The diagnostics of pain : lectures for medical students and physicians held at the University of Copenhagen in the autumn of 1934 / by Th. B. Wernøe.

  • Wernøe, Th. B. (Thorvald Benedikt), 1884-1936.
Date:
1936
Catalogue details

Licence: In copyright

Credit: The diagnostics of pain : lectures for medical students and physicians held at the University of Copenhagen in the autumn of 1934 / by Th. B. Wernøe. Source: Wellcome Collection.

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    thumb, and further to the forearm with the exception of a narrow radial stripe. After this the pains in the thumb became very acute; to a less extent pains were felt in the index finger and up the radial edge of the forearm and the outer side of the arm. In these areas there was pronounced hyperalgesia. In the course of three years the whole hand, the whole forearm, and the greater part of the arm had become analgetic and thermo¬ anaesthetic with the exception of the upper region of the outer side of the arm. The pains were now localised to this area and to the shoulder, and here there was likewise pronounced hyperalgesia. The case exemplifies how a gliomatous process may progress from segment to segment, irritating and then destroying, and accompanied respectively by pain and hyperalgesia, and then by anaesthesia and thermoanaesthesia. In this case the process spread successively through the 8th, 7th and 6th up to the 5th servical segment. The main features of pain from the posterior horn are herewith at the same time indicated. Immediately after its cessation this pain is superseded by analgesia and thermo¬ anaesthesia. In the case in question the distribution of the pain was segmental, in other cases it may be regional. Personally I have seen several cases of pains in the shoulder region which had been regarded as rheumatism, until the incidence of analgesia and thermoanaesthesia with the simultaneous preservation of deep sensibility revealed the true nature of the lesion. — After having left the posterior horn the pains rapidly cross over to the lateral column on the opposite side, continuing in this in company with all the other pain paths from the opposite half of the body. The pain paths here seem to be separated from the temperature paths, since there are reports of lesions of the antero-lateral column which have entailed crossed analge¬ sia alone, or crossed thermoanaesthesia alone. The most frequent clinical observation is, however, that