Physiology and pathology of the sympathetic system of nerves / by A. Eulenburg and P. Guttmann ; tr. by A. Napier.

  • Eulenburg, Albert, 1840-1917.
Date:
1879
Catalogue details

Licence: Public Domain Mark

Credit: Physiology and pathology of the sympathetic system of nerves / by A. Eulenburg and P. Guttmann ; tr. by A. Napier. Source: Wellcome Collection.

Provider: This material has been provided by the Francis A. Countway Library of Medicine, through the Medical Heritage Library. The original may be consulted at the Francis A. Countway Library of Medicine, Harvard Medical School.

    56/182 (page 48)
    increased in intensity, this compression had the effect of a force which lessens conducting power—thus causing myosis, Possibly also the rigors may be traced to an occasional abnormal excitation of the vasomotor filaments in the cervical sympathetic. When the bloodvessels of one side of the head contract, less blood flows to the medulla oblon- gata ; this temporary ansemia stimulates its vasomotor nerve-centres, by which means the phenomena attending rigors (contraction of the smallest arteries of the skin) are developed. H. Demme* noticed mydriasis and slight exophthalmos in a man suffering from cystic goitre. At the examination the cervical part of the sympathetic on the left side was found abnormally red, and surrounded by a serous exudation in the connective tissue. No changes were found on micro- scopic examination. Clearly the swelling here had irritated the oculo-pupillary fibres of the sympathetic. We have met with a very similar case—that of a patient suffering from a vascular goitre almost entirely confined to the right side. The symptoms were extreme mydriasis, complete immobility of the iris, considerable exophthalmos, and loss of accommo- dation power, in the right eye ; in addition to these there was a persistent lowering of the temperature of the auditory meatus of the same side, amounting to 0#3-0*4° C. compared with the healthy side. The pulse was much accelerated. ( alabar bean effected a temporary improvement in the mydriasis and the accommodative paralysis; local galvano- puncture, also, was followed by a slight decrease in the size of the tumour and in the frequency of the pulse. We have thus cited instances, first of paralysis, then of irritation, of the sympathetic, brought on by the pressure of tumours. In both groups the phenomena in the domain of the oculo-pupillary fibres (myosis, connected with paralysis, and mydriasis with irritation) are of a constant and per- sistent nature, while in the domain of the vasomotor fibres (reddening or pallor) they are inconstant and transient; the reasons for this are yet unknown. Vulpianf supposes that there are vasomotor symptoms in every case of affection of the sympathetic, but only at the beginning • that they some- times disappear in a few days, or even hours. If such patients come under medical observation only at a later * Demme, Wurzburger med. Zeitschrift, 1862, Bd. iii., p. 262 and 269. f Vulpian, Lecons sur l'appareil vasomoteur. Paris, 1875, p. 142.