NORMAL AND ABNORMAL MOVEMENTS. 119 



impairment of hearing in right ear was noted. No anaesthesia ex- 

 isted anywhere. The legs were paretic and spastic. No specific 

 history could be elicited. 



The spastic condition of the legs is well seen in the photographs, 

 though the gait is by no means a typical spastic gait, such as seen 

 in Plate 548 (lateral sclerosis). The feet are raised but little from 

 the ground, and appear to slide along the surface. The lateral 

 sway, though, is greater than in typical disease of the lateral 

 columns. In the latter, the meagre outward movement of the 

 foot is brought about by a forced and extreme swaying of the 

 trunk, and not by the action of the leg itself. 



In Fig. 543 is found another illustration of an atypical spastic 

 gait. The subject was an hysterical girl. 



It is seen by even a cursory examination that the feet, though 

 not raised to the normal height above the ground, are yet raised 

 to a height greater than that seen in typical lateral sclerosis. 

 The amount of the lateral sway, too, is also relatively large. 

 There is some tendency to scrape the feet along the ground, espe- 

 cially the right one, but there is a decided outward movement. 



Other instances of spastic gait are seen in Plates 547 and 552. 

 Both subjects were old hemiplegics with marked secondary con- 

 tracture. In both instances the paralyzed leg is quite stiff, little 

 or no flexion taking place at the knee. It is also noticed that the 

 foot is here, almost or quite, raised from the ground by the en- 

 ormous swaying of the trunk towards the sound side, to which 

 additional support is given to receive the sway by means of the 

 crutch. It is significant, therefore, that the crutch be carried on 

 the sound side. In these figures is also seen, precisely as in typical 

 lateral sclerosis, the exaggeration of the normal tendency of bring- 

 ing the outer edge of the foot to the ground in advance of the sole. 

 This is especially shown in the lower series of Plate 552. 



These instances of what might be called unilateral sclerosis 

 differ, therefore, from double lateral sclerosis chiefly in the great 

 exaggeration of the lateral sway. 



In Plate 542 still another example of spastic gait is found, but 

 it is not typical. The history of the case in brief is as follows : 

 J. C, female, aged forty-one, commenced to have pain in the 

 back some fourteen years ago. The pain has steadily continued. 

 Soon after its commencement she noticed some difficulty in walk- 



