PHYSIOLOGICAL RHYTHMS. 305 



she had wrenched it three months before while trying to 

 save herself from falling on the stairs. She did fall and 

 bruised herself in several places, but not on the shoulder. 

 Her arm was afterwards stiff and painful, and she found 

 it powerless at the shoulder and elbow ; she carried her 

 arm in a sling, and it had been treated electrically. At 

 the time of the examination there was pain in the elbow 

 when she raised the arm more than 45 degrees from the 

 side. When passive movements were made the muscles 

 about the shoulder resisted, and motion was not free. 

 Diagnosis of restraint and disturbed reflexes. Training 

 of the reflexes by systematic movements was followed by 

 marked improvement in mobility and usefulness of the 

 arm, but after being treated for a week the patient was 

 obliged to leave, and went home with the arm very 

 much disabled. It remained in about the same con- 

 dition until the death of her husband, which occurred 

 unexpectedly a few weeks later. The shock was so 

 great that she became entirely unconscious of her arm, 

 and from that it has been perfectly normal in every 

 respect, as she was able to prove to me at her next visit." 

 In this instance by a twist of attention the patient 

 became unduly conscious of processes in her spinal 

 cord, which were, so to speak, none of her business, and 

 it required another twist to free the spinal centres from 

 the abnormal surveillance, and restore the functions of 

 the muscles. 



Before leaving the subject in hand the perplexing 

 question of automaticity in the nervous system must be 

 touched upon. Examples of automaticity are the move- 

 ments of an amoeba, the pulsations in the umbrella of 

 a jelly-fish, the beat of the heart, the rhythms of respira- 

 tion or the purposeful movements of a higher animal. 

 In these instances, with the exception of the amoeba, 

 we have the reactions under the control of a distinct 



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