and unemployed, placed it, for business purposes, in the hands of his confidential broker. This sum he invested in a stock that had an unexpected, sudden, and enormous rise in value. In a fortunate moment, he sold out, and the 10,000. realized 60,0007. An account of the successful monetary speculation was transmitted to the fortunate owner of this large sum. The startling intelligence produced a severe shock to the nervous system, and the mind lost its equilibrium. The poor fellow continued in a state of mental alienation for the remainder of his life. His constant occupation, until the day of his death, was playing with his fingers, and continually repeating without intermission, and with great animation and rapidity, the words, "Sixty thousand! sixty thousand sixty thousand!" His mind was wholly absorbed in this one idea, and at this point the intelligence was arrested and came to a full stop!

CHAPTER XVIII.

Morbid Phenomena of Motion.

THIS function of the Cerebro-Spinal system may be,

Under the head of impairment, I propose to consider all those exceedingly subtle and insidious cases of paralysis which are preceded for a length of time by a deficiency of motor force and an enfeebled state of the muscular power. This condition of motility is often confounded with general physical debility, and attracts no special notice until more obvious cerebral symptoms appear, or the paralytic affection is quite localized.

In the second division of the subject are classified those cases of lesion of motion in which the volition ceases to exercise any influence over the paralysed limbs, as in well-developed cases of hemiplegia and paraplegia. In states of motor exaltation we have a condition of spasm, tonic and clonic, and in perverted conditions of the motility, we observe as types of the affection, epilepsy, tetanus, convulsions, and chorea.

It is important, in considering paralytic affections either in their incipient or advanced stage, to recognise

the threefold division of which the subject is susceptible. These affections of motility may in their origin be,

In other words, paralysis may commence in the brain, spinal cord, or in the peripheral ramifications of the nerves. It may be a centric or an eccentric affection. How important it is, when investigating practically this subject, to recognise this physiological and pathological classification of the lesions of the motor power, with a view to accuracy of diagnosis, and success of treatment.

Dr. Marshall Hall points out with his usual discrimination, the distinction between paralysis of spontaneous and voluntary motion arising from the removal of the influence of the cerebrum, from parts in communication with it, and the lesions of motility which result from an arrest of the supply of nervous influence from the spinal marrow. In cerebral paralysis, there will be always found augmented irritability, and in spinal paralysis the irritability is either diminished or altogether lost.

"We may conclude," says this distinguished physiologist, "that in cerebral paralysis, the irritability of the muscular fibre becomes augmented from want of the application of the stimulus of volition; in paralysis arising from disease of the spinal marrow and its nerves this irritability is diminished, and at length becomes extinct, from its source being cut off. We may further deduce from the facts which have been detailed, that the spinal marrow, and not the cerebrum, is the special source of the power in the nerves of exciting muscular contraction, and of the irritability of the muscular fibre; that the

cerebrum is, on the contrary, the exhauster, through its acts of volition, of the muscular irritability."

GENERAL MUSCULAR DEBILITY. For some period before any positive lesion of motility is perceptible, the patient complains of a general failure and loss of muscular power. He is easily tired; is obliged, if engaged in a walk, to frequently sit down, complaining of fatigue. This condition of muscular debility is observed to precede, for some length of time, any local or specific form of paralysis.

As the affection of the brain, involving a disordered state of the motor force advances, the patient's feet slip on one side. He is observed frequently to stumble whilst walking, as if the ligaments of the ankle-joint were weakened or elongated. He cannot put his foot or leg forward without an obviously conscious effort. Succeeding this general deficiency of muscular power, there is occasionally noticed a want of local specific motor strength in one of the limbs.

"The patient experiences a greater difficulty in executing forced and limited movements, than those in which he merely follows the impulse of his inclinations ; he finds it much more laborious to walk slowly, with a measured step in a given direction, than to let his feet take their own course; rising from the chair, or going up stairs, is more difficult than sitting down or descending; the next difficult matter is to turn round in walking.'

"'*

In the early stage of cerebral disease, complaints are made of a weakness in the arms, hands, legs, or in one side of the body.+ Objects cannot be grasped, or firmly

*Romberg. Dr. Sieveking's translation.

+ Dr. Fuch states a sudden loss of power in the extremities of one side while walking, so that the patient is compelled to sit down or fall, without suffering any loss of consciousness, to be an important and diagnostic symptom of softening of the brain. Among the early symptoms of this disease,

held steadily or comfortably. There is often in these cases an awkwardness in using one or both hands.

In a case related by Andral, for some months before an attack of paralysis which ended fatally, there was a loss of power in the right hand, and to such an extent, that the patient could not hold his pen when in the act of writing. There was no impairment of sensibility, affection of the motility in the right arm, or in any other part of the body. Andral says, "In cases of incipient paralysis, the patients perceive that one of the extremities has less strength than the other, one of the hands can hold objects less strongly than the other; one of the arms appears insensible to them, or the patients' legs drag a little in walking." He continues, and the observation is of great practical significance, "this commencement of paralysis may remain stationary for a long time, then it is seen progressively to increase, or else it becomes all at once more considerable."*

A gentleman who had previously manifested no symptom of decided illness, was observed frequently to drop his stick, as well as his umbrella, in the street. This was the first loss of motility observed for some weeks prior to an apparently sudden and acute attack of apoplexy, followed by paralysis.

A patient, aged sixty, previously to an attack of cerebral hemorrhage of which he died, exhibited in the incipient stage, indistinctness of speech and loss of recollection. He appeared, at times, to have a weakness of the is a slight degree of facial paralysis. Occasionally it affects the eyebrow and the mouth. The patient appears to have lost power over one of the eyelids, as if it were too heavy to be completely raised. One eyebrow is more elevated than the other. The mouth is occasionally seen to be drawn on one side. When these symptoms are present, Durand-Fardel says, we may almost predict with certainty that softening of the brain is threatening or has already commenced. These apparently slight attacks of paralysis, the same authority observes, are accompanied with an astonished look, or one of stupor, indifference, or idiocy.

* Andral's "Clinique."