anomalies and curiosities of medicine-第213部分

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rasburg　was　visited　by　the　dancing　plague　in　1418；　and　it　was　here　that　the　plague　assumed　the　name　of　St。　Vitus's　dance。　St。　Vitus　was　a　Sicilian　youth　who；　just　at　the　time　he　was　about　to　undergo　martyrdom　by　order　of　Diocletian；　in　the　year　303；　is　said　to　have　prayed　to　God　that　He　might　protect　all　those　who　would　solemnize　the　day　of　his　commemoration　and　fast　upon　its　eve。　The　people　were　taught　that　a　voice　from　heaven　was　then　heard　saying；　〃Vitus；　thy　prayer　is　accepted。〃

Paracelsus　called　this　malady　（Chorus　sancti　viti）　the　lascivious　dance；　and　says　that　persons　stricken　with　it　were　helpless　until　relieved　by　either　recovery　or　death。　The　malady　spread　rapidly　through　France　and　Holland；　and　before　the　close　of　the　century　was　introduced　into　England。　In　his　〃Anatomy　of　Melancholy〃　Burton　refers　to　it；　and　speaks　of　the　idiosyncrasies　of　the　individuals　afflicted。　It　is　said　they　could　not　abide　one　in　red　clothes；　and　that　they　loved　music　above　all　things；　and　also　that　the　magistrates　in　Germany　hired　musicians　to　give　them　music；　and　provided　them　with　sturdy　companions　to　dance　with。　Their　endurance　was　marvelous。　Plater　speaks　of　a　woman　in　Basle　whom　he　saw；　that　danced　for　a　month。　In　Strasburg　many　of　them　ate　nothing　for　days　and　nights　until　their　mania　subsided。　Paracelsus；　in　the　beginning　of　the　sixteenth　century；　was　the　first　to　make　a　study　of　this　disease。　He　outlined　the　severest　treatment　for　it；　and　boasted　that　he　cured　many　of　the　victims。　Hecker　conjectures　that　probably　the　wild　revels　of　St。　John's　day；　1374；　gave　rise　to　this　mental　plague；　which　thenceforth　visited　so　many　thousands　with　incurable　aberrations　of　mind　and　disgusting　distortions　of　the　body。　Almost　simultaneous　with　the　dance　of　〃St。　With；〃　there　appeared　in　Italy　and　Arabia　a　mania　very　similar　in　character　which　was　called　〃tarantism；〃　which　was　supposed　to　originate　in　the　bite　of　the　tarantula。　The　only　effective　remedy　was　music　in　some　form。　In　the　Tigre　country；　Abyssinia；　this　disease　appeared　under　the　name　of　〃Tigretier。〃　The　disease；　fortunately；　rapidly　declined；　and　very　little　of　it　seems　to　have　been　known　in　the　sixteenth　century；　but　in　the　early　part　of　the　eighteenth　century　a　peculiar　sect　called　the　〃Convulsionnaires〃　arose　in　France；　and　throughout　England　among　the　Methodist　sect；　insane　convulsions　of　this　nature　were　witnessed；　and　even　to　the　present　day　in　some　of　the　primitive　religious　meetings　of　our　people；　something　not　unlike　this　mania　of　the　Middle　Ages　is　perpetuated。

Paracelsus　divided　the　sufferers　of　St。　Vitus's　dance　into　three　classes　。

（1）　Those　in　which　the　affliction　arose　from　imagination　（chorea　imaginativa）。

（2）　Those　which　had　their　origin　in　sexual　desires　depending　on　the　will。

（3）　Those　arising　from　corporeal　causes　（chorea　naturalis）。　This　last　case；　according　to　a　strange　notion　of　his　own　he　explained　by　maintaining　that　in　certain　vessels　which　are　susceptible　of　an　internal　pruriency；　and　thence　produced　laughter；　the　blood　is　set　into　commotion　in　consequence　of　an　alteration　in　the　vital　spirits；　whereby　are　occasioned　involuntary　fits　of　intoxicating　joy；　and　a　propensity　to　dance。　The　great　physician　Sydenham　gave　the　first　accurate　description　of　what　is　to…day　called　chorea；　and　hence　the　disease　has　been　named　〃Sydenham's　chorea。〃　So　true　to　life　was　his　portrayal　of　the　disease　that　it　has　never　been　surpassed　by　modern　observers。

The　disease　variously　named　palmus；　the　jumpers；　the　twitchers；　lata；　miryachit；　or；　as　it　is　sometimes　called；　the　emeryaki　of　Siberia；　and　the　tic…convulsif　of　La　Tourette；　has　been　very　well　described　by　Gray　who　says　that　the　French　authors　had　their　attention　directed　to　the　subject　by　the　descriptions　of　two　American　authorsthose　of　Beard　upon　〃The　Jumpers　of　Maine；〃　published　in　1880；　and　that　of　Hammond　upon　〃Miryachit；〃　a　similar　disease　of　the　far　Orient。　Beard　found　that　the　jumpers　of　Maine　did　unhesitatingly　whatever　they　were　told　to　do。　Thus；　one　who　was　sitting　in　a　chair　was　told　to　throw　a　knife　that　he　had　in　his　hand；　and　he　obeyed　so　quickly　that　the　weapon　stuck　in　a　house　opposite；　at　the　same　time　he　repeated　the　command　given　him；　with　a　cry　of　alarm　not　unlike　that　of　hysteria　or　epilepsy。　When　he　was　suddenly　clapped　upon　the　shoulder　he　threw　away　his　pipe；　which　he　had　been　filling　with　tobacco。　The　first　parts　of　Virgil's　aeneid　and　Homer's　Iliad　were　recited　to　one　of　these　illiterate　jumpers；　and　he　repeated　the　words　as　they　came　to　him　in　a　sharp　voice；　at　the　same　time　jumping　or　throwing　whatever　he　had　in　his　hand；　or　raising　his　shoulder；　or　making　some　other　violent　motion。　It　is　related　by　O'Brien；　an　Irishman　serving　on　an　English　naval　vessel；　that　an　elderly　and　respectable　Malay　woman；　with　whom　he　was　conversing　in　an　entirely　unsuspecting　manner；　suddenly　began　to　undress　herself；　and　showed　a　most　ominous　and　determined　intention　of　stripping　herself　completely；　and　all　because　a　by…standing　friend　had　suddenly　taken　off　his　coat；　at　the　same　time　she　manifested　the　most　violent　anger　at　what　she　deemed　this　outrage　to　her　sex；　calling　the　astonished　friend　an　abandoned　hog；　and　begging　O'Brien　to　kill　him。　O'Brien；　furthermore；　tells　of　a　cook　who　was　carrying　his　child　in　his　arms　over　the　bridge　of　a　river；　while　at　the　same　time　a　sailor　carried　a　log　of　wood　in　like　manner；　the　sailor　threw　his　log　of　wood　on　an　awning；　amusing　himself　by　causing　it　to　roll　over　the　cloth；　and　finally　letting　it　fall　to　the　bridge；　the　cook　repeated　every　motion　with　his　little　boy；　and　killed　him　on　the　spot。　This　miryachit　was　observed　in　Malaysia；　Bengal；　among　the　Sikhs　and　the　Nubians；　and　in　Siberia；　whilst　Beard　has　observed　it　in　Michigan　as　well　as　in　Maine。　Crichton　speaks　of　a　leaping　ague　in　Angusshire；　Scotland。

Gray　has　seen　only　one　case　of　acute　palmus；　and　records　it　as　follows：　〃It　was　in　a　boy　of　six；　whose　heredity；　so　far　as　I　could　ascertain　from　the　statements　of　his　mother；　was　not　neurotic。　He　had　had　trouble　some　six　months　before　coming　to　me。　He　had　been　labeled　with　a　number　of　interesting　diagnoses；　such　as　chorea；　epilepsy；　myotonia；　hysteria；　and　neurasthenia。　His　palmodic　movements　were　very　curious。　When　standing　near　a　table　looking　at　something；　the　chin　would　suddenly　come　down　with　a　thump　that　would　leave　a　black…and…blue　mark；　or　his　head　would　be　thrown　violently　to　one　side；　perhaps　coming　in　contact　with　some　adjacent　hard　object　with　equal　force；　or；　while　standing　quietly；　his　legs　would　give　a　sudden　twitch；　and　he　would　be　thrown　violently　to　the　ground；　and　this　even　happened　several　times　when　he　was　seated　on　the　edge　of　a　stool。　The　child　was　under　my　care　for　two　weeks；　and；　probably　because　of　an　intercurrent　attack　of　diarrhea；　grew　steadily　worse　during　that　time；　in　spite　of　the　full　doses　of　arsenic　which　were　administered　to　him。　He　was　literally　covered　with　bruises　from　the　sudden　and　violent　contacts　with　articles　of　furniture；　the　floor；　and　the　walls。　At　last；　in　despair　at　his　condition；　I　ordered　him　to　be　undressed　and　put　to　bed；　and　steadily　pushed　the　Fowler's　solution　of　arsenic　until　he　was　taking　ten　drops　three　times　a　day；　when；　to　my　great　surprise；　he　began　to　improve　rapidly；　and　at　the　end　of　six　weeks　was　perfectly　well。　Keeping　him　under　observation　for　two　weeks　longer　I　finally　sent　him　to　his　home　in　the　West；　and　am　informed　that　he　has　since　remained　perfectly　well。　It　has　seemed　to　me　that　many　of　the　cases　recorded　as　paramyoclonus　multiples　have　been　really　acute　palmus。〃

Gray　mentions　two　cases　of　general　palmus　with　pseudomelancholia；　and　describes　them　in　the　following　words：

〃The　muscular　movements　are　of　the　usual　sudden；　shock…like　type；　and　of　the　same　extent　as　in　what　I　have　ventured　to　call　the　general　form。　With　them；　however；　there　is　associated　a　curious　pseudomelancholia；　consisting　of　certain　fixed　melancholy　suspicious　delusions；　without；　however；　any　of　the　suicidal　tendencies　and　abnormal　sensations　up　and　down　the　back　of　the　head；　neck；　or　spine；　or　the　sleeplessness；　which　are　characteristic　of　most　cases　of　true　melancholia。　In　both　of　my　cases　the　palmus　had　existed　for　a　long　period；　the　exact　limits　of　which；　however；　I　could　not　determine；　because　the　patient　scouted　the　idea　that　he　had　had　any　trouble　of　the　kind；　but　which　the　testimony　of　friends　and　relatives　seemed　to　vouch　for。　They　were　both　men；　one　thirty…six　and　one　thirty…eight　years　of　age。　The　pseudomelancholia；　however；　had　only　existed　in　one　case　for　about　a　year；　and　in　the　other　for　six　months。　One　case　passed　away　from　my　observation；　and　I　know　nothing　of　its　further　course。　The　other　case　recovered　in　nine　months'　treatment；　and　during　the　three　years　that　have　since　elapsed　he　has　been　an　active　business　man；　although　I　have　not　seen　him　myself　during　that　period；　as　he　took　a　great　dislike　to　me　because　I　was　forced　to　take　strong　measures　to　keep　him　under　treatment；　so　persistent　were　his　suspicions。〃

Athetosis　was　first　described　by　Hammond　in　1871；　who　gave　it　the　name　because　it　was　mainly　characterized　by　an　inability　to　retain　the　fingers　and　toes　in　any　position　in　which　they　might　be　planed；　as　well　as　by　their　continuous　motion。　According　to　Drewry　〃athetosis　is　a　cerebral　affection；　presenting　a　combination　of　symptoms　characterized　chiefly　by　a　more　or　less　constant　mobility　of　the　extremities　and　an　inability　to　retain　them　in　any　fixed　position。　These　morbid；　grotesque；　involuntary　movements　are　slow　and　wavy；　somewhat　regular　and　rigid；　are　not　jerky；　spasmodic；　nor　tremulous。　The　movements　of　the　digits　are　quite　different　from　those　attending　any　other　disease；　impossible　to　imitate　even　by　the　most　skilful　malingerer；　and；　if　once　seen；　are　not　likely　to　be　forgotten。　In　an　athetoid　hand；　says　Starr；　the　interossei　and　lumbricales；　which　flex　the　metacarpo…phalangeal　and　extend　the　phalangeal　joints；　are

affected；　rarely　are　the　long　extensors　and　the　long　flexors　affected。　Therefore　the　hand　is　usually　in　the　so…called　interosseal　position；　with　flexion　of　the　proximal　and　extension　of　the　middle　and　distal　phalanges。　The　athetoid　movements　of　the　toes　correspond　to　those　of