Case of exophthalmos, following epilepsy / by J.B. Nias.

  • Nias, Joseph Baldwin.
Date:
1892
Catalogue details

Licence: Public Domain Mark

Credit: Case of exophthalmos, following epilepsy / by J.B. Nias. Source: Wellcome Collection.

Provider: This material has been provided by The Royal College of Surgeons of England. The original may be consulted at The Royal College of Surgeons of England.

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    standing position, soft and regular. Heart, action quiet, and sounds feeble ; no murmurs. All bodily functions in good order. Gonorrhoea 16 years ago; no history of syphilis. Diagnosis: epilepsy,- with a suspicion of meningeal hcemorr- hage or syphiloma. Ordered pot. bromid, gr. x., pot. iod., gr. v., ter die. August 29th. Headache better; no more attacks of giddiness, staring of eyes, however, more evident; admits it himself, and says that wife and companions have noticed that he looked a. little wild. Pulse 85. Medicine repeated. September 5th. Better as ^regards headache. Exophthalmos now unmistakeable, the upper lid hardly touching the edge of the cornea, and the sclerotic quite visible on every slight movement. Yon Graefe's symptom (non-association of lid and eyeball in movement) well marked. Sclerotic not injected, but on the contrary attracts notice by its whiteness, perhaps on account of the sallowness of the complexion. The ophthalmoscope shows nothing abnormal, the turgidity of the veins having disappeared. The thyroid gland, carefully examined, presents no enlargement; it is below the average in size. Heart as before, the pulse always ranging about 85. Mr. Turner also sees the patient, and confirms the condition. Medicine repeated, with addition of pulv. gly- cyrrhizge co. for constipation. September 19th. Exophthalmos somewhat less; Von Graefe's symptom still evident. Headache still continuous, but better. During all this time, has been at work. Vision at no time im- paired. Complains, however, of having on one or two occasions during the week, felt for some hours as if something would happen to him, as if it would not be safe to get up from his seat. This passes off, and then he feels quite well. At the same time he loses the power of naming things; knows what they are, but cannot remember their names, and cannot call the children, when he wants them. This also completely passes off. Medicine changed to mist, quiniae et ferri, bis die. October 3rd. Seen in my absence by one of my colleagues, who notes the history of venereal affection as above, and that patient continues to complain of much headache. Medicine replaced by pot. iod. gr. v., decoct, sarsae co ter die. October 10th, on my return. Patient a good deal better for the change of medicine; exophthalmos subsiding; Von Graefe's symptom gone. Headache at times, not troublesome. About this time, on a date which I have forgotten to note, patient's vision was examined by my colleague, Mr. Lindsay Johnson, and