920 
— the disturbances of speech, the difficulty in swallowing, the laxity 
of the right leg — have been soon meliorated or cured. Another 
part of them however have become lasting. 
The most important of these residue symptoms are: 
a. Complete analgesia and thermanaesthesia in those regions of 
skin and mucous membrane that are controlled by the left N. trigeminus, 
— the tactile sense, localisation and motor-power having been 
preserved in the trigeminus-muscles. 
The reflex-action of the cornea no longer exists. 
This analgesia alternates with: 
4. Complete analgesia and thermanaesthesia in the right half of 
the body. Within the region of the upper cervical roots on the right 
this disturbance is incomplete. The tactile sense, the deep sensibility, 
tbe sense of space, localisation and stereognosy are undisturbed and 
have not suffered in the right half of the body. There is not one 
single symptom of hemiplegia. | 
c. Complete paralysis of the larynx to the left. Incomplete paralysis 
of the swallowing-muscles on that side. 
d. A peculiar involuntary attitude of the head, turned towards the 
right, together with a dissociation of the conjugate movement of the 
eyes and the head turning to that side. When this movement is 
made, the eyes cannot follow it. They first turn towards the left, 
afterwards slowly following the movement of the head towards the 
right, the patient being consequently unable to recognize instantly 
the objects placed beside him, on account of the defective stand of 
the eyes. 
e. A slight degree of static ataxy. 
Without any doubt this disturbance is caused by an occlusion in 
the arteria cerebelli posterior inferior and a softening (eventually a 
eyst) in the latero-dorsal portion of the left half of the medulla 
oblongata. 
This morbid affection has been tirst described and appreciated 
by Senator’), subsequently it has been carefully analysed by 
WALLENBERG*) and Marpure*), who have done most meritorious 
1) H. Senator. Zur Diagnostik der Nervenkrankungen in der Brücke und in dem 
verlängerten Mark. Arch. f. Phych. Bd. 14. 1883. p. 643 ff. 
2) ApoLF WALLENBERG. Acute Bulbir-affection (Embolie der arteria Cerebel- 
laris posterior inferior sinistra). Arch. f. Phych. Bd. 27. 1895 p. 504 ff. and: 
WALLENBERG. Anatomischer Befund in einem als Embolie der art. cerebellaris 
posterior inf. sinislra beschriebenen Falle. Arch. f. Ps. Bd. 34. 1901. S. 923 
3) R. BREUER und Orro MARBURG. Zur Klinik und Pathologie der apoplecti- 
formen Bulbärparalyse. Arbeiten aus dem neurologischen Instituten der Wiener 
Universität (OBERSTEINER) Bd. IX. 1902. p. 181. 
oe 
