TWO CASES OF PROGRESSIVE MUSCULAR DYSTROPHY


In this month of October the parents decided to take her to Johns Hopkins as the oracle of last resort. She stayed there in hospital for a week of observation and testing. Then the parents were given a letter signed by two heads of clinics stating the diagnosis, progressive muscular dystrophy, the prognosis, “no known cure,” a few years to live, not beyond ten years of age probably during which time she would become helpless and progressively weaker.


Since cases of progressive muscular dystrophy are rare, it is interesting to have two in one long practice. The first was reported to the I.H.A. in the early 1930s; it is sketched again here for purposes of comparison.

M.C. was four and a half years old when I first saw her in March, 1931. Up to about that time she had seemed to her parents a healthy child but her inheritance was bad. On the paternal side a great-grandmother had had tuberculosis, a grandmother cancer of the uterus, a grandfather died of spinal meningitis after hard drinking for many years. On the maternal side a great grandmother had had a paralytic stroke and a grandmother several strokes, an uncle died from a stroke, a great aunt had “leaky” heart valves, an aunt tuberculosis, an uncle paralysis from drinking jamaica ginger. The outlook from the point of view of heredity certainly was bad.

A year before I saw her, this child had been walking to her sisters school in the morning and again at noon, each way nine- tenths of a mile, making four miles five days a week. Also she took dancing lessons at that time.

At four and a half she was losing weight steadily, losing appetite, had increasingly poor color tending to be bluish in tint, was giving up play more and more to sit in on the sidelines, was developing fear of anything unusual. On physical examination hollows were noted where muscles ought to be, with a white nodular appearance of the skin over the hollow places. She would stumble and fall easily, would get down on her knees like an old person, would pull herself up with her arms, was very slow dressing and undressing. She had slight fever in spells.

I gave her Sulph. 10M in March and Calc. c. at the end of June. At that time her abdomen had become large and hard; she had noisy flatulence; her legs were looking like sticks. After the Calc., vitality and appetite improved, but the atrophy was progressive. By July she was apt to fall prone and strike her forehead. By October she was pulling herself upstairs with her hands on the banisters or hands on knees. She could not get up off the floor alone, could not get into a chair, had to be lifted, but she took more interest in life and in other children.

In this month of October the parents decided to take her to Johns Hopkins as the oracle of last resort. She stayed there in hospital for a week of observation and testing. Then the parents were given a letter signed by two heads of clinics stating the diagnosis, progressive muscular dystrophy, the prognosis, “no known cure,” a few years to live, not beyond ten years of age probably during which time she would become helpless and progressively weaker. So the despairing father and mother brought their child home and in a few days the father committed suicide because he could not face the future. This did not help matters any for the mother was left with two little children and a heavily mortgaged house.

I could think of only two remedies for this case, Calc. c. and Phos. I had her on one from June to November and on the other from November to January, 1932. Each one produced some improvement in strength, appetite and mental vigor, but neither produced a permanent gain or stopped the progress of the disease. By November it had become almost impossible for her to turn over in bed.

Then, on January 21st, I gave her Calc. phos. 10M and by February 17th, she looked decidedly better, had begun to gain weight. The muscles were really harder, more filled out, and she could handle herself slightly better.

From this time on changes for the better were steady and remarkable. In April she could run, picking feet up off the floor. In May she could walk and run normally. By August she could do almost anything other children could do, could go upstairs one foot over the other without holding the railing, could skip on one foot.

Julia M. Green