Selected essays and monographs : translations and reprints from various sources.

Date:
1897
Catalogue details

Licence: Public Domain Mark

Credit: Selected essays and monographs : translations and reprints from various sources. Source: Wellcome Collection.

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    EARLY SYMPTOMS. extremity, although this was much more atrophied. This muscular and cutaneous anaesthesia, as a rule, only supervenes in those patients who have experienced pain in the affected regions, which pain has been attributed to rheumatism. It will be shown that it is only a complication, or rather an extension of the anatomical lesion to the posterior horns of the cord.” From this quotation it is very evident that Duchenne had examined cases of syringomyelia, and his description, although incomplete, is still correct at the present day. But since the time of Duchenne, several important obser- vations, based upon a methodical examination of the various forms of sensation, permit us to study in a more perfect manner the symptomatology of this disease. The following account is based on a large number of cases scattered throughout medical literature. We have collected the most characteristic at the end of the present work, adding to them eight cases of our own. Syringomyelia generally makes its appearance in early life, and manifests itself by the disturbances of sensation, which are usually the earliest symptoms. These consist of loss of sensibility to pain and to temperature, with preservation of the sense of touch and of muscular sense. Professor Charcot proposes to give the name of “ dissociation syringomyelique ” to this group of sensory phenomena. We do not mean to infer that these symptoms are pathognomonic of syringomyelia; for instance, it is well known that they may be present in hysteria, but in no other well-recognized affection of the spinal cord are they to be met with in the same definite manner. It is only in rare cases, however, that one has the opportunity of observing this partial paralysis of sensation without complications. In such a case the patient is not conscious of his affliction; he experiences no inconvenience, he has no pain, and does not seek medical advice since he does not perceive that he is ill. On the other hand he is astonished on finding that he has burnt himself without experiencing pain, or that he has wounds, the origin of which he is ignorant, and of which he only becomes conscious by his other senses. The first symptoms which attract the atten- tion of the patient and of the physician are those of progressive atrophy of muscles, beginning usually in the hand and making
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