. Text-book of nervous diseases; being a compendium for the use of students and practitioners of medicine . i-ological factors. Symptoms.—In diaphragmatic paralysis, if bilateral, as is usuallythe case, there is either no movement of the abdomen or the epigas-trium and hypochbndrium are drawn in. On slight exertion thereare dyspnoea and increase of respiration. Diagnosis.—If no other muscles than the diaphragm are involved,the cause is probably in the trunk of the nerve. Inflammatorydisease of the diaphragm may cause a paralysis which is recognizedby its painful character and the febrile react
. Text-book of nervous diseases; being a compendium for the use of students and practitioners of medicine . i-ological factors. Symptoms.—In diaphragmatic paralysis, if bilateral, as is usuallythe case, there is either no movement of the abdomen or the epigas-trium and hypochbndrium are drawn in. On slight exertion thereare dyspnoea and increase of respiration. Diagnosis.—If no other muscles than the diaphragm are involved,the cause is probably in the trunk of the nerve. Inflammatorydisease of the diaphragm may cause a paralysis which is recognizedby its painful character and the febrile reaction. Treatment.—This is to be guided by the cause. It need only besaid that there is a motor point in the neck where by careful elec-trization one can get a contraction of the diaphragm (see Fig. .!, J>).In paralysis of the phrenic this fact should be borne in mind. 134 DISEASES OF THE NERVOUS SYSTEM. Group II. The Lower Cervical Nerves and Brachial Plexus. Anatomy and Physiology.—The anterior branches of the lowerfour cervical nerves and first dorsal nerve unite to form the brachial. Fig. 72.—Showing the Distribution of the Sensory Nerves of the Skin. KEUROSES OF THE MOTOR SPINAL NERVES. 135 plexus. This gives off shoH nerves to the shoulder aud trunk andlong nerves to the arm. The mode of formation of the brachial plexus is shown in thediagram (Fig. 73). It is in accordance with the descriptions ofWalsh and Allen. The short or upper branches supply the shoulderand iutercostal muscles. The long or lower branches supply thearm and hand. The neurologist needs to know: (1) the musculardistribution of each nerve and the function of the muscle; (2) thecutaneous sensory distribution; and (3) the level of origin of thenerves. The previous figure, Fig. 70, and table give these points, and willbe found useful for study and reference. They are based upon theinvestigations of Ferrier and Yeo, Thorburn, and also on Abbes andmy own experiments. The Arrangement of the Brachial
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