Lectures on the diseases of the nervous system / Delivered at La Salpêtrière. By J.M. Charcot. 2d series. Translated and edited by George Sigerson.
- Jean-Martin Charcot
- Date:
- 1881
Licence: Public Domain Mark
Credit: Lectures on the diseases of the nervous system / Delivered at La Salpêtrière. By J.M. Charcot. 2d series. Translated and edited by George Sigerson. Source: Wellcome Collection.
Provider: This material has been provided by the Francis A. Countway Library of Medicine, through the Medical Heritage Library. The original may be consulted at the Francis A. Countway Library of Medicine, Harvard Medical School.
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![LATERAL FASCICULATED SCLEROSIS. 2J remind you, also, that, in Lewisson's experiments, acute irritation of the visceral nerves (renal and uterine) produced temporary paralysis in the lower limbs. However this may be, it seems very difficult to explain, by an action of this kind, permanent symptoms like ataxia, or paralysis with or without contracture of the superior extremities in the pathological cases which engage our attention. According to my judgment, we must seek the solution of this problem in the modifications which ascending consecutive sclerosis may, under certain circumstances, present. Thus, as I have pointed out to you, gentlemen, ascending Sclerosis, consecutive on partial lesions of the dorsal cord, keeps strictly limited, in the posterior columns, to the median fascicles. Such, at least, is the rule. Now, as was demonstrated in our last lecture, a lesion of the median fascicles, when occupying the cer- vical enlargement, has not the effect of determining the appearance of tabetic symptoms in the upper extremities. But, when once established, consecutive sclerosis may acquire an individual exist- ence ; and it may happen that, spreading beyond the limits usually assigned it, it may in certain cases invade the lateral bands of the posterior columns, lesion of which, as you know, produces inco- ordination. This is how I propose that you should interpret the cases of the second category. It is true that this invasion of the external bands has not yet, so far as I know, been ratified by autopsy; but the foregoing considerations, if I do not mistake,, render our supposition most probable. The facts of the second category remain to be reviewed. The following is the explanation I would suggest in reference to them. Besides the fasciculated sclerosis of the posterior median columns, in cases of partial lesion of the dorsal cord, and especially when this lesion is situated very high, in ]the neighbourhood of the cer- vical enlargement for instance, there nearly always exists a more or less well-marked sclerosis of the posterior region of the lateral columns. This ascending lateral sclerosis remains generally in a rudimentary state, and then does not determine any symptom. But, it may, in certain cases, become very marked, and ascend to the bulbus, principally, I repeat, when the primary partial lesion occupies the superior portion of the dorsal region. Now, paralysis of the upper extremities, sooner or later followed by contracture, is a symptom connected with lateral fasciculated sclerosis occupying the cervical enlargement of the spinal cord.](https://iiif.wellcomecollection.org/image/b21045884_0041.jp2/full/800%2C/0/default.jpg)
