Page:The Journal of Nervous and Mental Disease, 1876.djvu/548

540 the left side remaining perfectly dry, no matter how warm the temperature or hard the labor, and that the line of demarcation between the wet and dry sides, was perfectly plain, and very conspicuous down the mesial line of the face. On my examination this was found to he the case, the perspiration being confined entirely to the right side of the forehead, the right cheek and side of nose and lips, on the chin, however, it encroached a little on the left, though not to any extent. Under the chin and in the throat, there was, he thought, a difference in the amount of the perspiration in favor of the right side, but not a very considerable one. On other portions of the body, there was no particular difference between the two sides in this respect.

At first sight, this looked like an ordinary case of facial hemidrosis, which is not so absolutely rare, but a closer examination showed quite a marked difference in the two sides of the face, and the patient voluntarily mentioned some peculiarities that could be observed on close inspection, and which he had himself observed. The left side was plainly less full than the other, the skin appeared tenser and more shining, the subcutaneous adipose tissue seemed to be largely lacking, the muscles did not seem to have lost any of their volume, but the hollows between them were more prominent,—noticeably so when he smiled. He stated, also, that a cut or scratch on the left side was longer in healing than one on the right. The beard as worn, was limited to a small moustache, which, though formerly black, was now reddish brown, with numerous gray hairs, which was likewise common in the h air of the scalp; and as he stated, had always been so. The moustache, so far as there was any difference in the two sides, was thinnest on the left, the hairs were continually falling out. The cheeks were kept closely shaven, but there appeared to be an equal growth on both sides. No paralysis, twitchings, or any disorder of molity whatever.

The left eye was a little less prominent than the other, the degree of enophthalmus though very slight, had already attracted the attention of the young man himself.

Careful measurements showed no appreciable difference be- tween the two sides, none, indeed, could be expected at this stage