. A text-book of medicine for students and practitioners . the long-est. The facial musclesalso are usually spared, al-thougli manifest changesmay finally occur even intliem, but no disturbanceshave thus far l)een observed in the doinnin of tlu bulbar nerves. Finally,we may mention the observations re])orted by Tlanel where the disease wastraced in many meml)ers of one family through four generations and wasalways confined to the U))per extremities. It is of importance Ioi our comprehension of ihe whole disease that theatrophying muscles show fibrillai-y contractions, usually slight, only exce
. A text-book of medicine for students and practitioners . the long-est. The facial musclesalso are usually spared, al-thougli manifest changesmay finally occur even intliem, but no disturbanceshave thus far l)een observed in the doinnin of tlu bulbar nerves. Finally,we may mention the observations re])orted by Tlanel where the disease wastraced in many meml)ers of one family through four generations and wasalways confined to the U))per extremities. It is of importance Ioi our comprehension of ihe whole disease that theatrophying muscles show fibrillai-y contractions, usually slight, only excep-tionally lively, and llial we can invariably find the most marked changes inthe electrical excitability of the nmscles and their corresponding nerves. Thenerves soon show a marked diminution or even a total loss of galvanic andfaradic excitability. In the muscles we find either the same conditions ora pronounced galvanic reaction of degeneniiion. It is a very interesting factthat, on electrical examination, we can often detect m:iniles( (Hinnges in ex-. FiG. 176.—Neurotic atrophy. The disease cameon in ahnost the same fashion in three members of onefamily. (Personal observation.) 382 DISEASES OF THE NERVOUS SYSTEM
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