. A practical treatise on medical diagnosis for students and physicians . tapping upon thehamstring tendons. They are of no particular clinical value. Tappingupon the inner condyle of the tibia often produces contraction of theadductor muscles, bul this is not, as a rule, as pronounced as the con-traction produced by percussion upon the patellar tendon. Next in importance to the knee-jerk is the Achilles tendon reflex, whichconsists in the contraction of the gastrocnemius and soleus muscles whenthe Achilles tendon is struck. It is most readily elicited by lifting theentire leg from the bed or
. A practical treatise on medical diagnosis for students and physicians . tapping upon thehamstring tendons. They are of no particular clinical value. Tappingupon the inner condyle of the tibia often produces contraction of theadductor muscles, bul this is not, as a rule, as pronounced as the con-traction produced by percussion upon the patellar tendon. Next in importance to the knee-jerk is the Achilles tendon reflex, whichconsists in the contraction of the gastrocnemius and soleus muscles whenthe Achilles tendon is struck. It is most readily elicited by lifting theentire leg from the bed or table, and holding it by the ball of the foot,which is gently pressed upward. The tendon is thus ,and may be struck directly. In nearly all healthy individuals this reflexis present, but is absent in some, and its absence is apparently of noclinical significance. Exaggeration may be indicated in moderate casesby the more forcible extension of the foot. In more pronounced cases itgives rise to a peculiar and characteristic phenomenon, known as ankle-. Ankle-clonus. clonus. This may be elicited by vigorously tapping the tendon once orseveral times in succession while the leg is being held in the manner de-scribed ; but is more readily produced by slightly flexing the leg and thethigh, then grasping the ball of the foot firmly, flexing it dorsally with con-siderable force, and holding it in that position. When ankle-clonus exists,there will be violent vibratory oscillations of the foot, as long as thepressure upon the sole is continued, that vary from two to three up to five ! C. K. Mills has devised an ingenious instrument, consisting of a metal ring with acurved handle, by which the patella may be drawn downward and the jerk or clonus morecertainly elicited. MINOR REFLEXES. 307 or ten movements per second. There is usually a rhythmical increaseand decrease in the rapidity, without absolute cessation at any , in very mild cases, the clonus aft
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