File:A. M. A. archives of neurology and psychiatry (1919) (14593789788).jpg

Title: A. M. A. archives of neurology & psychiatry Year: 1919 (1910s) Authors: American Medical Association Subjects: Neurology Psychiatry Publisher: (Chicago) American Medical Association Contributing Library: Gerstein - University of Toronto Digitizing Sponsor: University of Toronto

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Text Appearing Before Image: urn to work in March. In October, 1920. the trouble returned, and he worked with difficultyuntil January, 1921, when he stopped work for two months. He then workedthroughout April. On May 8 the pain came on again rather suddenly andincreased rapidly. On May 12 his feet began to itch and sting. On the 496 ARCiiiriis or MirKOLocY AM) rsycm.rrhv thirteenth he noticed that they were growing weak, and on the fifteenth theybecame paralyzed. When admitted he had pain in both legs and lower partof his back and a band sensation al)out his waist. He had lost from 3 to 5pounds (1360.7 to 2267.9 gm.) since the beginning of his illness. Exammation.—This revealed a man of small stature, in not very robusthealth and sufifcring much pain. His mind was clear. There was completeflaccid i)aralysis of both legs. His head, cranial nerves and chest were normal.There was a mass in the upper left part of the abdomen extending to mid-line and below the umbilicus. It had a rounded edge but no definite notch. Text Appearing After Image: Fig. 20 (Case 14).—Disturbances of sensation It moved slightly with respiration. There were no nodules or irregularities.Abdominal reflexes were absent. The genitalia were normal. No cremastericreflexes were present. Power was good in both hands. There was no wasting or atrophy. Thereflexes were prompt and equal, light and left (biceps and triceps). Therewas a slight intention tremor in l)cth bands. Xo adiadukokinesis or dysmetriawas present. There were flaccid paralysis (complete) and some wasting of both legs.There were fibrillary tremors in the calves. Xo Achilles reflexes or Babinskisign were present. Sense of position in the toes was gone (Fig. 20). Totalanesthesia was found in the area shown in the chart. Sensation over the restof the body was normal. Patellar reflexes were sulmormal and equal. Fig. 21.—Photograph of cord. 498 arcuuES or xeurolocy a\d psychiatry The patient said that sexual intercourse was possihle until two monthsbefore or less, hut caused much pain afterwa

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