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 . e ditli-culty whicli is experienced in rising from the recumbent, or even thesitting posture. The sufferer uses surrounding ol)jects as a means ofrising, drawing the body upward by the hands. When unable to reachsuch assistance, the steps which are taken to rise are thus described byGowers: If laid, for example, on iiis l)aek upon the floor and told to 168 LEfTrPiES 0\ NERVOUS DISEASES. rise, he would livsl with i^i^^it (lilhc
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 . e ditli-culty whicli is experienced in rising from the recumbent, or even thesitting posture. The sufferer uses surrounding ol)jects as a means ofrising, drawing the body upward by the hands. When unable to reachsuch assistance, the steps which are taken to rise are thus described byGowers: If laid, for example, on iiis l)aek upon the floor and told to 168 LEfTrPiES 0\ NERVOUS DISEASES. rise, he would livsl with i^i^^it (lilhculty turn on liis fac(; he would nextget on his knees, his head being almost between his thighs; from thisposition he would gradually extend himself, so that he stands ni)on liisfeet and hands with all his limbs extended ; finally lie would extend thehip-joint by grasping the thigh with the hand and pushing up the body, asit were, by the arm. This movement of -climbing Tip the thighs, as ithas ])een termed, is an indication of weakness in tiie muscles whichstraighten the knee, and also those which extend the trunk u])()n thethigh—the extensors of the Fig. 54.—Attitude Created by Atrophy of the Back Muscles. (Bramwell ) The gait of these patients is associated with an oscillation of thebody from side to side, or a waddling movement. The advance made ateach step is ver}- small, and a difficulty seems to be experienced in flexingthe thigh upon the abdomen. The muscles of the calf exhibit early a firmness and increase in sizewhich is not proportionate to their motor force—as that is far belownormal. Soon they become excessively developed, as do also those ofthe buttock; while the other muscles of the leg commonly grow smallerfrom atrophic changes. ATTITUDES ASSUMED IN NERVOUS DISEASES. IG9 The Intissiinus dorsi and tlu lower part of tlic pectoralis majormuscles exhibit marked wasting in a very large percentage of cases. Insome instances all the striated muscular f
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Keywords: ., bookcentury1800, bookdecade1880, bookidlecturesonne, bookyear1888
