Accident and injury ; their relations to diseases of the nervous system.
- Bailey, Pearce
- Date:
- 1898
Licence: Public Domain Mark
Credit: Accident and injury ; their relations to diseases of the nervous system. 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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![cles of the legs, while these extremities, or even the trunk, were being violently shaken bj the tremor. Cases similar to those described by Nonne are frequently regarded as simulators. A man presenting these motor symptoms, who was for a time under my observation at the Workhouse, was considered by the guards to be malingering in order to escape being made to work. In all of Nonne's cases the symptoms remained unchanged for several years, and the question of simulation, or even exaggeration, could be ex- cluded. In one the patient committed suicide, after the symptoms had existed for six years : Male, fifty-five years of age. Ancestral and personal history negative. A previously healthy man. After a fall on the back and head, by which two ribs were broken, the patient found him- self unable to walk. There was no trouble with the sphincters. In six weeks after the accident he could walk a little, but never was able to return to work. The patient was examined one year after the accident. He then walked with legs apart and knees slightly flexed. There was con- siderable dorsal flexion of foot in walking, and he pushed himself forward from the hips at the same time, thereby showing vacillation and coarse, shaking tremor in the trunk and all extremities. On standing, a slight tremor of the trunk persisted. No Romberg symptom. On walking, many muscles became the seat of invol- untary contractions, which the patient could not voluntarily over- come. There was slight bilateral foot clonus. All the reflexes were active. The strength was diminished in the upper extremities and still more so in the lower extremities. There was some diminu- tion of sensibility in the legs. There was slight lateral nystagmus and a moderate limitation of the visual fields. Speech was not in- terfered with. The intelligence was good, and there was no mental depression. Sleep and appetite normal. The clinical picture, with the exception of some variations in cutaneous sensibility, remained unchanged for six years. [However, since at the end of this period the patient took his own life, it is probable that depression had displaced the previous normal mental condition.] Although the gait in the unclassified forms does not pre- sent the stiff, dragging, spastic character of the gait of mul-](https://iiif.wellcomecollection.org/image/b21039471_0354.jp2/full/800%2C/0/default.jpg)
