On a prolonged first stage of Tabes dorsalis : amaurosis, lightning pains, recurrent herps; no ataxia; absence of patella tenson reflex / by Thomas Buzzard.

  • Buzzard, Thomas.
Date:
[1878?]
Catalogue details

Licence: Public Domain Mark

Credit: On a prolonged first stage of Tabes dorsalis : amaurosis, lightning pains, recurrent herps; no ataxia; absence of patella tenson reflex / by Thomas Buzzard. Source: Wellcome Collection.

Provider: This material has been provided by UCL Library Services. The original may be consulted at UCL (University College London)

    2/16 (page 2)
    amination showed that the knee-phenomenon was absolutely- wanting in the left leg, whilst it was present, but not strongly marked, in the right. The patient's gait was not ataxic. No sensory troubles of the left leg appeared objectively, nor was there loss of muscular sense, as tested by closing the eyes. In spite of all this the case was certainly one of tabes, for there was, besides the pains, white atrophy of the optic nerves, inequality of pupils, along with very frequent and scanty urination. In all the cases of confirmed tabes in which I have used this test since I became acquainted with Dr. Westphal's suggestion, I have found, as he has done, that the knee-phenomenon was absent. The case which I proceed to relate is one which goes to confirm the diagnostic value of the symptom described. It is one of the nature of which there can, I think, be no question; and it is published, not only on account of the support which it lends to Dr. Westphal's valuable suggestion, but also from the extreme interest which attaches to some of its other symptoms. Amongst these are the great prolongation (already, if we include the two years of herpes unaccompanied by pains, seventeen years) of the first stage of tabes—the remarkable recurrence of herpes every few wrecks during fourteen years, as well as certain points connected with the slight amount of vision which still remains in the amaurotic eyes. It was in April 1864, just fourteen years ago, that I first examined A. B., who was then 36 years of age. His complaint was of bad nights, and troubles in his organs of digestion. Incidentally he mentioned to me the state of his sight, which had become greatly impaired. With the right eye he could only discern light from darkness; with his left he could recog- nise faces, but all outlines were blurred and confused. He had consulted several ophthalmologists on account of his eyes, and they had described his disease, he told me, as atrophy of the optic nerves. For this he had undergone a variety of treat- ment, including hypodermic injection of strychnia and the application of the constant current, without any effect. Family history.—His father, who was gouty, died at 61 years of age. His mother, who was then still living, had always