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On diabetic neuritis, with a clinical and pathological description of three cases of diabetic pseudo-tabes. By T. Davies Pryce MRCS, Consulting Surgeon to the Nottingham General Dispensary. Brain 1893: 16; 416–424. With Diabetic neuropathy. A clinical study of 150 cases. By M. Mencer Martin. From the Department of Diabetes, King's College Hospital, Denmark Hill, London, S.E., UK. Brain 1953: 76; 594–624 (Thomas) Buzzard [(1831–1919): 1886] has suggested that absence of the knee-jerks recently described in cases of diabetes mellitus is due to peripheral neuritis and not pathology in the spinal cord. (Ernst Viktor) von Leyden (1832–1910) has proposed three types of diabetic neuritis: a painful symmetric form; one with paralysis of the legs, or of single muscles; and an ataxic, pseudo-tabetic, disorder with numbness and formication in the feet and absent knee jerks. But Mr Davies Pryce prefers to consider only two categories: the motor or paralytic type; and the sensory or ataxic form in which sensory, vasomotor and trophic nerves are mainly affected, and the resemblance to locomotor ataxy is close. He has published several cases of the latter in the British Medical Journal and coined the term ‘diabetic pseudo-tabes’. Dr (Frederick William) Pavy (1829–1911) presented a similar example to the Washington International Medical Congress in 1887: patients ‘complain of pains … in the limbs … these persons can stand and maintain their balance … with the eyes shut … but they walk with difficulty … there is some anaesthesia and hyperaesthesia and various forms of paraesthesia … with aching of the bones at night … and they feel as if walking on pebbles. The disease is most marked in the lower extremities … the condition appears to be due to peripheral neuritis’. To this, Mr Davies Pryce would add: ‘the knee jerks are diminished or frequently absent …

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