Strange as it may appear, these contractions, which cannot be
controlled by the will during wakefulness, are very much lessened or
arrested by sleep.

Prior to the development of the spasmodic affection, there is usually a
period in which the sufferer notes a want of appetite, languidness, with
disinclination towards mental or bodily pursuits, headache,
restlessness, pains in the limbs and joints, with irritable temper and
weakness of memory. There are many other symptoms in special cases. As
the disease develops, the patient gradually begins to exhibit an
awkwardness of movement in the extremities, and objects frequently fall
from the grasp. Children thus afflicted, spill their food while eating,
and it becomes difficult for them to stand still. Attempts to write,
sew, or draw are imperfectly performed. Such children are very often
punished for supposed ill-behavior or careless habits. Later on the
symptoms become more unmistakable, and the presence of the disease is
readily recognized. The patient may become incapable of dressing, and
the limbs and face are no longer under the control of the will.
Uncontrollable movements of the fingers, hands, shrugging of the
shoulders, dancing of the legs, grimaces of the face, and distortions of
the body, become more or less constant. Speech and swallowing may be
seriously embarrassed. Any unusual excitement of the mind or body is apt
to intensify the muscular twitchings. Severe mental application, the
reading of exciting books, the witnessing of entertainments, and
excessive indulgence in sports, have to be discontinued.

THE MOST COMMON CAUSES seem to be exhaustion of the nerve centres, due
to the appearance of the second teeth in children and the development
common to the age of puberty. Other causes may be briefly mentioned as
follows: rheumatic affections, constipation, a morbid state of the
blood, suppression of the menstrual function, uterine difficulties,
masturbation, or self-abuse, blows, injuries, or any cause which would
give rise to nervous debility. Sometimes it is caused by obstruction in
the alimentary canal, or by intestinal worms.

TREATMENT. The disease is one in which there is a debility of the nerve
centres, complicated with a lack of assimilation and digestion. There is
no affection more amenable to treatment in its early stages than this.
We are daily in receipt of correspondence from sufferers, or their
parents, or friends, in which the most gratifying r