Diseases of the nervous system / edited by Archibald Church.

Date:
1908
Catalogue details

Licence: In copyright

Credit: Diseases of the nervous system / edited by Archibald Church. Source: Wellcome Collection.

    1155/1256 (page 1113)
    due to similar processes in the smooth muscles of the intestine; these condi- tions are found in all traumatic neuroses. Abnormally frequent micturition, pollakiuria, is also common. Very rare but of undoubted occurrence is the occasional involuntary discharge of urine. This is sometimes found in hysterical astasia abasia. The sexual reflexes of erection and ejaculation also show severe disturbance. In certain cases the power of erection absolutely ceases. Vasomotor and Trophic Disturbances.—Derangement of the' circulation is very common. Conspicuous reddening or pallor of the face, livid discolora- tion with coolness of the hands, more rarely of the feet, bluish discoloration of the knees, and extreme redness of the face on stooping are often observed. A number of vasomotor disturbances are not confined to a definite portiQn of the body but are found over its entire surface. Among these is a peculiar bluish red mottling of the skin as well as irregular map-like red flakes upon the chest and back. Some very interesting vasomotor phenomena may be evoked. If the physician makes firm pressure upon the skin with the whole hand—for example, on the chest of the patient—after removing the hand a white impression of it with redness of the surrounding areas will, be seen for a few seconds. Furthermore, if we stroke the skin firmly with a hard, somewhat pointed object—for example, the tip of the percussion hammer— a red line appears in these areas, which often swells for a few minutes and becomes elevated, then turns pale, and remains so for some time (dermo- graphia). Instead of a sharply demarcated line, in some cases irregular red Hakes appear in the parts that have been stroked. A phenomenon which may be noticed during the test of sensation is the appearance of small nodules in the areas subjected to the needle; but these also are a form of dermographia. Colorless or pale edema is noted as simple stasis edema, occasionally in organic as well as in functional paralysis of the extremities. Besides this stasis edema we must mention so-called cedeme bleu, which accompanies hysterical paralyses, and the so-called ((flying edema ” The latter appears to be closely related to hysterical conditions. It reveals itself by edematous swelling which is most marked in the face, which appears sud- denly around the eyes, remains for hours, and then disappears without leaving any disturbance. The hair often shows trophic disturbance. The hair and beard suddenly or very rapidly turn gray; this may affect strands or uniformly implicate the entire hairy scalp. Besides grayness of the hair we must consider alopecia which follows the distribution of the fifth nerve, while the region of the occipital nerve is usually exempt. Frequently there is a derangement of the secretion of sweat; the secretion is usually profuse. In spite of the fact that the patients do not feel warm but are often even cold, there is copious perspiration in the hands and axilla. The opposite condition—an abnormally slight secretion of sweat and conse- quently unnatural dryness of the skin—is much more rare. The structures beneath the skin undergo little, if any, atrophy. Muscular atrophy is not peculiar to the nervous pathologic process as such; on the contrary atrophy may he of the so-called inactivity or reflex form (in arthritic diseases). Consequently it may be found in entire extremities, or in portions