Watercolour drawing of a case of unilateral atrophy of the tongue. From a man, aged 30 years, who had rheumatic fever seven years and syphilis four years before admission to the Hospital. Three months before admission sores were noticed on the right ankle, and one month later he had a sore throat and a headache, which he referred to the frontal and occipital regions. The headache was accompanied by occasional vomiting. About a month after the onset of the headache the tongue was first protruded to the right side and loss of power in the left arm and leg was noticed with slight dimness of sight. On admission his walk was feeble and the grasp of the left hand was impaired. The tongue was protruded to the right and on the right side of it great loss of substance with a flabby consistency was manifest. The neck was stiff and the head was rotated with difficulty. The temperature maintained a slightly hectic character. Electrical examination revealed complete loss of faradic excitability on the right side of the tongue with impaired sensation, whilst the muscles of the left thumb supplied by the median nerve did not readily react.
