File:Interstate medical journal (1909) (14597184249).jpg

Identifier: interstatemedica1619unse (find matches)
Title: Interstate medical journal
Year: 1909 (1900s)
Authors:
Subjects: Medicine
Publisher: St. Louis, : Interstate Medical Journal
Contributing Library: The College of Physicians of Philadelphia Historical Medical Library
Digitizing Sponsor: The College of Physicians of Philadelphia and the National Endowment for the Humanities

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m the Philadelphia General Hospital,* Spiller and Camp. American Journal of the Medical Sciences, June, 1907. 98 INTERSTATE MEDICAL JOURNAL was somewhat diminished, as was also the voluntary power of the upperlimbs. The biceps and triceps reflexes were exaggerated. The lower limbs were edematous and were kept flexed at the knees,and movement of these limbs caused much pain. The patellar reflexescould not be obtained, probably because of the position of the limbs.There was a suggestion of ankle clonus on the left side. An examination made by Dr. McConnell, in Dr. Mills service, Decem-ber 1, showed atrophy of the right interosseous muslces. There was notremor of the limbs. The patient had very little voluntary movement ofthe lower limbs. Sensation seemed to be normal in all forms. She remained in much the same condition until her death, March 17.1908. The symptom-complex was therefore one of spastic paraplegia of thelower limbs with contracture of the limbs, and pain produced by passive
Text Appearing After Image:
Sclerotic plaques in a section from the cervical region.We are indebted to Dr. Alfred Reginald Allen for the photograph. movement of these limbs, probably because of the contractures; exag-geration of tendon reflexes in both upper and lower limbs, although thereflexes could not be well demonstrated in the latter because of the posi-tion of these limbs; and loss of control of bladder and rectum, withpreservation of objective sensation. The typical symptoms of multiplesclerosis were absent, as there is no mention of scanning speech, intentiontremor, nystagmus, etc., and the diagnosis of multiple sclerosis was notmade. Numerous areas of sclerosis are found throughout the cervical andupper thoracic regions of the cord, and are confined to these regions.Some of these resemble very closely the degenerated areas found in mul-tiple sclerosis. They affect the grey as well as the white matter, are ofvarious shapes and sizes, and in general are not sharply defined fromthe surrounding normal tiss

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