Lectures on nervous diseases from the standpoint of cerebral and spinal localization, and the later methods employed in the diagnosis and treatment of these affections . y W. E. Smith.) to be a systematic disease of both the motor and sensory columns ofthe spinal cord, the question is still unsettled regarding the projierclassification of this affection. Symptoms.—These may begin during childhood, usually betweenthe fourth and seventh years, or at the period of puberty. The lan-cinating pains (which are typical of true ataxia) may be wanting; or, insome cases, they may develop late in the dise
Lectures on nervous diseases from the standpoint of cerebral and spinal localization, and the later methods employed in the diagnosis and treatment of these affections . y W. E. Smith.) to be a systematic disease of both the motor and sensory columns ofthe spinal cord, the question is still unsettled regarding the projierclassification of this affection. Symptoms.—These may begin during childhood, usually betweenthe fourth and seventh years, or at the period of puberty. The lan-cinating pains (which are typical of true ataxia) may be wanting; or, insome cases, they may develop late in the disease. From the very onset,marked incoordination of movement or a sense of weakness is developed POSTEKO-LATERAL SPINAL SCLEROSIS. 593 in both the upper and lower extremities. In some cases reported, theataxic symptoms have been confined to the upper limbs. The disturb-ance of coordination is very rapidly developed. It may affect themovements of the head, the muscles of speech, and possibly those of theeyeball. Changes in the pupil and defects of vision are not commonlyobserved,—a fact which is a marked contrast to the course commonlyobserved in tabes Fig. 131.—Photograph op Case. (Reported by W. E. Smith.) According to most observers, the tendon reflexes are usuallyabolished. The sensory functions are less disturbed than in ataxia ofadults ; although tactile anaesthesia is generally developed. The muscularsense is usually retained to a greater or less extent. The plantar reflexmay often be retained, in spite of the complete abolition of the knee-jerk. Some time after the symptoms of incoordination appear, paralysisand contracture tend to develop in some cases, these S3mptoms areusually more marked in the lower limbs than in the upper. The patients 38 594 LECTURES ON NERVOUS DISEASES. cannot walk, as a rule; and free movements of the hands or arms maybecome impossible. Bed-sores do not occur in this disease. The sphincters are notaffected. The mental faculties se
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