es, disturbances of vision, or cross-eyes. Sooner or later,
there appears the peculiar paralysis of the disease, which consists of
more or less numbness of the feet and legs, and, in the later stages, of
the hands and arms, sometimes of the face. As a rule, however, the
patient finds difficulty in properly maintaining his balance, and in
walking his movements are tottering, like a man partially intoxicated.
It is difficult for him to maintain his balance and walk with his eyes
closed. If the arms are affected, their movements are uncertain. In
guiding a needle or in buttoning or unbuttoning the clothing, there is
an inability to move the hand with rapidity and certainty, or to any
portion of the face or body if the eyes be closed. The eyes and
attention must be constantly directed to the motion that is about to be
performed, or it is imperfectly done. The brain centres in this case
supply the weakened action of the spinal cord, and the stimulus to the
muscles is directed by the intelligence instead of being automatic, as
in health, and due to spinal action. Still later, the voluntary
movements become spasmodic or jerking. The neuralgic pains often become
very distressing; there is often a sense of constriction around the
limbs or body, as if they were encircled with tight cords. In extreme
cases locomotion becomes impossible, the patient is unable to bring the
hand to the mouth, and the speech may become impaired, articulation
being difficult and imperfect. In all cases there is more or less loss
of sensation in the lower limbs, the patient generally being usable to
distinguish between two points and one, even when the two, are a
considerable distance apart. The inability to feel the contact of the
ground or floor with the feet occasions the difficulty in walking. THE
CAUSES of this disease are somewhat obscure, but unquestionably exposure
to cold and dampness, and over-mental work, are largely instrumental in
its production. Scrofula and syphilis favor its development, while abuse
of the nervous system, such as results from over-indulgence of the
animal and reproductive instincts, are frequent sources of the nervous
changes that lead to ataxia.

SHAKING PALSY.

_Shaking Palsy, or Paralysis Agitans_, is an affection dependent upon
degenerative changes in the nervous centres. It is characterized by a
tremulous agitation, or continual shaking, beginning in the hands, arms
or head, and gradually extending itself over