Clinical medicine : cases / by Dr. M'Call Anderson.

  • Thomas McCall Anderson
Date:
1881
Catalogue details

Licence: Public Domain Mark

Credit: Clinical medicine : cases / by 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.

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    CASE OF BILATERAL PARALYSIS OF THE YOCAL CORDS. The patient who now appears before you has reached the lecture- room with the greatest difficulty, on account of severe dyspnoea, which, however, troubles him only on exertion, and it shall be our aim this morning to endeavour to make out the cause of this and of other striking symptoms which he presents. He is a moulder, ^t. 49, who, on his admission on the 16th March, complained chiefly of cough, difficulty of breathing, and inability to speak above a* whisper, symptoms which set in about six months ago. The family history is good; his mother is upwards of 80 years of age; five brothers are alive and well; one died at the age of 19 of smallpox, and his father at 74, consequent upon an accident. He has always been a healthy man hitherto, has never suffered from venereal disease, and has been temperate in his habits. About half a year ago, as the result, he thinks, of severe drenchings and exposure to draughts, be became slightly hoarse, and in a day or two this was accompanied by some cough. He says that it was not like an ordinary cold, but seemed to be due to some irrita- tion in the throat, and he indicated the seat of irritation by pointing to the larynx. The hoarseness gradually became more pronounced, until he found it impossible to speak above a whisper, and two months ago the cough became more severe, and accompanied by slight mucous expectoration. Latterly he has been complaining of weakness and some loss of flesh, and exertion of any kind pro- duces great dyspnoea. Two months ago he consulted Dr Foulis, who treated him by means of the induced current to the interior of the larynx, and perhaps with some slight benefit, at first at least. On examining our patient we find that he is weak and has lost a good deal of flesh, but that his disease is unaccompanied by fever, the temperature being uniformly normal. When at rest he breathes quietly and with perfect freedom, but on exertion the breathing becomes stridulous, and there is great dyspnoea. He speaks, too, with manifest effort, and scarcely above a whisper; and his cough is hoarse, and accompaned by slight frothy expectoration. ^ o j
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