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On chorea and choreiform affections [Tapa blanda]

Sir William Osler

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This historic book may have numerous typos and missing text. Purchasers can download a free scanned copy of the original book (without typos) from the publisher. Not indexed. Not illustrated. 1894 edition. Excerpt: ... the first indication of any toxic symptoms, such as vomiting, diarrhoea, itching of the eye-lids, oedema, or skin eruptions. Pigmentation of the skin is occasionally met with; a more serious effect is neuritis, of which there have been 1 MedicoChirtirgical Transactions, Vol. IV, 1813. recently several cases reported. Considering the rarity of this toxic action upon the nerves, the cases in which it occurs must be regarded as instances of idiosyncrasy. Thus Marshall reports1 a case of neuritis and pigmentation in a boy of six years of age, who had taken Fowler's solution of arsenic, n x t. d., for about five weeks. The zinc compounds were much used during the first half of this century. Of other remedies cimicifuga, antipyrin in full doses, that is from twenty to sixty grains in the day, chloral, exalgine, sulphonal, and physostigmine have all been warmly recommended. Recently H. C. Wood has urged the use of quinine in large doses, and has reported very favourable results. Certain features and complications require special treatment. In the cases with arthritis the joints should be wrapped carefully in cottonwool, and opiates may be needed to allay the pain. The salicylates may, of course, be tried, but in the arthritis associated with chorea we rarely see the prompt and satisfactory results so constant in acute rheumatism. Should pericarditis or endocarditis supervene, the icebag may be kept applied to the praecordia. It allays the cardiac excitement, and in the former condition checks, I believe, the tendency to exudation. In the chorea insaniens hydrotherapy should be thoroughly tried, either in the form of the wet-pack or the bath. In order to apply the pack or put the patient in the bath it may be necessary at first to give chloroform, which...

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5.0 de un máximo de 5 estrellas A masterpiece 7 de enero de 2012
Por Rosario Trifiletti - Publicado en Amazon.com
Formato:Tapa blanda|Compra verificada por Amazon
All neurologists and psychiatrists should read this book. Osler is to Medicine as Einstein is to Physics.

After reading it, you will get a profound sense that medicine today is very very broken. What doctor today has the time to study and describe patients in the incredible detail and accuracy of Osler? Where is today's Osler - he or she are certainly not one of those doctors on television promoting their vitamins and diet products. Osler was a champion of therapeutic nihilism - and he was and, to a large extent, still is, right.

If you know anything about chorea - you will realize that Osler is describing primarily three conditions:

1. A very old disease - Sydenham chorea - "Chorea major"

2. A very new disease - PANDAS/PANS - "Chorea minor"

3. A very complex disease - Hereditary chorea - primarily Huntington's disease but many others making up the "olla podrida" of Chorea.

In case your wondering, I graduated from Johns Hopkins Med, where we worship Osler second only to Christ.
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