Superior Extremities
Both arms, but especially the right, began to feel numb and weak after his third attack of colic. The weakness gradually increased, and in about three weeks a trembling began, at first slightly, but which is now very great. The oscillations, especially of the arm, are uniform in extend, and rapidly performed. He says that the trembling diminishes and increases alternately. It is greatly aggravated after fatiguing work. The legs are not affected in any way. All the movements of the arms are performed naturally; the fingers and forearm can be extended with the greatest ease. Electro-muscular contractility is normal. The force of compression in the right hand, according to the dynamometer, equals 30 kilograms; in the left hand, 45 kilograms. The pulling strength is 70 kilograms. Muscular strength, in this case, is but slightly impaired. Trembling of the arms. Trembling of the hands, followed by weakness of the third and fourth fingers. so that they could not be fully extended; afterwards the second and fifth fingers became affected, afterwards the wrist, and finally even the shoulders; the arms hung down relaxed; the shoulders and arms were emaciated, especially the deltoid muscles; the balls of the thumbs emaciated; on passive motion of the hands and fingers there were trembling motions of the muscles, also at other times there was exquisite fibrillar twitching; if he attempted to raise the arm, the trapezius and sterno-cleido-muscles contracted and raised the shoulder as much as three in chest, then the pectoral muscles contracted and drew the arm slightly forward; he was, however, able to flex and extend the elbow by means of the biceps and long supinators on the one hand, and the biceps on the other; contraction of all the muscles was very weak; pronation and supination of the hand was possible, with trembling, etc. The whole right arm trembles a good deal. The oscillations are rapid and uniform, with a regular to and fro motion. The tremor persists even after the patient has been told to fix his attention on it, in order to prevent it. There is no decided movement of the fingers parts; it is rather a movement of the whole arm. The left arm also trembles, but in a much less degree. Incoordinate movements of the superior extremities, which consist in an indefinite and irregular series of contractions, and have their seat alternately in the extensor and flexor muscles.
These oscillations continue in spite of the patient’s effort to the contrary. The power of extending the arms upon the posterior portion of the trunk is much lessened. There exists a slight analgesia of the affected members, but not the least paralysis of the extensor muscles of the fingers. Convulsive movements from time to time in the arms. Trembling of the arms, worse towards evening, principally in the hands and forearms, but extending to the upper arms when he is compelled to any strong exertion of the limbs. Trembling, especially of the upper extremities. Trembling in the upper extremities. Quite severe tremor, confined to the upper limbs.
Very perceptible tremor of the upper limbs. Decided tremor of both superior extremities; oscillations rapid and uniform. The tremor diminished after a few sulphur baths; a paralysis of the extensors of both arms then set in. Tremor of the right arm. About three weeks ago his arms became affected. They re “shaky,” he says; are agitated by clonic convulsions when he attempts to use them. He cannot write, and can with difficulty feed himself; at one time he was unable.
His right arm at one time was fixed, by the contraction of its muscles, to his side up to 10 or 11 A.M. every day. After walking for some time, his arms get quite steady for three or four hours. His grasping power is lessened. The superior extremities are affected with a decided tremor, not very perceptible when they are at rest, but plainly visible on holding them out in front. Tremor of the arms, especially the right arm, during voluntary motion. Well-marked tremor of both arms, preceded by weakness and numbness, which are especially felt towards evening. Several attacks of colic. Three years ago, taken with weakness and numbness of the arms, worse towards evening, succeeded by a gradually increasing tremor confined to the arms; these were cured in six weeks). Paralysis of the upper extremities; the extensor muscles became completely paralyzed; both arms hung by the side, could not be raised; the patient could not use the hands in eating, drinking, or dressing himself; the flexor muscles were somewhat weakened, and use was associated with trembling; this was followed by atrophy of the muscles. Paralysis of the extensor muscles of the arm. When he pronate the hand, the wrist droops, to a right angle with the forearm; he cannot straighten it; supination in performed naturally. Generally paralysis of the upper extremities. Flexor muscles slightly enfeebled. Want of power of motor coordination quite marked in both upper limbs, the left especially; when his eyes are shut, he cannot touch any particular spot on his face without feeling for it; analgesia to pricking and pinching in both arms, especially the left. Paresis of the upper limbs, especially of the right hand and forearm. Complete paralysis of superior extremities.
Paralysis of the extensors of the upper extremities, especially of the forearms; flexor muscles unaffected; the paralysis of the fingers became so great that the patient was unable to write. Paralysis of the upper extremities and atrophy.
Almost complete paralysis of upper extremities, and gradually increasing emaciation. Paralysis in the extensor muscles of both upper extremities and one of the lower. Upper extremities paralyzed as to muscular power (after three weeks). Painful paralysis of the arms. Inability, by any effort of will, to raise his arms, which hang down by his sides. A few months ago, his arms and hands began to feel “fagged and powerless. Incomplete paralysis of the upper extremities; the extensors of the fingers, the supinators, extensors, abductors, and adductors of the thumbs seem to suffer especially, with incomplete paralysis of the feet, especially of the extensors of the leg, also the sensation of warmth not entirely lost. Paralysis of the left arm. He was able to make flexion and extension but to a slight degree; but, what is singular, the grasp was as perfect and as strong as in health. Both arms hung so powerlessly by his side, that the hands could not be raised more than a few in chest from the body. Diminished power of the extensor muscles, especially on the right side. This want of power does not seem to be confined as much as usual to the extensors, for the flexors of the arms and hands are also much enfeebled. It is evident that neither flexion nor extension can be fully accomplished, so that the angle included between the furthest limits to which these movement can be voluntarily carried is considerably lessened. The fingers can be extended farther by the application of outward force. Almost complete paralysis of the extensors of the arms. Loss of power in the right arm. Paresis of the extensor muscles, especially of the left arm. Paralysis of the arm began with loss of power in the extensor of the fourth finger, after which, trembling of the arm after exertion was frequently noticed. The whole of that arm which used to be thrust into the furnaces was paralyzed, and not, as in most cases, only the hand and forearm. The extensor muscles do not contract on the application of electricity; the inter. manus contract., causing flexion of the first phalanges and extension of the second. Paralysis of the extensors of both arms, especially the right. Both arms hang down, but there is no contraction of their flexor muscle.
Inability to lift the right arm, which is applied to the chest; its other movements are performed naturally. Pains in right side of neck, right shoulder, inner portion of right arm bend of right elbow, palmar surface of right forearm and wrist; increased by movement; unaffected by pressure; worse by paroxysms, during which they burn like fire, and between which they are contusive. Skin of these parts insensible, but their contractility unimpaired. Whatever efforts are made to move the whole upper extremity, contraction is only noticed in the fibres of the deltoid. The motor power of the right upper limb is diminished; the muscles of the posterior region of the forearm are also somewhat wasted. The flexors, as well as the extensors, are somewhat affected, since, when he clenches his hands, he exerts very much less strength with the right than with the left. Paralysis of the extensors of the forearms; pronation impossible; the lower portion of the forearm, especially of the right, much emaciated; the hypothenar decidedly diminished in volume; the action of the long supinators preserved; muscles of the right upper arm atrophied, as also those of the left, but in a less arms, especially of the right, the same symptoms were noticed in the lower extremities, only the extensors of the feet very little paralyzed; there was no ataxia of motion. The first indication of paralysis of the arm was noticed after writing, and manifested itself by weariness and trembling of the hands, and inability to completely extend the fingers; weakness affected at first the third and fourth, then the fifth and second fingers, then the thumb, at last the extensor, not at all of the supinators (the patient was left-handed, and the paralysis was worse on the left side). Raising the arm became difficult and almost impossible; after awhile the arm became entirely paralyzed, especially the deltoid muscle; the elbow, wrist, and finger- joints were somewhat flexed; the hand retained its position midway between pronation and supination; the paralysis that began in the extensors gradually extended to flexors, and the arm became completely paralyzed; tearing pains in the arm, aggravated by pressure, worse at night, at times so violent that the patient became wild with pain; the sensation of touch was absolutely unaffected; sensation of heaviness in the wrists and fingers; finally, a feeling of icy coldness in the extremities. Arms hang straight down, and seem as if fastened to the sides; when raised and let go, they fall like inert bodies. The arm is semi flexed at the elbow; it cannot be completely straightened; when this is attempted to be done, the limb immediately returns to its former position. Both arms fixed in pronation; no approach to supination possible. The left arm is laid against the chest; it cannot be raised by the action of the deltoid; its other movements are performed naturally. Upper extremities emaciated; the extensor muscles completely atrophied; the space between the radius and ulna sunken; skin dry, gray, rough; both hands flexed at the wrists; both osseous spaces hollowed; the bask phalanges stand at right angles with the metacarpus; the middle and terminal phalanges flexed into the palm of the hand, so that the nail pressed into the skin; the terminal phalanx of the thumb stands at right angles with the basal phalanx; abduction and adduction almost entirely lost; separation of the fingers impossible; all extensor motion is impossible; pronation and supination almost entirely lost; scarcely any power to flex or extend the forearm at the elbow; motion at the shoulder is free. There was a marked loss of substance over the right shoulder, all the scapular muscles being atrophied and shrunken; the head of the humerus could be distinctly felt, and even the irregularities on the surface of the shaft. Lower down, all the muscles of the arm and forearm were much wasted. The fingers were flexed. At times a distinct muscular tremor was seen in the affected muscles, but this was just after attempting to use them.
Born in 1837in Westminster, Vermont. . He was an orthodox doctor who converted to homeopathy
Dr. Allen compiled the Encyclopedia of Pure Materia Medica over the course of 10 years.
In 1881 Allen published A Critical Revision of the Encyclopedia of Pure Materia Medica.