Nervous and mental diseases . SES OF THE COED PEOPEE. cessory. Again, it may suffer early. The muscles of the back are amongthose early invaded, and those of the scapula are commonly firstaffected, allowing corresponding displacements of this bone and limit-ing the use of the arm. The thoracic muscles are also involved,impairing respiration, and if the abdominal groups suffer, breathingmay become purely diaphragmatic. Wasting in the legs is much lesscommon and is usually less in degree, though atrophy may here firstshow itself. In the same way the face escapes for a time, or the dis-ease may c
Nervous and mental diseases . SES OF THE COED PEOPEE. cessory. Again, it may suffer early. The muscles of the back are amongthose early invaded, and those of the scapula are commonly firstaffected, allowing corresponding displacements of this bone and limit-ing the use of the arm. The thoracic muscles are also involved,impairing respiration, and if the abdominal groups suffer, breathingmay become purely diaphragmatic. Wasting in the legs is much lesscommon and is usually less in degree, though atrophy may here firstshow itself. In the same way the face escapes for a time, or the dis-ease may commence in the bulbar nuclei, and labioglossopharyngealpalsy may be the first step toward generalized progressive muscularatrophy. Finally, no voluntary muscle may escape. The muscular wasting and loss of power result in correspondingchanges of contour and position deformities. The patient may beunable to hold the head erect. The uncovered acromium renders theshoulder angular. The claw-hand, the scoliotic spine, the displaced.
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