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LEWELLYS F. BAKKEE 



forcible abduction of the arm and of contracture of the muscles of the 

 lower extremity upon forcible flexion, at the thigh, of the lower extremity 

 extended at'the knee. In the report of this case in the Annals of Surgery 

 for October, 1907, these interesting a arm and leg phenomena" of tetany 

 were referred to as follows : "Contractures also resulted from making the 

 sciatic nerve tense by holding the patient in the sitting position, so that 

 the trunk and thighs were flexed beyond a right angle, with the legs 

 extended ; or by putting the nerves of the brachial plexus on the stretch by 

 elevating the arm above the head with the forearm extended (extreme 

 abduction). The contracted muscles were always board-like to the 

 touch." The methods of evoking these contractures in the extremities 

 were, in his paper, illustrated by reproductions of photographs (Fig. 5 



Fig. .1. Method of producing tetanic spasm of the hand by stretching the brachial 

 plexus by means of forcible abduction of arm. (The Arm Phenomenon of Pool.) (After 

 K. II . Pool. Annals of Surgery, 1907.) 



and Fig. G). Pool gave a further description of the details of his obser- 

 vations of the leg and arm phenomena in tetany in another paper pub- 

 lished in 1910, stating that, a in the arm test the abduction must be as 

 extreme as possible, the elbow being held in full extension; the brachial 

 plexus is thus put upon the stretch. The hand took, as a rule, a position 

 similar to that produced by stimulation of the ulnar nerve, with at times 

 flexion of the wrist," and that in the leg test "the muscles of the calves 

 become markedly contracted and the feet assume a position of extreme 

 plantar flexion, with the toes usually turned forcibly toward the soles." 

 About one and one half minutes elapse after the test is applied before the 

 response is seen, though the time is variable on applying the test on 



