Author Description

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. 1911 Excerpt:...This co-existence of meningeal, root, and cord symptoms, this multiplicity and incompleteness of clinical signs are in themselves somewhat characteristic, but the most convincing evidence of the specific nature of the process is furnished by the course of the disease, the inconstancy, the remissions, and the fluctuations in the severity of the symptoms. Thus there may be a sudden onset of paresis in one or both legs, or the paresis may, without warning, develop into paraplegia, which again may as rapidly change back into paraparesis or to paresis of one leg. I have, for instance, seen one case in which, during the course of a few weeks, there were four attacks of paraparesis, and another in which the spinal hemiplegia came and went three times during a short period of time. As one examines the case marked fluctuations in the intensity and extent of the motor disorders may be found from d&y to day. The bladder and sensory symptoms also show the same variability. This fluctuation is particularly characteristic with regard to the tendon reflexes; thus the knee jerks were in some cases quite absent at certain times, present a few days later, and at other times were markedly exaggerated. In one case of this kind I found the posterior roots in the upper lumbar region embedded in granulation tissue and partially atrophied, and I thought that this variability of the symptoms might be due to alterations of pressure within the membranes. Although this variability may occur in other diseases, such as sarcomatosis of the spinal cord (Nonne, 1 Prog, mid., 1897. « A. f. P., xxxvii. Mamlock1), it has been very pronounced in many cases of spinal syphilis. Ataxia is a not uncommon symptom, and it may also show the same inconstant character Finally, we must refer to...