Chorea.-- St. Vitus's Dance.
-RUDDOCK.E.H,
DEFINITION.-- A disease characterised by convulsive movements of the limbs, occasioning ludicrous gesticulations, and rising from incomplete subserviency of the muscles to the will. It has been wittily termed insanity of the voluntary muscles.
CAUSES.-- Chorea is a manifestation of Rheumatism, and probably due, like that disease, to a specific organism. The heart therefore should always be carefully watched in Chorea cases. nervous, unstable patients are more liable to the disease, and, as with stammering, the movements sometimes seem to come from a kind of unconscious imitation of other sufferers. Attacks may seem to be determined by emotional causes like fright or by worms, etc.
EPITOME OF TREATMENT.--
1. From fright.-- Acon., Ign., Stram.
2. From worms.-- Cin., Sant., Merc., Ign., Spig.
3. In weakly children.-- Iod., Ars. Ferr. ( with anaemia); sulph.
4. With Rheumatic symptoms.-- Cimic., Spig.
5. From causes not traceable.-- Cup.-M., bell., Agar., Stram., Hyos., Zinc., Ars. The last-mentioned remedy is an extremely valuable one, especially in uncomplicated cases. in our treatment it has proved of the greatest value, and often curative.
in febrile, rheumatic, anaemic, of tubercular patients, a larger range of remedies is generally required.
GENERAL MEASURES.-- The most important part of the treatment of Chorea consists in the use of moral influences. (1) there must be removal from too sympathising friends; the patient being placed under the care of a kind but firm guardian. (2) He must be encouraged to exercise his will in the control of the muscles; if the muscles of speech be implicated, inducing stammering or stuttering, (, This form of imperfect speech must not be confounded with the stammering which arises from a habit of excited speaking, in which the patient's words splutter out of his mouth in hurried confusion, with an occasional hesitation interruption, leaving the hearer to arrange them as best he may. This may have been primarily induced by a nervous excitability, and may be overcome by the patient exercising control, and speaking each word slowly and deliberately. Some persons, after uttering a few words, suddenly stop, and the hearer must patiently wait for the interruption is only prolonged. This impediment may be controlled by learning anew the use of language in the manner above indicated.) the best way is for the person to humble himself to the infant state and be taught anew the use of language from those ingenious instructors who teach the deaf and dumb, and systematically learn to shape slowly and deliberately his mouth into the form requisite for definite enunciation. By practicing thus at leisure, and before a looking- glass, he may gain great control over the articulating muscles (Chambers). (3) The patient must not be allowed to associate with others similarly affected; nor should his disease be enlarged upon in his presence; his attention should rather be diverted from it as much as possible. (4) Electricity has been praised, but is for doubtful value. (5) When the constitution is feeble, the best hygienic measures must be adopted., the ordinary duration of the disease when untreated is about six weeks, but some cases are much more obstinate.
Forcible control of the muscles only aggravates the disease.
DEFINITION.-- A disease characterised by convulsive movements of the limbs, occasioning ludicrous gesticulations, and rising from incomplete subserviency of the muscles to the will. It has been wittily termed insanity of the voluntary muscles.
CAUSES.-- Chorea is a manifestation of Rheumatism, and probably due, like that disease, to a specific organism. The heart therefore should always be carefully watched in Chorea cases. nervous, unstable patients are more liable to the disease, and, as with stammering, the movements sometimes seem to come from a kind of unconscious imitation of other sufferers. Attacks may seem to be determined by emotional causes like fright or by worms, etc.
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| Boys effected with Chorea |
EPITOME OF TREATMENT.--
1. From fright.-- Acon., Ign., Stram.
2. From worms.-- Cin., Sant., Merc., Ign., Spig.
3. In weakly children.-- Iod., Ars. Ferr. ( with anaemia); sulph.
4. With Rheumatic symptoms.-- Cimic., Spig.
5. From causes not traceable.-- Cup.-M., bell., Agar., Stram., Hyos., Zinc., Ars. The last-mentioned remedy is an extremely valuable one, especially in uncomplicated cases. in our treatment it has proved of the greatest value, and often curative.
in febrile, rheumatic, anaemic, of tubercular patients, a larger range of remedies is generally required.
GENERAL MEASURES.-- The most important part of the treatment of Chorea consists in the use of moral influences. (1) there must be removal from too sympathising friends; the patient being placed under the care of a kind but firm guardian. (2) He must be encouraged to exercise his will in the control of the muscles; if the muscles of speech be implicated, inducing stammering or stuttering, (, This form of imperfect speech must not be confounded with the stammering which arises from a habit of excited speaking, in which the patient's words splutter out of his mouth in hurried confusion, with an occasional hesitation interruption, leaving the hearer to arrange them as best he may. This may have been primarily induced by a nervous excitability, and may be overcome by the patient exercising control, and speaking each word slowly and deliberately. Some persons, after uttering a few words, suddenly stop, and the hearer must patiently wait for the interruption is only prolonged. This impediment may be controlled by learning anew the use of language in the manner above indicated.) the best way is for the person to humble himself to the infant state and be taught anew the use of language from those ingenious instructors who teach the deaf and dumb, and systematically learn to shape slowly and deliberately his mouth into the form requisite for definite enunciation. By practicing thus at leisure, and before a looking- glass, he may gain great control over the articulating muscles (Chambers). (3) The patient must not be allowed to associate with others similarly affected; nor should his disease be enlarged upon in his presence; his attention should rather be diverted from it as much as possible. (4) Electricity has been praised, but is for doubtful value. (5) When the constitution is feeble, the best hygienic measures must be adopted., the ordinary duration of the disease when untreated is about six weeks, but some cases are much more obstinate.
Forcible control of the muscles only aggravates the disease.
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