The nervous affections of the motor system are conveniently grouped by Dr. Laycock under three heads—(1) the first including those cases in which there is paralysis or spasm without. distortion; (9) those in which distortion follows cessation of muscular equi librium, as in the various forms of club-foot; and (3) paroxysmal affections. The Lest example of the first class is hysterical paralysis of the lower extremities, of which sir Benjamin Brodie long ago wrote as follows: "I have known not a few, hut very numer ous, instances of young ladies being condemned to the horizontal posture, and even to the torture of caustic issues and scions, for several successive years, in n hom air, and exercise, and cheerful occupations would probably have procured a cure in the course of a few mouths." A notice of such eases as these may be found in the article IIvsattuA. Paralysis of a lateral half of the body, or of oue limb only may also be merely a mani festation of hysteria. The second class is well illustrated by the following case, which is reported by 31r. Shaw. A young lady who had suffered from a train of symptoms indic ative cf a disturbed nervous system, had the ankle so turned round that. she walked on one side of the foot. The knee was also bent outward, and the spine was becoming dis torted. Sir Charles Bell,who saw her in consultation, regarded the case as one of willful deception, and in a year's (line his diagnosis was completely established, scarcely any trace of lameness being apparent. Many -of the joints—as the knee, hip, etc.—may be the seats of purely neuralgic symptoms, which so closely simulate organic disease of the cartilages, as to lead to the removal of the limb. Carmichael, Brodie, and others have recorded cases in which this terrible mistake has been made by experienced sur geons. Spinal irritation, or spinal tenderness, is a mysterious affection, whose diagnos tic value is not very definite, us it may arise from a large number of distinct conditions, as, for example, disease of some part of the spinal cord, uterine disease, chronic disease of the intestinal viscera, etc.
One of the most anomalous affections of the nervous system ever recorded is described by Mr. Holden in the St. Bartholomew's Hospital Reports, 1897, vol. iii., pp. 299-305. The
patient was a bright-looking boy about 12,1, who, as he lay reading in bed, presented every appearance of perfect health: all that he complained of was what he called his " bump, ' which was about the size of a lien's egg, and lay on the right side of the neck, just above the shoulder. If the " bump" were touched, even most gently, the boy instantly lost all consciousness, and became deaf, dumb, and blind, while his body became arched like a bow, and was supported only by the back of the head and the heels, while his anus were rigidly extended. He might be pinched or pricked, but showed no sign of sensation. remaining in this state for somewhat less than a minute, he drew a deep long breath, which was followedeby a deep sigh. Instantly the spasm ceased, and the body fell, seemingly lifeless, on the bed. After two other similar sighs, which occurred in a few seconds, the boy awoke as if from profound sleep, and in a few minutes was none the worse for what he had gone through. Whenever the bump was touched—even when the boy was fast asleep—the same phenomena occurred. (It was found that, on touching the backbone in the dorsal region, the same series of events hap pened.) By continuous gentle manipulation of the bump, the boy was kept unconscious for twenty minutes. Another and even more remarkable phase of the boy's affection was his crowing and barking fit. which took place every day at the same time, almost to a minute. See the reports above cited.
With this illustration, we close our remarks on what may be termed anomalous nerv ous affections. With regard to nerrousness, which also stands at the head of this article, we may observe, that it is a word pertaining rather to the vocabulary of the patient (and pre-eminently of the female patient) than of the physician. It is usually understood to indicate a condition of which a restless mobility, with or without an undue excitability of the nerves of sensation, Is the chief characteristic. For further information on this subject, the reader is referred to Dr. Layeock's various works, and to Romberg On Dis eases of the Nervous System, 2 vols., translated by Dr. Sieveking.