Lectures on the diseases of the nervous system / Delivered at La Salpêtrière. By J.M. Charcot. 2d series. Translated and edited by George Sigerson.

  • Charcot, J. M. (Jean Martin), 1825-1893.
Date:
1881
Catalogue details

Licence: Public Domain Mark

Credit: Lectures on the diseases of the nervous system / Delivered at La Salpêtrière. By J.M. Charcot. 2d series. Translated and edited by George Sigerson. Source: Wellcome Collection.

Provider: This material has been provided by the Francis A. Countway Library of Medicine, through the Medical Heritage Library. The original may be consulted at the Francis A. Countway Library of Medicine, Harvard Medical School.

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    To sum up : when ascending secondary sclerosis remains, as the rule is, limited to the median fascicles of the posterior columns, you observe in the upper extremities neither paralysis, nor contrac- ture, nor ataxic movements. If, on the contrary, the external bands are invaded, the superior extremities will be attacked by motor incoordination. Finally, the paralysis and the contracture would appear in cases where the consecutive sclerosis should occupy, to an intense degree, the lateral columns throughout the whole height of the cervical enlargement of the spinal cord. III. It is time, gentlemen, to enter upon the principal object of this conference. We have, you remember, to study some points in the clinical history of progressive locomotor ataxia, which are little known, or, at all events in my judgment, insufficiently known. If the cases which are about to engage our attention diverge all, though in different degrees, from the common type, they yet all are related to it by some essential features which never absolutely fail. It seems to me useful, before entering into details, to recall in a few words the fundamental characters of the most common type. We shall be the better able, after that, knowing the analogies, to set out and define the contrasts. You have in your minds the description of locomotor ataxia as it was laid down by M. Duchenne (de Boulogne). It will not there- fore be necessary to enter into long details to refresh your memory concerning, at least, its principal lines. All of you know that progressive locomotor ataxia is a primary chronic disease, which attacks different parts of the nervous system simultaneously, and which, as a general rule—there are some qualifications to be made on this point—as it advances almost inevitably becomes worse. The spinal lesion, to which our attention has chiefly been given hitherto, does not always, of itself alone, constitute the anatomo- pathological ground-work. To it are referred the symptoms termed ■spinal3 which, undoubtedly, form one of the most salient aspects of the symptomatic picture; but it is rare that these exist separately. Usually, there is superadded a whole group of phenomena, which are generally known as cephalic symptoms, and whose starting point is a lesion of the cerebral or bulbar nerves, such as the optic nerves, for instance, or the motor nerves of the eye. In this relation, we can draw a parallel between progressive loco-