Hitherto the patient will have experienced but little inconvenience;
and befriended by the strong influence of habitual endurance, would
perhaps seldom think of his being the subject of disease, except when
reminded of it by the unsteadiness of his hand, whilst writing or
employing himself in any nicer kind of manipulation. But as the
disease proceeds, similar employments are accomplished with
considerable difficulty, the hand failing to answer with exactness to
the dictates of the will. Walking becomes a task which cannot be
performed without considerable attention. The legs are not raised to
that height, or with that promptitude which the will directs, so that
the utmost care is necessary to prevent frequent falls.
At this period the patient experiences much inconvenience, which
unhappily is found daily to increase. The submission of the limbs to
the directions of the will can hardly ever be obtained in the
performance of the most ordinary offices of life. The fingers cannot
be disposed of in the proposed directions, and applied with certainty
to any proposed point. As time and the disease proceed, difficulties
increase: writing can now be hardly at all accomplished; and reading,
from the tremulous motion, is accomplished with some difficulty.
Whilst at meals the fork not being duly directed frequently fails to
raise the morsel from the plate: which, when seized, is with much
difficulty conveyed to the mouth. At this period the patient seldom
experiences a suspension of the agitation of his limbs. Commencing,
for instance in one arm, the wearisome agitation is borne until
beyond sufferance, when by suddenly changing the posture it is for a
time stopped in that limb, to commence, generally, in less than a
minute in one of the legs, or in the arm of the other side. Harassed
by this tormenting round, the patient has recourse to walking, a mode
of exercise to which the sufferers from this malady are in general
partial; owing to their attention being thereby somewhat diverted from
their unpleasant feelings, by the care and exertion required to ensure
its safe performance.
But as the malady proceeds, even this temporary mitigation of
suffering from the agitation of the limbs is denied. The propensity to
lean forward becomes invincible, and the patient is thereby forced to
step on the toes and fore part of the feet, whilst the upper part of
the body is thrown so far forward as to render it difficult to avoid
falling on the face. In some cases, when this state of the malady is
attained, the patient can no longer exercise himself by walking in his
usual manner, but is thrown on the toes and forepart of the feet;
being, at the same time, irresistibly impelled to take much quicker
and shorter steps, and thereby to adopt unwillingly a running pace. In
some cases it is found necessary entirely to substitute running for
walking; since otherwise the patient, on proceeding only a very few
paces, would inevitably fall.
Public-domain text, read in full here on John Shaqi.
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