Selections from the clinical works of Duchenne / Translated and edited by G.V. Poore.

  • Duchenne, G.-B. (Guillaume-Benjamin), 1806-1875.
Date:
1883
Catalogue details

Licence: Public Domain Mark

Credit: Selections from the clinical works of Duchenne / Translated and edited by G.V. Poore. Source: Wellcome Collection.

Provider: This material has been provided by UCL Library Services. The original may be consulted at UCL (University College London)

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    in cases where the sight is much weakened or completely lost, has taught me that the optic papilla is wasted, showing, as one knows, a lesion (sclerosis) of the optic nerve at its origin or in its length. I reported a remarkable case of this in my last edition, and gave a picture of the fundus oculi. I did not con- clude from it, however, that the blindness of ataxic patients was always caused by the same lesion, for up to that time I had not made any ophthalmoscopic observations on the greater part of my ataxic patients suffering from dim sight. I foresaw, however, that this wasting of the papilla must be frequent, if not constant. It became necessary then to examine the fundus oculi of ataxic patients as soon as a slight dimness of sight began to show itself, in order to study the manner of development of this lesion, and the possible congestive or irritative appearances which precede it. My surmises have since proved correct. Further, having never neglected since then to examine the fundus oculi in ataxic patients with dim sight, I have always noted varying degrees of whiteness of the papilla, with a wasting of the retinal vessels, directly proportionate to the dimness of sight. In ordinary squint, as one knows, dim sight does not exist, and by making the patient use one eye only, the sight becomes perfectly clear. I have met with cases in which while the squint diminished, the sight got gradually more dim. Nevertheless, the squint and the dimness usually progress pari passu. Complete blindness may, however, exist without squint at the very outset of the disease. Dim sight affects usually one eye only, and when there is squint this affects also the same eye ; but too often, indeed, both eyes are affected, and too often also, in spite of all treatment, sight is completely lost before the locomotor troubles have appeared, or have become generalised. Nothing can be more pitiable than the condition of these poor blind patients when the ataxy has reached its last stage. With their legs already deprived of the power of orderly movement; unable to appreciate the resistance of the ground ; without the power of correcting their movements by the eye ; standing or walking become to them more and more difficult and painful, and accompanied by most irregular actions. Finally, when the sense of touch in the feet is completely lost, they are unable to walk at all, although still possessed of con- siderable muscular power. I have often noticed in the first stage of locomotor ataxy an