General Symtomatology and Diagnosis. 3 



Hemiplegia is the loss of voluntary motion in many muscles 

 on one side of tlie face or body. In general hemiplegia, the fol- 

 lowing muscles are usually excepted : — muscles of the tongue, of 

 mastication, of the eye, of respiration, of the neck and trunk, 

 generally and of the proximal part of the limbs. The hind limbs 

 are usually most affected, and muscles that are most exclusively 

 under the control of the will those dominated by the cortical 

 centres of the brain. When due to a clot on the brain or de- 

 generation it occurs on the side opposite to that occupied by the 

 clot, on account of the motor fibres crossing at the anterior pyra- 

 mids of the medulla. Hemiansesthesia is a rare attendant and 

 when present is often on the side opposite to the hemiplegia. 

 Sensory fibres cross in the spinal cord, and the lesion is probably 

 spinal. 



Crossed Hemiplegia is motor paralysis of certain cephalic 

 nerves (3d, 7th, 5th, 6th, and 8th,) on the same side with the clot 

 or lesion, and of the muscles of the trunk on the other side. The 

 cranial nerves proceed to muscles on the same side as their 

 origin, while filaments going to the trunk through the spinal 

 cord, cross in the pyramids (motor), or spinal cord (sensory). 

 In crossed hemiplegia, hemianaesthesia is common with both 

 forms of paralysis on one side. 



Spinal Hemiplegia has the face and head sound (except 

 sometimes the iris), and half the bod}' paralyzed on the side op- 

 posite to that on which the spinal lesion (clot) exists. If an- 

 aesthesia exists it is on the side opposite to the lesion and posterior 

 to it — the sen.sory filaments crossing just before leaving the cord. 



Paraplegia is loss of voluntary power of one transverse half 

 of the body ; usually the posterior, and affects the tail, and ha.s 

 coincident anaesthesia, being due to a spinal lesion. Anal and 

 vesical sphinctors may or may not be paralyzed according as the 

 lesions implicate their respective spinal centres or not. If there 

 is neither anaesthesia nor vesical paralysis the lesion may be cere- 

 bral, in the paracentral lobes of both hemispheres (meso-vertix 

 at the fissure of Rolando). 



Monoplegia is a circumscribed paralysis, as of one limb, or on 

 one side of the face, one group of muscles or a single muscle. 

 It may be due to cerebral, spinal or nervous lesion. Cerebral 

 monoplegias are distinguished by : ist, initial spasm ; 2nd, ab- 



