Nervous and mental diseases . radually develop, appearing very insidiously and requiring many monthsfor its complete evolution. The striking peculiarity of the atrophy isthat it is usually, and at first always, confined to the extensors of thejoint, and involves them in their entire length. The only exception isin arthritis of the ankle-joint, in which case the calf-muscles of the shoulder aifects the deltoid, of the elbow the triceps, ofthe wrist the extensors, of the fingers the interossei, of the hip the glutei,of the knee the anterior crural muscles, of the ankle the calf-m
Nervous and mental diseases . radually develop, appearing very insidiously and requiring many monthsfor its complete evolution. The striking peculiarity of the atrophy isthat it is usually, and at first always, confined to the extensors of thejoint, and involves them in their entire length. The only exception isin arthritis of the ankle-joint, in which case the calf-muscles of the shoulder aifects the deltoid, of the elbow the triceps, ofthe wrist the extensors, of the fingers the interossei, of the hip the glutei,of the knee the anterior crural muscles, of the ankle the calf-muscles,of the toes the interossei of the foot. When the flexors are also involved,they suffer to a less degree. Sensory disturbances are absent, or aresuch as are referable to the arthritis. In occasional instances the joint-inflammation also affects the nerve-trunks in its neighborhood, and aneuritis is added, with symptoms below the joints. The wasting in-volves the affected muscles uniformly from end to end, and there is a. Fig. 179.—Severe arthritic muscular atrophy in a case of multiple arthritis. corresponding loss of poicer. The electrical excitability of tlio muscles maybe reduced slightly, but is generally increased relatively to the bulkof muscle present. The reaction of degeneration is never found. Thetendon reflexes are exalted. In very pronounced cases a rectus-clonus oran ankle-clonus may be obtained. When the joint-disease subsides, thetendency is for the muscles to slowly recover, but in quite a proportionof cases they never completely regain their former vigor, and sometimesthey remain permanently wasted. Morbid Anatomy.—The atrophic muscles arc flaccid, pale, andinelastic. The fibers are simply diminished in size and there may bea little interstitial fibrosis. The only change in the nervous apparatusthus far recorded is in the nerve-terminals within the inflamed joint,due to their implication by the local disease. Better technic may beexpected to discover
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Keywords: ., bookcentury1900, booksubjectmentalillness, booksubjectnervoussys
