Series of clinical cases (with observations) illustrating the views recently put forward by Dr. Brown-Séquard, as regards certain points connected with the physiology of the nervous system / by John W. Ogle, M.D.

  • Ogle, John W. (John William), 1824-1905.
Date:
[©1859?]
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Licence: Public Domain Mark

Credit: Series of clinical cases (with observations) illustrating the views recently put forward by Dr. Brown-Séquard, as regards certain points connected with the physiology of the nervous system / by John W. Ogle, M.D. 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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    Fourthly. Great numbers of clinical records evidently display con- siderable research into the question of anaesthesia in one form or an- other; but there is obvious neglect of attendant observation (and this tlso to a great extent) as respects hyperesthesia or the exaltation of .he various fonns of sensibility. Fiftldy. We have in very mxmerous instances an entire want of evidence, and in many a deficiency, at least, of evidence, as to the temperature of the skin or mucous membrane of the affected parts of the body (the thermometer being in only few instances resorted to). In many cases the subjective sensations of the patients are all that is alluded to, Sixthly. We frequently have observations, obviously rigid and complete, as to all needful particulars respective of the side or portion of the body mainly affected and therefore pre-eminently attracting the attention of the observer, whereas there has been at the same time a total neglect of any mention of the opposite side as to the existence of any affection of sensibility or voluntary power of motion (al- though, of course, such may have been present to a very subordinate extent). SeventMy. We often find vague mention made of such symptoms as strabismus, distortion of the eyes, &c, but no indication as to which form of squinting existed, or even as to which eye was affected, and we are in consequence utterly ignorant as to what sets of muscles or what nerves have been implicated. Also the pupils are oftentimes spoken of as being dilated or contracted, but it is manifest that sufficient care has not been taken to observe whether the pupils harmonized with each other or not, or whether they deviated from their natural condition as to size or form; or whether they were constant or variable in size. Again, with regard to the special senses, or the faculties of deglutition or swallowing, symptoms are very often quite unmentioned, or when at all alluded to, the statement is often omitted as to the particular side on which the sight, or smell, or taste, or hearing, &c, was subjected to interference.* Fighthly. Constant omissions exist as regards the powers of reflex nervous action enjoyed by various affected parts of the body; or if they at all attracted attention, their presence or abeyance have only been studied in the case of the soles of the feet. Again, touching the deter- mination of the degree of excitormotory power enjoyed, very often, perhaps most frequently, this has only been effected by means of tickling the skin (the use of heat or cold, or galvanic stimuli, being not at all resorted to). Ninthly. Symptoms, precise and extensive enough, are often noted, either wholly without reference to date, or without relative dates of their occurrence as regards the exact time of death, so that the reader is often at a loss to conjecture with any degree of accuracy as to the • Dr. Brown-Sequard shows that when deglutition is impaired, indicating an affection of the nerves of the pharynx, it may be diagnostic of the exact part of the nervous system interfered with, for in cases of alteration of the pons Varolii, this symptom is observed to cxiBt unaccompanied by loss of speech; whilst, if the latter co-exist-. the lesion is probably situated in the medulla oblongata or the vagi nerves.