Case of diphtheritic paralysis without any preceding history of throat affection / by C.O. Hawthorne.

  • Hawthorne, C. O. (Charles Oliver), 1858-1949.
Date:
[1893]
Catalogue details

Licence: Public Domain Mark

Credit: Case of diphtheritic paralysis without any preceding history of throat affection / by C.O. Hawthorne. 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.

    2/4 (page 2)
    negative facts which must be put on record, though, in face of the positive aspects of the case, they do not, I think, invalidate the diagnosis. Thus, there was no anaesthesia or paralysis of the soft palate; no defect in the power of accom- modation for near objects; no strabisnius or paresis of the extra-ocular muscles; and no cutaneous anaesthesia or abnormal state of the muscular sensibility. The special interest of the case arises when the history of the patient's illness is considered. This was obtained from the mother, and is as follows:—The boy was in his usual health, when, in the early part of June of the present year, he ran a piece of tin into his left heel, producing a sore which gave some little trouble. In the middle of June the mother, with the patient and three other children, went from home to a country district in Ross-shire, and whilst there the boy's foot for a time became much worse. He was, however, never confined to the house, and after some weeks the sore on his foot healed. It was not until the early part of August that his present illness commenced. At that time his mother observed that he began to betray some difficulty in walking, und at the same time his voice acquired a nasal quality, he ^'gulped when swallowing food, and fluids returned through his nostrils. The latter symptoms disappeared in the course of a fortnight. Neither the patient, nor any of the other children, at any time, suffered from sore-throat, and the mother considers that they were all in very good health during their stay in Ross-shire. In the light of this history, the question may perhaps be raised whether, in spite of the symptoms, this case is really one of diphtheritic paralysis. I think that question must still be answered in the affirmative. Its close approximation as regards its positive aspects to the diphtheritic type, and more especially the paralysis of the soft palate, the absence of the knee-jerks, and with these features the existence of albuminuria, leaves no other interpretation open. If, however, this conclusion involves the admission that the boy has had diphtheria of the fauces or neighbouring parts, obvious difficulties arise. No doubt paresis, extensive and severe, may follow very mild attacks of diphtheria, and indeed there seems a general tendency to believe that the severity of the ensuing paralysis is rather in inverse than in direct ratio to the original inflammation. But it is certainly exceptional to find that there has been no complaint whatever of the throat before the onset of the paralysis; and especially to learn that the other children in the family, J