On the cerebro-spinal origin and the diagnosis of the protrusion of the eyeballs termed anaemic / by Thomas Laycock.

  • Laycock, Thomas, 1812-1876.
Date:
1863
Catalogue details

Licence: Public Domain Mark

Credit: On the cerebro-spinal origin and the diagnosis of the protrusion of the eyeballs termed anaemic / by Thomas Laycock. 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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    may, however, be so trivial in extent, or so transient in occurrence, being in fact paroxysmal, as not to attract notice, while the other symptoms may attain to an alarming importance; and the blood- degeneration may be manifested by local litemorrhages, the extreme palpitation may be associated with intense pain in the back or the precordial region, the increased vascular activity in the head and neck be accompanied by globus and other hysterical symptoms. When, therefore, as to such cases the exophthalmos and thyroid eal enlargement are constituted pathognomonic signs, a misapprehension as to the true nature of the disorder may easily arise from the trivial or paroxysmal character of the morbid changes in the eyeballs and thyroid body. This misapprehension occurred, I think, in two cases of paroxysmal exophthalmos which came under my observa- tion many years ago, and one of which was published.1 One patient was a young girl of highly nervous temperament, who, at the age of eighteen, was admitted into hospital for a supposed inflammation of the knee. This had come on after a fright, at the age of seventeen, at the moment she was menstruating for the third time. It was accompanied by pain in the hip and back, shooting down the thigh, and was in fact an example of the u hysterical” knee described so well by the late Sir B. C. Brodie, for which she had during several weeks been heroically treated. Soon after admission she perspired so profusely that her bed and body linen would be completely soaked, and she would lie at the same time with only a sheet over her, on account of the great heat of the surface. This condition continued for many months under my own eyes. She also complained of dreadful palpitations, which were so severe sometimes as to stop her breath. The action of the heart was exceedingly tumultuous, and the pulse was from 115 to 155 per minute. From time to time the fingers and thumb of the right hand presented a mottled, livid appearance, and there was an aching pain along the arm; at other times the left hand was affected, becoming purple, while a deep-red blush extended along the forearm, with a sense of aching and smarting. At these times the perspirations were incredibly profuse, the pulse 144 to 158 and undulating. The action of the heart was distinct and forcible, but no murmur audible. Dyspnoea was. very distressing, with acute pain under the left mamma, frequent syncopes, and globus. This state, during the latter periods of observation, passed into a sort of convulsive fit, when the throat swelled very much, and the eyes started from their orbits. No attention was paid to these appear- ances at the time, as they were attributed (and I am now satisfied erroneously) to the strangulation she experienced. They were evidently part of the paroxysm. This patient had a wonderful variety of symptoms in addition to those mentioned. The surface of the body was sometimes exquisitely sensitive; the tongue was always dry and brown, except at the edges, so that practitioners 1 Case of Elizabeth Camidge, Edin. Med. and Surg. Journal, April 1838, p. 441.