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.

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    with whom the patient was living and sleeping, entirely escaped.* On the other hand, it may be suggested that the original diphtheritic inflammation was manifested, not on the mucous membrane of the fauces, but on the surface of the wound in the boy's foot. Such a view is at least possible, for there are several cases of similar character on record.-)- In this particular instance it is, of course, impossible now to determine where the original specific inflammation occurred, or even indeed if any such event preceded the paralysis. But there are certain features of the case which lend some support to the suggestion that the patient had a diphtheria of the wound in his foot, rather than of his fauces. First, there is the absolute and complete absence of all history of sore- throat, and the further fact in the history, that the weakness in the lower limbs was observed not after, but at the same time as, the paresis of the soft palate. I Then, in so far as deficiency in the superficial reflex irri- tability existed, this was confined to the plantar reflexes. Again, anaesthesia of the fauces and neighbouring parts was not present, though it must be remembered that there was no opportunity of examining the patient until all evidences of paresis of the soft palate had disappeared. On the whole, too, it is, I think, easier in the light of such a suggestion to understand the complete escape of the other children. But in any view the case seems noteworthy, as showing it to be possible to have a paralysis of the diphtheritic type without preceding symptoms, not only not recognised as diphtheria, but not even giving the patient any ground for complaint, nor attracting the attention of his friends. * I have seen and examined the other children. All are free from any evidence of throat aflfection and paralysis, and in each child the knee-jerks are quite readily obtained. t See Med. Times and Gazette, 8th December, 1866, p. 609 ; British Med. Journ., vol. i, 1889, p. 1,291. X In the cases of paralysis following diphtheria of the skin, reported by Trousseau, the limbs seem to have been affected as early as the fauces (Fagge's Medicine, second edition, vol. i, p. 275). OLAsaow: printed by alrx. macdouoall.