A clinical lecture on remissions and relapses in insular sclerosis / by Thomas Buzzard.

  • Buzzard, Thomas, 1831-1919.
Date:
[1904]
Catalogue details

Licence: In copyright

Credit: A clinical lecture on remissions and relapses in insular sclerosis / by Thomas Buzzard. 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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    from the commonly recognised type of insular sclerosis. Yet it is clear that this affords the only reasonable solution of the symptoms shown in the patient’s history and present condition. In no other way can we explain the presence of such symptoms as transitory numbness, diplopia, short-lived but recurrent facial paralysis, loss of power with spasticity of gait, ankle clonus, the Babinski phenomenon, and pallor of the optic discs. This, then, is a case of insular sclerosis which well illustrates the importance of recoveries and relapses as a symptom of the disease. There is no doubt that not only have recoveries such as have occurred here- been in many cases the cause of a patient’s illness being lightly treated as one of hysteria but also, in my judgment, the common picture of hysteria has been somewhat largely based upon a misinterpretation of such symptoms. Another example is that of a man, agecf 35 years, tailor, married, who was first admitted under my care in April, 1895, with not strongly marked symptoms of insular sclerosis. It seemed that in 1881, when 21 years of age, he suffered from some hemiamesthesia from which he rapidly and completely recovered and remained well till 1894. He then complained of numbness, tingling, and weakness in both hands and feet. From this he recovered in a fortnight and returned to his work. About a year later he was again attacked with numb- ness in both feet and slightly in the hands, together with some weakness in both lower limbs, especially the right. There was also some slight bladder trouble. He had to give up work and was eventually admitted into this hospital. He had then distinct weakness in the right upper and slightly also in the right lower limb. There was loss of sensation, both to touch and pain, in front of each thigh. The knee-jerks were in excess. After a few weeks he had improved and was able to leave the hospital, walking alone. After his discharge he continued to improve and was apparently quite well in a month or two. He remained well and steadily at His work for nearly three years. In 1898 he began to be weak in the legs again but remained at work till June, 1900. He was then much worse and could not walk without help but after three weeks’ stay in a convalescent home he improved greatly and returned home, but still continued to suffer from numbness and stiffness of the fingers which interfered with his work. He again became worse and was readmitted into this hospital in January, 1901. I will only refer to a few salient points of his