. A manual of diseases of the nervous system. RD. and quite distinct from tlie peroneal type to be presently men-tioned. The muscles of tlie neck are very seldom affected, but I bave noted,in a few cases, wasting of tbe clavicular part of tbe sterno-mastoid. Those of the face do not suffer except in extremely rare casesintermediate between this and the third type (see also Westphal,* Charite Annalen, 1887, xii, p. 477), but in the .patient shown inFig. 162 there was considerable enlargement of the masseters. Thetongue has been increased in size in a few instances. The othermuscles supplied by
. A manual of diseases of the nervous system. RD. and quite distinct from tlie peroneal type to be presently men-tioned. The muscles of tlie neck are very seldom affected, but I bave noted,in a few cases, wasting of tbe clavicular part of tbe sterno-mastoid. Those of the face do not suffer except in extremely rare casesintermediate between this and the third type (see also Westphal,* Charite Annalen, 1887, xii, p. 477), but in the .patient shown inFig. 162 there was considerable enlargement of the masseters. Thetongue has been increased in size in a few instances. The othermuscles supplied by the cranial nerves always escape. The diseased muscles are weak, but the impairment of power is tosome extent irrespective of the change in size. The muscles that areabnormally small are generally weaker than those that are abnormallylarge; and in the latter the weak-ness increases with the wasting. Inthe legs the greatest weakness is inmuscles that are inaccessible to ex-amination—the flexors of the hips;next in order of weakness come the. FlO. 160.—Modeof obtaining extension of hipsin pseudo-hypertrophic paralysis. F, ful-crum of the lever formed by the femur. P,mean position at which the power is appliedby contraction of the quadriceps , position of weight in the ordinary modeof rising, w, the place to which part ofthe weight is transferred by putting handson knees.
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