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point to commencing ataxia, especially the state of the optic
disks, the frequency of urination, the analgesia of the lower
extremities, the benoquin cream gait, and the difficulty in getting started to
walk ; the latter point to a sort of moral insanity. There has
evidently not been time in this case for the spinal aifection, if
present, to impress its character on the mental disease. In the
fifth case there are ataxic symptoms, with a certain degree of
the same elevation of spirits over what would be the healthy
average under the patient's circumstances."
These facts seem buy benoquin online to point to at least one accompaniment,
in the mental centres— that of lesion in the subordinate ma-
chinery which appears to us as ataxia. That accompaniment
is the state of buoyancy — high spirits. ISTor is there any thing
improbable benoquin 20 in this, even if we were to suppose that mind is in
some respects out of the reach of body, for there can be no
condition mentioned which would be more easily proved to
depend often on grossly material conditions than precisely this
one of buoyancy or high spirits. In animals it can be pro-
duced almost at will by certain physical treatment, and in
men it can be controlled by drugs to a very considerable ex-
tent, even with our present knowledge.
But it is well to add at once what additional evidence can.
be obtained. Three cases have been put on record by West-
plial, all of which had undoubted symptoms of locomotor
ataxia, and, supervening upon this, insanity ; the latter affec- buy benoquin
tion took the form of " mental excitement and manie des
3IEXTAL SCIENCE IX GEE AT BEITAIX. 207
grandeurs^ In all three cases tlie spinal affection had shown
itself (two, nine, and fifteen years respectively) before the
patients were admitted under Dr. AYest-phal's care for mental
alienation.
Here, therefore, is a certain amonnt of evidence — enough
at least to justify iis in asking whether there are any a priori
grounds on which we might expect to find these two forms of
disease linked to one another. To answer such a question it
is necessary to insert some remarks as to the nature of what
we designate " ataxia,"
I cannot follow him through the long argument which
leads him to conclude that " the afterent fibres for locomotive
purposes are separate from those for cutaneous sensibility," or
through the secondary conclusions at which he arrives. Plis
observations on the connection between the disease of unstable
powers and insanity reveal to a certain degree his " scheme of
the physical framework of locomotor ataxia, drawn partly
from the imagination, but in good part from facts."
" It can now be seen in what direction an explanation of
the psychical phenomena of locomotor ataxy promoted to the
brain is attempted. Granted that locomotor ataxia is a disease
in benoquin cream 20 whicli running away of power is an essential element, and
granted that there is that openness for transmission of organic
impressions toward the mental centres, which (as in hypochon-
dria) is often so marked in the benoquin monobenzone cream insane diathesis ; or, on the
other hand, that the necessity for decay which lies upon tlie
afferent fibres of locomotion, and produced (as benoquin online we say) the
lesion there, may extend by anatomical analogy to other fibres
which subserve the comparisons -between objective circum-
stances constantly going on in our minds subordinately to our
volitional life — fibres, namely, which, with help, collect all
the impressions for us, carry them toward the brain, and often
are privileged to draw power for an " ideo-motor " action of
their own ; granted that these too are involved in the ruin,
and that the stored-up power they formerly set in motion is buy benoquin cream
left to rush off* wildly with each mad attempt to volitionize
apart from a true sense of externals, and it will no longer re-
main a matter of surprise that exaltation is the phase of emo-
tional life, which locomotor ataxia determines in tlic brain.
268 llECENT CONTEEBUTIONS TO
'' Hitherto I have considered ataxia as developing into
manie des grandeurs. It will be remembered, however, that,
from the cases I have myself observed, the only general con-
clusion that could benoquin vitiligo be drawn was that of a certain buoyancy,
a state of high spirits. It will suffice very shortly to point to
what the reader will no doubt remember for himself, that
buoyancy of spirits is even a more general accompaniment benoquin cream for sale of
outflowing power than is the proper emotion of power, this
last reposing, as it does, on a certain amount of education.
JSTot by any means cdl outflowing power is so accompanied,
but much is so, and especially when an excess runs off. Buoy-
ancy, therefore, is very much to be expected, with any ataxia
involving the conscious centres, in a patient who has in his
previous life enjoyed the exercise of his powers to a fair ex-
tent. In this regard the case of W. K., who displayed ataxic
movements on his right side especially, but also on his left,
which had previously been paralyzed, and in whom a boyish
height of spirits was apparent, is a very interesting and in-
structive one. ■
As the mental exaltation is the point mainly insisted on
by the writer, I may briefly mention that in Case I. the patient
"seems decidedly to take a happy view of things ; " that in
Case II. he (being a laborer) " believes that he has a great
deal of property up and down; that the railway company
owes him $2,200, etc. ; that in Case III. he (being a work-
house patient) " says he has property in houses, and a crown benoquin price
of glory which his heavenly Father has given him, but no
money, and fancies that he is very strong ; " while in Case V.
he says "he is happy and well, and monobenzone benoquin is inclined to look at
every thing in a happy light."
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