$ectton of 1ReurolooW. President-Dr. WILFRED HARRIS. Dystrophia Myotonica (Myotonia Atrophica), an Heredo- familial Disease with Cataract. By W. J. ADIE, M.B. IT happened about a year ago in the course of routine out-patient work that my first patient on two consecutive days suffered from a disease which I was then content to call myotonia atrophica; and when I related this coincidence to a colleague at another hospital a day or two later I was promptly invited to " come into the wards and see two more." Naturally, the lively interest thus created by chance supplied the stimulus for further investigation. I can remember seeing one case only before the incident I have related, but since that time I have come across twelve more, many of them in the course of routine work at general hospitals. In all but four cases, which I saw by the courtesy of colleagues, the trouble was either unrecognized, the patient being under treatment for some unrelated condition-on the surgical side in one instance-or it was labelled progressive muscular atrophy or myopathy or, in one case, myasthenia gravis. I was not surprised then, in my search for further information, to find that the number of cases recorded already runs into hundreds, and that much more is known of this interesting and many-sided disease than is indi- cated by the meagre descriptions that exist in the English language. So far as I know, the subject has not been discussed at length by this Section for many years, and although the foreign literature is extensive, little has been written upon it in this country since the late Dr. Batten made it known to us some thirteen years ago. This would not be surprising if dystrophia myo- tonica were a very rare disease or one of which little remained to be said; but it is certainly far from rare in comparison with many nervous and general diseases the characters of which are well known to us; and I trust that what I have to say will convince you that much remains to be said before the problems are solved that it presents not only to neurologists but also to ophthalmologists, to physicians who interest themselves in disorders of internal secretion, and to those who make a study of heredo- familial disease. The htstory of dystrophia myotonica may be said to begin in 1886 with the appearance of Erb's work on Thomsen's disease, for although the two conditions are quite distinct, Erb's work, by arousing widespread interest in myotonia, led to the publication of descriptions of a large number of cases of " atypical Thomsen's disease "-so called because myotonia was a symptom common to them all-and it was from this heterogeneous mass that the group of cases which now concerns us finally emerged. [December 14, 1922. at SAGE Publications on June 21, 2016 jrs.sagepub.com Downloaded from
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