Proceedings of Societies

Glaisher James
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Abstract

The concurrence of the renal and cerebral symptoms was singular. When the urine became freer from blood corpuscles and casts, the amaurosis gradually decreased, when an attack of congestion of the kidneys supervened, facial paralysis occurred, and with the return of the urine to its normal state, gradually vanished. We must admit that idiosyncrasy must have had much to do with the facility with which our patient's brain became affected, for it is by no means common to find such severe brain symptoms with the earlier stages of a sub-acute nephritis. The possibility of paralysis occurring without actual cerebral lesion, or pressure, or solution of continuity at some point in the course of the nerve in fault, is a matter of experience. A man, Bacon by name, came into the hospital under my care, with the lower extremities cedematous, the urine highly albuminious, and containing fatty epithelium, and became suddenly paralysed in the left arm and leg; sensation remained. The face was not affected. I examined him carefully several times during the day ; the loss of power over the limbs was perfect. In fifty-six hours he had recovered the power of movement to a certain extent. He died from pericarditis some few days after the paralysis had left him. I examined the brain and upper part of the spinal cord most carefully, without finding the least evidence of there being, or having been, sufficient disease to explain the occurrence of so considerable a paralysis. The corpora striata and grey substance generally, were paler than usual. The kidneys were far advanced in Bright's disease. We constantly see the functions of the superficies of the brain partly arrested or perverted, by the action of blood poisons, and the two cases I have recorded appear to demonstrate that other parts of the brain are within the influence of morbid matters in the circulating fluid.
学会学报
肾脏和大脑症状的同时出现是罕见的。当尿液脱离血球和铸型时,黑朦逐渐减少,当肾脏充血发作时,发生面瘫,随着尿液恢复正常,逐渐消失。我们必须承认,这种特质一定与我们病人的大脑受到影响的能力有很大关系,因为在亚急性肾炎的早期阶段发现如此严重的大脑症状绝不是常见的。在没有实际的脑损伤、压力或在故障神经的某一点上连续性的解决的情况下发生瘫痪的可能性,是一个经验问题。有一个人,名叫培根,在我的照料下住进了医院,他的下肢有脓肿,尿液呈高度白蛋白,并含有脂肪上皮,他的左臂和左腿突然瘫痪了。感觉依然存在。那张脸没有受到影响。白天我仔细检查了他几次;四肢失去力量是完美的。五十六个小时后,他在一定程度上恢复了行动的能力。瘫痪后几天,他死于心包炎。我非常仔细地检查了他的大脑和脊髓上部,但没有发现任何证据表明他患有或曾经患过足够的疾病,足以解释如此严重的瘫痪的发生。纹状体和灰色物质普遍比平时苍白。布莱特氏病的肾脏已经发展到晚期。我们经常看到,由于血液毒素的作用,大脑表层的功能部分被抑制或扭曲,我所记录的两个案例似乎表明,大脑的其他部分受到循环液体中病态物质的影响。
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