Trousseau's lectures

Opening showing the beginning of Lecture XV, Senile trembling and paralysis agitansThe French clinician Armand Trousseau (1801-67) held the shaking palsy to be:

a singular neurosis … a strange form of chorea, which is so inappropriately termed paralysis agitans, since there are cases…in which the muscular power, tested by the dynamometer, is, temporarily at least, greater on the shaking than on the opposite side.

He reconciled the progressive slowing of bodily movements with the absence of true weakness or paralysis by analogising the problem to a leaking steam engine, which, as it pulls its load, runs low on steam, losing power and slowing; when it has rested and pressure has once again built up, it can resume activity at full power.

The passage which explores the disease starts in the opening reproduced here.    

Trousseau believed that the condition could be caused by psychological shock. He cited the case of a patient who had been terrified when accidentally caught up in the bombardment of Vienna in 1848. The man had immediately begun to shake, which progressively spread to other limbs and never left him.

Trousseau noticed what are now referred to as ‘non-motor’ features of the condition, such as increased perspiration. He was the first to describe the associated rigidity: ‘muscles which are the seat of the trembling are rigid at the same time, especially the muscles of the neck and the shoulders.’

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