The patellar tendon reflex : read before the Medico-Chirurgical Society of Edinburgh on June 4, 1879 / by Byrom Bramwell.

  • Byrom Bramwell
Date:
1879
Catalogue details

Licence: Public Domain Mark

Credit: The patellar tendon reflex : read before the Medico-Chirurgical Society of Edinburgh on June 4, 1879 / by Byrom Bramwell. Source: Wellcome Collection.

Provider: This material has been provided by The University of Glasgow Library. The original may be consulted at The University of Glasgow Library.

    22/40 (page 20)
    tions as to the position of the lesion be correct, we may theoretica;lly conclude that the innermost fibres of the pos- terior roots—the fibres which pass through the outermost part of the posterior column (median portion of posterior nerve-roots) in making their way to the posterior cornu— are the fibres concerned in this reflex act. Leaving it, therefore, undecided whether the arrest takes place in the posterior root-fibres or in the posterior cornua, it only remains to explain those exceptional cases of loco- motor ataxy in which the patellar tendon reflex is still pre- sent. This we can readily do by supposing that in such cases the particular portion of tlie lumbar cord through which the reflex travels is as yet unaffected by the lesion, or possibly that, the lumbar cord being affected, the lesion has as yet spared the particular fibres concerned in this reflex act. But we know from actual observation that it is quite excep- tional to find the lumbar cord free from disease ; hence it is also quite exceptional to find the patellar tendon refiex still present. Other Diseases in which the Patellae Tendon Reflex is Absent. Destruction of the lumbar portion of the cord, the centre through which the reflex travels, will of course arrest the phenomenon. This destruction may be the result of trau- matic injury, or it may be the result of myelitis, cancerous deposits, etc. In the following case of cerebro-spinal sclerosis the phe- nomenon was absent, -the ordinary skin reflex being well- marked. Case 7.—Case of sup]joscd Cerebro-Spinal Sclerosis (chiefly Intra-cranial)—Absence of the Patellar Tendon Reflex. J. M., aged twenty-seven, single, a soldier, was admitted to the Newcastle-on-Tyno Infirmary, under my care, on January 24, 1878, complaining of shaking of th(^ body, dimness of vision, and deafness. Previous-History.—He enjoyed excellent health until three years ago. He then began to complain of deafness. He was