September 13, 1912] 



SCIENCE 



349 



The next noteworthy manifestation ap- 

 peared during an expedition of 1900, when I 

 frequently found myself unable to raise the 

 left foot to the stirrup on mounting — indeed 

 it became necessary generally to modify the 

 attitude in mounting so as to permit giving a 

 hitch upward to the left foot with the hand. 

 Sometimes, too, on dismounting the left leg 

 partially gave way ; so that I acquired the habit 

 of swinging out of the saddle in such a man- 

 ner as to land on both feet. During subse- 

 quent months in office work I noticed an ab- 

 normal condition, though I failed at the time 

 to associate it with that experienced in the 

 field — i. e., on rising after occupying my chair 

 for a considerable time, either a sharp pain or 

 a sensation of weakness was experienced in 

 the left groin. This condition continued until 

 the habit was acquired of rising with care and 

 putting the weight at first wholly on the right 

 foot. 



In 1902 I noticed that the footfall sounds 

 of my two feet as I walked the pavement were 

 unlike; and I made considerable vain efPort, 

 sometimes with the help of friends, to find the 

 reason for the asymmetry in movement indi- 

 cated by the diversity in sound. This abnor- 

 mality was not then associated with the abnor- 

 mal conditions observed in field and office; 

 but when within a year I noticed that the 

 sole of the left shoe wore out twice as rapidly 

 as that of the right I began to associate the 

 several conditions, though without forming 

 any idea as to cause. 



In 1906 I suffered an epididymitis on the 

 left; and in casting about for the cause of 

 this attack my physician seemed so confident 

 that it must be gonorrheal or syphilitic in 

 origin (which I knew to be erroneous) that I 

 gladly welcomed the occasion to have an ex- 

 pert blood examination made by a practi- 

 tioner recently from a noted expert and school 

 in London. The examination showed no trace 

 of the infection suspected by the physician, 

 but gained my confidence by detecting evi- 

 dences of a typhoid fever through which I had 

 passed some years previously; but it left the 

 epididymitis totally unexplained. 



About this time I made a trip through the 

 Sierra Nevada region, largely in company with 

 Gifford Pinchot, then Chief Forester, and J. 

 A. Holmes, now Director of Mines ; and in the 

 course of the trip was much embarrassed by 

 inability to climb or to ascend slopes of more 

 than moderate degree — the trouble lying in 

 the same inability to lift the feet first ob- 

 served in Seriland. 



In the autumn of 1909 while in field work 

 in Washington state I noticed uncertainty in 

 coordination of the control and movement of 

 the left foot, especially in passing over slip- 

 pery rocks or logs; and on one occasion suf- 

 fered an accident of some severity due to a 

 needless slip of the left foot. About this time 

 also I noticed a slight bladder difficulty which 

 continued increasingly for over a year — when 

 treatment began for enlarged prostate. After 

 preliminary examination and treatment of the 

 conventional sort, prostatectomy was pre- 

 scribed, and in April, 1911, I underwent the 

 operation — which revealed a cancerous condi- 

 tion in which the carcinomatous tissue was of 

 an exceptionally hard type, and too extended 

 for complete extirpation. Recovery was tedi- 

 ous and complicated, and within a few weeks 

 after leaving the hospital an epididymitis on 

 the right developed — this time with little 

 doubt in my mind as to the cause. The symp- 

 tom of weakness and pain in the left groin 

 also recurred with increased intensity, and a 

 hitching gait was developed. The bladder 

 never became completely normal; and in Jan- 

 uary, 1912, the lower intestine evidently be- 

 came afPected, producing assimilative difficul- 

 ties of growing gravity. 



In April, 1912 — a year after the operation — 

 a condition gradually developed on the ten- 

 dons of the left knee similar to that first ob- 

 served in the groin — the twinge of pain on 

 sudden movement, inability to exercise full 

 control, etc. The general burden on the sys- 

 tem attending the abnormal development was 

 noticed (without realization of the cause) 

 about 1904, and increasingly thereafter. 



Any significance this record may have lies 



