File:The Journal of nervous and mental disease (1874) (14778955134).jpg

Identifier: journalofnervous10ameruoft (find matches)
Title: The Journal of nervous and mental disease
Year: 1874 (1870s)
Authors: American Neurological Association
Subjects: Nervous system Psychology, Pathological
Publisher: Baltimore (etc.) Williams & Wilkins (etc.)
Contributing Library: Internet Archive
Digitizing Sponsor: Internet Archive

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the clinic on ner-vous diseases. Upon examination I found that she could endurebut little handling about the shoulder-joint, and that even mod-erate pressure above the clavicle caused considerable pain. Painis almost constant about the shoulder. The left hand, espe-cially the ring and little finger, feels numb, but she complains ofno decided pain in it. Movements of the elbow-joint unim-paired ; supination imperfect ; movements of wrist stiff. Handcan be only partially closed because of stiffness in the last phalan-geal joints. Slight appearance of deformity about the wrist, butthere is no history of direct injury to it, nor does the most care-ful examination discover the signs of there having been a fractureof radius or ulna. The fingers stand apart as seen in the cut, 615 6i6 F. T. MILES. and can, by voluntary effort, be only partially and with difficultyapproached to each other. Slight atrophy of muscles aboutshoulder and arm ; none in forearm. Muscles of hand but littleatrophied.
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As seen in the cut, all the fingers showed marked nutritivechanges, the little and ring fingers most of all ; the thumb wasnot affected ; the little finger was deformed, its joints stiff; theskin of the little and ring fingers was pale, glossy, and as ifstretched. The same condition of the skin was observed in thelast phalanx of the other fingers, but in a less degree. The nailsof all the fingers were affected, showing lateral and longitudinal ALTERA TIONS AND DEFORMITY OF FINGERS. 617 curvature. That of the little finger was much distorted, and, asit were, crumpled. Sensation was by no means lost in the fingers, but blunted, fortactile impressions, for heat and cold, and for the faradic current—especially in the little and ring. Stroking the ring or little finger,even lightly, caused a feeling of uneasiness that irresistibly im-pelled the patient to pluck the hand away. The muscles of the forearm showed normal electric reaction.The interossei replied feebly to both the faradic and

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