The patellar tendon reflex : read before the Medico-Chirurgical Society of Edinburgh on June 4, 1879 / by Byrom Bramwell.

  • Bramwell, Byrom, Sir, 1847-1931.
Date:
1879
Catalogue details

Licence: Public Domain Mark

Credit: The patellar tendon reflex : read before the Medico-Chirurgical Society of Edinburgh on June 4, 1879 / by Byrom Bramwell. Source: Wellcome Collection.

Provider: This material has been provided by The University of Glasgow Library. The original may be consulted at The University of Glasgow Library.

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    Case 4.—Locomotor Ataxy—Typical Case—Tendon Reflex absent. C. W., aged forty-five, mari-ied, a rivetter, was admitted to the Newcastle-on-Tyne Infirmary, under my care, on October 3, 1878, suffering from locomotor ataxy. Previous History.—The disease has been characteristically marked for five years. He was under my care four years ago. The first symptoms were rheumatic pains and double vision j this was so bad that he had to close the left eye when at work. The rheumatic pains began to trouble him about six years ago. Unsteadiness of gait commenced about a year after the pains, and rapidly got worse. He has been under my care, every now and again, during the past four years. Twenty years ago he had syphilis. He has been a hard drinker, and much given to sexual excess. Family History.—None of his relatives have suffered from nerve disorders. Present Condition.— The gait is the most typical, the patient being unable to advance a step when his eyes are raised from the ground; the legs are thrown out wildly, and the heels come down with the characteristic stamp. The muscular force of the lower extremities is very great, the muscles being powerfully developed. There is most marked loss of co- ordination and of the muscular sense. SensibiUty of all sorts (tickling, power of localising impressions, pain, tem- perature) is very much impaired. When the eyes are bandaged he cannot tell the position of his legs, and is unable to place his feet in any given j)osition. He is quite unable to stand with his eyes shut, even when the feet are placed wide apai?t. The power of distinguishing weights is very defective. The patellar tendon reflex and skin reflex are quite absent. There is some loss of tone in the bladder. The bowels are obstinately constipated. Sexual power is much weakened. He frequently suffers from sharp, shooting pains in the lower extremities, and complains of numbness in the soles of the feet. He feels as if he were standing on something soft, but has no tight band round the abdomen. The contractUity of the muscles of the lower extremities is