The Medical and scientific archives of the Adelaide Hospital. No. 2.

  • Adelaide Hospital (Adelaide, S. Aust.)
Date:
[1923]
Catalogue details

Licence: Public Domain Mark

Credit: The Medical and scientific archives of the Adelaide Hospital. No. 2. Source: Wellcome Collection.

    34/50 (page 32)
    no control of his sphincters. Otherwise the physical condition was unchanged. On September 12th, 1922, his condition was still unchanged, and he left the hospital, against medical advice. Microscopical Appearances (Dr. Bull).—Section's show a fairly dense fibrous stroma, in parts extensively infiltrated by plasma-like cells and round cells, sometimes collected into narrow bands or cords, sometimes occurring in large cellular masses fairly well circumscribed, sometimes more diffusely infiltrating. The large masses are apt to degenerate and show osdematous infiltration and polymorphonuclear invasion. In the cellular areas are found chiefly typical plasma cells or round cells approaching these, with occasional eosinophile cells and fine capillaries pass between the cells. The larger vessels in the stroma show marked endartcritic proliferation. Capillary haemorrhages are present in places. The medulla of a lamella of one of the vertebrae shows proliferation of the cellular ele¬ ments and the presence of cells like plasma cells. Comment.—The microscopical features of this growth seem identical with those met with in multiple myelomata. Albu¬ mosuria was, however, apparently not present, and the growth was single. An alternative possibility is that the growth is an unusual granulomatous reaction, due to the presence of an infective agent. The Spvrochceta pallida suggests itself (the vessels showed endarteritis). The Wassermann reaction in the cerebro-spinal fluid was negative, which is some evidence per¬ haps against this view—the test was not done on the blood. We consider that the growth is closely related to, if not identical with, the plasma-cell myeloma. (10) ANGIOMA OF THE PIA MATER OPPOSITE THE CAUDA EQUINA. (Under the care of Dr. de Crespigny, Honorary Physician, and Dr. Cudmore, Honorary Surgeon. Notes by Drs. Fleming and Gartrell.) J. W., a male clerk, cet. 18, was admitted on August 7th, 1922, complaining of loss of power in the right foot. He had pre¬ viously suffered from diphtheria and measles when a child, and in later life had had pneumonia and pleurisy, and also ‘1 fluid on the knee. ’ ’ Three and a half years before admission he fell off a bicycle, but did not notice any immediate ill effects. Six months later, however, he noticed that whenever he started to run he would trip. This defect slowly increased till the time of admission. He had had no pain or alteration in 'sensation in the legs, but had had pain in the right hip joint and the bottom of the spine. He had been 11 costive ’ ’ for six months. He had not lost weight. He was a somewhat pallid man. The temperature was normal, and the pulse rate was 96. The pupils reacted to light and accommodation. The heart, lungs, and abdominal organs were apparently healthy. At the level of the third and fourth dorsal spines there was some lateral deviation, but no abnormal projection and no tenderness. The right leg was somewhat bluish in color and perspired more than the left. Some periarticular thickening was felt around the right knee joint, which contained some fluid. The movements of the right knee and hip were equal to those on the left side. The knee jerks, which were hyperactive, were equal on both sides. An ankle clonus was obtained on both sides, but it was stronger on the right. There was an ulcer on the big toe of the right foot where a corn had been cut. Measurement showed the cir¬ cumference of the right calf to be ^in. less than that of the