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LEADING ARTICLES. 433 NEW YORK MEDICAL JOURNAL, A Weekly Revieiv of Medicine. Published by D. Appleton & Co. Edited by Frank P. Foster, M. D. NEW Buy Lotrel YORK, SATURDAY, APRIL Lotrel Coupon 20, 1889. THE TABETIC EYE. Before the Societe de m^decine de Paris, M. Trousseau lately read an interesting paper upon Lotrel 20 Mg this subject that appears in the "Union medicale" for March 9, Lotrel 10 Mg 1889. The ocular symptoms of tabes, he says, are important in exact Discount Lotrel proportion to a knowledge of their special characteristics and relations to the disease that causes them. Whether they serve to trace the malady or to confirm a doubtful diagnosis, they are equally valuable, and should receive the most careful study. Fournier has noted eye troubles in thirty-four out of two hundred and twenty-four cases. This proportion is probably smaller than actually exists, for many patients present ocular phenomena perceptible only to the physician, and of which they themselves do not complain. These insidious manifesta- tions are especially helpful in discovering Order Lotrel the disease during its early stages. Certain conditions belonging to the pre- ataxic state have been set down to syphilis pure and simple, owing to ignorance concerning ataxia, and to the fact that so frequently an antecedent history of syphilis is given. According to Galezowski, in nine cases Lotrel Online out of Lotrel Mg ten, tabetic affections of vision are due to syphilis alone. Of thirty cases investigated by the author, twenty-five presented unmistakable Cheap Lotrel evidences of this disease, two were doubtful, and in the tliree others the patients had never been inoculated. The eye muscles, the iris, and the optic nerve are the tracts most apt to be affected, but they are not the only Lotrel 10 ones. Lotrel Cost In 1886 P^trolacci, of Montpellier, wrote a thesis on ataxic lacry- mation. Fere had under observation a Lotrel 510 patient in whom at- tacks of circumorbital pains of lightning-like character and unilateral lacrymation appeared Purchase Lotrel and disappeared with equal suddenness, and in ataxic subjects disseminated circumorbital anaesthesia is of frequent occurrence. Berger has called at- tention to the diminished ocular tension during the paralytic Ophthalmic migraine, with its scotoma and hemianopsia, the author thinks may be allied to tabes, for he has observed two patients in whom frequent attacks of this sort accompanied the pretabetic period. One of the unfortunates retained this inconvenient symptom. As a general thing, not enough im- portance is attached to ophthalmic migraine as a precursory sign of ataxia. The eye muscles are often paralyzed during the course of the disease, sometimes at the beginning and sometimes toward the end. This seems to have no Lotrel 5 Mg clinical connection with optic atrophy. In other words, it is unreasonable to conclude from the presence of muscular paralysis that the patient is predis- posed to optic atrophy. In six hundred cases of atrophy. Galezowski has encountered, before or during the course of profound ataxias, two hundred in which mu.scular paralysis existed. This simply illustrates a certain relative frequency, but can not be looked upon as bearing a very close relation. The lesions are of a different order. The prognosis is of a Lotrel Coupons fatal nature in papillary atrophy, while muscular paralyses are curable. When, however, such paralyses are joined to pupil- lary disturbances, it is safe to affirm the Lotrel 5 probability of tabes. In the pre-ataxic stage, when the diagnosis is doubtful, the presence of Buy Lotrel Online these united signs is Lotrel 10 20 of chief importance. Ocular paralyses vary in character according to the stage of the spinal- cord affection. At the onset they are for the most part simple forms of paresis (di|)lopia without strabismus), dovelopiog and disappearing readily enough, sometimes instantaneously and without treatment, and returning suddenly at times. They may affect one or several muscles at the same time or in succession. These are the peculiar phenomena formerly con- sidered distinctive of syphilis. But they are certainly rare except in the syphilitic patient who is a candidate for ataxia. The muscles that move the ball may be attacked, and also those of the hd, causing the slight narrowing of the palpebral fissure that Berger notes in Lotrel Price ataxic subjects. The ptosis that exists in other cases has a similar origin, as well as the paraly-

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