124 .' PHYSICAL EXPRESSION. 



appeared to indicate the use of bromides and other 

 sedatives ; and this plan of treatment was generally 

 adopted, tonics being occasionally used, together 

 with small doses of chloral at night for short periods, 

 till the habit o sleep was induced. Under treat- 

 ment, marked improvement occurred in many cases, 

 the child gaining one or two pounds in weight in 

 a month or six weeks, at the same time losing the 

 headaches, sleeping quietly at night, and again 

 becoming fit for a child's school-life. 



Dr. Hughlings Jackson (Lancet, July llth, 1875) 

 has shown that, in cases of chorea, paroxysmal head- 

 aches are of common occurrence. Dr. Herman col- 

 lected the histories of seventy-six cases of chorea, 

 and found that paroxysmal headaches occurred in 

 fifty-three cases ; in these, the headaches were not 

 often preceded by ocular spectra. In the group of 

 cases described in this paper, certain active and 

 passive conditions of the muscles, especially the 

 small muscles, are commonly met with in conjunc- 

 tion with disturbance of the higher nerve-centres ; 

 this appears to afford evidence that the two con- 

 ditions may be owing to disturbance of the same 

 nerve-centres, possibly the same as are affected in 

 a greater degree in chorea. A girl, thirteen years 

 of age, came under observation, complaining of 

 frequent headaches, with ocular spectra, restless 

 nights, tooth-grinding, and slight muscular twitch - 

 ings, such as have been described. She had never 

 suffered from rheumatism, but the family were 

 rheumatic; she had no cardiac disease. Three 

 years previously, she had had acute general chorea 



