AN INTERESTING NEURITIS, 



By F. D. Barker. Ph. M., M. D., Dayton, O. 



The patient. Dr. G., is a dentist, 48 years old. For sev- 

 eral years prior to 1890, there was slight twitching of the mus- 

 cles on right side of neck. General health was good. He was 

 a moderate though regular drinker. 



In 1889 the twitching (chorea) increased till it became quite 

 annoying. In January, 1890, he had a severe attack of La 

 Grippe. The chorea increased under the best treatment attain- 

 able. Later the Doctor's general health improved, but a con- 

 dition of " spasmodic wry-neck " developed with considerable 

 deformity and great pain. Any attempt to maintain an erect 

 posture was accompanied by powerful contractions of the right 

 cervical muscles, drawing the head downward and to the side. 

 These spasms were accompanied by most excruciating pain. 



In June, 1890, two operations were performed by a Co- 

 lumbus, Ohio, surgeon, first making simple section and then 

 excising the Spinal Accessory nerve. Neither operation was of 

 any benefit. The skill of this surgeon is such that it is unlikely 

 that he failed to reach the Spinal Accessory. 



The patient's condition remained unchanged till in April, 

 1892, when he came to me for operation. May 5th, a subcu- 

 taneous tenotomy was done, cutting off the Sterno-cleido-mast- 

 oid at its insertion into the collar bone. The antiseptic dress- 

 ings were removed on the fifth day, when the wound was healed. 

 From this operation the Sterno-mastoid ceased to draw the head 

 forward. It was, however, still drawn hard and strong to the 

 side and somewhat backward. 



On June 5th, I excised the posterior branches of the cer- 

 vical nerves supplying the powerful group of muscles on right 

 side and back of neck, including the Trapezius, Levator Anguli 

 Scapulae, Trachelo-mastoid and Complexus. 



This necessarily was a long and tedious operation. The 

 patient was anaesthetized face down. A free incision was made 



