Muscular hypertonicity in paralysis : being the opening of a discussion on the subject, at the Neurological Society of London, July 7, 1887 / by A. Hughes Bennett.

  • Alexander Hughes Bennett
Date:
1887
Catalogue details

Licence: Public Domain Mark

Credit: Muscular hypertonicity in paralysis : being the opening of a discussion on the subject, at the Neurological Society of London, July 7, 1887 / by A. Hughes Bennett. 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.

    8/32 page 292
    slight ]oss of capacity to localise movements Vv-itli the eyes shut.' In these cases, however, some doubt existed as to the uncomplicated nature of the disorder. There are nowhere primary trophic changes of any kind. In very chronic cases the affected limbs become somewhat smaller than the others, evidently due to physiological atrophy from diminished functional activity, as the decrease in size is universal, and the electrical reactions remain normal. The affected parts are cold, and sometimes slightly cyanotic, but not to any great extent. Intellect and the various organs and functions of the body are normal, the bladder, rectum, and sexual apparatus remaining as in health. Occasionally, but rarely, the patient complains of some difficulty in retaining urine for long periods, otherwise the bladder and its accessories are intact. The foregoing brief account may be looked upon as typical of the group of symptoms under consideration, and serve to describe the majority of cases, as they have come under my observation. The only complaint made by the patient is motor weakness, and the only objective sign discoverable by the physician is excessive muscular contraction on percussion. As in other morbid conditions, there are varieties in severity, course, complications, termination, and so on, which deviate from the more common forms. For example, as to dis- tribution, the most ordinary seat of the affection is the lower extremities. Usually it begins in one leg, and sometimes but rarely remains limited to it. A young lady, aged 26, and otherwise in good health, suffered from the characteristic symptoms of this complaint, and limited to the left lower extremity. This appeared very gradually, remained for three years, and slowly disappeared. She is now perfectly well. Asa rule, however, the morbid state after a shorter or longer interval extends to the other leg, thus constituting the paraplegic form of the disease, one extremity remaining more advanced than the other. This is by far the most common variety. Beginning in the leg, the malady not infrequently s^H-eads to the arm of the same side, producing the hemiplegic type. Occasionally the weakness and muscular irritability to percussion is limited to one side of the body, more frequently
    digitised image 1
    digitised image 2
    digitised image 3