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tablished by the author was that the cells of the anterior horns were the first 2 Nizoral to be changed. The theory of Strumpell and oth- ers as to the infectious nature of some spinal-cord diseases might often be explained perhaps by vascular changes. Possibly bac- terial occlusion of spinal vessels might cause acute poliomyelitis. Nizoral Tablets The muscular Nizoral Oral changes described by the writer were different in man. In animals vacuolization was early, but in man after long- continued chronic disease of the muscles. Dr, Mary Putnam Jacobi had been particularly struck by the apparent identity of symptoms produced by cutting Hair Loss Nizoral off the blo.od-supply and by furnishing blood in excess. Some of the Older experimenters had occluded Nizoral India arteries by the injection of powders. The author's contribution confirmed Eanvier's state- ment that the first step in inflammation was change in nutri- tion. The question had occurred to her whether all these vascu- lar alterations were not the immediate result of loss of directive power over the blood-vessels by the cells which governed it. The President had examined Dr. Herter's specimens micro- scopically, and there was no doubt as to the changes in the pos- terior roots. He did Nizoral 1 not think the alterations in the muscles were properly vacuolization — not such as in Wagner's specimens, which he had also seen. It was a question if all the changes were due to the cord lesion. Dr. Herter said that, as to Dr. Heirzmann's criticisms, to answer him would involve a reconsideration of the whole ques- tion Oral Nizoral of inflammation, as his views upon that subject seemed to be so sweeping and revolutionary that they would require more examination and thought Nizoral 200 than he was able at the time to give them. His specimens had many of them been examined in the fresh state, and some after hardening in Mtiller's fluid. They had not been treated with alcohol. As to there being no con- Inective tissue in the spinal cord, this was at variance with the generally accepted views, and it was difficult for him Nizoral Hair to conceive of its absence. He knew of the experiments referred to by the president, but thought they were confined more to the study of grosser effects and lesions, and not to the study of microscopical changes. A Case of Hemiplegia with remarkably Perfect Associ- ated Movements on the Paralyzed Side. — Dr. Sachs then presented a young man of twenty-three who had had infantile hemiplegia at the age of one year as the probable result of a fall. The paresis, contractures, and exaggerated reflexes of the left side were the remnants of this early attack. He also de- scribed a second case occurring in a girl of twelve whose early history was very obscure, but whose physical symptoms pointed to a similar attack in early life. Both cases presented the marked peculiarity that all the movements of the sound arm and hand were imitated by the paretic members, Nizoral 2 and vice versa. The same Nizoral Hair Growth was true to a lesser Nizoral Ketoconazole degree of the lower extremities. In Case No. I, if he attempted to raise his arm, the right would also be raised ; in lifting a glass from the table with his left hand, the right hand would perform the same movements. They were very marked in buttoning or unbuttoning his clothes, when the paretic hand would make the same motions. In Case II these delicate movements were also present, but the grosser kinds were not imitated by the paretic hand. Some charts designed by Dr. Nizoral Hair Loss Peterson were exhibited to show the resemblance be- tween the original and the associated movements. They were copies of zigzag lines made by the patient on a horizontal black- board with a piece of chalk in each hand. Dr. Sachs remarked that it was difficult to explain these associated movements, and it was curious that the very members of our bodies which were innervated singly from our earliest days should perform associ- ated movements in disease. It was sup[)Osed by some that, in- hibition having been removed by cortical or intracerebral dis- ease, the naiural tendency to bilateral movements returned, and that the paretic hand was moved from the sound half of the brain. There were numerous objections Nizoral Buy to this theory, and it could not explain the associated movements of the Nizoral Hairloss sound hand when attempts were made to move the paretic hand. The speaker thought it more probable than an irradiation took Ketoconazole Nizoral place lower down in the central nervous system, either in the pons, medulla, or even in the spinal cord, and that these associated movements were to be regarded as imperfect reflex movements. He did not think that such movements could be explained by the supposed existence in many persons of an unusually Nizoral Price large number of uncrossed motor nerve-fibers. Dr. Herter asked if there were athetosis and atrophy in the cases, and was answered that there was as much atrophy as usual in cerebral cases, but no athetosis. Dr. Lesztnsky had noticed in such cases that when the at- tention of patients was directed to the paretic hand these asso- ciated movements occurred, but not otherwise. Dr. Peterson said they were undoubtedly increased by the attention of the patient being directed Nizoral Tablet to the movements, but not caused by it. Dr. Biedsall and the President both remarked upon the great rarity of cases showing Nizoral 200mg associated movements to such an unusually perfect degree. i s r ^ 1 1 a It g , Irish State Prisons and their Physicians. — Dr. Thomas I,affan, of Cashel, Ireland, has sent us a comiuuuieation iu which he says : " I venture to invite a discussion in your columns on the obligations of

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