Two cases of tabes: one with laryngeal crisis, the other with hypermsthesia to light and sound. Chareot (La Sem. Med., June 4, '90).
Case of tabes with laryngeal crisis, in which the post-mortem histological ex amination revealed, besides the usual characteristic spinal lesion of tabes, a bi lateral chronic diffuse neuritis of the vagus and spinal accessory roots, but without involvement of the nuclei of these nerves. Van Gieson (Jour. of Nem and 'Mental Dis., July, '90).
Attention called to peculiar pains in certain glands which may occur in tabes from time to time. Several hours before the onset of the attack the patient com plains of a peculiar, uncomfortable sensa tion in the region in qiiestion, and sud denly very severe pain is felt, lasting sev eral hours; the glands quickly swell, and the skin becomes reddened; the swelling and redness slowly disappear after a few days. "Wood (La Sem. Med., No. 7, '93).
Case with pharyngeal crises. Patient was a man who had become exceedingly emaciated, the slightest attempt at tak ing nourishment causing severe contrac tions of the pharynx. After a single treatment by suspension, this condition entirely disappeared. Courniont (Revue de Med., Sept., '94).
Two cases of severe pharyngeal crises, one of the patients dying during such an attack. Moreira (Pharingismo Tabetico, '94).
In 122 cases of tabes laryngeal disturb ances referable to tabes were found in 17 cases. In 4 cases laryngeal crises were observed. Boline (Inaug. Dissert., '95).
Cardiac Crises.— Cardiac crises re semble symptomatically attacks of an gina pectoris. There may be actual ease of the heart of trophic origin. A rapid pulse-100 to 120—was frequently noted in Charcot's cases without asso ciated cardiac crises.
Case of tabetic patient who was sub ject to attacks of tachycardia with ac celerated breathing without dyspncea; these attacks occurred several times a day and lasted about half an hour. They were cardiac crises. Zenner (Ohio Med. Jour., Dec., '91).
In 138 cases of locomotor ataxia 12— or 8.76 per cent.—were complicated with valvular disease. In 9 of the eases—or
6.5 per cent. —the lesion was aortic dis ease. The valvular affection generally first showed itself after the tabetic symp toms were well advanced. Five cases were undoubtedly syphilitic, and 6 prob ably so, but in 1 case there was no evi dence of the disease. In 2 cases aortic aneurism was associated with the valvn litis. Rheumatism was only noted in 2 of the 12 cases. As symptoms are not always present, the aortic disease may be overlooked. The association of the two diseases is probably the result of syphilis, which is an important cause, both of tabes and of cardiac disease. Ruge and Hutter (Berliner klin. Woch., Aug. 30, '97).
The crises of tabes possess a localizing pathological value quite analogous to that of the aura or signal symptom in epilepsy, pointing to an invasion and irri tative degeneration of the yagus-nuclei or fibres, or to fibres elsewhere that are in physiological relation to the functions involved in the symptoms. Crises are among the earlier clinical phenomena usually, but they may persist for many years. They often disappear with the lancinating pains, with which they are intimately associated, as the disease ad vances.
A constant secretion of tears is some times met with in tabes, while in other eases there are actual tear-crises, similar to gastric crises. Panas (La Presse May 4, '94).
Case of a waiter, 41 years old, who suffers from locomotor ataxia and begin ning paralytic dementia. lie has fre quent and sudden attacks of violent burn ing pain in both eyes and the peribulbar tissues, accompanied by spastic myosis, epiphora, and ehemotic swelling of the conjunctivfe. There also is much hyper wsthesia in the eyelids, which makes further examination of the eyes impos sible. These attacks last from two to three hours; an hour after the attack the eyes are practically normal. These attacks considered to be true ocular crises—attacks of neuralgia of the ciliary nerves, and irritation of the fifth nerve. Pel (13erliner klin. Woch., No. 2, Jan. 10, '98).