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distortion of

debility of the fibres of the extensor muscles, proscribes Gen. I.

Spec. III. an extended position in every instance; and, as already Entasi observed, recommends a curved relaxing couch in its Rhachybia.

w in Muscular stead, so that the patient may sink into it at his ease, instead of being put upon the stretch. The advice is good so the spine. far as the opinion is correct, and the disease is dependent upon debility of the extensor muscles alone: for here nothing can afford so much ease to the patient as such an indulgence. But it is not to be conceded that the fibrous structure of these muscles form the seat of the disease in every case, and consequently the recommendation will not always apply: for the flexor muscles may be affected, or the debility be seated in the extensor ligaments, or'the vertebral cartilages with which they are connected. I have at this moment under my care a lady just of age who, for four years past, has been labouring under a slight affection of lateral distortion, feeling much more of it whenever she suffers fatigue, or is affected in her spirits. A position strictly Illustrated. supine, and somewhat extended, upon a hard mattress or a level floor is the only posture that affords her ease, and takes off the sense of weight on the spine, and oppression on the chest. She has often tried other positions but in vain. To this, therefore, she has uniformly recourse after dinner, and, occasionally, at other times in the day as well. Pure country air has also been of great service, but above all things sea-bathing. She has just returned from an excursion around the Devonshire coast. The first day's journey, though in a reclined position in an open landaulet, with every attention that could afford ease and accommodation, proved so fatiguing, and produced so much pain in the spine, that it was doubtful whether she would be able to proceed. A better night, however, than was expected, capacitated her for another trial, and the fatigue was considerably less : on the third or fourth day she had an opportunity of beginning to bathe ; and by a daily perseverance in the same was enabled, soon after reaching Teignmouth, to engage in long walks, climb its loftiest hills, and enjoy the entire scenery: her appetite became almost unbounded, and her flagging spirits were restored to vivacity.



Gen. I. It is hence perfectly clear that while that position and Entasia

" that mode of dress are most to be recommended which afford Rhachybia. the highest degree of ease and comfort; gestation, pure air, Muscular distortion of sea-bathing, and every other kind of tonic, whether exterthe spine. nal or internal, are also of the utmost importance; and

egeso that perfect and continued rest, in whatever position tation, pure air, sea-ba- it be tried, is far less efficacious than when interrupted by bathing, and

nd such motion as can be borne, though with some degree of tonics to fatigue, and the other tonic auxiliaries just adverted to. combine with in

In extreme cases, indeed, such exercise as is here ad

v the preceding.

verted to should be postponed till the debilitated and,

most probably, irritable organs have lost some part of their interrupted rather than disease: yet the motion of friction or manipulation by a continued : skilful and dextrous hand may still be adverted to, and except in extreme should supply its place..






Muscular Stiff-joint.



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The joints of the limbs are as subject to muscular con-
tractions as the neck: and, in many instances, from like
causes: the following are the varieties of affection hereby
produced :
a Irritata.

From excess of action in the
Spastic stiff-joint. muscles contracted.
B Atonica.

From direct atony in the yield-
Atonic stiff-joint. ing muscles.
q Inusitata.

From long confinement or negChronic stiff-joint. lect of use...

Besides the ordinary causes of cold, inflammation, and Gen. I.

Spec. IV. strains, by which the first and second variety are produced, Enta the former has sometimes followed upon a sudden fright*, articularis.

Muscular upon drying up a cutaneous eruption, or checked per- stiff-joint. spiration t. Freind, also, mentions a case in which it has Causes. been cured by a frightf; and Baldinger one in which it disappeared on the revival of a suppressed eruption which had given rise to it. Rheumatism has often produced it, and particularly the second variety, in the joint of the knee and thigh-bone.

In a case of the latter kind, it was successfuly attack- Treatment. ed by Richter ll, with a cautery of a cylinder of cotton. In this and the third variety much benefit is often derived from repeated and long continued friction with a warm hand, and particularly if illined with some stimulant balsam or liniment. In an obstinate contraction of the fingers succeeding to a fractured arm, Dr. Eason relates an instance in which the rigidity suddenly gave way to a pretty smart stroke of electricity after every other mean had failed ; and the patient had the use of his fingers from this time TSuch exercise, moreover, or exertion of the limb, should be recommended as it may bear without fatigue. The cold-bath, as an antispasmodic, has sometimes been serviceable in the FIRST VARIETY, and more frequently, as a tonic, in the second.

Most men exhibit proofs of the THIRD VARIETY or Chronic chronic stiff-joint, from a neglect of using many of their stogourd. muscular powers: for nearly a fourth part of the voluntary duced from

habitual muscles, from being seldom called into full and active

e neglect of exertion, acquire a stiffness which does not naturally muscles belong to them, while many that, by exercise, might have an been rendered perfectly pliant and obedient to the will have lost all mobility, and are of no avail. Tumblers Explained. and buffoons are well aware of this fact, and it is principally by a cultivation of these neglected muscles that they are able to assume those outrageous postures and gri


* Starke, Klin. Instit. p. 32. # Vit. Gabriel.

| Chir. Bibl. Band. x. 219. VOL. IV.

t Paulini Cent. 1. 39.
S N. Magazin. Band. xi. 78.

Edin. Med. Comment. v. p. 84.


Gen. I. maces, and exhibit those feats of agility which so often SPEC, IV.

. amuse and surprise us. It is a like cultivation that gives articularis. that measured grace and firmness as well as erect position Muscular stiff-joint. in walking, by which the soldier is distinguished from Treatment.

the clown; and that enables the musician to run with rapid execution, and the most delicate touch, over keys or finger-holes that call thousands of muscular fibres into play or into quick combinations of action, which in the untutored are stiff and immoveable, and cannot be forced into an imitation without the utmost awkwardness and fatigue.







Gen. I. SYSTREMMA, literally “contortio, convolutio”, “globus”,
Srec. V.
Origin of' is derived from ouotpeow, “ contorqueo”, “ convolvo in
specific fascem”. Stremma, the primary noun, is an established

technical term for “ strain, twist, wrench”; and the
author has hence been induced to add the present term

to the medical vocabulary in the sense now offered, for invented to the purpose of superseding and getting rid of crampus

which has hitherto been commonly employed, though at the barbarous term the same time commonly reprobated, as a term intolerably crampus.

barbarous, derived from the German krampf. The proper Raptus of Latin term is, perhaps,“ raptus nervorum”; whence

opisthotonia or opisthotonus is denominated by the Latin writers “ raptus supinus". But raptus is upon the whole of too general a meaning to be employed on the present


the Latins, what.



occasion, unless with the inconvenience of another term combined with it.

Spec. V.

Entasia The parts chiefly attacked with cramp are the calves Systremma. of the legs, the neck, and the stomach. The common Cramp. causes are sudden exposure to cold, drinking cold liquids

chiefly during great heat and perspiration, eating cold cucurbi- affected. taceous fruits when the stomach is infirm and incapable Causes, of digesting them, the excitement of transferred gout and overstretching the muscles of the limbs, in which last case it is an excess of reaction produced by the stimulus of too great an extension. Hence many persons are subject In the last

case, how to it, and especially those of irritable habits, during the

mg the produced, warmth and relaxation of a bed, and particularly towards especially

in the long the morning when the relaxation is greatest, the accumu. muscles. lation of muscular or irritable power most considerable, and the extensor-muscles of the legs are strained to their utmost length to balance the action which the flexormuscles have gained over them during sleep. Cold night. Other air is also a common cause of cramp, and it is a still more frequent attendant upon swimming, in which we have How prothe two causes united of cold and great muscular exten

duced in

- swimming sion. An uneasy position of the muscles is also in many cases a sufficient cause of irritation; and hence we often meet with very painful cases of cramp in pregnant women down the legs, or about the sides, or the hypogastrium.

When the hollow or membranous muscles are affected, Symptoms they feel as though they were puckered and drawn to a me point; the pain is agonizing, and generally produces a membraviolent perspiration : and if the stomach be the affected organ the diaphragm associates in the constriction, and affected. the breathing is short and distressing. If the cramp be When the

more fleshy seated in the more fleshy muscles, they seem to be writhed muscles are and twisted into a hard knot, and a knotty induration is affected. perceivable to the touch accompanied with great soreness, which continues for a long time after the balance of power has been restored.

In common cases where the calves of the legs are Mode of affected, an excitement of the distressed muscles into their usual train of exertion is found sufficient: and hence

causes of cramp.

when the hollow or

nous mus. cles are


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