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Traumatic Paralysis.

muscles, the deltoid excepted,
in which there was some dimi-
nution, it was intact. The
muscles were regularly fara-
dized on alternate days for
about ten minutes. In spite
of this, atrophy rapidly pro-
gressed, until at the end of
the second month from the .
onset the muscular tissue was
hardly discernible, the thenar
and hypothenar eminences
had disappeared, the flexor
tendons projected into the
palm, as shown in fig. 49, and

Traumatic

in the dorsal surface were deep hollows from wasting of the interossei. It was six months before flexion Paralysis. and extension of the forearm were regained, and four years before the development of the muscles again equalled those of the uninjured side. Although there was complete restoration of voluntary power, there was return of farado-muscular contractility. Fig. 48 shows the arm one month after the accident, the deltoid is but slightly atrophied, but the arm and

FIG. 49.

no

forearm
are one third less in circumference
than on the uninjured side. Fig. 49 is the palm
of the hand two years after the accident. Fig. 50
the arm after the end of treatment. We see then
that in traumatic paralysis the regular application
of faradism from its onset, does not prevent the
muscles from almost complete atrophy, but its use,
after repair of nerve lesion, will restore their deve-
lopment, nutrition, and voluntary movement.

But it is in these recent cases of traumatic paralysis that the interrupted voltaic current should be localized in the wasted muscles.

Traumatic
Paralysis.

Infantile Para

lysis.

I have now under my care a gentleman who was sent to me by Sir James Paget. Five months ago, as the result of a stab which probably divided the supra-scapular and circumflex nerves, there was complete loss of power in the deltoid and supra and infra-spinatus muscles. Two months afterwards, when I first saw the patient, these muscles had almost completely wasted away. The electro-sensibility of the little muscular tissue that remained was greatly diminished, the contractility to faradism abolished, but that to the interrupted voltaic current from thirty cells of the BeckerMuirhead battery was retained. For the past two months I have daily applied the current from fifty cells; holding the sponge from the positive pole stationary upon the centre of the deltoid, and painting, as it were, every part of the affected muscles with the sponge from the negative pole for ten minutes. There has been a considerable

return of power; the development of the wasted muscles is remarkable and the result of the treatment most satisfactory.

Duchenne strongly advocates faradization in the essential paralysis of infancy, a disease to which he has devoted much attention. Under the term "infantile paralysis" many different forms of paralysis are liable to be included, but the variety now to be considered has the following history. It is characterized chiefly by motor paralysis occurring suddenly, by greater or less diminution of farado-contracti

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lysis.

lity, by simple atrophy in various Infantile Para-
degrees of the paralysed muscles,
by degeneration of the muscular
tissue, and by secondary contrac-
tions and consequent club feet.
The sensation is unaffected or in-
creased, and there is usually in-
creased reaction to the inter-
rupted voltaic current.

Duchenne gives the following
as a typical case: A child 11
years old.
old. At three years of age

loss of consciousness, convulsions,

lysis.

Infantile Para- and paralysis of both legs occurred. In a month he could sit up, but there was no return of power in the legs and they rapidly wasted. There was never affection of the bladder or rectum. The state of the child eight years after the onset of the disease was as follows:-The skin literally adhered to the bones, as shown in figs. 51 and 52, engraved

any

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from photographs. No reaction to faradism. He could neither move his toes, feet, or legs, and if he were set up upon his feet the joints flexed one upon another, as seen in fig. 51. But like all similar

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