STUDIES IN DISEASES OF MUSCLE: XI. PROGRESSIVE MUSCULAR ATROPHY: REPORT OF A CASE WITH UNUSUAL FEATURES; EFFECT OF PROSTIGMINE AND PHYSOSTIGMINE ON FASCICULATIONS; METABOLISM OF ASCORBIC ACID

The present paper may properly be considered as consisting of three parts: (1) report on a patient in whom the clinical picture was that of progressive chronic anterior poliomyelitis with onset of symptoms in earliest childhood and a course that had been slowly progressive for about twenty-six years; (2) investigations on the effect of prostigmine and physostigmine on muscular fasciculations in this patient and in other subjects with progressive muscular atrophy, with comparison of the effects on the adventitious movements and those on choline esterase activity, and (3) a study of the metabolism of ascorbic acid in this and in other patients after administration of large amounts of the vitamin for prolonged periods. METHODS During the period of investigation the patient was in the research metabolism ward of the New York Hospital, where the diet could be rigorously supervised. A creatinine-creatine-free diet constant in its content of calories, protein and