Spondylotherapy : physio and pharmaco-therapy and diagnostic methods based on a study of clinical physiology / by Albert Abrams.

  • Abrams, Albert, 1863-1924.
Date:
1918
Catalogue details

Licence: In copyright

Credit: Spondylotherapy : physio and pharmaco-therapy and diagnostic methods based on a study of clinical physiology / by Albert Abrams. Source: Wellcome Collection.

    55/1092 (page 29)
    Now, in locomotor ataxia, the knee-jerk is abolished, owing to involvement of a part of the reflex arc (the afferent or sensory path), and when the knee-jerk is elicited in the usual way, it may be difficult to say whether any other part of the arc in question is implicated. If one can provoke the central quadriceps reflex, one can at least conclude that the descending paths (efferent or motor) are intact. For a like reason a peripheral neuritis may be difficult to differen¬ tiate from locomotor ataxia owing to involvement of the peripheral sensory nerves. In a number of patients with locomotor ataxia examined by the author, a quadriceps reflex was usually present, and in a number of instances an exaggerated knee-jerk was obtainable on either one or the other leg. Usually it was absent in the more atactic leg or in advanced stages of the disease. Here one was constrained to conclude that when the knee-jerk was obtainable, the posterior root-fibers were not entirely destroyed. It was also found that the Achilles reflex could be elicited (corresponding to segment V of the medulla lumbalis, Fig. 14) in a number of cases of loco¬ motor ataxia by sinusoidalization over the sacrococcygeal articulation. The elicitation of the vertebral reflexes directs reference to a mooted point in physiology, viz., whether the tendon reflexes are or are not true reflexes. According to the prevailing opinion, they are not true reflexes but are due to direct stimulation of the muscle itself. The author questions the correctness of the latter observation insomuch as a veritable Achilles reflex and knee-jerk can be elicited in the norm by vertebral stimulation.* *The author is convinced that this subject embraces a field of research of vast im¬ portance to the neurologist. Man is available for experimentation for, in the study of the vertebral reflexes, they can be evoked with an accuracy almost equal to their elicitation by vivisection.