of full doses of the testicular fluid was given. A rapidly
interrupted faradic current, with an uncovered electrode, to the
neighborhood of the rectum, bladder, and buttocks, greatly relieved the
anaesthesia, upon which galvanism had no effect; and, in brief, from a
state which looked almost as if the last paralytic stage of tabes had
suddenly come upon him, he recovered in two months, and is now (July,
1899) better than he was a year ago, before the relapse, and will
probably remain so, as he has had his warning.
Without multiplying case histories, it may be said that ataxic
paraplegia (a combination of lateral and posterior sclerosis) may be
treated in much the same manner. In this disease there is usually much
less pain than in ataxia, but greater weakness, and late in its course
some rigidity in the extensor groups of the legs; the knee-jerk is
preserved or exaggerated. The disease is a rare one. But two recent
distinct cases are in my list, and one of these, the one here reported,
seems rather more like an ataxia with some anomalous symptoms. The
second one had the symptom, uncommon in this malady, of very frequent
and excessively severe stabbing pains, and though his co-ordination grew
somewhat better, he improved very little in any other way, which, as his
trouble was of fourteen years standing, was not astonishing.
The other patient, seen in 1897, was a rancher from New Mexico,
thirty-three years old, who had led an active, hard-working,
much-exposed life, but had been perfectly well until 1891, when he was
said to have had an attack of spinal meningitis, from which he recovered
very slowly. Four years later he noticed numbness of feet and weakness
of legs, great enough to make it hard for him to get a leg over his
horse. Some pains were felt in the limbs, and a constriction about the
chest and abdomen, which had steadily increased in severity. Sharp
attacks left distinct bruise-marks at the seat of pain each time. Could
not empty bladder. Gait feeble, spastic, and paralytic, could not mount
steps at all or stand without aid, sway very great. Knee-jerks and
muscle-jerks increased, especially on left; ankle-clonus; very slight
loss of touch-acuity in lower half of body. Eyes: muscles and
eye-grounds negative; pupils equal and active. Bladder could not be
emptied; cystitis. Ordered rest, massage, electricity, and full doses of
iodide in skimmed milk. In this way he was able to take without distress
or indigesti
|