File:Railway and other accidents with relation to injury and disease of the nervous system - a book for court use (1904) (14574536559).jpg

Identifier: railwayotheracci00hami (find matches)
Title: Railway and other accidents with relation to injury and disease of the nervous system : a book for court use
Year: 1904 (1900s)
Authors: Hamilton, Allan McLane, 1848-1919
Subjects: Railroad accidents Nervous system Medical jurisprudence Accidents Jurisprudence
Publisher: New York : Wood
Contributing Library: Francis A. Countway Library of Medicine
Digitizing Sponsor: Open Knowledge Commons and Harvard Medical School

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pillary insensibilityto direct light stimulation, with conservation of power foraccommodation (Argyll-Robertson symptom), diplopia;dysuria, sexual weakness, constipation, joint weariness,loss of knee-jerk and other deep reflexes, arthropathies,etc., are followed by the characteristic ataxic gait, diffi-culty in turning or descending inclined surfaces or steps,sudden inhibition of muscular power through fear, gradu-ally developing optic-nerve atrophy, while subsequentparalysis and atrophy of the affected muscles and pos-sible exaggeration of the knee-jerks occur when otherparts of the cord than the posterior columns are invadedby the degenerative process. True tabes is manifestedby a certain similarity of symptoms, the nature of thepains and their method of occurrence being very muchalike in a given number of cases which are compared, andthey are usually associated in active cases with gastric,laryngeal, rectal, or vesical crises, although in many cases 198 RAILWAY AND OTHER ACCIDENTS.
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Fig. 24.—a, Gait in Traumatic Locomotor Ataxia ;B, Static Ataxia in the same case. (Cinemato-graph by author.) there may be littleor no pain. Thesame is true of thedistribution of an-esthesia, which, ifplantar, is morecommonly found atthe outer edge ofthe foot, or, if oc-curring in the up-per extremities, af-fects the ulnar sideof the forearm andhand. The arthro-pathies, althoughcomparatively rare,cannot by any well-informed physicianbe long mistakenfor any other formof joint enlarge-ment ; even whenoccurring after in-jury they have acharacter of theirown, and are, asCharcot first point-ed out, quite insep-arable from spinal-cord degeneration,and when foundhave been precededin every case by INJURIES OF THE VERTEBRAL COLUMN. 199 some of the peculiar symptoms of the spinal affection.In some cases of fracture, an accident to which tabeticsare prone, it will not be difficult to get a history. The samemay be said of perforating ulcers and of the earlier trophicdisorders, which by the uni

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