Nervous and mental diseases . ia, angina ^ pectoris, or a rheu- matic trouble inthe shoulder and Fig. 111.—Brachial palsy from birth-injury, due to traction in axilla. arm. AcCOrdinff tO Gowers, who firstcarefully described it, brachial plexus neuritis is analogous to sciaticneuritis in the lower extremity. Causes.—This disease of the brachial plexus is encountered mainlyafter middle life, and especially in rheumatic and gouty subjects. Inthe majority of cases there is a history of attacks of lumbago or sciaticaand a strongly marked lithemic heredity. Women suffer more frequentlythan men. Symp
Nervous and mental diseases . ia, angina ^ pectoris, or a rheu- matic trouble inthe shoulder and Fig. 111.—Brachial palsy from birth-injury, due to traction in axilla. arm. AcCOrdinff tO Gowers, who firstcarefully described it, brachial plexus neuritis is analogous to sciaticneuritis in the lower extremity. Causes.—This disease of the brachial plexus is encountered mainlyafter middle life, and especially in rheumatic and gouty subjects. Inthe majority of cases there is a history of attacks of lumbago or sciaticaand a strongly marked lithemic heredity. Women suffer more frequentlythan men. Symptoms.—Pain is the first and constant complaint. It is oftenof rather sudden onset and is likely to come in paroxysms, especially atnight, becoming more continuous, but still with exacerbations. Motionthat stretches the plexus, such as elevating the arm, is sure to provoke it,and any considerable use of the member is inhibited by the pain to whichit gives rise. The pain may begin first in the region of the plexus, in the. LESIONS OF SPECIAL SPINAL NERVES. 305 clavicular hollows, or under the scapula^ but soon involves the entire arm,runs up into the neck, and frequently affects the side of the chest. Upon manipulation one or all of the nerves in the arm Avill be foundtender to the touch, and this tenderness can be traced through the axilla,under the clavicle, and into the scaleni muscles at the side of the is often tenderness over the scapula in the distribution of thesuprascapular nerve. The skin over the arm is usually hypersensitive,and the constant dragging ache in the shoulder and arm is almost unen-durable. The patient is constantly trying to find an easier position forthe extremity, but without success. The tender muscles become flabby andwasted, and sometimes show slightdegenerative reaction to electricityin certain groups. Dermal, epithelial,and vasomotor disturbances are notinfrequent. The reflexes are dim-inished, rarely exaggerated. Diagnosis.—The
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