On the pathology of chorea / by Francis T. Bond.

  • Bond, Francis Thomas.
Date:
[between 1800 and 1899?]
Catalogue details

Licence: Public Domain Mark

Credit: On the pathology of chorea / by Francis T. Bond. Source: Wellcome Collection.

Provider: This material has been provided by The University of Glasgow Library. The original may be consulted at The University of Glasgow Library.

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    emotions, in the occupations of maternity, in the peculiarly feminine amusements of singing and dancing, or in some other form of activity. The nervous energy of children, too, keeps them in a state of perpetual movement from morning to night, which it is very prejudicial to repress; and in infants, where nature has not yet acquired the full use of the limbs as an outlet for her surplus nerve force, she relieves herself by those frequent and tumultuous fits of crying which, though they appear to betoken such severe suffering, in nine times out of ten are merely the safety-valve for the surplus energy before mentioned, and as un- desirable to restrain as are the violent outbursts of the highly-wrought feelings in riper years.* We are then, I think, warranted in assuming that the peculiarity of the constitution of choreic patients consists in a tendency to generate a constant excess of nerve force, which in their ordinary state of health, when the will is strong enough to restrain unusual miiscular move- ments, finds a vent in emotional manifestations, in activity of body, or more rarely in intellectual efforts.t It is important to remember that such a constitution as this is radically a weak one: it is a state of chronic irritability, and like all irritable conditions, rapidly succumbs to exhaustion. The functions of organs whose irritability is heightened ai-e performed with increased activity, but their energy is soon dissi- pated. The irritable heart, with its tumultuous throbbings which simulate strength, is essentially a weak one. The man whose heart beats vigorously never feels its action. The irritable stomach is soon worn out. Kepose, self-control, is pre-eminently the attribute of real strength. The difference between the two states—to recur to elec- tricity for a metaphor—is just the difference between the charge of a Leyden jar and that of a galvanic battery. The effects of the one are more instantaneous and brilliant than the other, but it is not capable of that prolonged and steady activity which gives the latter its strength. Hence it is why chorea, like delirium tremens (to which it is closely analogous, the one being automatic motion, the other auto- matic ideation^), in so many cases supervenes upon agencies which have a tendency to exhaust the general power or tone of the nervous system, and to increase its irritability; and hence, too, the efficacy of those medicines and hygienic appliances which act by restoring this loss of tone. It would be interesting, if possible, to ascertain to what extent this peculiarity of constitution which is manifested by choreic patients is dependent upon hereditary influences, and what may be its relation to other diseases arising from a similarly ill-balanced state of the nervous faculties, such as insanity, epilepsy, and hysteria. There are many • See Bain, op. sup. cit, p. 76. t This idea of a constant discliarge of nerve force in the form of a stream passing out from tlie nervous centres into their trunlcs is illustrated, though to a much feebler extent, by the phenomenon of muscular tonicity ; wliich, after the experiments of Marshall Hall, must be attributed chiefly to the continuous passage of nervous influence from the spinal cord into the muscles, manifesting itself in the form of a tonic contraction, which is almost, if not entirely, abolished by the destruction of the spinal cord, or the severance of the nerve-trunks leading to the muscles. t BouElaud has graphically called chorea insanity of the muscles I (.folie muacu- laire.)