OBERSTEINER, Assoc. Ed., Annual, '96.] Locality of anresthesia studied in fifty cases of tabes, ten of which had aman rosis. Four principal types found: 1. Thoracic, present in 40 eases either as an horizontal zone in the nipple-region of either side, which if it reaches to the axillary line, may extend to the inner aspect of the arms; the nipple bands are united anteriorly. 2. In the upper limbs anresthesia may be limited to the internal surfaces of the arms, or nmy extend along the inner aspect of the forearms to the little finger. 3. In most cases of tabes the perinea], anal, and genital regions, espeeially the latter, are anresthetie, and particularly at the lower part of the scro tum; this is often found in the early stage of the disease. When present it is generally found in other parts as well, such as the thorax or feet. 4. In the lower limbs the position of the antesthesia is very variable, being common in the plantar and dorsal regions of the foot, the dorsmn of the toes, the outer surface of the legs, and on the anterior or posterior surface of the thighs. Other parts of the body where anresthesia may be found are the epigastrium, the left hypoehondrimn, and the larynx. Cases of tabes with amatirosis often have normal or nearly normal tactile sensations. Subjective symptom.s are related to the situation of the anresthesia: to the first group there is often a girdle sensation, to the second numbness of the arms. to the third tronbles of rnicturition and impotence, and to the fourth, lightning pains and "pins and needles" in the legs and feet. INIarineseo (Sem. Med., Oct. 13, '97).
Case of loeomotor ataxia in a man who presented all the ordinary symptoms of locomotor ataxia; but in addition there was complete analgesia over the whole body except on and around tlie mouth. The analgesia began in the legs and spread upward. C. E. Beevor (Laneet, Jan. 22, '98).
Partial epigastrie analgesia noted. Epigastrie sensation eonsiderably dimin ished in 22 out of 50 cases, and com pletely absent in 9. The epigastrie re• gion (the "solar plexus," so called) eoula be violently compressed or struck with out the least feeling of discomfort. This
does not appear to be accompanied by any special sensory alteration nor loss of the skin or abdominal reflexes, nor even with gastric crises. The only func tional alteration which appeared with any frequency was loss of sensation of hunger. Pares (Jour. de ARd., Jan, 25, '99).
The writer has bad 7.4 per cent. of cases of tabes in 1200 patients with various nervous affections in his private practice and 2.6 per cent. in 4000 in hospital and dispensary patients. The proportion of men to women was 83 to 6 in the first class and Si to 17 in the second. The age ranged from 23 to 73. The longest interval after syphilitic in fection before the tubes developed was twenty-seven years and in 10 eases it was only one to five years. In 7 in stances both man and wife exhibited tabes. The primary symptom in 67.5 per cent. of 195 cases was lancinating pains, while diplopia was noticed as the first symptom in 3.6 per eent., and gas tric symptoms, vertigo, or parresthesia were the first in 3.1 per cent. each. Weakness of the feet was the first symptom in 2.7 per cent., and bladder symptoms, gastric crises, or impaired . vision were each the first in 2.2 per cent. In 1.6 per cent. the girdle sensation first attracted attention ;, in 1.1 per cent. the heart-erises or painful lassitude. In 0.5 per cent. the first sy-mptom noted was dyspncea, deafness, ptosis, or the Argyll sign.
In the total of 195 cases lancinating pains occurred at some stage of the af fection in 93 per cent., the Romberg in the same proportion, and the ankle clout's was abolished in 91 per cent. Westphal's sign occurred in 89.4 and the Argyll in 883 per cent. Analgesia of the peroneus region in 85.5 per cent.; bladder symptoms in 79 per cent.; parcesthesia in 72; a-nalgesia in ulnar region in 66, and atrophy or blanching of the optic nerve in 61 per cent. Anis ocoria 46.6 per cent., bilateral myosis in 21, and mydriasis in 14 per cent. Crises in 13.7 per cent., paralysis of ocular muscles in 10.5 per cent., and trophic disturbances in 4.5 per cent. .A. von Sarbo (Deut. Zeit. f. Nervenh., xxiii, Nos. 1 and 2; Jour. Med. Assoc., April 25, 1903).