It is true that beriberics show the steppage gait of multiple neuritis as, owing to more or less foot-drop and lack of power to extend the toes, the patient lifts his foot high from the ground to avoid scraping the toes, and bends to the other side. It is as if a man were walking through a mire.
When other groups of muscles than the foot extensor ones become involved the gait is that of extreme weakness—a shuffling one.
In sleeping sickness it is a shuffling gait. It is as if one were dragging the feet along from pure muscular weakness.
In pellagra we may see a gait in which the patient separates his legs rather widely and uses a stick in front, shuffling his feet along with knees slightly bent and soles of the feet scarcely raised from the ground.
Some cases show a typical spastic paralytic gait.
We often note under dengue the designation dandyfied gait. This refers to the stilted, mincing gait of a dandy and is probably the explanation of the derivation of the word dengue. The pains about the site of the insertions of muscles with the slightest movement make these patients walk in a stiff, self-conscious manner.
Psychic and Neurasthenic States
A very remarkable fact is that in many tropical and subtropical regions where syphilis is rampant among the natives there is slight or absent incidence of general paresis and locomotor ataxia.
Jefferys and Maxwell state that the parasyphilitic manifestations were absent in thousands of cases observed by them in Formosa. In the Philippines one sees occasionally typical cases of these parasyphilitic diseases but of course standard methods of treatment of syphilis have been employed there for many years.