In certain cases no
other improvement will be observed, showing that what has taken place
is of course not an alteration of the diseased nerve-tissues for the
better, as no treatment can restore sclerotic spinal tissue to a normal
state, but is merely a substitution of function, in which other and
associated nerve-tracts have replaced in control the ones affected.
As to the pains and bowel and bladder disturbances, their handling will
be discussed in considering the treatment of the next or middle stage of
tabes. In this period the ataxic symptoms are most prominent; the gait
has become so unsteady that the patient needs canes to walk at all and
must constantly watch his feet. He walks a little better when well under
way, but at starting or when standing still he sways and totters. The
girdle-sense is severe and constant, various pains assail the body and
limbs; the numbness of the feet, often described as a feeling "like
walking with a pillow under the foot," still further incommodes his
walking.[30] The bladder control may be so enfeebled as to require
daily catheterization, and the bowels move only with enemas or
purgatives, and often without the patient's knowledge, owing to the
anaesthesia which affects the rectum and its vicinity.
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