ways a disease of childhood. So-called post-hemiplegic chorea is, in
the opinion of both Hammond and Gray, simply athetosis. The silly,
dancing, posturing, wiry movements, and the facial distortion observed
in Huntington's chorea would hardly be mistaken by a careful observer
for athetosis. The two diseases, however, are somewhat alike. Paralysis
agitans (shaking palsy), with its coarse tremor, peculiar facies,
immobility, shuffling gait, the 'bread-crumbling' attitude of the
fingers, and deliberate speech, would be readily eliminated even by a
novice. It is, too, a disease of advanced life, usually. Charcot, Gray,
Ringer, Bernhardt, Shaw, Eulenberg, Grassel; Kinnicutt, Sinkler, and
others have written on this affection."

The following is the report of a case by Drewry, of double (or, more
strictly speaking, quadruple) athetosis, associated with epilepsy and
insanity: "The patient was a negro woman, twenty-six years old when she
was admitted into this, the Central State (Va.) Hospital, in April,
1886. She had had epilepsy of the grand mal type for a number of years,
was the mother of one child, and earned her living as a domestic. A
careful physical examination revealed nothing of importance as an
etiologic factor. Following in the footsteps of many of those
unfortunates afflicted with epilepsy, she degenerated into a state of
almost absolute imbecility.

"Some degree of mental deficiency seems usually to accompany athetosis,
even when uncomplicated by any other degenerating neurosis. Athetoid
symptoms of an aggravated character, involving both upper and both
lower extremities, had developed previous to her admission into this
hospital, but it was impossible to find out when and how they began.
She had never had, to the knowledge of her friends, an attack of
'apoplexy,' nor of paralysis. The head was symmetric, and without scars
thereon. The pedal extremities involuntarily assumed various distorted
positions and were constantly in motion. The toes were usually in a
state of tonic spasm,--contracted, and drawn downward or extended,
pointing upward, and slightly separated. Irregular alternate extension
and flexion of the toes were marked. The feet were moved upon the
ankles in a stiff and awkward manner. During these 'complex involuntary
movements,' the muscles of the calf became hard and rigid. The act of
walking was accomplished with considerable difficulty, on account of
contractures, and because the feet were not ex