Perhaps it may be well to mention in this place a condition known by the above name, which, although belonging rather to diseases of the brain, clinically presents features so closely allied to the ordinary forms of bulbar paralysis that it may best be considered here.

It is a "bulbar paralysis " of cerebral origin, or, in other words, there is paralysis of the lips, tongue, and larynx, parts which, as we have just seen, have their lower centres in the "bulb"; but unlike the last group, where these centres have suffered degenerative change, in this the lesion is a bilateral one affecting the centres for those parts in the cortex - the lower part of the ascending frontal convolution, or about the knee of the internal capsule. Although the lesion is usually a bilateral one, in several instances it has been unilateral.