Nervous diseases : their description and treatment / by Allan McLane Hamilton.

Date:
1878
Catalogue details

Licence: Public Domain Mark

Credit: Nervous diseases : their description and treatment / by Allan McLane Hamilton. Source: Wellcome Collection.

Provider: This material has been provided by the Royal College of Physicians of Edinburgh. The original may be consulted at the Royal College of Physicians of Edinburgh.

    477/540 (page 477)
    noticed the fact tlmt voluntary power may return to a great degree witliout a corresponding return of electric contractility. I liav(! before alluded to an inatrument devised by Dr. J. Van Bibbei-,' and it is well to apply tliis so that the muscles may be entirely supported.^ In conclusion, I may present the records of a representative case of lead palsy. Tiie patient was under the care of Dr. Cross, through whose kindness I had the opportunity of seeing him:— M. C.,- aged 32 years, single, born in Ireland, a painter by occupation. He has been moderately temperate in liis habits, and has always enjoyed good health until 1863, when he was suddenly seized with u severe attack of colic, which was preceded by great constipation of the bowels and loss of a|)pctite. There soon succeeded nausea and vomiting of bile, accom- panied by an acute lancinating pain in the epigastric region, which was so severe that the patient was obliged to lie flat on the floor and press his abdomen strongly against that surface, in order to obtain temporary relief. ' '' After many attempts to secure this advantage by means of sti-ips of plaster, it was determined to try the India-rubber muscle as used by Dr. Lewis A. Sayre in orthopedic surgery. The great difliculty in the use of such an appliance was to effect its application without causing injurious pressure upon the circulation of the arm and hand. I am not aware that these elastic tubes have been used before to correct this deformity, or attached by a method so simple and so free from pressure as that which I shall now describe. Two bands of inelastic webbing, pierced by eyelets at certain points, and each having a convenient buckle, serve as points of attachment. The one for the hand, about three-quarters of an inch wide, so made, that the free end placed upon the palm pointing towai-d the the- nar eminence, and the eyelet-hole resting on the ball of little finger, the band folded once around that finger and passed over dorsum of the hand, the buckle would come in a convenient place upon the palmar surface. The band for the arm about one inch in width, so an-anged that the eyelet being placed upon a line a little above the external condyle, the buckle would rest upon the internal surface of the arm. As seen in the illustration, two transverse strips of plaster are adjusted to the arm so as to form an angle just below the eyelet, and thus relieve the band, which should be buckled loosely, from all injurious traction. The fold around the little finger, and the muscle resting upon the webbing on the dorsum of the liand, enable us to buckle the band loose enough to insure perfect abduction of all the fingers. Finally, a piece of India-rubber tubing of correct length and medium elasticity, with one of Dr. Sayre's metallic hooks attached at each end, consti- tutes the entire apparatus. Looking upon this artificial muscle as performing to some extent the duty of those paralyzed, I can probably best describe its application by saying, in ana- tomical language, that it arises from a point a little above the external condyle, and ])assing downward on the extensor surface of forearm, under the cuff, which we might call the annular ligament, forward over dorsal aspect of the hand, jiass- ing between the index and second fingers, which serve as a trochlea or pulley, then transversely across the palmar surface of the hand, and is inserted at a jioint about the articulation of the fifth metacarpal bone with its first phalange. N. Y. Med. Journ., May, 1874. 2 Reported in the PsychologicalJournal, Jan. 1871, by Dr. Cross.