On Locomotor Ataxy
J. Lockhart Clarke · BMJ · 1869
air which prevents this occurring each time we shake up water in a phial, while in the partial vacum of the water-hammer, the beautifully elastic cushion of the air has been purposely removed.The conclusion to be drawn from these ohservations is, that it is not safe to explore the interior of the bladder in the female with a catheter or hollow sound, while there is any chance of the fluid escaping and being suddenly stopped during the operation.This rule does not apply to the case of the male bladder, on account of a male catheter being generally so much curved as to prevent the urine flowing through it at any great velocity.If, however, in examining the bladder for stone, we always use a solid sound, there can be no such error; or if, which is in effect the same, we keep the plug in the hollow one while it is moved about in the bladder, these concussions will not occur, and a possible fault of diagnosis will be avoided.Jl ON LOCOMOTOR ATAXY.*Bv J. LOCKHART CLARKE, M.D., F.R.S., etc. CASE I.-R.L., aged 35, and a very intelligent man, carrying on the business of a shoemaker at Richmond, was sent to me by a practitioner of that town.About seven years back he began to feel what he called rheumatic pains, caused, as he supposed, "by working in a draughty shop."These pains were first experienced in his feet and legs; seldom in his thighs.They come on suddenly and violently, like electric shocks, but may be absent for several days together.As in most other instances, there are two kinds of pains-the one gnawing or "'rheumatic", the other lancinating.Sometimes they begin in the knee-caps, sometimes at the back of the knee-joints, and always shoot upwards from below.He has scarcely ever experienced any pain in either of the upper extremities.For the last five or six months he has had numbness all over his feet, reaching above the ankles.For the last twelve months or more he has felt, as he says, "great weakness in his