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]
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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.

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    lar manner. The muscles of the face and lower jaw were similarly affected’; and, finally, those of the right arm and right pectoral muscle. These motions increased in extent and activity for ten minutes, after which they gradu¬ ally declined, and ceased twenty mi¬ nutes after they began. With regard to the Malay, about fifteen minutes after he expired the toes began to move in various directions; and the feet were made to approach each other. Muscular contractions were speedily propagated upwards along the inside of the legs and thighs. The thighs were turned slowly inwards so as to approach each other, and again out¬ wards ; the whole of the lower extre¬ mities moving on the heels as on pivots. These motions proceeded up¬ wards, producing a quivering in the muscles. In five minutes the upper extremities began to be similarly af¬ fected. The fingers were extended and often rigidly bent inwards, and pro¬ nation and supination of the hand w'ere steadily though slowly performed. The same quiverings were observable in the lower extremities, and extended to the pectoralis major muscles, and the su¬ perior margin of the latissimus dorsi. The muscles of the face moved, and the head was observed to shake. The total duration of these appearances was half an hour. By moving or pricking the arms or limb, these contractions were rendered stronger, and were again re¬ newed when they had ceased.”* With respect to what is affirmed in the latter part of this extract, of these motions being increased and provoked by pricking, I have but little to re¬ mark. In one case very favourable to the making of the experiment, I en¬ deavoured to repeat the observation. I cannot say that I was successful. At first I thought that pricking with a pin did excite contraction ; but after careful and repeated experiment I was driven to the conclusion that no result could be fairly assigned it. Sometimes, indeed, motion followed a puncture, but by no means invariably; and where it did ensue it was extremely doubtful whether the muscle would not have contracted independently of the experiment. I pricked muscles which were quiescent to see if motion could * Lectures on the Principles and Practice of Medicine, London, 1842, p. 1076. be provoked, and such as were slightly contracting to discover if it could be increased. I used punctures, both su¬ perficial and deep, and with every attention to time, place, and circum¬ stance, but there was not that unifor¬ mity of result, or that approach to it, which would alone have justified me in the inference that the muscles were really excited by the experiment. I applied water to the skin of the tem¬ perature of 150°, and afterwards water with heat raised nearly to the boiling point, but it had no effect. The case, I repeat, was well adapted for making the investigation, the motions endur¬ ing for nearly an hour, and affecting almost every part of the body; but after all I speak of a single instance, and let it only be rated at its worth. I hope that some of the fellows of the Society will state their experience of these curious movements. Doubt¬ less many of them have observed them either during the present or former epidemic. They vary in degree exceed¬ ingly, and in duration also: ranging between a few slight or hardly visible quivers (which are somewhat compara¬ ble to gentle undulations on calm water), and the most decided and energetic contractions, they may either entirely elude the attention, or at once seize it as a marvel. Sometimes they restrict themselves to certain muscles, those of the legs most commonly, or are confined to the muscles of the face, or, it may be, a particular muscle of it. Dr. Sibson has related to me a case in which the pectoral muscle, together with its fellow, was exclusively affected; and I have already referred to an exam¬ ple in which motion was confined to the eyes. There seems as little limit to the narrowness of the operation of these movements in some cases as to the wide sphere of their display in others. A matter most curious to note upon occasions is their strange pro¬ gression from part to part: they pro¬ ceed for a while, in some examples, with great regularity from below up¬ wards, but in others they travel about waywardly, and fitfully appear and vanish time after time. Commonly they occur within a quarter or half an hour of death, but they may be delayed much longer. We know not yet the remotest interval which may pass be¬ tween death and them; but this is one of the most important as well as in-