SCRIVENERS' SPASM MOGIGRAPHIA. 



355 



CHAPTER XVII. 



SCEIVENEES' SPASM MOGIGRAPHIA. 



ETIOLOGY. The term scriveners' spasm is employed to denote a mor- 

 bid excitement of the motor fibres of the nerves which supply the muscles 

 of the figers, and which renders further writing impossible, by inducing 

 spasmodic contraction of the muscles to which they belong. If such 

 spasms are provoked by other kinds of manipulation, and not by writing, 

 for instance, by shoemaking or by milking, they receive other names, such 

 as " cobblers' " or " milkers' spasm." Numerous as are the hypotheses 

 as to its origin, we know nothing positive as to the pathogeny of this 

 disease, which is not at all uncommon, and which often deprives the 

 individual afflicted of his means of subsistence. The theory of Fritz 

 is in some respects satisfactory. He regards it as a reflex neurosis, in 

 which, however, excitement of the motor nerves is not derived from 

 the cutaneous nerves, as in most reflex neuroses, but proceeds from the 

 muscular nerves. The observation that the touch of a feather or paper 

 is not of itself sufficient to excite the cramp, although holding the 

 hand in the attitude of writing, even though it touch neither pen nor 

 paper, will do so, argues in favor of this view. The theory is equally 

 probable, however, that the morbid irritation is not reflected from the 

 sensory to the motor nerves, but proceeds from transmission of the im- 

 pression of the nerves excited by the will to other motor nerves. 

 Scriveners' cramp would then resemble the convulsive movements of 

 chorea, and stammering, and the movements which disturb the writer 

 would have to be regarded as sympathetic movements. 



With regard to its etiology, it is to be observed that the affection 

 is much more common among men than among women, in whom it 

 has only been observed occasionally. Will it not turn out upon ex- 

 amination that, just as in many other diseases (although perhaps less 

 strikingly so), the apparent difference of tendency to the disease in the 

 two sexes is really due to a difference of habit and occupation ? Wri- 

 ters' cramp is most liable to occur between the ages of thirty and fifty 

 years, that is, during the time of life when occupation is most intense. 

 Professional penmen, clerks, teachers, and merchants are most subject 

 to the affection. Narrow coat-sleeves, which compress the muscles of 

 the arm during writing, an inconvenient attitude, but, above all (since 

 scriveners' spasm has only come into notice since the introduction of 

 steel pens), the use of a hard steel pen seems to favor the devel- 

 opment of the affection. Why the disease should develop under these 

 causes alone is unknown. 



SYMPTOMS ANT> COURSE. The usual precursory signs of writers' 



