Some hitherto undescribed symptoms in angina pectoris / by G. A. Gibson.

Date:
1905
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Licence: In copyright

Credit: Some hitherto undescribed symptoms in angina pectoris / by G. A. Gibson. Source: Wellcome Collection.

Provider: This material has been provided by the Royal College of Physicians of Edinburgh. The original may be consulted at the Royal College of Physicians of Edinburgh.

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    Numbness of the arm, the forearm, or the hand, has often been observed in cases of angina pectoris, but complete anaesthesia, such as is present in this case, must be rare indeed; in fact, no instance even distantly approaching that just described, has ever come under my notice. Neither in the beautiful researches of Mackenzie,^ nor of Head,^ is there any reference to such conditions. In a private communica- tion, however, the former states that he seemed to obtain anaesthetic areas when he first investigated the sensibility in angina pectoris, but that in late years he had failed to find them and concluded he had made a mistake. The wasting of the muscles has been described both by Eichhorst ® and myself,^ and there is no difficulty in explain- ing such trophic results from powerful afferent impulses. They are strictly analogous to the conditions which are found in arthritic muscular atrophy. This has long been considered as due entirely to reflex influence, which has been Lfully discussed by Paget® and by Vulpian,® and the theory is (Istrongly supported by the fact that in experimental joint I lesions wasting of the muscles is prevented by previous I division of the posterior spinal roots, w'hich has been de- iscribed by Raymond.^ But there are some distinct differences Ebetween the wasting in this case and in that of arthritic muscular atrophy. In this patient, just as occurs in arthritic atrophy, there is considerable increase in myotatic irrita- ibility. But no case of arthritic dystrophy of muscles has lever been under my notice in which there was an in- screase in the electric irritability of the atrophied muscles. Ct is possible, however, that what we are dealing with is an nearly condition, and that a reduction in electric irritability limay be a later phase. 1 In addition to providing a number of hitherto undescribed symptoms for our study, the patient seems to me of the tieepest interest as giving proof of a means of communica- ' Medical Chronicle, 1892, p. 293; and Lancet, 1895, Vol. I., p. 16. ^ Brain, 1893, vol. xvi., p. 1, and 1894, vol. xvii., p. 3.39. 4 r der Specieller Pathologie und Therapip,” 1895, S. 231. ‘ The Nervous Affections of the Heart,” 1904, p. 18. The Lancet, 1873, Vol. II., p. 727. ^ ‘‘Lemons sur TAppareil Vaso-moteur,” 1875, Tome 2, p. 327. Itevue de Mddecine, 1890, p. 374.