The  most  common  form  of  occupation  neuroses  is  that  of  writing,  and
since  this  is  not  only  the  most  common  but  is  typical  of  the  class,  it  will  be
most  convenient  to  describe  it  at  length,  the  conclusions  regarding  it  being
applicable  to  all  other  forms.
WRITING  NEUROSES ;  WRITERS'  CRAMP.
Writers'  cramp  was  first  described  by  Sir  Charles  Bell  in  the  year  1830.
It  was  called  "  scriveners'  palsy  "  by  Solly,  a  term  still  sometimes  applied
to  it*

Etiology. — The  affection  is  very  much  more  common  in  males  than  in
females,  especially  in  its  motor  form,  doubtless  because  comparatively  few
women  are  engaged  in  occupations  that  involve  a  large  amount  of  writing.
If  all  forms  are  included,  males  constitute  two-thirds  of  the  sufferers,  but  a
still  larger  proportion,  at  least  five-sixths,  of  those  who  present  the  motor
form.  It  is  a  disease  of  the  active  period  of  adult  life,  very  rarely  com-
mencing under  twenty  or  after  fifty,  while  about  five-sixths  of  the  cases
begin  during  the  intervening  thirty  years.  The  distribution  of  135  cases  f
is  as  follows  :  —

*  The  most  important  writings  on  the  disease  are  those  of  Berger  ("  Eulenburg's  Real
Encyclopaedia,"  art.  Beschaftigungs-neurosen)  and  of  Poore  {Practitioner,  1878  ;  "  Text-
Book  of  Electricity,''  and  Med.-Chir.  Trans.,  v.ol.  lxi).  The  latter  article  contains  a  large
number  of  carefully  observed  facts.
•f  33  cases  described  by  Poore  [Practitioner,  1878),  64  collected  by  Berger  (loc.  cit.),  and


ETIOLOGY.  1061

io-  20-  30-  40-  50-  60-

Cases         .         .  2        ...      48       ...       44       ...       27       ...        9        ...        5

Thus,  about  one-third  of  the  cases  commence  in  each  of  the  third  and
fourth  decades  of  life,  and  only  a  fifth  in  the  following  ten  years.
