Nervous diseases : their description and treatment / by Allan McLane Hamilton.

  • Allan McLane Hamilton
Date:
1878
Catalogue details

Licence: Public Domain Mark

Credit: Nervous diseases : their description and treatment / by Allan McLane Hamilton. Source: Wellcome Collection.

    483/540 (page 483)
    V. touticollis. The sterno-cleido-mastoid muscle may be the seat of a spasmodic con- traction. This condition may be preceded by peripheral tronble, sucli as dentition, which was the canse in one of Romberg's cases, or by such gen- eral diseases as rheumatism. One case, which was seen by Dr. White antl myself, wi^ preceded by chorea, and another, that I saw at the New York State Hospital for Diseases of the Nervous System, was due to general antvmia. In both tliese cases, as well as in others I have observed, the head was bent forward and the chin pulled downward. In one case, that of the elderly woman seen at the nervous hospital, the spasms were intermittent. Radclitle reports a case which somewhat resembles this. The muscles of the neck were tender and the 'seat of soreness, and the movements were attended by pain. The sjui^ms are usually increased by emotional excitement, but subside during sleep. The notes of my case are the fol- lowinsc:— M. A. A., aged 56, U. S. Came to the hospital Oct. 29, 1872. Her present trouble began five years ago in a very gradual manner. There are now marked clonic spasms of the muscles of the anterior part of the left side of the neck. With their intermitting contraction, there is some pain at the lower insertion of the stemo-cleido-mastoideus muscle; the tra])ezius is also the seat of spasmodic contraction. There is headache, and pain at the upper part of the cord. Patient's expression anxious and excited. Gahanism to muscles and spine, and zinci phospliidi gr. ^ t. i. d. Pa- tient complains of dizziness and constipation. The muscles concerned in this form of disease are the sterno-cleido- mastoideus, complexus, trapezius, and levator anguli scapulas. Pathology Weir Mitchell has divided the conditions under which spasms of this kind may occur into three groups :— 1. Those in which the functional activity of a muscle or set of muscles gives rise at times to an exaggeration of the motion involved naturally, and sometimes also to a more or less spasmodic activity in remoter groups. 2. Those in which the functional action of one group results only in sudden and possibly in prolonged acts, tonic or clonic, in remote groups of muscles not implicated in the original movement. 3. Those in which standing or walking occasions general and disor- derly motions affecting the limbs, trunk, face, and giving rise to a general and imcontrollable spasm without loss of consciousness. The central condition is one of great reflex irritability; certain forms of rej)eated irritation producing an activity of the motor centre which re.Hults in an alinormal increase in reflex susceptibility. Treatment Agents which lower the excitability of voluntary mu-*cular action are to be adojjted. Of these I know of no better drug than gdsemium sempervircTis (F. ^O), conium (F. 51), musk, assaftctida, or valerian (FF. .02, o3, 54). Rest, and removal of the peripheral irritation, .should the spasm be o( reflex origin, and the ether spray to the