132 PHYSICAL EXPRESSION. 



Her general health was good, and development 

 appeared good in all particulars, but for the athe- 

 tosis ; she was well nourished. 



The child was unable to stand or do anything for 

 herself on account of the movements of the hands 

 and feet, associated with which there was, no doubt, 

 some want of muscular power. The muscular con- 

 dition of the head and face appeared natural. There 

 appeared to be a fair amount of voluntary power 

 over the shoulders and elbows, so that she could 

 hold a doll to her. When told to take hold of a 

 toy she brings her hand to it, but is unable to open 

 the fingers so as to clasp it ; all through the time 

 of this effort the fingers are in constant movement. 

 When the object is placed in her hand she clutches 

 it and is unable to drop it. 



Supporting the left upper extremity free from 

 the trunk by holding the humerus, it was possible 

 to observe the following movements succeeding in 

 a rhythmical manner. 



The wrist was frequently bent backwards, and 

 sometimes abducted. The thumb is mostly bent 

 in on the palm, turned in under the index finger. 

 The fingers are frequently extended at the meta- 

 carpo-phalangeal joints, remaining flexed at the 

 inter-phalangeal joints. The greatest power of 

 extension seems to be of the index finger. In 

 getting the hand near an object it moves about 

 much before it comes in contact with the object, 

 and then cannot grasp it on account of the condition 

 of the .fingers. The fingers are usually kept flexed ; 

 she cannot spread them voluntarily. When the 



