Modern medicine : its theory and practice, in original contributions by American and foreign authors . ubjective paraesthesia. If the skin istouched with a soft camels hair brush, the patient feels as if paper inter-vened between the skin and the brush. The intensity and the extent of suchdisturbances of sensation vary not only in different individuals but also atdifferent times in the same individual. These disturbances have a tendencyto spread upward from the feet and legs. In the severer cases the upperextremities are similarly affected. The face is rarely involved, but occa-sionally distur
Modern medicine : its theory and practice, in original contributions by American and foreign authors . ubjective paraesthesia. If the skin istouched with a soft camels hair brush, the patient feels as if paper inter-vened between the skin and the brush. The intensity and the extent of suchdisturbances of sensation vary not only in different individuals but also atdifferent times in the same individual. These disturbances have a tendencyto spread upward from the feet and legs. In the severer cases the upperextremities are similarly affected. The face is rarely involved, but occa-sionally disturbances of sensation are found around the mouth. Trueanaesthesia is rare, as is also hypersesthesia. The disturbances of motilitygenerally begin as a sensation of weakness in the legs, which is first noticedin the calves and later on in the thighs. After these have lasted for sometime, atrophy is generally evident or it may appear even before distinctparalysis becomes obvious. Usvially the anterior sharp edge of the tibiabecomes more prominent, the calf becomes thin and flabby and the thigh Fig. Dry beriberi with great atrophy of the muscles of the legs and equinovarus positionof tlie feet. (Autnor.) gradually becomes emaciated. When more or less contraction is associatedwith the atrophy, the foot assumes an equinovarus position. In severeattacks, similar changes occur in the upper extremities. Paralysis of thelower extremities is much more common than paralysis of the upper ones;but in the severest cases both feet and hands, including the toes and fingers,may be paralyzed. The hands and fingers in such cases may occasionallybe more affected than the feet. In the gravest ijpes neither the hands northe fingers can be flexed toward the dorsum, and there is complete wrist-drop. The electrical excitability shows various degrees of change, from a simplediminution to a complete reaction of degeneration. According to K. ]\Iiura,one can foretell from the position of the foot and toe
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