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A tall girl afflicted with chorea St. Vitus's dance was dancing with every limb, without a pause, the left side of her face being continually distorted by sudden, convulsive grimaces. A younger one, who followed, gave vent to a bark, a kind of plaintive animal cry, each time that the tic douloureux which was torturing her twisted her mouth and her right cheek, which she seemed to throw forward.
And in this they differ from the successive dissimilar exertions of the retina, mentioned in this section, which resemble in miniature the more violent agitations of the limbs in convulsive diseases, as epilepsy, chorea S. Viti, and opisthotonos; all which diseases are perhaps, at first, the consequence of pain, and have their periods afterwards established by habit.
Dancing is defined to be "to move in measure; to move with steps correspondent to the sound of instruments." But there are other species of dancing as -for three long months To dance attendance for a word of audience: and to dance with pain, or when, as Lord Bacon says, "in pestilences, the malignity of the infecting vapour danceth the principal spirits." The Chorea S. Viti, or St.
Ulcerative endocarditis was for a long time believed to be inevitably fatal; it is now known that a small proportion of patients with this disease recover. Children occasionally suffer from it, but it is generally a disease of middle adult life. Chorea may bear an apparent causal relation to it in rare instances.
This form of chorea is almost always a disease of childhood. So-called post-hemiplegic chorea is, in the opinion of both Hammond and Gray, simply athetosis. The silly, dancing, posturing, wiry movements, and the facial distortion observed in Huntington's chorea would hardly be mistaken by a careful observer for athetosis. The two diseases, however, are somewhat alike.
The symptom is so frequently met with that it is strange that it should have attracted so little attention as compared with the contrasting condition of chorea. And yet it is of more serious significance, more difficult to overcome, and with a greater danger that permanent symptoms of neurasthenia will result.
A tall girl afflicted with chorea St. Vitus's dance was dancing with every limb, without a pause, the left side of her face being continually distorted by sudden, convulsive grimaces. A younger one, who followed, gave vent to a bark, a kind of plaintive animal cry, each time that the tic douloureux which was torturing her twisted her mouth and her right cheek, which she seemed to throw forward.
Attention to the twitching, spasmodic, fibrillary movements, having a quick beginning and a quick ending, which is characteristic in Sydenham's chorea, would at once exclude that disease. These jerky movements peculiar to St. Vitus's dance may be easily detected in a few or many muscles, if moderate care and patience be exercised on the part of the examiner.
In the higher classes it is one in twenty-three. In the insane Hospital of Massachusetts I have it from authority which I cannot question, the proportion is at least one in three or four. At present there are about twenty cases of the kind alluded to. Chorea Sancti Viti; or St. Vitus's dance.
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