General paresis, practical and clinical / by Robert Howland Chase.

  • Robert Howland Chase
Date:
1902
Catalogue details

Licence: Public Domain Mark

Credit: General paresis, practical and clinical / by Robert Howland Chase. Source: Wellcome Collection.

Provider: This material has been provided by the Harvey Cushing/John Hay Whitney Medical Library at Yale University, through the Medical Heritage Library. The original may be consulted at the Harvey Cushing/John Hay Whitney Medical Library at Yale University.

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    into the face of the patient may cause unusual reac- tion. Clouston, Mickle and Folsom especially refer to this condition. A CASE OF EXCESSIVE REFLEX EXCITABILITY. In G. M. general paralysis began with aphasia. As he began to speak, the peculiar articulation was noticed and he died in about two years. In this case, the motor reflex excitabilitytof the brain and cord was greater than I have ever seen in any case whatever. A very slight tap on the toe would set up a convulsion, first in that leg, and then in the next, a slight puff suddenly into his face would make him jump wholly off his seat. (Abstract, Clouston, op. cit., p. 400.) The superficial reflexes may be lessened, lost, or increased at any period; as]a rule, the skin reflexes are often lessened or lost, which is particularly the condition in the last stage. Bianchi and Bettencourt-Rodrigues {vide Mickle) observed that in general paresis, expansive mental symptoms correspond to exaggerated reflexes, mental depression to lessened or abolished reflexes. But in the early stage of a typical case are exaggerated knee- jerks, and lessened or lost plantar reflex; and the early exaggeration of reflexes is supposedly related to the congestion, excitement, functional dynamic quasi-exaggeration of the early stages of general paresis. Lewis and others give exaggeration of the knee- jerk as the more frequent phenomenon; although they may be temporarily or permanently increased, normal, lessened or lost. He adds that it may be simply a functional disturbance, transient only, in- duced by nervous discharges from the cerebral cor- tex. If temporary, it is often found as the immediate result of a congestive seizure. On the other hand,