§ 168. F. Rheumatismus paralyticus.

This rheumatism affects the motor nerves only, and is without pain or swelling. It affects principally the muscles of the face, and those of the extremities, and sets in suddenly, without any precursory symptoms.

The facial muscles are strikingly distorted; the mouth and frequently the eyelid on the affected side droop, and inasmuch as the muscles of this side do not counterbalance those of the opposite side of the face, the mouth is constantly drawn to this side, in laughing, talking, etc. Mastication is more or less impeded, the saliva flows from the half-opened mouth, the tongue is frequently involved, and can only be put out of the mouth on the sound side, the eyelids are generally open, and cannot be closed except with the finger, and then they remain so. The affected parts feel cold and more or less insensible to the patients, although they have the usual temperature to others. If the extremities should be affected, it is generally the lower, and usually both together, they become stiff, immoveable, more or less insensible, without change of shape or temperature. Sometimes a painful creeping and formication is experienced for some hours before the attack sets in. If the upper limbs should be affected, the breathing is generally impeded. There is scarcely ever any fever.

The disease cannot well be confounded with apoplexy, inasmuch as the functions of the brain and senses remain undisturbed, and the patient feels otherwise well.

This rheumatism is generally caused by exposure to cold water or a current of air.

The rheumatic lameness of the facial muscles is generally without danger; that of the extremities may change to actual paralysis, or, by invading the central portions of the nervous system, may terminate in nervous apoplexy. When the upper extremities are affected, the pectoral muscles may become paralyzed, in consequence of which the respiration may stop.

§ 169. This affection is principally cured by Nux vom., Bellad., Rhus t., Caust, Graph., Secale corn.

Nux vom. has cured many cases of paralysis, particularly of the facial muscles, when a painless drawing, jerking, and formication were experienced in the affected part. Motion is restored very gradually. Nux v. is likewise useful in paralysis of the lower extremities, with or without pain in the vertebral column.

Belladonna corresponds to paralysis of the facial muscles, when the tongue is involved and the speech impeded in consequence. Rhus t. is eminently useful in catarrhal affections with perspiring skin, and particularly in rheumatic paralysis of the extremities. Se-cale cornutum deserves great attention in this affection, and Plumbum likewise, particularly in paralysis of the eyelids. For further details we refer the reader to the article "Paralysis."