Wheeler's handbook of medicine / by William R. Jack.

  • Wheeler, Alexander, -1903.
Date:
1920
Catalogue details

Licence: Public Domain Mark

Credit: Wheeler's handbook of medicine / by William R. Jack. Source: Wellcome Collection.

    560/592 (page 534)
    brarum also suffers, and the disease spreads to the shoulder girdle and arms. The tongue and ocular muscles are not affected. v Prognosis is least favourable in the pseudo-hypertrophic and infantile forms, in which few patients survive to the age of twenty, and the majority die of intercurrent pulmonary disease, due to weakness of the respiratory muscles. In the other forms life may be prolonged for many years. Diagnosis.—These affections are to be distinguished from spinal muscular atrophy by the following points. They begin in early life, and show a hereditary or family tendency ; they involve most markedly the muscles of the trunk and proximal sections of the limbs, while the distal sections, and particularly the hands, are little affected ; fibrillary tremors are absent; electrical reactions are only quantitatively diminished ; and the atrophy is often combined with hypertrophy or pseudo - hypertrophy. Treatment.—Most benefit is to be expected from a thorough system of well-planned gymnastic exercises, massage, careful hygiene, and galvanism. The diet should be highly nourishing. Cod-liver oil or malt extract may be given. Tonics such as strychnine and phosphorus may be employed, and of these strychnine hypodermically is most frequently used. Arsenic also is often prescribed, and may be given hypodermi¬ cally or by the mouth. The thinness of the chest walls renders the patient very prone to chest affections, which are often fatal, and should be particularly guarded against. THOMSEN S DISEASE. (Myotonia Congenita) A rare condition, characterised by a tendency of the muscles to tonic spasm during attempts at voluntary movements. The disease is probably always associated with some con¬ genital defect, but auto-intoxication has been suggested as the cause. Heredity is an important factor, and more than one member of a family may be affected. Morbid Anatomy.—The muscular fibres are hypertrophied, and may be more than twice the ordinary size. The nuclei of the sarcolemma are increased, and there is a slight increase of interstitial tissue. Among the hypertrophied fibres atropbio fibres have been founcb