how his feet are placed, so long as he does not
straddle. He can repeat this effort for himself a dozen times a day, for
a minute or two each time. Next we try the same position with a little
more care about getting the feet pretty near together and parallel, or
with the toes turned out only a very little. In another couple of days a
little more severity may be exercised about maintaining the correct
attitude,--heels touching, hands hanging down, and eyes looking straight
forward,--and until he is able to do this _easily_ it is best to ask
nothing more. Then he is requested to stand on one foot, being permitted
just to touch a chair-back or the attendant's hand to give confidence.
This is practised until he can keep his erect station for a few seconds
without difficulty. This point of improvement may be reached in three
days or a week or may take a fortnight. Women, as I have before
observed, although rarely in America the victims of tabes, when they do
have it have far less disturbance of balance than men, and this is to be
attributed to their life-long habit of walking without seeing their
feet. I have found in the few cases of ataxia in women that I have seen
that they benefited much more quickly by these balance instructions than
did men, though their other symptoms were in no way different.
Continuing every day the practice of all the previous lessons, movements
are rapidly added as soon as station is better. A brief list of them
follows. When the exercises grow so numerous as to take overmuch time,
the simpler early ones may be omitted.
When the learner is able to stand on one foot, let him slowly raise the
other and put it on a marked spot on the edge of a chair. This, like all
the other exercises, must be practised with both feet.
Stand erect without bending forward and put one foot straight back as
far as possible.
Do the same sideways.
Stand and bend body slowly forward, backward, and sideways, with a
moment's rest after each motion.
Having reached this point, I usually order the patient to practise all
these with closed eyes. When he can do this, he begins to take one or
two steps with shut eyes, first forward, then sideways, then backward.
If he falter or move without freedom, he is kept at this until he does
it confidently. Then exercises in following patterns traced on the floor
are begun. In hospitals, or where bare floors are to be found, the
patterns may be drawn with chalk. In carpeted room
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