An inquiry into the influence of libidinous excess on the causation of locomotor ataxy or tabes dorsalis / by Thomas Laycock, M.D.

  • Laycock, Thomas, 1812-1876.
Date:
1869
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Licence: Public Domain Mark

Credit: An inquiry into the influence of libidinous excess on the causation of locomotor ataxy or tabes dorsalis / by Thomas Laycock, M.D. 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.

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    spermatorrhea, there are illusive sensations and neuralgic })ains in tlie back and legs, often extending to the arms, impotence, and a peculiar instability in walking. For a long period, and even yet, these and other affections of the lower extremities were attributed without distinction to spermatorrliea or sexual intemperance, and were also designated tabes dorsalis. Professor Romberg was the first (nearly thirty years ago) to differentiate the peculiarly unstable gait and its concomitants from ordinary paraplegia. Although he clearly described the head-symptoms, and most particularly the defects in vision and other sensory affections which accompany the ataxy, yet, finding the anatomical changes restricted to the spinal cord and to the posterior roots and columns in the dorsal region, he considered it to be a spinal disorder,—not, however, involving the cord as an instrument for the transmission of motor and sensory stimuli, but as a central organ and source of nervous power by M'hich the continuance and vigour of motion and sensation are secured, and a general stimulus for the entire organism is provided. To this diminution of power Romberg attributed the group of t^yuiptoms which he described under the old term tabes doy^salis, and the diminution of power to certain anatomical changes in the cord. M. Duchenne communicated a series of papers to the Archives Gen. de Med., commencing with December, 3 858, in which he described the affection described by Romberg as a new disease, evidently, and indeed confessedly in ignorance of Romberg's researches. But as Dr. Axenfeld pithily says in a letter in the Archives for Nov., 1863, p. 475, deux noms, une chose. Dr. A.s account of the dis- ease, in the same journal, for August and October, I may here say, is one of the best extant. The chief difference between the two intpiirers is in the anatomy. Duchenne dwells more than Romberg upon the encephalic symptoms, and fixes upon the cerebellum as the seat of the disease. My impression is that both are right except in so far as they deny or omit. In wl at respects then docs the old tabes dorsalis differ from the ataxic tabes? Anatomically in the progressive character of the disease ; in the former there is no progressi\'e degeneration of the nerve tissues. In both there are head-symptoms, but it is in the onset of a progressive spinal degeneration with obscure head-symptoms that ataxy chiefly differs from the old tabes. And this is of the greatest practical importance, for the progress of the affection when once the spmal symptoms are established is so inevitable, however slow, that the diagnosis in the early stage is essential to successful treatment.