coming to me. He had been labeled with a number
of interesting diagnoses, such as chorea, epilepsy, myotonia, hysteria,
and neurasthenia. His palmodic movements were very curious. When
standing near a table looking at something, the chin would suddenly
come down with a thump that would leave a black-and-blue mark, or his
head would be thrown violently to one side, perhaps coming in contact
with some adjacent hard object with equal force, or, while standing
quietly, his legs would give a sudden twitch, and he would be thrown
violently to the ground, and this even happened several times when he
was seated on the edge of a stool. The child was under my care for two
weeks, and, probably because of an intercurrent attack of diarrhea,
grew steadily worse during that time, in spite of the full doses of
arsenic which were administered to him. He was literally covered with
bruises from the sudden and violent contacts with articles of
furniture, the floor, and the walls. At last, in despair at his
condition, I ordered him to be undressed and put to bed, and steadily
pushed the Fowler's solution of arsenic until he was taking ten drops
three times a day, when, to my great surprise, he began to improve
rapidly, and at the end of six weeks was perfectly well. Keeping him
under observation for two weeks longer I finally sent him to his home
in the West, and am informed that he has since remained perfectly well.
It has seemed to me that many of the cases recorded as paramyoclonus
multiples have been really acute palmus."

Gray mentions two cases of general palmus with pseudomelancholia, and
describes them in the following words:--

"The muscular movements are of the usual sudden, shock-like type, and
of the same extent as in what I have ventured to call the general form.
With them, however, there is associated a curious pseudomelancholia,
consisting of certain fixed melancholy suspicious delusions, without,
however, any of the suicidal tendencies and abnormal sensations up and
down the back of the head, neck, or spine, or the sleeplessness, which
are characteristic of most cases of true melancholia. In both of my
cases the palmus had existed for a long period, the exact limits of
which, however, I could not determine, because the patient scouted the
idea that he had had any trouble of the kind, but which the testimony
of friends and relatives seemed to vouch for. They were both men, one
thirty-six and one thirty-eight years of ag