432 GENERAL NEUROSES, OF UNKNOWN ANATOMICAL ORIGIN. 



drawn down, the arm raised from the thorax, the forearm flexed. 

 If the lower limbs are affected, the rigidity may resemble paraplegia 

 with contractions. There may be various anomalies of sensation, 

 such as numbness, prickling, neuralgia, anaesthesia, heat, etc., and 

 cerebral symptoms, such as headache, dizziness, sleeplessness, etc. 



The disease may drag along for -years, death at last resulting 

 from age, debility, or some intercurrent disease. The autopsies 

 made have proved nothing about the seat of the disease or the an- 

 atomical changes causing it ; their results have been so varied that 

 it is not even certain whether the original seat of the disease be in 

 the brain or spine. 



Senile tremor, or that of very excitable persons, is less marked 

 than that of paralysis agitans. That due to poisoning by alcohol, 

 lead, or mercury is accompanied by other symptoms of poisoning ; 

 but it may be mistaken for multiple sclerosis, although this comes 

 earlier in life, and paresis appears as one of its first symptoms, and 

 the tremor usually comes only when the patient tries to execute 

 some movement. 



Although some recent cases have seemed to recover, this must 

 be considered as spontaneous rather than as a triumph of medicine; 

 in some of the cases there may have been an error of diagnosis. 

 Among the remedies said to have proved beneficial are hyoscyamus, 

 hypodermic injection of small doses of Fowler's solution, continued 

 use of carbonate of iron, cold douches while in a warm bath, gal- 

 vanism, etc.] 



[CHAPTER IX. 



DELIRIUM TREMENS MANIA A POTU. 



THE name delirium tremens is used even by the laity, and un- 

 fortunately it is so common that the symptoms which characterize it 

 are very generally known. Frequent as is this affection, the opin- 

 ions as to its immediate cause are not unanimous. Some believe 

 that it is the direct result of the abuse of alcoholics, while others 

 say that it is due to their sudden withdrawal. It is not improb- 

 able that it may be caused either way ; perhaps the worst cases are 

 those that come on during the use of liquors; those that result from 

 the patient's inability to obtain liquor, from having a broken leg or 

 some acute disease, or from being locked up, have seemed to us to 

 run a much lighter course than the former. Possibly the long-con- 

 tinued use of alcohol may induce such a state in the gastric mucous 

 membrane that it will absorb neither liquor nor nourishment ; this 



