A system of practical medicine . femor. Semiraeinb. Ext. long. dig. Gastroc. Gastroc. Tibialis post. Tibialis Peronei. Intrinsic muscles of foot. Iiitriusic musi les of foot. Sphincter ani et vesicx. Perineal muscles. Certain special forms of the second type of paralysis arc quite com-monly recognized. Thus we have in anterior poliomyelitis the upper-arm type of paralysis in which the deltoid, biceps, supinator longus,and about the shoulder-blades are aifected together, the musclesmoving the wrist and fingers escaping. Reference to the table Avillshow th
A system of practical medicine . femor. Semiraeinb. Ext. long. dig. Gastroc. Gastroc. Tibialis post. Tibialis Peronei. Intrinsic muscles of foot. Iiitriusic musi les of foot. Sphincter ani et vesicx. Perineal muscles. Certain special forms of the second type of paralysis arc quite com-monly recognized. Thus we have in anterior poliomyelitis the upper-arm type of paralysis in which the deltoid, biceps, supinator longus,and about the shoulder-blades are aifected together, the musclesmoving the wrist and fingers escaping. Reference to the table Avillshow that this form is due to a lesion in the u])per ])art of the cervical SYMPTOMS. 81 enlargement. We also have a lower-arm type of paralysis, in whichthe muscles which move the fingers and wrist are alone invaded, thesupinator longus which lies among them escaping entirely. Referenceto the table will show that this is due to a lesion of the lower cervicalenlargement. The same distinction can be made in paralysis of the leg, Fig. The groups of cells in the second sacral segment of the spinal cord. there being a thigh type, a leg type and a foot type, according as thelesion is in the upper lumbar, mid-lumbar, and sacral segments. Byreference to the table, therefore, it will be possible in any case ofparalysis of the second type to arrive at a localization of the lesion orat an estimate of its extent in the cord when the muscles paralyzed areexactly determined. The electrical examination will assist in thisdetermination, inasmuch as the muscles whose groups of cells aredestroyed will have lost their faradic excitability, while the muscleswhose groups of cells are intact will show no change in electricalreactions. That the motor neurons of the cord have a distinct influence uponthe nutrition of the muscle and upon the circulation in it is shown bythe rapid atrophy and the vasomotor disturbances in the muscle whichalso attend this tyj)e of paralysis, and to which allusion has alrea
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