118 A STUDY OF SOME 



affected. In Fig. 14 the rise and fall are more marked, and this 

 again is in harmony with the fact that the right leg was much less 

 affected than the left. On comparison, however, with the rise and 

 fall of the normal leg (see Fig. 5), these factors are seen to be 

 much less pronounced. 



Again, the left foot at the completion of its movement is brought 

 too far within the median line, and thus gets in the way of the 

 right foot. The latter in order to prevent a fall is brought too far 

 outside of the median line, and thus the direction of the walk as 

 a whole is changed. 



As regards the lateral sway of the trunk, it is of course grossly 

 exaggerated, and always takes place towards the side opposite the 

 advancing leg. It is, in fact, only by means of this grossly ex- 

 aggerated sway that the leg can be advanced at all ; the sway tilts 

 the pelvis and thus assists in raising the limb from the ground. 



As regards the relative extent of the lateral movement of the 

 trunk, it is always greater towards the side of the less affected 

 limb. 



The gait in lateral sclerosis is so very slow that medical writers 

 have in general given accurate descriptions of it, though the ex- 

 tent of the lateral sway of the foot is too much insisted on. la 

 all probability the lateral sway is never very marked when both 

 legs are affected or affected about equally. It, however, becomes 

 much exaggerated, as we shall see below, when the disease is con- 

 fined to the lateral column of one side. 



Various other Spastic Gaits. 



In Plate 553, are presented the photographs of an interesting case, 

 the history of which is briefly as follows : C. M., aged twenty-four, 

 a laborer, sixteen months ago fell into a pit eight feet deep, striking 

 on the top of his head ; he was unconscious for four hours, and ex- 

 perienced upon awakening a severe pain in the back of the neck 

 which increased upon motion. He had absolute paralysis of both 

 legs for six weeks, and of the bladder and rectum for four weeks. 

 The arms, especially in the act of flexion, were markedly paretic. 

 He did not regain the power of walking for nine weeks. He 

 had improved to a certain degree, but failed to progress. At the 

 time of being photographed the pupils were slightly unequal, 

 the right being the larger. No affection of special senses except 



