When  the  muscles  of  the  lower  limbs  are  affected  with  this  disease
the  patient  is  very  apt  to  experience  great  difficulty  in  attempting  to
rise  and  walk,  after  a  prolonged  recumbent  or  sitting  posture.  Such  sub-
jects have  been  known  to  fall  as  soon  as  eff"orts  to  walk  were  attempted.
Fibrillary  contractions  of  the  muscles  may  occasionally  be  detected.
Continued  movement  and  the  application  of  heat  tend  to  diminish  the
spasm,  while  mental  excitement  and  cold  usually  aggravate  it.
Again,  the  muscles  in  these  patients  show  an  abnormal  excitability
to  mechanical  and  electrical  stimuli.  Artificially  produced  contractions
are  apt  to  be  very  much  prolonged.  Erb  describes  peculiar  "wave-like
contractions "  in  the  muscles  of  the  limbs,  whenever  galvanic  currents
of  sufficient  intensity  are  employed  upon  the  patient  by  the  stabile  polar
method.  These  contractions,  according  to  this  author,  alwaj's  tend  to
pass  toward  the  anode.  After  a  time  they  subside  "  like  waves  of  water
produced  bj-  a  falling  stone."  Any  increase  of  the  strength  of  the
current,  however,  tends,  as  a  rule,  to  reproduce  them.
442  LECTUKES   ON  NERVOUS  DISEASES.
To  test  this  reaction  in  the  upper  extremities,  one  pole  maj'  be
phaced  at  the  najjc  of  the  neck  and  the  other  in  the  pahn  of  the  hand  or
at  the  annuhir  ligament  of  the  wrist-joint  on  its  palmar  aspect.  To  test
it  in  the  lower  extremity,  one  pole  should  be  at  the  neck  and  the  other
ma3'  be  placed  adjacent  to  the  patella  or  upon  the  tendo-Achilles.  The
strength  of  the  current  employed  varies  from  six  to  twenty  milliaraperes.
Jacoby  has  observed  an  absence  of  any  fixed  relationship  of  Ca.C.C.
and  An.C.C.  to  each  other,  as  exists  in  healthy  muscle  (page  190).
