The Surgical Clinics of North America Volume 1, No. 6 (Paperback)

This historic book may have numerous typos and missing text. Purchasers can download a free scanned copy of the original book (without typos) from the publisher. Not indexed. Not illustrated. 1921 Excerpt: ...OF TUMOR. RAPID IMPROVEMENT WITH RETURN OF REFLEXES In this patient, Mrs. F., fifty-eight years old, the first symptom, beginning three and a half years before admission to the hospital, was burning pain about the left hip. This remained the sole manifestation for two years, when it began to abate. Pain in both feet gradually extending up to the knees then began, and this became steadily worse and more constant. Weakness of the lower limbs appeared soon after, and has been more slowly progressive than the pain. The patient has been bedridden for a year more from pain than disability. For several months there has been vesical and rectal urgency, and incontinence on a number of occasions. Glycosuria has been noted and the case was apparently treated as one of diabetic neuritis. During three weeks' observation in the neurologic service of Dr. B. Sachs the patient suffered almost constant pain in the lower limbs unless relief was given by morphin. Incontinence of urine and feces occurred occasionally. There was marked loss in power in the legs, more pronounced on the left side, together with some spasticity. Bilateral complete drop-foot. The knee-jerks were absent, the Achilles reflexes present, but reduced. A tendency to ankle-clonus, more marked on the left side, was noted. There was a bilateral Babinski phenomenon. The only discoverable disturbance in sensation was an illdefined area of very slight reduction in pain and tactile sense over the buttocks. Two disturbing factors in the diagnosis came up. One was a greatly enlarged uterus and the question was if we were dealing with a spinal metastasis from a uterine growth. The other was the x-ray examination. This showed a marked spondylitis of the lower dorsal and lumbar vertebrae with well-developed osteophyt...