The Journal of nervous and mental disease . ecially at the knees. The patellar reflexis much exaggerated on each side. There is no patellar and noankle clonus. The feet perspire very freely. The Babinski reflexis with flexion of the big and other toes on each side. Touch andpain sensations are normal in the lower limbs. The Achilles reflexes are about normal. When standing theman has a marked tendency to flex each knee and to incline for-ward at the hips, assuming a position very suggestive of paralysisagitans. He can, when he first rises from the chair, assume an uprightposition, but he soon,
The Journal of nervous and mental disease . ecially at the knees. The patellar reflexis much exaggerated on each side. There is no patellar and noankle clonus. The feet perspire very freely. The Babinski reflexis with flexion of the big and other toes on each side. Touch andpain sensations are normal in the lower limbs. The Achilles reflexes are about normal. When standing theman has a marked tendency to flex each knee and to incline for-ward at the hips, assuming a position very suggestive of paralysisagitans. He can, when he first rises from the chair, assume an uprightposition, but he soon, especially if a little fatigued, takes the posi-tion of partial flexion. He drags his toes along the ground, and his slippers are wornat the toes, equally so on both sides. The gait shows some festina-tion. He has no atrophy anywhere. John, a brother of the man just described, was 44 years old in1914. He is now in the service of Dr. Mills but has been fre-quently observed by me. He has used alcohol freely. He contracted WILLIAM G. SPILLER. Fig. I. Edward, aged 47 years. Symptoms bc-Kun when the man wasabout 30. Tremor and attitude those of paralysis agitans. Rigidity of Babinski. Toes are scraped a little on the floor in walking. THE FAMILY FORM OF PSEUDO-SCLEROSIS ^ syphilis about nineteen years ago. His facial expression is verysuggestive of paralysis agitans. His pupils are equal and respondpromptly to light and in convergence. He has had a tremor of theupper limbs for nineteen years, suggesting that of paralysis agitans,and not ceasing during voluntary movements. The tendon reflexesof the upper and lower limbs are prompt, and the patellar reflexesmay be a little exaggerated. There is no upward movement of thetoes in testing the Babinski reflex. The muscular power of thelimbs is fair. There is no ankle clonus. The patellar reflexes maybe a little exaggerated. The tremor began in the right lower limb, then affected theright upper limb, then the left upper limb, and
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