. A treatise on the nervous diseases of children : for physicians and students. brothers to be referred to in this chapter. (Figs. io6-io8.) Landouzy - Dejerine haveinsisted on the right of theirtype to special consideration,claiming that ordinary muscu-lar pseudo-hj^pertrophy, andeven Erbs type of disease,were never associated withan involvement of the face,yet it is very certain that theirtype is practically nothingmore than that described byErb, plus involvement of theface muscles. Landouzy-De-jerine also denied that an at-rophy of the face muscleswas ever associated with typ-ical pseudo-hy
. A treatise on the nervous diseases of children : for physicians and students. brothers to be referred to in this chapter. (Figs. io6-io8.) Landouzy - Dejerine haveinsisted on the right of theirtype to special consideration,claiming that ordinary muscu-lar pseudo-hj^pertrophy, andeven Erbs type of disease,were never associated withan involvement of the face,yet it is very certain that theirtype is practically nothingmore than that described byErb, plus involvement of theface muscles. Landouzy-De-jerine also denied that an at-rophy of the face muscleswas ever associated with typ-ical pseudo-hypertrophy ; butWestphal first published acase which showed that theface muscles are occasionallyaffected in cases of typicalpseudo - hypertrophy, and Iwas able, some years ago, torecord a case which was atypical representative of mus-cular pseudo- hypertrophy,which passed through thestage defined by Erbs type,and in which the muscles ofthe face were also involved. There is, therefore, no suffi-cient reason to retain the Landouzy-Dejerine type as a sep-arate form of Fig. io6.—Oldest Brother, aged SixteenYears, exhibiting Atrophy followingPseudo-Hypertrophy of the Calves,and Extreme Atrophy of ShoulderMuscles. Boy unable to move fromchair or to hold himself erect (latestage of pseudo-hypertrophy). represent three brothers. PROGRESSIVE MUSCULAR ATROPHIES. 423 The characteristic symptoms of the various types maynow be described. Muscular Pseudo-hypertrophy.—As described manyyears ago, above all by Meryon, Duchenne, and Gowers,pseudo-muscular hypertrophy is characterized by its oc-currence in early are affected some-what more frequentlythan girls ; but althoughaffecting boys, the dis-ease is inherited almostinvariably through themother. The first symp-toms are, a weakness inthe muscles of the legand an early increase inthe size of the calf mus-cles. In rare instancesthe hypertrophy may be-gin in the thigh gait is waddling, andthe chi
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