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.

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    less of the eyeball was seen through the palpebral fissure on the right side than on the left, in consequence of a marked difference in the vertical diameter of these fissures; the right pupil was at least one half smaller than the left, and was on some days contracted to the size of a phi's head, but still acting normally under the influence of light and shade. With respect to the colour and temperature of the skin, the two sides of the face were alike, but in the course of the disease a slight but perceptible atrophy of the right side of the face presented itself. The paralysis improved under the use of electricity; after three months the right pupil, too, was not so contracted as formerly, but with that exception the state of the pupils and of the atrophied parts remained unchanged. The second case was that of a man of 34 years, who was run over by a railway waggon, sustaining an injury to the left breast and shoulder, and fracture of the left fore- arm. Three months afterwards there were paralysis and emaciation of the left arm, with considerable disturbances of nutrition, and complete ansesthesia of the whole forearm. The left pupil was only half as widely dilated as the right, but quite sensitive to light, and the palpebral fissure on that side was only a very little shorter than that on the right. On instillation of atropine the contracted pupil became dilated almost as widely as possible, and in the following 48 hours contracted but slightly, though the paper prepared with Calabar bean was used. Galvanic irritation of the cervical sympathetic, though repeatedly tried, was followed only once by a transient dilatation of the pupil; whilst under this treatment, however, the left ear was usually warmer to the touch than the right, a sensation which was felt by the patient himself. He was a long time under observa- tion, but the differences between the pupils remained unchanged. The phenomena in the two last-mentioned cases correspond to a paralysed condition of the cervical sympathetic, but only in the sphere of the oculo-pupillary fibres, whilst the vasomotor fibres appear to be quite unaffected. Whether the trunk of the sympathetic itself, or the middle cervical ganglion, or the twigs passing from that ganglion to the brachial plexus, were injured, remains unknown. Further, Baerwinkel,* in two cases of traumatic paralysis of the brachial plexus, (produced, in one instance, by fracture * Baerwinkel, Zur Pathologie des Sympathicus. Deutsclaes Archiv. fiir kliniscke Medicin. Bd. xiv., p. 545.