IN THE VOLUNTARY MUSCLES. 



247 



have been the primary cause, we are still far from being able to supply the links of causation 

 which would connect it with so peculiar an effect ; and we shall probably in vain seek for them 

 in the obscurities of foetal pathology. 



If we were allowed so far to disregard the statements of the parents — or so far to doubt 

 the accuracy of their observation — as to suppose the muscular defects not to have been really 

 congenital, but the effect of atrophy of limited groups of muscles, commencing in infancy or 

 early childhood, and leaving these strange defects as its permanent result — then the cases I have 

 related would not stand alone. They might be classed with some of those interesting observa- 

 tions, published in recent years, of groups of the voluntary muscles becoming attenuated to an 

 extreme degree, though all the ordinary, well-known causes of muscular atrophy were absent. 

 In two of these examples published by DrReade* of Belfast and Dr Brittan-j- the atrophy was 

 confined to the muscles of the neck, shoulders and upper arms; and these were reduced to the 

 most abject degree of emaciation, while the forearms and hands displayed the full development 

 of a robust and vigorous man ; and I have myself observed the atrophy limited to the upper 

 arms and thighs in a man J aged 25, in whom the disease has been in progress seven years. 

 These resemblances in peculiar features must indicate some analogy in pathological con- 

 ditions, the reality of which I cannot doubt, even though in one set of cases the muscular 

 defects be congenital, and in the others be the effect of disease in adult life. 



• Dublin Quarterly Journal of Medical Science, Nov. 1856. 

 .|- British Medical Journal, Kanking's Abstract, June, 1857. 

 J This man has a brother aged 20, in whom the disease 



has been in progress four years : — a parallel case to the in- 

 teresting facts published by Dr Meryon in the Med. Chirurg. 

 Trans. 



