. A text-book of medicine for students and practitioners . the disease, sotliat diplopia may be the firstsubjective symptom of whichthe patient complains. Inevery sudden oculomotor orabducens paralysis, comingon without any other cause,we must think of the possi-bility of an incipient is remarkable that theseparal^ses in many cases dis-appear permanently and en-tirely after some time, but itis alwaA^s possible that theymay recur later. We oncesaw a case of tabes with pro-nounced periodical oculomo-tor paralysis {vide page 22!)).The oculomotor paralysis,however, when it has oncea])pear
. A text-book of medicine for students and practitioners . the disease, sotliat diplopia may be the firstsubjective symptom of whichthe patient complains. Inevery sudden oculomotor orabducens paralysis, comingon without any other cause,we must think of the possi-bility of an incipient is remarkable that theseparal^ses in many cases dis-appear permanently and en-tirely after some time, but itis alwaA^s possible that theymay recur later. We oncesaw a case of tabes with pro-nounced periodical oculomo-tor paralysis {vide page 22!)).The oculomotor paralysis,however, when it has oncea])peared, may be permanent,as we have repeatedly seen,especially in a case with bi-lateral abducens and uni-lateral oculomotor paralysis,and also in a case with al-most complete bilateral oculomotor paralysis. In the autopsies on such caseswe find the trunks of the affected nerves ami their nuclei markedly atrophic,but it is very probable that the temporary ocular paralyses in tabetic patientsdepend upon changes in the peripheral nerves of the ocular Fig. -P:iral\ uf the left oculomotor nerve ill tubes.(Eriangen Medical Clinic.) TABES DORSALIS 351 The third eomi^lication in tlie eyes in tabes is optic atmpliy. It occurs inabout ten or fifteen per cent ol all cases, and is usually an initial symptom, ata time when the absence of the tendon reflexes, which may usually also be no-ticed, is the only thing, except this, to render the diagnosis of the diseasepossible. The patient complains of diminution of vision; and the power todistinguish colors, especially green, disappears quite early. On objectiveexamination, we find, besides this anomaly in the color sense, usually a limi-tation of the field of vision, and the beginning atrophy of the optic nerve caneasily be made out on ophthalmoscopic examination. The affection sometimesmakes little halts and slight apparent improvements, but it usually ends withcomplete blindness. It is very noticeable that in tliose cases of
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