ST. VITUS DANCE (chorea): This is a nervous derangement and develops largely in those of the neurotic diathesis-- a tendency to disease of a nervous type. Osler tells us that it is often found in "abnormally bright, active-minded children belonging to families with pronounced neurotic taint."
Chorea is caused by anything that will use up the child's nervous powers and impair its health. Good general health, based on natural hygiene, is the best protection against chorea. Dr. Bendix says: "Anemic, scrofulous and debilitated children, as well as those children who have become weakened by acute or chronic disease and nutritive disturbances, are unquestionably affected by chorea more frequently than those who are robust. Therefore anaemic, chlorotic conditions, exhaustive diseases, rapid growth, improper nourishment, the influence of school and other factors, appear to be favourable media for the development of this affection."
Cases following scarlet fever, diphtheria, measles, etc., must be attributed to the suppressive drugging and the inoculations commonly employed in these conditions.
Chorea develops most frequently from the ages of seven to fifteen, although it may develop as early as two years. From seven to fifteen when the "deleterious influence of school life makes great demand on the youthful organism," it is most common.
Night-lessons or "home work" keep children's noses buried forever in their books. There is no time for play; no time to get out-doors. A child, unless he is exceptionally bright, either neglects his home work or else he neglects more important things. The mills of education grind slowly but they grind exceedingly anemic. The nervous, anemic, mentally and physically stunted products of this senseless process are unfitted for the burdens of life. Sir. Wm. Osler says:
"The strain of education, particularly in girls during the third hemidecade, is a most important factor in the etiology of this disease. Bright, intelligent, active-minded girls from the age of ten to fourteen, ambitious to do well at school, often stimulated in their efforts by teachers and parents, form a large contingent of the cases of chorea in the hospital and private practice. Sturgis has called attention to this school-made chorea as one serious evil in our modern method of forced education." ### "So frequently in children of this class does the attack of chorea date from the worry and strain incident to school examinations that the competition for prizes and places should be emphatically forbidden."
This condition is often attributed to tonsillar troubles and "rheumatic" affections. There is nothing to this however. They are not causes of the chorea.
Fear, excitement, masturbation, overfeeding, wrong feeding sugar-excess, lack of rest and sleep, undue fatigue, ghost stories, harsh treatment--"punishment"--all help to bring on nervous derangement.
SYMPTOMS: The disease manifests in all degrees, ranging from mild to severe and even manical forms. Jerky, twitching movements, restlessness, inability to keep still, and ungraceful movements in getting about are seen in mild stages.
The severe form is more distressing. The involuntary contractions of its various groups of muscles partially disable the child, which must have some help in attending to itself and its daily tasks These symptoms are all greatly exaggerated in the manical forms and the child requires constant supervision.
Pains in the limbs and joints and disturbances of the heart attest to the general impairment of the child's health. Fits of crying, loss of temper, irritability, and a general lack of mental and physical poise indicate an unbalanced "psychic" life and a profound impairment of the nervous system.
MEDICAL ABUSE: The medical abuse of these cases is appalling. Dr. Osler says: "Medical treatment of this disease is unsatisfactory; with the exception of arsenic no remedy seems to have any influence in controlling the processes of the affection." Of course, arsenic it not a remedy for anything, unless death may be regarded as a cure. Not all doctors share Osler's skepticism and they do not hesitate to dope and drug these children as long as the money and patience of the parents hold out. For instance, in his Diseases of Children, Dr. Jacobi says:
"The best remedy for mild and severe cases is arsenic. The liquor potassii arsenitis should be given three times a day after meals, amply diluted in water. The doses should be slightly increased from day to day, and may reach the double or threefold quantity; for instance, half on ounce may be mixed with one ounce of water. The initial dose of one--six drops may be seven drops, eight drops, nine drops, etc., up to fifteen or twenty or more, a drop to be added every consecutive day. If symptoms of over-dosing appear, edema of the eyelids or face, intestinal disturbance, eruptions, no increase would be allowed, or the dose slightly diminished. When no effect is attained, the dose was too small. Medicine should be given for effect or not at all. A dose of antipyrin with a bromid, or codein, will secure a good night's rest. When chorea persists in the night, rest must be enforced by chloral and a bromid. Bad cases must be made to sleep from fourteen to eighteen hours daily."
It is not Dr. Jacobi who is forced to take these dangerous drugs so freely. It is not he who has to stay in a stupor (it is not sleep) produced by chloral and bromid, fourteen to eighteen hours a day. It is not his nervous system that is wrecked by such criminal treatment. It is your child and not the doctor who is submitted to this damaging abuse. No sane doctor or parent can approve of such mad-house processes as Dr. Jacobi advises.
CARE OF THE PATIENT: The key to the proper care of these cases lies in the fact that the nervous twitching and other symptoms are seldom present during sleep. Rest in this, as in all nervous cases, is the great desideratum. The child should be put to bed and kept there until all twitchings and convulsive movements are throughly controlled.
Everything that tends to excite or disturb the child should be excluded from his environment. Noise, bright lights, quarrelsome people and other disturbing factors should not be permitted in the child's room.
When the child is put to bed, he should also be placed upon a fast. No food should be allowed for at least a week. The fast may be carried further if the child's condition warrants.
After the fast the child should be placed upon a fruit diet for from a week to ten days.
If after a week to ten days on fruit, the nervousness is overcome and the child has control over its movements a normal diet, as described in this book, may be fed to the child.
After all symptoms are overcome, exercise, sunshine, fresh air, play and outdoor life will rapidly restore the child to full health. All factors that impair health and weaken the nervous system should be corrected in the child's life. If the child is of school age, it certainly should not be re-entered in school until it is fully recovered.