Sensory Symptoms. — The defects or abolition in the several forms of common sensations have been sufficiently de scribed in the clinical history of which they form an exceedingly constant and essential part. Among the less fre quently noted sensory phenomena arc analgesia of the testicle and amnsthesia in the distribution of the fifth nerve, especially over the mucous membranes of the mouth and eyelids.
Frequent changes in the pharynx and larynx of 36 tabetic patients. There were sensory disorders of the pharynx in 14, of the larynx in 10, paresis of the adduc tors in 10, immobility of the cords in 4, diminished power of adduction in 8, and ataxic movements of the tongue in 9. The pharyngo-laryngeal disorders were more intense in the advanced stages of tabes. Marini (Archly f. Psych. 11. Nervenk., 13. 21, II. 1, '90).
Case presenting the typical signs of tabes of many years' duration, in which lancinating pains occurred in the left side of the face, and in which the pharynx %%as insensible to the touch, and the uvula anwsthetie and paretic. Speech and deglutition. however, were not affected. Schnell (Marseille-m6d., Oct. 15, 'Ill).
Case of male tabetic patient, with ul cerations both in the region of the right upper and the left lower jaw. These ul cerations arc to be referred to a tabetic neuritis of the trigeminus, since complete atuesthesia of the face and mucous mem brane of the mouth was present. Hudelo (Bull. de la Soc. Francaise de Derm. et de Syp 31ay IS, '93).
Pitres found analgesia of the testicle in ;',5 per cent. of his cases. It varies in degree from time to time and may dis appear entirely to return, however, after varying intervals. lts disappearance has been noted as occurring simultaneously with a return of sexual power. While pain is a very common symptom in many forms of nervous disease, the sharp stab bing vagabond pains which occur in loco motor ataxia are so distinctive in char acter as to be unique. No two patients will, perhaps, describe tbem in the same way, and yet their identical character is at once evident from the description of a dozen or more patients. They are often worse at night and -under baro metric conditions of excessive humidity presaging- a storm. Tabetics are often,
indeed, quite reliable weather-prophets.
Of 34 tabeties, 5 had normal testicles, 10 were hyperalgesie, and 16 analgesic; of the latter 4 had atrophy of the testicle. Pitres's sign considered of great value. It consists in the loss or diminution of the characteristic pain produced in the normal testicle by compression. Bitot and Sabrazils (Jour. de -Med. de Bordeaux, Feb. 2. '90).
Among 35 tabetic patients, both tes ticles were normal in 11, in 4 there was bilateral analgesia; in 4 bilateral hyper a-sthesia; in 2 there was atrophy of both testicles; in 2 atrophy of only the riotht testicle; in 7 diminished sensibility of the pettis; and in 11 impotence. Anal gesia of the testicles and failure of the eremaster reflex are entirely independent of each other. In 15 patients inconti nence was found, in 3 retention, and in 1 isehuria paradoxa (constant dropping of urine from a full bladder). 13. A. Tatart seheff (Die Urogcnital Storungen bei Tabes Dorsalis, '92).
Trophie Symploms.—Some degree or variety of trophie disturbance is usually manifest at some time during the prog ress of the disease. Such trophic disturb ances do not appear as complications, but are essentially a part of the disease. Oc curring in the early stages, they are due to involvement of the peripheral sensory fibres; late trophic symptoms may be dependent upon lesions of the ventral horns. Among the trophic symp toms are superficial and perforating ulcerations of the skin and other cuta neous lesions, loss of the hair or teeth, onychia; atrophies of muscles, singly or in groups; nutritional disease of the bones, particularly the femur, giving rise to spontaneous fractures; affections of the joints known as arthropathies, with secondary luxations and displace ments; cedema, and bed-sores.
Case of man in whom there were trans verse fractures of both the upper thigh bones without any apparent cause, the second fracture occurring after an inter val of four months. The retarded consoli dation, with the enormous callous forma tion, go toward proving a medullary cause for these spontaneous fractures. Fourmeaux (Jour. des Sci. MM. de Lille, June 16, '93).