton. , . , , , . Case 5 —James Hawker, aged 40, coachman, admitted under the care of Uv GreenhVw 15th September 18G2. A strong healthy man until two years ago, when he had rheumatic fever; since which time he had been less robust and subject to slisrht rheumatic pains. Three months ago, had an attack of sore thmat winch lasted in a severe form two weeks, and in a slighter form for several weeks longer, l^rom this illness he had never entirely recovered, though he had b,.en .able to return to work, and continue it until within a few days of Ins admission. About the time that he was attacked with sore thro.at his four chi dren had each a sli-ht feverish attack, attended by redness of skin ; and about fourteen