A Case of Insular or Disseminate Sclerosis

creasing for the two following days. On the fourth day of his illness, the giddiness increased very much and he began to vomit and had fever, which passed off in two or three days. The objects around him, he felt, were moving, and it was for the treatment of his vertigo that he came to hospital to be treated. The patient named Dukhi, a Hindu male, aged 22 years, is a muscular man of active liabit, a syce by occupation. He has no history of syphilis nor of alcoholism. There is no indication of neurotic temperament in his features nor in his family history. On admission, the digestive and respiratory systems were normal and the pulse very slow? 49 per minute. There are jerky movements of the muscles supporting the head. The head moves from side to side, remaining inclined to the ! right side. The movements cease when the I patient lies flat on the bed, but are present while the patient sits up in bed, and the movements increase when he is being looked at and when the head is moved about; the}' diminish markedly when he fixes the head towards a certain point. There is also some tremor of the small muscles of the eyebrow (corrugator supercilii) and those over the upper maxillary region. There is nystagmus of both eyes, which markedly diminishes when the eyeballs are fixed on