A system of practical medicine. By American authors. Vol. 5 : $b Diseases of the nervous system
Science
A system of practical medicine. By American authors. Vol. 5 : $b Diseases of the nervous system
Medicine -- Practice
Numbness, formication, etc. occur in a vast number of nervous
affections—in cerebral and spinal organic lesions, in neuritis, in
toxic conditions, and in neuroses. The distribution of paræsthesiæ is
a valuable index to the seat of the lesion.
(_c_) Cutaneous itching and prickling may occur independently of any
other skin lesion, constituting true or nervous prurigo. This may be
universal and last for years.
(_d_) Paræsthesiæ of pressure are felt either as expansive or
constrictive. The part appears swollen to consciousness, or it seems
to be tightly compressed. Both these sensations are often felt about
the head in a variety of pathological states, and an absurd and
dangerous fashion has arisen of looking upon a sense of fulness in the
head as indicative of hyperæmia. The sense of constriction may show
itself around one toe, a leg, the trunk, around the neck, etc.; it may
be narrow, like a cord, or broad and extensive, like a stocking or
corset. Sometimes it is localized, and likened to the grasp of a hand
or a spot-pressure. Not infrequently, especially in cases of
paraplegia, the sensation of pressure is combined with subjective
cold, the legs feeling as if tightly encased in ice.
(_e_) Subjective sensations of heat and cold are often of the
strongest kind, and are very distressing. A part whose real objective
temperature is normal may appear to the patient's consciousness as icy
cold or burning hot, even to the degree of apparent contact of fire
(causalgia of Mitchell). We observe such sensations in posterior
spinal sclerosis, myelitis, neuritis, injuries to nerves. In some
functional cases complaint is made of patches of hot or cold skin, not
relieved by cold or heat.
(_f_) Odd sensations, such as rolling or longitudinal motion of
something under the skin, general or local throbbing, coition
movements, are described, especially in functional or hysteroid cases.
(_g_) Sensations of hunger, thirst, dyspnœa, defecation, micturition,
the sexual feeling, may all appear in an abnormal or unprovoked
manner, and are to be classed as visceral paræsthesiæ. An important
paræsthesia of this variety is met with in cases of hypochondriasis
and melancholia; it is a sense of indescribable distress, with
constriction, usually at the epigastrium and about the heart—the
precordialangst of the Germans, or, as we would term it, præcordial
anguish.
(_h_) Paræsthesiæ of the muscular sense occur. The subject has a
feeling as if a part were lying in an unnatural position, or as if it
were being pulled or twisted in various ways, and he is sometimes
obliged to assure himself by the use of sight and by tactile
examination that the sensation is illusory.
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