. A practical treatise on medical diagnosis for students and physicians . the finger—as, for example, the nose or ear—or inbringing the heel of one foot against the knee of the other. There is TABES DORSALIS. 1155 diminished muscle-tone, so that it is possible to bring the foot to theshoulder without bending the knee; and, of course, absolute loss of thetendon-reflexes, even when reinforced. The nutrition of the musclesremains good, and the electrical reactions are not altered. There areparamnesia?, especially in the lower extremities; analgesia in the samesituation, or sometimes delay in the
. A practical treatise on medical diagnosis for students and physicians . the finger—as, for example, the nose or ear—or inbringing the heel of one foot against the knee of the other. There is TABES DORSALIS. 1155 diminished muscle-tone, so that it is possible to bring the foot to theshoulder without bending the knee; and, of course, absolute loss of thetendon-reflexes, even when reinforced. The nutrition of the musclesremains good, and the electrical reactions are not altered. There areparamnesia?, especially in the lower extremities; analgesia in the samesituation, or sometimes delay in the conduction of pain. The nerve-trunks lose their sensitiveness to pressure; this is best tested with theulnar nerve, which can be rolled under the finger against the lower end ofthe humerus without causing pain (Biernackis symptom). Visceral anses-thesia is also present. The skin-reflexes are often preserved late in thecourse of the disease. Micturition is sometimes difficult; at other timesthere is incontinence, but insufficiency of the sphincter ani rarely Testing the knee-jerk. Impotence is complete. The Argyll-Robertson pupil is present; there areusually myosis, nyctalopia, and occasionally atrophy of the optic nerve,first manifested by disturbance of the color-perception (red and greenblindness). In the latter condition it has been noted that when blindnesshas fully developed, the ataxia becomes less pronounced or may disappearcompletely (amaurotic tabes). The visceral crises are characterized byattacks of intense, cramp-like pain, involving usually the stomach, butsometimes affecting the larynx, heart, kidney, bladder, rectum, or otherviscera. The laryngeal crises are often accompanied by distressing coughand dyspnoea that may simulate the symptoms of aneurism of the archof the aorta. Trophic changes occur, of which the most common arethe arthropathies. These involve particularly the knee, hip, andshoulder-joints. In addition, the patient may have painless fal
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