PLUMBUM.
SUPERIOR EXTREMITIES.
► Both arms, but especially the right,
began to feel numb and weak after his third attack of colic. The
weakness gradually increased, and in about three weeks a trembling
began, at first slightly, but which is now very great. The oscillations,
especially of the arm, are uniform in extend, and rapidly performed. He
says that the trembling diminishes and increases alternately. It is
greatly aggravated after fatiguing work. The legs are not affected in
any way. All the movements of the arm are performed naturally; the
fingers and forearm can be extended with the greatest ease.
Electro-muscular contractility is normal. The force of compression in
the right hand, according to the dynamometer, equals 30 kilograms; in
the left hand, 45 kilograms. The pulling strength is 70 kilograms.
Muscular strength, in this case, is but slightly impaired, [392]. ►
Trembling of the arms, [451]. ► Trembling of the hands, followed by
weakness of the third and fourth fingers, so that they could not be
fully extended; afterwards the second and fifth fingers became affected,
afterwards the wrist, and finally even the shoulders; the arms hung down
relaxed; the shoulders and arms were emaciated, especially the deltoid
muscles; the balls of the thumbs emaciated; on passive motion of the
hands and fingers there were trembling motions of the muscles, also at
other times there was exquisite fibrillar twitching; if he attempted to
raise the arm, the trapezius and sterno-cleido-mastoid muscles
contracted and raised the shoulder as much as three inches, then the
pectoral muscles contracted and drew the arm slightly forward; he was,
however, able to flex and extend the elbow by means of the biceps and
long supinators on the one hand, and the biceps on the other;
contraction of all the muscles was very weak; pronation and supination
of the hand was possible, with trembling, etc., [542]. [Here follows, in the original the
detailed careful examination of the muscles and groups of muscles by
means of faradic and galvanic currents, with tables of the exact
irritability for each. -T. F. A.] [2800.] ►
The whole right arm trembles a good deal. The oscillations are rapid and
uniform, with a regular to and fro motion. The tremor persists even
after the patient has been told to fix his attention on it, in order to
prevent it. There is no decided movement of the fingers per se; it is
rather a movement of the whole arm. The left arm also trembles, but in a
much less degree, [401a]. ► Incoordinate movements of the superior
extremities, which consist in an indefinite and irregular series of
contractions, and have their set alternately in the extensor and flexor
muscles. These oscillations continue in spite of the patient’s effort to
the contrary. The power of extending the arms upon the posterior portion
of the trunk is much lessened. There exists a slight analgesia of the
affected members, but not the least paralysis of the extensor muscles of
the fingers, [384]. ► Convulsive movements from time to time in
the arms, [324]. ► Trembling of the arms, worse towards
evening, principally in the hands and forearms, but extending to the
upper arms when he is compelled to any strong exertion of the limbs, [383]. ►
Trembling, especially of the upper extremities, [114]. ►
Trembling in the upper extremities, [273],
[319]. ►
Quite severe tremor, confined to the upper limbs, [397]. ► Very
perceptible tremor of the upper limbs, [466].
► Decided tremor of both superior
extremities; oscillations rapid and uniform, [394]. ► The
tremor diminished after a few sulphur baths; a paralysis of the
extensors of both arms then set in, [396].
[2810.] ►
Tremor of the right arm, [496]. ► About three weeks ago his arms became
affected. They are “shaky,” he says; are agitated by clonic
convulsions when he attempts to use them. He cannot write, and can with
difficulty feet himself; at one time he was unable. His right arm at one
time was fixed, by the contraction of its muscles, to his side up to 10
or 11 A.M. every day. After walking for some time, his arms get quite
steady for three or four hours. His grasping power is lessened, [563]. ►
The superior extremities are affected with a decided tremor, not very
perceptible when they are at rest, but plainly visible on holding them
out in front, [329]. ► Tremor of the arms, especially the right
arm, during voluntary motion, [517].
► Well-marked tremor of both arms,
preceded by weakness and numbness, which are especially felt towards
evening, [395]. ► Several attacks of colic. Three years
ago, taken with weakness and numbness of the arms, worse towards
evening, succeeded by a gradually increasing tremor confined to the
arms; these were cured in six weeks, [395].
► Paralysis of the upper extremities;
the extensor muscles became completely paralyzed; both arms hung by the
side, could not be raised; the patient could not use the hands in
eating, drinking, or dressing himself; the flexor muscles were somewhat
weakened, and use was associated with trembling; this was followed by
atrophy of the muscles, [364]. ► Paralysis of the extensor muscles of the
arm. When he pronates the hand, the wrist droops to a right angle with
the forearm; he cannot straighten it; supination is performed naturally,
[525]. ►
General paralysis of the upper extremities, [545]. ►
Flexor muscles slightly enfeebled, [508].
[2820.] ►
Want of power of motory co-ordination quite marked in both upper limbs,
the left especially; when his eyes are shut, he cannot touch any
particular spot on his face without feeling for it; analgesia to
pricking and pinching in both arms, especially the left, [528]. ►
Paresis of the upper limbs, especially of the right hand and forearm, [481]. ►
Complete paralysis of superior extremities, [385]. ►
Paralysis of the extensors of the upper extremities, especially of the
forearms; flexor muscles unaffected; the paralysis of the fingers became
so great that the patient was unable to write, [363]. ►
Paralysis of the upper extremities and atrophy, [347]. ►
Almost complete paralysis of upper extremities, and gradually increasing
emaciation, [361]. ► Paralysis in the extensor muscles of both
upper extremities and one of the lower, [394].
► Upper extremities paralyzed as to
muscular power (after three weeks), [78].
► Painful paralysis of the arms, [35]. ►
Inability, by any effort of will, to raise his arms, which hang down by
his sides, [141]. [2830.] ►
A few months ago, his arms and hands began to feel “fagged and
powerless,” [558]. ► Incomplete paralysis of the upper
extremities; the extensors of the fingers, the supinators, extensors,
abductors, and adductors of the thumbs seem to suffer especially, with
incomplete paralysis of the feet, especially of the extensors of the
leg, also the sensation of warmth not entirely lost, [12]. ►
Paralysis of the left arm. He was able to make flexion and extension but
to a slight degree; but, what is singular, the grasp was as perfect and
as strong as in health, [250]. ► Both arms hung so powerlessly by his
side, that the hands could not be raised more than a few inches from the
body, [390]. ►
Diminished power of the extensor muscles, especially on the right side.
This want of power does not seem to be confined as much as usual to the
extensors, for the flexors of the arms and hands are also much
enfeebled. It is evident that neither flexion nor extension can be fully
accomplished, so that the angle included between the furthest limits to
which these movements can be voluntarily carried is considerably
lessened. The fingers can be extended farther by the application of
outward force, [466]. ► Almost complete paralysis of the
extensors of the arms, [396]. ► Loss of power in the right arm, [498]. ►
Paresis of the extensor muscles, especially of the left arm, [480]. ►
Paralysis of the arm began with loss of power in the extensor of the
fourth finger, after which, trembling of the arm after exertion was
frequently noticed, [540]. ► The whole of that arm which used to be
thrust into the furnaces was paralyzed, and not, as in most cases, only
the hand and forearm, [476]. [2840.] ►
The extensor muscles do not contract on the application of electricity;
the inter. man-s contract., causing flexion of the first phalanges and
extension of the second, [516]. ► Paralysis of the extensors of both arms,
especially the right. Both arms hang down, but there is no contraction
of their flexor muscles, [396]. ► Inability to lift the right arm, which is
applied to the chest; its other movements are performed naturally. Pains
in right side of neck, right shoulder, inner portion of right arm, bend
of right elbow, palmar surface of right forearm and wrist; increased by
movement; unaffected by pressure; worse by paroxysms, during which they
burn like fire, and between which they are contusive. Skin of these
parts insensible, but their contractility unimpaired, [165]. ►
Whatever efforts are made to move the whole upper extremity, contraction
is only noticed in the fibres of the deltoid, [143]. ► The
motor power of the right upper limb is diminished; the muscles of the
posterior region of the forearm are also somewhat wasted, [527]. ► The
flexors, as well as the extensors, are somewhat affected, since, when he
clenches his hands, he exerts very much less strength with the right
than with the left, [530]. ► Paralysis of the extensors of the
forearms; pronation impossible; the lower portion of the forearm,
especially of the right much emaciated; the hypothenar decidedly
diminished in volume; the action of the long supinators preserved;
muscles of the right upper arm atrophied, as also those of the left, but
in a less degree; deltoids also atrophied; analgesia and anæsthesia of
both arms, especially of the right; the same symptoms were noticed in
the lower extremities, only the extensors of the feet very little
paralyzed; there was no ataxia of motion, [497].
► The first indication of paralysis
of the arm was noticed after writing, and manifested itself by weariness
and trembling of the hands, and inability to completely extend the
fingers; weakness affected at first the third and fourth, then the fifth
and second fingers, then the thumb, at last the extensor carpi ulnaris,
associated with transient weakness of the extensor muscles, not at all
of the supinators (the patient was left-handed, and the paralysis was
worse on the left side), [541]. ► Raising the arm became difficult and
almost impossible; after awhile the arm became entirely paralyzed,
especially the deltoid muscle; the elbow, wrist, and finger-joints were
somewhat flexed; the hand retained its position midway between pronation
and supination; the paralysis that began in the extensors gradually
extended to flexors, and the arm became completely paralyzed; tearing
pains in the arm, aggravated by pressure, worse at night, at times so
violent that the patient became wild with pain; the sensation of touch
was absolutely unaffected; sensation of heaviness in the wrists and
fingers; finally, a feeling of icy coldness in the extremities, [273]. ►
Arms hang straight down, and seem as if fastened to the sides; when
raised and let go, they fall like inert bodies, [144]. [2850.]
► The arm is semiflexed at the elbow;
it cannot be completely straightened; when this is attempted to be done,
the limb immediately returns to its former position, [139]. ► Both
arms fixed in pronation; no approach to supination possible, [138]. ►
The left arm is laid against the chest; it cannot be raised by the
action of the deltoid; its other movements are performed naturally, [166]. ►
Upper extremities emaciated; the extensor muscles completely atrophied;
the space between the radius and ulna sunken; skin dry, gray, rough;
both hands flexed at the wrists; both osseous spaces hollowed; the basal
phalanges stand at right angles with the metacarpus; the middle and
terminal phalanges flexed into the palm of the hand, so that the nail
pressed into the skin, the terminal phalanx of the thumb stands at right
angles with the basal phalanx; abduction and adduction almost entirely
lost; separation of the fingers impossible; all extensor motion is
impossible; pronation and supination almost entirely lost; scarcely any
power to flex or extend the forearm at the elbow; motion at the shoulder
in free, [434]. ► There was a marked loss of substance over
the right shoulder, all the scapular muscles being atrophied and
shrunken; the head of the humerus could be distinctly felt, and even the
irregularities on the surface of the shaft. Lower down, all the muscles
of the arm and forearm were much wasted. The fingers were flexed. At
times a distinct muscular tremor was seen in the affected muscles, but
this was just after attempting to use them. He had no power to raise the
arms, which hung useless by his sides. He complained of a good deal of
tenderness when his arms were moved about, [362]. ► The
flexor muscles, although not paralyzed, are somewhat reduced in size,
owing to the long continuance of the disease, [161]. ► Upper
limbs emaciated, but not paralyzed; he only complains of general
muscular weakness, [515]. ► Upper extremities exceedingly emaciated, [143]. ►
Arms emaciated, especially their lower part, [526]. ►
Entire upper extremity greatly emaciated, [517].
[2860.] ►
Arms very much wasted, [585]. ► Very numerous dilatations of the cutaneous veins
of the forearm and under surface of the lower third of the upper arm;
the dilatations much larger than peas; especially noticed at the point
of union of veins, but also at other points, especially after muscular
exertion and on compression of the venæ profundæ brachii; these
dilatations had the appearance of strings of pearls, [382]. ► Very
numerous moniliform dilatations of the veins on the forearm, upper arm,
and back of the hand, chiefly corresponding to the points of union of
veins, always much more prominent after muscular exertion;
there were no varices in other parts of the body, except a few slightly
dilated veins on the calves; this was associated, as in other cases,
with colic, arthritic pains, paralysis of the extensors of the forearm;
relieved by a galvanic current, [383].
► The veins of the arms were only
slightly filled, but on compressing the deep veins of the upper arm they
became swollen, and exhibited numerous rather large olive-shaped
dilatations, [378]. ► Weakness of the right arm and hand; the
middle and ring fingers are the weakest, [470].
► General feeling of weakness in the
arms, [194]. ►
Weakness of the extensor muscles of the right upper extremities, [472]. ►
Has noticed, for some time back, a good deal of weakness in the upper
limbs, especially in the evening, [402].
► Paralytic weakness of the arms, [458]. ►
Diminished tactile sensibility in the hands, forearms, and arms,
especially the right, [477]. [2870.] ►
Loss of tactile sensibility on the anterior surface of the left wrist,
left forearm, and lower half of left upper arm (the lead bar, when going
into the furnace, slid over these parts). Tactile sensibility only
diminished in the remaining portions of the left upper limb and in the
palm of the right hand by which the metal was taken up, [480]. ►
Muscular strength considerably diminished in both arms; none in the
left, [528]. ►
Complete insensibility of either arm from the junction of its upper with
its middle third down to the finger tips. Tactile sensibility of these
parts entirely abolished; the hardest pinching, the deepest pricking
with pins and needles, was unfelt; his hands being tied behind him, a
glowing coal was placed in one of them without eliciting any sign of
feeling. Tactile sensibility was unimpaired in the shoulders and upper
arms, [144]. ►
Some analgesia and slight anæsthesia in both arms, but chiefly in the
right, [525]. ► The extensor muscles of the upper limbs
could not be made to contract by inductive currents of electricity; a
constant current excited some fibres in the left arm to contraction, [517]. ►
Tickling and changes of temperature less felt in the left upper limb, [480]. ►
Numbness, formication, and weakness in the upper limbs, followed by all
the symptoms of motor and sensory paralysis of those parts, [479]. ►
Sensibility to tickling lost in the whole right upper limb and in the
left hand; is only diminished in the remainder of the left upper limb, [477]. ►
Sensibility to temperature slightly diminished in the right upper limbs,
[477]. ►
Sensibility he holds his arms against the hottest parts of the stove,
sometimes wants to have them sprinkled with cold water, [136]. [2880.]
► Insensibility to pricking of the
whole right upper limb, also of the left hand, wrist, and forearm;
diminished sensibility of the left arm, yet burning caused pain, [477]. ►
Sensibility to contact and pain is diminished in the whole right upper
limb; he has to be pinched very hard to feel it; his skin may be pricked
through without causing pain, [530].
► Diminution of regional sensibility
and of the sense of muscular movement in the right upper limb, [487]. ►
Sensation of weight and powerlessness at the posterior surface of the
middle portions of the arm and forearm, [152].
► All forced movements of the limb
are painful, [139]. ► The right arm is affected like the left,
but in a less degree, [139]. ► Cramps in the superior extremities only, [475]. ►
Lacerating pain in the upper limbs, [179].
[2890.] ►
Lacerating pains, with occasional cramps, of the entire upper limb from
the shoulder to the wrist. These are neither increased nor diminished by
pressure or movement; they are sharp one moment and dull the next. No
redness or swelling. The pains seems deeply seated. Cutaneous
sensibility is unimpaired. The affected limbs tremble slightly all the
time, [152]. ►
The pains in the upper limbs are more acute about the shoulders and at
the bends of the elbows, [132]. [2900.] ► Neuralgic pains in the upper limbs, [356]. ►
Pains in the muscles and joints of the superior extremities only, [475]. ►
Pressure upon the joints of the upper extremities, especially on the
elbows and fingers, sensitive, [455].
► Pain and formication in right arm, [488]. ►
Fine boring in the right arm, extending from the middle of the forearm
to near the shoulder-joint, after breakfast (after three-quarters of an
hour), [4]. ►
Dull, boring pain, especially at the bend of the elbow, and extending up
to the shoulder; the hand is kept flexed, and cannot be straightened or
lifted; the arm cannot be raised; uses both hands in carrying a glass to
his lips; on trying to straighten the bent arm, while the patient
opposes the effort, the supinator longus is perceived to resist quite
forcibly, [517]. ► Transient tearing in the right arm, [49]. ►
Shoulder. ► The shoulder
is raised without difficulty, [140].
► Cannot lift the right shoulder at
all, [152], [163]. ►
Cannot raise the left shoulder, [132].
[2910.] ►
Apparent difficulty in moving the shoulder-joint, and especially in
raising the arm; the muscles are not wasted, [524]. ► Both
shoulders are depressed; the upper limbs hang straight down, and he
cannot lift them, [143]. ► The shoulder seemed depressed, [144]. ►
Sense of weight at the shoulder and finger tips, [166]. ► There
was a sense of weight in the shoulder, which was felt more in the elbow,
and most of all in the wrist. The pains increased by the slightest
exposure of the parts to cold; and there was a cold feeling all through
the limb, especially on the dorsum of the hand, which was perceptible
externally, [142]. ► Feeling of weight in the shoulders, felt
more in the elbows, and most of all in the hands, [144]. ►
Movement of the right shoulder painful, [456].
► Marked numbness in the shoulders, [143]. ►
Violent pains in the region of the shoulders, [364]. ► Acute
pain in the shoulders, especially in the left, and along the extensor
surface of the forearm on moving the upper extremity; pressure on the
deltoid muscle painful, especially in the left side; on stretching out
the arm there was decided tremor, [451].
[2920.] ►
The shoulders were affected with constant pain, especially the deltoid
muscles, which also were slightly paralyzed, [271]. ► Pain
in shoulders and arms; the latter were much wasted and useless, [341]. ►
Pain in right shoulder and between the shoulders, [338]. ► Pains
in both shoulder-joints and in the flexor muscles of the upper arm, so
violent that he was unable to raise the arm, [540]. ►
Aching pains in the shoulders, extending down to the elbows, and more
especially felt over the deltoid muscles, [362].
► Sticking in the shoulders, [273]. ►
Sticking from without inward, in the right shoulder (after one hour and
a half), [4]. ► Sticking beneath the right shoulder, that
extends outward at the shoulder (after two hours and three-quarters), [4]. ►
Some fine burning stitches on the right shoulder (first day), [2]. ►
A stitch in the right shoulder, [4].
► Arm. [2930.] ►
Both deltoids were remarkably small and atrophied, and the wasting of
these muscles was so apparent as to be a disfigurement. The sharp, lean,
bony shoulders, incongruously associated with the fine, full, muscular
development of all other parts of the frame, [390]. ► He
could not extended (laterally) or raise his upper arms, but the
antero-posterior movement of both arms were comparatively unimpaired, [340]. ►
Remarkable immobility of the muscular fibres of the deltoid, while the
surrounding fleshy parts are moving in different directions. All other
movements of upper extremities are slow, feeble, and difficult, but not
impossible, [141]. ► Electrization of the anterior fasciculi
of the deltoid muscle causes no marked contraction of its fibres, [516]. ►
Severe myosalgic pains, which seem to be most intense about the point
where the radical nerve leaves the spiral groove of the humerus, [384]. ►
Muscular pains only once in a while in the right pectoralis, [537]. ►
Bruised pain in the deltoid muscle, [3].
► Dull very acute drawing in the
bones of the upper arm, hand, and fingers (fourth day), [2]. ► Tearing
in the middle of the right upper arm (after a quarter of an hour), [4]. ►
Boring in the right upper arm, together with tearing in the right lower
teeth, afterwards with sticking in the left scapula (after two hours and
a half), [4]. [2940.] ►
Tearing in the right upper arm beneath the shoulder (after two hours and
three-quarters), [4]. ► Tearing on the inner surface of the left
upper arm, in the forenoon (second day), [4].
► Tearing in the lower portion of the
left upper arm, in the morning (fourth day), [4]. ► Acute
drawing in the right humerus (eighth day), [2]. ► Tearing
on the posterior surface of the left upper arm, which, on rubbing it,
went into the elbow, [4]. ► Unable to raise his elbow to the level of
his head, or indeed, to that of his shoulder, [552]. ►
Muscular twitches above the left elbow (after one hour and a quarter), [4]. ►
Some diminution of sensibility on the right upper arm, [518]. ► Loss
of sensibility in all the tissues on the external and anterior surface
of the left deltoid region. Pricking with pins and needles,
electro-puncture, friction in every direction, forced and violent
contraction of the deltoid muscle, elicited no sign of sensation, [159]. ►
Feeling of weight in the elbows, and still more in the wrists, [155]. [2950.]
► A very annoying sensation of weight
in the elbows, wrists, and fingers, [139].
► Joints of elbow, wrist, and fingers
slightly flexed, [144]. ► Twisting pains in the bends of the
elbows, and the palmar surfaces of the forearms, worse by paroxysms;
ameliorated by pressure, [131]. ► Lancinating pains from the elbow to the
finger-ends, without swelling, and without apparent paralysis of any
muscle, [168]. ► Pains confined to right elbow and
wrist-joints, and to muscles of right arm, [487]. ► Pains
in the joints and muscles of the elbow, wrist, the fingers and their
tendinous sheaths, knees, popliteal spaces, and insteps; spontaneous or
excited by movement and pressure, [479].
► Sense of weight in elbows and
wrists, and especially in the fingers; it is felt more in the left limb,
[151]. ►
Forearm. ► The forearms
and hands, especially the left, tremble considerably, [151]. ►
Extensors of the forearm completely paralyzed, [523]. ►
Paralysis of the extensors of the forearm, [374], [429].
[2960.] ►
Complete paralysis and atrophy of the extensors of the forearm, etc., [548]. ►
On applying Gaiffe’s electrical machine, the extensor muscles were found
to contract with difficulty, as also the deltoid and pectoralis major;
the flexors also contracted with difficulty, as also the outer layer of
the muscles of the forearm, and the posterior rhomboid, trapezius, and
longissimus dorsi, [524]. ► Complete debility of the forearm,
affecting particularly the extensor muscles, [322]. ► On
waking suddenly, at 3 A.M., he found he had lost the use of his right
forearm and hand; the palsy was not restricted to the extensors of the
forearm, but also affected the flexors to a considerable extent, [435]. ►
Great loss of power over the extensors of both forearms, especially the
right; the affected muscles were greatly withered; the paralysis
gradually stealing upon him during attack of colic, [436]. ► Loss
of power in the right forearm and wrist. The extensor muscles are
especially enfeebled, and he has wrist-drop on the right side. The left
arm and wrist are also paralyzed, but less so than on the right side, [336]. ►
Dropping of supinators soon after his first lead colic, [556]. ► Left
forearm semiflexed upon the arm; it can be almost completely flexed at
will, but its extension is impossible, [163].
► Pronation and supination of the
forearm and hand are easily performed; in the latter position, the
flexors of the wrist and fingers cease to act, so that the parts become
extended by their own weight, [149].
► The forearm is capable of
supination and pronation, abduction and adduction of the wrist and
fingers are only possible by flexing them, [150]. [2970.]
► The forearm is kept pronated;
supination is impossible, [139]. ► When at rest, the forearm is strongly
pronated, it cannot be supinated; it is semiflexed, and incapable of
extension, [140]. ► The superior portion of the outside of
the forearm (edge of the radius) is no longer on the same plane with the
inferior portion, which is twisted inwardly, [140]. ► The
arm and hand held edgewise, i. e.,
in a position midway between pronation and supination, [144]. ► Both
forearms fixed in pronation; with much effort they can be brought to a
position half way between pronation and supination; the hand does not
take part in this movement, [145].
► Electro-muscular contractility of
the forearms greatly diminished, [395].
► Posterior surface of right forearm
visibly atrophied; a bony projection is observed at the carpo-metacarpal
region; the skin of these parts is dried up and flabby, [136]. ►
Muscles of the forearms and the thumbs are much wasted, the wasting
being greater in the right arm and hand than in the left, [532], [568].
► The inferior portion of the forearm
in emaciated; the hypothenar eminences especially are diminished in
size; upon the whole, the right arm is more affected than the left.
Muscles of the right arm wasted, also those of the left, but in a less
degree; also both deltoid muscles, [525].
[2980.] ►
The muscles of the forearms, especially the extensor, were flabby, weak,
and tremulous, [419]. ► During the three years the muscles of the
forearm became atrophied, [403]. ► The posterior surface of the forearm in
strikingly emaciated and flabby, while the anterior surface is more
nearly of its natural size, [145].
► The forearms are extremely wasted;
they retain their normal sensibility, but, at intervals, are affected by
pretty strong cramps, [148]. ► The posterior surface of the left forearm
is as much atrophied as that of the right; the left thenar region has
also fallen away; its muscles have apparently vanished, [156]. ► The
forearm, wrist, and hand on the right side were found to measure in
every part of their circumference some four or five less than on the
left, [155]. ►
Numerous pearl-like dilatations at the points of union of the veins of
the forearms and hands, especially on compressing the venous trunks, and
after working, [380]. ► Veins of the upper arm very large and
knotted, varicose at the points of union, but the veins on the extensor
surface of the forearm were scarcely visible even after compressure of
the venous trunk, [381]. ► Arteries of the forearms extremely rigid
and tortuous, [381]. ► The cutaneous veins of both forearms
could not be seen, though after long working, on compressing the venous
trunks, the cephalic could be seen on the left side, and on the right
side a few dilated spots at the points of union of veins, [379]. [2990.]
► During the worst paroxysms, the
palmar surface of his forearm becomes hard and tense, and it is affected
by cramps, which are renewed on movement, [136].
► Sensation of exhaustion in the
forearms (fifth day), [5]. ► Weakness of the forearm, [313]. ►
Bluntness of sensibility in the extensor surface of the forearm and
fingers; the patient, however, is able to localize sensation; sensation
benumbed; the test of electro-muscular contractility with the induced
current shows in both arms moderate reaction in the extensors of the
thumb, scarcely noticed in the extensors of the fingers; there is,
however, good reaction along the course of the median and ulnar nerves;
there is no reaction in the extensors digitorum communes; it is
noticeable, however, that while the patient is able to extend both
hands, there is no trace of action in the extensors of the wrist, [453]. ►
Some anæsthesia on the back of the forearm, [435]. ►
Analgesia and anæsthesia, especially of the forearms, [444]. ► On
the both forearms, 68 millimeters of separation between the points of
the æsthesiometer, [474]. ► Hypalgesia of the upper two-thirds of the
palmar surface of the lest forearm; not so well marked in the rest of
the limb, [480]. ► Skin of the forearm partially insensible,
[396]. ►
Almost complete anæsthesia of both forearms, especially of the extensor
surface, [354]. [3000.] ► No sensation when pricked burned in the
hands or forearms; only a partial sensation in the lower half of the
arms. Burning does not cause even a feeling of warmth, and no pain was
experienced, even when the anterior surface of the forearm was burned so
as to raise a blister; yet there are severe pains in this region.
Neither tickling nor changes of temperature are felt in the hands or
forearms, [479]. ► Slight anæsthesia of the forearms; less
in the fingers; it is much more decided in the lower extremities, [474]. ►
Boring pains all over the palmar surface of the forearm, in the bend of
the elbow, and in the axilla; the upper arm is not painful; ameliorated
by gentle pressure, but somewhat aggravated by firm pressure; constant,
but returning in very hard paroxysms, during which he squeezed his
forearms with his hands; entreats to be tied round with ropes, his
handkerchief, etc., [136]. ► Excruciating pains in the forearms, with
paralysis of the extensors, [402].
► Pain, especially in the left
forearm, elbow-joint, and arm, [480].
► Seized suddenly, in the daytime,
with pains in both forearms; these pains took a course which seems to
have corresponded with that of the radial nerve. They were so severe as
to prevent sleep. At the same time, she felt a great deal of pain when
stretching out the hand, though able to perform the movement. Only the
ring finger of the left, and the ring and little fingers of the right
hand, could not be extended. In both elbow-joints there was a sort of
uneasiness, like a feeling of fatigue. This was also felt in the leg
behind the ankle-joint, [518]. ► Wrist. ►
The wrists and hands shake and tremble very easily under the influence
of any emotion, [147]. ► A small bony elevation, formed by the
projecting heads of the second and third metacarpal bones on the back of
the wrist, [139]. ► Wrists much swollen, while extensors of
hand are completely paralyzed; supinators intact, [385]. ►
Wrists entirely dropped, from complete paralysis, being perfectly
helpless and unable to straighten either hand, unless by the aid of the
opposite arm, and requiring all the care of an infant, in being fed,
washed, etc., yet a comparatively good grip with his hands, [271]. [3010.]
► Marked wrist-drop, with wasting of
forearms and hands. Has no power of extension of wrist-joint, and
scarcely any power of separating the fingers, [360]. ►
Complete wrist-drop on the right side, incomplete on the left, [532]. ►
Wrist-drop of both hands, but the right hand more powerless than the
left, [230]. ►► Wrist-drop, [316], [337],
[370], [443], [553],
[554], etc. ►
Subsultus tendinum, [334]. ► Wrist permanently flexed at a right angle
with the forearm; it could be further bent; its extension, abduction,
and adduction were impossible; it is somewhat turned inwards, so that
the lower extremity of the radius forms a marked projection on its outer
side, [146]. ►
Right wrist remained flexed upon the forearm, [155]. ► The
right wrist is permanently flexed at an obtuse angle with the forearm.
Instead of the hollow space which naturally exists at its ulnar border,
there is a slight convexity; while conversely, the convexity at its
radial border becomes a hollow space, so that the entire wrist and hand
are twisted outwards, [155]. ► The wrist is quite forcibly flexed upon
the forearm, and can be bent still further by an effort of the will, but
cannot be extended; abduction and adduction are equally impossible, [143]. ►
The left wrist is carried into abduction; its ulnar border has become
convex. It can also be straightened into a line with the arm; in short,
there is paralysis of the extensor carpi ulnaris, [161]. [3020.]
► The right wrist and fingers are
semiflexed, and can be bent still farther; when flexed as much as
possible, the finger-ends fall upon the middle portion of the thenar and
hypothenar regions. The semiflexed parts cannot be extended. When he
shuts his hand, and then tries to open it, he merely stops contracting
the flexors; the extensors do not act at all, [149]. ►
Wrists strongly flexed upon forearms; the left much more so than the
right; extension, abduction and adduction are impossible. Fingers flexed
and extended at will. All other movements of forearms and hands freely
performed, [148]. ► Right wrist strongly flexed upon the
forearm; its extension, abduction, and adduction are impossible, [147]. ►
Right wrist twisted inwards; its radial border describes a bold curve;
it is incapable of abduction, and can only be carried a little further
into adduction than when at rest. It can be extended, but cannot be
burned back upon the forearm; on attempting this movement, the whole
hand is thrown into adduction, [161].
► The wrist is considerably flexed;
the fingers form almost a right angle with the metacarpal bones; when
most flexed, their tips touch the thenar and hypothenar regions, [140]. ►
On clenching the fist, the flexion of the wrist is increased in
proportion to that of the fingers, [140].
► Right wrist flexed at a right angle
with the forearm, and can be further flexed at will, but incapable of
the least extension. Pronation and supination of the forearm freely
performed, [156]. ► Between the paroxysms, the right wrist
and the semi-flexed fingers could neither be separated nor completely
extended. When the hand was closed, the tips of the fingers reached only
to the thenar and hypothenar regions. All other movements of the upper
limb were easily performed. No paralysis on the left side. The paralyzed
parts have retained their normal sensibility; no cramps or tremor. Sleep
is good; the senses are perfect; digestion well performed; a stool every
day, [180]. ►
The left wrist cannot be extended, [156].
► The wrist is quite forcibly flexed
upon the forearm, and can be bent still further by an effort of the
will; but it cannot be extended, [138].
[3030.] ►
The wrist and fingers are almost semiflexed, and can only be slightly
extended, [150]. ► Left wrist flexed at an obtuse angle with
the forearm; it can be bent further at will; its extension, abduction,
and adduction are impossible, or nearly so, [154]. ► The
wrist is slightly flexed on the forearm; it cannot be extended unless
the hand is placed edgeways; it is with difficulty abducted or adducted
at the same time that it is extended or flexed, [139]. ►
Complete paralysis of the right wrist; the right hand dropped powerless,
and could only be raised by means of the left, and he could not grasp
anything, [324]. ► Paralysis of the extensor muscles of the
wrist and partially of the fingers, [137].
► Palsy of wrist and fingers, with
decided tremor on trying to move them, [167].
► Paralysis of the extensors of the
right wrist and hand, [331]. ► Extension of the left wrist and fingers
is slowly and feebly performed, [135].
► When the left hand is closed, the
wrist is easily extended, abducted, or adducted, [166]. ► The
right wrist is less easily extended than the left; the extensors of the
right wrist are somewhat paralyzed, [327].
[3040.] ►
The left wrist is flexed and extended with ease, when the hand is
previously closed, [147]. ► The wrist can still be straightened out
upon the forearm, but in making this movement, it is brought into
abduction, never into adduction; during extension, the strong action of
the radial muscles is plainly visible, while hardly the slightest motion
can be detected in the extensor carpi ulnaris, [135]. ►
Weakness of wrists and fingers (after the subsidence of the colic), [140]. ►
Sensation of heaviness in the wrists and fingers, [150]. ►
Sensation of weight in the extremities of the wrists and fingers, [161]. ►
Feeling of weight in the right wrist and fingers, [147]. ►
Frequent attacks of pains, extending from the wrists up the arms, [382]. ►
Pains in the articulations of the arm and hand, with convulsive
movements, [11]. ► Tearing on the lower surface of the right
wrist, extending thence to the back of the hand and fingers, in the
afternoon, [4]. ► A peculiar sensation of numbness in the
left wrist, [453]. ► Hand. [3050.]
► (The parts chiefly exposed to contact
with the paint were the right hand, wrist, and forearm; and these were
also the parts most affected by paralysis), [466]. ► In
the upper limbs, the trembling is almost wholly confined to the hands,
which move to and fro in almost uniform oscillations. Only when he is
vexed or fatigued, does it spread all over the upper limbs. The tremor
is always worse in evening than in the morning. He can still squeeze
quite forcibly with either hand; but as he is very powerfully built, it
is evident that the strength of his limbs is not in proportion to his
general muscular vigor. Measured by Duchenne’s dynamometer, the
compressive force exerted by the right hand is equal to 12 kilog., that
of the left hand to 10 kilog., the pulling force is 62 kilog., which is
certainly below what his appearance would indicate. The sensibility is
entirely unimpaired. The muscles of the forearm contract as normally as
those of other parts under the action of electricity. Tremor worse when
he is intoxicated, [400]. ► Trembling of the hands, [30], [52],
[357], [472], [585].
► Constant violent trembling in the
right hand, almost disabling him from work; unaccompanied, for eight
days, by weakness, distortion, or pain of the part, [155]. ► His
hands tremble violently when he tries to take his shovel, [585]. ► Hand
unsteady and trembling, [499]. ► Began to notice that his hands trembled a
little when he was fatigued; though his general strength seemed entirely
unimpaired, [401a]. ► Had lead colic forty-seven years ago (his
only attack), two or three months afterwards his hands began to tremble,
and they have been trembling ever since, with some periods of remission
and aggravation. He has observed that when anything goes wrong with him,
the trembling becomes sensibly worse, [400].
► When the hands are stretched out,
they are both seen to tremble, the right one rather more than the left.
The right ring finger hangs down semiflexed, and cannot be completely
extended. The paralysis of the extensors affects especially the last
phalanx. On the left hand, only the ring finger is paralyzed. The grasp
of the hands, especially of the right hand, is very weak. The lower
limbs are somewhat weak, but do not tremble. Cramps in the last three
fingers of the right hand, and in the calves, [486]. ► He
began to feel first tremor and weakness in the hands; the tremulousness
increased; it was confined to the hands and wrists; his hands grew
gradually worse for about six weeks, and then he had the
“drop-wrist;” the ligaments were very lax, [262]. [3060.]
► Tremor of the hands, [335]. ► Some
lead tremor, especially in the right hand (with which she handled the
type), [469]. ► Tremor of the hands, especially the left,
[480]. ►
Sudden tremor of the right hand, while at work; this slight agitation of
the fingers was soon followed by paralysis (a week after being cured of
colic). Four days later, tremor and paralysis of the left upper limb, [152]. ►
Slight tremor of the right hand, [482].
► Slight tremor of both hands, [487], [523].
► Both hands drooped. Had the power
of pronation but not of extension, [389].
► The back of the hand is convex; it
exhibits two prominent projections formed by the heads of the second and
third metacarpal bones, [146]. ► The back of the hand is convex; on the
right side of the wrist is a small elevation formed by the projection of
the second and third metacarpal bones; on the left side a swelling,
similarly formed, by the trapezium and trapezoid, [145]. ► The
backs of the hands were blue, clammy, and slightly infiltrated, [144]. [3070.]
► The back of the hand is curiously
deformed; the metacarpal bones form a concavity, being much enlarged
where they articulate with the phalanges; there is a small elevation on
the wrist, formed by the projection of the second and third metacarpal
bones, [138]. ► It is impossible to close the hand
entirely; in attempting to do so, the tips of the fingers fall upon the
thenar and hypothenar regions; the last phalanges are very slightly
flexed upon the second, [155]. ► Hands flexed upon the forearms; when he
tries to lift them he observes that the right hand is bent inward, and
can scarcely be raised above the horizontal plane; the left hand, on the
contrary, makes almost a right angle with the forearm, and is not bent
inwards, [526]. ► The palm of the hand does not lie on the
bed, but looks the other way, [140].
► Wasting of the muscles of the hand,
accompanied with great contraction of the flexor tendons and rigidity of
the joints of the fingers. The hand has been stiff and useless ever
since stopping the Goulard lotion, [430].
► Phlegmonous swelling of the back of
the hand and forearm, followed by an abscess, after the opening of which
the patient improved, [578]. ► Shortly after the occurrence of the
paralysis, a circumscribed swelling of the extensor tendons was
observed, extending from the wrist to the middle or two-thirds of the
metacarpus. The swelling was hard and nodose, but was formed without
pain, although this was produced in a slight degree by pressure. The
sheath of the tendon participated in the tumefaction, and on the back of
the hand a series of three or four rounded and cylindrical digitations
were observable, which caused a projection of the skin to the extent of
two or three millimeters. In one of the patients, as the paralysis of
the muscles gradually disappeared in the course of two months, so did
this deformity of the tendons, [564].
► Paralysis of both hands; they hang
from the forearms quite relaxed; they are dry and deathly pale,
constantly cold; the backs of the hands are raised by scabs under which
cavities are formed, [54]. ► Four days after the use of the water had
been stopped, she was suddenly seized with loss of power in her hands,
one morning (she had awoke in the night with a feeling of numbness in
them), [460]. ► Incipient motor paralysis of the right
hand; with special weakness of the index and middle fingers; their
complete extension has been impossible for several years, [471]. [3080.]
► Paralysis of the extensor muscles
of the hands, [326]. ► Paralysis of the extensors of the hands
and wrists, [75]. ► Paralysis of hands and forearms, worse on
the right side, [475]. ► Complete paralysis of the extensor
muscles of the right hand, [385]. ► Lost the use of his hands three years
ago, so that he could not grasp anything, nor button his clothing, [403]. ►
The hands were paralyzed to about the same extent as the feet. They hung
down at right angles from the forearms, and could not be raised at the
will of the patient. The wrist-joints looked flaccid and powerless like
the ankles. When the forearms were placed in the supine position, and
then pronated, the hands dropped down into their hanging position, as if
they had been attached to the forearms, by hinges. The flexors seemed to
be somewhat paralyzed, but not nearly so much as the extensors. There
was no well-marked emaciation, except of the bundle of muscles composing
the ball of the thumb. These were wasted almost entirely away, so that
the shape of the metacarpal bone of the thumb could be distinctly traced
through the integument, [404]. ► Paralysis of the hands, especially of the
right, [581]. ► Paralysis of both hands, [52]. ►
Paralysis of the extensors of the right hand. He cannot stretch out the
fingers horizontally; they are always semiflexed, [530]. ►
Having soon satisfied myself that these fingers were completely
insensible when pinched, I made him stretch out his right hand as far as
possible, when, despite all his efforts, the little and ring fingers
hung down semiflexed on the palm, while the other fingers were fully
extended. He could bend the two paralyzed fingers somewhat further, but
no completely. Impressed by this peculiar attitude of the hand, which at
once brought to my mind that rare affection, local lead poisoning, I
mentioned my suspicions to my colleagues and the students in attendance.
I questioned the patient concerning his occupation. He said he was
employed in the manufacturing of certain chemical compounds, where he
rinsed bottles, etc., but distinctly denied that any preparation of lead
was among the ingredients used, and insisted that the same was the case
as to mercury. He had never had colic, and his gums showed not the
slightest trace of a lead line; but this was not inconsistent with my
view of the case, under the supposition that the paralysis was due to
the local and direct action of the metal. I asked him if he was
right-handed. He answered in the affirmative. I then asked him to
compress my hand in his right hand. He tried to comply; but that hand
had no grasping power, being especially weak at its inner border; a
trial with his left hand, however, gave me severe pain. The right little
and ring fingers, also the inner border of the right hand and the inner
half of the palm and back of the same, were completely insensible to
touch, pricking, pinching, cold, and tickling; the other fingers, and
the rest of the right hand, retained their natural sensibility. In spite
of the patient’s denial that he had been in the habit of touching lead,
or of using a leaden tool, I assured him that he had been poisoned by
that metal, which he had frequently handled with the last two fingers of
his right hand. In order to convince him, I told him to take a sulphur
bath, which, if it should have the effect of blackening the paralyzed
hand only, especially its affected parts, would show, beyond doubt, the
presence of lead in his system, and the propriety of his following my
advice. If otherwise, then I would confess myself mistaken. I prescribed
for him 1 gram of Iod. Potass. daily; and Iodide ointment to be rubbed
with the right hand. Just as he was leaving the dispensary, he turned
around and remarked, that “perhaps it was capping the vials which
had done the mischief.” Now, if I had not stuck to my theory, this
case would certainly have slipped through my fingers. Seizing the cue
thus presented, we got him to explain to us the mode in which he fitted
on the leaden capsules. He applied the sheet-lead smoothly over the neck
of the vial, by clasping the latter between the inner half of the palm
and the last two fingers of his right hand; after working in this way
for awhile, these parts became covered with a grayish-black
discoloration derived from contact with the metal. On re-examining the
palm of the hand, we found two callosities on the inside of the
knuckle-joints of the two paralyzed fingers, and none elsewhere. These
sufficed to show that the patient told the truth, since these were the
precise points most subject to friction during the process he had
described to us, [489]. [3090.] ►
Hand flexed on forearm and on the phalanges, [524]. ►
Stiffness of the entire right hand; in the left hand, of the fingers
only, [481]. ►
Left hand much enfeebled, but the right hand still more paralyzed, being
unable to grasp an object. Lower limbs still quite strong, [485]. ►
Her hands and arms presented all the characteristic symptoms of lead
palsy; the wrists were dropped, and the power of extending the fingers
almost lost, while the muscles composing the thenal and hypothetical
eminences were remarkably atrophied, [351].
► Some inability to extend the hand,
or open the fingers, from want of power or control over the muscles of
the wrist, [315]. ► Weakness of the hands, [15]. ► Right
hand weaker than the left, [482]. ► Weakness of the hands, especially the
right, [488]. ► The right hand is too weak to grasp
anything; the left, on the contrary, is as strong as ever, [476]. ►
Great difficulty in closing the left hand entirely, [154]. [3100.]
► After his first attack of colic, he
began to perceive a difficulty in extending his fingers and hand;
drawings in the arms and legs, [524].
► His right hand is weak; he can
extend it, but not completely. When extended as far as possible, the
ring and little fingers are less extended than the other fingers, and
form a curve whose concavity is directed towards the palm, [530]. ►
Loss of strength in the right hand; it is bent upon the forearm and
cannot be straightened, [521]. ► Weakness and trembling of the hands, [453]. ►
The hands, the left especially, have a weak grasp of anything, [480]. ►
Muscular weakness and paresis of the extensor muscles of the hand,
especially the right. The right hand does not grasp as strongly as the
left, [475]. ►
The extensor muscles of the right hand no longer contract under the
influence of electricity; those of the left hand react readily, [508]. ►
Grasp of right hand evidently weaker than that of the left, [478]. ►
Either hand exerts a force of 18 by the dynamometer, [523]. ► The
compressive force exerted by the right hand is not great; it is
registered at 5 kilograms by Duchenne’s dynamometer; the left hand is
stronger, marking 5 1/2 kilograms. The right hand is used with much
difficulty; he cannot button his clothes with it, but can still employ
it in conveying food and drink to his mouth. Movements are performed
quite easily with the left hand. There is not the least paralysis of the
extensor muscles; their muscular contractility is practically
unimpaired, [401a]. [3110.] ►
Compressive force of the right hand, as estimated by the dynamometer, 11
kilograms; of the left hand, 9 1/2 kilograms; pulling strength, 50
kilograms, [394]. ► Entire loss of electro-contractility in
the extensors of either hand, [523].
► Evident muscular weakness of the
parts; compressive force of the right hand equal to 10 kilograms; that
of the left hand to 9 1/2 kilograms; pulling strength much reduced; only
equal to 14 kilograms, [393]. ► The muscular sense of the right hand is
weakened, [481]. ► Skin of left palm entirely insensible to
pinching or any other stimulus; superficial pricking was unfelt; a pin
caused pain only when thrust into the subcutaneous tissues. Strong
pressure upon all this region; a forced extension of the fingers was
painful. The backs of the hands and sides of the fingers retain their
sensibility, [166]. ► Loss of sensitiveness to tickling in the
right palm; less sensitiveness in the right sole than in the left, [469]. ►
On applying to the skin the lighted end of a match, a certain space is
found to be insensible to the heat. This space includes the right hand
and wrist, extending as far as the lower half of the dorsal surface of
the forearm, but only 3 or 4 centimeters above the wrist, on its palmar
aspect, so that it is shaped like a wrist-bandage, which is cut away
slopingly from its posterior or dorsal portion. The transition from the
total insensibility of this space to the normal sensitiveness of
surrounding parts is gradual, [466].
► Right hand, especially the fingers,
insensible to pricking and burning. The latter only causes a sensation
of warmth, [471]. ► Anæsthesia of the hands, wrists, and
forearms; only partial insensibility of the lower half of the arms, [479]. ►
Diminished sensitiveness to tickling of the palm of the right hand, [472]. [3120.]
► Diminished sensibility to pain,
tickling, and changes of temperature, in the right hand, [478]. ►
Sensibility to tickling is somewhat increased in the right hand, [482]. ►
Diminished sensibility to temperature of the right hand, [482], [488].
► Diminished sensibility of the right
hand, most marked on its dorsal surface, [486].
► Diminished tactile sensibility of
the right hand, [478], [481]. ►
Sensibility to tickling lost in the right hand; diminished in the left
hand, [488]. ►
Diminished sensibility to tickling in the hands, especially the right
hand, [487]. ►
Diminished sensibility to tickling and temperature on the palm of the
right hand, [486]. ► Diminution of sensibility and of
sensitiveness, to pricking and burning, of the right hand, right wrist,
and lower third of the back of the right forearm, [482]. ► The
right hand is less sensible to changes of temperature than the left;
this is still more the case, corresponding, by with the feet, [469]. [3130.]
► Slight diminution of tactile
sensibility, and of sensibility to pain, in the right hand and lower
part of the right forearm, [475]. ► Slight degree of anæsthesia in the right
hand and forearm; rather diminished sensitiveness when burnt on the
right limb, [468]. ► Slight anæsthesia, especially of the
right hand; on applying the æsthesiometer to the middle part of the
anterior surface of the forearms, a difference of 8 mm. was observed in
the distance at which the separated points, could be felt, [471]. ►
Of the right hand, only the palm is deprived sensibility, [166]. ►
Numbness in hands and arms, [297],
[298]. ►
Cramps only of the right hand, [487].
► Jerking in the back of the left
hand (after two hours and a half), [4].
► Pains in the left hand, with loss
of power, on moving it, [49]. ► Sudden pain in hands and arms, followed
by inability to use the hands, [582].
► Fine sticking, extending inward, in
the back of the right hand (after two hours and a half), [4]. [3140.] ► Tearing in the right hand at the point
where the pulse is felt (after two hours), [4]. ► Fingers.
► Spasmodic flexion of the last
phalanx of the thumb and in the third finger, [382]. ► The
finger-nails become bluish-gray, [375].
► Slight spasms of the fingers; these
attacks were frequently repeated in the course of the next three days;
then paralysis set in, [180]. ► Paralysis and atrophy of the extensor
digitorum communis indicator, extensores digiti quinti et pollicis
extensores carpi (except the left extensor carpi ulnaris), abductor
pollicis longus and brevis, interosseous muscle, deltoid muscles,
biceps, brachiales interni, and the supinators, [543]. ►
Atrophy of the balls of the thumbs, [545].
► About three months ago, he lost the
power of the middle and ring fingers of the right hand; and after the
last attack the index and little fingers of the same hand became
similarly affected, [113]. ► Paralysis of the flexors, and especially
of the extensors of the fingers, chiefly on the right side; he cannot
grasp anything. Weak contraction of these muscles under the stimulus of
electricity, [479]. ► Shortly after the admittance of the
painter, in case twenty-nine, we were consulted by a young man who
stated that, a few days before, the last two fingers only of his right
hand had become benumbed and paralyzed. What astonished him was, that
his health otherwise was good, [489].
► Paralysis of the extensor muscles
of the right fingers. Hand semiflexed upon the forearm. Fingers bent
into the hand, [508]. [3150.] ►
Unable to extend the fingers of either hand, [532], [560].
► If his fist is clenched and he
wishes to unclench it, he has merely to stop trying to contract the
flexor muscles, when the fingers at once return to their state of
semiflexion, the extensors taking no part in the movement, [140]. ►
The two left middle fingers are firmly flexed upon the metacarpus; the
other fingers are similarly bent, but to a much less degree, and can be
extended almost completely, which is not the case with the former. When
the hand is shut, the two middle fingers reach only to the upper portion
of the thenar and hypothenar regions; the other fingers touch the palm,
but fall short of the lower metacarpus. The left middle fingers can only
be separated when flexing them. The left thumb can be abducted,
adducted, and brought into opposition. The left wrist, when at rest, is
less bent than the right, and can be straightened out without previously
shutting the hand, [153]. ► The right fingers are bent almost to a
right angle with the metacarpus; when the hand is shut, their tips only
reach the upper portion of the thenar and hypothenar regions. When the
hand is opened, and the flexors cease their contraction, the fingers
return to their semiflexed condition by a purely mechanical movement, in
which the extensors take no part. The right fingers can only be
separated partially, and when flexing them. The right thumb cannot be
abducted or brought into opposition, but is still capable of adduction.
The right wrist is kept somewhat flexed; it can be straightened out only
when the hand has been previously shut; it is then capable of adduction
and abduction, [153]. ► The left middle and ring fingers are bent
at a right angle with the metacarpus, and cannot be in the least
extended; the thumb, index, and little fingers can be extended pretty
well, but not completely; the dorsal surfaces of the latter describe a
slight curve, and the superior extremities of the index and little
finger form a considerable angle with those of the middle and ring
fingers. During extension of the wrist and fingers, and when the forearm
is brought into supination, the forcible contractions of the supinator
and radial muscles, and of the extensor carpi ulnaris are plainly
visible; and between the two lumps which they form is seen a very small
portion of muscle which remains without motion; this is the extensor
communis; on the back of the wrist, the tendons of the extensores
proprii digitorum are seen contracting with their wonted energy;
abduction and adduction, impossible by the middle and ring fingers, can
be performed by the index and little fingers, though in an obscure and
uncertain manner; the thumb is freely abducted, adducted, and brought
into opposition, which last movement is easily effected by the little
finger also; the phalanges can be bent on one another, so that the tips
of the ring and middle fingers shall fall between thenar and hypothenar
regions, while the remaining fingers touch the palm. The fingers of the
right hand are similarly affected, but to a much less degree, [151]. ►
The fingers are bent upon the metacarpus, at an obtuse angle, which is
almost a right angle; they can be extended and separated a very little;
the last phalanges are but slightly flexed upon the second phalanges;
the hand cannot be firmly closed, and when this is attempted, the
finger-ends come in contact with the middle portion of the thenar and
hypothenar regions; the thumb and little finger cannot be placed in
opposition; all other movements of the upper limb are easily performed,
but they are rather slow and feeble, [146].
► The two middle fingers of the right
hand are less flexed than those of the left, but their extension and
separation are equally impossible. The index and ring fingers, on the
contrary, are held above the middle fingers, and are capable of complete
extension and separation, but cannot long maintain these positions,
being drawn into slight flexion by the weight of the paralyzed fingers,
and by the permanent contraction of the flexors communi digitorum. On
trying to squeeze a small object, the two middle fingers grasp it less
firmly than the index and ring fingers. The thumb is moved naturally in
all directions, [166]. ► The thumb is firmly flexed and turned
inwards; it can be further adducted, but cannot be abducted, extended,
or brought into opposition. All other movements are easy, [161]. ► The
fingers are firmly flexed upon the metacarpus; on shutting the hand,
their tips come into contact with the lower portion of the thenar and
hypothenar regions. The fingers can be but partially separated, and that
only when flexing them; on ceasing to contract they are drawn closer
together, and they are quite incapable of extension, [161]. ► On
the right hand, the ring finger alone is flexed at an obtuse angle, and
it cannot be in the least extended; yet it does not seem so much bent
down as the left middle fingers, because the other fasciculi of the
extensor communis digitorum kept it somewhat extended. When the fingers
are closed, the ring finger does not get as far down as the others,
neither can its abduction and adduction be fully effected, [152]. [3160.]
► The left fingers, excepting the
thumb and index, are firmly flexed, almost at a right angle. Their
complete extension is impossible. When the last phalanges are flexed as
much as possible, the tip of the index finger falls upon the metacarpus,
while the other fingers cannot be carried beyond the thenar and
hypothenar regions. All the movements of the left thumb are performed
naturally, [166]. ► Right fingers flexed at an obtuse angle
with the forearm; can be extended 3/4, and separated to a like distance.
On shutting the hand, the right finger-tips fall beneath the thenar and
hypothenar regions. The right thumb can be adducted and placed in
opposition; it is incapable of abduction or extension. Right little
finger easily brought into opposition, [156].
► The left thumb is crooked, flexed
at a right angle; the second phalanx is less bent than the first. Its
movements of extension, abduction, and opposition are abolished;
adduction, however, can still be performed, [156]. ►
Fingers of right hand considerably flexed upon the metacarpus; they are
capable of very slight extension, especially the forefinger; on shutting
the hand, the finger-ends fall somewhat below the thenar and hypothenar
regions. They cannot be far separated, except in the line of flexion, [147]. ►
The two left middle fingers are semiflexed upon the metacarpus and
cannot be extended; on closing the hand, their tips fall on the middle
portion of the thenar and hypothenar regions, [147]. ► The
left index and ring fingers are bent back; slightly flexed; only
partially extensible; held above the middle fingers, so that, when the
hand is shut, their tips fall below the thenar and hypothenar regions,
but do not reach to the lower extremity of the metacarpal region, [147]. ►
Fingers of left hand kept flexed at an obtuse angle with the metacarpus;
their phalanges being similarly bent upon one another, and their
extension, abduction, and adduction very imperfectly performed, [154]. ►
The fingers are flexed at almost a right angle with the metacarpus; the
two middle fingers appear somewhat more bent than the others, and can
scarcely be at all extended by any effort of the will; they can be very
slightly separated, but only in the line of their flexion, [155]. ►
The fingers and phalanges are more than half flexed; on attempting to
close the hand, the finger-ends touch the thenar and hypothenar regions;
the fingers can neither be separated nor approximated, except in the
line of their flexion. The thumb and little finger cannot be brought
into opposition, [138]. ► The fingers are semiflexed on the
metacarpus; they are capable of partial extension, adduction, abduction,
and opposition; the hand cannot be firmly closed, as the finger-ends can
only be brought to touch the lower portion of the thenar and hypothenar
regions, [139]. [3170.] ►
The thumb is kept turned inwards; it cannot be opposed to the other
fingers, or abducted, [140]. ► The fingers, when flexed, can only be
slightly separated, [140]. ► Middle and ring fingers of right hand
became flexed so gradually, that he was hardly aware of it. During
treatment for the colic, which supervened, the thumb and remaining
fingers became bent in like manner, [135].
► The fingers, as well as the two
phalanges, are more than semiflexed; when he tries to clench the fist,
the finger-ends are brought down on the thenar and hypothenar regions, [145]. ►
Fingers of one hand were curled up into the palm, [343]. ►
Fingers, especially those of the right hand, semiflexed into the palms, [306]. ►
Fingers flexed upon one another without muscular contraction, [524]. ►
From the beginning, he has observed that any attempt to stretch out the
fingers results as follows: the middle and ring fingers are flexed, the
thumb and little finger are extended, [326].
► Both middle fingers are firmly
flexed at an obtuse angle; and are incapable of the least extension;
they can only be a little separated when in the act of flexion, [153]. ►
Fingers difficult to move, [30]. [3180.] ►
No contraction could be obtained by magneto-electricity, nor by
inductive currents of electricity, in the extensor comm. digit.; by the
continuous current (forty or fifty elements), a few faint contractions
were produced in these muscles, on closing the current. They were
scarcely visible in the extensor of the left hand, and it is doubtful if
they occurred at all in that of the right, [517]. ►
Complete extension cannot be accomplished by the right fingers, nor by
the left middle and ring fingers, [451].
► The thumb and little finger cannot
be placed in opposition, [145]. ► When the hand hangs down, the fingers can
hardly be separated in the least, [145].
► The thumb cannot be completely
abducted; the abductor pollicis longus remains entirely motionless, [155]. ►
Opposition or abduction of the thumb is almost wholly impossible, [150]. ►
The fingers cannot be separated except by flexing them a little, [149]. ►
When the thumb is fully adducted, it is incapable of opposition or
abduction, [149]. ► When the hands are kept forcibly
extended, the fingers being flexed, he is unable to extend the latter,
with the exception of the left little finger, and in a slight degree the
right index, [526]. ► When the hand is shut, the tips of the
index and little fingers reach to the lower portion of the metacarpus,
while those of the middle fingers do not fall beyond the thenar and
hypothenar regions, [182]. [3190.] ►
The left middle fingers are less easily separated and approximated than
are the forefinger and little finger, [147].
► The left thumb and little finger
are easily brought into opposition; the left forefinger cannot be
abducted, [147]. ► The thumb moves freely in every
direction, as also do the wrist and forearm, [152]. ► The
left index, middle, and ring fingers are easily and completely extended
separated, and flexed; on shutting the hand, their tips touch the lower
part of the metacarpal region. The left little finger, however, is
firmly flexed on the metacarpus, and cannot be extended separated,
adducted, or brought into opposition, [159].
► Abduction of the right thumb is
easy, adduction is impossible, [147].
► The extensors of the fingers are
very much enfeebled on both sides, but more on the right. The left hand
grasps very well, but the right can scarcely keep hold of anything, [483]. ►
The contracted fingers when forcibly extended, the extension causing
pain up the whole arm to the shoulder, were almost immediately again
completely flexed, [341]. ► The index and little fingers are capable
of complete extension, but cannot maintain it for any length of time,
being drawn into flexion by the weight of the middle fingers, which are
held immovably beneath them, and by the action of the flexores communi
digitorum. Their power of abduction and adduction is unimpaired, [152]. ►
Sudden weakness of the fourth and fifth fingers of the right hand, [453]. ►
The feeling of weight in the left fingers is less decided than in the
right, [147]. [3200.] ► Sensation of weight in the finger-tips, [153]. ►
Weakness of the right ring finger; the left hand being almost
unaffected, [486]. ► Loss of muscular sense in the right
fingers, [470]. ► Dorsal and palmar surfaces of little and
ring fingers entirely insensible to all stimuli; the anæsthesia extends
also from the fourth and fifth metacarpal bones to the styloid process
of the ulna. The skin of the inner surface of the middle finger, and of
the third metacarpal bone is equally insensible. Pain is felt on
thrusting a pin deep into the affected portion of the metacarpal region;
and also on wringing or jerking violently the fingers whose skin is
insensible. The fingers move without difficulty, but less nimbly than
usual, and as if benumbed; but not one of their muscles is paralyzed, [164]. ►
Diminution of sense of contact. Cannot distinguish a fine fabric from a
coarse one by the touch merely, [488].
► The sense of touch, judging from
the perception of polished surfaces, is somewhat enfeebled, [485]. ►
Sense of touch is weaker in right fingers, [486]. ►
Slight dextral analgesia, especially of the finger-tips, [470]. ►
Formication and numbness in the right finger-tips, [470]. ►
Peculiar sensation of numbness and fuzziness in the tip of the left
fourth finger, [379]. [3210.] ►
Numbness of fingers, [304]. ► Numbness of the fingers and the muscles
of the back of the arm with wrist-drop. He could not pick up a pin,
although sensation, which was tested by two points, but not by
galvanism, was unaltered, [532]. ► Falling asleep of the right thumb (after
seven hours), [4]. ► Sensation of tension in the left thumb,
painless, for five minutes, [4]. ► The fingers feel as if much swollen, and
heavy, [530]. ► Cramps in the fingers whenever he tries
to grasp anything; but without pain, [398].
► Occasional cramps in the fingers, [481]. ►
Pain in the fingers, [468]. ► Tearing on the side of the left index
finger, between the second and third joints, in the afternoon, [4]. ►
Tearing in the left thumb (after two hours and a half), [4]. [3220.] ► Tearing in the right ring and middle
fingers, towards the tips, disappearing after rubbing, but returning
violently (after one hour), [4]. ► Transient jerking in the left thumb
(after seven hours), [4].® 2000
Article