eyes. This is a well-recognized fact. Constant tremulous agitation of
the inferior palpebral and great zygomatic muscles is pathognomic of
the earlier stages of general paralysis. The countenance has a pleased
and benevolent expression. As the disease advances other muscles become
involved, but until complete fatuity is reached, the prevailing
expression is that of feeble benevolence.
As in laughing and broadly smiling the cheeks and upper lip are much
raised, the nose appears to be shortened, and the skin on the bridge
becomes finely wrinkled in transverse lines, with other oblique
longitudinal lines on the sides. The upper front teeth are commonly
exposed. A well-marked naso-labial fold is formed, which runs from the
wing of each nostril to the corner of the mouth; and this fold is often
double in old persons.
A bright and sparkling eye is as characteristic of a pleased or amused
state of mind, as is the retraction of the corners of the mouth and
upper lip with the wrinkles thus produced. Even the eyes of
microcephalous idiots, who are so degraded that they never learn to
speak, brighten slightly when they are pleased.[812] Under extreme
laughter the eyes are too much suffused with tears to sparkle; but the
moisture squeezed out of the glands during moderate laughter or smiling
may aid in giving them lustre; though this must be of altogether
subordinate importance, as they become dull from grief, though they are
then often moist. Their brightness seems to be chiefly due to their
tenseness,[813] owing to the contraction of the orbicular muscles and
to the pressure of the raised cheeks. But, according to Dr. Piderit,
who has discussed this point more fully than any other writer,[814] the
tenseness may be largely attributed to the eyeballs becoming filled
with blood and other fluids, from the acceleration of the circulation,
consequent on the excitement of pleasure. He remarks on the contrast in
the appearance of the eyes of a hectic patient with a rapid
circulation, and of a man suffering from cholera with almost all the
fluids of his body drained from him. Any cause which lowers the
circulation deadens the eye. I remember seeing a man utterly prostrated
by prolonged and severe exertion during a very hot day, and a bystander
compared his eyes to those of a boiled codfish.
To return to the sounds produced during laughter. We can see in a vague
manner how the utterance of sounds of some kind would naturally become
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