Spasm

“ Next to refusal of food and refusal of sleep perhaps the most frequent manifestation of nervous unrest is provided by the group of symptoms which we may call, with a certain latitude of expression, Habit Spasms. By a habit spasm is meant the constant repetition of an action which was originally designed to produce some one definite result, but which has become involuntary, habitual, and separated from its original meaning. The nervous cough forms a good example of a habit spasm. ”

“ Again, in some cases, the spasm may affect the respiratory muscles, giving rise to a curious barking articulation, in consequence of spasm of the expiratory muscles, and in such cases the patient utters the first part of the sentence slowly, gradually accelerates the speed, and makes a rush towards the close. ”

“ My brain was all in a whirl. I could do nothing but lie there shivering; my joints and muscles seemed to be possessed by an attack of twitching spasms, as if I had been suddenly smitten with some hideous disease. ”

“ I have just mentioned one instance in which intermittent spasm of a voluntary muscle, the orbicularis palpebrarum, was caused by irritation of a sensory nerve. This leads me to remark that a very important condition to be borne in mind is that constant stimulation of a sensory nerve will often produce clonic or intermittent, and not tonic or continuous, contraction of the muscles which it may set in action. ”

“ A second is catochus, like the preceding, but with a higher96 power of spasm, so that the joints are rigidly fixed; and if you overcome one for a moment with superior strength, being let go, it flies back to where it was. A third, partial spasm of equal rigidity, arching the body forwards or backwards or laterally, or fixing one limb or more. The fourth, clonic spasm, for instance, the contortions and convulsive struggles of epilepsy. The fifth, an impulse to rapid and varied muscular actions, nearly equalling convulsions in violence, but combined so as to travesty ordinary voluntary motion ”

“ These cases have presented a few or many of the symptoms of grave hysteria, such as anæsthesia, analgesia, hyperæsthesia, blindness, aphonia, paralysis, contracture, etc., and have also had attacks of tonic and clonic spasm, with complete or partial loss of consciousness. The phenomena of the periods of contortions and great movements, of emotional attitudes, and of delirium have been, however, altogether or almost entirely absent. ”

“ During the whole time the breathing is difficult, the mouth froths very much, and the heart palpitates quickly, but irregularly. When the spasm is over the patient falls into a perfect stupor, during which she remains unconscious, but with all the limbs soft and moveable, except the fingers, which appear to grasp. The jaws generally remain closed, and so do the [338] eyes, but they may be easily opened, and will sometimes remain open; the breathing becomes powerful and loud, and the pulse beats with rapidity. ”

“ But if the spasm supervene on its being reduced, the joint should be quickly displaced, and bathed frequently with warm water, and the whole body should be kept in a warm, soft, and easy condition, and more especially about the joints, for the whole body should rather be in a bent than in an extended state. ”

“ Pressure on brain—pain, spasm, nausea, dullness, blindness, stupor, coma, palsy. Congestion and anæmia synchronous. Lesions of cortex. Encephalic lesions—hemiplegia, with spasms, increased reflexes, spasms follow cranial nerves, vertigo, apoplexy, epilepsy, dementia, coma, little muscular atrophy, or dermal sloughing. Spinal lesions, paraplegia without spasm, reflex reduced or nil, follow spinal nerves, head symptoms less, much muscular atrophy, bed sores. Sensory and motor tracts, in crus cerebri, respiratory centres—inspiratory expiratory, inhibition. ”

“ The rigidity and spasm are greatest and most constant in labourers and persons accustomed to athletic exercises, and they are usually absent in patients who have been long confined to the room, or are much reduced in strength from any cause. ”

“ Secondly, After a person, whose eye is distorted by a spasm, has seen double for a certain time, this ceases, and he gains the power of seeing single again, provided the distortion remain fixed to a certain degree. ”

“ A greater proportion of those painful muscular actions called spasms, are the effect of sensations; though Ideas, also, appear to be concerned in the production of those which become frequent. One very remarkable case, which is named the Locked Jaw, is often the result of a pain produced by an external wound. ”

“ Cullen's Works, vol. i. p. 493. Compare, respecting his general theory of spasm, p. 84, and vol. ii. p. 400.
[842] ‘The idea of fever, then, may be, that a spasm of the extreme vessels, however induced, proves an irritation to the heart and arteries; and that this continues till the spasm is relaxed or overcome.’ Cullen's Works, vol. i. p. 494.
[843] ‘Such, however, is, at the same time, the nature of the animal economy, that this debility proves an indirect stimulus to the sanguiferous system ”

“ Toward death, however, the agitation is renewed but in a different way; the fore feet are raised and put forward, the tongue often has a peculiar spasm, the chest is raised, the eyes drawn back into the orbits, pupils contracted ”

“ If the spasm does not break, and the breathing does not become easy within fifteen or twenty minutes, then change to hot water. Wring out the cloth from water as hot as can be borne and apply about the neck, changing in a few moments, and so on. ”

“ The patient is extremely sensitive to any kind of external impression; a bright light, a loud noise, a breath of cool air, contact with any one, are all apt to bring on one of these seizures. But besides these suffocative attacks there also occur general convulsions affecting the whole muscular system of the body, and occasionally a condition of tetanic spasm. ”

“ As the nerves are instruments of sensation, it follows that spasms in the nerves may produce all symptoms, and therefore a disorder in the nervous system shall imitate all distempers, and occasion, in appearance, an asthma for instance, a pleurisy, or a fit of the stone. ”

“ In the intervals between the spasms the respiration is quite natural; but during the attack there is great difficulty of breathing accompanied with a crowing noise, and with violent struggling on the part of the little sufferer. ”

“ A large athletic man, long accustomed to the use of ardent spirit, on drinking a glass of raw whiskey, dropped instantly dead. On carefully dissecting the body, no adequate cause of the sudden cessation of life could be found in any part, except the heart. This organ was free from blood, was hard and firmly contracted, as if affected by spasms. I am convinced that many of those cases of sudden death which take place with intemperate persons, are the result of a spasmodic action of the heart, from sympathy with the stomach, or some other part of the system. ”

“ Results equally distressing, if not so unsightly, are produced in some individuals without the introduction to the stomach of articles of food or medicine. Floating particles in the air are sometimes sufficient to produce all the symptoms of spasmodic asthma. ”

“ The muscles or organs of motion, when affected with spasms or convulsions from an irritating cause, are assuredly moved no otherwise than the decapitated cock or hen, which is agitated with many convulsive movements of its legs and wings, but all confused and without a purpose, because the controlling power of the brain has been taken away:—common sensation has disappeared, under the controlling influence of which these motions were formerly coordinated to progression by walking or to flight. ”

“ The pulse is accelerated when the spasms are on, ranging from 60 to 65 beats a minute. If inflammation has set in, the pulse instead of rising and falling remains more constant and is high all the time. ”

“ These spasmodic pains are sometimes very violent; the patient writhes in agony, tossing herself from side to side upon the bed, and sometimes it is necessary for a number of persons to hold her. These symptoms sometimes become so violent as to end in convulsions, it is said. Spasmodic after-pains appear to happen, for the most part, with those who are excessively nervous, and particularly with such as have been in the habit of using strong tea and coffee, opium, and other narcotic substances. ”

“ An external shock causes "a functional disturbance of the delicate mechanism of the psychic centers shown in 1, faulty distribution of motor impulses, 2, hypo-innervation, 3, hyper-innervation, causing tremors, tonic and clonic spasms, etc., instead of single muscle actions." ”

“ The eyes, violently injected, become haggard, and the look uncertain, or, in the majority of cases, the eyes are closed spasmodically to avoid the contact of the light. The respiration is hurried, sometimes interrupted, and may be suspended by the spasmodic contraction of the larynx, and the air, for a time compressed, is at last emitted in broken and meaningless words. The congested nervous centers only communicate confused sensations and volitions; mobility and sensation show extreme disorder ”

“ Ultimately, the spasms become general, are induced by the most trifling exertions or noises, and prove fatal in a few days. Frequently the patient retains his senses throughout, and is fully aware of his lamentable situation ”

“ Crying consists of short deep inspirations and prolonged expiration's with the glottis partially closed. Long-continued crying leads to sobbing, in which sudden spasmodic contractions of the diaphragm cause sudden inspirations and inspiratory sounds generated in larynx and pharynx.
Sighing is a sudden and prolonged inspiration following an unusually long pause after the last expiration. ”

“ The pulse is now much weaker and more rapid, and may be irregular. The color returns to the face, the patient closes his eyes, and the body is covered with profuse perspiration. The fingers are unlocked and every evidence of spasmodic movement disappears. ”

“ The motor reaction then manifests itself in laughing, crying, or deglutitory spasms, and, if the irritation be of the severest kind, epileptic or tetanic spasms in addition. Now the occurrence of laughing, crying, or deglutitory spasms could be easily understood if the molecular oscillation induced by the irritation were to travel along the associating tracts from the given spinal segment to the nuclei of the medulla oblongata. For in the medulla are found the nerve nuclei which preside over the facial, laryngeal and pharyngeal muscles. ”

“ All cases of convulsions are in the spasms family no matter with what other conditions they are associated. If there are other complications, and there usually are, the family for the complications will depend upon the functions involved. ”

“ Prior to the development of the spasmodic affection, there is usually a period in which the sufferer notes a want of appetite, languidness, with disinclination towards mental or bodily pursuits, headache, restlessness, pains in the limbs and joints, with irritable temper and weakness of memory. There are many other symptoms in special cases. As the disease develops, the patient gradually begins to exhibit an awkwardness of movement in the extremities, and objects frequently fall from the grasp. ”

“ When, therefore, spasms come on at the commencement of the complaint, or nearly so, and are protracted, they have their origin in plethora; but when they supervene after copious sweatings, vomitings, discharges [402] from the bowels, hemorrhages, watchfulness, hunger, or much and violent exercise, they proceed from depletion. If they suddenly attack a person in health, they must necessarily proceed from plethora. But when from ardent fevers the nerves and whole body are dried, and then spasms come on owing to the dryness, this is one of the worst possible cases, and is almost incurable. ”

“ In some instances there is a degree of spasmodic action in certain muscles which may cause the patient to make some unexpected movement, such as turning half round, or walking abruptly aside, or may show itself by some unusual expression of countenance, such as squinting or grinning. ”

“ There are many stories of men in the midst of a severe asthmatic seizure being suddenly roused by the cry of fire, or an alarm of some {367} kind near them, having the spasmodic conditions disappear as if by magic. ”

“ Defect of stimulus repeated at certain intervals causes fever-fits. 6. Stimulus long applied ceases to act a second time. 7. If a stimulus excites sensation in an organ not usually excited into sensation, inflammation is produced. IV. Of stimulus greater than natural. 1. A stimulus greater than natural diminishes the quantity of sensorial power in general. 2. In particular organs. 3. Induces the organ into spasmodic actions. 4. Induces the antagonist fibres into action. 5. Induces the organ into convulsive or fixed spasms. 6. Produces paralysis of the organ. V. Of stimulus less than natural. ”

“ Among the most unfavorable nervous symptoms are great restlessness, rigid retraction of the head, spasms of other than the spinal muscles, general convulsions, extensive hyperæsthesia, deep coma, dilatation and insensibility of the pupils or their rapid change from a dilated to a contracted state, retention or incontinence of urine, and all cerebral paralyses, including that of the muscles of deglutition. ”

“ When affected with uneasy sensation from wind, I have not only been sensible of a general debility and flatness of spirits, but the unexpected opening of a door, or any such trifling unforeseen accident, has instantly occasioned an odd sensation about my heart, extending itself to my head and arms, &c. At other times, when my stomach is in a firmer state, I have no such feeling: at least, in a very small degree, from causes which might be thought more apt to produce them. Fainting, Tremors, Palpitations of the Heart, convulsive motions, and all those disorders which are called nervous, &c. ”