Paralyses : cerebral, bulbar and spinal : a manual of diagnosis for students and practitioners / by H. Charlton Bastian.

Date:
1886
Catalogue details

Licence: Public Domain Mark

Credit: Paralyses : cerebral, bulbar and spinal : a manual of diagnosis for students and practitioners / by H. Charlton Bastian. Source: Wellcome Collection.

Provider: This material has been provided by the Royal College of Physicians of Edinburgh. The original may be consulted at the Royal College of Physicians of Edinburgh.

    646/716 (page 626)
    Still, it is most common for the paralysis to predominate in the muscles supplied by the ulnar and median nerves, and for the atrophy also to be most marked therein. The muscles supplied by the musculo-spiral nerve are decidedly less affected. This, at least, is what happens in the majority of cases, that is, when the lower half of the cervical enlargement is the region most distinctly involved in the morbid process. The result of the above-mentioned predomi- nance of paralysis in certain groups of muscles is the production of a peculiar position of the hand (Fig. 135), in which the hand and the thumb are strongly extended while the fingers are flexed m claw-like fashion. rLARGBMEKT OF THE SPINAL CoBD [after Charcot]. When the stress of the disease occurs, however, at a higher level, that is, opposite the upper half of the cervical enlargement, then i is that he roots of the musculo - spiral nerve, oi the c esponding areas of grey matter, become more involved than hose of th: ulnar and median nerves, and the maximum amount o pllysis also occurs in muscles supplied by the e^- J- resul as was seen in a remarkable case under the care of Di. Leech, was to produce an altogether different attitude of the hand and Z Speaking of this case, Eoss says:- The arm is held close tHhe ^de the forearm is extended on the arm and strongly pronated, 1 hand ^flexed on the forearm, the fingers are on a line with or h% ex^^^ on the metacarpal bones, and the phalanges ave extended upon one another, while the thumb is flexed into the palm. ^^Se''p!iysed and atrophied muscles either wholly, or almost