Chorea or as it is more commonly called, St. Vitus' dance, is a spasmodic affection generally accepted as purely nervous.

The causation is obscure. Worms have been assigned, but the evidence is insufficient. Great mental excitement, fear, and anger might induce the • disease. It very commonly follows distemper. It is characterized by irregular contractions or twitching of certain muscles, movements which the animal has no power to control. The affection may be extensive, involving several parts of the body, but it is more generally confined to one set of muscles, the head or a limb.

Treatment

The disease is exceedingly obstinate, and recovery is by no means certain. The purpose should be to remove if possible all morbid states of the body which may tend to aggravate the disease, such as constipation, indigestion, worms, debility, etc. To sustain the general strength and improve the vigor of the nervous system by tonics, nutritious diet, and every influence conducive to perfect health.

A diversity of remedies have been advised by different authors as a cure for this disease. Doubtless the most serviceable drugs are strychnine and arsenic; the preference given to the former. It should be commenced early in the affection and may be given as follows. -

℞ Strychniae Sulph. gr. ij Aquae ℥ i.

Ft. Mist. Sig. Dose three drops twice a day. The dose should be increased one drop daily until the physiological effects of the strychnia are observed, as evinced by a stiffening of the legs or neck. When this occurs the dose should be at once reduced to three drops, and increased again as before. It will not do to make the giving of this medicine a matter of convenience; it must be faithfully and regularly administered, and its action carefully watched. If no decided improvement follows the use of strychnine after a reasonable quantity has been given, arsenic should be substituted. The most convenient preparation is Fowler's solution and of this four drops can be given twice daily, and increased one drop every two or three days until the specific effects of the medicine are produced when it must at once be discontinued. These are puffiness about the eyelids, loss of appetite, a disturbed digestion, occasionally a falling out of the hair, and salivation. If it is deemed wise to add iron to the arsenic, one half an ounce of the ferri et ammonias citratis can be mixed with an ounce of Fowler's solution. The dose of this preparation is three drops. If the bowels are constipated, the syrup of buckthorn should be given as needed to promote a free action. In exercise, fatigue should be avoided. The use of the nerve tonics, strychnine or arsenic should be prolonged even after the chorea has disappeared, and when they are discontinued, cod liver oil in tablespoonful doses should be substituted, and persisted in until perfect health is restored.