| Unequally sized pupils in combination
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| | nervous case that I remember was a very
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| with a drooping eyelid on the side of the
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| | remarkable one, and the first of its kind
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| smaller pupil and decreased sweating on
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| | ever recorded. It occurred while I was
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| the same side of the face is known as
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| | executive officer at the Satterlee
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| Horner's syndrome, named for Johann
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| | Hospital, West Philadelphia. As executive
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| Friedrich Horner, a Swiss ophthalmologist
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| | officer it was my duty to assign new
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| who wrote up a case in 1869. When
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| | patients to the wards, and also to
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| present, Horner's syndrome indicates
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| | transfer the cases in the specialties,
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| interruption of the sympathetic nervous
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| | such as the eye, nervous diseases, and
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| system on that side of the body and is
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| | injuries, etc., to the special hospitals.
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| still a valuable tool in modern
| |
| | One morning, as I sat at my desk, a
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| diagnosis.The sympathetic nervous system
| |
| | soldier applied for assignment. On
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| helps govern various functions outside
| |
| | looking up at him I said to myself: 'You
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| conscious control, like pulse, blood
| |
| | are Dalton's cat.'"Those familiar with
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| pressure, sweating, etc. The portion of
| |
| | Dalton's good old textbook of physiology
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| the sympathetic pathway influencing the
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| | will remember a cat whose right cervical
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| eyes and face follows a convoluted
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| | sympathetic nerve [the portion in the
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| pathway that starts in the brain and
| |
| | neck] had been severed. The left pupil is
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| flows down through the brainstem to the
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| | very large, the right one very small, and
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| spinal cord. At the base of the neck, the
| |
| | the moment I looked at this man I was
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| pathway passes outward from the spinal
| |
| | struck by the similar condition of his
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| cord and through the top of the lung.
| |
| | pupils. I quickly asked him, 'Where are
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| From there it rises through the neck
| |
| | you wounded?' and when he pointed to his
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| again and into the head where it finally
| |
| | neck I said to myself again, 'That ball
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| reaches the eye and face. A pair of
| |
| | destroyed the sympathetic nerve.'"In the
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| otherwise identical sympathetic pathways
| |
| | autumn of 1864 I took a copy of [our]
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| serves each side of the head.While
| |
| | book to Claude Bernard, in Paris, [a
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| Horner's observations were valid and the
| |
| | legendary physiologist and] the
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| syndrome has been known by his name ever
| |
| | discoverer of the function of the
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| since, he was not the first to recognize
| |
| | cervical sympathetic and the effect of
|
| this condition. Instead, an American
| |
| | its division [cutting] upon the pupil and
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| physician by the name of William Keen
| |
| | the blood vessels. He exhibited true
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| first diagnosed a case of "Horner's
| |
| | Gallic enthusiasm when I showed him the
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| syndrome" in an injured Union soldier
| |
| | first recorded case in the human subject,
|
| during the American Civil War. The
| |
| | which confirmed his brilliant
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| soldier, Edward Mooney, had been shot
| |
| | researches.""Dalton's cat" was a drawing
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| through the right side of his neck at the
| |
| | in John Call Dalton's "A Treatise on
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| battle of Chancellorsville.In 1864, along
| |
| | Human Physiology." Keen attended
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| with fellow physicians, Silas Weir
| |
| | Jefferson Medical College in Philadelphia
|
| Mitchell and George Morehouse, Keen
| |
| | between 1860 and 1862, and may have seen
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| published a small book, "Gunshot Wounds
| |
| | the drawing in either the first edition
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| and Other Injuries of the Nerves," that
| |
| | (1859) or second edition (1862). At a
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| included Mooney's case report under the
| |
| | time when medicine was struggling to gain
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| title "Wound of the Sympathetic Nerve."
| |
| | a scientific footing, Dalton's writings
|
| Fresh out of medical school when he
| |
| | were notable for being based on
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| entered military service, Keen made the
| |
| | experimental observations. Dalton was one
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| diagnosis upon recognizing the
| |
| | of America's first physiologists and had
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| similarities between the soldier's face
| |
| | studied with Claude Bernard after
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| and that of a cat illustrated in a
| |
| | graduating from Harvard Medical School in
|
| textbook of physiology.In 1905, near the
| |
| | 1847.(C) 2006 by Gary CordingleyGary
|
| end of Keen's career as a pioneering
| |
| | Cordingley, MD, PhD, is a clinical
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| neurosurgeon, the College of Physicians
| |
| | neurologist, teacher and researcher who
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| of Philadelphia published his
| |
| | works in Athens, Ohio.
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| reminiscences about the case:"The first
| |
| |
|
