. Medical and surgical therapy. fication predominates in the phalanges of the thumband index finger, but it also affects those of the last three fingers aswell as the heads of all the metacarpal bones. The bones of the carpus are much less affected. The decalcification is more marked in the neighbourhood of theinter-phalangeal and metacarpo-phalangeal articulations. B. Appearance of the leg and foot in a painful form of paralysisof the great sciatic nerve. Considerable atrophy of the muscles of the calf. Development of the pilous system. The foot is in extension {plantar flexion) on the leg th
. Medical and surgical therapy. fication predominates in the phalanges of the thumband index finger, but it also affects those of the last three fingers aswell as the heads of all the metacarpal bones. The bones of the carpus are much less affected. The decalcification is more marked in the neighbourhood of theinter-phalangeal and metacarpo-phalangeal articulations. B. Appearance of the leg and foot in a painful form of paralysisof the great sciatic nerve. Considerable atrophy of the muscles of the calf. Development of the pilous system. The foot is in extension {plantar flexion) on the leg through ankylosisof the tibio-tarsal articulation. The toes, and particularly the great toe, are strongly flexed. Thisirreducible flexion is most marked in the last phalanx. The inner border of the foot is also rolled inwards towards the plantarsurface, and the whole foot is more contracted than the healthy one. C. The same foot seen on its dorsal surface. The ^rolled-in^*appearance of the internal edge comes out very PLATE VII.—Nerve lesions (clinical foinfis). GREAT SCIATIC AND POPLITEAL NERVES 181 lesion of those centrifugal fibres that spread out andform the organ of Timofeew, round the sensory cor-puscles of the skin, and round their central myelinatedfibre (page 84). What is the nature of this lesion ? As in the caseof the median nerve, we consider that it is a case ofa chronic interstitial inflammation, as might be con-cluded from the congested, cedematous appearance ofthe nerve in recent lesions of this description, and fromthe induration and shrunken greyish aspect of thenerve in older lesions. Paralysis of the External Popliteal Nerve A lesion affecting the external popliteal nerve inthe popliteal space below the bifurcation of the greatsciatic nerve produces the same paralytic and sensorydisturbances as a wound in the fibres of the externalpart of the great sciatic trunk. The differences thatmay exist between the two clinical forms are veryslight, and wi
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