Pseudo-hypertrophic muscular paralysis : a clinical lecture.

  • Gowers, W. R. (William Richard), 1845-1915.
Date:
1879
Catalogue details

Licence: Public Domain Mark

Credit: Pseudo-hypertrophic muscular paralysis : a clinical lecture. 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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    extremely curved (Fig. 3), the convexity being backwards, as in the other patients, in the opposite dii-ection to that observed when standing. There is a shght rotation of the spine, and the wasting of the extensors is so great that you can feel the anterior sui-faces of the transverse processes, and even the bodies of the vertebrae on the left side. This curve is solely dependent on the muscular weakness, and disappears if the boy is raised by the arms. His latissimi, rhomboids, and serrati are almost gone, and the consequent mobihty of the scapulae is extreme, so that the weight of the arm rotates them and brings the inferior angles in contact. The trapezii are also much wasted and feeble, and his head readily falls forward. The lower parts of the greater pectorals are gone, and even the upper parts are thin. The deltoids are of mode- rate size; their power is somewhat impaired. The arm muscles, however, are, although thin, not extremely wasted. Those of the upper arm are weak, the biceps smaller and weaker than the triceps, but those of the hand and fore- arm possess fair power. The buttocks are thin, and there is very little power of flexing or extending the hip-joints. The right thigh is thin, but in the left the vasti are distinctly enlarged in then' lower parts. The knees' can be ■flexed or extended, but with little force. The calves are not now large or hard; they possess moderate power, and ai'e not much contracted; the ankle-joint can be flexed to a right angle. He is imable to stand.* On the left side of the neck and trunk there are some peculiar spots of warty growth following the course of certain nerves, f They are not, however, increasing, and probably cannot be associated with the disease. The photograph I now show you (Fig. 4) represents Case 10 ^ (Edward Grloster) who, at the age of four- teen, was imder my care here in 1874, in a still more advanced stage of the aflection. He was one of a * Under treatment, rest, tonics, etc., subsequently to the delivery of this lecture, he again recovered the power of standing and wallciug. t A form of local ichthyosis, according to Dr. RadclifiPe Crocker, who kindly examined them.