Possible cerebral origin of the symptoms usually classed under 'railway spine' / by G.L. Walton.

  • Walton, George Lincoln, 1854-1941.
Date:
1883
Catalogue details

Licence: Public Domain Mark

Credit: Possible cerebral origin of the symptoms usually classed under 'railway spine' / by G.L. Walton. 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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    uncertain on account of blindness, but is riot ataxic ; the only peculiarity noticed is a slight tendency to scrape the left toe in walking. Motion. No ataxia. On testing the strength of the various muscles all muscles on the right side prove very strong, those of the left arm and leg only fairly so. The grasp as measured by the dynamometer bears the relation of (left) 22 to (right) 40, repeated trials giving the same result. Measurements of the upper arm show (right) 30.5 centimetres, (left) 29.5 centimetres. Fore-arm (right) 27.5 centimetres, (left) 26 centimetres. Calf (right) 33.5 centimetres, (left) 33.5 centimetres. Reactions to the faradic current, strong on the right, are lesseued on the left. Patellar reflex is increased on both sides, especially on the left. Sensation. All forms of sensation are markedly diminished on the entire left side to the median line, with the exception of an area over the abdomen bounded above by the line of the ribs, below by Poupart’s liga- ment, and outwardly by the axillary line (the line of demarkation is quite sharp, but the above is only an approximate description of its situation). The dimi- nution of sensation is somewhat less on the head and face than on the trunk, but is bounded here also sharply by the median line. A pin can be thrust through a fold of the skin on the left leg without causing the least pain, and only strong pressure is perceived at all. All attempts to surprise the patient by painful stimuli over the anaesthetic area prove futile. Special sensations. The senses of smell and taste, normal on the right, are entirely absent on the left. The general anesthesia is marked on the inside of the mouth, and pinching of the left side of the tongue is not felt. The left side of the tongue shows signs of having been severely bitten (probably due to the anes- thesia, the patient stating that he finds himself very awkward in the mastication of his food on the left side).