A system of practical medicine. By American authors. Vol. 5 : $b Diseases of the nervous system
Science
A system of practical medicine. By American authors. Vol. 5 : $b Diseases of the nervous system
Medicine -- Practice
the later stages of diffused paralytic atrophy, after an uncertain
number of years, no reaction can be obtained with either electrical
current. In fascicular non-paralytic muscular atrophy (as in
progressive muscular atrophy) the loss of faradic contractility is
only demonstrable in the affected fasciculi, good contractions being
obtained in adjacent healthy fasciculi of the same muscle. The amount
or extent of contraction varies pari passu with the progress of the
atrophy. The galvanic reactions of this form of muscular atrophy are
not yet well established. Muscles and muscular groups in a condition
of impaired nutrition exhibit at an early period an interesting
condition—viz. that they no longer contract by reflex excitation. Thus
in a case of infantile poliomyelitis with paralysis of the muscles of
the leg, these muscles no longer contract when the sole of the foot is
tickled, and if the thigh-muscles are affected even so slightly as to
appear of normal size and consistence, the patellar reflex is found
wanting. In these and in traumatic cases the {56} reflex act is
prevented by lesion of the centrifugal motor nervous apparatus, and
perhaps also by the associated muscular trophic alterations.
[Footnote 6: Conveniently expressed by the symbol De R.]
Histological changes in atrophied muscles vary somewhat in character
in different diseases, and vary much in degree at different periods of
the atrophy. An early appearance is the presence of proteinaceous and
of fatty granules or molecules in the sarcous substance. Later, the
muscular fibres become reduced in size, lose their striation, and show
inequalities; the interstitial connective tissue becomes active and
increases in amount, at the same time that fat is deposited. The fatty
change in some cases, in others the granular or proteinaceous
transformation, ultimately completely destroys the muscular substance,
so that in the place of a muscle we find abnormal connective and fatty
tissues, blood-vessels, fatty and proteinaceous débris, the whole
presenting a pale yellowish-white aspect. It is in this final stage of
degenerative atrophy that all electrical reactions are lost. In the
pseudo-hypertrophic state the interfibrillary and interfascicular
connective-tissue growth is much more active, and the wasting muscular
fibres are buried in masses of wavy and fatty connective tissue. In
this condition also electrical reactions may be wholly absent.
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