Observations on general paralysis of the insane and on the morbid changes found on post-mortem examination of the spinal cord / by Robt. Boyd.

  • Boyd, Robert, 1808-1883.
Date:
1871
Catalogue details

Licence: Public Domain Mark

Credit: Observations on general paralysis of the insane and on the morbid changes found on post-mortem examination of the spinal cord / by Robt. Boyd. 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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    room 65 deg.; would not allow the thermometer to be placed in his mouth or axilla, and became excited and violent when an attempt was made to do so. March 10. Still bedridden, passes his feces and urine involuntarily and unconsciously. Is able to feed himself, takes his food heartily ; had his neck blistered, and is taking bichloride of mercury.—From Case Book:—Oct. 11, confined to bed, quite help- less ; requires to be fed; can only swallow fluids; deglutition im- perfect. Nov. 1, seized by a fit of convulsions ; sank rapidly and died the same day. Autopsy 19 hours after death. Weight of body 98lbs.; length 5 feet 7 inches. Head: circumference, 22-|, antero- posterior 12-J-, transverse 12 inches. A sanious fluid in arachnoid sac ; dura mater of a yellowish tinge, and coated by a pulpy substance. Brain very much congested with blood, and softened in the deeper part of the anterior lobes. Each hemisphere weighed 19 ounces, cerebellum 5, medulla and pons 11 ounce. Spinal cord softened throughout, softening more distinct in some places than in others, 1\ oz. (sent to Dr. Clarke). Chest: both lungs in the first stage of pneumonia, right 31, left 25 ounces ; heart 9 ounces : a deposit of fibrine in walls of aorta and about the base of the semilunar valves. Abdomen : liver 41, nutmeggy, stomach 5f, pancreas 21, spleen 21, right kidney 4J, left 4^, capsules, f-; intestines thin. Cause of death, cerebritis, myelitis, double pneumonia. Case VI.—S. B., a stableman, aged 46, married, first attack, dura- tion five months; admitted Jan., 1868, in a state of general paralysis and dementia, caused by a bullet rebounding from a target and strik- ing him on the head when employed as a marker at a rifle range. Previous History.—Parents alive, only child, disposition quiet, temper good, habits intemperate; education, can neither read nor write. Present state.—(Physically) general health bad, pulse 90, tongue clean, skin cool, appetite good, sensations dull, motion imperfect, staggers about, expression silly, hazel irides, black hair, sallow com- plexion. (Morally) conduct violent to others, conversation about his wealth incoherent, ideas that he is rich, memory lost, affections not changed, propensities to destroy clothing, &c. Additional particulars. —Staggers in walking. Feb. 3. Very noisy and violent, had to be placed in the strong room. Feb. 6. Pulse 108, appetite good, bow'els regular, utterance thick and indistinct, speaks as if he had a plum in his mouth, walks with his legs wide apart, docs not stagger, not dirty, has control over sphincters. Feb. 18. Seems to have more difficulty in walking, is very obstinate ; it was quite impossible to take the temperature of axilla and mouth, as he struggled directly the attempt was made, and almost broke the thermometer; pulse 96, no sensation in the soles of the feet. March 11. Staggers in walking, is unable to lift a cup of water to his mouth without spilling it; quite unable to protrude his tongue, is becoming emaciated, wets the bed occasionally, appetite still good, lisps a little when he speaks, speech almost uniu-