Cases of paraplegia / by T. Grainger Stewart.
- Stewart Thomas Grainger, Sir, 1837-1900.
- Date:
- 1876
Licence: Public Domain Mark
Credit: Cases of paraplegia / by T. Grainger Stewart. 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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![ulnar when affected by severe neuralgia. The function of tlie nerve is temporarily abolished, the skin which it supplies is utterly anaesthetic, and the muscles palsied. Under the influence of quinine, and perhaps galvanism, the sensory and motor power is restored. It is certain that these remedies would not amend a state of neuritis; and I can see no other view to adopt than that, owing probably to some minute molecular derangement of tissue depending upon impaired nutrition, the nerve-fibres are no longer capable of conveying centrad and peripherad the impressions they normally transmit. It obviously implies but little to say that probably minute molecular changes take place in sucli a condition, but the statement may help some minds to form a conception of the kind of change which may be supposed to exist in nerves affected as were those of our patient. Whatever may have been the nature of the morbid process, it is manifestly of the utmost importance to inquire into the causes which induced it. Various factors probably played a part in its production. Among tlie circumstances preceding the attack, there were three, which are well recognised as causes of paraplegia, viz., wetting, fatigue, and exposure to cold. But the accident on the lake preceded the illness by seven months, and the special fatigue and frequent wettings occurred during the winter, and certainly were not immediately followed by the paralysis or the pain. The question then arises. Whether the malarious poison could have had any share, or even a leading share, in its production ? Eisenmann' remarks that malaria, like cold, is capable of pro- ducing not only febrile, but all kinds of non-febrile affections of the nervous system, and it may be added that all parts of the nervous system may be affected. With the view of getting light upon this case, I have searched such authorities as I have had access to, and, while I liave not succeeded in finding any example of malarious nervous affection exactly corresponding to the one we are consider- ing, I have found many cases which in some measure bear upon it. The mental functions have long been known to be occasionally influenced by malaria. Sydenham^ recognised the fact that a peculiar form of mania in some instances follows long-continued agues, that it sometimes results in fatuity, and terminates only with the life of the patient. Bucknill and Tuke^ recognised the same fact; and Griesinger,* entering more minutely into the sub- ject, describes one kind of case in which mania takes the place of an ague fit, the proper ague fit never occun-ing ; anotlier, in which the regular ague paroxysms, having existed for a time, disappear, and are replaced by maniacal attacks, these attacks frequently assuming a remittent or continuous type, and becoming chronic; ' Die Bewegungs-Ataxie, Wien, 1863, p. 191. ^ Sydenham's Works. Sydenham Society's edition, vol. 1. p. 93. ]\sychological Medicine, 2d edit., p. 287. * Griesinger on Mental Diseases. Syd. Soc. transl., p. 184.](https://iiif.wellcomecollection.org/image/b21696962_0016.jp2/full/800%2C/0/default.jpg)
