
The hands are kept rolling-first the palms upward, and then the backs. If the patient attempt to protrude the tongue it is accomplished with a great deal of difficulty and uncertainty. All the voluntary muscles are liable to be affected, those of the face rarely being exempted. The upper extremities may be the first affected, or both simultaneously. The eyelids are kept winking, the brows are corrugated, and then elevated, the nose is screwed first to the one side and then to the other, and the mouth is drawn in various directions, giving the patient the most ludicrous appearance imaginable. The disease commonly begins by slight twitchings in the muscles of the face, which gradually increase in violence and variety. There is no loss of sense or of volition attending these contractions, as there is in epilepsy the will is there, but its power to perform is deficient, the desired movements are after a manner performed, but there seems to exist some hidden power, something that is playing tricks, as it were, upon the will, and in a measure thwarting and perverting its designs and after the will has ceased to exert its power in any given direction, taking things into its own hands, and keeping the poor victim in a continual jigger as long as he remains awake, generally, though not always, granting a respite during sleep. Its most marked and characteristic feature is a clonic spasm affecting the voluntary muscles.

The disease, as it is commonly seen, is by no means a dangerous or serious affection, however distressing it may be to the one suffering from it, or to his friends. The name "chorea" is given to the disease on account of the dancing propensities of those who are affected by it, and it is a very appropriate designation.

Essay read before the Meigs and Mason Academy of Medicine at Middleport, Ohio, February 15, 1872.Ĭhorea is essentially a disease of the nervous system.
