. Railway and other accidents with relation to injury and disease of the nervous system : a book for court use . retained in place, when he can then raise them verti-(jally. There are always associated sensory symptoms,neuralgia or dysesthesia. In describing Erbs paralysis the terms tipper andlower arm types are used by neurologists to define a formin which there is in-volvement chiefly ofthe muscles of theshoulder, or another inwhich those of the fore-arm and hand are aswell paralyzed. Theformer is apt to bean obstetrical accident,while the latter is afamiliar consequenceof trauma that may be
. Railway and other accidents with relation to injury and disease of the nervous system : a book for court use . retained in place, when he can then raise them verti-(jally. There are always associated sensory symptoms,neuralgia or dysesthesia. In describing Erbs paralysis the terms tipper andlower arm types are used by neurologists to define a formin which there is in-volvement chiefly ofthe muscles of theshoulder, or another inwhich those of the fore-arm and hand are aswell paralyzed. Theformer is apt to bean obstetrical accident,while the latter is afamiliar consequenceof trauma that may bereceived at any timein life. There is al-ways considerable atro-phy and the reactionof degeneration occurs. In some cases thediagnosis is difficult,especially when there isa suspicion of poliomyelitis; but in making an examina-tion it will be found that in the latter, which is a diseaseof the spinal cord, the sensibility will be a young child, however, the matter may be different,owing to the difficulty of making a subjective test. Careshould be taken to recognize valgus or some lower leg or. Fig. 29.—Wing-like Deformity due to Paralysisof Serratus Majfnus. (Leszynsky.) 234 J^AILWAV ) OTHER ACCIDENTS. foot symptoms, which, if found, will remove doubt as tcthe central nature of the paralysis. The supinator longus, which is supplied by the mus-culo-cutaneous nerve, when paralysed, will be manifestedby the lost ability to flex the forearm on the arm, and thisis seen more fully when the attempt at flexion is madeduring the supination of the forearm. It is a rare affec-tion by itself, but is usually found as a symptom of thecombined brachial-plexus paralysis and as a rule there issome anesthesia of the outer border of the forearm. Musculospinal paralysis is one of the commonest oftraumatic forms because of the exposed position of thisimportant nerve. The nature of the loss of function hasbeen elsewhere detailed, but attention may be called tothe fact that its ex
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