Identifier: practicaldiagno00hare (find matches)
Title: Practical diagnosis: the use of symptoms in the diagnosis of disease
Year: 1899 (1890s)
Authors: Hare, H. A. (Hobart Amory), 1862-1931
Subjects: Diagnosis
Publisher: Philadelphia and New York, Lea brothers & co.
Contributing Library: The Library of Congress
Digitizing Sponsor: The Library of Congress

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hilis, and as the result of poison-ing by the bisulphide of carbon. Recently Grube has reportedthree cases in which the Argyll-Robertson pupil developed in thecourse of diabetes mellitus. It is worthy of note, however, thatlate in all these affections the reaction to accommodation may alsobe lost. Rarely the reverse of the Argyll-Robertson pupil occursas the result of a lesion in the second and third parts of the oculo-motor nucleus. If the eyes fail to react to light and to accommo-dation, there is probably blindness due to optic-nerve disease. If on throwing light into the right eye there is no reaction of thepupil of that eye, and on throwing it into the left eye there is stillno reaction in the pupil of the right eye, there must be a lesion ofthe nucleus of the right oculomotor nerve or palsy of the conductingfibres of each optic nerve. Sachs asserts that immobility of the pupil is very characteristicof syphilitic cerebro-spinal disease, and if the diagnosis lies between PLATE IV.
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PATHS OF THE PUPILLARY REFLEX. (Baas. The green line connecting the Corpora Bigemina Anterior and the Oeulo-motor Nucleus represents Meynerts Fibres and the site of a Lesion, causing Unilateral Reflex Iridoplegia is shown in red lines outlining the Oeulo-motor .Nucleus. THE EYE. 187 multiple sclerosis on the one hand, and cerebro-spinal syphilis onthe other, the discovery of immobility of one or both pupils shoulddecide in favor of its being a syphilitic case. He also asserts thatpersistent pupillary immobility in a case of hemiplegia indicates asyphilitic endarteritis. It is important in this connection to remem-ber that the pupillary changes due to syphilis often suddenly im-prove, while those due to sclerosis are absolutely permanent. Contraction of the pupil occurs in a large number of conditions,and yet possesses considerable diagnostic significance. Thus it isgenerally found in the early stages of all acute inflammatory proc-esses in the brain or its membranes. In cerebral hemor

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