Cases, with remarks illustrating the association of chorea with rheumatism and disease of the heart / by William Senhouse Kirkes.

  • William Senhouse Kirkes
Date:
[1850]
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Licence: Public Domain Mark

Credit: Cases, with remarks illustrating the association of chorea with rheumatism and disease of the heart / by William Senhouse Kirkes. Source: Wellcome Collection.

Provider: This material has been provided by The Royal College of Surgeons of England. The original may be consulted at The Royal College of Surgeons of England.

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    CASES, WITH REMARKS ILLUSTRATING THK ASSOCIATION OF CHOREA WITH RHEUMATISM AND DISEASE OF THE HEART. By WILLIAM SENHOUSE KIRKES, M.D. LICENTIATE OF THE BOYAL COLLEGE OF PHYSICIANS, DEMONSTRATOR OF MOBBID ANATOMY, st. Bartholomew’s hospital. From the London Medical Gazette. Fob some years past attention has been frequently directed to the occurrence of various nervous phenomena, especially of chorea, in the course of acute rheu- matism The subject has engaged the notice' of those best qualified for its investigation, and several ingenious hy- potheses have been advanced in expla- nation of this singular association in disease. To the complete exposition of the views of those who have especially studied this point in pathology, given by Dr. Burrows in his Treatise on Dis- orders of the Cerebral Circulation, it will be needless, even were it possible, to attempt making any addition: in- deed, the subject is so thoroughly dis- cussed there, and in the works therein mentioned, that, but for the obscurity in which the association between the rheumatism and the nervous pheno- mena is still confessedly involved, I should not feel justified in again draw- ing attention to it. The very variety of the explanations which have origi- nated from equally competent sources, bears ample testimony to this obscurity on the subject; and on this account it may be hoped that any additional facts which seem calculated to throw light on any part of it can scarcely be deemed superfluous. The cases and remarks which I now offer have reference to only one form of the nervous disorders that may arise in the progress of acute rheumatism, and this because it is the form most apt to ensue, and because I am more fami- liar with it than with any of the other affections of the nervous system asso- ciated with this disease. Case I.—Mary Anne Burke, aged 20, admitted into Hope Ward, under Dr. Hue, Dec. 3, 1849. Dark-haired, pale, anaemic-looking; manner strange, with an anxious alarmed expression. There were frequent spasmodic movements of the muscles of the face, especially about the nose, the movements being usually accompanied by ashortinspiratory moan. These, with an occasional jerk of her head, were the only choreic movements observed. Although involuntary, yet the movements seemed to be under some degree of control; for, by an effort, she could restrain them for several seconds, though after such pause they returned with increased force. She was very taciturn, owing apparently to difficulty in uttering words rather than to disin- clination to speak : her answers, when obtained, were rational and correct. She said that she was in pain all over, especially in the ankles, knees, and hips. The left ankle and foot were slightly swollen and tender, but not red. I may remark here that this slight swelling and tenderness, which shortly
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