File:Medical and surgical therapy (1918) (14804068013).jpg

Identifier: medicalsurgicalt02keog (find matches)
Title: Medical and surgical therapy
Year: 1918 (1910s)
Authors: Keogh, Alfred, Sir, b. 1857
Subjects: Military Medicine Therapeutics Surgery, Operative
Publisher: New York and London : D. Appleton and Company
Contributing Library: University of California Libraries
Digitizing Sponsor: Internet Archive

View Book Page: Book Viewer
About This Book: Catalog Entry
View All Images: All Images From Book
Click here to view book online to see this illustration in context in a browseable online version of this book.

Text Appearing Before Image:
e months after a wound of the second dorsal interosseous space(September 1914), and was preceded by a slight weakness of thehand. The bullet remained in the hand without perforating it,and was removed three months after the wound. In January 1916 we also found vaso-motor symptoms andhypothermia and the existence of a very marked faradic, voltaicand mechanical hyperexcitability of the hand and forearm. Hypo-tonus is very marked and allows the hand to be hyperflexed onthe forearm. When the patient moves the forearm or walks, theaffected hand swings to and fro like a lifeless body, in every direc-tion, as if it were obeying the laws of gravity only. These peculiarities are clearly shown in the cinematographpictures which we produce (Gaumont film shown at the DoulensCongress in January 1916). In May 1916 the condition of thepatient who had been temporarily discharged and examined inhis district by Porot (159) had not changed, and the signs mentionedabove were still quite distinct. .-)!).S
Text Appearing After Image:
HISTORICAL 509 to solve the problem, we were struck by the followingsymptoms : a remarkably intense hypotonus (especiallyof the wrist), which equalled if it did not actuallyexceed the hypotonus seen in paralysis following lesionsof the deep nerves ; very marked mechanical hyperexcita-hility of the muscles of the hand and forearm, withslowness of the muscular contraction, and lastly electricalhyperexcitability of the muscles with premature fusion ofthe faradic contractions (131). Objective signs which were independent of thewill had thus been discovered, and consequently we feltconvinced that these disorders were not due to hysteria. On making a fresh examination of the patientswhom we have already discussed, and in whom observa-tion during anaesthesia had shown the undoubtedexistence of a disturbance of the spinal centres, wefound the signs which we have just described, especiallymechanical hyperexcitability with slowness of thecontraction. They were also found in several patientswho

Note About Images