( 929 ) 
Respirations 22 per minute. Nothing abnormal in the organs of the thoracal and 
ventral region. In the urine neither albumen nor glucose. 
Speech is slow, monotonous, stammering and scanned. No disturbances from 
aphasia or faults of articulation. The patient is able to read and to understand what 
he reads. Writing is bad (claxy of the right hand). The pressure on the paper is 
irregular. The pencil cannot be maintained in the right direction. Still the wriling 
is not illegible, each letter and each word being taken separately. No vestige of 
agraphy. The head, measuring 53 c.M. in circumference, nowhere aches under 
pressure. 
The sense of smelling is intact. That of hearing is disturbed slightly on both 
sides, to the right a whisper is heard at 1 M. distance, to the left at 2M. The sense 
of taste -is impaired. 
The pupils of the eyes, unequal, a little more dilated to the right than to 
the left, are reacting well on light and in converging. The movements of the 
eyes, except for nystagmus, expecially when looking to the right, can be per- 
formed completely. The convergency is not disturbed. The commissure of the lips 
to the right is drooping, the orbital fissure on that side is wider than to the left. 
On the right half of the face hardly any folds are to be seen. By active movements, 
the muscles around the right angle of the mouth are hardly moved at all. The 
facial muscles react normally on electric stimull. 
The tongue is put out tremulously. pointing to the right. The patient holds his 
head inclined to the right. The right shoulder droops. The right arm is oedema- 
tous, without rigidity or hypotony. All active movemenis can be made, but they 
are performed unsteadily. It is impossible to the patient to make both indexes 
meet. Unsteadiest of all are the movements of the fingers. Fastening or unfastening 
buttons, taking matches from a box etc, — all this is done ina very clumsy way. 
The reflex actions in the right arm are exaggerated. When walking, the right 
leg is training. To hop on it is impossible. There is ne:ther rigidity nor hypotony. 
Paresis and ataxia are more marked in the nether portion of leg and foot than in 
their upper region. With his right foot the patient is not able to put on a slipper, 
nor to perform the heel-knee test. 
To the right the skin-reflexes of abdomen and cremaster are suspended. The 
reflexes of the knee and the tendon of Achilles are exaggerated, without cloni, 
A stimulus of the foot-sole to the right is answered by flexion of the small toes 
and extension of the large one. 
Sensibility is disturbed over the whole of the right half of the body. 
The sense of touch is only slightly disturbed. Coarse touches are perceived 
everywhere, subtler ones remain sometimes unperceived, 
The sense of pain has suffered much more important alteration. To the right 
a pin-point is not perceived to be sharp. This hypalgesia passes the diameter of the 
body for nearly 1 c.M. The subjective statement of the patient is, that the sensa- 
tions of touches and of painful stimuli are entirely different on the right and on 
the left. Cold and heat are perceived léss clearly on the right than on the left. 
What is most disturbed to the right is the deep-seated feeling, and distally 
still more than proximally. Passive movements of the fingers and toes are not 
perceived at ali. The tactile circles of Weger are much larger on the right than 
on the left. The patient localizes badly on the right half of the body. 
To the right he is astereognostic, e. g. a key given in the right hand is called 
after long hesitation “a small hammer’’, a matchbox is called a cork, a ring a 
six-penny piece. To the left all these objects are recognized immediately. 
