A treatise on the practice of medicine / by John Eberle.

  • John Eberle
Date:
1831
Catalogue details

Licence: Public Domain Mark

Credit: A treatise on the practice of medicine / by John Eberle. Source: Wellcome Collection.

Provider: This material has been provided by the University of Massachusetts Medical School, Lamar Soutter Library, through the Medical Heritage Library. The original may be consulted at the Lamar Soutter Library at the University of Massachusetts Medical School.

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    and mineral poisons have also been known to produce this affec- tion. Stramonium, {Comment. Litter. Norimburg. Jin. 1774); mercury, (De Haen Ratio Medend. tom iii. p. 202) and lead, have excited paroxysms of chorea. Dentition, pregnancy, par- turition, and cold, are also mentioned among the exciting causes of this affection; and it appears frequently to depend upon rapid corporeal evolution, or that peculiar change of constitutional habit which occurs at the age of puberty. The ]xithology of chorea derives little or no light from anato- mical examinations. There are good reasons, however, for be- lieving that it is essentially a cerebral afl'ection. Its frequent oc- currence from mental excitement; the intellectual weakness which almost invariably results from its protracted continuance; the suspension of the convulsive motions during sound sleep; and its exclusive confinement to the voluntary muscles, point directly to the sensorium commune, as the immediate source of the irritation upon which the spasmodic actions of the disease depend. Un- questionably, however, the cerebral irritation is itself very fre- quently secondary, depending on a primary irritation, located in some remote part of the system, and frequently, perhaps, in the alimentary canal. In some cases which I have seen, it appeared to me that the irregular muscular motions were not so much the result of involuntary muscular actions, as of an irresistible voli- tion to perform these peculiar motions. In those instances of the disease, at least, that are characterized by leaping on tables, chairs, dancing, clambering up walls, and other similar actions, the propensity or luill to do so appears to be irresistibly exerted; and we might, with some plausibility, ascribe the characteristic phenomena of the disease to a morbid action of the faculty of volition, depending generally on a sympathetic, and sometimes an idiopathic irregular excitement of the brain. Richter thinks that the proximate cause of chorea is seated in the system of ganglionic nerves, and particularly in the abdomi- nal plexus. It is from this location of the primary irritation, he says, that the first manifestations of the disease generally occur in the feet; that gastric and uterine irritation so frequently con- stitute its exciting cause; and finally, that those remedies which act more especially upon the abdominal viscera, are usually the most beneficial. All these circumstances may, however, be ad- duced with equal plausibility in favour of the cerebral pathology of this affection. Prognosis.—Chorea very rarely proves fatal, but it cannot be said to be entirely free from danger, as some writers have assert- ed.* I have known one instance to terminate fatally, by the supervention of a slow and wasting irritative fever. Occasionally • Wichniann, Baumes.
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