Observations placeholder

As described in Illustrations Of The Influence Of The Mind Upon The Body In Health And Disease, Designed To Elucidate The Action Of The Imagination - Daniel Hack Tuke, M.D., M.R.C.P.,

PART II. THE EMOTIONS.
CHAPTER VIII. INFLUENCE OF THE EMOTIONS UPON THE VOLUNTARY MUSCLES.
SECTION III.— Loss of Muscular Power : Paralysis.

Francoise Classin, aged 28, possessing a strong constitution and married. Two years ago she had a violent altercation with her husband, and being herself in a great passion, she lost her speech. She became unable to walk or support herself, or eat without assistance.

At the end of six months her speech had gradually returned, and she could walk a little and grasp large objects. She has subsequently recovered some power over her muscles, but has great difficulty in turning over the pages of a book, and in walking she is obliged to seek some support. She has never experienced any pain; with the exception of amenorrhea, the bodily functions are healthy (Annales Medico-Psychologiques. Edited by Baillarger, Cerise, et Longet, 1859, p. 451).

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PART III. THE WILL.
CHAPTER XIV. INFLUENCE OF THE WILL UPON SENSATION, THE VOLUNTARY AND INVOLUNTARY MUSCLES, AND THE ORGANIC FUNCTIONS.
SECTION II.— Influence of the Will upon the Voluntary Muscles.

" A widow, set. 50, who had already passed through two apoplectic attacks, causing loss of speech and paralysis of the left side, the former occurring after violent vexation. The face of the patient was perfectly smooth, without either furrow or expression. All the muscles of the face were deprived of voluntary movement. She was neither able to contract her forehead nor her eyebrows, to raise the nostrils, nor to move her cheek and chin. She was incapable of closing the eyelids ; when required to do it, she used her finger or looked on the ground, by which the eyeball was directed downwards ; the levator tarsi relaxed in its contraction, and the upper eyelid also moved downwards. On the other hand, she was not able to raise or close her lips, so that the mouth was constantly opened slightly, and the saliva ran out, rendering it necessary for the patient to be constantly wiping her lip. The lower jaw was movable, the patient was able to open her mouth and chew ; but even these movements were not quite of a healthy character, for she was unable to open the mouth wide, and she was equally incapable of performing rapid movements of the lower jaw upon the upper jaw.

The tongue did not obey the Will in the least; she was neither able to protrude it between the teeth, nor to move it backwards or to the sides ; it lay in the mouth like a wedge, and rendered voluntary deglutition and mastication almost impossible. The sense of taste, as well as tactile sensation, were unimpaired, both in the tongue and throughout the surface of the face. Speech was impeded, but there was not complete aphonia, for the patient was able to utter an inarticulate sound, but it was out of her power to modulate its pitch.

The sound was not a distinct vowel, but something like ang or ong, for even when the mouth was wide open she was unable to say a distinctly, much less to articulate any other vowel.

On the other hand, while the Will could not influence the contraction of these muscles, their action was excited by direct or reflected stimulation, if we may call emotional excitement direct, and that which arose from without, reflected. A ludicrous idea — an internal excitor — at once excited the muscles employed in laughter.

The patient smiled and laughed, passing through all the shades of the movement without any difficulty, and at the same time the lips, cheeks, and nostrils went through the same movements which a healthy person can perform, but over which our patient had no control. They were as little induced by any external stimulus, as pricking or pinching the cheek. When she laughed, she was also able to produce other sounds besides those mentioned. These sounds were also inarticulate, but still they varied in their elevation according to the character of the emotion that caused the laugh, a circumstance not otherwise observed. But it became evident how little these sounds were under the voluntary control of the patient when she laughed violently ; she then uttered a peculiar, grunting, animal sound, of which she was in a measure ashamed, and would willingly have suppressed. She therefore tried to shorten it as much as possible ; however, the sound continued even after the movements of laughter had ceased, at a time when in a healthy individual no further sound would have been emitted" (abridged from A Manual of the Nervous Diseases of Man. By M. H. Romberg, M.D. Translated for the Sydendam Society by Dr. Sieveking. 2 vols. 1853, II, p. 278).

This patient subsequently died of cholera, and a post-mortem examination disclosed a haemorrhagic cyst, the size of a small walnut, at the external edge of the right hemisphere, at the junction of the anterior and middle lobes.