Modern medicine : its theory and practice, in original contributions by American and foreign authors . ness in the lower ex-tremities and occasionally in the upper onesare complained of. One of the earliest symp-toms usually referred to by the patient ispalpitation of the heart on slight exertion;next, pain in the legs is frequently noticed,particularly in the calves, which soon be-come tender on pressure. Later the gaitbecomes unsteady; the patient walks as ifit were difficult, as indeed it is, to lift theWet beriberi, showing cudema of tiie fgg^ from the ground. The gait of a personlegs and
Modern medicine : its theory and practice, in original contributions by American and foreign authors . ness in the lower ex-tremities and occasionally in the upper onesare complained of. One of the earliest symp-toms usually referred to by the patient ispalpitation of the heart on slight exertion;next, pain in the legs is frequently noticed,particularly in the calves, which soon be-come tender on pressure. Later the gaitbecomes unsteady; the patient walks as ifit were difficult, as indeed it is, to lift theWet beriberi, showing cudema of tiie fgg^ from the ground. The gait of a personlegs and feet. (Author.) ^j^.j^ ^^j^j^ beriberi has not been improperly compared to that of a man walking in soft and very sticky clay, or to thatof a man, heavily dressed, who has been in the water and whose clothingis heavy from the fluid absorbed. At this stage, in the case of the wet form,an oedema of the lower extremities is generally noticeable. It is partic-ularly well marked over the anterior tibial region, over the dorsum of thefeet and around the ankles. Here the skin pits on pressure. In the dry. BERIBERI {KAKKE) 35 form, a slight oedema may be present at an early period, but this is not wellmarked and is transitory. The lower extremities in this variety, instead ofbeing swollen, progressively become more and more emaciated and themuscles become atrophic, often indurated and contracted. Together withthe disturbances of locomotion, disturbances of sensation develop simulta-neously. Hypsesthesia of the lower extremities is the most common form of dis-turbance of sensation. This generally begins on the anterior or externalsurface of the legs and frequently extends to the dorsum of the feet and is found in the territory supplied by the peroneal and saphenous hypsesthesia, there is a subjective 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 th
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