Clinical notes on nerve disorders in surgical practice / by George Wherry.

  • Wherry, George, 1852-1928.
Date:
1891
Catalogue details

Licence: Public Domain Mark

Credit: Clinical notes on nerve disorders in surgical practice / by George Wherry. 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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    mentions three cases, in one of which the diagnosis was verified post-mmrtem, the second case was still under treatment, and the third being syphilitic was recovering. Seven years later, when this boy was ten years old, he was brought to me with the lost left eye staphylomatous and bulging on the cheek. It was accordingly enucleated, and three years later the socket was still unhealed, and the following note of his condition was taken. The boy, now aged thirteen, is healthy and intelligent. The left eye, excised three years ago, shows the wound still unhealed,^ and all the lid edges and eyelashes have ulcerated away ; a dirty pus fills the open socket. There is not any evidence of syphilitic taint in the teeth or physiognomy. There is a slight nebula on right cornea. Facial paralysis is evident on the left side. The face and fore- head are smooth and immobile. The left side of the upper lip has the mucous membrane sore and scabbed, and the lip is swollen on this side so that it stands away from the teeth. There is no sensation on the left forehead up to the roots of the hair, no sensation on left cheek as far outwards as the malar prominence and downwards to the lower jaw. The junction of sensitive with insensitive skin, in the mid-line alonsr the fore- head, nose, and lip, is fairly well defined. The mucous membrane of the upper jaw also appears to be insensitive. The left nostril, which was always full of unhealthy secretion before the eye was removed, is now merely rather smaller, and the ala is drawn up exposing more septum on that side. In the left ear there is perforation of the membrana tympani, which is covered with unhealthy secretion, but there is never any discharge from the ear. On the left side he is quite deaf. He hears the tuning-fork only on mastoid or skull. The right ear is normal, and although the patient cannot whistle he sings well and with good ear for music. There are some enlarged cervical glands on the left side, but not on the right. With regard to the teeth, in which the baby was so deficient on the left side, they are rather more decayed in this left jaw (of course the permanent set), and the second bicuspid and second ^ The mother tells me that this is sometimes quite dry, and then at other times there is excess of secretion, which runs over the cheek.