clxxii Journal of Comparative Neurology. 



are clearly hysterical phenomena. Moreover, developments show 

 that a return of the attacks of hysterical rachialgia resulted from the 

 influence of a persistant and suggestive idea referring to the initial 

 attack, this suggestive idea or force culminating in paralysis of the 

 right leg. 



The logical conclusion is : In the diagnosis between hysteria and 

 organic maladies, one must not be contented with considering the 

 symptoms and nothing else ; but it is necessary to interpret them by 

 studying their relation with the mental state of the patients. Only 

 on this condition will the diagnosis be complete and fruitful in results 

 useful for therapy. 



We append also notes upon three cases of hysterical brachial mo- 

 noplegia, by Dr Kinnosuke Miura. Archives de Neurolgie, XXV, 75. 



Case I. Hereditary antecedents of the patient favoring develop- 

 ment of nervous disorders. Patient broke his right clavicle. Con- 

 tinued to work three and a half months after his accident. Finally 

 went to have his condition treated and in a short time was much im- 

 proved and resumed work. For two years used his right hand the 

 same as his left. The right arm was suddenly and inexplicably par- 

 alyzed ; the patient had had good health ; no troubles ; had made no 

 violent effort. But, a few days previous, he had assisted in burying a 

 nephew who had crushed his arm in a factory. He had visited his 

 nephew in the hospital and the event had strongly impressed him. 

 The patient's muscular sense was intact ; sensibility entirely intact. 

 Reflexes slighdy stronger than normal but equal on both sides. Spe- 

 cial senses only slightly modified. 



The question here concerns an individual, tainted by neuropathic 

 heredity, in whom a vivid emotion seems to have provoked the devel- 

 opment of brachial monoplegia on the side where, two years before, 

 he had a clavicle fracture. 



The absence of troubles of the sensibility in this patient is quite 

 singular, — a fact not yet observed, to our knowledge, in similar cases 

 of hysterical monoplegia. After a few days of treatment the patient re- 

 covered, to some extent, the use of his hand, fingers and arm. 



Case H. Right brachial monoplegia. Patient, a painter by 

 trade ; overworked ; while painting a ceiling, was taken with a sensa- 

 tion of vertigo, then with general trembling, finally resulting in par- 

 alysis of the right arm. Sensibility entirely destroyed, from finger 

 tips to shoulder. No hemianesthesia. After four months' treatment 

 left the hospital, able to move elbow and shoulder, the wrist and fin- 

 gers, however, remaining paralyzed. Like the preceding, this pa- 



