Lectures on nervous diseases from the standpoint of cerebral and spinal localization, and the later methods employed in the diagnosis and treatment of these affections . ^ which could lie easily mistaken for a progressive muscular. Fig. 108.—Expression due to Implication of the Nuclei of the Medulla governingTHE Mouth, Tongue, and Throat. (After Hammond.) atrophy of one extremity. Amyotrophic lateral sclerosis and lead-poisoning present points of difference which should be readily deformity of the hand which ensues from progressive muscularatrophy can be distinguished from that
Lectures on nervous diseases from the standpoint of cerebral and spinal localization, and the later methods employed in the diagnosis and treatment of these affections . ^ which could lie easily mistaken for a progressive muscular. Fig. 108.—Expression due to Implication of the Nuclei of the Medulla governingTHE Mouth, Tongue, and Throat. (After Hammond.) atrophy of one extremity. Amyotrophic lateral sclerosis and lead-poisoning present points of difference which should be readily deformity of the hand which ensues from progressive muscularatrophy can be distinguished from that due to paralysis of the ulnar,musculo-spiral or median nerves by the following points: (1) the groupsof muscles attacked are not supplied by one nerve, as a rule, but oftenby several; (2) the thenar eminence is usually attacked first, then thehypothenar eminence, and finally the interossei muscles ; (3) the musclesof the arm and shoulder are liable to be attacked simultaneously withthose of the hand; (4) a microscopical examination of the musclesalfected reveals extensive fatty changes; (5) the so-called bird-clawhand is produced, which differs from that of any post-i)aralyticdeformit}. PKOGKESSIVE MUSCULAR ATROPHY. 385 T
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