Tubercular meningitis as it occurs in children : with an appendix of illustrative cases and two chromo-lithographs / by Martin Oxley.

  • Oxley, Martin.
Date:
[1885]
Catalogue details

Licence: Public Domain Mark

Credit: Tubercular meningitis as it occurs in children : with an appendix of illustrative cases and two chromo-lithographs / by Martin Oxley. 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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    health, when suddenly vomiting, apparently causeless and without nausea, takes place, or a convulsion occurs followed by strabismus or paralysis of some group of muscles, or delirium sets in, sometimes of a violent character. Pain in the head is now very marked, the headache is continuous, with exacerba- tions of great severity, and the characteristic hydrocephalic cry is almost constant; the patient is drowsy, and has to be roused to take food or answer questions. The pulse is irregular, 80 or 90 to the minute, while the temperature rises to 99° or 99°'5. Then the drowsiness deepens, the pupils become unequal and sluggish, convulsions succeed one another, the hydrocephalic cry becomes frequent and piercing; congestion of the optic discs may now be observed, while the paralyses become more marked. This condition may last from two to ten days, when the stupor deepens, the pulse is quickened to 120 or 160 and is regular, the temperature rises to 100° or 102°; the respiration is irregu- lar and sighing, swallowing becomes difficult, the bladder and bowels are evacuated unconsciously, the muscular system rela.xes, and the pupils dilate widely. The temperature now rises to 102° or 106°, and the patient dies comatose. Frequently during the last few days an apparent improvement will take place, food may be swallowed, and the tongue put out when the patient is asked to show it. He may appear to recognise friends, and give those who are watching the case a fallacious idea of im- provement. But this seeming change for the better will nut deceive the experienced, as the pulse will indicate the real state of the case by remaining small and frequent. The following is a good instance of this delusive improvement:—A boy, aged 8 years, was admitted into the Infirmary for Children in 1876; he became unconscious on 30th March, and was unable to swallow; on April 1 he had the rattle in his throat, and seemed to be dying; pulse 140. On April 2, the day on which he died, he became conscious, and put out his tongue when asked to do so. He remained sensible to within five minutes of his death, but his pulse during this time rose to 160, and was almost imperceptible at the wrist. In the above description are included all the prominent