. Contributions from the Department of Neurology and the Laboratory of Neuropathology (reprints). dulla oblongata shows no degeneration of the anteriorpyramids. The cells of the lower olive are normal in numberbut are much smaller. The optic nerves and chiasm are notdegenerated. I am indebted for the photographs illustrating this case to J. Smith. The following clinical case of Friedreichs ataxia has beenin my service frequently at the Philadelphia General Hospital,and has been studied also by my colleagues on the neurologicalstaff. It is included because of the pronounced atrophy of
. Contributions from the Department of Neurology and the Laboratory of Neuropathology (reprints). dulla oblongata shows no degeneration of the anteriorpyramids. The cells of the lower olive are normal in numberbut are much smaller. The optic nerves and chiasm are notdegenerated. I am indebted for the photographs illustrating this case to J. Smith. The following clinical case of Friedreichs ataxia has beenin my service frequently at the Philadelphia General Hospital,and has been studied also by my colleagues on the neurologicalstaff. It is included because of the pronounced atrophy of thelimbs. FRIEDREICHS ATAXIA 421 W. Soudan, 41 years old, began to walk when three years old,and walked with a cane until he was 15 years old. He staggeredmuch and was clumsy in lifting his feet, and often fell whenwalking. In 1895 he became unable to walk, and for some timebefore his admission he found it more difficult to walk at night. In 1890 he had severe attacks of pain in the stomach, withnausea and vomiting, suggesting gastric crises. Speech always has been slow. Intelligence is Fig. 9. Pronounced atrophy of the hands in a case of Friedreichsataxia. (Case II.) His condition since 1898 has varied very little, except that hehas grown weaker in his lower limbs. In 1898 he had markedatrophy of the interossei muscles and of the thenar and hypoth-enar eminences, and marked symmetrical atrophy of the station was very ataxic. In May, 1905, Babinskis sign was absent on both toe was not present. His condition at present (March 2, 1910) as observed by meis as follows: He has marked nystagmus in looking either to the 422 WILLIAM G. SPILLER right or left, but none in looking straight forward. There is notremor of the head, and no paralysis of the muscles of the tongue is normal. Touch, pain, heat and cold sensations arenormal in the face. Speech is slow and somewhat pupils are equal, although the left may be a trifle large
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