Marked Rigidity Research Articles

DECEREBRATE RIGIDITY FOLLOWING ENCEPHALITIS

Postencephalitic muscular rigidity is not an uncommon occurrence and is seen most frequently in the parkinsonian states. Here it manifests itself as a mild to severe from of hypertonia with poverty of movement, relative motor weakness, parkinsonian attitude and other characteristics pointed out recently by Wilson.¹Occasionally, however, the rigidity that occurs after epidemic encephalitis is of such extreme degree as to make it the outstanding feature; it is as an illustration of this that our case is reported, the rigidity closely simulating decerebrate rigidity. In addition, the absence of pathologic reports in these cases makes such records desirable. That marked rigidity may occur as a sequel of other organic diseases than encephalitis has already been demonstrated both clinically and pathologically. Antheaume and Trepsat,²in 1920, reported a case of general paralysis in a patient, aged 43, with catatonia, cataleptic states and stereotypy. In 1923, Urechia and Elekes

STUDIES IN DECEREBRATION

In two previously published communications 1 it was pointed out that simultaneous ligation of the basilar and carotid arteries produced a decerebrate preparation which was free from the objections of mutilation and shock. In an article just published we 2 have described the results of destruction of the labyrinths in animals decerebrated by the anemic method. From this study it appeared that the labyrinths exert a strong influence on the extensor reflex of the neck, which tends to produce a fixed position of the head in extension, with a consequent marked extensor rigidity in the forelegs. Not only does this position evoke an extensor rigidity in the forelegs, but the play of labyrinthine tone on the extensors of the neck is sufficient alone to reinforce the extensors of the forelegs when the head is passively flexed in an ordinary decerebrate animal. When the labyrinths are destroyed and the head is

Gastric Ulcer Demonstrated by the Gas-Filled Stomach: Case Report

The patient was an unmarried female, aged 23, who entered the hospital February 7, 1926, with a temperature of 105.6° and the following chief complaints: Headache; abdominal pain; lumbar pain; vaccination on right thigh. Patient felt ill on the day preceding her entry to the hospital, had severe back pains and complained that “all her bones felt as if they would break.” Vomited several times before entering hospital; vomitus after entering was of greenish hue. Had abdominal pain and epigastric tenderness, but no diarrhea. No jaundice, no cough nor dyspnea since day of entrance, when back pain seemed to cause difficult respiration. Physical Examination. — (Abdomen) Slight area of distention in epigastrium, with regional tenderness. The lower abdomen was quite spastic; no tenderness; no marked rigidity. Tender area over region of stomach and pancreas. (Extremities) Vaccination area on right thigh. Progress Record February 8: Reaction from vaccination can account for all symptoms. February 10: Epigastric tenderness and some muscle spasm in this region. Vaccination not causing symptoms now, and evidence of pathology in upper abdomen quite marked. February 11: Pain and tenderness in upper abdomen suggestive of acute pancreatitis. Tenderness most marked on left side of abdomen near costal margin and area of left kidney. Impression is that of general blood infection, possibly from vaccination, but could be from other focus. February 12: Chest clear, no râles; heart regular, rapid, no irregular sounds ; extreme tenderness left kidney and spleen area; nausea produced by turning on right side. February 13: Left kidney area distinctly more swollen and tender, more marked than any other portion of the abdomen; right kidney area soft; twelfth rib easily felt; left rib cannot be felt. Advise X-ray of this area. X-ray Findings The radiograph showed both kidneys normal in size and position, with no evidence of calculus. Patient was much worse on the two following days and a radiograph of the epigastric region, including the upper border of both diaphragms, was made; this was the examination that showed up the gas-filled stomach. The X-ray work was done by portable as it was impossible to move the patient. The X-ray report of the epigastric region is as follows: “This shadow includes both diaphragms and extends down to the fourth lumbar. The diaphragms are apparently normal. There is a calculus about the size of a French pea, in the region of the pelvis of the right kidney. The stomach is well outlined, being markedly distended with gas. Pylorus is well up under the right costal margin, while the cardiac portion is pressing the left diaphragm. Underneath this we find a heavily outlined gas-filled transverse colon, showing in hoth the hepatic and splenic flexures.

Protoplasmic papillae of Echinarachnius oocytes

1. Unripe eggs ofEchinarachnius parma, with germinal vesicle intact, in the presence of sperm, give rise to protoplasmic processes protruding from the surface of the oocyte. These processes have been termed “oocyte papulae”. 2. The oocyte papillae may be fine threads, heavy club-shaped structures, or thin, broad films. 3. The papillae are of hyaline protoplasm, amoeboid in movement, and of temporary existence, persisting, on an average, some twenty minutes. 4. The papillae are apparenty functionless structures representing a premature response which, in the ripe ovum, or in the embryo, would produce similar but functional processes. 5. The gel nature of protoplasm is emphasized by the marked rigidity and elasticity of the oocyte papillae.

A CASE OF MENINGITIS DUE TO MICROCOCCUS CATARRHALIS

History. —S. J., a Jewish girl, aged 5 years, admitted to the pediatric service at the Boston City Hospital, March 2, 1923, two weeks previously had awakened at night with nausea and vomiting, a sore throat, and a temperature of 100 F. Five or six days before admission, she had a severe headache on the left side, associated with pain in the left ear, and became drowsy. The headache grew progressively worse and was present day and night. No history of convulsions or paralyses was obtained. Physical Examination. —The child, a well developed and well nourished girl, was irritable and uncooperative. She breathed rapidly, and the face was flushed, the tongue coated, and the pharynx injected. Marked rigidity of the neck was present, with pain on the slightest motion. The Kernig sign was positive. The temperature was elevated, and the pulse and respirations were increased. Examination of the urine was

NOTE ON THE BACTERIOLOGY OF THE SPINAL FLUID IN POLIOMYELITIS AND SCARLET FEVER

During the routine examination of a patient admitted to the contagious ward of the Cook County Hospital with a diagnosis of scarlet fever, a lumbar puncture was performed because of marked rigidity of the neck. The spinal fluid was under increased pressure, the cell count was 28, principally of lymphocytes, and the globulin tests were positive. The spinal fluid was inoculated into dextrose broth and dextrose agar, and a pure culture of a small gram-positive coccus was obtained within thirty-six hours. The organism exhibited both the cultural and the morphologic characteristics of the micrococcus described by Nuzum 1 as occurring in the cerebrospinal fluid in poliomyelitis. Repeated inoculations yielded pure cultures of the same micro-organism. From the nasal discharge a micrococcus was obtained resembling the organism in the spinal fluid. The organism from the nasal secretion was agglutinated by the antipoliomyelitic serum 2 in a dilution of 1:500; control organisms

RUPTURE OF GALL BLADDER OR DUCT FROM VOMITING.

<h3>RUPTURE OF GALL BLADDER OR DUCT.</h3><h3>Case 1.</h3> —A. C. D., aged 53. Four years ago, I am informed, he had two attacks of colic. Aug. 1, 1902, had an attack that resembled biliary colic. In each instance recovered promptly, with no evidence of gallstone in the intervals. On September 1 last I was called at 2 a. m. to see this patient, who was suffering severely from colic, with greatest pain over gall bladder. He was given a hypodermic of morphia and atropia, hot applications to abdomen. He became easier and I returned home. Two hours later I was again called. He had been vomiting and his pain was now excruciating, and there was marked rigidity of abdominal muscles, with decided localization of pain under the right costal arch. I believed perforation of gall bladder or duct was imminent or had occurred. I returned at 8 o'clock, when his