A microcephalic youth of sixteen, a monorchid, developed what
appeared at first to be an ordinary chorea subsequently to an
orchidopexy. The movements, however, varied from day to day and
from hour to hour. Sometimes they disappeared for days at a time,
to reappear suddenly just when the neurosis seemed cured. The
influence exerted on them by the will was both mild and transient.
They constituted, in short, a particular kind of chorea, changing
and changeable, and differing from intermittent chorea in that
neither remissions nor relapses were ever wholly complete. Further,
the condition was implanted on a basis of mental and physical
degeneration, and seemed likely to become established as a
permanent functional stigma.
In another case a peculiar chorea gradually supervened, for no
obvious reason, in an adult female of tardy and imperfect physical
and intellectual development. It was difficult to decide whether
the psychical or the somatic phenomena were preponderant; but to
the material, tangible, and visible signs of constitutional
inferiority was superadded a choreiform instability of the whole
voluntary muscular system, consisting in agitation, gesticulation,
and incorrigible motor restlessness, coupled with a conspicuous
incapacity for rational action.
The steps in the evolution of this functional defect were very
slow, and coincided with final confirmation of the intellectual
insufficiency. As for the chorea, its localisation and its
intensity, its increase and its decrease, its extension and its
limitation, seemed to vary, in a way that could not be foreseen, at
the call of certain undetermined circumstances.
In a third instance we meet with many of the symptoms already noted
among those who tic:
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