. A practical treatise on medical diagnosis for students and physicians . rcumducted. The armmay be rigid, or bent at the elbow, the fingers being flexed upon tlie pahiiand the thumb turned in. In locomotor ataxia there is uncertainty in the gait, which may only befelt by the patient or be apparent to the observer also. There is irregu-larity in the line of progression, or the movements become very jerkyand erratic. As there is very little motion at the knee, because it isspasmodically braced, the pelvis is slightly tilted until the foot is released ;the foot is then raised unnecessarily high,
. A practical treatise on medical diagnosis for students and physicians . rcumducted. The armmay be rigid, or bent at the elbow, the fingers being flexed upon tlie pahiiand the thumb turned in. In locomotor ataxia there is uncertainty in the gait, which may only befelt by the patient or be apparent to the observer also. There is irregu-larity in the line of progression, or the movements become very jerkyand erratic. As there is very little motion at the knee, because it isspasmodically braced, the pelvis is slightly tilted until the foot is released ;the foot is then raised unnecessarily high, jerked rapidly forward andoutward and brought down with a sudden stamp, or flail-like action, onthe heel. The patients centre of gravity undergoes several changes ateach step, so that he swings from side to side. He cannot walk in thedark, and at a later stage requires the aid of canes to prevent him fromfalling forward. In i^aralysh agitans the attitude and gait of the patient are head and body are thrown forward and fixed in that position ; the Fig. Gait in a case of locomotor ataxia : instantaneous serial photographs. (Muybridge and Dekcum.) arms are slightly abducted and partly flexed, the hands being in theposition in which a pen is held or a pill rolled. The legs are also bent atthe knees. Rhythmical tremors affect the hands first and then the restof the body, the head and neck usually escaping. The gait is festinatinr/—that is to say, eacli step becomes more rapid than the preceding, untilthe patient is prevented from falling only by catching hold of something. I GAIT IN HYSTERICAL rARAPLEGIA. 155 The tremors cease during sleep, and are independent of voluntary motion.(See Fio-. 14.) In !<pastic parapler/ia the patient walks with two sticks. He leans onthe left one, arches the back, and then lifts the pelvis and the right limbas far from the ground as possible, but cannot quite clear it. The leg isrigid and the foot dragged around in a semicircle.
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