nds against the fore part of his shoulders. His words are now
scarcely intelligible; and he is not only no longer able to feed
himself, but when the food is conveyed to the mouth, so much are the
actions of the muscles of the tongue, pharynx, &c. impeded by impaired
action and perpetual agitation, that the food is with difficulty
retained in the mouth until masticated; and then as difficultly
swallowed. Now also, from the same cause, another very unpleasant
circumstance occurs: the saliva fails of being directed to the back
part of the fauces, and hence is continually draining from the mouth,
mixed with the particles of food, which he is no longer able to clear
from the inside of the mouth.

As the debility increases and the influence of the will over the
muscles fades away, the tremulous agitation becomes more vehement. It
now seldom leaves him for a moment; but even when exhausted nature
seizes a small portion of sleep, the motion becomes so violent as not
only to shake the bed-hangings, but even the floor and sashes of the
room. The chin is now almost immoveably bent down upon the sternum.
The slops with which he is attempted to be fed, with the saliva, are
continually trickling from the mouth. The power of articulation is
lost. The urine and faeces are passed involuntarily; and at the last,
constant sleepiness, with slight delirium, and other marks of extreme
exhaustion, announce the wished-for release.

CASE I.

Almost every circumstance noted in the preceding description, was
observed in a case which occurred several years back, and which, from
the particular symptoms which manifested themselves in its progress;
from the little knowledge of its nature, acknowledged to be possessed
by the physician who attended; and from the mode of its termination;
excited an eager wish to acquire some further knowledge of its nature
and cause.

The subject of this case was a man rather more than fifty years of
age, who had industriously followed the business of a gardener,
leading a life of remarkable temperance and sobriety. The commencement
of the malady was first manifested by a slight trembling of the left
hand and arm, a circumstance which he was disposed to attribute to his
having been engaged for several days in a kind of employment requiring
considerable exertion of that limb. Although repeatedly questioned, he
could recollect no other circumstance which he could consider as
having b