. A treatise on nervous and mental diseases, for students and practitioners of medicine. he junction with the teeth. Lead colic is too well knownto need more than a bare mention. It is accompanied bv vomit-ing, slight changes in tlu; pulse, and constipation. The pains are 380 NERVOUS DISEASES, either vague or referable to the muscles of the joints, sometimescoDJoiued with tenderness of the muscles, with slight sensory symp-toms, such as tingling, very rarely with anaesthesia. Motor paralysis,with atrophy, is a most frequent symptom in the cases presentedat our clinics. Thus, in 75 cases observ
. A treatise on nervous and mental diseases, for students and practitioners of medicine. he junction with the teeth. Lead colic is too well knownto need more than a bare mention. It is accompanied bv vomit-ing, slight changes in tlu; pulse, and constipation. The pains are 380 NERVOUS DISEASES, either vague or referable to the muscles of the joints, sometimescoDJoiued with tenderness of the muscles, with slight sensory symp-toms, such as tingling, very rarely with anaesthesia. Motor paralysis,with atrophy, is a most frequent symptom in the cases presentedat our clinics. Thus, in 75 cases observed at the New York Poly-clinic, this muscular paralysis and atrophy were present 69 typical paralysis is that known as wrist-drop. It is due toan inability to extend the fingers, sometimes all the fingers, some-times only the two middle ones, or the first and second. The longextensors are the muscles primarily affected. But at this time, itshould be remembered, the distal phalanges can be extended, asDuchenne has shown, by the interossei and lumbricales. Extension Fig. Photograph of a case of lead paralysis affecting the extensor muscles. of the thumb is also generally impaired or lost, although its meta-carpal bone can be extended. The extensors of the wrist next becomeaffected, and the wrist-drop then becomes complete. These differentmuscles are affected in varying degrees in different cases, sometimesfirst upon the radial, sometimes upon the ulnar side. As Duchennehas shown, the wrist can nevertheless in some cases at this periodbe extended when the fingers are strongly flexed, which is due tothe fact that the extensor carpi ulnaris or radialis are affected muscles, therefore, are in a range of distribution otthe musculo-spiral nerve, but the supinator longus, supplied by thesame nerve, generally is not impaired, nor is the extensor of themetacarpal bone of the thumb. The paralyzed muscles are usuallyatrophied, the atrophy sometimes coming firs
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