WRITERS' CRAMP, or SCRIVENERS' PALSY, is a peculiar kind of local spasm,'in which every attempt to write instantly calls forth uncontrollable .movements in the thumb, the index and middle finger, so that the pen starts up and down on the paper, and instead of a legible handwriting a mere scrawl results. "The more," says Romberg, "the patient persists in his attempt, the more the difficulty of using his pen increases; and to the visible and sensible contractions of the muscles of the thumb, contractions of the fore-arm, and even of the upper-arm, are often superadded. Abnormal sensations, especially • of a sense of weight and constriction of the hand or of pain extending from the upper arm to the back, are occasionally present. It is liagnostic of these attacks that they are instantly arrested when the individual ceases w.•ting, and that the hand is capable of every other combination of movements and exertions."—The Nervous Dis eases of Man, vol. i. p. 320. The disease is chiefly confined to middle age, and scarcely ever occurs in women; and there can be no doubt that en occupation entailing much writing predisposes to it, the quality of the paper or of the pen having nothing to do with
.t. The treatment hitherto pursued, both local and general, has, according to Romberg, peen " invariably ineffectual. This is, however, too strong a term, since he mentions a case in which Stromeyer applied the principle of division of the muscles to the cure of writers' cramp, and in one case a brilliant result justified the antispasmodic reputation of tenotomv; the patient being perfectly able to write as early as the fourteenth day after the subcutaneous division of the tendon of the long flexor of the thumb." The same operation was, however, several times performed by Diffenbach without success. Mr. Solly, in his recently published Surgical Experiences, describes several cases of this peculiar affection, in some of which judicious treatment, combined with entire cessation of writing for a considerable time, led to satisfactory results.
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