The principles and practice of medicine : designed for the use of practitioners and students of medicine / by William Osler.

William Osler

Date:: 1901

Credit: The principles and practice of medicine : designed for the use of practitioners and students of medicine / by William Osler. Source: Wellcome Collection.

Provider: This material has been provided by The University of Leeds Library. The original may be consulted at The University of Leeds Library.

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$Sottas have found hypertrophy of the primitive fibres with multiplication of the nuclei of all the muscles, including the diaphragm, but not the heart. The spinal cord and the nerves were intact. From Jacoby's recent studies it is doubtful whether these changes in the muscles are in any way characteristic or peculiar to the disease. ]^o treatment for the condition is known. III. PARAMYOCLONUS MULTIPLEX {Myoclonia), An affection, described by Friedreich, characterized by clonic contrac- tions, chiefly of the muscles of the extremities, occurring either constantly or in paroxysms. The cases have been chiefly in males, and the disease has followed emo- tional disturbance, fright, or straining. The contractions are usually bilat- eral and may vary from fifty to one hundred and fifty in the minute. Occa- sionally tonic spasms occur. They are not accompanied by any sensory disturbances. In the intervals between the attacks there may be tremors of the muscles. In the severe spasms the movements may be very violent; the body is tossed about, and it is sometimes difficult to keep the patient in bed. Gucci has described a family in which the affection has occurred in three generations. Weiss has also noted heredity in four generations. According to this author the essential symptoms are continuous or paroxysmal muscular con- tractions, usually symmetrical and rhythmical, of muscles otherwise normal, which cease during sleep. There are neither psychical nor sensory disturb- ances. The condition is most common in young males, and is unaffected by treatment. Eaymond groups this disease with fibrillary tremors, electric chorea (Henoch), tic non douloureux of the face, and the convulsive tic, under the name of myoclonies, believing that it is only one link in a chain of pathological manifestations in the degenerate.$