But syphilis
is so frequently antecedent that a history of that infection may make
certain the diagnosis when doubt exists. This may be an important
point, for some of the cardinal symptoms are occasionally absent; cases
are seen with no incooerdination, sometimes with the station unaffected,
even, though rarely, with the knee-jerk preserved.
The diagnosis established, treatment will somewhat depend upon the stage
which the disease has reached.
In the pre-ataxic stage, where slight unsteadiness, often not
troublesome except in the dark or with closed eyes, sharp stabbing pains
here and there, numbness of the feet, girdle-sense in the region of
chest, waist, or belly, some recurrent difficulty in emptying the
bladder, a fugitive partial palsy of the external muscles of the eye,
are the chief or, perhaps, the only complaints, it would not be
justifiable to put the patient to bed at complete rest. This early stage
calls for a different plan of treatment, to be presently described.
In the middle or more distinctly ataxic period long rest in bed should
be prescribed, and will be gratefully accepted by a patient whose
sufferings from incooerdination, pains, and numbness of the extremities
are often so great as to incapacitate him.
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