On the progressive locomotor ataxia : its history, symptomatology, pathology, and treatment / by Roberts Bartholow.

  • Bartholow, Roberts, 1831-1904.
Date:
1866
Catalogue details

Licence: Public Domain Mark

Credit: On the progressive locomotor ataxia : its history, symptomatology, pathology, and treatment / by Roberts Bartholow. Source: Wellcome Collection.

Provider: This material has been provided by The Royal College of Surgeons of England. The original may be consulted at The Royal College of Surgeons of England.

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    of this organ. Finally incomplete, and sometimes, complete paralysis is a remote termination of the malady. The anatomy and physiological pathology of this disease agree perfectly with this view. Considered with reference to the periods, it is certain that integrity of the muscular force is a character more constant in the second, although its diminution is an indication of aggravation of the lesion in the cord. Course and Duration.—The course of the malady has been suf- ficiently indicated in the preceding pages. The duration of the first period only, can be approximative^ fixed. We have before remarked that it oscillates between some months and twenty years; it averages from four to five years. From the origin of the disease, indicated with more or less clearness by the pains, the ocular troubles and the ataxia, to the second period—in 4 cases the duration is spoken of as months; in 6 cases as one year ; in 27, as from two to three years ; in 47, as from four to seven years; in 17, as from eight to fourteen years; in 18, as from fifteen to thirty years. The average is seven years. We have seen that in our patient Kelch, the duration of the first period, was somewhat less than one year—taking as the point of departure from the state of health, the sudden occurrence of spermatorrhoea. If, however, we assume that the ocular troubles were the first symptoms in his case, six months will in- clude the whole course of the malady, so far as it had developed itself. There can be no question that the sexual disorder was the first symptom. It will be perceived that the phenomena observed in his upper extremi- ties, were those of the first period, and not of the second. We have consequently no means of determining the duration of the first period if its evolution had not been interfered with it. As Topinard's statis- tics show, somewhat more than four per cent, had a duration less than one year. Complications.—These are divisible into two classes: those pertaining to the cerebro-spinal axis; those of other parts of the body. Among the first are spinal meningitis, congestion and softening of the cord and of the brain, general paralysis, and progressive muscular atrophy. Cephalalgia, dizziness and intellectual disorders which sometimes ac- company the ocular derangements, must be viewed as complications. Some patients complain of loss of memory, and forgetfulness of certain words, certain events, etc. Others present various hallucinations. Mania or dementia, is found at an advanced period—the termination of the second or in the third period. The complications of the second class are either acute or chronic. Of the acute affections, cystitis, enteritis and erysipelas are the most fre- quent. Cystitis usually results from the prolonged retention of the