Lectres on the localisation of cerebral and spinal diseases delivered at the Faculty of Medicine of Paris / Translated and edited by Walter Baugh Hadden.

  • Charcot, Jean Martin.
Date:
1883
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Licence: Public Domain Mark

Credit: Lectres on the localisation of cerebral and spinal diseases delivered at the Faculty of Medicine of Paris / Translated and edited by Walter Baugh Hadden. Source: Wellcome Collection.

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

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    What, too, Avas the condition of the tcndon-reflcxcs. Tlicre is no reference to these points. (3) In another case of the same nature (Pick's), althougli there was no contracture,, the patient was liable to involuntary shakings. Now these tremblings, like exaggeration of the tendon- reflexes, are phenomena of similar or identical origin, and closely allied to contracture. As to the reflexes, in this observation as in the preceding there was no allusion to them. (4) There remain, then, only Leyden's four or five contra- dictory cases. Now, as regards the tendon-reflexes, Leyden does not think that absence of the reflexes was unremarked in any of his observations. In this respect, however. Observation II in his memoir is exceptional, for he says, the tendon-reflexes of the knee are distinctly present.Contracture never existed ; at the most a certain amount of rigidity determined by the habit- ual position of the limbs might be granted, this rigidity being perceptible in the knees, shoulders, and elbows. Seeing that articular rigidity, pure and simple, in the case of flaccid paralysis, appears to be a very improbable occurrence, is it not much more natural to look upon this rigidity as a feeble degree of contracture, as the state characteristic of morbid yet still active muscular tissue, and which, in a word, is sufficient to maintain that amount of adhesion between the articular sur- faces, which gives rise to the peculiar sensation of resistance called flexibilitas cerea. This, however, is not Leyden^s opinion. He enumerates other signs of contracture, such as flexion of the fingers with inability to extend them and provoked trembling.^ This phenomenon is common in the state of permanent con- tracture and has long been noticed in the contracture of hemi- plegic patients. Professor Leyden likewise calls attention to the trembling which accompanies the movements of progression and on which M. Charcot has laid such great stress as being a cause of considerable embarrassment in walking. Now, in one of Leyden's patients, the gait was not merely difficult, but ^ Sehnenreflexe am Knie sind cleutlicli vorhanden, ' Arch. f. Psjch.,' 1878, viii Bd., 3 Heft, p. 675. - Die Finger konnen nicht gestreckt werden, und beim versnch der Bewegung, tiitt ein eigenthiimliches leichtes Littern ein, loc. cit.