MUSCULAR ATROPHY CONSIDERED AS A 

 SYMPTOM. 



By WILLIAM CHRISTOPHER KRAUSS. 



Atrophia or wasting of the muscular fibers, whether occur- 

 ring insidiously or e7i masse may or may not be indicative of 

 disease of the nerve centers. Although not of such serious 

 import that its recognition demands early therapeutic pro- 

 cedures, nevertheless, it is necessary to detect the cause of 

 this retrogression in order to render a correct prognosis and to 

 plan the proper treatment. Diseases of the brain and spinal 

 cord are, as a rule, sub-acute or chronic, run a long course, 

 manifest themselves by vague, indifferent symptoms and 

 yield grudgingly to the resources at the neurologist's com- 

 mand. Wasting of the muscles is one of the most prominent of 

 the objective symptoms of brain and cord disease, and if proper- 

 ly considered and appreciated may give us important clues for 

 the location and detection of the neural lesion with which we 

 are confronted. It is by no means pathognomonic, but when 

 associated with other groupings of subjective and objective 

 symptoms, becomes at once characteristic of definite lesions 

 in the brain, cord, peripheral nerves or muscle itself. 



The premise must not be inferred, however, that all muscle 

 degeneration is pathological or dependent upon some initial le- 

 sion in the nerve centers, for it is a fact that wasting of muscles 

 occurs independently of any nerve or muscle lesion, but is due 

 to purely physiological changes, or the active cell growth is 

 no longer predominant, and has been succeeded b)' a period of 

 involution or cell decay. This we call senile wasting or 

 acute atrophy. Another form of atrophy, or lack of develop- 

 ment, which must not be confounded with either physiological 

 or pathological wasting, is aplasia and hypoplasia of the extrem- 

 ities, conditions arising in utero due to the arrested develop- 

 ment of the embryo as a whole or in part. These developmental 



