HEALTH NOTES

New Zealand Times, Volume LXXIV, Issue 4978, 30 May 1903, Page 5 (Supplement)

HEALTH NOTES

(By Dr,'Andrew Wilson. F.E.S.E.) ST. VITUS’ DANCE. I'n nij former article on the nervous B Prteni i described the two-great elemeuvs < i i. wuieu n was’comirtsea —nerve ceils auu r terve nbres. I showed that of the two the nerve cells were obviously the more I important, the duty of nerves being merely to carry the messages going to or coming from the brain cells. An apt illustration of a nervous trouble of common occurrence, and regarding which . var.ous correspondents have written lo me of late from time to time, is the affection’known‘as St. Vitus’ Dance. This trouble is known to medical men under the name of "Chorea,” - a term derived from the Greek word meaning dancing or jumping. It is a curious affection, olten causing a good deal of alarm and trouble to mothers, seeing that it 1 generally occurs in . girls between the fifth and sixteenth years of life, although it may be found, but not so frequently, in the case of boys. One curious point about St. Vitus’ Dance is that it mat occur after rheumatism, and as this is a trouble that certainly affects the muscles we might judge here rightly enough of the relation 'between cause and effect. I also find that it is more frequent when rheumatism comes on after the attack of scarlet fever. .Regarding the cause of this curious trouble there is a pretty fair agreement amongst medical men that it is "the result of some kind of mental shock. Children have been known to be affected with it by receiving a severe fright, but there are cases known in which no such distinct cause for the ailment is traceable. Whatever, however, bo its origin, there cannot bo the'slightest : doubt that it gives us' an! excellent example of a nervous trouble, the exact seat ; of which is by no means clear. ■ ATS NATURE. The chief feature of Bt, Vitos’ Dance is, of course, tile want of power to control ; the movements of the muscles. Muscles 1 form'the tiesh'of our body, and, as my leaders must know,' they form our means of movement. When they contract or grow shorter they pull together the parts between which they are attached, and ■ thus enable us to discharge all the or- ' dmary ■ duties of life. •Xu a healthy body 1 we have these muscles well under command. If we wish to move a muscle of i the arm, the leg, head, or neck,, or other part we know that, not being paralysed,we have the power to execute .this move. . ineul,. In plain language, the ordinary [ muscles of the body are called voluntary muscles, because they are brought into ’ play, and are so stimulated at the oom- ’ mand of our wilh . .When we d(f not wish • to move til eni.- 'Or: :lo oAhthetn into play, they remain perfectly' quiescent. We ■ might, therefore, readily suppose'that the i brain or the spinal cord, "which' is the ' extension of 'the brain downwards, ax- , ercises Over the muscles when not in use , what we may - call an inhibitory action, j —that is to say, an'action restraining any , independent : movement. Suppose this i action one cause or another is altered, and suppose that the break, -so to speak, is iremoved from-the muscles, then ; left to their own device they may proceed to contract, being stimulated so to do by ; some part or other of the nervous system. over which the 'brain ’ .has ; for the time 1 being lost control. Also, we must note that the child who has St. Vitus’ Dance, in addition to being unable practically i .to sit still, cannot use the muscles properly. The movements are what we i call spasmodic, or jerky, in their nature. Thus the walking will rather be a process of dragging ' the'feet ’after' the' patient, ’ and even when sitting the hands are not I kept' still, but exhibit various irregular movements. The jaws are also affected : in the same way by the irregular action ( of the muscles, . and speech, breathing. . and swallowing may all in turn Ba im- , perfectly performed . owing to the same ' action or condition affecting tho muscles 1 through the nerves. THE'TREATMENT, ’ A trouble of this: kind, though nobneess- • sarily dangerous, it must bo confessed ; is extremely-annoying, not merely -to the i patient i herself, but 'also to those sur--1 rounding-her. In a severe case ■it might . bo • necessary, to feed the subj eot of this trouble. Happily in many oases it does not last long. Mts duration is sat down at from two to’ three months as a rule! Under: proper treatment it might probaSly be cured at-an earlier stage; buf the danger which exists is that it may become chronic and lasting, Aii 'which case, *■ of 1 course. tho ailnientassumes, ; a-much more serious character. ■• Amongst the causes of. : St. Vitas’ Dance’worms have been included. It is more than ■ probable that this opinion is correct, because the presonce of worms in the bowel, whilst ordinarily not giving rise to grave nervous symptoms, are often associated with disturbance of: health, and if we assume that an easily excitable, nervous system exists iu the child or .youth the presence of these parasites might iu ’ this way act as a cause of thiyaff ection we are considering. I Having these latter facts in mind, it may'therefore;lio ; ‘w'CU'to caution parents - to make* due Ahqff’irJ' %hdHekdniination to • -see whether or mot' worms' may be re- > presented as a cause of the ailment. If I the presence of these parasites be de- • tected it is more than probable that their treatment and removal may cure the case. i OTHER HINTS.

There seems to ■bo little dbubt that in ordinary cases a tonic treatment is that which is ‘best adapted to secure success. In the first place, the life of the patient mast be duly regulated. All excitement must be avoided, and existence must be lived in a quiet and regular fashion. A child affected with this ailment is. of course, not a fit‘subject for'school, and all lessons should for the time being be stopped, the aim being as far as possible to give the nervous centres complete rest. The doctor’s advice naturally, should be taken, and the probability is that ho may prescribe arsenic in some form or other, this being a remedy in much favour amongst physicians for the euro of this disease. I may ‘here mention that arsenic cannot at all be used without the consent and advice of a doctor. being a medicine of a character which cannot be sold to the public direct on account of its otherwise poisonous properties. The arsenic seems to exert some special action bn the nerve centres involved in the disease, whilst, of course, in itself it also forms a very powerful tonic. Xu cases which are not of a very severe character a considerable amount of benefit may often be derived by giving bromide of potash, a dose Of this for. say, a child above six years being about five or six grains given twice or thrice daily. Doctors nowadays, however, are fond Of combining bromide with another substance so as to form a medicine called chlcrobrom (not chloroform note). This medicine also should only be given under the advice of a doctor. Very good results appear to have been derived from its use in St. Vitus’ Dance, especially where there is a want of sleep, and where the movements are very violent. Arsenic, of course, in such a case would probably also be ordered by the doctor as a tonic. The food must be light, but nourishing, but I need hardly say the most important point in this disease must be the careful tonine up of the patient’s system throng l medical advice and home treatment in the way of rest and avoidance of all undue causes of excitement.