The causes of the disease are not well known. Sexual excess, exposure to cold, over-exertion, syphilis, are all said to be causes. Its progress is very slow, extending often over many years, and recovery is rare. It is not common in women.
The treatment consists mainly in measures for maintaining the general health. Nothing is as yet known to have any permanent benefit.
Shaking Palsy (Tremor—Paralysis A gitans) is characterized by tremulousness of muscles quite apart from any effort at movements. When developed, the trembling is incessant, affecting several limbs. It does not stop during sleep, and may be sufficient to prevent sleep. In walking, the patient usually bends head and trunk in advance, and then runs straight for ward, as a man trying to regain his balance. The muscles tend to become rigid and cramped, and great restlessness is exhibited.
Treatment is as hopeless as that for the pre ceding paralysis.
Wasting Palsy (Progressive Muscular At rophy—Creeping Palsy) is attended with loss of muscular power, and, associated with the loss of power, wasting of the muscle. It generally begins slowly, attacking one muscle, or a group of them, the muscles of the ball of the right thumb being usually first affected, then the muscles opposite—those of the little finger. The wasting gives the hand a claw-like look. Then the disease passes up the limb, from forearm to upper arm and shoulder, then on to the trunk, afterwards invading the lower limbs. The course of the disease is slow, unless the muscles con nected with breathing and swallowing become affected early, when choking or difficulty of breathing is liable, with attendant troubles, to cut off the patient in two or three years.
Among its causes, exposure to cold and wet are mentioned as chief. It attacks children, however, sometimes, and appears in them to be hereditary. • The chief treatment is with electricity, which seems to do good by so acting on the muscles as to restore their nutrition and arrest wasting.
Paralysis is a par alysis occurring in children, and especially boys, and attended with apparent increased growth of muscles, particularly of the calves and buttocks, The increased growth is only apparent, however, the muscular fibres actually dwindling, while the increased size is due to fat and connective tissue between theni. Feebleness of the muscles of the legs appears to be among the early symp toms, and the boy walks with legs kept apart and shoulders thrown back. The affection of the muscles, which begins low, passes upwards, affecting muscles of back and trunk, arms and
face. As the bulk of the muscles increases, the waddling movement of the child is more pro nounced, he has great difficulty in getting up, and is constantly falling. With the enlarge ment, the weakness of the muscles keeps pace, till the child becomes helpless. Death usually occurs before eighteen.
No treatment is of any avail if the disease has reached the stage of muscular enlargement. Before that period electricity seems the main remedy.
Infantile Paralysis occurs in children dur ing the second year of life, but may be any time between birth and ten years of age. Like the other forms, exposure to cold is said to be a frequent cause, teething being also set down as favouring its occurrence.
The symptoms begin with fever, accom panied now and again with convulsions. The paralysis, which affects motion only, not sen sation, occurs quickly, and increases rapidly, sometimes arms and legs being attacked, some times only groups of muscles in them. The muscles rapidly lose their power, become relaxed and cold. After some time—two to six months —some improvement may take place. Later, however, owing to the irregular wasting of the muscles, or the unequal recovery, deformities result, mainly of the band and foot. Frequently also the bones of the affected part cease to grow.
The treatment, while the attack of fever lasts, is simple, attention to procure movement of the bowels, and the giving of light diet. The use of electricity is highly commended in the later stage, to prevent the rapid wasting of muscles and to restore those already wasted.
Lead Palsy, in which the paralysis is usually limited to the extensor muscles of the forearm, specially the right, is one of the commonest symptoms of chronic lead poisoning. The lead poisoning may arise from many circumstances wo•kers in white-lead manufactories, painters, plumbers, those engaged in glazing pottery where oxide of lead is used, makers of some kinds of glazed cards, bleachers of Brussels lace, are all liable to it. It is those who work among preparations of lead, however, and not those who work with the metal itself, that are most liable. Lead may be taken into the system also in drinking water which has lain in leaden cisterns or leaden pipes. Hard waters which contain sulphate and carbonate of lime act less readily on lead than soft waters. Lead poison ing has been due to drinking wines contami nated with the metal, and to the drinking of Devonshire cider made in leaden vessels. The use of cosmetics containing lead has also been productive of harm.