Systematic case-taking / by Henry Lawrence McKisack.

  • McKisack, Henry Lawrence.
Date:
1912
Catalogue details

Licence: In copyright

Credit: Systematic case-taking / by Henry Lawrence McKisack. Source: Wellcome Collection.

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

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    pulses will result in more or less complete loss of common sensation {ancesthesia). This symptom is often a help in locating the situation of such an obstructing lesion. In neurotic states anaesthesia is common, but without anatomical consistency. An undue sensitiveness of the organs concerned in the perception of tactile stimuli may give rise to excessive acuteness of the sense of touch [hypercBsthesia); abnormal sensations [parcesthesia) may be perceived, such as tingling, tickling, cotton-wool feeling, crawling of insects [formication); a single stimulus may give rise to several tactile impressions [polycesthesia]; the patient may be unable to localize pain or touch sense [allocheiria). (2) Pain.—^The inability to recognize painful stimula- tion may be diminished or lost [analgesia), or may be intensified [hyperalgesia). The former is tested by pricking or pinching the skin, noting if the patient shows any sign of suffering; the latter by rubbing a blunt instrument [e.g., the head of a pin) firmly in parallel lines over the surface, or by pressure of the hand. Should hyperalgesia be present, the patient wiU be able to indicate the position where the friction or pressure causes pain instead of mere tactile sensibility. Loss of the sense of pain usually accompanies loss of tactile sensibility, but in cases of syringomyelia the pain- ful impulses (as well as those of heat and cold) are ob- structed by the disease of the central canal, while those of common sensation passing upward through the pos- terior columns are less interrupted. The loss of painful and thermal sensibility, with the retention of touch sense, is termed dissociated ancesthesia. Increased sensibility to pain may be found in lesions of the spinal cord and its meninges, whereby the pos- terior nerve roots are irritated. As a result there may