. A practical treatise on medical diagnosis for students and physicians . tation in the early stage isusually only slightly affected. There is a sense of constriction about thebody (girdle pain), and sometimes hypsesthesia of the lower extremitiesthat may be associated with a slight hyperalgesia in the zone just aboveit. The patients may also remark that they have slight difficulty inurination and some diminution of sexual potency. The second stage, orthe stage of ataxia, is characterized by the symptoms of the precedingstage, all of which are now pronounced. In addition the patient exhibitsin
. A practical treatise on medical diagnosis for students and physicians . tation in the early stage isusually only slightly affected. There is a sense of constriction about thebody (girdle pain), and sometimes hypsesthesia of the lower extremitiesthat may be associated with a slight hyperalgesia in the zone just aboveit. The patients may also remark that they have slight difficulty inurination and some diminution of sexual potency. The second stage, orthe stage of ataxia, is characterized by the symptoms of the precedingstage, all of which are now pronounced. In addition the patient exhibitsincoordination of movement, especially in the lower limbs. Station isso impaired that it is usually impossible for him to stand alone with the 1154 DISEASES OF THE NEEVOUS eyes closed and the feet together (^Romberg^s syinptoni). Walking in thedark is difficult and results in frequent falls. In the daylight, with theaid of the eyes, the patient can usually walk quite well, but lifts the feetliigher than usual from the ground, and separates thern widely. (See Fig. Schematic representation of the lower portion of the spinal cord and canda equina, according toRaymond. The bodies and spines of the vertebrse are designated by the letters D (dorsal), L (lum-bar), S (sacral), with the number of the vertebra prefixed. The roots are designated by the samesymbols followed by R. The upper horizontal line indicates the level at which the root emergesfrom the cord, the lower horizontal line the level at which it pierces the dura. The vertical linejoins the two horizontal lines belonging to the same root. Ataxic Gait.) The incoordination is manifested by the difficulty withwhich the patients perform certain movements, such as touching someobject with the tip of the finger—as, for example, the nose or ear—or inbringing the heel of one foot ao-ainst the knee of the other. There is TABJ^:S DOBSALIS. 1155 diminished mnscle-tone, so that it is possible to brino; the foot to tlieslioiil
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