At present he is almost constantly troubled with the agitation, which
he describes as generally commencing in a slight degree, and gradually
increasing, until it arises to such a height as to shake the room;
when, by a sudden and somewhat violent change of posture, he is almost
always able to stop it. But very soon afterwards it will commence in
some other limb, in a small degree, and gradually increase in
violence; but he does not remember the thus checking of it, to have
been followed by any injurious effect. When the agitation had not
been thus interrupted, he stated, that it gradually extended through
all the limbs, and at last affected the whole trunk. To illustrate his
observation as to the power of suspending the motion by a sudden
change of posture, he, being then just come in from a walk, with every
limb shaking, threw himself rather violently into a chair, and said,
“Now I am as well as ever I was in my life.” The shaking completely
stopped; but returned within two minutes' time.
He now possessed but little power in giving a required direction to
the motions of any part. He was scarcely able to feed himself. He had
written hardly intelligibly for the last three years; and at present
could not write at all. His attendants observed, that of late the
trembling would sometimes begin in his sleep, and increase until it
awakened him: when he always was in a state of agitation and alarm.
On being asked if he walked under much apprehension of falling
forwards? he said he suffered much from it; and replied in the
affirmative to the question, whether he experienced any difficulty in
restraining himself from getting into a running pace? It being asked,
if whilst walking he felt much apprehension from the difficulty of
raising his feet, if he saw a rising pebble in his path? he avowed, in
a strong manner, his alarm on such occasions; and it was observed by
his wife, that she believed, that in walking across the room, he would
consider as a difficulty the having to step over a pin.
The preceding cases appear to belong to the same species: differing
from each other, perhaps, only in the length of time which the disease
had existed, and the stage at which it had arrived.
CHAP. II.
PATHOGNOMONIC SYMPTOMS EXAMINED—_TREMOR COACTUS_—_SCELOTYRBE
FESTINANS_.
It has been seen in the preceding history of the disease, and in the
accompanying cases, that certain affections, the tremulous agitations,
and the almost invincible propensity to run, when wishing only to
walk, each of which has been considered by nosologists as distinct
diseases, appear to be pathognomonic symptoms of this malady. To
determine in which of these points of view these affections ought to
be regarded, an examination into their nature, and an inquiry into the
opinions of preceding writers respecting them, seem necessary to be
attempted.
* * * * *
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