St. Vitus’s Dance.
Chorea sancti Viti. This very uncommon disease may afflict either of the sexes about the period of adolescence and puberty; rarely afterwards. Its symptoms are lameness of one leg, which, when attempts are made to walk, is dragged as if paralytick; and is then, more or less, convulsed: at the same time, whenever the patient attempts to convey any food or drink to the mouth with the corresponding arm, it is incessantly convulsed, with a rapid succession of gesticulations. Some are even compelled to dance, leap, run, sing, or laugh. The paroxisms vary in duration and frequency: sometimes they are terminated in half an hour: sometimes they continue several days, rarely a week, without intermission: sometimes they recur several times daily, leaving behind debility and weakness. Delirium and a degree of fatuity are not unusual in the paroxisms. The predisposing and occasional causes are mostly unknown: sometimes worms.
Catalepsis, and extasis.
It falls to the lot of very few physicians, at least in this island, to see a single instance of this phenomenon, a living statue fixed in whatever situation and posture they happen to be in when seized: the legs and arms flexible, remain sometime in whatever posture they are placed by a spectator: the functions of internal and external sensation are suspended; the eyes are open; the countenance and colour are nearly natural; the pulse and respiration alone continue in motion, but obscure. The duration of the paroxism is from a minute to hours, very rarely days: and the recovery as if from a profound sleep: in some with confused ideas of surrounding objects during the chasm. In the extasis strange visions are seen: and of these trances there are extraordinary instances on record. It may be complicated with somnambulismus, and hystericks. The causes, deep meditation, fanaticism, mental passions, intense cold, worms, foul stomach, suppressed evacuations: it is feigned by impostors.
Fainting and asphyxy:
syncope, leipothymia, asphyxia, idiopathick, symptomatick. In syncope the action of the heart and of respiration become considerably weaker than usual, or for a short time suspended: the pulse and breathing are sometimes so weak as to be imperceptible; the countenance pale and cold, with a clammy sweat, especially on the forehead; the functions of external and internal sense, and of voluntary motion, during this vital chasm, are interrupted or suspended. It sometimes arrests suddenly, sometimes with preceding languor and anxiety about the heart, giddiness, and dimness of sight; objects are seen as through a mist, sounds are scarcely audible; and there is confused noise in the ears. In the gradation and duration of vital suspension, there are diversities: after the lapse of a few or more minutes they gradually revive, yawning, sighing; some with vomiting; and some without vestiges of reminiscence during the temporary interreign. This partial cessation of the vital functions distinguishes it, at the first glance, from apoplexy. Asphyxy is only a more violent degree of syncope in which the intire human machinery is stopped: the counterfeit of death; but in which there are embers capable of being fanned and vivified into vital renovation. The first exertions towards a restitution of the vital energy when suspended, are sometimes with symptoms of epilepsy and convulsions.
The predisposing and occasional causes of syncope and asphyxy, idiopathick and symptomatick are, profuse evacuations and hemorrhages; venesection; tapping the abdomen in ascites; strong emeticks and purgatives; exhausted strength; violent exertions of strength, or muscular action; excessive fatigue; venery in excess; sudden terror or joy, or other mental emotions; intense anxiety; severe pain; offensive smells; foul air; close rooms and crowds, and the air contaminated with their breath, and effluvia; charcoal fumes; foul stagnant confined air, and gas of old damp pits, wells, subterranean caverns, mines; mephitick vapours from fermenting liquors in considerable quantity; lightening, thunder-shocks; excessive heat; excessive cold; sanguineous plethora; various diseases of the stomach; poisons, narcoticks; repelled cutaneous eruptions; hysterick, scorbutick, arthritick, febrile; wounds or blows on the head, spine, or stomach; severe labour and parturition, in which the infant’s head and brain is compressed, injured, or mouldshot, or the navel-string compressed, and the circulation interrupted; hydrocephalus; internal aneurism, polypi of the heart, or large arterial trunks; rupture of large blood vessels, or of internal abscess; palsy of the heart, dropsy of the pericardium; gangrene; drowning; hanging.
Palpitation of the Heart.
Chronic is here meant, not transitory, which may occur on every sudden emotion of body or mind. In this the contraction of the heart is with preternatural outrageous rapidity and force, and often with audible strokes against the ribs, and intermittent pulse. It is generally periodical; and by continuance, it is evident that, from the convulsion of this important motory pendulum, the entire subordinate series of hydraulick offices, together with those of sense and motion, must share in the disorder. The predisposing and occasional causes are, plethora; repletion, intemperance in food or drink; suppression of habitual evacuations; excessive evacuations; inanition; passions of mind; long continued grief, terror, venery, pain, anxiety, thirst, immoderate exercise; light cloathing; extreme irritability, peculiar irritability of the heart, and debility, spasm; pressure on the aorta; aneurism; ossification and straitness of the aorta; tumors about the great vessels; polypi; dropsy of the pericardium; impeded respiration and circulation through the lungs; broken ribs; weak disordered stomach, flatulence; diseases of the abdominal viscera; sweat of the feet, ulcers, scabs prematurely repressed; cachexy; hysterick, hypochondriack, melancholick, scorbutick, arthritick, atrabilarious, inflammatory.