. A manual of diseases of the nervous system. The extensors of the phalanges ofthe thumb are lost on the left side, and the extensor carpi radialis on the right. Allthe other forearm and hand muscles appear to be unaflfected. The erectors of thespine are small and feeble; intercostals strong, diaphragm powerless, abdomin;ilmuscles weak. In the legs the glutei and flexors of the knees seem normal, the flexorsof I he hips weak, extensors of the knees small and feeble, muscles of the lower legrather small and feeble, but only the peronei are powerless, right-angled contractureof ankle-joint with
. A manual of diseases of the nervous system. The extensors of the phalanges ofthe thumb are lost on the left side, and the extensor carpi radialis on the right. Allthe other forearm and hand muscles appear to be unaflfected. The erectors of thespine are small and feeble; intercostals strong, diaphragm powerless, abdomin;ilmuscles weak. In the legs the glutei and flexors of the knees seem normal, the flexorsof I he hips weak, extensors of the knees small and feeble, muscles of the lower legrather small and feeble, but only the peronei are powerless, right-angled contractureof ankle-joint with tendency to varus. Knee-jerk absent. Circumference (ininches) of upper arms (middle), R. 5-^, L. 5|-; of forearm (maximum), each 8; oftliighs (minimum 2J inches above patella), fl. 10^, L. 9^; calves (maximum),R. lOf, L. 11. Electric irritability much lowered in all affected muscles to eachcurrent; in most, no contraction can be obtained. Sensation, the sphincters, andthe viscernl functions are unaffected.• Landouzy and Dejerine, loc. SIMPLE IDIOPATHIC MUSCULAR ATROPHY. 591 cases that really belong to this form, but in wliicli the characteristicenlargement is absent, because no fat-cells are deyeloped in the multiplication of nuclei is, however, sometimes seen. The chiefchange is sometimes a simple narrowing of the fibres, vith an ultimatedisappearance of the transverse striation. Degenerative changes arefrequently met with, indistinct striation or granular, fatty, or waxy transformation being seen here and there, alike in narrowed orenlarged fibres, and in those that retain their normal calibre; occa-sionally fibres present longitudinal striation, fissuring, or vacuolation ;but in other cases, or in some muscles (especially in the juvenileform), a remarkable increase has been found in the size of fibres inexcised fragments,* even of muscles that are below the normal seems to show definite pathological enlargement. The statements made regarding the spin
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Keywords: ., bookcentury1900, bookdecade1900, booksubjectnervoussystemdisease
