A system of practical medicine. By American authors. Vol. 5 : $b Diseases of the nervous system
Science
A system of practical medicine. By American authors. Vol. 5 : $b Diseases of the nervous system
Medicine -- Practice
Tremor, or trembling, observed in persons during repose in any
attitude, consists in small, wholly involuntary muscular contractions
of sufficient extent to communicate to the parts a visible to-and-fro
movement which is very often rhythmical. In order to distinguish this
from any form of inco-ordination it is necessary that the observed
movement should occur independently of all volitional effort. Thus in
the senile state, in chronic alcoholism, in paralysis agitans, and in
dementia paralytica we observe trembling of the facial and lingual
muscles, of the extremities, and even of the whole body in some cases.
These are usually conditions of permanent or chronic tremor, but the
symptom is sometimes observed as a transient phenomenon, as after
violent muscular effort, after excesses of various sorts, under the
influence of emotions, etc. Occasionally, persons are met with who
have trembled from childhood or early years without actual disease of
the nervous system. It is clinically useful to divide tremor into
varieties, as rhythmical and irregular, fine and coarse, constant and
occasional. These terms define themselves sufficiently, so that no
further statement is necessary, but we would repeat that it is of much
advantage in diagnosis to determine accurately the characteristics of
tremor.
2. A much more useful classification of spasms, and to a certain
extent a physiological one, is into types according to their
distribution in the body, following exactly the classification of
paralyses. There are few topics of more utility for the physician to
study, in our opinion, than that of monoplegias and monospasms, of
hemiplegias and hemispasms in their genesis, mutual relations, and
diagnostic significance.
(_a_) Hemispasm of cerebral origin, tonic or clonic (or both forms
associated), may affect the face and limbs on one side of the body,
with or without paralysis. As in hemiplegia, the morbid phenomena are
greatest in the most distal muscular groups or in those whose
innervation is most {46} cortical. Very often hemispasm precedes,
immediately or remotely, hemiplegia in the same parts. In other cases
the relation is inverse, as when, after a severe hemiplegia, we find
the paralyzed muscles in a state of nearly constant tonic contraction
(secondary contracture), or when hemi-epilepsy follows a cerebral
lesion. In the former case the spasm, clonic or tonic, is designated
as pre-paralytic; in the second case, as post-paralytic. These terms
are useful, because they are associated with laws of diagnosis and
prognosis.
Public-domain text, read in full here on John Shaqi.
Reviews
Reviews
No reviews yet
Be the first to share your thoughts on this work.
Join the Discussion
Join the discussion
Sign in to leave a comment or review.
Sign InorCreate an account