Diseases of the nervous system / edited by Archibald Church.

Date:
1908
Catalogue details

Licence: In copyright

Credit: Diseases of the nervous system / edited by Archibald Church. Source: Wellcome Collection.

    1200/1256 (page 1158)
    suffered from numbness in the little finger and in the ball of the member; there were no spastic symptoms, but, on the other hand, there was slight tremor, Meige observed the same symptoms in an engraver; Stephan reports occupation neurosis in diamond cutters. The same symptoms are common in persons who fold paper as an occupation. One of my patients who held the paper firmly with the left hand while he used the folder with the right hand complained of pain in the left elbow joint, thence radiating to the neck and region of the ear; in the right hand there was paresthesia. As he formerly suffered from neuralgia paraesthetica this is interesting in a patho- genetic sense. In paper sorters I have seen paresthesia; others have reported this in addition to spastic symptoms in money counters. Occupation neuroses have been reported in watchmakers. T. Cohn re- ported spasm of the orbicularis in a watchmaker; Oppenheim reports spasm of accommodation; similar conditions have been noted after the prolonged use of the microscope. A drill-ocular muscle spasm (spasmodic position of the ej^es to the right upon rotation of the head to the right) is reported by Franjen. Oppenheim regards the nystagmus of miners as belonging to this category. The occupation spasms of seamstresses, tailors and cobblers affect the small muscles of the hand. Here sometimes the question of tetany may arise. The objective signs of the latter affection, especially Trousseau’s sign, and the characteristic increase of electric contractility, will permit a differen- tiation. Oppenheim has reported 2 cases of barber’s spasm. This consisted of spasmodic tension of the muscles of the hand and fingers, occurring in barbers upon any attempt at using the razor in shaving. Painful and spasmodic conditions appear in the muscles of the upper arm in connection with the labor of lock-smiths, black-smiths, tin-smiths and car- penters. Duchenne reports the case of a tailor whose arm was rotated inward by contraction of the subscapularis; a fencing master had the rapier rotated inward, at the same time presenting extension of the forearm. In the course of this article I have several times pointed out that it is necessary to discriminate between professional pareses and professional neu- roses. There are, however, cases in which, in addition to spasmodic and neuralgic symptoms, atrophic paresis is added. It has been known for a long time that in milkers spasmodic symptoms appear (milker’s cramp) : there is painful spasm in the flexors of the hand and fingers upon any at- tempt at milking, sometimes associated with vasomotor, irritative symptoms. In the cases reported by Remak, Stephan, Bernhardt, and myself, there were, however; in addition, degenerative-neuritic symptoms. Remak insists upon the great importance of this fact in the consideration of some of the varieties of occupation spasm, as it lends support to the view that they originate from peripheral, irritative conditions and are maintained by these. Similar symp- toms have been observed in cigar-makers. Wood-sawer’s cramp also belongs to the occupation spasms. B. Frankel reports a professional neurosis of the voice (mogiphonia). In analogy with writer’s cramp he differentiates three varieties, spastic, tremor, and painful fatigue. The voice refuses to act in the professional empWment; the laryngoscopic examination reveals normal conditions.