IDIOPATHIC CRAMP. 357 



treatment proposed by Benedict, by which he has obtained some suo 

 cess, and which consists in the application of " spinal-root, and spinal 

 nerve-streams," has utterly failed in my hands ; and in one or two 

 cases it has aggravated the disease. If the pathogeny of scriveners' 

 spasm be really as I have suggested above, my treatment of it was an 

 entirely rational one, although I myself was not aware of it at the 

 time. I applied the current to the muscle of the thumb and index- 

 finger, and hence to the sensory muscular nerves running into them : 

 thus if the explanation be correct, the cure would be accounted for by 

 an abatement of the morbid nutritive state, and of the morbid exci- 

 tability of the sensory nerves of the muscles, from whose reflex action 

 the cramp proceeds, by the catalytic action of the constant current. 

 Sometimes apparatus, by means of which the patient writes without the 

 aid of his fingers, also are of service for a while. 



CHAPTER XVIII. 



IDIOPATHIC CRAMP OP THE MUSCLES OF THE EXTREMITIES 

 ARTHROGRYPOSIS. 



ETIOLOGY. According to the example of the Frenoh authors, the 

 term idiopathic spasm (spasmes musculaires idiopathiques) is applied 

 to tonic contractions which sometimes attack the muscles of the ex- 

 tremities, without being attributable to disease of the brain or spinal 

 marrow. They are analogous to the neuralgias, but we are still less 

 able to point out the anatomical cause of this morbid condition of the 

 motor nerve, causing idiopathic muscular spasm, than to discover that 

 which acts upon the sensory nerves in neuralgia. The harmless course 

 usually taken by the disease makes it probable that idiopathic cramps 

 of the extremities are due to trifling and transient lesions of the 

 nerves and their sheaths. By many observers, these affections are 

 regarded as a form of rheumatism, and are attributed to hyperaemia 

 and oedema of the neurilemma. In some cases, this may be the truth, 

 especially in such as occur in children previously healthy. However, 

 the occurrence of idiopathic muscular spasm during the course of and 

 convalescence from acute and chronic disorders, which have an exceed- 

 ingly pernicious effect upon the assimilation and nutrition of the body, 

 and which often lead to great functional disturbance, such as typhus, 

 intermittent, Bright's disease, and epidemic diphtheritis, makes it 

 quite probable that in other instances idiopathic muscular cramps are 

 the result of derangement of the tissues, the character of which is 

 almost unknown, and which develops during the diseases above men- 

 tioned, giving rise to a great variety of functional disturbance. 



The muscular spasms which arise during pregnancy, during laboi 



