A system of practical medicine . frequentlypermanent and amount to actual con-tractures. I have seen ankylosis of allthe joints of the hand and wrists in thecharacteristic position, and observed con-tractures in the toes and double talipesequino-varus in some cases. One casehad such rigidity of the orbicularis oristhat the moiith was motionless, open,and the patient was constantly drivel-ling. Protrusion of the tongue may bealmost impossible. It is not uncommon to note in oldcases a certain amount of muscular wasting, but this may not attractattention unless the disorder is unilateral in type.
A system of practical medicine . frequentlypermanent and amount to actual con-tractures. I have seen ankylosis of allthe joints of the hand and wrists in thecharacteristic position, and observed con-tractures in the toes and double talipesequino-varus in some cases. One casehad such rigidity of the orbicularis oristhat the moiith was motionless, open,and the patient was constantly drivel-ling. Protrusion of the tongue may bealmost impossible. It is not uncommon to note in oldcases a certain amount of muscular wasting, but this may not attractattention unless the disorder is unilateral in type. One case of mine(Fig. 73) presented so striking an atrophy in the affected parts that 1reported it in the N. Y. Medical Journal, Oct. 11, 1890. A man, agedsixty, had a typical Parkinsons disease of nine months standing, con-fined to the left face, arm, and leg. The middle and ring fingers werestrongly contracted into the palm. The atrophy involved especiallythe intrinsic muscles of the hand and adductors of the thiirh, but was. Case of paral5sis agitans, showing theattitude, the position of the hands,and the facies (Gray). 680 PARALYSIS AGITANS. also noteworthy in most of the other muscles. The faradic reaction inthe atrophied muscles was normal. The measurements of the circum-ferences were as follows : Showing the Amount of Wastmg in a Case of Paralysis Agitans wherethe disease teas limited to the left side. Circumference of— Right. Left. Difference. Arms : IS cm. below shoulders ....Forearms : 15 cm. below elbows .... Thighs : 15 cm. above patellae Legs : 15 cm. below patellae 28-26 1 The illustration shows fairly well the wasting and contractures, but therigidity was so great that the patient could not be photographed in thebest position to show the defects. Fig. 73.
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Keywords: ., bookcentury1800, bookdecade1890, bookpublish, booksubjectmedicine
