Medical aspects of compressed air illness / by W.D.M. Paton.

  • Paton, William D. M.
Date:
[1954?]
Catalogue details

Licence: In copyright

Credit: Medical aspects of compressed air illness / by W.D.M. Paton. Source: Wellcome Collection.

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    with a rheumatic pain, which (in general) it seems to resemble in other respects. “ Bends ” occur most commonly in the joints and muscles most used, and may be restricted entirely to these. Cutaneous symptoms and signs Itching.—A harmless, though sometimes tiresome, symptom is itching (the “ sandbug itch ”). This is commoner under higher pressures (such as are used in diving). The itching is usually felt in the trunk or the central part of the limbs—in the warm clothed parts, rather than those that have been exposed. In character it is identical with other itches (such as flea-bites), and may lead to social embarrassment if, as sometimes happens, the delayed onset causes the itching to appear while the victim is using public transport on the way home. Bruising.—With serious cases of “ bends ” or with paraplegia, bruising of the skin may occur, giving more or less extensive areas of ecchymosis and (very rarely) of subcutaneous emphysema. The vigorous friction and appli¬ cation of heat or counter-irritants, to which a joint with “ bends ” may be exposed, can, however, also cause some cutaneous effusion of blood, which must not be confused with the above. Spinal paralysis The most important and serious form of decompression sickness is a spinal paraplegia; this is recorded frequently in the literature, and occurs readily whenever grossly inadequate decompression is used. The lesion is usually in the lower thoracic portion of the spinal cord, mostly in the white matter. The symptoms and signs are those of any other spinal lesion. Usually motor paralysis and numbness of the legs are the presenting symptoms, but intense bilateral pain may occur. Incontinence of urine is the rule. If the condition is treated promptly, almost complete recovery may occur; but if re-compression is delayed, a permanent paraplegia remains, although with lapse of time some improvement is probable. When re-compression can produce no further benefit, treatment is that of any other spinal lesion. Other symptoms Bubbles may also form in the brain (causing a wide variety of neurological lesions, with aphasia, deafness, dizziness, cranial palsies, or unconsciousness). Bubbles in the pulmonary vessels may cause coughing and thoracic pain, particularly on inspiration. Bubbles in the abdominal viscera can give rise I to abdominal pain and vomiting. In the presence of any of these symptoms, re-compression is vital. Development of bone disease In rare cases, moderate or severe “ bends ” may be followed, months or years later, by an avascular necrosis of the bones of the affected limb (Swain, 1942). When this lesion affects the shaft of the bones, no functional disorder