Image from page 68 of “Practical diagnosis: the use of symptoms in the diagnosis of disease” (1899)

Image from page 68 of “Practical diagnosis: the use of symptoms in the diagnosis of disease” (1899)
diabetes tips
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Identifier: practicaldiagno00hare
Title: Practical diagnosis: the use of symptoms in the diagnosis of disease
Year: 1899 (1890s)
Authors: Hare, H. A. (Hobart Amory), 1862-1931
Subjects: Diagnosis
Publisher: Philadelphia and New York, Lea brothers & co.
Contributing Library: The Library of Congress
Digitizing Sponsor: The Library of Congress

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Text Appearing Before Image:
e whichresult in hypertrophy. They arise in cases of paralysis not only THE HANDS AND ARMS. 67 from wasting of the muscular tissues, so that hollows or sunkenplaces occur, but also from the distortions caused by the contrac-tions of healthy muscles, which, having no opposition as in health,speedily draw the bones of the hand into abnormal positions. Inother cases the diseased muscular fibres may be spasmodically con-tracted, overcoming the resistance of the healthy muscles. The wasting of the hand seen in old age, particularly in women,and in advanced phthisis, diabetes mellitus, and other conditions inwhich the tissues of the body in general lose their plumpness, is souniversally distributed that a diagnosis of wasting from old age isnot difficult. On the other hand, the wasting due to nervous lesionsis generally not universal, but limited to single muscles or groupsof muscles, the remaining portion of the hand having its normalappearance or being only indirectly influenced. Fig. 22.

Text Appearing After Image:
Claw-hand. (Gray.) Under the name of claw-hand, or main-en-griffe we finda deformity of the hand which is in itself very characteristic, althoughindicative of several causes which all operate in an identical manner.The back of the hand loses its normal convexity and becomes some-what concave, the tendons on the extensor surface stand out inridges, the proximal phalanges are drawn backward toward thewrist, while the second and third phalanges are drawn toward thepalm of the hand (Fig. 22). Sometimes, however, the tips of thefingers are drawn toward the back of the hand. This deformityresults from atrophy and paralysis of the interossei muscles andlumbricales, which are supplied by the median and ulnar nerves.The extensor communis digitorum and flexor digitorum produce adorsal flexion of the first phalanges and a complete palmar flexion 68 THE MANIFESTATION OF DISEASE IN ORGANS. of the second and third phalanges. A certain amount of immo-bility is also caused by the fact that flexion of

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