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observation that those painful affections of the muscles very
frequently occur in both men and women, and may arise from a
multitude of causes. Strong or long-continued " emotional feel-
ings," particularly such as are unpleasant, or harassing, or any
way nerve-exhausting, are capable of harrowing up this singular
demonstration either in man or woman ; and the more in>i>rcssi-
ble the existing sensibilities or mental faculties, or the more
feeble the muscle fibres are from want of exercise, or from over-
exertion, the more liable is he or she to this painful, and, doubt-
less, often mistaken affection. There is not a question that the
habitual indulgence in mere thoughts of vencry may also pro-
duce it, and much more the habitual excess. Besides, it is no
uncommon thing to find these cases complicated, or, rather,
mixed with some rhcumatismal or neuralgic manifestation, or
else attended with cramps, or spasms of the muscle fibres; but
this, more particularly, in females. Debility, — debility, with
nervous irritability, and this with over-mental or over-manual
ivork, — is at the bottom of the whole.
One other important fact should be noticed ; and that is, that
when this kind of pain appears to be the result of over-exertion of
muscles, whether that was too great or too protracted, or from the
muscular strength being below par, and inadequate to the task,
then the seat of these pains is rather referred to one insertion of
the muscle or muscles, but rarely to both insertions; and in
that case, never to the fleshy body of the muscle. This fact, I
believe, was first noticed by Dr. Inman, of Liverpool, who says
that in the weak-muscled, or in the over-worked, it is not un-
common to find that both insertions of the muscles suffer equally.
That it is really so, recent experience proves, though it affords
no adequate explanation of the reason why. Thus, in exces-
sive cough, one patient refers the pain to the origin, another to
the insertion, of the pectoralis major and minor; one seamstress
refers all her pain to the occipital, another to the spinal, another
to the scapuloclavicular attachment of the trapezius muscle.
One refers her pain to the infra-mammary, another to the ingui-
nal, and another to the semilunar attachment of the external ob-
lique muscle. One refers his, or her, sufferings, perhaps, chiefly,