The surgical diseases of children . nd feetalone are affected. The thumb is adducted, but theterminal phalanx is not flexed, thus differing fromthe position in the ordinary convulsions of first joint of the fingers is flexed, the other jointsbeing extended. In the slightest form of the diseasethe thumb alone is affected ; the sole is arched, andthe toes are flexed. Opisthotonos and trismus arerare complications. The rigidity of the muscles per-sists during sleep, nor is it affected by the administra-tion of chloroform; these facts may be considered asevidence of the spinal origin
The surgical diseases of children . nd feetalone are affected. The thumb is adducted, but theterminal phalanx is not flexed, thus differing fromthe position in the ordinary convulsions of first joint of the fingers is flexed, the other jointsbeing extended. In the slightest form of the diseasethe thumb alone is affected ; the sole is arched, andthe toes are flexed. Opisthotonos and trismus arerare complications. The rigidity of the muscles per-sists during sleep, nor is it affected by the administra-tion of chloroform; these facts may be considered asevidence of the spinal origin of the disease. Completeintermissions in the rigidity are rare. Laryngismus stridulus (page 30) is spoken of as a constant symptom of tetany, as is also irritability of the facial nerve; passing the finger over the nerve trunk sufficing to cause contraction of the sphincter * Abercroinbie, 1SS0. 160 The Surgical Diseases of Children. fibres of lips or eyelids. The disease has a tendencyto relapse; mild cases get well Fig. 17. —Spastic Paralysis. Treatment—Attention must be paid to diet,and rickets must be treated (page 60), diarrhoeachecked (perhaps by the administration of castor oil),and tonics of oil and iron prescribed in due course. Chap, xii.] Spastic Paralysis. 161 Cases of spastic paralysis are often met with atthe Childrens Hospital, not, perhaps, because thedisease is common, but because, proving unsatisfactoryto treatment elsewhere, the children are brought onthither as a last hope. Goodhart describes* thedisease as one of gradually developing motor paraplegiaor hemiplegia, associated with muscular twitchingsand contractures. The rigid limbs are moved withdifficulty; the toes scraping along the floor. Thereis no affection of sensibility, no wasting of the muscles,and no disturbance of the functions of the may come on suddenly, and is often associated withfits or with imbecility. Case.—A child of ten years was in the Louiseward with hi
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