r, the muscular power of the lower
extremities became much stronger and equal to that of the upper
extremities. Grip was strong and equal on both sides. Station and gait
were unimpaired when a steady and erect attitude and firm gait were
suggested to the patient; left alone, he was inclined to be slightly
unsteady on his feet. With eyes closed and feet together, there was
considerable swaying present; said he felt like falling over.
Voluntary movements were performed well. He described accurately a
circle, a square, and triangle in the air with either hand. Movements
were steady and accurate. Cooerdination was slightly impaired in f-f
and f-n tests; the termination of the act was accompanied by a slight
tremor. The musculature of thighs showed a more or less constant
clonic twitching. When attention was called to this he was able to
control it to a certain extent. Upon assuming a sitting posture the
twitchings ceased. He said it was due to weak ankles. There was no
tremor of protruded tongue or lips when showing teeth; fine tremor of
the extended fingers and forearm when extended; no tremor of facial
musculature. There was no paralysis, but there seemed to be a slight
weakening of the lower extremities. No atrophies or hypertrophies
noted. The triceps and radial reflexes were definitely exaggerated.
Upon tapping, the quadriceps tendon caused a brisk marked contraction
of thigh muscles, followed by mild clonus. Tapping of one knee tended
to set musculature of opposite knee in mild clonus of short duration.
Knee kicks were definitely exaggerated. Tendo Achillis exaggerated. No
ankle clonus. Muscular irritability to mechanical stimulation
increased. Superficial reflexes were normal, except plantar defense
reaction was slight. Cutaneous sensibility was unimpaired: heat and
cold readily distinguished. Light touches of pin pricks were felt and
localized all over the body. Sense of position normal. No
astereognosis in either hand. No excessive sweating. Eyes clear;
irides brown; pupils round and regular, moderately dilated, reacted
readily to all tests; eye movements well performed in all directions;
no nystagmus nor strabismus. Vision--20/30 in each eye, improved by
glasses. Skin of vitreous clear; slight weakness of external recti;
cornea clear; field of vision normal for white; both fundi normal
except for slight hyperaemia. Smell, taste, audition, and spee