. A treatise on nervous and mental diseases, for students and practitioners of medicine. quently altered in consequence ofthe muscular movements of the buccal cavity, pharynx, and re-spiratory diaphragmatic muscles. This alteration imparts to thespeech a nasal, confused, obstructed, and sticky articulation. Theexternal muscles of the eye are not often affected. Although mostof the muscles of the body are affected, nevertheless individual casesvary in the predomiuauce of certain muscles, so that in some theextremities may be most implicated, in others the face, respiration,and deglutition ; whi
. A treatise on nervous and mental diseases, for students and practitioners of medicine. quently altered in consequence ofthe muscular movements of the buccal cavity, pharynx, and re-spiratory diaphragmatic muscles. This alteration imparts to thespeech a nasal, confused, obstructed, and sticky articulation. Theexternal muscles of the eye are not often affected. Although mostof the muscles of the body are affected, nevertheless individual casesvary in the predomiuauce of certain muscles, so that in some theextremities may be most implicated, in others the face, respiration,and deglutition ; whilst in others again there is a hemiplegic distribu-tion, or the lower extremities are imphcated. There is seldom anyimpairment of sensation, and when there is, it is only some slight 332 NERVOUS DISEASES. dulness of perception of painful sensations, which is probably dueto the mental enfeeblenicnt. The special senses are not is nsually marked incoordination, evidently dependent uponthe movements, so that the patient brings tiie forefinger to the nose Fig. 152. Fig. Photograph of a case of Huntingtonschorea. One attitude. Photograph of a case of Huntington;chorea. One attitude. in a series of zigzags and fails to hit the mark, or cannot walk astraight line, etc. There is no alteration in the response of nervesand muscles to either the galvanic or faradic currents. The sym-pathetic nervous system is not affected, nor the bladder or rectum,except in a very advanced stage. The urine is unaltered. There is DISEASES OF THE CEREBRUM. 333 almost invariably some mental impairment, generally consistiug ofslight and progressive dementia, which may pass on to absolutedementia. Memory is generally enfeebled. At the onset there isapt to be a great tendency to depression, although this is not a truemelancholia, but rather a depression of spirits, partly due to the dis-ease itself—more largely, I think, to the fact that this disease is knoM-nto be hereditary and is looked
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