File:Organic and functional nervous diseases; a text-book of neurology (1913) (14758766906).jpg

Identifier: organicfunctiona00star (find matches)
Title: Organic and functional nervous diseases; a text-book of neurology
Year: 1913 (1910s)
Authors: Starr, M. Allen (Moses Allen), 1854-1932
Subjects: Nervous system Nervous System Diseases
Publisher: New York, Philadelphia, Lea & Febiger
Contributing Library: Columbia University Libraries
Digitizing Sponsor: Open Knowledge Commons

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t cases, Putnam being the only observer to distinguish betweensymptoms of long and of short standing in the same case. In addition to the sclerosis of the cord the majority of observers havenoticed a thickening of the pia mater, especially upon the posterior andlateral surfaces, with adhesion to the cord. Some have seen a state ofarterio-capillary fibrosis or a true endarteritis in the spinal vessels.The anterior nerve roots have been found atrophied. The combination of secondary degeneration of the motor and sensorytracts sometimes found in advanced cases of general paresis is not tobe classed with this disease.25 386 COMBINED SCLEROSIS. Etiology. — Little is known of the cause of ataxic paraplegia, butthe widespread degeneration in many columns of the cord has givenrise to the supposition that it is due to an inherent want of vitality inthe nervous system with a tendency to degeneration from general mal-nutrition of the neurones. It is certainly more common in persons of Fig. 170.
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Section through the lower cervical cord showing combined sclerosis of the lateral and posteriorcolumns. (Larkin.) neurotic tendency. It develops usually in males in early adult life, isnot particularly related to syphilis, though it has been traced to it insome cases. In many cases it follows extreme muscular exertion, andhence is more common in workmen and those subject to long marchesor heavy labor. It has been known to develop after severe exhaust-ing diseases, such as anaemia, leucocythsemia, and cancer, and especiallyas a complication of pernicious anaemia. Marie traces it to endarteritisin the spinal vessels. Symptoms.—Patients suffering from combined sclerosis complainfirst of considerable fatigue in the legs after short walks, a sense ofnumbness and heaviness in the legs, and of stiffness of the muscles andof an unsteadiness of gait. This unsteadiness of gait is usually worsein the dark, and gradually as months go by the patient becomes dis-tinctly ataxic. But this ataxia is

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