434 IM. \i. Kennedy. On // 'ftn <>f 



some time, the muscles losing their faradic irritability. In course of 

 time gradual improvement showed itself, heralded first by recovery of 

 faradic irritability in the muscles. The earliest indications of improve- 

 ment were shown in the orbicularis palpebrarum, which began to 

 recover faradic irritability and movement, thereby enabling the eye to 

 be slightly closed, about the 18th day. The movement of the muscle 

 on stimulation with the faradic current was, however, so slight, that 

 there was a possibility of error, and the slight voluntary movement 

 might have been due simply to the relaxation of the levator palpebrae. 

 By the 49th day, however, there was no doubt, as the contractions to 

 faradic stimulations were well marked, and the palpebral fissure could 

 be voluntarily closed one-half. 



By the 141st day the faradic irritability of the other muscles began 

 to be recovered, and by the 155th day the faradic current gave, on 

 applying the electrode over the junction between facial and spinal 

 accessory, strong contractions in all the muscles of the face. 



Improvement gradually continued, and on August 17, 1900, about 

 fifteen months after the operation, the condition was as follows : She 

 experienced no difficulty on account of the condition of the face. There 

 was no return of the spasmodic condition. The conjunctiva of the right 

 eye was quite normal ; there was no increased lachrymal secretion, and 

 she never was troubled with dust getting into the eye, as winking was 

 perfectly efficient. She could shut the eye completely, although not so 

 tightly as in the case of the sound eye. The orbicularis palpebrarum 

 also contracted well to reflex stimuli. The right side of the brow could 

 be wrinkled to a very slight degree only, and movements could be made 

 in the cheek and mouth, although they could not well be co-ordinated. 

 The labial letters could be perfectly pronounced, and the buccinator 

 was efficient to prevent accumulation of food between cheek and gums 

 while eating. 



There was no atrophy of the side of the face, and in repose there 

 was no appearance of facial paralysis, the muscles having regained 

 their tonus, and the normal sulci being well marked. 



There was evidence of want of power over the face in the difficulty 

 of raising the eyebrow, or of making a circular aperture with the mouth 

 in whistling or blowing. The muscles, however, of these parts were 

 perfectly sound, as the faradic current gave perfectly normal reactions, 

 both when applied directly to the muscles and when applied to the 

 motor point of the nerve. This motor point lay about 2 cm. lower 

 down than normally, i.e., over the junction of the facial and spinal 

 accessory. 



The reactions and movements of the trapezius and of the sterno- 

 mastoid were normal. 



A curious effect resulted when the arm was suddenly thrown up ; 

 for the face at the same time was thrown into contractions, owing to 



