On Arsenical Paralysis. 5 



round or cornered, hard or soft. The same is the case with the feet 

 and lower-legs, a slight touch is not felt, and with greater pressui-e it is 

 some little time before she can appreciate it. 



Such a feeling seems to remain some time because if after hard 

 pressure of the one foot the other be touched, the patient then says the 

 first foot is still being touched. 



Feelin<j of pain examined with Björnström's algesimeter gave no 

 decided results; on the instep the same seems the most impaired. 



Sense of temperature seems on rough examination to be more sen- 

 sitive than that of touch or localization. With her hands she can distin- 

 guish between hot and cold objects, sometimes the only sensation she 

 experiences on fingering them. 



Muscular sense. 



Seems almost normal: arm and hand movements coordinate well, 

 and the patient can with closed eyes, account for the difterent positions 

 of the hands and arms but not for the fingers. She can with her hand 

 take hold of a certain named part of the body and fairly correctly judge 

 weights. The patient can even very well give the position of the legs 

 on different occasions and is capable of — with closed eyes — doing 

 exactly with one leg what has just been done with the other. 



Sense of localization. 



Examined with Sieveking's aesthesiometer shows a slight impair- 

 ment on the tonguetip, nose, back, upper-arm and thigh. The patient, 

 cannot feel the points on the fore-arm, lower-leg, hand and foot before 

 such hard pressure is used as to produce pain. 



Motility. 



Movements of the shoulder-joints take place unimpeded but the 

 patient feels a slight ache in one shoulder. The bending and stretching 

 of the elbow joints is not particularly restricted, nor yet uoticeable pro- 

 nation and supination of the fore- arm. The movements of the hand- 

 joints are considerably limited particularly ab- and adduction. On trying 

 to bend the fingers the patient cannot with the tips reach the palm, 

 especially with the right hand ; neither can the fingers be quite outstret- 

 ched. The abduction of the fingers is also very limited. The thumb 

 cannot meet the tip of the little finger. In the feet and lower-legs there 

 is complete paralysis; all attempts to voluntarily move the feet or toes 

 are fruitless. Bending and stretching the knee-joints can take place 

 almost unhindered. 



