A CASE OP PROGRESSIVE MUSCULAR
ATROPHY. Das, m.b., Surgical Registrar, Medical College Hospital, By Kedarnath
Medical and
Calcutta.
30, Bengali, Hindu male, admitted into the Medical College Hospital 14th December 1892 under the care of Dr.
Gostobehari,
oat.
was on
McConnell. Weakness with wasting of the muscles of the hand noticed ten months ago. The attack was insidious. The Thenar eminence of the right hand was first affected. At first there were no neuralgic pains or tingling sensation. Soon the ball of the thumb became wasted. Movements of the fingers became impaired. Could not perform any delicate work requiring the "use of fingers. The fingers became bent like bird's claw." The left hand soon became implicated. Within a month the legs became affected. Other muscles of the body gradually became affected There was a constant feeling of weight and too. heaviness over the chest, specially when lying down, probably due to the wasting of intercostals. Four months after he was admitted into the Medical College Hospital under the care of Dr. Birch. He " walked from the Howrah station to the Hospital." During his stay in hospital (for a fortnight only) he became rapidly worse. Lost power over his legs, so that he could not walk without help. At home he became worse still and could no longer stand. No atrophy of the muscles of the face. Fibrillary twitchings were noticed in the early part of the disease, becoming marked on exertion or by a blast of cold. Bladder and rectum were unaffected. Patient was subject to malaria. Had gonorrhoea. No history of exposure to cold or injury. Had never to use his muscles excessively, his occupation having been of a sedentary nature (shopkeeper). No history of syphilis or intemperance. Grandfather was insane, and one of his sisters had developed symptoms of insanity. On admission the muscles of the extremities and trunk were wasted, soft and flabby. Voluntary power over them completely lost. Thenar and hypothenar eminences as also the inter-ossei and lumbricalis were wasted. Extensors of the forearm more wasted than the flexors. Shoulder prominent. Deltoid markedly wasted. Trapezius wasted to a slight degree did not show though the " ultimum moriens." Muscles of neck much atrophied; felt a kind of tingling isensation in the tongue and some difficulty in deglutition. Reflex irritability abolished. Power over legs completely .lost. Could not stand; knee-jerk absent. No rigidity of muscles. No myalgic or articular pain. Bladder and rectum unaffected; sexual function not impaired. Articulation not affected. No bed-sores. Organs normal. Patient remained in hospital only for a week I and was discharged at his own request.
ATROPHY. Das, m.b., Surgical Registrar, Medical College Hospital, By Kedarnath
Medical and
Calcutta.
30, Bengali, Hindu male, admitted into the Medical College Hospital 14th December 1892 under the care of Dr.
Gostobehari,
oat.
was on
McConnell. Weakness with wasting of the muscles of the hand noticed ten months ago. The attack was insidious. The Thenar eminence of the right hand was first affected. At first there were no neuralgic pains or tingling sensation. Soon the ball of the thumb became wasted. Movements of the fingers became impaired. Could not perform any delicate work requiring the "use of fingers. The fingers became bent like bird's claw." The left hand soon became implicated. Within a month the legs became affected. Other muscles of the body gradually became affected There was a constant feeling of weight and too. heaviness over the chest, specially when lying down, probably due to the wasting of intercostals. Four months after he was admitted into the Medical College Hospital under the care of Dr. Birch. He " walked from the Howrah station to the Hospital." During his stay in hospital (for a fortnight only) he became rapidly worse. Lost power over his legs, so that he could not walk without help. At home he became worse still and could no longer stand. No atrophy of the muscles of the face. Fibrillary twitchings were noticed in the early part of the disease, becoming marked on exertion or by a blast of cold. Bladder and rectum were unaffected. Patient was subject to malaria. Had gonorrhoea. No history of exposure to cold or injury. Had never to use his muscles excessively, his occupation having been of a sedentary nature (shopkeeper). No history of syphilis or intemperance. Grandfather was insane, and one of his sisters had developed symptoms of insanity. On admission the muscles of the extremities and trunk were wasted, soft and flabby. Voluntary power over them completely lost. Thenar and hypothenar eminences as also the inter-ossei and lumbricalis were wasted. Extensors of the forearm more wasted than the flexors. Shoulder prominent. Deltoid markedly wasted. Trapezius wasted to a slight degree did not show though the " ultimum moriens." Muscles of neck much atrophied; felt a kind of tingling isensation in the tongue and some difficulty in deglutition. Reflex irritability abolished. Power over legs completely .lost. Could not stand; knee-jerk absent. No rigidity of muscles. No myalgic or articular pain. Bladder and rectum unaffected; sexual function not impaired. Articulation not affected. No bed-sores. Organs normal. Patient remained in hospital only for a week I and was discharged at his own request.
