Several years ago, having had an opportunity to observe a large series of individuals working in lead, a problem presented itself for solution. Some workers showed left handed wrist-drop, others right handed; another had a paretic condition of the long flexor of the right thumb; another had a double wrist drop; another had paresis of the right leg. In all these cases there was an absolutely identical etiologic factor, and still the functional disability did not manifest itself in the same portions of the body. In several professional pianists I have observed attacks of cramp-like sensations in the wrist, and in others in some of the fingers. The occupation and the continuous efforts being the same, the seats of the disorder are not identical.
In a large group of tabetic patients I had three cases of the cervical type in which ataxia began in the upper extremities. Why, therefore, is
GORDON A. OVERACTIVITY AS A POTENT FACTOR IN THE ETIOLOGY OF SOME NERVOUS DISEASES: INQUIRY OF 187 CASES. JAMA. 1916;LXVI(9):641–645. doi:10.1001/jama.1916.02580350029010
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