SUGGESTIVE CASE OF NERVE-ANASTOMOSIS. 3 21 



At the end of 168 days the asym- 

 metry of his face when at rest was 

 barely appreciable. He could to a 

 slight extent dissociate movements 

 of eve, nose and mouth. He could 

 almost close his eye by voluntary 

 effort. He could pronounce labials 

 perfectly. He could pucker his 

 lips, although not enough to 

 whistle. He had considerable 

 freedom of facial movement with- 

 out lifting the arm or shrugging 

 the shoulder. But "Elevation of 

 arm and shrugging of shoulder 

 still called forth general contrac- 

 tion of facial muscles which could 

 not be controlled and which was 

 sustained." The condition of the 

 patient's facial muscles at rest is 

 seen by the photograph taken at 

 this time (Fig. 4). Another photo- 

 graph (Fig. 5) shows the result 

 of a volitional effort to contract 



Corfi 



accessor! us. 



aci 



ali 



accessor*! us 



'# 



Fir;. 2. 



vol. lxvii.— 21. 



the facial muscles, when aided by the' 

 arm elevated but completely at rest. 

 At the end of 287 days the volitional 

 control of individual groups of mus- 

 cles had quite completely returned 

 and could ' be effected without asso- 

 ciated shoulder movements of con- 

 traction in the other. facial muscles/ 

 And although emotional expression 

 had not improved to the same extent, 

 it had returned in considerable 

 measure. How involuntary contrac- 

 tion of the face was still pro- 

 duced by a sudden and vigorous 

 elevation of the arm and shoulder 

 is apparent from a photograph 

 taken at this time (Fig. 6). But 

 how, at the same date, symmet- 

 rical closure of the eyes was pos- 

 sible, without associated shoulder 

 movements or the contraction of 



