A treatise on the principles and practice of medicine . reading, and the entire body must beturned to enable the patient to looklaterally. There is also slow, mo-notonous, monosyllabic speech, withhesitation at first, but hurried atthe finish, (ii) The attitude is char-acteristic, because of the flexor posi-tions assumed; the head and the chinare held forward, the neck is ex-tended and rigid, the body is inclined forward, the elbows are fixed and brought somewhat forward and awayfrom the body; the forearms are brought toward the body, the tremblingthumb and index-finger are apposed, or the fin
A treatise on the principles and practice of medicine . reading, and the entire body must beturned to enable the patient to looklaterally. There is also slow, mo-notonous, monosyllabic speech, withhesitation at first, but hurried atthe finish, (ii) The attitude is char-acteristic, because of the flexor posi-tions assumed; the head and the chinare held forward, the neck is ex-tended and rigid, the body is inclined forward, the elbows are fixed and brought somewhat forward and awayfrom the body; the forearms are brought toward the body, the tremblingthumb and index-finger are apposed, or the fingers deviate toward theulnar side as in arthritis deformans, and in standing the knees are some-what bent and at times closely apposed. The body expression, we may sayis like that of the face, (hi) The gait is equally characteristic. Like thespeech, it is initially hesitant, later hurried. The patient, when oncestarted, may not be able to stop himself. Trousseau spoke of the patientsas chasing their centre of gravity. This destination or propulsion is. Fig. 78.—Side view of a case of par-alysis agitans, showing forward inclinationof the trunk. Tendency to propulsion.(Dercum.) 936 THE NEUROSES purely mechanical from the forward bodily inclination, although inter-preted by Charcot as a forced movement. To counteract the throwingforward of the centre of gravity the arms may be carried behind the some cases, if the patient is pushed backward or sidewise, he may notbe able to stop for some steps; this is retro- and later opulsion. (iv) Thepalsy is often slight and rarely extreme, although simulated by the help-lessness caused by rigidity. The patient is not inclined to exertion,moves like a piece of machinery, as Parkinson describes it, and maynot be able to turn over in bed. Patients have drowned from fallingon the face in a small puddle of water. Muscular reaction requires40 per cent, more time than normal. The mind is clear, but stiff like the face and limbs, and a cert
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