Proceedings of Societies

Abstract

The concurrence of the renal and cerebral symptoms was singular. When the urine became freer from blood corpuscles and casts, the amaurosis gradually decreased, when an attack of congestion of the kidneys supervened, facial paralysis occurred, and with the return of the urine to its normal state, gradually vanished. We must admit that idiosyncrasy must have had much to do with the facility with which our patient's brain became affected, for it is by no means common to find such severe brain symptoms with the earlier stages of a sub-acute nephritis. The possibility of paralysis occurring without actual cerebral lesion, or pressure, or solution of continuity at some point in the course of the nerve in fault, is a matter of experience. A man, Bacon by name, came into the hospital under my care, with the lower extremities cedematous, the urine highly albuminious, and containing fatty epithelium, and became suddenly paralysed in the left arm and leg; sensation remained. The face was not affected. I examined him carefully several times during the day ; the loss of power over the limbs was perfect. In fifty-six hours he had recovered the power of movement to a certain extent. He died from pericarditis some few days after the paralysis had left him. I examined the brain and upper part of the spinal cord most carefully, without finding the least evidence of there being, or having been, sufficient disease to explain the occurrence of so considerable a paralysis. The corpora striata and grey substance generally, were paler than usual. The kidneys were far advanced in Bright's disease. We constantly see the functions of the superficies of the brain partly arrested or perverted, by the action of blood poisons, and the two cases I have recorded appear to demonstrate that other parts of the brain are within the influence of morbid matters in the circulating fluid.