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St Vituss

steam, twitchings, dance, baths, time, body and head

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ST. VITUS'S DANCE.—In the Middle Ages the term " St. Vitus's Dance " denoted the peculiar epidemics of dancing which, as a rule, were caused by states of religious exaltation ; as, for instance, at the time of the great pestilence in Germany, when whole communities were affected, on account of which the spirit of St. Vitus was invoked. At the present time the term denotes a specific, rather common disease of the nerves, which expresses itself particularly by irregular twitchings of the muscles. The former St Vitus's dance was a type of teria ; at the present time the term applies more particularly to chorea.

St. Vitus's dance occurs especi ally during childhood and at the time of puberty, more often in girls than in boys. Heredity plays no great role. The chief cause is arti cular rheumatism, especially when some valvular disease of the heart is present in addition. St. Vitus's dance may occur also during preg nancy.

In severe cases the muscular twitchings occur over the entire body. The patient tosses about in his bed, with abrupt movements of body and limbs. The brow alternately contracts and relaxes, the eyes open and close, the facial twitchings produce the strangest grimaces, speaking and eating become difficult, excursions are made by the arms and legs, and the body twists and turns, assuming the most peculiar positions (muscular delirium). In milder forms there are fewer facial contractions ; but rapid twitchings of the fingers, raising and lowering of the toes, etc., are present. Ignorant persons believe children suffering from St. Vitus's dance to be naughty, and punish them accordingly. They are especially punished at school because they are unable to sit quietly, and also because they talk indistinctly, write poorly, and make grimaces. The affection is generally accompanied by a state of irritability, stubbornness and fickleness ; and the condition should, therefore, be judged carefully, so as not to do the children an injustice. The twitchings become stronger during any emotional excitement, as yell as when the patient feels that he is under observation. They subside during sleep.

With proper treatment, St. Vitus's dance is generally curable ; sometimes, however, only after months. Relapses may occur. In severe cases the child

should be kept in bed, and pillow's and holsters should be used to guard it against possible injury from tossing about. The child should, under all conditions, be kept from school, if only for the reason that the twitchings arouse in other children an inclination to imitate them.

STAMMERING.—See SPEECII DISTURBANCES.

STEAM-BATH.—The so-called " Russian bath " is the oldest form of steam-bath known. The attendant merely allowed the steam from a furnace, which served to heat the water for other warm baths, to escape into a large, closed room, very little attention being paid to either the pressure or the temperature. Later, the method was somewhat improved by main taining a low pressure of steam, and a definite temperature not above F. The bather remained in this room until a profuse perspiration resulted, some of which, however, consisted of moisture which had condensed on the skin. The bather was also compelled to inhale the steam, this being really superfluous. The steam-bath was followed by a cool sponge-bath or by a plunge. Russian baths are fortunately little used nowadays, being rarely found in modern bathing establishments. A general warning should be given against their use, as they not infrequently bring on hzemorrhages into the brain, eye, lungs, etc.

Russian baths have been largely supplanted by so-called cabinet-baths, which may be found in all modern establishments. The cabinet consists of a wooden closet, with an aperture for the head, so that this is not exposed to the steam (see Fig. 393). The steam is admitted from below through a system of pipes, and an even pressure of about one-half atmosphere pounds per square inch) is maintained. Cloths wrapped around the patient's neck prevent steam from escaping above. Steam-cabinets are made in various shapes, adaptable for full baths, sitz-baths, and baths for different parts of the body. For a steam-bath for the face and head, an ordinary flat vessel filled with boiling water may be used, the patient inclining his head over it and preventing a too rapid escape of the steam by spreading a piece of oilcloth over his head (see Fig. 394).

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