Miisndar Atrophy Co7isidered as a Symptom 243 



faradic and galvanic nerve irritability preserved, but weak- 

 ened ; faradic and galvanic muscle irritability preserved, but 

 the contractions, instead of being short, sharp and quick, are 

 slow and vermiform. In the second degree, or complete de- 

 generative reaction, the galvanic and faradic nerve irritabilitj' 

 and faradic muscle irritability are lost, but the galvanic muscle 

 irritability is increased. The action of the poles is, however, 

 reversed, the anode closure contraction being greater than the 

 cathode closure, and thirdly, the contractions are slow and 

 vermiform. In the third degree, or severe type, there is entire 

 loss of galvanic and faradic nerve and muscle irritability. 

 Any one of these three degrees may be present, according to 

 the seat and character of the primary lesion. Of these symp- 

 toms, the wasting and weakness are the only ones which are 

 truly pathognomonic. The others, which are characteristic, 

 are present in some forms of muscular atrophy, and absent in 

 others. 



Diagnosis. — To diagnose a case correctly, two essentials are 

 necessary : First, a thorough knowledge of the symptoms, 

 and second, a good working classification in which each par- 

 ticular variety has its only and proper place. One of the best 

 lessons taught us by our esteemed teacher whom we delight 

 to honor to-day, was to properly classify and arrange all facts 

 so that they could be most readily consulted. If this is good 

 practice in the scientific laboratory, it certainly must apply to 

 the human laboratory with even greater force. The study of 

 the tumors was vague and unscientific until Virchow proposed 

 his peerless classification. Charcot's classification of the dif- 

 ferent forms and symptoms of hysteria has brought order out 

 of chaos, and the study of hysterical aff"ections is to-day more 

 advanced and scientific than many of the longer recognized dis- 

 eases. Therefore, I hold that to be able to diagnose correctly 

 the different forms of muscular atrophy, symptomatically con- 

 sidered, one must have at command a classification based 

 upon the underlying pathology. A classification which has 

 served me well, was described by me in the Btiffalo Medical 

 and Surgical Journal ior April, 1891, and is here appended, 

 with but one or two slight changes. 



