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Tabes Dorsalis

power, spinal and disease

TABES DORSALIS, an affection of the nervous system akin to locomotor ataxia and paralysis. It is characterized by a lack of power in harmonizing the action of certain muscles, the absence of such co-ordinating power being apparent first in the lower extremities, making the gait straggling and unsteady. There is no true paralysis, hut sensitiveness is diminished; the loss of power proceeds and the later stages of the malady are marked by such symptoms as disordered vision, incontinence of urine and exhaustion. The duration of the disease varies from a few months to several years. Its causes are obscure. A peculiar change in the posterior columns of the spinal cord and in the posterior or sensory roots of the spinal nerves accom panies it. Prolonged exposure to cold and damp, drunkenness, sexual excesses, masturba tion; etc., have been regarded as causes. Many authorities believe that it is, in many instances, or even exclusively, a remote result of syphilis. It is alleged to he more common in men than in women and subjects between the ages of 30 and 50 are said to be most liable to it. The

patient has an unsteady gait and walks like a drunken person, but soon recovers his bear ing in some degree. A difficulty in carrying out the intents of the will is experienced and in picking up an object one hand is employed to steady the other. When the eyes are shut the patient walks with extreme difficulty. Tabes dorsalis may be distinguished from disease of the cerebellum by absence of the characteristic pain at the back of the head, and of vomiting. The progress of the disease may be retarded, but the prospect of cure is nearly hopeless. The treatment is limited to improyemPnt of the general health: warm clothing, nutritious food and rest are the chief items. Salvarsan is sometimes injected directly into the spinal column with good results. Consult Osler, Wil liam,