File:Internal medicine; a work for the practicing physician on diagnosis and treatment, with a complete Desk index (1920) (14782563334).jpg

Identifier: internalmedicine02wils (find matches)
Title: Internal medicine; a work for the practicing physician on diagnosis and treatment, with a complete Desk index
Year: 1920 (1920s)
Authors: Wilson, J. C. (James Cornelius), 1847-1934 Potter, Nathaniel Bowditch, 1869-1919
Subjects: Medicine Diagnosis
Publisher: Philadelphia, London, J. B. Lippincott Company
Contributing Library: Columbia University Libraries
Digitizing Sponsor: Open Knowledge Commons

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es), unbutton-ing his coat, etc. It is also seen when the patient is lying down and attemptsto move his legs. It is often an early symptom, but may be preceded byfulgurant pains and changes in the pupils. The loss of static equilibrium is seen when the patient attempts tostand without support and with this feet close together; but it is muchincreased when he closes his eyes. He then sways violently and in somecases would even fall. This is the Romberg symptom. The knee-jerks are abolished early in tabes. This is one of the mostconstant symptoms, and is the Westphal sign. The other deep reflexes arealso lost. The Achilles jerks are lost early in the disease; even before theknee-jerks, in most if not in all cases. The fulgurant pains are usually an early symptom. They are light-ning-like and severe, and felt most in the lower limbs. They may preventsleep, and are most urgent in their demand for relief. They are usuallyparoxysmal, and may remit for days and even weeks. Closely associated
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IlG. ■S-i2a.—Lymphadenoma.—Atlas of Clinical Medicine (Dt. Byrom Uramwell;.By courtesy of the author. LOCOMOTOR ATAXIA. 759 with these pains arc tlu> irinllc sense aiitl viniou.s crises. The former isfelt as a l)and tied al)oiit the waist or ahdoiiieii, oi about tlie cliest, oreven about one liiul). ihe crises are bouts of j)ain felt in various parts ofthe body, especially in the epigastric region, hut sometimes in the thorax,the larynx, or even the rectum. They may siinulat(. some disorder of oneor other internal organ. The laryngeal crises cause a sense of stranglingand excite cough. According to Scmon the essential cause is a paralysisof the abductors of the vocal cords, and the attacks may begin with a senseof tickling, or even pain in the throat, followed quickly by a sense of sutfo-cation; among accessory sAmptoms arc dizziness, mental confusion, andeven loss of consciousness with convulsive movements, but the attacks arein no sense epileptic. Involuntary passage of uri

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