Volume 1

Clinical lectures on the diseases of the nervous system : delivered at the infirmary of La Saltpêtrière / by J.M. Charcot ; translated by Thomas Savill.

Charcot, J. M. (Jean Martin), 1825-1893.

Date:: 1889

Credit: Clinical lectures on the diseases of the nervous system : delivered at the infirmary of La Saltpêtrière / by J.M. Charcot ; translated by Thomas Savill. 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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$are slightly bent and gathered together. Both hands are disposed in the same manner. The legs approximate, though the knees do not touch. If the legs are separated, the equilibrium becomes uncertain. Whether the eyes are open or closed the attitude of the patient is the same. She sits down heavily, and all of a sudden. She cannot rise until she get assistance, and even then the attendants have to use strength to raise her. After hesitating, she begins to walk, advancing first with short steps, afterwards hurriedly,—there \s> propidsion. Some- times, says Gav— I am driven very far, until I meet a wall,— and if I don^'t, I fall. The existence of retropulsion is also marked; to observe it, it is only necessary to pull the patient gently by the skirt,—the method adopted by M. Charcot. Immediately she begins to walk backwards, and with such rapidity that she would soon fall if not watched. The hesitation of the patient, before returning, is greater than before beginning to walk. The trembling is scarcely noticeable, especially when she is at rest. The head trembles, at times, a little more than the hands. When these are hanging by the side, they generally remain motion- less. The patient can incline her head more than it usually is in- clined, but it is impossible for her to raise it in extension completely, because the vertebral column is stiff. Neither cephalalgia, nor vertigo, nor giddiness. The intellect is preserved and the memory good. Her sleep is less abridged than we find to be the case with most patients suffering from the same complaint. She would even sleep well if she were not frequently waked up by pains in the heel that prick me, and you^d think ^twas water running inside the heel.^' She complains of a constant feeling of heat, and only keeps a sheet over her even in winter time. We have mentioned the state of her strength, measured by the dynamometer (Note to Lecture Y) and that of her temperature, so we shall not revert to these points. July, 1875.—The weakness has gone on increasing. The general attitude remains the same; however, the head and trunk are more and more inclined forward; besides, a sort of lateral inclination has occurred, in consequence of which the right half of the body pre- cedes the left half in walking. At present, the lips are almost always adherent each to the other; the upper lip is puckered; sometimes, according to the patient, both of them are stiff. The dental arches are not pressed$