76 PHILOSOPHICAL TRANSACTIONS. [ANNO 1797. 



may appear to many who have not seen similar affections of other muscles, that the 

 present opinion is rather theoretical than practical ; it will therefore be satisfactory 

 to illustrate this disease in the muscles of the eye, by examples of the same kind of 

 morbid action in other muscles, more within the reach of common observation. 

 The following instances all refer to the muscles of the fore-arm and hand, employed 

 in actions with which every one is familiar, and show that these muscles are liable 

 to be affected in the same manner as the muscles of the eye. 



A gentleman, 46 years of age, naturally of an irritable habit, which had been 

 much increased by a long residence in the East Indies, was, about 8 years ago, in 

 a situation of great responsibility in that country. He was much engaged in writing, 

 and previous to the sailing of a vessel for England, had, with a view to finish some 

 dispatches of importance, written incessantly for a great many hours; the immediate 

 effects of this exertion were simply fatigue, and stiffness in the muscles ; but when 

 he again attempted to employ the muscles in that action, he felt a nervous pain in 

 the fore-arm, which was so severe as to oblige him to desist. This pain gave him 

 considerable alarm, from the notion of its being of a paralytic nature, and many at- 

 tempts were made to remove it. Recourse was had to electricity, and several other 

 stimulating applications ; but these always aggravated the symptoms, and they still 

 continue. The circumstance in this case which is peculiarly applicable to my pre- 

 sent purpose is, that the pain is only felt in the act of writing, the common mo- 

 tions of the fingers and thumb not giving the smallest uneasiness. 



A gentleman about 40 years age, of a very irritable constitution, who had been 

 in the habit of dealing cards for whole evenings together, was engaged in this em- 

 ployment one night for 6 hours ; the weather was very warm, and he walked home 

 in a state of perspiration, and went to bed. The window of his apartment, which 

 faced the north, and was directly opposite to the foot of the bed, had been left open ; 

 the bed curtains were also undrawn. In the course of the night there was a sudden 

 change in the weather from hot to cold, and the wind having shifted to the north, 

 blew directly on his right arm, which was accidentally exposed. In the morning 

 when he awoke his arm was in a very uneasy state. This however went off; but 

 there was a pain in the muscles situated between the thumb and fore-finger, and 

 those of the fore-arm, which continued, and gave him great uneasiness. As it was 

 supposed to be paralytic, blisters were applied to the origin of the nerves at the 

 shoulder, and a visit to Bath was agreed on as a necessary measure. The effects of 

 the blister rather increased the complaint, which raised a doubt about its nature ; 

 and I found, on a careful investigation, that particular muscles only were affected, 

 which suggested an inquiry into the use that had been made of them. This in- 

 quiry led to a discovery of the real nature of the complaint, as only those muscles 

 used in dealing cards were particularly affected. They were not in pain while at 

 rest, but were unable to bear the least action without considerable uneasiness. This 

 was greater at some times, than others; and though a year has now elapsed since the 

 complaint came on, it is not entirely removed. 



