[Nervous system 291]

Shaking palsy. (Paralysis Agitans).—­This is a chronic affection of the nervous system, characterized by muscular weakness, trembling and rigidity.

Causes.—­It usually occurs after the fortieth year, and is more common in men than in women.  The exciting causes are exposure to cold and wet, business worries, anxieties, violent emotional excitement and specific fevers.

Symptoms.—­The four prominent symptoms are trembling, weakness, rigidity, and a peculiar attitude.  It generally develops gradually, usually in one or the other hand.  There is at first a fine trembling, beginning in the hands or feet, gradually extending to the arms, the legs and sometimes the whole body.  The head is not involved so frequently.  This trembling (tremor) consists of rapid, uniform “shakings.”  At first it may come in spells, but as the disease advances it is continuous.  Any excitement makes it worse.  It is very marked in the hands.  The trembling generally ceases during sleep.  The muscles become rigid and shortened; the head is bent and the body is bent forward; the arms are flexed (bent) and the thumbs are turned into the palms and grasped by the fingers; the legs are bent, movement soon becomes impaired and the extremities show some stiffness in motion.  There is great weakness of the muscles and it is most marked, where the trembling is most developed.  There is no expression on the face, and the person has a slow and measured speech.  The walk is very peculiar, and in attempting to walk the steps are short and hurried.  The steps gradually become faster and faster, while the body is bent forward and the patient must keep on going faster to keep from falling.  It is difficult to go around in a short circle.  The patient cannot change his position in bed easily.  The mind is rarely affected.

Recovery.—­It is an incurable disease.  It may run on for twenty years or more.  There may be times of improvement, but the tendency is to grow, gradually worse.

Physicians’ treatment for Shaking Palsy.—­This is simply to make the patient as comfortable as possible.  Regulate the diet.  The patient should not worry or have much exercise.  Frequent warm baths are sometimes beneficial with gentle massage of the muscles.

Aphasia.—­A partial or total inability to express thoughts in words or to interpret perceptions.

Varieties.—­Motor and sensory aphasia.

Causes.—­Softening of the brain, tumors of the brain, lesions in syphilis especially, hemorrhage in the brain, blows on the head, and inflammation of the brain and its covering.