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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![The symptoms observed in the case of Ler— require a more minute description. We find: complete blindness, supervening gradually (sudden invasion, you perceive, is nowise necessary in optic neuritis); intense cephalalgia, occupying the forehead and occiput, well nigh continuous, but liable to be exasperated by paroxysms; acute pains in the eyes, subject to remissions and exacerbations; vomiting coming on in paroxysms, just as in the case of Deg—, and occasionally persisting for some days ; finally, pains in the extremities. These pains, which constitute an exception to the rule I men- tioned at the beginning of this lecture, when describing tabetic pains, displayed in an unmistakable manner the characteristic peculiarities of shooting pains. Over a score of times, in the notes taken down from the sincere description of the patient, and regis- tered at the very moment of the paroxysm, we find it stated that these pains come on suddenly, like flashes of lightning, that they affect but a point, either near the joints (knee or wrist), or on the body of the limbs, and that they are accompanied by a sort of starting of the members attacked. When exasperation of these pains and of the cephalalgia occurs then the paroxysms of vomiting come on. In addition to all these symptoms we should add a vertebra] pain, spreading round the body and simulating the girdle pain. These peculiar pains, so remarkably manifest in our patient, do form an absolutely exceptional fact in cases of cerebral tumours. Thus, in 133 cases M. Ladame mentions twenty-three times the existence of rheumatoid pains in different parts of the extremities. Undoubtedly, it is but very rarely that these assume the character of fulgurant pains; nevertheless, this author, though not indeed emphasising it, points out the presence of more or less acute pains, recurring in paroxysms, and flitting frequently from one point to another. However that may be, this singular complication is established in a peremptory manner, were it but by the case of Ler— alone. And to account for it, you cannot appeal to some tabetic complica- tion, for the posterior columns, which were carefully examined at the autopsy, have been found perfectly healthy. Well, then, gentlemen, with such a case, and in all probability cases of this kind will occur again, is not the question of diagnosis a most embarrassing one ? Allow me also to inform you, in order to add to the interest of the situation, that in the tumour case there was titubation, whilst in the ataxic case there was no trace of it.](https://iiif.wellcomecollection.org/image/b21045884_0065.jp2/full/800%2C/0/default.jpg)
