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Wingate M. Johnson, M.D.
JAMA. 1927;89(18):1513. doi:10.1001/jama.1927.92690180001013.
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Mrs. R. P. F., aged 34, the mother of three healthy children of 2, 9 and 12 years, was in good health until a year ago, when she began to experience muscular weakness, especially of the legs. This weakness has progressed until now she cannot rise from a sitting or lying position without assistance.

Physical examination revealed a typical picture of the pseudohypertrophic type of musclar atrophy. The legs were quite large in proportion to the rest of the body, and felt firm to the touch. The abdomen was prominent, on account of the marked lordosis position when standing. The muscles of the arms and chest were shrunken. The tendon reflexes were absent. On attempting to rise from a chair, the patient assumed the attitude, so familiar in textbook pictures, of climbing up on her thighs with her hands. Even then she had to have assistance from her husband before she


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