Paralysis

“ Whether under these circumstances it is philosophic to consider the so-called pseudo-general paralysis and general paralysis as essentially distinct affections, each physician can well judge for himself. ”

“ The general health of the patient remains remarkably good, the intelligence clear, the disposition lively. The duration of life seems to be in nowise shortened by the paralysis. Thus, suddenness of development, intimate association of trophic, motor, and electrical disturbance, absence of cerebral or sensory lesion, peculiar localization and grouping of the permanent paralyses,—such are the salient characteristics of this remarkable disease. ”

“ BARBIERS, s. This is a term which was formerly very current in the East, as the name of a kind of paralysis, often occasioned by exposure to chills. It began with numbness and imperfect command of the power of movement, sometimes also affecting the muscles of the neck and power of articulation, and often followed by loss of appetite, emaciation, and death. ”

“ So far as my observation goes, the injury to the head, supposed to be the cause of general paralysis, often has appeared to probably come from an accident due to the impaired physical strength and to the vaso-motor disturbance in the brain incident to the early stage of the disease and while it was still unrecognized. Cases are observed in which no predisposing or exciting cause is found by the physician. ”

“ The onset of general paralysis is slow and gradual, and the earliest symptoms may be either physical or mental. The disease may commence either in the brain itself or the spinal cord may be primarily the seat of lesion, the brain becoming affected secondarily. ”

“ Paralysis and apoplexy are often, through ignorance, used synonymously, but they really mean very different conditions. Paralysis is a loss of power of contracting a muscle, due to disease or injury of the nervous system; it frequently follows or is associated with apoplexy.
In the case of apoplexy, and most conditions of coma, there is generally little for the attendant to do. The patient should be put to bed, with light coverings, and the head raised on pillows. Do not annoy the patient by trying to rouse him, and do not give stimulants. ”

“ Both, too, lie in wait for their victims at the entrance in middle life. I have a very fine case of paralysis now; a man built up by nature to live to a hundred—never saw such a splendid formation—such bone and such muscle. ”

“ But no diagnosis, saintly or scientific, can add to the sense of misery and waste with which we recall that strong life so early broken, those twenty-five years of strained nerves and aching limbs, that six-months-long daily death of hysterical paralysis. ”

“ The most prominent symptoms which mark a peripheral paralysis are the implication of all the branches of the nerve, the loss of the reflexes, the development of the degenerative reaction, and atrophy of the muscles. In facial paralysis of cerebral origin the frontal and orbital branches are not at all or but slightly affected, leaving the eye with its natural appearance, in contrast to the lagophthalmos, and the open eye which does not close even in sleep. In cerebral paralysis the reflexes are normal and the muscles retain their natural electric reaction. ”

“ Those left white were, on the contrary, never injured without motor disturbances of some sort. Where the injury to the cortical substance is profound in man, the paralysis is permanent and is succeeded by muscular rigidity in the paralyzed parts, just as it may be in the monkey. ”

“ That under the powerful combination of causes, each of which is in itself sufficient to endanger life, and greatly intensified as paresis gradually deepens into paralysis, the heart, even of large animals, succumbs in a comparatively short time, may be readily understood. ”

“ But, when paralysis takes place, and the nerves refuse to perform their functions, the will is absolutely useless, and, however desirous a man may be of walking, he cannot move a step if the nerves of his legs are paralyzed. In cases where the paralysis comes on slowly and in detail, the patient mostly becomes conscious of the part played by the nerves, and feels that his will can to a certain degree rouse the expiring powers of the nerve fluid. ”

“ Every second paralysis can strike him down, so that the right side of the face, the right arm, the right leg die—it isn’t a human being that’s living, but some sort of a little half. Half-man-half-corpse. The majority of them go out of their minds. ”

“ Late Syphilis of the Nervous System—General Paralysis.—General paralysis, or paresis, is a progressive mental degeneration, with relapses and periods of improvement which reduce the patient by successive stages to a jibbering idiocy ending invariably in death. Such patients may, in the course of their decline, have delusions which lead them to acts of violence. ”

“ Paralysis may be general or partial. The latter is divided into hemiplegia and paraplegia. When only a small portion of the body is affected, as the face, a limb, the tail, it is designated by the term local paralysis. When the irritation extends from the periphery of the center it is termed reflex paralysis.
Causes are much varied. Most of the acute affections of the brain and spinal cord may lead to paralysis. Injuries, tumors, disease of the blood vessels of the brain, etc., all have a tendency to produce suspension of the conducting motive power to the muscular structures. ”

“ He keeps mumbling something about the triangle, or something of that kind, but that is, of course, unintelligible."
"I understand Retlaw is improving, also?"
"Yes; we have thought of bringing the two men together, as soon as the paralytic is so improved that he can talk."
"I have often wondered what kind of a disease paralysis is?" inquired Harry.
"Paralysis is not a disease of itself. It is merely a sign of some disorder of the nervous system. It may be shown by complete disability on one side of the body, or in some particular portion, and only certain sets of nerves may be affected." ”

“ Third—Paralysis is frequently present. It may be one-sided or only of the lower extremities, or only one limb. The face is usually not involved when it is on one side. The leg is more affected than the arm. Sensation is lessened or lost on the affected side. Paralysis of the lower extremities is more frequent than one-sided paralysis. The power in the limbs hardly ever is entirely lost; the legs may usually be moved, but the legs give way if the patient tries to stand. The affected muscles do not waste. The feet are usually extended and turn inward. ”

“ Eyes, Paralysis of.—The partial paralysis of the muscles of one eye produces double vision, so that the patient sees two similar objects where there is only one. This double vision is often, however, the result of stomach derangement. If so, it may soon pass away. The true paralysis is more persistent. To cure this, rub the entire skin of the head gently and steadily with the hands and finger-tips (stroking always upwards) for some fifteen minutes. Then apply cold cloths to the eyes as already directed. If the cold cloths are uncomfortable, hot ones should be tried. ”

“ We have seen a case of general paralysis, in the second stage drink a glass of quinine and water under the impression that he was drinking whisky.
The third stage of the disease is characterized by sleeplessness and rapid loss of body weight. Mentally the patient becomes quite demented. On the physical side the paralysis advances rapidly, so that the patient becomes bedridden and speechless. Death may occur as the result of exhaustion, or a congestive seizure, or of some intercurrent illness. ”

“ Club-feet, spinal curvature, and other deformities resulting from paralysis, have been successfully treated in our Institution. In short, our success has been most flattering in all curable cases of paralysis, and it is such experience that induces us to hold out encouragement to those who are afflicted with paralysis and other nervous affections. ”

“ When the effect of the mischief is so great as to cause complete paralysis, convulsive twitches do not take place, although they frequently precede, and may in many cases be considered as premonitory signs, while the evil which gives rise to the paralysis is gradually accumulating. ”

“ Mental shocks of various kinds, excessive emotional strain with mental exhaustion, and injuries to the brain, are the commonly reported exciting causes of general paralysis, but it is not certain that—in many cases, at least—they do more than hasten the pathological process and call attention to the symptoms. ”

“ Now every physician knows that the cause of the paralysis succeeding apoplexy is the clot of blood effused in the attack, and the damage which the brain has received in the neighbourhood of that clot. Nature, at length, absorbs the effused blood, or surrounds it with a sac, and then the adjacent brain gradually recovers its function, if within the power of nature, and the motion of the paralyzed limb is regained in proportion. How this salutary process is to be accelerated by the baths or waters of Wisbaden, I cannot imagine ”

“ Paralysis will therefore be associated with two of the great systems into which the body is divided for the purposes of medical and physiological description—namely, the muscular and the nervous—and, on account of the similarity of the clinical symptoms of lead paralysis, attention has been drawn rather to the nerve changes preceding muscular paralysis and degeneration than to other influences affecting the nerve inflammation. ”

“ Ordinarily the rupture of an artery on one side of the brain causes a paralysis on the other side of the body. This paralysis or loss of control over muscular action is due to disturbance of the motor tracts of nerves through which muscular action is controlled and directed by the brain, and these normally cross to the other side on the way to the periphery. In nearly everyone the tracts remain uncrossed to some slight extent. In some so much of the pyramidal tract remains uncrossed that there may be decided weakness on the same side as the lesion in the brain. ”

“ It is not, as is usually supposed, an affection of the muscles, but of the nerves that control the muscular movements. Sometimes one entire side of the body becomes affected and completely deprived of voluntary motion. Congestion of the brain is a preliminary of paralysis, and congestion of the brain are invariably due to an enlarged transverse colon.
One form of paralysis affects only certain parts of the body, such. as the lower limbs, or the reproductive organs, and is caused by pressure upon some large nerve communicating with the paralyzed portion. ”

“ Late heart failure is one of the forms of post-diphtheritic paralysis which arise from disturbances of the nervous system. The other common varieties are paralysis of the palate, of the pharynx, of the eye muscles, and of the respiratory muscles. ”

“ Thus injury to a single nerve, or to a complex of two or more, was far more common than one implicating the whole plexus. Again, while complete paralysis might affect one set of nerves, another might simply exhibit signs of irritation in the form of hyperæsthesia or pain. ”

“ These are the two opposed symptoms that we produce experimentally by electrization and ablation of the substance of the convolutions. It goes without saying that the symptoms vary with the locality of the lesion: the intellectual region gives delirium; the motor region, spasms; the sensitive region, subjective sensations. The symptoms of functional paralysis are also diversely represented by mental feebleness, motor paralysis, and anæsthesia limited to one sense. A lesion frequently presents both orders of symptoms, which succeed each other, or alternate, according to its nature. ”

“ Three fourths of the 664 cases of general paralysis were married and 69 per cent, of them were in comfortable or affluent circumstances. The most unfortunate feature of general paralysis is that it occurs most often in the third and fourth decades of life; frequently in those who have long since abandoned the immoral or heedless mode of life which led to their infection and have become responsible for the support of families and of economic value to their communities. ”

“ Compression of the brain may be the direct and immediate result of a head-injury, a piece of the vault of the skull being driven in, and a local or a general paralysis of muscles being at once observed. In addition to the muscular paralysis, which may enable the surgeon to localize the spot at which there is pressure upon the brain, there is the grave symptom of coma or insensibility. And, as in deep sleep, there is often loud snoring, due to the vibration of the paralysed soft-palate. ”

“ Whenever paralysis is the result of some organic derangement of the brain, such as tumors pressing upon the substance of that organ, diseased alterations in its structure, or extravasations of fluid which cannot be absorbed, then this remedy will be of no avail. ”

“ Where the paralysis is complete the patient seems gradually to learn to use his limbs over again by repeated efforts, as in infancy; and, as time is required for this purpose, it becomes difficult to know, whether the cure is owing to the effect of medicines, or to the repeated efforts of the voluntary power. ”

“ The treatment of paralysis depends upon a careful consideration of its cause. The first object should be, as far as possible, to remove any compressing force, and to gradually arouse the torpid portion of the nervous system. ”

“ The condition in the hand suggests a radial paralysis. The patient is unable to flex his fingers, though he probably is able to make some movements with his thumb. Sometimes, on request to move the hand, a series of coarse oscillations follows, somewhat like a tremor. ”