Handbook of insanity for practitioners and students . DISORDERS OF ARTICULATION. 273 Numerous bodily disturbances also occur, usually at thesame time as the psychical symptoms, sometimes earlier,but also often later. They belong to the entire clinicalhistory, but for the sake of clearness must be describedseparately. Speech and voice are first affected. Articulation is in-terfered with by tremor and irregular twitchings of themuscles of the face, lips, and tongue. The tremor beginsgenerally near the naso-labial fold and in the upper originally fibrillary twitchings are seen more dis-ti
Handbook of insanity for practitioners and students . DISORDERS OF ARTICULATION. 273 Numerous bodily disturbances also occur, usually at thesame time as the psychical symptoms, sometimes earlier,but also often later. They belong to the entire clinicalhistory, but for the sake of clearness must be describedseparately. Speech and voice are first affected. Articulation is in-terfered with by tremor and irregular twitchings of themuscles of the face, lips, and tongue. The tremor beginsgenerally near the naso-labial fold and in the upper originally fibrillary twitchings are seen more dis-tinctly when the patient is excited or begins to a few words have been spoken, the twitching disap-pears for a few minutes. In connection with other sus-picious symptoms, it may permit a very early diagnosis,as it is rare in other psychoses. It is seen occasionally inmelancholia, more often in neurasthenia, and may also bea prodrome of bulbar paralysis. Notable differences in the innervation of the facialnerves may be found at an early per
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