CHOREA, 121 



occasional consequence of distemper that has been unusually severe or 

 imperfectly treated, and sometimes it is seen even after that disease has 

 existed in its mildest form. 



It first appears in one leg or shoulder, and is long, or perhaps entirely, 

 confined to that limb. There is a singular spasmodic jerking action of the 

 limb. It looks like a series of pulsations, and averages from forty to sixty 

 in a minute. Oftener, perhaps, than otherwise, both legs are similarly 

 affected. When the animal is lying down, the legs are convulsed in the 

 way that I have described, and when he stands there is a pulsating depres- 

 sion or sinking of the head and neck. In some cases, the muscles of the 

 neck are the principal seat of the disease, or some muscle of the face ; the 

 temporal muscle beating like an artery ; the masseter opening and closing 

 the mouth, the muscles of the eyelid, and, in a few cases, those of the eye 

 itself being affected. These convulsive movements generally, yet not 

 uniformly, cease during sleep, but that sleep is often very much disturbed. 

 If the case is neglected, and the dog is in a debilitated state, this spasmodic 

 action steals over the whole frame, and he lies extended with every limb 

 in constant and spasmodic action. 



In the majority of cases, such an expenditure of nervous and muscular 

 power slowly destroys the strength of the animal, and he dies a mere 

 skeleton ; or the disease assumes the character of epilepsy, or it quiets 

 down into true palsy. 



In the most favourable cases, no curative means having been used, the 

 dog regains his flesh and general strength ; but the chorea continues, the 

 spasmodic action, however, being much lessened. At other times, it seems 

 to have disappeared ; but it is ready to return when the animal is excited 

 or attacked by other disease. In a variety of instances, there is the irri- 

 table temper which accompanies chorea in the human being, and most 

 certainly when the disease has been extensive and confirmed. 



Chorea, neglected or improperly treated, or too frequently pursuing its 

 natural course, degenerates into paralysis agitans. There is a tremulous or 

 violent motion of almost every limb. The spasms are not relaxed, but are 

 even increased during sleep, and when the animal awakes, he rises with 

 agitation and alarm. There is not a limb under the perfect control of the 

 will ; there is not a moment's respite ; the constitution soon sinks, and the 

 animal dies. No person should be induced to undertake the cure of such 

 a case : the owner should be persuaded to permit a speedy termination to 

 a life which no skill can render comfortable. 



Chorea is oftenest observed in young dogs, and especially after dis- 

 temper ; and it seems to depend on a certain degree of primary or sympa- 

 thetic inflammatory affection of the brain. 



Chorea is often very plainly a consequence of debility : either the 

 distribution of nervous power is irregular, or the muscles have lost their 

 power of being readily acted upon, or have acquired a state of morbid 

 irritability. The latter is the most frequent state. Their action is irre- 

 gular and spasmodic, and it resembles the struggles of expiring nature far 

 more than the great and uniform action of health. It is not the chorea 

 that used to be described, in which there was an irresistible impulse to ex- 

 cessive action, and which was best combated by complete muscular ex- 

 haustion ; but the foundation of this disease is palpable debility. 



In the treatment of chorea there must be no bleeding, no excessive 

 purgation, but aperients or alteratives, merely sufficient to keep the faeces 



