On the muscular contractions which are occasionally to be observed after death from cholera : read before the Westminster Medical Society, October 20th, 1849 / by Wm. Frederick Barlow.

  • Barlow, W. F. (William Frederick), 1817-1853.
Date:
1849
Catalogue details

Licence: Public Domain Mark

Credit: On the muscular contractions which are occasionally to be observed after death from cholera : read before the Westminster Medical Society, October 20th, 1849 / by Wm. Frederick Barlow. Source: Wellcome Collection.

Provider: This material has been provided by The Royal College of Surgeons of England. The original may be consulted at The Royal College of Surgeons of England.

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    The fibies of the pectoral muscles were often in full action ; distinct bundles of them were seen at intervals beneath the skin. But it is vain to attempt a description of the many various and shifting movements which were seen. After watching these contractions for a long time (together with my friends Mr. Payne, Mr. Turner, and others, whom I had called to see this curious spectacle), I left the body, thinking there would be nothing further to wit- ness,first observing that it was singular that the muscles of the face should re- main unaffected; but this remark was made without due regard to the order of occurrence (how it can be ex- plained I know not) which such move- ments are wont to observe. They occur, not simultaneously, but some succeed to others very slowly; they have been noticed in many cases to begin in the muscles of the lower ex- tremities, and, advancing upwards by degrees, to end in those of the face. After I had taken leave of the body, the nurse was horrified by a movement of the lower jaw, which was followed by others; and thought for a moment that the man was yet alive. The facial muscles became generally af- fected, and at length all was still. Let it be observed of some of these movements, that they assumed the shape of voluntary actions ; others had not the most distant similarity thereto. Ridges and knots would rise from the surface, showing the violence of the contractions, just as they are seen to do in life-time. Sometimes only slight tremulous movements, such as gentle galvanism produces, could be noted in some muscles; then the more powerful actions were renewed. Be it remarked that when the spasmodic contractions of the legs and arms were persisting with so great an intensity that they must have terribly tortured a sentient body, and led, without fail, to the ex- pression of agony, the countenance had the usual stillness of death, the lips were as those of a statue. The next case which I shall detail has many features similar to the fore- going. I may call attention, in parti- cular, to the locality of the beginning and termination of the movements. T. W., set. 35, an in-patient of the Westminster Hospital (under the care of Dr. H. Roe), all but convalescent from an attack of acute rheumatism, died of an attack of cholera of about fourteen hours' duration. The cramps were dreadful; the hands and feet were much distorted, and the voluntary muscles of all the limbs were occa- sionally very hard and rigid ; the col- lapse came not on step by step, but al- most suddenly; never were the cold- ness, the oppressed breathing, the pulselessness, and other symptoms which tell of sinking, more marked. There was a most rapid and profuse discharge of serum. After he had been dead ten minutes-, I examined the body to see if there were any muscular contractions ; none were visible. Five minutes afterwards I again made search j the extensors af the right leg were beginning to be contracted ; soon they became ex- tremely so. The vasti and rectus mus- cles, and the tibialis anticus, were those which seemed most powerfully affected ; sometimes the muscles of the thigh would start into the boldest out- line, such as that beheld in the exag- gerated representations of certain sculptors. The extremity was occa- sionally turned inwards and outwards, and there were extension and flexion of the toes. Six minutes after the commence- ment of these movements some similar contractions took place in its fellow, but they were not so violent. In a quarter of an hour from the first occurrence of the latter there were remarkable motions of the right arm ; pronation and supination of it, and flexion and extension of the fingers, being observed : sometimes the thumb would be moved alone ; sometimes the fore-finger; sometimes a particular muscle of the arm or fore-arm, or a portion of that muscle, would separately act. In half an hour from the observation of the very first contractions, the pec- toralis major of the right side was in action, shortly after which the left arm was influenced; the fingers were ex- tended and flexed alternately, and when a watch was placed in the hand during the former state, it appeared as though grasped so soon as the flexor muscles acted again. I watched these movements for an hour and a quarter, others observing them too : they had not ceased alto- gether at the expiration of that time. The deltoid, and other muscles than