File:Practical diagnosis- the use of symptoms in the diagnosis of disease (1899) (14785191513).jpg

Identifier: practicaldiagno00hare (find matches)
Title: Practical diagnosis: the use of symptoms in the diagnosis of disease
Year: 1899 (1890s)
Authors: Hare, H. A. (Hobart Amory), 1862-1931
Subjects: Diagnosis
Publisher: Philadelphia and New York, Lea brothers & co.
Contributing Library: The Library of Congress
Digitizing Sponsor: The Library of Congress

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Typical pseudo-muscular hypertrophy.(Dercum.) THE FEET AND LEGS. 97 spasm may be so great that the legs overlap each other as walkingis attempted. (Fig. 38.) The gait in disseminated sclerosis is often markedly spastic andparetic—that is, stiff and feeble, and may in the early stages ofthe disease closely resemble that of spastic paraplegia due to lateralsclerosis. When the patient attempts to pick up a small object with Fig. 38. Fig. 39.
Text Appearing After Image:
Spastic paraplegia; crossed-legged pro-gression. (From a patient of Dercurns inthe Jefferson Medical College Hospital.) Side view of a case of paralysis agitans, showing forward inclination of trunk. Tendency topropulsion. (Dercum.) his fingers there are tremor and oscillation of the hand. Scanningspeech and nystagmus develop later on in these cases. It is, how-ever, important to remember that multiple cerebro-spinal syphilismay closely simulate multiple, or disseminated, sclerosis. Some-times they may be differentiated by the fact that in disseminatedsclerosis there is apt to be paresthesia, whereas in syphilis there is 7 98 THE MANIFESTATION OF DISEASE IN ORGANS. more apt to be pain. An important differential symptom is thatnystagmus is rare in syphilis, common in disseminated sclerosis, andocular palsies are common in syphilis, rarely so severe in sclerosis,so that complete ocuio-motor palsy with ptosis and squint would bemore likely syphilitic than sclerotic. (See chapter on the E

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