2. Stage of Ataxia (Disturbance of motion).—The disturbance of motion (ataxia) is very marked, especially in the lower extremities; the walking becomes difficult and uncertain; there is difficulty in rising or rapid turning; the legs are wide apart; feet lifted too high and come down too forcibly; the length of the steps is irregular, and the body is imperfectly balanced. If the patient stands with his feet together and eyes closed he begins to sway, (Romberg's symptom), which is due to a defect in controlling the muscles from impairment of sensation. There may be imperfect use of the hands in dressing, writing, etc.; lancinating pains are marked in all cases and come on in paroxysms. The pains are mostly in the legs, but also occur in the arms, head, loins, back, and trunk. Then the sense of touch is partially lost. The prick of a pin may not be felt until a few seconds after being applied. This stage may last for years and remain at a "standstill;" but it is usually progressive, and advances to the third stage.
3. The stage of paralysis is marked by a gradual change to the worse, and the patient must remain in bed, because he cannot get out. The lower and sometimes the upper extremities have lost a great deal of their power of sensation: The joints, mostly the knee and hip joints show on both sides of the body a painless swelling, owing to the great quantities of watery liquid there. Dislocations and fractures occur simultaneously. Bed-sores and peculiar ulcers on the sole of the foot also occur. The urine dribbles away constantly, for all control of the bladder is lost. Death occurs from exhaustion; bedsores, inflammation of the bladder, or pneumonia coming on as a complication.
Treatment;—The only thing to do when the patient has this disease is to make him comfortable and arrest the progress of it, if possible. It is incurable, but treatment sometimes arrests the progress and at least lessens the suffering and prolongs life as long as it is worth living to them. I have given a longer description than was necessary, for I wanted men who live such fast lives to understand what it brings them for most cases are caused by syphilis. The description could have been made longer and other symptoms and complications put in. I think enough has been given and perhaps this description may deter some one from going the same road.
The Diagnosis is made at first by the fatigue, peculiar pains, loss of the knee jerk, the peculiar pupil and history of syphilis. Later it is made from the ataxia; the peculiar walk, etc., and the bladder disturbances.
HEREDITARY ATAXIA. Friedrich's Disease.—This peculiar disease is due to a degenerative disease of the posterior and lateral columns (parts) of the spinal cord, occurring in childhood, and often in several children of the same family.
Causes.—More in boys than in girls and oftener in the country districts. Heredity is frequently a cause and it is traced to syphilis, epilepsy, alcoholism, and insanity in the ancestors. Several children of the same family may have it.
Symptoms.—In very young children it is noticed that they are slow in learning to walk; the child staggers in trying to stand or to walk; it uses its hands clumsily, and has difficulty in speaking. The movements of the hands are peculiar, the hands move like in chorea, the speech is slow and drawling.
Recovery.—Very doubtful, but they may last for years.
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INFANTILE PARALYSIS. (Acute Anterior Polio Myelitis).—This is an acute disease occurring almost exclusively in young children with paralysis, followed by rapid dwindling of the muscles of the parts affected by the paralysis.