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1914. 7. Zentralblatt fiir Chirurgie, Leipsic, March 21, 1914. 8. Semaine viagra not working Medicale, Paris, January 21, 1914. 9. Cretti: Journal A. M. A., January 11, 1913. 10. Pusey viagra not working and Caldwell : "The Roentgen Ray in Therapeutics," page 646. 11. Campbell: Journal A. M. A., 1902, Vol. XXXIX, p. 313. 12. Butler: viagra not working British Med. Journal, 1902, Vol. II, p. 1303. 13. R. Freund: Miinch. med. Woch., 1907, No. 7. 14. Ludin: Zentralblatt f. d. Gronzgebiete d. med. u. Chir, Jena, April 4, 1914. 15. Wagner: Wiener klin. Wochenschr., 1909, Vol. 22. 16. Howell: Fortschr. a. d. Geb. d. Rentgenstrahlen, 1907, Vol. XII, p. 286. 17. viagra not working Holland: viagra not working Fortschr. a. d. Geb. d. Rontgenstrahlen, 1908, Vol. XIV, p. 149. 18. Schultz: "J^-ray Treatment of Skin Diseases." 19. Pancost: Musser and Kelley, "Practical Treat- ment," pink viagra reviews Vol. I. 20. Pfahler: "Forchheimer's Therapeusis of In- ternal Diseases," Vol. I, p. 556. 21. Friedlander: Archives of Pediatrics, 1911, p. 810. 22. Rachford: "Diseases of Children," p. 548. 23. Ledoux: Journal de Physiotherap., 1912, Vol. X, p. 233. 1219 Connecticut Avenue. N. W. CEREBELLAR SYMPTOMATOLOGY.* By MALCOLM S. WOODBURY, M pink viagra reviews D . CLIFTON SPRINGS, N. Y. It is universally true in regard to symptoms asso- ciated with lesions of the nervous system that the pathological anatomy and physiology of the affected areas furnish a ready e.xplanation for the symptoms which are encountered, the only limitation being that our physiological and anatomical knowledge is very incomplete. The cerebellum may be roughly divided into two lateral lobes and a central lobe or vermis. The cere- bellum is not in the usual acceptation of the term either truly motor or truly sensory in function. It receives impressions from afferent tracts and trans- mits impressions to certain efferent tracts. The following anatomical reminders will serve to recall the more essential elements concerned in connecting the cerebellum with other structures. The component fibers of the posterior spinal nerve roots may be subdivided into several different groups varying in destination and function ; only one of these groups concerns us at the present moment. The fibers of this group enter the posterior portion of the cord and terminate in arborizations around the cells of Clarke's column. Thence new neurones extend by way of the direct cerebellar tract and Gowers' tract to the cerebellum — the direct cerebel- lar tract by way of the inferior peduncle, Gowers' tract by way of the superior peduncle. Both these tracts are homolateral, though some writers hold *Read before the Ontario County Medical Society, April 9, 1916. that there may perhaps be contributing fibers to Gowers' tract from the contralateral side. These tracts represent the principal afferent fibei-s from the cord to pink viagra reviews the cerebellum, and furnish the direct nervous connection between muscles and joints and the cerebellum, to which they convey joint and muscle impressions. There are two principal efferent tracts which leave the cerebellum, one being the vestibulospinal tract, and the other the rubrospinal tract. Both are physiologically essentially homolateral (though the latter becomes so only after crossing to the red nucleus of the opposite side and then recrossing to the side of its origin), and both convey stimuli from Ihe cerebellum to joints and muscles by way of the viagra not working anterior spinal nerve roots. Recognition of these facts reveals the reflex mechanism which permits cerebellar muscle control. There is also a connection between the cerebellum and the oculomotor nerves by way of a group of fibers which is known as the posterior longitudinal bundle. Furthermore, there is a connection between the internal ear and the cerebellum by way of the vestibular nerve, the vestibular nucleus, Deiter's nucleus, thence to the vermis. The cerebellum, then, is a reflex apparatus in close connection with the spinal cord. It is a modifier of influences, rather than an originator. It is closely connected also with the semicircular canals and with the eye muscles, and, furthermore, there are fibers pink viagra reviews connecting the frontal and temporal cere- bral regions with the cerebellum. While it is not an originator of motion, pink viagra reviews it in a