Some practical remarks on chronic rheumatism / [by WIlliam Pepper].

Date:
[1880]
Catalogue details

Licence: Public Domain Mark

Credit: Some practical remarks on chronic rheumatism / [by WIlliam Pepper]. Source: Wellcome Collection.

Provider: This material has been provided by the Royal College of Physicians of Edinburgh. The original may be consulted at the Royal College of Physicians of Edinburgh.

    6/28 (page 6)
    lift her arm from her side, or lift her hand to her head to feed herself, or to use it in dresssing herself ; and finally it grew al- most entirely useless. During this time she suffered constant pain. It was of a wearing, dull character, in the shoulder joint, frequently shooting down the arm to the fingers, and was so severe at night that she scarcely slept at all ; and her general health had suffered greatly, with much loss of flesh in consequence. The condition had lasted for several months when she first consulted me. She stated that she had been treated for chronic rheumatism, and that she had been recom- mended to keep the arm at rest. There was advanced atro- phy of the right deltoid muscle, and the application of the faradic current, or of a slowly interrupted galvanic current, caused scarcely any contraction of its fibres. The head of the right humerus was firmly fixed in a position of slight subluxation for- ward and downward, and any attempt to rotate it, or to elevate it in any direction, met with firm resistance, and caused intense pain. The cords of the brachial plexus were swollen, hardened, and exquisitely tender. The muscles of the right arm and fore- arm were somewhat atrophied ; the hand was puffy and swollen, and there were severe complaints of burning and tingling pain, with numbness down the arm and through the hand. Systematic manipulation of the arm, directed toward breaking up the adhe- sions, was used at intervals of about five days, despite the intense suffering caused. After each treatment, however, the pain was lessened, and mobility was increased. She was also exhorted to use the arm as much as possible, car- rying her efforts as far as her endurance would enable her to do. Repeated blisters along the inflamed nerves were used ; the whole shoulder was enveloped in a batt of wool saturated in a strong liniment of chloroform and aconite. Iodide of potas- sium and bichloride of mercury were given internally. After some degree of mobility was restored, massage of the deltoid, with occasional faradisation, was used. Electromotor contractility gradually returned, and the muscle gained in bulk satisfactorily. Treatment extended over three months, by the end of which time pain was entirely relieved, and she was able to use her arm quite freely. She was directed subsequently to continue regular gymnastic exercise with it, so as to thoroughly complete the restoration of motion and power, and I learn now (June, 1880), that the arm has long since returned to its normal state.