7CO APPENDIX. 



and superficial, anaesthesia, may exist without much if at all dis- 

 turbing the co-ordination of movements on the same side of the body 

 a phenomenon several times seen by the writer, and which was also 

 recently pointed out to him by Prof. Charcot on the occasion of an 

 examination of some of his remarkable hemiansesthetic patients at 

 la Salpetriere. In Demeaux's case (in addition to cutaneous and 

 deep sensibility) those peculiar 'unconscious-' impressions may 

 have been cut off, the loss of which alone in the patients of Landry 

 produced an inco-ordination of movement in the absence of sight 

 impressions. His case is r therefore, most instructive in its bear- 

 ings upon the general question. There was in this woman a total 

 disappearance of all that kind of knowledge which has, by one or 

 other, been ascribed to, or supposed to be derived from, the ' mus- 

 cular sense.' The woman was ignorant of the position of her 

 limbs, and unconscious of any movements which she might execute. 

 The volitional centres, the spinal motor centres, the motor nerves 

 and the muscles were capable of being called into activity as before 

 yet all the information usually supposed to be derived through 

 the ' muscular sense ' had vanished. 



A precisely similar condition of things also existed in a cele- 

 brated case of spinal- cord disease, associated with extreme anesthe- 

 sia, which wa observed by Spaeth and Schueppel (see Ziemssen's 

 " Cyclopaadia," vol. xiii. p. 88). Concerning the state of this 

 patient the following note may be quoted : " Sense of pressure in 

 the upper extremity, and the sense of force, entirely extinct. Sense 

 of position of the upper extremity and of passive movements of 

 the latter completely extinct. Movements of the upper extremities 

 powerful and perfectly correct ; the patient eats alone, dresses him- 

 self, etc., as far as he can direct his acts with his sight " 



No clearer evidence than this, together with what has been 

 previously mentioned, could be forthcoming to show that the know- 

 ledge of the position of our limbs, of their movements, and of the 

 state and degrees of contraction of our muscles generally, does 

 not depend, as Wundt, Bain, and others assume, upon impres- 

 sions that are " concomitants of," or that coincide with, " the 

 ou1 going stream of nervous energy." 



