12 S. E. Henschen, 



Disorders of motility are certainly met with in all four extremities, 

 but the lower limbs are by far the most severely seized with paralysis 

 and the fact is particularly striking if the hands and feet are principally 

 attacked and certain authors have remarked that the extensors are espe- 

 cially changed in nutrition and functions. 



This arsenical paralysis agrees with the most neuritis in that respect, 

 that neither the psychical functions nor the cranial nerves are altered; 

 and that the bladder and rectum work normally. 



The paralysis seldom terminates in death; on the contrary the prog- 

 nosis of the some times very severe paralysis is very good, even if the 

 paralysed members in severe cases be restored very late. 



After this short review of the characters of the arsenical para- 

 lysis, it will be interesting to look at the symptoms of the above case. 



Already 5 to 6 hours after taking arsenic, very pronounced symp- 

 toms of intoxication, vomiting and burning heat in the throat, appeared. 

 The following day diarrhoea mixed v^ith blood came to and now the first 

 signs of irritation of the sensibility showed that the peripheral nerves 

 were attacked. Pat. felt pricking sensation in hands and feet. On the 

 third day was already motor paralysis in the foot-joints performed, some 

 day later phenomena of motor irritation of the fingers appeared in forme 

 of ftvitchings. The paralysis extended soon to the arms and general 

 weakness and atrophy entered, aneesthesia in hands- and fore-arms came 

 soon, whilst the paraesthesia and pains continued. 



The patient must on account of the paralysis be fed and could 

 not leave her bed. 



From the brain, bladder and rectum no sj^^mptoms were observable. 



In april the pains and pricking sensation still continued but para- 

 lysis in the arm had lessened -and the patient could feed herself but not 

 cut her food; the legs remained paralysed. Feeling was considerably de- 

 preciated, also the sense of touch and temperature, but not the muscular 

 sense excepting in the hands. 



The movements of the muscles showed no ataxia but slight con- 

 tractions had developed. The mechanical as well as electrical irritability 

 was much diminished and in the peroneal region no twitchings could 

 be produced either by faradic or galvanic current, fibrillary muscle 

 twitchings existed. No reflexes could be produced from the patella or 

 planta pedis. 



