The patient was a woman æt. 24, with alcoholic and neuropathic taint in ancestry; she suffered in childhood from general choreiform tremors, which gradually disappeared before puberty. Always odd in disposition, as she grew older she appeared more unstable and eccentric; she developed homosexual tendencies, and became addicted to drinking. At twenty-three years of age she came under treatment for persecutory delirium, with suicidal ideas and refusal of food. After a short period of improvement she was readmitted with the same mental symptoms, which were associated with ordinary hysterical stigmata. She now presented, in addition, anomalous muscular phenomena combining the characters of myoclonus, electrical chorea, convulsive tic (Charcot), and fibrillary chorea (Morvan). She remained huddled up in a state of general flexion; the upper limbs and right leg were agitated by constant, rapid, synchronous tremors; the shoulders were jerked up and down in movements of wider range; from time to time rapid fibrillar contractions ran along some of the larger muscles; occasionally one or more muscles passed into tetanoid spasm. The muscles of the face showed no clonic movements, they were occasionally contracted in a grin of pain. Emotion and effort increased the spasmodic symptoms; they ceased during sleep.
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