Lectures on nervous diseases from the standpoint of cerebral and spinal localization, and the later methods employed in the diagnosis and treatment of these affections . some cases) is not that of paralysis. The two should not be con-founded with each other. In this disease, the motor power of any indi-vidual muscle is not impaired, nor do the limbs usually show any lackof development. It is only when some act is demanded which involvesa coordination of muscular movement, or. in other words, where severalmuscles must be employed in some special order, that the ditliculty SCLEROSIS OF THE POSTE
Lectures on nervous diseases from the standpoint of cerebral and spinal localization, and the later methods employed in the diagnosis and treatment of these affections . some cases) is not that of paralysis. The two should not be con-founded with each other. In this disease, the motor power of any indi-vidual muscle is not impaired, nor do the limbs usually show any lackof development. It is only when some act is demanded which involvesa coordination of muscular movement, or. in other words, where severalmuscles must be employed in some special order, that the ditliculty SCLEROSIS OF THE POSTERIOE COLUMNS. 399 becomes manifest. Too much emphasis can not be laid upon tliisdistinction between incoordination and a loss of muscular power. Among the early symptoms of incoordination which the patient ex-periences may be mentioned a ditiiculty in performing feats of locomotionwhen suddenly called for, as in hastily crossing a street, climbing a flightof steps, or washing the face with the eyes closed. Under such circum-stances a sense of insecurity lirst dawns upon the ])atient and causeshim to avoid such acts. Grradually he finds it necessary to stand wiili. Fig. 117.—Extensive Joint-Changes in Connection with Locomotor Ataxia. (Charcot.) the feet apart to increase his base of support; to keep his eyes upon theground when walking, so as to use the visual sense in directing hismovements, and to employ canes to aid him in preserving his patients have great difficulty from the first in placing the feet uponsmall objects, as in mounting into a saddle by means of the stirrup,climbing ladders, or in getting upon a chair to reach some object. When incoordination l)ecomes still more imi)aired, the patient walksslowly and with great deliberation. The feet may be suddenly jerkedoutward, the heel generally strikes the ground before the sole of the foot, 400 LECTURES ON NEKVOUS DISEASES. ciiiisiug the peculiar sttim|)ing gait; and sometimes the movementsof tlie legs ar
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