On chorea and other allied movement disorders of early life / by Octavius Sturges.

Date:
1881
Catalogue details

Licence: Public Domain Mark

Credit: On chorea and other allied movement disorders of early life / by Octavius Sturges. Source: Wellcome Collection.

Provider: This material has been provided by the Royal College of Physicians of Edinburgh. The original may be consulted at the Royal College of Physicians of Edinburgh.

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    about it, and not nniuch that is ludicrous. Sydenham's com- parison of chorea to the feats of Merry Andrew is familiar to everyone. The more modern definitions are confessedly faulty and inadequate. In the latest treatise upon the subject Pro- fessor Ziemssen declares that it is only possible as yet ' to aim at a definition.' In his own description he is chiefly careful to dis- criminate between true chorea and the so-called chorea major; the latter as he believes being 'the product of hysteria or of genuine psychoses and cerebral maladies.' ^ By true chorea he understands ' a neurosis of which the seat (as it seems) may some- times be the brain alone, sometimes the entire nervous system ; characterised by incessant twitchings or jerks of groups of muscles, which are sometimes spontaneous and sometimes excited by voluntary impulse, which occur almost exclusively in the waking state, and are accompanied by a more or less developed psychi- cal disturbance.' It may be questioned whether such definition really pictures the affection to anyone not already familiar with it. To ordinary observation, at all events, chorea consists in an exaggerated fidgetiness. It is an extravagant exaltation of that continual unrest which is the natural characteristic of child- hood. Its movements, that is to say, resemble the emotional, the same muscles being affected in the same kind of way. Chorea, therefore, may be imitated as emotion may. But up to a certain point only; extreme chorea, like extreme emotion, is beyond imi- tation, for there belongs to both a degree of spasm and dis- tortion which can never be assumed, or only partially and for a moment. Consistently with this comparison the muscles of the upper part of the body are much more often affected than the rest, and the hands suffer most of all. The thoracic muscles seldom escape altogether, but it is only exceptionally that their concern in the disorder is a prominent feature. The lower limbs are never 1 Ziemssen's CycL, vol. xvi. p. 418.