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May 22: The muscles of the calf are no longer tender to pressure. 
May 29: The patellar reflexes have become more distinct. Flexion and exten- 
sion of the knee joints are much improved; however, the feet and the toes are 
still entirely immobile. The right hand and fingers are almost normal in motility. 
June 24: The left foot has become somewhat mobile. 
July 2: The left large toe has become somewhat mobile. 
August 10: The muscles of the calf on both sides are somewhat indurated. 
On both plantar surfaces of the feet one feels some nodular hardenings, which are 
quite tender te pressure, in consequence of which the patient can not walk on 
his soles. 
August 19: Both feet and both large toes have become mobile. In attempting 
passive dorsal flexure of the feet and toes, one encounters strong opposition, 
which is caused by the tendo achilles and the aponeurosis of the plantaris. The 
patient complains of pain along the flexor muscles of the leg. 
August 31: The motility of the toes and feet is now better and the patient 
can walk with the aid of crutches. 
Case No. III. 
T. 1, 20 years old; in the military railway service. The patient comes from 
a healthy family and has always been well. About the beginning of August he 
had acute gastritis, lasting for three weeks: Shortly following it, there was 
noticed palpitation of the heart. The muscles of the calves were tender to pres- 
sure. There was hypesthesia of the legs. The patellar reflex had disappeared. 
August 23: The patient was admitted to the hospital on this date. Status 
praesens: Medium-sized man, poorly nourished. Pulse 80, small and weak. The 
tongue is not coated. The voice is hoarse. The skin is dry. No oedema. The 
muscles and the subcutaneous tissue are somewhat diminished, especially at the 
extremities. Heart: The upper boundary of dullness is in the third intercostal 
space, extending to the right to the middle .of the sternum and to the left to the 
left mamillary line. All the heart sounds are pure. The second pulmonic 
sound is somewhat accentuated. Liver dullness: The upper boundary is in the 
mamillary line at the upper margin of the sixth rib. The abdomen is moderately 
distended. The epigastrium and the hypogastrium are tender to pressure. A 
vibration can be distinctly felt at the left iliac region over the crural artery, ‘The 
appetite is good. Stools twice daily. There are no dyspeptic symptoms. The 
hypesthetic areas are to be found only at the inner half of the feet. The right 
knee joint is slightly mobile; but the left one is entirely immobile. The dorsal 
flexion of the foot on the right side is fairly good; on the left side, however, it 
is disturbed. The motion in the toes is almost normal in excursion. However, 
the dorsal flexion of the large left toe is very insufficient. The muscles of the 
lower extremities are flabby and tender to pressure. This tenderness is especially 
marked in the adductor muscles of the thigh. The patellar reflex is completely 
abolished, as is also that of the tendo achilles, the abdominal wall, the cremaster 
and the plantaris. The triceps reflex is present. 
August 30: The hypesthesia is now confined to one place, namely, the distal 
inner surface of the left foot. Both knee joints are somewhat immobile, partic- 
ularly the left one. The dorsal flexion of the foot is improved, especially on the 
right side. The muscular pain is much lessened. 
Therapy: Magnesium sulfuricum. 
September 8: The dorsal flexion and the motility of the toes are much improved. 
The motility of the knee joints is now almost normal. The appetite is good. 
Stools once daily. 
September 17: The extension at the knee joints is now almost normal in ex- 
cursion. 
