1829 The Lancet  
17, was admitted into Colston's Ward at eleven o'clock P.M., March 24, under the care of Mr. Vincent, with spasmodic contraction of the muscles of the superior and inferior extremities. About five weeks ago, he was occasionally seized, for about an hour and a half at a time, with spasmodic contraction of the muscles, principally about the hands and toes, but it went off without any medical treatment. About five o'clock, on the even. ing of admission, he was again seized with a more violent
more » ... k than any that had preceded. The arm and legs were drawn up in a manner that gave him more the appearance of a trussed fowl than any thing else. One or two fingers were contracted, a few others extended ; so also were the toes. Was quite unable to stand or move. Was not sensible of any material pain. The wrists and toe-joints a little swollen, and had a burning sensation. Was not aware of having caught a violent cold, or of any cause likely to have produced this state of the muscles. Nothing done for him tonight, but ordered to be kept quiet. 25. Ordered forty drops of laudanum, and afterwards hydrg. sub., 4 grs. ; jalap, 1.5 grs. Much the same. 26. To be cupped from the neck and loins to twelve ounces, and to rub a drachm of the unguent bydrarg. on the limbs night and morning. 27. Feels much better to-day. The toes seem quite recovered. Can move the arms with a degree of facility, except at the wrist-joints, the hands being drawn in towards the internal surface of the forearm. The wrist-joints are swollen, and preternaturally hot. Describes the heat to be more violent at one time than another. When the temperature is at the highest, the painful sensation is most severe. Can stretch out the legs with ease. Ordered Cotchicuna Llritae, a drachm every six hours. 28. Continues recovering, though the swelling, stiffness, heat, and contraction, still continue about the wrist-joints. April 7. Has continued gradually to improve, though he still feels a slight stiffness and inconvenience, particularly in some of the finger-joints. Left the hospital this day, DISEASE OF THE TOES AND NAILS. Thomas Crouch, ætat. 27, was admitted, March 27, into Henry the Eighth's Ward, under the care of Mr. Lawrence, with inflammation of the toes, ulceration of the beds of the nails, and on the outside of the right foot a very foetid discharge. The patient was a coachman to a gentleman in the Kent Road; has light hair and a fair countenance. About three months ago, felt shooting pains throughout the foot, as high as the ancle ; soon afterwards they both presented a scarlet appearance, and the beds of the nails became ulcerated. Seven weeks ago, the nails were removed by a medical gentleman, and the parts of the new nails which appear at present, are more a source of irritation than any thing else ; they have also a black unhealthy appearance. The great toe, and two toes next to it, of the left foot and the great and little toes of the right foot, areemuch swollen, of a dark purple colour, approaching in appearance to that of mortified parts. A considerable quantity of foetid sanious matter exudes from the points of the nails, from between the toes, and from the outer
doi:10.1016/s0140-6736(02)92355-x fatcat:vr2ovqacmfczxhrhzgd54uhnxu