Electro-physiology and electro-therapeutics : showing the best methods for the medical uses of electricity / By Alfred C. Garratt.

If the invasion of this terrible and insidious disease first af- fects the shoulder muscles, and by way of its usual preference, wastes, first, the trapezius, then the serratus magnus, the rhom- boide, and those other muscles that hold the shoulder blade to the thorax, and in its natural place, then the outer angle of the scapula becomes depressed by the weight of the arm, while the lower angle is raised and projected widely from the body. The disease then spreads down the shoulder to the arm, wasting and palsying the deltoid and the biceps, which leave the shaft of the humerus near the surface, and the acromion and the cora- coid process very prominent under the skin. The patient can no longer raise the arm, nor even feed or dress himself. It may then pass into the general form, sooner or later, and thus speedily cause death. Then, again, if the invasion is of the general character, it will make its appearance in the muscles of the lower extremities, which will be first discovered from the fact that walking has rapidly become difficult, and as rapidly the muscles are found to have wasted away, and then the movements soon become quite im- possible. The muscles of the thighs go first, and this wasting extends up to and through the spine, so that, next, the pecto- ralis major is found already consuming away. In this form, it is noticed, that all the voluntary muscles throughoiit the organism may be affected by it, excepting only the muscles of the eyeball and the muscles of mastication. But, when we see the ravages of this malady already wasting the facial, muscles, then we know we have a certain sign that the disease, in that case, will shortly prove fatal. That is known by the whole physiognomy losing its expression; and sometimes the saliva drools from the lips. The speech is very slovenly and slow; swallowing difficult; the diaphragm loses tone, and respiration is feeble. The slightest impediment to respiration, now occurring, most generally closes the scene. Wasting palsy is not a " self-limited " disease, in the common acceptation of that term, although in one peculiar sense it is so ; but it is rather a chronic affection, and that in its profound- est signification. Its tendency is to death, although in some 48