shaking that threatened every moment to overturn whatever she took hold of, raise a cup brimful of tea, or a glass brimful of wine to her lips by way of experiment, without spilling a single drop. Where the corporeal health is so little interfered with, as in the present case, a course of medical treatment might, perhaps, do more mischief than benefit. But where the constitution is generally affected, or the muscles that form the seat of the convulsion are manifestly debilitated, general and local tonics and stimulants may sometimes be tried with advantage, though they frequently fail of producing any good effects. Sea-bathing and horse-exercise, a generous diet, change of air and scene, may be found useful auxiliaries in the general treatment; and long continued and daily friction by a skilful rubber, ammoniacal embrocations, blisters, setons, and a course of voltaism or electricity offer the best promise, as topical means of relief. The affected limbs may also be put into a train of gradual exertion for the purpose of obtaining both strength and steadiness: and to this end the head or shoulders may be occasionally made to balance an easy weight for a given period of time, and the hands to suspend or carry a wine-glass or tumbler brimful of water. Here also may be recommended the kneading-friction, or shampooing of the Egyptians and Turks, which has of late become a fashionable refreshment in the wateringplaces of our own country, and there can be no question that the pungent and exhilarating essential oils which are applied to and absorbed by the skin afterwards, add considerably to the general efficacy. Something like this the French have long been in the habit of employing under the name of frictions sèches *. The horse-hair shirts and periodical flagellations of the old Franciscan friars would probably be found to answer the same purpose. But this is a remedy which is not likely to be revived in the present day whether from a medical or a moral call. .* Ardouin, Essai sur l'Usage des Frictions Sèches, &c. SPECIES II. SYNCLONUS CHOREA. St. Uitus's Dance. ALTERNATELY TREMULOUS AND JERKING MOTION OF THE SPEC. II. dern date. called St. Vitus's dance or THE term CHOREA from xogos, " chorus", "coetus saltan- GEN. III. tium", is comparatively of modern date in its applica- Specific tion to the present disease, nor is it easy to determine term of mosatisfactorily who earliest employed it. It was first more limitedly denominated CHOREA SANCTI VITI, under which limitation it occurs in Sydenham, and is still known in popular language, being called in colloquial English, St. Whence Vitus's Dance, and in colloquial French, Dance de St. Guy. According to Horstius the name of St. Vitus's Dance was given to this disease, or, perhaps, more probably to a disease possessing some resemblance to it, in consequence of the cure produced on certain women of disordered mind, upon their paying a visit to the chapel of St. Vitus, near Ulm, and exercising themselves in dancing from morning to night, or till they became exhausted. He adds that the disease returned annually, and was annually cured by the same means. dance de St. Guy. the reme dial dance described. The marvellous accounts of this dance, as related by Nature and old writers, are amusing from their extravagance. The duration of paroxysm of dancing, we are told, must be kept up whatever be the length of the time, till the patient is either cured or killed; and this, also, whether she be young or old, in a state of virginity or of parturition; and in the growing energy of the action we are further told that stools, forms, and tables are leaped over without difficulty SPEC. II. Synclonus GEN. III. if they happen to be in the way. Felix Plater gravely tells us that he knew a woman of Basle, afflicted with this complaint, who, on one occasion danced for a month together*: and the writers add generally that it was hence necessary to hire musicians to play in rotation, as well as various strong sturdy companions to dance with the kept up for patients till they could stir neither hand nor foot †. St. Vitus's dance. Said to have been sometimes a month without ceasing. Recent case to it. The nearest approach to this kind of gymnastic medicine which I am acquainted with in modern times, is a singular case of the same disease described by Mr. Wood approaching in the seventh volume of the Medico-Chirurgical Transactions. The morbid movements were in measured time, and constituted a sort of regular dance as soon as music was struck up, but ceased instantly upon a change of one time to another, or upon a more rapid roll of the drum, which was the instrument employed on the occasion, than the morbid movements could keep up with. Advantage was taken of the last part of this very singular influence, and the disease was cured by a perseverance in discordant or too rapid time. This form of the disease appears to have a near relation to the tarantismus of Sauvages, which is the carnevaletto delle donne of Baglivi, all of them probably nothing more than modifications of the present. Linnéus, and after him Macbride, from the epithet of sanctus, as applied to CHOREA, or a belief that such affections are induced by the immediate agency of a superior order of beings, have applied to it the name of HIERONOSOSs, or "morbus sacer -a name, however, which, by earlier writers, was appropriated to convulsionfits. Tarantis mus. Carneva letto delle donne. Probably with the scelotyrbe In Galen chorea seems to be included under a disease synonymous which he calls SCELOTYRBE, literally, "cruris turba or perturbatio”,—" commotion of the leg "; and his description, which is as follows, is extremely accurate. "It is a species of atony or paralysis, in which a man is incapable of walking straight on, and is turned round to the left, of Galen. * De Mentis Alienat. Cap. iii. † Paracels. De Morb. Amentium. Tract. 1. Schenck, De Maniâ. Lib. 1. when the right leg is put forward, and to the right, when the left is put forward, or alternately. Sometimes he is incapable of raising the foot, and hence drags it awkwardly as those that are climbing up steep cliffs." GEN. III. Synclonus Chorea. SPEC. II. St. Vitus's dance. tion from appearing One of the best general descriptions which have been given us of chorea, is the following of Dr. Hamilton, contained in his valuable treatise on the utility of purgatives: "Chorea Sancti Viti attacks boys and girls indiscriminately; and those chiefly who are of a weak constitution, Descripor whose natural good health and vigour have been im- Hamilton. paired by confinement, or by the use of scanty or impro- A disease of per nourishment. It appears most commonly from the debility eighth to the fourteenth year. I saw it in two young most comwomen who were from sixteen to eighteen years of age. monly The approaches of chorea are slow. A variable and often children. a ravenous appetite, loss of usual vivacity and playfulness, a swelling and hardness of the lower belly, and, in general, a constipated state of the bowels, aggravated as the disease advances, and slight, irregular, involuntary motions of different muscles, particularly those of the face, which are thought to be the effect of irritation, precede the more violent convulsive motions, which now attract tacked first. the attention of the friends of the patient. among Muscles of the face usually at other kinds. "These convulsive motions vary. The muscles of Afterwards the extremities and of the face, those moving the lower muscles of jaw, the head, and the trunk of the body, are, at different different times, and in different instances, affected by it. In this state the patient does not walk steadily; his gait resembles a jumping or starting; he sometimes cannot walk at all, and seems palsied; he cannot perform the common and necessary motions with the affected arms. This convulsive motion is more or less violent; and is constant except during sleep, when, in most instances, it ceases altogether. Although different muscles are sometimes. successively convulsed, yet in general, the muscles affected in the early part of the disease remain so during the course of it. Articulation is now impeded, and is Articula- frequently completely suspended. Deglutition is also oc- deglutition casionally performed with difficulty. The eye loses its impeded. tion and SPEC. II. Synclonus GEN. III. lustre and intelligence; the countenance is pale and expressive of vacancy and languor. These circumstances give the patient a fatuous appearance. Indeed there is every reason to believe that when the complaint has subsisted for some time, fatuity to a certain extent interrupts the exercise of the mental faculties." St. Vitus's dance. Patient appears fatu ous, and sometimes becomes really so. Sometimes has evinced The mind not unfre quently un influenced where the disease is violent and habitual. Has accompanied good orators, Thermaier gives a case in which it was connected with a deeply melancholic temperament, and the limbs were in a state of constant snatching and trepidation*: but this is a rare concomitant; nor is fatuity a constant sequel of a deep me it even in its most obstinate and chronic form. The prelancholic temperasent author has met with various instances in which the ment and disease has continued with considerable violence from an perpetual trepidation. early period to old age, without making any inroad whatever on the mind, or even spreading to any other joints, limbs, or muscles, than those at first affected. He once knew a man under the habitual influence of this complaint who was a good orator, always reasoning with great clearness, and delivering himself with much animation. The movements of his arms were indeed in ungraceful snatches, and the muscles of the neck frequently evinced a like convulsive start, yet not so as to interrupt the flow of his periods, or to abridge his popularity. He knew public mu- another person for many years severely afflicted with the same complaint, who was an excellent musician, public singer, and composer of music; and this, too, notwithstanding that he was blind from birth. The person alluded to is the late Mr. John Printer of the Foundling Exemplified. Hospital. In walking he was always led on account of his blindness, and used a staff on account of the unsteadiness of his steps; but, notwithstanding every exertion, his gesticulation was extreme, and so nearly approaching the antics of a buffoon, that it was often difficult for a spectator to suppress laughter. Yet in singing and playing he had a perfect command over the muscles of the larynx and of the fingers; his tones were exquisitely clear and finely modulated; but his neck and head curvetted a little sicians and singers. Consil. Lib. II, cap. xi. |