Paralytic

“ The victim will sometimes manifest incredible strength in breaking his chain and scaling high walls. Twitchings of the muscles of the face, and even general convulsions, are sometimes seen. Food is usually rejected, or if swallowed is soon vomited. In the course of two or three days the furious stage merges into the paralytic one, first shown by paresis of the hind extremities and a swaying motion in walking, then by paralysis of the lower jaw, which hangs pendent and allows the escape of a viscid saliva. ”

“ The blush of young girls on coming into an assembly room, where they expect their dress, and steps, and manner to be examined, as in dancing a minuet, may have another origin; and may be considered as a hot fit of returning confidence, after a previous cold fit of fear.
7. Tarditas paralytica. By a stroke of the palsy or apoplexy it frequently happens, that those ideas, which were associated in trains, whose first link was a voluntary idea, have their connection dissevered; and the patient is under the necessity by repeated efforts slowly to renew their associations. ”

“ 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. ”

“ Nowhere else, too, are developed finer sympathy, more beautiful unselfishness, more generous charity, or more heroic resignation where no hope in life remains but for death.
The State has taken charge of these most unfortunate people, shutting up behind the same locked doors and barred windows people of all social grades, often mingling together in one presence the so-called criminal insane, insane criminals, idiots, imbeciles, epileptics, paralytics, the chronic insane, and the demented, with patients suffering from acute mental disease. ”

“ 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. ”

“ 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. ”

“ 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. ”

“ 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. ”

“ In mild cases instead of deep coma, there may be only headache, faintness, nausea and vomiting.
Subsequent Symptoms.—When the patient improves, consciousness returns, but there remains a half-side paralysis, hemiplegia, on the side and opposite to that of the seat of the injury in the brain. It may not take in the whole side, only a part. The gait is peculiar. In walking the patient supports the paralyzed arm. In many cases the paralyzed parts gradually regain their functions in a few weeks, but not always complete. The leg improves more than the arm. There is danger of other attacks. ”

“ Paralysis, or Palsy, when occurring as a complication of spermatorrhea, may be preceded by an attack of apoplexy, in which the patient loses consciousness, and lays in a condition of profound stupor for a time, and on recovery from his unconscious state, finds himself unable to use one or more of his limbs, or the disability and loss of power, which may also be accompanied by more or less loss of sensation, may come on gradually, without any premonition or marked manifestation of its approach. ”

“ Sooner or later, there appears the peculiar paralysis of the disease, which consists of more or less numbness of the feet and legs, and, in the later stages, of the hands and arms, sometimes of the face. As a rule, however, the patient finds difficulty in properly maintaining his balance, and in walking his movements are tottering, like a man partially intoxicated. It is difficult for him to maintain his balance and walk with his eyes closed. If the arms are affected, their movements are uncertain. ”

“ It’s increasing by leaps and bounds, and it has the distinction of being absolutely incurable. General paralysis is its full title, and I tell you it promises to be a perfect scourge. Here’s a fairly typical case now which I saw last Monday week. A young farmer, a splendid fellow, surprised his fellows by taking a very rosy view of things at a time when the whole country-side was grumbling. ”

“ Tell the patient that he cannot open his eyes or his mouth, cannot unclasp his hands or lower his raised arm, cannot rise from his seat, or pick up a certain object from the floor, and he will be immediately smitten with absolute impotence in these regards. The effect here is generally due to the involuntary contraction of antagonizing muscles. But one can equally well suggest paralysis, of an arm for example, in which case it will hang perfectly placid by the subject's side. Cataleptic and tetanic rigidity are easily produced by suggestion, aided by handling the parts. ”

“ The Causes of Paralysis are very numerous. Whatever destroys, or impairs the natural structure of nervous matter, or whatever interferes materially with the conducting power of nerve-fibre, or the generating power of the nerve-centres, will produce a paralysis, the extent of which will depend upon the amount of nervous matter affected. Thus paralysis may be due to disease of the brain arising from apoplexy; to abscess, softening, syphilitic or other tumors, or epilepsy; to disease of the spinal cord, or marrow ”

“ 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. ”

“ But, secondly, this paralysis may extend to the muscular sense, so that the feeling of muscular tension is wanting as well as that of contact-pressure; and yet none the less can a weight be lifted or sustained by a conscious effort, provided that the deficiency of the guiding sensations ordinarily derived from the muscle itself is supplied by the sight. A woman whose arm is sensorially but not motorially paralyzed can hold up her child as long as she looks at it, and a man affected with the like paralysis of his legs can stand and walk while looking at his feet. ”

“ 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. ”

“ IF there is any one disease that the diligent brain-worker, a little past middle life, has reason to fear, it is apoplexy. Although statistical evidence is wanting, the experience of the physician confirms the popular belief that more of our distinguished men are carried off by this disease, or by one of its sequels, paralysis, than by any other cause. ”

“ 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. ”

“ When the paralysis is recent and the face in complete repose, there may be little or no deformity to mark the condition of the muscles. When, however, the patient speaks or the slightest emotional or reflex movements of the face are excited, as laughing, frowning, etc., it becomes obvious from the bizarre grimace caused by a one-sided contraction. After the paralysis has existed for some time the contrast of the two sides of the face is marked. The paralyzed side is characterized by a vacancy of expression to which the staring, unwinking eye contributes. ”

“ 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 ”

“ 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. ”

“ Infantile paralysis is a general infection, with lesions most marked in the central nervous system. Clinical manifestations exhibit a wide-spread and scattered motor paralysis or weakening. The large majority of all cases are of the central nervous system, but there are variations in which the symptoms are not of the usual kind. ”

“ Symptoms.—The onset is usually sudden; often the child is put to bed at night seemingly well and in the morning is found paralyzed in one or more limbs. High fever or chills, general feeling of illness, pain all over the body, decided brain symptoms, like delirium or convulsions and intermittent contractions of the muscles may usher in the disease. These forerunning symptoms may last a short time or for several weeks, after which the paralysis is noticed, being extensive as a rule, and affecting one, two, or all of the extremities and sometimes the muscles of the trunk. ”

“ 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 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. ”

“ The patient was a lad about seventeen, who at that time had laboured under this extraordinary disease for more than twelve years. His body was so distorted, and the legs and arms so twisted round it, by the continued convulsive working, that no words can give an adequate idea of the oddity of his figure; the agitation of the muscles was perpetual; but in general he did not complain of pain nor sickness ”

“ So slight and nearly imperceptible are the first inroads of this malady, and so extremely slow is its progress, that it rarely happens, that the patient can form any recollection of the precise period of its commencement. The first symptoms perceived are, a slight sense of weakness, with a proneness to trembling in some particular part; sometimes in the head, but most commonly in one of the hands and arms. These symptoms gradually increase in the part first affected; and at an uncertain period, but seldom in less than twelvemonths or more, the morbid influence is felt in some other part. ”

“ Professor Heim wisely cautions those who have been of a plethoric constitution, from too free an use of the baths, till they have ascertained how they agree with their constitutions. Before any amelioration takes place, the patient generally experiences some pricking pains and tinglings in the paralyzed parts, followed by a sense of heat, perspiration, and increase of feeling. To these symptoms succeed a gradual restoration of muscular power, accompanied by a sense of electrical sparks passing along the nerves. Numerous cases of paralysis of one side are detailed by Dr. ”