1484), which was in the market at the same time; while the collection of eleven pieces, comprising a portion of the Protector's layette, and including a cap with the words "Sweet Bab, don't cry-1599"-the date of his birth-embroidered upon it, fetched but 321. in the aggregate. The average price of these latter garments, by the way, compared most unfavorably with the value set upon the tiny shoe worn by Longman's Magazine.

the baby King of Rome, which was presented in a crystal casket, resting on a cushion of violets, "as a memento of her triumphant resurrection of L'Aiglon," to Madame Sarah Bernhardt recently, or with the small enamelled gold Masonic ring, once the property of the Hon. Miss Aldworth, née St. Leger, the only lady Freemason, which realized 121. two years last July.

Harold Macfarlane.

Craft cramp, or craft palsy, is a nervous disease "caused by handicraft or interfering with it; the body being otherwise unaffected." Dr. Vivian Poore, a well-known specialist, says (A System of Medicine, vol. viii.), there can be no reason why any occupation which involves the incessant repetition or some one action should not give rise to a "cramp" of this sort. A French scientist, Dr. Duchenne, describes these peculiar cramps or palsies as "professional impotences, whereby the patient finds himself unable to perform the particular acts by which he earns his living." In extreme cases the patient may become totally and permanently incapacitated.

Sometimes, to begin with an example not too familiar, the impotence may take the form of a strange affection of the eyes, from which miners have been known to suffer. What is called "miner's nystagmus" has been found among workers in mines both in England and in France. In walking or creeping along the narrow, low-roofed tunnel of a mine, the miner goes with his head down and his eyes strained upwards. Again, the miner engaged in getting coal by "holing," lies prone

on his side in an awkward and uneasy attitude, and his eye is turned "obliquely upwards and to one side." In both situations the strain upon the eye is extreme, and may give rise to nystagmus, when the organ of vision is thrown out of gear, so to speak, and the sight ceases to be true. Cases not wholly dissimilar are those of students or hard readers, whose eyes give out or who suffer from vertigo; of postmen worrying over ill-addressed envelopes; and of savants engaged in the terrible labor of deciphering manuscripts. Duchenne records the case of a patient of his own, a young man, who committed suicide when his eyes had refused their office of reading. Dr. Poore was consulted by a watchmaker who was "seized with a painful cramp" whenever he tried to hold his watchmaker's lens in his eye. These are instances of the failure, through fatigue, of what are called the muscles of accommodation.

Stammering, as distressing as any among the lesser disorders we are prey to, is an obvious hindrance in some callings, and would completely debar its victim from entrance into others. A stammerer in the pulpit

could seldom edify; a stammerer on the stage would be impossible. An extreme instance of stammering as a "professional impotence" is that of the auctioneer who suddenly found himself unable to say, "going, goinggone!"

As illustrations these are, however, for the most part a little out of the

common.

What is universally known as writer's cramp is the nervous disease of handicraft the doctors are best acquainted with. It is what one might almost call the current, household, or ready-made instance of craft palsy. "Cases of difficulty in writing," says Dr. Poore, "are far more common than all the other craft palsies taken together. In the past twenty-five years I have seen many hundred cases of craft palsy of one kind and another, and of these at least ninety per cent. have been cases of 'writing difficulty.'" There are patent reasons for this. Most of us are writers to some extent, and the name of the professional clerk is legion. Hence, if there were anything in the mere act of writing which was especially liable to derangement, we should expect to find that the palsy of writing, among those who use the pen for a living (I speak here of the pen as a tool and of penmanship as a clerkly calling), was not only a usual and prevalent, but a quite preponderant disease of its kind. Now, the act of writing is, in fact, exceptionally liable to derangement. It is, in the main, exceptionally liable to derangement because of the immense and extraordinary variety of muscular exertion which goes to produce the properly written word. My pen, as I write these lines, moves almost automatically, and I am conscious of no effort but the intellectual one of giving birth and form to my successive sentences. But the mother who gives the child its first lessons in writing

sees the pen clutched convulsively betwixt finger and thumb, the little legs twisted around the leg of the table, the eyes fixed, the mouth twitching, the forehead puckered; all these terrific efforts directed to the making of the first pot-hook-"almost every muscle of the body is engaged." And this conscious strain in the endeavor to write continues during years. The schoolboy, after four, five or six years in class, is still painfully "forming his hand"; and the full-blown clerk has not acquired it within a year or two's drudgery at the ledger. Some of us never write to be read, but only to be deciphered. It is to be noted that the form of muscular fatigue called writer's cramp is usually confined, or chiefly confined, to the fingers which grasp the pen. The muscles which drive it seem to be much less affected. In all occupations which involve a prolonged, habitual, and more or less incessant muscular strain, there is a liability to break down; but, as might be expected, the break-down rarely occurs in early life. The craft palsy, that is to say, is the untoward result of sticking steadily to the trade one has to live by; of sticking to it till the muscles concerned are SO completely wearied that they will no longer respond to the bidding of the brain -willy nilly, they go on strike: and the disease affects alike the highly skilled artisan, the indifferent one, and the bungler. When the craft palsy proper attacks a very young worker, some congenital defect is generally looked for.

Old women earning a little by knitting, which is a complicated process, are sometimes forced to lay their needles aside.

The professional pianist, compelled to practise many hours a day, is liable to a disabling form of wrist cramp. We may not often hear of the collapse of a Paderewski; but the humbler ar

tist, toiling heroically over the technique, and who has never done with the scales, may find some dreadful morning that the extensors of the wrist and fingers are seemingly paralyzed. It is time then to call on the doctor, even at the risk that his verdict may mean little less than professional extinction. Happily, however, for the army of small piano-players and teachers, cramp of the most seriout kind is infrequent in this calling. The manipulation of the key telegraph is a somewhat similar exercise, but one which apparently does not often lead to nervous breakdown.

The bow-arm of the violinist is apt to get cramped while the learner is going through his arduous apprenticeship; but when this is over, and the day of artistic execution has arrived, the movements of the bow-arm are so delicate as almost to preclude the possibility of strain. With the violin and 'cello it is the left hand that does the greatest amount of muscular work, and this accordingly is the hand most prone to suffer; yet the master player, a Sarasate or a Nachez, will enthral his hearers through the hours of a long recital with scarcely any consciousness of physical fatigue. What strain there is, is chiefly felt in the higher

nerve centres. Dr. Poore cites from Duchenne the case of a priest "who had a mania for playing the hautboy, and, as a consequence (as the patient thought) of excessive practicing on this instrument, he became troubled with a spasmodic contraction of the muscles of the right half of the abdomen, which came on with each inspiration for a sufficient blast. Consequently the hautboy often emitted wrong notes, which considerably astonished his congregation."

I take from the "Lancet" (June 28, 1890) an instance of the effect of bagpipe-playing on the teeth:

Mr. Macleod, at a meeting of the

Odonto-Chirurgical Society, said that, having his attention drawn to a single case, he has been led to examine the teeth of various pipers, and all of them presented "wearing away" of the cutting edges of six front teeth, in a greater or lesser degree, varying with the density of the tooth-structure and the time engaged in pipe-playing. He found on inquiry that, on the average, marked impression, but that once the it took about four years to make a wellenamel edge was worn through, the "wearing away" was more rapid. Every one was aware of the way in which the tobacco-pipe wore the teeth of the smoker, but this was not to be wondered at, the baked pipeclay being a hard and gritty substance, but that a horn mouthpiece should have such an appreciable effect was, he thought, a matter of curious interest. He might mention, however, that the mouthpiece suffered more than the teeth, the average life of a horn mouthpiece being twelve to eighteen months, that of a bone or ivory one being about two years. The peculiarity noticed was a crescent-shaped aperture on the cutting edge of the front teeth in three localities-viz., between the central incisors and between the lateral and canine on both sides. Mr. Macleod offers no explanation, but might not one be found in the friction caused by the constant movement of the mouthpiece during playing?

In the same journal (March 29, 1890) appeared the following letter on the subject of the clarionet:

In reply to "B Flat," I beg to say that I used to play the cornet, and found that it had a decided tendency to increase some friction and pain of dry pleurisy from which I suffered. I then changed to the clarionet, with complete relief to the symptoms. I was after a few years tempted to return to a brass instrument, and had a return of the pain. I think that with moderate skill there could be no injury to the neck from playing the clarionet. It is not a question of hard blowing, but of "knack" in the management of the reed, and in keeping the whole instrument in order. I think a wind instrument requires almost as much care as a watch. C Natural.

It is, however, in the occupations mainly mechanical, involving the constant repetition of some particular and more or less automatic movement or series of movements, that the true craft palsy most commonly arises. "I have seen," says Dr. Vivian Poore, “a case of 'sawyer's cramp' in a man who made 'packing-cases' by the piece. Another interesting case was that of a man whose work consisted in covering pickle-jars with bladder. In this case it was the left hand which hecame impotent, and the muscles affected were the flexors of the finger which tightly grasped the top of the jar."

...

But it matters little what the trade is, provided the conditions are there which may tend to induce partial or complete impotence of a particular group of muscles. In all probability there is scarcely a workshop in the kingdom from which the possibilities of craft cramp in some form would be completely excluded. In greater or less degree the disability might be found in the composing-room of a printing office, in the sewingroom of a dressmaking establishment, in the tailor's shop, in the carpenter's, in the upholsterer's, in the monger's-the list might be extended ad inf. Dr. Poore has observed cases of bricklayer's cramp, in which the difficulty consisted in handling the trowel; and of milker's cramp, in which the milker could no longer grasp the teat.

iron

Dancing, not the pastime of the ballroom, but the severe occupation of the trained and paid performer, is very liable to cause functional derangement when the toes are forced to bear the weight of the entire frame, the muscles of the calf being then subjected to an excessive strain. Dancer's cramp is said to be by no means un

common.

The shop-assistant and shop-walker,

one of whom is more or less always standing and the other more or less always walking, are apt to contract a condition of the foot which the medi

cal profession recognizes as "flat foot." It is observed that "when the foot is taken off the ground the arch of the foot reappears." This disfigurement is more likely to be found in young persons who "have not finished growing," than in adults.

Dr. Poore (Lancet, August 23. 1890) describes a case of "mercurial tremor," the patient being an Italian aged sixty-two. He came to England at the age of seventeen, and had been working here for thirty-four years as a looking-glass silverer. His duty was to "run" the mercury over tin-foils spread upon sheets of glass; he was therefore constantly handling mercury and exposed to its fumes. With the exception of the mercurial tremor, the direct toxic effects of his trade, Dr. Poore found the man in perfect health. The tremor affected the hands mainly and the right hand more than the left. When at rest, the arms and hands of the patient were steady, but the instant he attempted to use his hands they were seized with an excessive trembling and shaking. He could not pick up a scrap of paper, he could not feed himself, and he was obliged to drink through a glass tube, owing to the impossibility of holding a cup steadily to his lips. The tremor was so "coarse" (unlike the tremor from alcohol or general paralysis) that when he tried to use his hands they jerked through several inches of space. He had been attacked first twenty-six years earlier, and after thirteen weeks' treatment in the London Hospital had completely recovered. Eight years later he had had a second attack, and from that also he had made a satisfactory recovery. After three weeks' treatment for the third attack, the Italian left the hos

pital much improved, and able to feed himself, but still far from well.

Dr. Poore says that cases of mercurial tremor are rare in this country, although "met with among workmen whose occupation brings them in contact with mercury or its salts." Mirror-makers are a class who have always been recognized as liable, "but not very liable," to chronic mercurial poisoning. At the present day, however, mirrors are made largely by chemical methods, the salts of silver being employed more than those of mercury. Cases of mercurial poisoning in this trade are likely therefore, to become rarer and rarer.

Dr. Poore had under his care in the hospital a mat-maker, forty years of age, whose left arm had become so stiff, contracted, and absolutely useless, that he could no longer follow his craft. The joints of this arm were so stiff that they "creaked audibly," and, although sensation was but little impaired the power of voluntary movement was almost nil.

In "tailor's cramp" the trouble seems generally to begin with a certain weakness of the right thumb and forefinger, which makes it difficult to hold the needle; and this difficulty increases until the tailor is obliged to give up work. There is little to see in the hand affected, any more than there is in a case of writer's cramp or writer's palsy; but, after a few stitches, the needle held between the thumb and forefinger eludes the tailor's grasp, and he can no longer push it through the fabric.

On the subject of glassblower's cramp-a professional deformity of the hand to which attention has not often been drawn-a French specialist, M. Poncet, made an interesting communication some years ago to the Académie des Sciences. He described the deformity as consisting in a perma

The Leisure Hour.

nent and very pronounced flexion of the fingers upon the hand, which was more pronounced in the case of the third and fourth fingers than in that of the other two, leaving the thumb wholly unaffected. The inflexion occurred principally at the second joint, so that the second phalanx was fixed almost at right angles to the first. The malady, said M. Poncet, was unaccompanied by pain. The "distal joints" were more or less deformed, the fingers were bent into a curve and could not be extended. The skin of the palmar surface was somewhat thicker and more callous than was usual even with manual laborers. This deformity, known among French glassblowers as main en crochet or main fermée, comes on after a short practice of the art of glassblowing, and increases progressively. It appears to attack the majority of glassblowers, and, naturally, is most marked in those who have been longest at the work. M. Poncet regards it as due to the continuous application of the hand to the tube with which a glassblower manipulates his "metal." Thus, during the eight hours a day through which such a man ordinarily works, his fingers are without intermission kept closed about this tube, and the constraint induces, even within a month, some difficulty in effecting complete extension. This difficulty gradually becomes greater and greater, until at last it develops into a completely crippled condition of the hand. Altogether, according to M. Poncet, the trade of the glassblower as pursued in France is so unhealthy that the operatives who habitually take it up as young men are obliged to abandon it at about thirty-five years of age, "and do so with their hands permanently crippled in such a way as to render them useless for almost any other occupation."

Tighe Hopkins.