. The Journal of nervous and mental disease . es. The movements of the right leg aremuch better than those of the left, but probably are not fullynormal. The patellar reflex is diminished on each side, but isbetter on the right side. Ankle clonus is not present on eitherside. The Achilles jerk is diminished on each side. TheBabinski reflex is not obtained on the left side, but the toesare neither flexed nor extended. On the right side the move-ment of the toes is distinctly flexion. Sensation of pain is prob-ably preserved in each lower limb. PRESIDENTIAL ADDRESS 499 On attempting to converge
. The Journal of nervous and mental disease . es. The movements of the right leg aremuch better than those of the left, but probably are not fullynormal. The patellar reflex is diminished on each side, but isbetter on the right side. Ankle clonus is not present on eitherside. The Achilles jerk is diminished on each side. TheBabinski reflex is not obtained on the left side, but the toesare neither flexed nor extended. On the right side the move-ment of the toes is distinctly flexion. Sensation of pain is prob-ably preserved in each lower limb. PRESIDENTIAL ADDRESS 499 On attempting to converge the right eyeball moves downand inward, but the left eyeball moves only slightly down-ward. Feb. 20. He has been quiet. Bowel movements have allbeen involuntary. Temperature has gone up somewhat andbreathing is difficult. He has a tendency to let the tonguefall back and obstruct the ingress of air. Hands are twitchingat times. Left pupil is larger than the right. Inward squint ofright eye continues. Immobility in lateral direction Fig. 9. Line shows hemorrhage of the right tegmentum of pons. Inwarddeviation of the right eyeball. Immobility of both eyeballs ten days afterthe apoplexy. Temporary paralysis of all associated movements. Con-vergence preserved, although weak. Feb. 22. Condition while very alarming yesterday is nowmuch improved. Breathing is easier, intelligence is recognized and talked with bis son. Feb. 24. The eyes have regained a large amount of lateralmovement [the direction not stated]. Hand grasp slightly 500 WILLIAM G. SPILLER firmer, pulse moderately good. Temperature touched normalyesterday. Feb. 26. Condition gradually getting worse, but no specialchange in nervous symptoms. He is weaker. Temperature during first few days after admission wasbetween 99 and 101 degrees, then dropped below normal forseveral days, but on Feb. 20 rose again and remained more orless elevated until death. Feb. 28. Patient died at The clinical diagno
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