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tached to them. It did not occur to the earlier observers that they indicated a true disease. But such proved to be the case, and the affection is now known as "Writer's Cramp," or " Scrivener's Palsy," because it is more often met with in this class of persons. This singular disease is chronic in its form, and is "characterized by the occurrence of a spasm when the attempt is made to execute a special and complicated movement the result of previous education." At first the spasm is often very slight, so as hardly to attract attention, and when the effort ceases there is no evidence that there is any special affection. But when an attempt is again made, the spasm returns. The disease is liable to extend and involve other fingers, the thumb, and even more distant muscles, as of the arm. Persons sometimes endeavor to overcome the difficulty by moving the entire arm in the act of writing, and some have even learned to write with the other hand. But it has too frequently happened that the spasm has immediately occurred in the hand last educated. All efforts to control the spasm and force the affected hand into action has resulted in increasing the difficulty. The cause of this cramp is unknown. It has been supposed to be due to excessive writing, but there are no facts to warrant the opinion. Some have attributed it to the use of a metallic pen, but there is no proof of this assertion. The truth is that writing, like playing upon a piano, is a very complicated

act, and requires great coordinating power. It is learned with difficulty, as many muscles have to be educated to act in harmony. The performance of the function of every muscle depends upon the integrity of the nerve supplying it, and of that part of the brain from which the nerve takes its origin. A slight derangement, therefore, of any of these parts interferes or destroys the function of a muscle or muscles, and the result is interference with the particular act previously so easily and rapidly performed. It is no uncommon thing to find a loss of power in a part which destroys some most important function of the body. In writer's cramp, there is, from some cause unknown, a defect in the power of coördinating movements of a limited kind, but yet sufficient to interrupt a series of movements which we have been educated to perform, and which have through long practice become automatic. The treatment of this malady is simple, and consists in rest. When the patient promptly lays aside the particular business in the performance of which spasm or cramp occurs, recovery is almost certain. Every effort to overcome it by persistent use of the part only increases the immediate spasm, and renders it more liable to extend and involve other parts. It is idle to attempt a cure by any known medicinal preparations. When recovery is complete, the patient may resume his business, but he must not overtax the previously affected part. Relapse is not liable to occur unless the part is overworked.



T may safely be affirmed that there is no


man pestilences that has created greater havoc and been more justly dreaded than small-poxvariola, or as once well named, the Great Destroyer. Other contagious diseases have slain their thousands, but small-pox has slain its tens of millions. It has destroyed armies, raised sieges, and scattered whole tribes and communities of people. The barbarian devoutly sacrifices to its deified representation when it appears, and the Christian flees as from the presence of death. The date of the first appearance of small-pox is doubtful. There is a tradition in the East that it was first derived from the camel; but there is no proof of the truth of the statement. The sore boils" of Job have been attributed to small-pox, but foolishly. There is no evidence even that the Greek and Roman physicians knew of this disease. Procopius, who lived in the middle of the sixth century, gives a graphic account of a disease closely resembling small-pox, which began A. D. 544, in Egypt, and spread to Constantinople. In A. D. 569, the year of the


birth of Mohammed, an Abyssinian army was compelled to raise the siege of Mecca by a pestilence very like small-pox, which created a terrible mortality. The first medical writer who gave an authentic description of the disease was Rhazes, an Arabian physician, who wrote about 910. From that period the pestilence has had many historians, and we have no difficulty in tracing its progress from time to time, and estimating the extent of its ravages. It has spread most widely where there have been the largest movements among nations; as in the conquests of the Arabs and Saracens, during the crusades, in the emigration of the Spaniards to America, etc. Wherever it appeared in those early periods, it was regarded as an avenging angel. Whole continents were decimated, and some nations were almost completely annihilated. It is estimated that 45,000,000 of the people of Europe died of small-pox in the one hundred years preceding the introduction of vaccination. As late as 1720, 20,000 persons died of small-pox in Paris. It did not respect rank or condition. A recent writer makes the following statement of its ravages in the royal families of Europe: Among the family of Charles I. of Great Britain, of his forty-two lineal descendants up to the date of 1712, five were killed outright by small-pox: viz., his son Henry, Duke of Gloucester; and his daughter Mary, wife of the Prince of Orange, and mother of William III.; and three of the children


of James II.: viz., Charles, Duke of Cambridge, in 1677; Mary, Queen of England, and wife of William III., in 1694; and the Princess Maria Louisa, in April, 1712. This does not include, of course, severe attacks, not fatal, such as those from which Queen Anne and William III. suffered. Of the immediate descendants of his contemporary, Louis XIV., of France (who himself survived a severe attack of small-pox), five also died of it in the interval between 1711 and 1774: viz., his son Louis, the Dauphin of France, in April, of 1711; Louis, Duke of Burgundy, son of the preceding, and also Dauphin, and the Dauphiness, his wife, in 1712; their son, the Duc de Bretagne, and Louis XV., the great-grandson of Louis XIV. Among other royal deaths from small-pox in the same period were those of Joseph I., Emperor of Germany, in 1711; Peter II., Emperor of Russia, in 1730; Henry, Prince of Prussia, in 1767; Maximilian Joseph, Elector of Bavaria, December 30, 1777." The history of nearly every case shows that the sick were abandoned by their most devoted friends, and left to die or recover alone. The mode of propagation of small-pox long remained doubtful. That it could be communicated by actual contact (to touch) of the sick with the well, or by contagion, was early apparent, and it was soon demonstrated that the sick infected the air of the room in which they lay. It became in time well established, therefore, that the disease was both contagious and

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