Strabismus

“ Do you not find in persons whom you love, whom you esteem, and even admire, some marks of obliquity in mental vision? Are there not some subjects in looking at which it seems to you impossible that they should ever see straight? Are there not moods in which it seems to you that they are disposed to see all things out of plumb and in false relations with each other? If you answer these questions in the affirmative, then you will be glad of a hint as to the method of dealing with your friends who have a touch of cerebral strabismus, or are liable to occasional paroxysms of perversity. ”

“ Mortar read a talented paper on the cure of strabismus, or squinting, by dividing the muscles of the eye. The patient, a working man, squinted so terribly, that his eyes almost got into one another’s sockets ”

“ If he is repressed, suppressed, frightened, he will not see very much, and what he does see will be out of focus. [Pg 282] Spiritual strabismus and mental myopia are the results of vicarious peeps at the universe. ”

“ The eyes may be turned upward, or may be fixed in the center, or be drawn irregularly outward or inward, causing strabismus, which is, however, a more rare occurrence. If the eyelids should be partially open, tickling the cilia or the conjunctiva of the ball with a straw or a feather will cause them to close, if the spinal cord be sound. The mouth and lips are more or less compressed, and fluids run out at the corners, unless placed on the very back of the tongue by a long, narrow spoon, when they are swallowed with difficulty. Paralysis of one side of the face and hemiplegia are common ”

“ We often observe in man a discordance in the organs of sense. One ear hears better than the other, one eye sees further, &c.; hence false hearing, hence a species of strabismus, &c.; but the cause of these discordances appears to reside in the organ itself, and not to be connected with the brain.
Moreover, it does not appear that each hemisphere always corresponds necessarily with the nerves of motion175 of the opposite side. In fact, we often see on the right side effusions or injuries of the cerebral substance, without any alterations of motion on the left, and vice versa. ”

“ At the beginning of sexual excitement, Vaschide and Vurpas have observed, tonicity of the eye-muscles seems to increase; the elevators of the upper lids contract, so that the eyes look larger and their mobility and brightness are heightened; with the increase of muscular tonicity strabismus occurs, owing to the greater strength of the muscles that carry the eyes inward. [124]
The facial expression which marks the culmination of tumescence, and the approach of detumescence is that which is generally expressive of joy. ”

“ The squire hadn’t heard of anybody dying of that complaint; but when the doctor explained that strabismus was French for cross-eyes, he naturally thought of poor558 Abe Dodge, and the young doctor was right up on his ear. ”

“ At the end of a week or more from the beginning of this stage symptoms of irritation of some of the cerebral nerves begin to show themselves, in consequence of pressure from the increasing exudation at the base of the brain and into the ventricles. Strabismus (usually convergent) , twitching of the facial muscles and grimaces, grinding of the teeth, or chewing movements of the mouth are noticed. The somnolence deepens into sopor, from which it becomes more and more difficult to arouse the patient, who gradually becomes completely insensible. ”

“ The old crone's tirade seemed to break loose something hot and seething in Strawbridge's brain. The enormity of his delinquence, the pitifulness of the girl, the rapture which might have been his! His legs shook so that he caught at the effigy of the Blessed Virgin. But all that remained of his mutilated hand were two fingers. These gave way instantly, he staggered against the wooden figure, and the thing swung slowly over and crashed on the tiles.
The ancient shifted from the dowager back to the servant again. ”

“ That cell of his brain was closed and lost; that picture in his mind was faded and vanished. He tramped on still struggling. There was something sinister, almost tragic in this near-illumination, in this warning he had almost heard, and which had died in silence. ”

“ STRUMBO.
O, alas, sir, ye are deceived. I am not Mercury;
I am Strumbo.
HUMBER.
Give me some meat, villain; give me some meat,
Or gainst this rock I’ll dash thy cursed brains,
And rent thy bowels with my bloody hands.
Give me some meat, villain; give me some meat!
STRUMBO.
By the faith of my body, good fellow, I had rather give an whole oxe than that thou shouldst serve me in that sort. Dash out my brains? O horrible! terrible! I think I have a quarry of stones in my pocket. ”

“ There was an insidious pleasure mingled with it, an intangible titillation of the nerves; but that only alarmed me the more. The poisons that are most to be feared are those which captivate the senses; they convey no warning to the body, and betray the mind, however watchful, by effecting a paralysis of will. Perhaps—unwittingly—I had been very near death. The notion was disturbing. I began to regard the sarcophagus much in the light of an infernal machine possessing dangerous potentialities for ill. ”

“ Little child, if you go to hell there will be a devil at your side to strike you. He will go on striking you every minute for ever and ever without stopping. The first stroke will make your body as bad as the body of Job, covered, from head to foot, with sores and ulcers. The second stroke will make your body twice as bad as the body of job. The third stroke will make your body three times as bad as the body of Job. The fourth stroke will make your body four times as bad as the body of Job. ”

“ Is there any real difference between giving a woman her first stain, and giving her the last [Pg 248] pollution that destroys her! If you can imagine the señora flung about the streets, defiled, mocked, and paid for, do you think she would be any more pitiful than any other woman? A human soul is a human soul, my dear son."
A distressful feeling arose in Strawbridge at this renaissance of his transgressions. For some reason the priest's words aroused with painful distinctness the memory of his first impurity. ”

“ Suppose, for instance, a child to be born a fool, and also with its legs and arms broken in the same manner as those are of criminals executed; the phenomena may be accounted for thus: Every stroke given to the poor man struck forcibly the imagination of the mother, and, by a kind of counter-stroke, the tender and delicate brain of the child. Now, though the fibres of the woman’s brain were strongly shaken by the violent flux of animal spirits on this occasion, yet they had strength and consistence enough to prevent an entire disorder ”

“ The imperfect and irregular action of the lungs associated with the arrests in development of the face, nose, palate, jaws, and chest may produce an irregular blood supply to the brain, which will exaggerate the mental instability of the degenerate.
Among the conditions which are expressions of degeneracy of the body, combined with degeneracy of the head and face, are three conditions known as infantilism, masculinism, and feminism. Practically all three are arrests of development of the promise of the child type. ”

“ This human error about physical wounds and colics is part and parcel of the delusion that matter can feel and see, having sensation and substance." "Insanity implies belief in a diseased brain, while physical ailments (so-called) arise from belief that some other portions of the body are deranged.... A bunion would produce insanity as perceptible as that produced by congestion of the brain, were it not that mortal mind calls the bunion an unconscious portion of the body. ”

“ If we could go into the causes of false strokes in work or play, we should doubtless find that each has its antecedents, and that the false stroke often has a more or less definite meaning and is the expression of some trend which does not lie on the surface. Such occurrences are readily explicable as failures of adjustment due either to weakening of control or disturbances in the controlled tendencies to movement. ”

“ He could feel her form pressed against him, her milky palm against his face; then just as he swung her into destruction, he awoke with a violent start, gasping for breath, with a hammering heart and a sweating body. ”

“ In Chapter VIII the differential diagnosis between perplexity and stupor has already been touched upon. Here again the affect is a point of contrast. The patient has not too little emotion but too much. The feeling of intangible, puzzling ideas and of an insecure environment causes the subject distress, of which complaint is made and which can be witnessed in the furrowed brow and constrained expression. There is also, as we have seen, a rich ideational content in these cases, if one can get at it. The mind is not a blank, as in the stupor, or concerned only with delusions of death. ”

“ And dissection demonstrates the frequent causes of all this; for, in the skull of these beings, we often find a bluish jelly, instead of healthy brain. This diseased pulp is thus the source of both animal and intellectual apathy. The idiot will often seem insensible to pain, while his flesh is burning; and objects or subjects do not cause sufficient impression on this pulpy brain to produce their image, so that the being may almost live without a sense. ”

“ The bloodless lips, the dull, heavy eye surrounded with dark rings, the nerveless hand, the blanched cheek, the short breath, the old, faded look, the weakened memory and silly irritability tell the story all too plainly. The same evil result follows, ending perhaps in death, or worse, in insanity. ”

“ Now the straw hat raises its pretensions against prescribed right, and insolently lays claim to half of the year. And since then approbation fluctuates between these two appurtenances of the human race. When the unstable minds of mortals wavered toward straw, the most beautiful felts, velveteen, silk, and pasteboard were left unnoticed and eaten by moths. On the other hand, when the inclinations of men turned to felt, every human being--women, children, and nurses--wore men's small hats ”

“ The turn of phrase in the dream also sounds ambiguous; something which I feel ... in spite of the dress. “Feel on my own body” is intended. Moreover, I am struck with the unusual sound of the term “infiltrated portion of skin.” “An infiltration behind on the upper left” is what we are accustomed to; this would refer to the lung, and thus again to tuberculosis patients.
In spite of the dress.
This, to be sure, is only an interpolation. We, of course, examine the children in the clinic undressed; it is some sort of contradiction to the manner in which grown-up female patients must be examined. ”

“ To this end we first examined typical cases of deep stupor and found that the clinical picture is made up of the following symptoms: In the foreground stands poverty of affect. The patients are almost unbelievably apathetic, giving no evidence by speech or action of interest in themselves or their environment, unmoved even by painful stimuli. Their faces are wooden masks; their voices as colorless when words are uttered. In some cases sudden mood reactions break through at rare intervals. The second cardinal symptom is inactivity. ”

“ Though sensation and volition begin or terminate at the extremities or central parts of the sensorium, yet the whole of it is frequently influenced by the exertion of these faculties, as appears from their effects on the external habit: for the whole skin is reddened by shame, and an universal trembling is produced by fear: and every muscle of the body is agitated in angry people by the desire of revenge. ”

“ Knauer reports that in post-rheumatic stupors illusions are frequent—an ice bag thought to be a cannon, or a child, etc.—and there are bizarre misinterpretations of the physical condition, such as lying on glass splinters, animals crawling on the body, and so on. Such illusions are, in our experience, not found in stupor, and, on the other hand, are cardinal symptoms of delirium. ”

“ The anesthesia to pin pricks, the immobility and the refusal to recognize the existence of the world around, in patients who give evidence of some intellectual operations still persisting, are probably all part of a feigned [197] death, with the delusion expressing itself in corpse-like behavior.
Finally we must consider the meaning of the deep stupor where no mentation of any kind can be proven and where none but vegetative functions seem to be operating. ”

“ It is not difficult to perceive the relation existing between a defective brain weight, paucity of the gyri, deficiency of properly developed cortical cells and such an elementary form of mental aberration as simple imbecility. The subject of the relation between structure and function gains in interest when we leave this domain of simple mental weakness to analyse the relation between structural defects and the positive symptoms of insanity and degeneracy—that is, moral perversion, mental obliquity, delusions, and morbid impulses. ”

“ This conclusion is confirmed by pathology. Disease of the striatum is followed by paralysis on the opposite side of the body. Disease of the thalamus, while not always so uniform in its testimony, does still, sometimes, give striking evidence of a sensory significance of the organ. It should be distinctly borne in mind, when speaking of these bodies, that paralysis of sensation and of voluntary motion may be produced by lesions in the cell-matter of the cerebrum apart from any injury to the thalamus and striatum ”