Vol. 60, 1909 - University of North Carolina at Chapel Hill

XXVI
.
THE CHARLOTTE MEDICAL JOURNAL.
ernosa. They are distended and hard, toralis major, latissimus dorsi, serratus
The glatis and corpus spongfiosum are magnus, etc. He could not support himself
scmetimes increased in volume, but soft on being placed on his feet. Both knees
and of a totally different consiftency from were partially flexed from contracture of the
that of the corpora cavernosa. One can hamstring muscles, and could not be exfeel
the!r hardened points through the tended. Both feet were in the position of
glaus. The pain generally begins some talipes equinus from contracture of the calf
hours after the beginning of the erection, muscles. There was such weakness of the
and can at times he very severe. In severe extraordinary muscles of respiration that
cases the patient is in a perpetual agitation, the child could not easily by coughing clear
with the face moist with sweat, and anx- his bronchial tubes of mucus. The life of
ious. He rolls himself about and cries the patient in this advanced state depended
lustily. The pain does not continue with on the progress of the increasing muscular
such intensity, but abates and then returns weakness and the chance occurrence of some
in attacks, The weight of the bedclothes pulmonary complication. Complete rest for
is unbearable, and the patient particularly any time was considered a mistake, as the
dreads any attempt to lower down the penis, muscles rapidly waste and the patient be-
As a general rule micturition is normal; comes gradually more and more helpless.
in some cases retention follows, and the . .w ^ - .> .
r ,, .1 . A Alleged Dangers of the Coniunctlval
use of the catheter is required. » »
This affection ends generally in gradual ReacHon.-Teichmann (Mediz. Klniik),
recovery, sometimes at the end of a few bases the following conclusions on his obweeks;
other times at the end of two or servation of l.SOi) cases, and on a comparithree
months. Of the 4S cases collected, son with the results obtained by others:
31 recovered spontaneously, 5 died later on (1) That the harm alleged to have been
from leukemia, 10 were operated and re- caused by the conjunctival reaction depends
covered, 2 died in full priapism. without exception on the choice of unsuitable
tuberculin preparations or
Owingtothe difficulty of following up
on the neg-
of important contramdications
those cases, it is impossible to say what the (2)
^f^
after results have been, but in many cases
^^^ installation, in diseased and espe-
^^f}
'
^lally in
permanent impotence
tuberculous eyes, in the scrofulous.
followed.
^, r .1 1- 11 particularly in those of vouthtul age, and a
The cause of this disease is not well as-
^^^^^^^^ ^-^^ j,, the same eve, especially with
certamed. Leukam.a seems to be the most
^ solutions, is not' permissible. (3)
frequent cause. As regards treatment the
That the conjunctival reaction-undertaken
^" ^^""^y incision in
..-ith freshly-prepared solution-is absolutebotir'''rrr°'''°'^
1 corpora.
j^ j.^^^ from danger, and is at present the
Pseudo Hypertrophic Paralysis in an simplest means of diagnosing a tuberculous
AdvanccdStage.—R. Barclay Ness, in The focus, not recognizable by other clinical
Glasgow Medical Journal, mentions the case methods of examination,
of a boy, aged l.i years, and was one of a The cases observed by Teichmaiin were
family of six. None of these were affected all treated with one per cent old tuberculin,
in the same way as the patient. Between and the majority showed only a mild conthree
and four years of age he was recog- junctivitis lasting three or four days. Isonized
as being in an early stage of the dis- lated cases, however, occuired in which
ease. He then had large calves, wadling chemosis, follicular enlargement, purulent
gait, lordosis, and the characteristic way of secretion, and subjective sensations of presarising
from the supine to the erect position, sure and burning were present. These were
The succeeding years had been marked by limited to the conjectiva, and disappeared
a gradually increasing failure of muscular in four to eight days, leaving no trace, and
power and by wasting of muscles. At the the eyes after some further months of obserage
of thirteen years the boy showed great vation still gave no sign of conjunctival ir
emaciation and general helplessness. Lying ritation. Reactions which threaten to be
on his back he could only to a slight extent severe are readily checked hy the instillation
pull up and extend his legs. He could move of cocaine 2 per cent and adrenalin 1 in
his arms slightly, but they were quite flail- 1000. These marked reactions occur almost
like. He could not raise himself into the solely in cases in which tuberculosis is clin-
sitting posture. Placed in this position his ically manifest, so that the test will not in
back became markedly curved (kyphosis) future be used in such cases, but if it is used.
Any attemi)t with hands in the armpits to a transient ophthalmia is better than the
raise him by the shoulders only elevated the general disturbances which, in these same
scapuliu and brought them together on the cases, would probably occur from the injecback,
all support having been evidently lost tion of tuberculin. Severe conjunctivitis of
by the wasting of such muscles as the pec- long duration, corneal ulcers, iritis, etc.,