The importance of early diagnosis of tabes and cerebro-spinal lues / by Tom A. Williams.

  • Williams, Tom A. (Tom Alfred), 1870-
Date:
1909
Catalogue details

Licence: In copyright

Credit: The importance of early diagnosis of tabes and cerebro-spinal lues / by Tom A. Williams. 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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    Extractc m “The Archives of Diagnosis,” New York, July, 1909 AND CEREBRO-SPINAL LUES By TOM A. WILLIAMS Washington, D. C. Now that the troponema pallida and the Wassermann reaction are accepted facts, there is less excuse than ever for loss of time in beginning the treatment of organic disease of the central nervous system. Moreover, it is now unpardonable to experiment with mercurial treatment because of a remote chance that the patient’s symptoms may arise from syphilis; for in the non-syphilitic diseases of the nervous system, early diagnosis and appropriate treatment are just as important, and often as successful as in the former. Surgeons have been particularly guilty in this respect; but there is no longer the faintest justification for the common procedure of permitting a spinal or cerebral tumor to grow for ten weeks while mercury is tried; for not only can the clinical neurologist in most cases diagnose this condition without assistance, but the laboratory affords irrefragable proof whether or not the lesion is specific. However, before applying to the patient so complicated and difficult a laboratory test as is even its simplification by Noguchi, it is as well to ascertain whether the clinical signs justify the essaying of the test. I do not refer to such obvious changes as the loss of the knee jerk and locomotor ataxia and reflex iridoplegia; for it is surely the aim of modern medicine to anticipate, and in doing so to prevent supervention of such gross and irreparable defects. It thus becomes necessary to suspect, even if not to diagnose, tabes dorsalis long be- fore the cardinal signs have shown themselves.