On characteristic modes of fatal termination in multiple neuritis, with clinical and pathological investigation of an illustrative case / by G. A. Gibson and R. A. Fleming.

Date:
1895
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Licence: Public Domain Mark

Credit: On characteristic modes of fatal termination in multiple neuritis, with clinical and pathological investigation of an illustrative case / by G. A. Gibson and R. A. Fleming. 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.

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    for whisky, and had borrowed money to get it. She suffered frequently from morning sickness and headaches. State on admission.—Height, 5 ft. 6 in.; weight, 9| st. Her development and muscularity very fairly good. She wore an anxious expression, and seemed greatly depressed. She stared in a vacant manner when spoken to, but was quite reasonable and perfectly intelligent. Her appetite was good; pulse and respiration perfectly normal; temperature about 98° Fahr. on admission. The nervous system was the only one affected. Sensory functions.—Patient complained of pain in the “ small of her back.” This was so great that she had con- tinually to change her position, and, when touched in any part of her back, the pain was excessive. It was relieved by sitting up, as a rule. There was no history of pain anywhere else. Numbness was present in the hands, feet, and legs; in the hands she also experienced “ pins and needles ” sensation. Her sensibility to touch was unimpaired in all regions— localisation and rate of conduction being perfect. Sensibility to pain was normal except over the right external malleolus, where the prick of a pin was referred to as a “ touch.” Temperature sense was impaired, in that delay of conduc- tion was manifested, but she could correctly distinguish between heat and cold. Muscular sense was markedly impaired—the usual tests being applied. She said that her right lower limb did not feel as if it rested on the bed at all. Pupils equally and moderately dilated. Motor functions.—Organic reflexes unimpaired. Shin reflexes.—The plantar reflex on each side was abolished; the other superficial reflexes were present. Tendon reflexes.—The patellar reflex was absent on both sides ; no ankle clonus was present. Voluntary movements.—There was distinct pointing of the toes on both sides, due to a condition of talipes equinus of long standing (since birth). The patient could not draw up her knees, but if put up