Two cases of nervous disease / by Walter K. Hunter, M.D., B.Sc., Assistant Physician, Royal Infirmary.

  • Hunter, Walter King.
Date:
[1901]
Catalogue details

Licence: In copyright

Credit: Two cases of nervous disease / by Walter K. Hunter, M.D., B.Sc., Assistant Physician, Royal Infirmary. Source: Wellcome Collection.

Provider: This material has been provided by The University of Glasgow Library. The original may be consulted at The University of Glasgow Library.

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    This condition of the limbs, however, improved with electrical treatment and he was ultimately able to walk quite well. For some months prior to admission there was difficulty in swallowing, which seemed to gradually get worse. More recently loss of power in the lips and tongue developed, and there was difficulty in chewing and controlling the food while in the mouth. At the time of admission to the ward the tongue, though it presented no apparent atrophy, could not be protruded to any extent and its movements within the mouth were very limited. Neither could the lips be closed even by a strong effort, and saliva was always dribbling from out the corners of the mouth. The patient could make no whistling sound and when he attempted to do so the air escaped freely from between the lips. The lower jaw seemed to be too loosely articulated, it tended to fall forwards, and the patient seemed to find it impossible to keep the upper and lower dental arches in apposition. At this time he could still swallow, though with difficulty, and his speech, while indis- tinct, was quite intelligible. But during the week subsequent to admission the symptoms rapidly got worse, so that by the 18th inst., he had to be fed by the stomach tube and his articulation was so much affected that he could only be understood when he conveyed his wishes in writing. The respiratory move- ments by this time were mostly diaphragmatic, although on admission to the ward there was still considerable intercostal action. Finally the breathing became entirely abdominal and death seemed to supervene from failure of respiration. While in hospital there was little loss of power to be noted in the muscles of the arms and legs. The grasp in both hands was good, and the patient could stand with his feet together and the eyes shut without any difficulty. He could walk quite well, and while the gait was slow and deliberate, it presented no characteristic abnormality. The tendon reflexes were normal and there was no ankle clonus. The plantar and cremasteric reflexes were not obtained, but the abdominal reflex was active. There was no reaction of degeneration to be found in the muscles of the face, arms, shoulders or legs. There was no impairment of general sensibility and the special senses seemed quite normal. The movements both of the internal