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February 24, 1900


JAMA. 1900;XXXIV(8):503. doi:10.1001/jama.1900.02460080055017

When the paralysis due to lead poisoning was first described systematically, it was thought that the small muscles of the hands escaped. The wasting of the thenar eminence observed in painters was attributed to the pressure exerted in the use of the brush, although subsequently this was correctly ascribed to the toxic effects of lead. In this process the adductor of the thumb and the first interosseous muscle are also involved. It has been held that this paralysis constitutes part of the so-called forearm type, including paralysis of the extensors of the hand and the fingers, with escape of the supinators. An upper-arm type has also been described, with involvement of the supinators, the biceps, and the brachialis internus; and finally a third variety, with paralysis of the small muscles of the hand, the thenar and hypothenar eminences and the interossei. The last, it has been thought, may be the

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