Diphtheritic paralysis / by J.D. Rolleston.

  • Rolleston, John Davy, 1873-1946.
Date:
1913
Catalogue details

Licence: In copyright

Credit: Diphtheritic paralysis / by J.D. Rolleston. 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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    alysis developing later, occurred in 139 cases, but only one pa- tient, aged twenty-nine, was above fifteen years. Lastly it may be noted that of the 73 recorded cases of post-diphtheritic hemi- plegia the oldest patient was seventeen years. Not only actual paralysis, but abolition of the tendon jerks, also is commoner in children than in adults. Thus among 1,550 cases of diphtheria in which the knee and ankle jerks were ex- amined, the knee jerks were lost in 267 and the ankle jerks in 196, but only four of these cases occurred in patients over four- teen years, although 149 of the 1,550 were above that age. I have recently shown* that Babinski’s sign may be found in a considerable percentage (19.6 per cent.) of all cases of diph- theria during the acute stage, being probably due to a transitory perturbation of the pyramidal system by the circulating toxins. This sign though not confined to infants and liable to be met with up to adult life shows a marked decrease in frequency and dura- tion after the eighth year. Relation of Paralysis to Antitoxin.—The following table con- firms my previous observations on the prophylactic value of the serum treatment of diphtheria. Whereas in pre-antitoxin times early treatment had no power to cut short the disease or to pre- vent paralysis, early injection of antitoxin undoubtedly jugulates the disease and tends to diminish the occurrence of subsequent complications. Table IV. Showing Relation of Paralysis To Day of Disease on which Antitoxin was Injected. Total number of Paralysis Severe Day of disease. cases injected, cases. Percentage, forms only. Percentage. 1st day 83 3 3-6 0 0 2d ii 461 65 14.09 18 3-9 3d U 54t 116 21.4 41 7-5 4th (( 460 124 26.9 46 10.0 5th (( 304 80 26.3 41 134 6th (( 166 45 27.1 21 12.6 7th “ and later. 215 40 18.6 17 7-9 2,230 273 184 * Review of Neurology and Psychiatry, 1910, Vol. VIII., p. 404.