NORMAL AND ABNORMAL MOVEMENTS. 



115 



would suddenly fly backward when he attempted to move it, and 

 that the muscles of the left side would tremble violently in quick 

 clonic spasm. Unless he moved very carefully this occurred at 

 ev'ery step. He next observed that he was losing flesh. His 

 height is six feet one and one-half inches, and his best weight 

 has been one hundred and seventy-nine pounds. Three months 

 ago, when this note was made, he weighed one hundred and 

 sixty-five pounds. 



" In July, 1884, the affected ankle was strained, and this was 

 followed by swelling of the foot and leg. 



"About this time, or a little earlier, he noticed that the fingers 

 of the left hand were disposed to contract, so that the hand would 

 remain closed until the fingers were forcibly extended. The 

 contraction was increased by fatigue. This gradually increased 

 until it involved the hand, forearm, arm, and shoulder." 



At the time at which the photograph was taken, the summer 

 of 1885, the patient presented in addition the following symp- 

 toms : He habitually carried the left arm (vide Plate 548) in the 

 semi-flexed position assumed by patients having lateral sclerosis 

 or secondary degeneration of tiie lateral columns. The left leg 

 was decidedly stiff; When sitting on a chair it was extended. The 

 knee-jerk was markedly exaggerated. The gait was "spastic." 

 The right leg also was somewhat affected. It was somewhat re- 

 sistant to flexion and tlie knee-jerk was evidently increased. 



Fig, 0. 



BSEii!iiniiii»ia">SBESSSBl 

 ■Hn!Hl"!!"iS!!!"!"9!S=SS3!! 



Lateral sclerosis, left foot. 



Fir;. 10. 



■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■n 

 ■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■I 



^iBBBII 



BMBBBII 



■■■BflBBBBBBBaHIBBBBBBBBBBBIBBBB 



l«BBBB«IBBriBI 



iJ!!!!!!lS*"i 



■■■■BiiBaab;<BB>:«i,iBBB;<BBm%<Kt<iw.iii 



!!!!■!■■ ■■''■■•■■■■■'■■■•'Kiu^i'iBiM 



■■■■Bi mm ank^Bik^^BBBNBBvuBkitiBh II 

 ■laaai la ai«niikiK!iaBS«aMt>«aiiiH 



■■BBBI IB ■■BB:«aak1BB9BBKW»B\1BltllB 



■■■BBiiaiaiBai^aBBaaisaii!«!iA«u'iiil» 

 aiBBB ■ Bag ■■■ft:«BkiaBBk^an^'\HMis.BB 



■■■HIIIMI ■■ BBHaSBf aaBBilBS.M'll BI 



BBaaMaaBiiHBBiiBiBBkiBBBiiBCinivLiBaa 

 UKSmtm^mmmumumum^^mmmtMrM'lM'Mmmmm 



iaS=aJiBBBBBBIBaB«B«BBtaESggB!Mli 



Lateral sclerosis, right foot. 



The gait was studied in detail in the lower series of Plate 548. 

 Fig. 9, as well as the lateral series in the plate, shows, in the first 

 place, that the left foot scarcely left the ground, that the heel only 

 was elevated, and that the ball of the foot and the toes were 

 merely raised sufficiently to permit them to slip or scrape along 

 the surface ; also that the leg as a whole was very little flexed. 



