Injuries of nerves and their consequences - Reflex Sympathetic ...

MUSCULAR LESIONS. 203
are nnexcitable, as a rule, by induced electric currents,
.whilst muscles in a state of spasm are often abnormally
irritable under this form of stimulation. The atrophied
muscle is hard, shrunken, and motionless, and cannot be
elongated. The muscle in spasm is firm, plump, often
exhibits fibrillar movement, and can be lengthened when
ether or chloro-
the patient has been made insensible by
form. Wlien awake, the effort to extend these muscles
We
causes pain and increasing spasmodic contractions.
remarked in our wards* many cases of what might be
called a tendency to spasm, which was shown by quivering
and resistance in a muscle, which gave no proof of
spasm until suddenly extended by the hand of the physician
or by the action of its antagonists. In a case of injury
of the shoulder, which I saw a year ago, the lower arm
nerves became secondarily diseased ; and, owing to this,
the supinator longus and biceps passed into the condition
described. The arm was carried slightly bent, but if I
extended it,
a spastic contraction of these muscles drew
it into a state of extreme flexion, which lasted for some
minutes, durino- which the fibres of the muscle could be
felt to be firmly contracted.
I was lately consulted by Dr. Ellis, of Elkton, Maryland,
in regard to a patient who presented a remarkable instance
of this form of fibrillar spasm.
The lad, aged eighteen years, was run over five years
previously by a cart, which passed across the back of the
neck and the right shoulder. Both arms were palsied
as to motion alone. The left recovered entirely, as did
also the right forearm and hands; but the arm muscles,
except the triceps extensor, remained motionless, and
became excessively wasted. The atrophied deltoid, supraand
infra-spinatus, and biceps are now the seats of the
* Gunshut Injuries of Nerves, op. cit., p. 124.