ON

OBSCURE

DIAGNOSIS,

PROPHYLAXIS.

AND

TREATMENT,

MIND

PATHOLOGY,

SYMPTOMS,

INCIPIENT

BRAIN,

THE

OF

DISORDERS

THEIR

THE

OF

DISEASES

BY

FORBES

M.D.,

WINSLOW,
Ac.

Ac.

CHURCHILL,

[ r\t

Antttor

rtterrtt

BURLINGTON

NEW
DCCC
lk"

OXON,

Ac.

LONDON
JOIIN

D.C.L.

LX.

rightof Tr"i"*!,ilio*.\

STREET.

LONDON
BAV1J.I,

AND

EDWARDS,
COYENT

PRINTERS,
GARDEN.

CUANDOS

STREET,

PREFACE.

THIS

work

ductory
intended as an introoriginally
chapter to a treatise I have for some
been preparingfor publication
ing,
Softenon
and other types of Organic Disease of the

time

was

"

Brain."
In consequence

great and unexpected

lengthto which the contemplatedprefatory
essay
be
that it would
to me
extended, it occurred
consistent

more

subjectto
them
the
the

in

of the

with

continue
distinct

my

of the
analysis
researches,and publish

scientific

and

separate volume,

IncipientSymptoms
Brain, and Disorders

avant

of Obscure
of the

courier,or introduction

"

Diseases

Mind,"

to the work

as

On
of
an

which

vidual
and indispecific
Such
types of encephalic disease.
is the originof the present treatise.
briefly
I
have
anticipated in the first chapter
is

to
exclusively

relate to the

what, strictly
speaking,should
for

designof
the

have
The

prefatoryobservation.

this work,

as

well

great importance of the

will be found

there

as

my

been

served
re-

general

estimate

of

subjectanalysed,

fullydetailed.

VI

PREFACE.

The

will

perceivethat I have
to confine myself to a resume
prominent incipientsymptoms
reader

more

various

of cerebral

forms

I could

not

enter

of these
materiel

upon
of

which

Affections

of

Disorders

the

of the

viz.,one
and

Brain,

the

of

the

vestigat
in-

an

trenching
the

will constitute

succeedingworks

two

into

minutely
subjectswithout

more

of

disorder.

mental

and

voured
endea-

Organic

on

the

bases

second

on

Cerebro-Psychical
Intelligence,

in their nature.
In

justiceto

I make

this

somewhat

reader

the

explanation,as

cursory

obligedto treat
subject. I
my
of

as
softening,

cerebral
It

an

myself,

to

as

apology for

in which

manner

I have

the

been

portionsof
practical
to those sections
particularly

the

more

refer

of the treatise that

treatment

well

as

relate to

the

medical

incipient paralysis,apoplexy,
of organic
forms
other
well as

disease and

functional

mental

disorder.

larging
impossiblefor me, without greatlyenthis alreadytoo bulky volume, to enter,
except in general terms, upon the consideration
of the subject of therapeutics. If I had
tempted
atwas

to

necessary
work

for

otherwise, it would
me

to

have

excluded

and
salient,illustrative,

have
from

been
the

relevant

having a direct bearing upon the class

gation.
investimorbid
phenomena under analytical

matter

of

much

do

PREFACE.

bound

am

confess

to

the

appreciate
defects
is

my

duty,

reader.

His

not

the

found

be

to

detect

all

and

which

allowance

of

to

the

the

"Vicar

hundred

But
with

is

April,

to

soon

of

ground

make

in

this
said
A

errors,

SQUARE,

in

every

or

it

preface

and

an

may

to
an

are

hundred
beauties.

them
may

to

were

There

prove

book

exposing

if I

his

--"

thing,
to

be

not

egotism,

Wakefield,"

needless.

18GO.

shall

said

single absurdity/'

CAVENDISH

that

Goldsmith

be

numerous

out

commission,

travel,

to

It

doubt

no

extent

vast

of

of

might

it

and

them

and

imputation

faults

things

23,

trust

what

repeat

will

eye

had

tively
sensi-

pages.

point

to

the

and

them.

sincerely

myself

following

omission

have

for

the

critical

fully

shortcomings

however,

sins

that
many

in

will, considering

over

vn

be

be

amusing
dull

out
with-

TABLE

OF

CONTENTS.

I.

CHAPTER

INTRODUCTION.

aphorismsof Hippocrates in

Important
Marshall

Hall

General

neglect

the

on

neglect

incipient

of

of disease

symptoms
symptoms

in other

Insidious

"

reference

cerebral

organs

character

symptoms

illustratingthe

Cases

"

of disease

the

of

brain

cerebral

Obscure

"

"

"

paid to the early

neglect of incipient

Attention

"

brain

the

of

disease

of

disease

of

the early treatment

to

premonitory symptoms

of

toms
symp-

of the
disease
Latent
incipient stage
brain
Diseases
Neglected
of the brain
snbject to general pathological laws
affections of the brain
of alterations
of the brain
Cases
of structure
Physiology
disease
cerebral
ment
of the brain
Early treatNecessityof watching for incipient
portance
of
the
existence
of insanity
insanity ImUnwillingness to recognise
1"23
of early treatment
pp.
affections

All

"

of

the

brain

have

an

"

"

"

"

"

"

"

"

"

II.

CHAPTER

MORBID
alterations
physical

All

disease
to

suicide

mind

the

on

Ennui

"

brain modify its

Emotional

condition

Disorders

"

psychicalfunctions

exaltation

always

not

disorder

of mental

of the

"

INTELLIGENCE.

OF

PHENOMENA

of mental

Irresistible

"

"

shown

mind

of the

of cerebral

Effect

"

impulse
inactivity Early symptoms
by alterations of thought and

excitement

and

24

conduct

Ignorance of
What

is

the

knowledge

of the

Poetical

"

"

nature

OF

SYMPTOMS

of insanity
Ignorance of

nature

insanity?

the

and

of mind

29

III.

CHAPTER

PREMONITORY

"

of insanity by
description

mental
matter

INSANITY.

ana

force

nerve

"

The

lunatic

of

extent

"

our

of defining insanity
Impossibility
"

"

the

governing
an
Suggestions
improved analysis
State of the mind
between
Insanity
sleeping and waking
operation of thought
solved
dreams?
intellectual
Are
and
during
problems
dreaming
Insanitya
Pascal
dreams
dream
Rapidity
"c.,
sleep"
during
on
Poetry,
waking
composed
of
of the phenomena
Resemblance
Curious
of mental
action
in dreams
case
Lucid
of its creations
In dreams
the mind
is often conscious
dreams
to insanity
intermissions during attacks of insanity Singular temporary restoration to reason,
morbid

of

for

mind

"

Laws

"

"

"

"

"

"

"

"

"

"

"

30"46

CHAPTER
OF

CONFESSIONS
OR

PATIENTS
OF

CONDITION

THE

AFTER
THE

IV.

MIND

INSANITY

FROM

RECOVERING

IN

WHEN

STATE

OF

ABERRATION.
The

autobiography

"Can

the

insane

of the

insane

interestingand

accurately describe, alter

of mind
Indivisibility
of
condition
their previous

instructive
recovery,

"

CONTENTS.

disordered mind?"

Shakspeare the only correct

delineator of insanity Former

Pinel's efforts to ameliorate the condition of
the insane
of insanity Symptoms
Progress in the pathologyand therapeutics
of insanitydescribed
Morbid
by a lady after recovery
suggestionsin tinbarbarous

of the insane

treatment

"

"

"

"

"

incipientstage Cases of incipient

insanity"Case of double consciousness
Singularcase of incipient
insanity 1 HUMOUS of hearing Hallucinations of sight
Letters from patientsafter recovery
Confessions of the insane after recovery,
"

"

"

"

"

"

47"149

CHAPTER
STATE

OF

THE

MIND

WHEN

V.

RECOVERING

FROM

AN

ATTACK

OF

INSANITY.
State of the mind

when
Cases illustrating
passingout of an insane into a sane condition
of delusions among
the insane
phenomena Doubts as to the reality
of their previous
Descriptions
given by patientsafter recovery
of mind
state
of recovery
from attacks
of insanity ITie Rev. Mr. Walford's
Singularcase
of his recovery from an attack of mental derangement
account
150
158
"

the

"

"

"

"

"

CHAPTER
ANOMALOUS

AND

MASKED

VI.
OF

AFFECTIONS

of defininginsanity Singular case

Impossibility

THE

MIND.

insanity Insanity among

disease
Remarks
by Dr.
and others on
the insanityof earlylife Insanity
in the
United States of America
Statistics of insanity among
children
Hereditary
to insanity Incipient
of insanity Transformations
of
predisposition
symptoms
character in the early stage of insanity Exaggerations of natural
of
states
mind
often indicative of insanity Delusions
Diagnosis of insanity Obscure
disease of the brain
Latent and unrecognised
insanity Serious results following
of insanity Pseudo
a
forms
of mental
disorder
Insidious
non-recognition
of insanity Symptoms of latent insanity Alterations of character and
approach
of passion
disposition
precedingattacks of insanity Cases of morbid paroxysms
of disordered
mind
Temper disease Curious case
Insanityshown in acts of
Moral character changed by physical
brutality Concealed monomania
injury
Illustrations of moral
scription
Paralysisof the moral sense
idiotcy Shakspeare'sde"

children
Symptoms
Brierre de Boismont

of

"

Undetected

insanity
"

of
mental

"

"

"

"

"

"

"

"

"

"

"

"

"

"

"

"

"

"

"

"

"

"

"

"

"

"

of this affection

Latent

of monomania
Transformation
of character
Effects of diseased brain on
the character
the mind
the mind
blance
ResemEffect of chloroform on

"

case

by physicaldisease

caused

influence
Meteorological

on

"

"

"

"

"

of mental

phenomena caused by the use of chloroform to insanity Curious

of poisonin the blood
phenomena caused by the absorption
Singularcase
of hydrophobiaaffecting
the mind
Influence of physicalirritation on the mind
Morbid views of religion Extraordinary
organicchange discovered after death in
the membranes
of the brain
and
Brutality immorality Cases of erotic monomania
lessness
Speedy cure of a case of insanity Singularcase of concealed insanity Reckin monetary transactions exhibited in the incipient
order
phase of mental disCase of undetected
connected with
insanity Motiveless acts of brutality
latent insanity Homicidal insanity Wail of the homicidal maniac
Duties of the
sanity
psychological
Importanceof the testimony of experts in subtle cases of inexpert
of allegedlunacy Case
Popularignoranceof insanity Evidence in cases
of Atkinson, the homicidal
idiot
Danger of lunatics being at large Decision of
of insanity Serious consequences
of a wrong
verdict in commissions
juriesin cases
de Innatico
Anomalous
defective state of the law of lunacy Justice to
be tempered with mercy
224
159
"

mental

"

"

"

"

"

"

"

"

"

"

"

"

"

"

"

"

"

"

"

"

"

"

"

"

CHAPTER
THE

Neglect of habits
Mysteriesof the

of

STAGE

OF

VII.
CONSCIOUSNESS.

Innate
self-inspection

inner

"

mental

life
"

wickedness

Consciousness

of the human

of the

heart

"

approachof insanity

CONTENTS.

XI

Morbid
and insanitv
between
reason
gs of insanity Struggle
advances
of
of insanity Confessions
of patients Insidious
of
ideas
"i"lili'urlit Obscene
and immoral
Singular perversion thought
Illusions
illusions
Illusions premonitoryof insanity I'hantuKiiiH and s|M-ctral
"

"

ic

-.ions

"

"

"

"

"

"

"

of insanity
Incubation
hearing (voices) Singular cane of hallucination
;- m.i-le to conceal
iiiHanityInsane impurityof thought The insanityof
of the
whilst insane
Explanation
Ophelia Indecent remarks of young women
of pervertedthought Sources
of earlymoral deterioration
Purity of
.uises
insane ideas
Power of controlling
thought sometimes exhibited by the insane
insanity Morbid
;ito:ns of im-ipiciit
presentimentof insanity Prediction
of attacks of apoplexy Sir W. Scott's anticipation
Dean
of brain disease
of
Swift's presentiment
Morbid
of his approaching
insanity,
anticipation
imbecility
of

"

"

"

"

"

"

"

"

"

"

"

"

"

"

"

"

225"

CHAPTER
STAGE

265

VIII.
EXALTATION.

OF

State of mind premonitoryof insanity Morbid exaggeration

tion
with great exaltaexultation
Suicidal delirium connected
of
and cunning of the insane
Mental acuteness
of spirits Wit, ingenuity,
the
insane
Mental
abilities of the insane
Poetical enthusiasm
in mania
Selfdisease
S. mptoras of insanityin young
Peculiar type of mental
women

Psychicalexaltation"
of ideas

"

Emotional

"

"

"

"

"

"

"

"

"

of insanity.
cases
of delusions by the
insane
and subtletyof
Subtle case
of homicidal insanity Cunning, cleverness,
of the insane
Acute instinctive manifestations of the insane
the insane
Subtlety
of
The
physical
agitationof
explained Symptoms
insanity
metaphysically

control and
"

shrewdness

Art of
of the insane
chloroform"
by
"

analysingsubtle

Feigned imtanityunmasked

Concealment

"

"

"

"

"

"

incipient
insanity Tortures of a wicked conscience
Happy type of insanity
of the happy madman
Horace's
description
Premonitory signs of apoplexy
of
IMseaseof
the brain caused
Insidious symptoms
by a blow upon the head
Obscure
260
298
of
case
generalparalysis
generalparalysis
"

"

"

"

"

"

"

"

CHAPTER
STAGE
Acute

morbid

OF

IX.
DEPRESSION.

MENTAL

melancholy Symptoms of brain disease

insanity Melancholia a symptom
types
Apoplexy precededby depressionof spirits
"

of suicidal

Concealed

"

"

of

delusions

Subtle

"

the

softeningof

brain

299

"

302

"

X.

CHAPTER
STAGE

ABERRATION.

OF

of ideas
Exaggeration and perversion
progress of aberration of mind
Disorder
faculties
of the perceptive
Delusions, how they originate Illusions
of disease
premonitoryof apoplexy Illusions of hearing Illusions premonitory
moral
the
of
Perversions
sense
i
llusions
of
of the brain
case
Singular
spectral
Insane pilfering
manifested by avarice and licentiousness
and concealing"Insanity

Obscure

"

"

"

"

"

"

"Insanity

exhibited

by

acts

of

immorality Softeningof
"

CHAPTER

Insidious advances

of
nutrition of the brain
"

303

"

323

OF

MIND.

imbecility Symptoms of softeningof the brain and

softeningof the brain Singularcase of cerebral
Impaired
preceding disease of the brain
intelligence

of mental
of
case

apoplexy Subtle
paralysis Lesions

the brain

XI.

IMPAIRMENT

"

"

"

"

"

"

"

324

"

331

Xll

CONTENTS.

CHAPTER
MORBID

Importanceof
of

the

attention

XII.

PHENOMENA

facultyof

attention

ATTENTION.

OF
Genius

"

attention

continued

Impairment

"

Injuriouseffects of protracted
reverie
of reverie to dreaming
Morbid imaginative contemplation
On the importance of
Hypochondriasis Morbid concentration of attention
order
the
Weakness
of
attention
controlling imagination
a
symptom of cerebral disMorbid
Resemblance

"

distraction

"

"

reverie

and

"

"

"

"

"

Morbid effect of concentrated

of attention
Morbid
distraction a

attention"

"

distraction

Post-mortem

Oscar,King

of

"

examination

Defect

the

of

Sweden, exhibitingitself

Case of morbid
cerebral disease of
early stage by distraction of

brain

in the

speech^Impairment

of

of brain

symptom

"

disease

"

The

"

mind

332

CHAPTER
MORBID
What

356

"

XIII.

PHENOMENA

OF

MEMORY.

is memory?
The natural classificationof ideas
Cause of decay of memory
in old age
Mode
of acquiringknowledge Theory of memory
Loss of memory
in apoplexy Laws
the
admission
ideas
the
mind
357
of
into
363
regulating
"

"

"

"

"

"

"

CHAPTER
ACUTE

XIV.

DISORDERS

Decay of memory

OF

THE

MEMORY.

in old age
Retention of earlyimpressions
in old age
Premature
Loss of memory
in advanced
life The poet Rogers'loss
impairment of memory
of memory
a
Importance of preservingthe memory
Impairment of memory
Loss of memory
of paralysis
and softening
a
symptom of brain disease
symptom
of the brain" Sudden
and transient loss of memory
order
Symptoms of mental disCase of softening
of the brain
Causes of impairedand paralysedmemory
"

"

"

"

"

"

"

"

"

"

Sir H. Holland's

"

of temporary loss of memory

case

Effect of stimulants

"

in

the memory
Treatment
Disease of brain
of cases
of loss of memory
restoring
indicated by loss of memory
Case of sudden loss of memory
Enfeebled memory
caused by mental
of a case
of loss of memory
anxiety Successful treatment
Loss of memory
caused by blows upon
the head
Singularcase of forgetfulness
of dates and names
Insidious case
of brain disease
Injuriouseffect of the hot
bath in cases
of cerebral disease
Confused
state of the memory
Symptoms of
"

"

"

"

"

"

"

"

"

"

brain
brain

disease

"

Confused

Effect of mental

"

"

state of the memory

emotion

the ideas

on

CHAPTER
CHRONIC

(MODIFIED)

of the

of ramollissement

symptom

364

387

"

XV.
OF

AFFECTIONS

THE

MEMORY.

of names
Forgetfulness
previouslyto an attack of brain disease Loss of language
caused by a blow on the head
gotten
Singularcase of revival of a language long forLoss of language after attacks of apoplexy,"c.
Effect of injuryto the
head on the memory
Loss of memory
after
Singularcase of defect of memory
Loss of certain words,
acute
the memory
on
bodilydisease Effects of paralysis
"

"

"

"

"

"

"

"c.

the
of disordered
Effect of a bullet-wound
on
memory
of memory
after epidemics"Paralysisof the memory
caused by intense cold
Effect of the Russian campaign on Buonaparte's
memory
Loss of memory
caused by fever
Loss of language Singularmanifestations of
Effect of apoplexy on the memory
Singular loss of memory,
priorto death
memory
the result of a blow upon the head
-Effectof a mental shock on the memory
of morbid
Remarkable
"of disordered memory
Proximate
case
cause
memory
"

memory

Remarkable

"

"

cases

"

Impairment

"

"

"

"

"

"

"

"

"

"

Singularcases

of defect of memory

"

Cases of

impairmentof

memory,

388

"

415

CONTENTS.

CHAPTER
PERVERSION

AND

XVI.

EXALTATION

OF

THE

MEMORY."

MEMORY

OF

INSANE.

Curious cases
of perversionof memory
Remarkable
of double personality
case
Case of double or divided consciousness
Exaltation of memory
a fatal diagnontic
in the brain diseases of earlylife" Improvement of
sign" Exaltation of memory
"

"

"

in advanced

memory

memory

life often

of the insane

Memory

"

of

precursory

Cases

apoplexy
"

Shakspeareon

"

of exaltation of
of the insane,

the memory

416"426

CHAPTER
PSYCHOLOGY

AND

and
Destruction,
a physical

T.

PATHOLOGY

OF

MEMORY.

of mental impresimpossibilityIndestructibility
sions
the mind
Inexplicable
psychical
"

Effects of organicphysicalchanges on

"

and
"Is

moral

XVI

physicalphenomena

Assimilative
situated in the brain ?

the mind

ought to

be

Nutrition of the brain

power
The subjectof chemico-cerebral pathology

"

more

investigated Phenomena
"

facts relative to latent

caused

light
"

"

at death

by

fever

of latent mental impressions Curious

Indestructible character of ideas
Singular phenomena

"

"

"

Mental

by hanging

manifested
revived

"

of the blood"

"

phenomena caused by drowning Curious phenomena

guages
phenomena of language Knowledge of lanphenomena observed in somnambulism and
"

Morbid
Curious
"

"

catalepsy Laws governingthe association of ideas

of the memory
activity
Physicaltheoryof latent
"

"

with thought
impedimentsinterfering

The

"

Sudden resuscitation of latent ideas

brain

"

Morbid

and sensitive state

mental

of

impressions Physical
compared to a galvanicbattery
"

Rapidityof mental action Cases of loss

of memory,
and its sudden
restoration
Idiotcycured by blows upon th" bead
Connexion
between
wit and madnels
Dormant
of mental
nature
impressions
Latent
ness
ideas suddenly recalled to consciousness
Loss of speech and consciousSudden
of
of intelligenceGarrick's accurate
arrest
knowledge
insanity,
how acquired Morbid fixedness of idea
427"
4C7
"

"

"

"

"

"

"

"

"

"

"

CHAPTER
MORBID

XVIII.
OF

PHENOMENA

MOTION.

General muscular debility Early

Diagnosisbetween cerebral and spinalparalysis"
of
motor
of
Partial
loss
of
the
brain
Incipient
symptoms
power
signs softening
Case of brain
of apoplexy and paralysis Insidious progress of brain disease
Muscular
tremors
disease without impairment of intellect
symptomaticof brain
co-ordination
of
muscular
Morbid
want
disease
Irregularmuscular action
Obscure
Convulsive
action"
o
f
these
types
phenomena
Difficulty explaining
in epilepsy Diagnosisof epilepsy
of nocturnal
epilepsy Loss of memory
Premonitorysymptoms of epilepsy Affections of the tongue and muscles of the
Effects of softeningof the brain on
mouth
Insidious symptoms of paralysis"
the motility Morbid handwriting" Paralysis
apitans" Premonitory symptoms of
paralysisagitans Loss of sleep Morbid affections of the spinalcord" Acut
"

"

"

"

"

"

"

"

"

"

"

"

"

"

"

"

"

"

ramollissemeut

of the

com
spinal

"

paralysis
Peripheral

CHAPTER
MORBID

PHENOMENA

468"

XIX.
OF

SPEECH.

i of
speechth" result of affectioni
CM*
absces."
cerebral
Loss of speechcaused by
anterior lobes of the brain?"
DUMM
of the cerebellum"
and softening
loss of speechin general paralysis

Cerebral localizationof speech" Is loss of

IM

th"
of
ol

XIV

CONTENTS.

the corpora

olivaria a cause
of loss of speech Morbid
impairment of speech
cerebral
Irregular
impairmentof the articulation Paralysisof ideas in incipient
of speech Forgetfulness
disease
Morbid
of certain words a sympirregularity
tom
of apoplexy Singularmisplacement of words
Cases of curious defect of
articulation
Morbid
articulation
Loss of speech a symptom of apoplexy,congestion,
and softening Morbid misuse of words
Singularalterations of speech
and impairment of speech Diagnosticvalue of affections of speech
Irregularity
Symptoms of acute
softening Loss of speech caused by mental distress
Loss of speecha symptom
of epilepsy
and apoplexy Premonitorysignsof paralysis
Sudden
loss of speech Successful treatment
of loss of speech
of a case
Morbid
speech following
apoplexy Singularcase of mutism caused by a bullet
wound
Perversion of speechthe result of a wound
the head
Case of extraordinary
on
of speech Morbid
of articulation
The
imitative movements
perversion
"echo"
symptom of softeningof the brain
Involuntaryarticulation a symptom
of brain disease
Effect of insanity
the voice
Singularrecovery of speech
upon
before death
Alterations of voice symptomatic of insanity
535
497
shortly
"

"

"

"

"

"

"

"

"

"

"

"

"

"

"

"

"

"

"

"

"

"

"

"

"

"

"

"

"

"

CHAPTER
MORBID
Exaltation
cerebral

of

sensation

XX.

PHENOMENA

OF

SENSATION.

Softening of the spinalcord Vertigo a symptom of

of vertigo Symptoms of epileptic
vertigo Obscure
of epilepsy Diagnosis of epilepsy Hypersesthesia
cases
of the brain" Cephalalgiagenerallyaccompanying cerebral affections" Cerebral headache"
thesia
Anaesof brain disease
a symptom
bility
Incipientsymptoms of apoplexy Insensiof the mucous
membrane
of the conjunctiva in incipient
disease of the brain
Sensation of cold a symptom
of apoplexy Impairment of the sense
of taste a
symptom of softening Sensation of weight and heaviness in the side a symptom
of cerebral softening Deficient sensibility
of the insane
Explanation of the
of anaesthesia
causes
in incipient
Impairment of sensibility
generalparalysis
Remarks
of the insane
Cases of insensibility
by Pinel on the insensibility
to
the insane
from pre-occupation
pain among
of mind
Vitiated
Insensibility
sensation symptomatic of cerebral disease
536
559
disease

"

"

Cause

"

"

"

"

"

"

"

"

"

"

"

"

"

"

"

"

"

"

CHAPTER
MORBID
Normal

PHENOMENA

XXI.
OF

THE

SPECIAL

SENSES.

of the senses
Mental distress caused by certain odours
Mozart's
of hearing
of the sense
Acuteness
of touch among
the blind
Singular
defects of vision
to distinguish
colours symptomatic of brain disease
Inability
Curious cases
of error
of colour
560"564
acuteness

"

"

acuteness

"

"

"

"

CHAPTER
MORBID

PHENOMENA

OF

VISION,
AND

Impaired and paralysedsight

brain
Early signs of cerebral
"

"

"

"

sight

HEARING,

TASTE,

TOUCH,

SMELL.

Defect

of vision

symptomatic of disease of the

of centric
Cephalalgia a symptom
ophthalmoscopein detectingobscure diseases of

amaurosis

cerebral amaurosis
Value of the
Double
vision a symptom

the eye
of

XXII.

"

of disease of the brain

-Loss of

"

Case of sudden

tion
restora-

Causes of amausightcaused by tumours in the brain

rosis
Loss of sightpremonitoryof apoplexy Singularcase
of sudden recovery of
the sense
of vision
Importance
of the earlydetection of cerebral disease
toms
Sympof amaurosis
dependentupon vascular congestion Singularcase of morbid
derangement of sight Exaltation of vision premonitory
of brain disease
Cases
of morbid exaltation of vision
Spectralillusions Goethe's power of producing
of vision connected
phantasms Cases of hyperaesthesia
with
disease of the
Perversion and aberration of sight Peculiar
opticthalliums
expressionof the
"

"

"

"

"

"

"

"

"

"

"

"

"

"

CONTENTS.

in

of bruin

forms

disease

XV

Incipient
symptoms of apoplexy Derange*
meningitis,congestion,and cerebral hypenemia
Vitiated
of ajtoplcxy Symptoms of cerebral
a
hemorrhage
symptom
perception
Morbid
luminous
of disease of the brain
phenomena
Photopsia a symptom
Illusions of bight Morbid
Singular phantasmal phenomena
phenomena of
Double
vision an important
symptomatic of disease of the brain
sight Strabismus
of cerebral disease
Double
vision symptomatic of apoplexv,
symptom
cerebritis,and meningitis"Morbid
phenomena ol hearing Acutcneis
paralysis,
of hearing in incipientcerebral affections
Ilypcnesthcsiaof hearing a symptom
of hearing MunK-r
of insanity Illusions of the sense
and
suicide caused
by
illusions of hearing Morbid
Disordered
phenomena of taste, touch, and smell
smell in incipient
of the taste and
condition
of thu
state
insanity Disordered
tactile sensibility
in incipientparalysis Exalted
tactile sensibility 565"
5l"9
eyes

some

sight

of

ment

"

"

premonitoryof

"

"

"

"

"

"

"

"

"

"

"

"

"

"

"

"

"

"

CHAPTER

XXII

PHENOMENA

MORDID

OF

I.
AND

SLEEP

Sleeplessnessof incipientinsanity Heavy and

caused
Insomnia
cerebral disorder
by a severe
of sleep Pathology of sleeplessness Case

drowsy

"

"

Lethargy

death

after

dreaming

in the blood

urea

sleeping and

between

commencing

in

and

symptomatic
Morbid
waking

often

Dreams

"

Method

"

drowsiness

Morbid

"

disorder

of cerebral

symptom

of

retention

dream

"

"

Sympathy
"

the brain and

between

Derangement

sea-sickness

renal disorder

by

in the

urea

sleep
"

disease

want

the

of

causing

blood

Morbid

brain

and

phenomena of

brain

Hallucinations

"

preceding insanity Insanity

600
617
during sleep
"

"

XXIV.

ORGANIC

OF

PHENOMENA

from

dreaming

CHAPTER
MORBID

of

symptom

Death

"

"

of

excess

shock

long-continuedsleeplessness

induced

committed

Murder

of

of detecting
of

sensation

mental

"

"

DREAMING.

digestive
organs

Case

"

LIFE.

NUTRITIVE

AND

of delirium

gestion
by indi-

caused

resembling
in incipientinsanity" Nausea
of the stomach
ence
Influthe
brain
of
and
softening
of cerebral tumours

symptomatic

"

the mental

impressionsduring
and depraved appetite

digestiveorgans
of" Vitiated
by the Insane,causes
Influence of disorders of the
chronic
in
insanity"
of the insane"
Embonpoint
Morbid
nutrition"
of
phenomena of circulation,
functions
the
nervous
system upon
between
apoplexy and cardiac disease"
and generation"Connexion
respiration,
of chronic

disorders

insanity" Refusal

Influence

"Sympathy
of the

of food

of cardiac
caused

insane"

of the

on

disease

on

the

psychicalfunctions
of the

State
of the heart"
examination
Post-mortem
the lungs and brain"
the
generative
organs
and impairment of
Exaltation

by

disease

PRINCIPLES

OF
AND

cinations
Hallu-

cerebrum"

pulse in incipientinsanity
of the

between

CHAPTER
GENERAL

of the

luiijr

I
.

XXV.
DIAGNOSIS,

PATHOLOGY,
PROPHYLAXIS.

the
illustrating

Obscurityof the pathologyof the brain-Cases

of wlcl"rate
pathology-Opinion,
of central
the investigation
a
conest,
of iproximate cause

TREATMENT,

CONTENTS.

XVI

arteries
of

between

insanity

between
of

the

and
of

acute

of

knowing

palsy

brain

of
and

use

the

by

his

from

patient

self-control

of

of

of

the

of

softening

head
the

brain

treated

in

after

early
be

to

of

of

cultivation
does

of

the

affected
to

toft, Titian,
Locke,

of

memory

with

Clarendon,

Euler,

Muratori,

James
the

Mackintosh,
insane

Duties
"

memory

R.

Bacon,

defect

vigour,

Dugald
the

of the

an

of

Handel,
Sir

E.

illustrated

in

Archbishop
Themistocles,

psychological

Lord

and

Lord

of

in

of

memory

the

the

lives

of

Tillotson,

Cyrus,

Gregory,

schools

When

intellectual
M.

Waller,

powers

des

John

Quen-

Maple-

Isaac

Sir

Eldon,

Lord

ton,
New-

Kenyon,

Mansfield

Dr.

of

Is

great

Grotius,

Seneca

Pascal,

physician

Kind
"

memory

Johnson,

Hortensius,

and

bined
com-

Edmund

Leibnitz,
Sir

Niebuhr,

of

treatment

628
....

of

careful
"

strength

"

"

ment
improve-

"

Great

judgment?

Dr.

the

Impairment

Jonson,

Ben

Coke,

ment
impair-

insanity

loss

Corneille,
Mr.

the

intellectual, principle

their

Cherubini,

Bolingbroke,

Stewart,

for

"

the

Richelieu,

Cumberland,

of

of

book

retained

have

lives

Chaucer,

of

of

attack

memory

not

of

intelligence

Importance

"

vital,

Voltaire,

Locke,

Jonson,

of

the

Stowell,
to

Gibbon,
Ben

who

men

in

impaired

Montaigne's

life

early

The

Fontenelle,

Lord
allied

in

if

Course

Importance

remedies

"

the

state

preventible

head

Treatment

commonplace

"

West,

intellectual

Burke,

cases

after

straining

decline

Celebrated

Johnson,

Hardwicke,

vigour

Excessive
to

exhibited

Benjamin
Dr.

brain

to

"

of

Mental

of

the

of

the

"

the

of

"

Treatment

injuries

the

attention

mind

improvement

straining

"

Lerov,

disease

"

the

of

"

begin

as

age,

of

faculty

disadvantages

memory

age

sounmeres,

Lord

the

old

gj-eat

the

cultivation

undue

of

intellect
in

to

memory

the

the

"

"

of

thoughts

watching

head

"

and

result

of

the

of

"

the

memory

symptoms

advantages

of

upon

upon

Treatment

Treatment

On

memory

the

On

the

diseases

blows

severe

of

Isolation

by mechanical

blows

from

ment
treat-

"

"

after

memory

of

Susceptibility

Various

Use

"

the

"

evil

"

cultivation

head

opium

paralysis

Importance

"

insanity,

in

organic

and

caused

head

Abscesses

stage

head

of

loss

"

brain

the

upon

the

to

adopted
of

Importance
and

the

of

blows

injuries

the

detection

early

Disease
of

stomachin

insanity

of

treatment

apoplexy

of

tumours

purgatives

subduing

of

"

treatment

"

brain
effects

Injurious

"

of

cases

method

early

of

of

"

in

incipient

in

treatment

of

Value

insanity

chloroform

Importance

"

tonic

of

Value
"

of

of
the

Depletion

"

"

Rheumatic

and

of

exhibition

tne

Spurgeon's

Mr.

friends

sickness

physician

in

cure

of

"

"

Necessity
brain

Use

incipient insanity

of

exercised

the

for

ancients

the

of

symptoms

cephalalgia

cerebral

symptomatic

idiopathic

and

"

paralysis

Importance

"

Neuralgic

"

cephalalgia

the

"

be

to

"

of hellebore

the

Caution

abuse

tumours

of

view

of

disease

general

Premonitory

and

Diagnosis

"

inflammation

cerebro-spinal

"

point

Duties

insanity

incipient

patients

cerebral

between

Diagnosis

"

Treatment

abscesses

Distinction
"

and

between

brain

of

Cerebral

and

headache,

"

the

softening

diagnostic

Distinction

congestion

Diagnosis

"

Diagnosis

"

"

meningitis

"

of
in

cephalalgia
Nervous

cephalalgia

its

softening

antecedents

the
of

Importance

of

Diagnosis

"

chronic

ana

paralysis

apoplexy

confounded

preceding

Anaesthesia
"

general

to

between

Diagnosis

"

brain

of

symptoms

wasting

the

the

be

cerebral

of

Diagnosis

"

cerebritis

of

substance

Incipient

delirium

and
and

of

cause

is liable

insanity

which

"

insanity

"

with

Affections

insanity

arteries

Diseased

circulation

the

upon

"

706

Olf

OBSCURE

DISEASES

OF

THE

BRAIN

AKD

MIND.

CHAPTER

I.

Introduction.
THERE

is not in the

ancient

modern,

or

whole
a

range of medical
passage that transcends

literature,
in grandeur

of

of
conception,
majestyof diction,and sublimity
with which
truth, the exordium
Hippocratesintroduces
to the
reader his celebrated
aphorisms: 1 *O /3ioc
(Art long);
(Lifeis short};2. 'H " rtyvii /la/c/oi}
/3/oa)(uc
3. 'O " K-ai/ooe o"u? (The occasion feetiny]
; 4. 'H
5. 'H St Kpiais
a"j"a\tpii
(Experience
fallacious)
;
(Judgmentdifficult}.
*O Sc Kaipoq
o^uc-" How
importantit is,to fully
of
the
consideringthe treatment
appreciate,when
diseases of all vital structures, the practical
significance
of this great medical apophthegm.
Let this profoundlywise
The occasion feelingf"
in
axiom
be present to the mind, and engraven
ever
materials,and in indestructible characters,
imperishable
.

"

"

upon

the memory.
these
fleeting moments
"

and

"

of

incalculable,
inestimable,

or
preciousvalue, are neglected

serious morbid

states

of brain

are

trifled with; if

overlooked,
B

or,

if

INTRODUCTION.

not
recognised,

ment,
immediatelysubjectedto proper treatand incurable organic alterations
chronic,irreparable,

in its structure

be the

may

result,succeeded, when

it is too late to

remedy the mischief,by the bitterness of

the unceasing
lamentations and regrets
self-accusation,
or
of those who
ought to have been the firstto observe and
attack the fatal disease !
How

often is the

physiciancalled

to witness

upon

the

melancholy consequences, to health of body and mind,

life and reason,
of a neglectof well-marked
premonitory
his painsymptoms of cerebral disease ! It is frequently
ful
duty to hear both relatives and friends reproach
themselves,when the time for action has, alas ! passed
negligencein wilfully
closing
away, for their criminal
their eyes to the long-existing
evidence of positive
disease
of the brain.

The

late Dr. Marshall

to the consideration
work

Hall, when

of head

be written

himself
addressing

remarks
affections,

"
"

ful
use-

the

of insidious and
subject
impending diseases,with the view of making their first
antecedent
to the public,
and of
or
symptoms known
thus suggesting
the care
and means
necessary for their
prevention."*
No
better qualified,
one
was
by habits of thought,
educational attainments, practical
and enlarged
sagacity,
to form a rightestimate of the importanceof
experience,
with
accurate
the incipient
an
acquaintance
symptoms
of the diseases of the brain, and
nervous
system,than
this justly
and accomplished
distinguished
physician.
of a long
It was
his painfulprovince,
in the course

might

and brilliant

career,

on

witness

to

the sad

of the precursory
non-recognition
symptoms of those organicaffections of

consequences

the

"

On

sect. iv.
Diagnosis,"

M.D., F.R.S.

1817.

"

Diseases

or

of

premonitory

the brain, for the

of the Head."

By

Marshall

Hall,

INTRODUCTION.

organicconditions do not, as a
neglect. In
generalrule, meet with similar systematic
affections of the stomach, liver,howels, lungs,and skin,
disease,or depar"c., the first symptoms of approaching
ture
from
a
healthy condition of those organs, are
without loss of time, seeks the
observed, and the patient,
aid of his physician.
deviations

Other

circumstances, he does

such

Under

from

not

hesitate

to

placehimself under curative treatment ; he feels no

delicacyin describinghis physicalsensations ; is not
at being thought ill,and
ashamed
readily
adopts the
treatment
suggestedfor his recovery. But when the
with
brain is affected,and the patientis troubled
sistent
perheadache, associated with some
slightderangement
of the intelligence,
disorder of the sensibility,
of spirits,
loss of mental
illusions of the senses, depression
his condition
is, in
power, or modification of motility,
overlooked, or studiously
cases, entirely
ignored,
many
if such
abnormal
as
symptoms were
signs of robust
tions
health,instead of being,as they undoubtedlyare, indicaof cerebral disorder requiring
the most
grave and
serious
and
skilful treatment
attention,prompt, energetic,
!

It will be

neglectto
the

well to

which

influence

the
consider,briefly,

the

brain

of disease.

is

It is

cause

of the

subjectedwhen under
notion too commonly

fatal cerebral diseases are suddenly

entertained, that many
developed affections,presentingno evidence of
any

antecedent

accompanied
encephalicorganic change, and unby a premonitory stage, or incipient

symptoms.
It is indeed
even

has

not

natural

by

that such

educated

been

class of disease,or

an

idea should be entertained,

whose
tion
attenprofessional
men,
directed to a studyof this
specially
whose opportunities
of watching the

ILLUSTRATIVE

CASES.

progress of sucli affectionshave been

A
with

man,

his

in the

and circumlimited,
scribed.

in vigorous
apparently
health,mixing daily
family,
going to his counting-house,
engaging

active

attention
into

pursuitsof

occupyinghis
in professional
or
duties,whilst stepliterary
ping
his carriage,
when
or
his friends
entertaining

at the festive

commerce,

board, falls down

or

either at his door

in

state of

unconsciousness,
bows his head on his
or
quietly
plateat the dinner table and dies,surrounded by his

family,in a fit of cerebral hemorrhage!

A
midwife, whilst sittingby the bed of a patient
whom
she is attending,suddenlyexclaims,
I am
gone,"and immediatelyfalls down in a state of apoplectic
"

coma

gentleman duringdinner, complainssuddenlyof

giddinessand sickness. He retires to another room,
where
he is found a minute afterwards supportinghimself
confused and pale.Being put to bed,
by a bed-post,
he

becomes

soon

person in
exercise in the
A

comatose, and dies.

good health, after using rather

forenoon, returns

home

to

violent

dinner, and

the fire,without
near
sitting
any warning starts
ing,
with violence,exclaimup, pushes his chair backwards
Oh, my head !" Immediatelyafterwards he falls
the floor in a state of apoplectic
insensibility.
on
whilst speakingat a publicmeeting,
A literary
man,
is suddenlyseized with an uneasy sensation in his head.
whilst

"

He

says

it feels

"

as

if it would

burst,"

"

as

if the

big for the skull." He returns home,

and dies on the eveningof that day.
becomes
apoplectic,
is observed to stop,
A clergyman,whilst preaching,
then attempts to
He
to his head.
and put his hand
and has
proceedwith his sermon, but talks indistinctly,
from
lost his recollection. He keeps himself
evidently
brain

was

too

fi

INTRODUCTION.

side of the

by graspingthe
falling

church, and

the

from

removed

pulpit. He

and paralytic.He
pale,speechless,

mediately
is im-

cold,

is found

dies in

days

few

after the attack.*

previously
complainedof
head
denly
ill health, or
of any
symptoms, suduneasy
from
awakes
an
apparent state of profound
slumber, and begins screaming, Oh, my head ! my
his parents could
head ! my head !" Before
be summoned
A

had

lad who

young

not

"

the

into
without
A

being restored

and

to

in
lady,apparently

her brother

in Rotten

cheerful

and
giddiness

minutes

insensible, and

state of consciousness

excellent

Bow.

dies

If

health,is ridingwith

Whilst

engaged in active
conversation, she suddenly complains of
sickness,and becomes deadlypale. A few

afterwards
She

becomes

he

room,

it is found

is carried

and

dies

and

defective power

home,

that

she could not articulate.

becomes

soon

unconscious,

the

followingday !
A gentleman who
had formerly
been
in Parliament,
and
who
had
been
for many
tioneering
years engaged in eleccontests,is in the act of gettinginto a railway
carriage.He complains of vertigo,mental confusion,
on

of articulation.

He, however, takes

his seat

restored to his usual health.

Once,
apparently
duringa three hours' journey,he has a slightrecurrence
of these symptoms, but they again
On
his
pass away.
arrival home, he complains of nausea,
and an indisposition
take
to
food.
He has no
headache, and can
speak
*

After death there

was

in the left ventricle,

which
the

septum.

All

the

found in this
had

extensive extravasation

case

of blood

passedpartlyinto the right,by laceration of

of the brain were
ossified.
extensively

arteries

"

ABEECEOMBIE.

f All the
the substance
of the
with

ABEBCROMBIE.

ventricles
of the
cerebral
the

filled with coagulatedblood.

In
completely
formed
tion
lacerathere
a
was
hemisphere,
by
cavity
substance,filled also by the coagulum, and communicating
were

left

ventricle.

There

was

no

other

morbid

appearance.

"

ILLUSTRATIVE

and distinctly.
As he
clearly
a

medical

and

man,

as

the

CASES.

resides

some

symptoms

are

distance from
not such

to

as

create any

as to his state of health,

apprehension
for the case.
The gentleman,
medically
partakingof a lightdinner,retires in a cheerful

grave
is
nothing done
after

state of mind

to bed.

About

two

o'clock in the

ing,
morn-

his wife is

band's
suddenlyroused from sleepby her husloud stertorous breathing. She finds him
in a
state of profound coma.
He
dies before the surgeon,
who is immediately
summoned, could arrive. The brain
exhibits symptoms, of what was
assumed
to be, organic
disease of long existence.
A medical gentlemanof known
and great
reputation,
personalworth, having been to one of her Majesty's
levees,visits on the evening of that day the home
of a friend in the environs of town.
He appears, during
dinner and afterwards, in excellent health and spirits.
After playing a rubber of whist, he retires,with his
wife,to bed, complainingonly of generallassitude,but
In the
other signof bodily
no
exhibiting
indisposition.
middle of the nighthe is found by his wife in a state of
In the attempt made
by her to place
coma.
apoplectic
and instantly
him on
his back, he heaves a deep sigh,
!
expires
The
historyof

gated,
investicarefully
dence
eviaffordingsatisfactory
without, it is alleged,
of any decided precursory symptoms, that would
of the presence of any latent
the suspicion
justified

have
and

these

mischief

dormant

sad

within

cases

is

the head.

It is

possible

headache, defective articulation,

have been
may
cerebral lassitude,
dimness and loss of vision,giddiness,
there

and

evanescent

but of
not

to awaken

In many

and confusion,
depression
trivialand unimportanta character, ai
so
excite attention.
or
apprehension,
attacks

of mental

instances of this kind it is

that
affirmed,

no

INTRODUCTION.

The
discovered.
appreciable
precursory stage could be
of apoplexy,
acute softening,
attack, whether it be one
cerebritis,or mania, had
meningitis,
epilepsy,
paralysis,
all the characteristics of

sudden

which
seizure,

no

dence
pru-

had
or
foresight
prevented,
anticipated
health been made
the patient's
state of brain and general
the subjectof careful and anxious analysis.
what
It occasionally
a
cases,
happens,that in some
would be considered,as the most importantsympjyriori
toms
to be
of serious brain disorder, are
represented
For
example: attacks of apoplexy
altogetherabsent.
and paralysis
are
allegedto occur without beingpreceded
by any observable cerebral symptoms ! There have been
could have

headache, alienation of mind, lesion of the sensorial

no

the unhappy patient

or his friends
power, to warn
The fatal,obscure,and
of the approachof the enemy.
and stealthily
its
insidious disease has creptquietly
on
motor

or

victim, givingno

its

signof

advent,

no

indication of its

notice of its presence, until it has surprised

effected a
sentinels,boldlyseized upon the outposts,

advance, no
the

breach

in,or scaled,the ramparts,and by

coup de

an

act of

logical
patho-

of the citadel !
main, taken possession

It is

of
an
as well as
objectof physiological,
generally
when consulted in
importance,for the physician,
practical
of suddenly-developed
brain disease, to make
case
a
himself
acquainted with the past condition of his
patient. With this view,he institutes diligent
inquiries
into the invalid's pathological
antecedents.
To the often
Have
there been observed any
repeatedinterrogatories,
previouslymanifested symptoms of disorder of the
encephalonand nervous
system ?" how commonly is the
whatever ;
the patienthas not
No, none
response,
known
shown
the
a
day'sillness,his brain has never
indication of any kind
of disorder!"
It is
slightest
in some
and obsticases, how
singular,
pertinaciously
"

"

OBSCURE

CEREBRAL

SYMPTOMS.

cerebral indisposition,
uatelyall idea of past,and even existing
is emphatically
ignored,and zealously
diated
repuby the relations of the patient! But how often
does the physician
tigation
detect,before he concludes his invesof the case, that his patient
of the history
has

exhibited,it may

be,in the far distant horizon,some

time

to his attack, evidences of the threatening

and
previously
approachingstorm, which, if seen, had not been made
matter of observation, reflection,
anxiety,or treatment !
The headache has been attributed to derangementof the

stomach,

or

to

bilious

disorder;
"

feebleness of purpose,
of manner,
flightiness
of irritability
for
or
passion, inaptitude
paroxysms

temper,

"

"

"

vacillation of

the

"

the loss
exaltation of spirits,
or
business, depression,
have all (if
of sensibility,
manifest lesion of motility,
even
"

"

subjectof comment) been attributed to some

and transient bodilyailment,connected with the
trifling
vertigo,
digestive,
hepatic,or renal organs. Epileptic
cerebral headache,and disordered conditions of vision,
in the immediate
caused by the pressure of a tumour
neighbourhoodof the opticthalami, have existed for some
to the presence of
time without
as
excitinga suspicion
the brain ! The attacks of episerious disease affecting
leptic
vertigohave occurred, unobserved, at night,and
made

with

the

littleor
;

no

convulsive

the headache

bilious,
rheumatic,or

movement,

for
optici,

sciousness
cona

character; the impairment

of visual power has been treated as

unconnected
with disease in the
thalami

loss of

considered to be of

has been

nervous

or

affection of the eye,

of the
neighbourhood
an

the relief of which

the

instead
optician,
all

has been consulted,and thus have

physician,
symptoms of
the salient,important,and
significant
to undermine
encephalic
organicmischief been permitted
the bodily health, damage and impair the intellof the

even

tlireaten the extinction

of reason,

and

destruction

10

INTRODUCTION.

of

without
life,

is

involved, I would

remedial

treatment
palliative
being
adoptedto arrest the steadyand onward advancingprogress
destructive cerebral disorganization
!
of the fearfully
the obscurity
in which
this subject
Fullyrecognising
any

or

ask, whether

the

affections

of the

brain, in the majorityof cases, are not precededby a

and
but often undetected
well-marked, clearly-defined,
for a person
stage? Is it possible
of death by an
prostratein the arms

unobserved

precursory

suddenlylaid
attack
of apoplexy, cerebritis,meningitis,
paralysis,
acute softening,
mania, evidencingafter death, longor
existingchronic alterations in the cerebral structure,
time previously,
faint
without having exhibited,for some
and transitory
they may be, but nevertheless decidedly
characteristic symptoms, pointingunmistakeably
to the
brain, as thefons et origomali ?*
Is not the allegedabsence
of all premonitorysymptoms
not the history
more
apparent than real ? Would
of the antecedents, the pre-existing
state of
pathological
these
and
unravelled
if carefully
cautiously
cases,
evidence
afford conclusive,if not demonstrative
analysed,
of a priorstate,of undetected
and
unrecognisedbrain
to be

disorder?
*

is

that in many
realize the fact,
of
cases
freely
affected.
and
the
brain
primarily,
secondarily,

the absence
what

sudden

death the

This

will account

heart
for

of all morbid

conditions of the brain in many

of death from
cases
diseases
of the
associated
with
organic
apoplexy,
appreciable

is termed

heart.
It is often

head

to decide,in
difficulty

cases

of sudden

with
death, conjoined

and

symptoms, what proportionof the fatal issue is attributable to the heart

what
brain.
to the
If the former organ be examined
after death,

and

the

drawn

alteration
slightest

is, that this is the

brain may

be discovered

is detected

cause

in

in

of death, even
a

its structure, the conclusion

although the vessels of the

condition of great turgescence. Under

such

right to infer,that the brain has had nothing

to do with the death,merely because the heart is found either in a partial
state of disease,or
weak, small, and flabbyin its condition. It would be
safer,under such circumstances,to conclude,that death has been caused by
circumstances, we

have

no

the combined

effect of disorder in both organs.

12

INTRODUCTION.

natural,the organs of special

sensibility
sense, viz. :
state of
smell,hearing,
taste,and touch,in a normal
sight,
life of relation,
as well as the phenomena of
; the
activity
free from all signsof morbid
nutritive and organiclife,
derangement?
It is generally
admitted, that no structural changes
in the heart, lungs,liver,stomach, uterus,
can
originate
kidneys,or bladder, without presenting,
priorto death,
obvious symptoms of their existence.
disease of the lungs,hydatidsof the liver,
Tubercular
of the uterus, calculus of the bladder,fattydegecancer
neration
of the kidneys,
and valvular disease
hypertrophy,
of the heart, cannot (inthe majorityof cases)exist without
disturbingthe
manifestly,and often seriously,
functions of these organs.
Upon what principle
special
should
the brain be an exception,
to the generalpathological
and physiological
other organic
laws, regulating
the

structures ?
The

affections
a

of the

upon

have,

maintain, undoubtedly

precursory stage. In the

mischief established within
the

and
premonitory,

majorityof cases, the

the
cranium, disorganizing
may,

brain

careful

delicate tissue

of the

examination, be detected.

brain,

There

are

pathognomonic,and diagnostic
precursory signs,which
to guide the inquiring,
observant, and
serve
diligent,
and enable him,
intelligent
physician,
eye of the practical
with some
tillations
to discover the first scindegreeof certainty,
when
the patient and
of brain disease,even
those about him repudiate
all idea of cerebral ill health,
and
the necessity
for medical
refuse to acknowledge,
advice, or treatment.
disease of
incipient
if his attention were
the brain, the physician,
even
closely
riveted to the existingpathological
condition, could
diagnoseits exact nature, or pointout its
satisfactorily
I do not

affirm,that in all cases

of

NEGLECTED

DISEASE

OP

THE

IS

DRAIN.

little or no
precise
locality
; but lie will have
difficulty,
after carefully
the general
analyzingthe case, in deciding
the brain is the seat of difpnf^and the
whether
question,
referable to that organ, is of a
disorder,apparently
pathetic,
symcharacter?
or
an
idiopathic
Structural alterations may,
to a considerable
undoubtedly,
extent, be developedin the material instrument
of the mind, without, for a
period,in a marked
with
the mental, sensorial,
motoor
interfering
manner,
This
admits
of a satisfactory
rial functions.
nation.
expladisorder

This

earlyperiodof

of the
its

functions

of the

manifestation, is of

brain, in the
so

slightand

overlooked
character,that it is easily

by the
important
unas well as by his physician.An
apparently
patient,
sensation
knittingof the brows, a trifling
in some
of numbness
part of the body, a condition of
local muscular
weakness, a state of ennui,"
or
general,
and physical
mental peevishness,
restlessness,
irritability,
exaltation of the
almost inappreciable
or
depression
an
animal spirits,
an
impairmentand disorder of the sense
fect
deof sight, loss,aberration,or confusion of memory,
of hearing,"
in, or acute manifestation of the sense
to concentrate
for mental work,
an
inability
an
inaptitude
the attention continuously
on
any subject,a state
tion
trivialdeviaof sleeplessness,
or condition of lethargy, a
of talking,such as suddenly
from the usual mode
pausing in the conversation, as if to regain a lost

transient

"

"

"

"

"

"

"

"

"

"

train of

ideas,
"

with

ciated
assoslightdefect in the articulation,
to
of words, and inability
transposition
a

certain letters,
are

pronounce

all characteristicsymplomt,

of disease having commenced

diagnostic
frequently

in the

brain*
"

Vide

chapteron

the
"

case
interesting

The

of the late

.Morbid 1'honomena

King

of Sweden, detailed in the

of Attention."

14

INTRODUCTION.

How

do

often

discover, when

the

historyof a
serious case
of brain disease is investigated,
that years
bited
priorto its apparent development,the patienthas exhisimilar
symptoms of cerebral disorder, somewhat
have entirely
to those justdetailed,which
vation
escapedobserwe

seizures, marked deviations from

Slightepileptiform
gence,
healthythought, obvious impairment of the intelli"

"

occasional either

"

in

power,

part of

some

and

headache

anesthesia,
or exaltation

the

of

an

of

sation
sen-

loss of motor
body, trifling
acute type,have
existed for
"

time

to the supposed commencement

of
previously
disease,and yet have entirely
escapedobservation,
if recognised,
been soon
forgotten
by the patientand

some

the
and

his friends.
The

alterations of structure

after death

pia mater,

the internal table of the skull,dura

on

araclmoidea,and in

tunica

in the vesicular structure

as

the

observed
frequently

so

mater,

the

fibrous,as well
of the brain,are
commonly

results of

irritation,
long-continued
gestion,
concapillary
of adveninflammation, (causingdepositions
titious
in the blood
matter,) toxic agents circulating
ducing
promodifications of cerebral nutrition,
morbid

in the coats of the bloodvessels

which
to
anteriorly
of this organ,

of the

have, in many

the
and

attention

before

the
pathologist,

that

has

of the

brain

cases,

commenced

beingawakened

death,has

sad extent

been

and untreated,within

changes

(fatty
degeneration)
years

to the state

revealed

to the

of fatal structural

almost
progressing,

organizatio
dis-

cognised
unre-

the cranium.

this subject,
bound
we
considering
are
ignorethe fact,that the brain has greatpowers
In

and

eye

is facile to the existence of

not

of

to

modation,
accom-

considerable

degree of organicpressure, if equallydiffused,and of

structural lesion,
providedit be restricted to "the niedul-

PHYSIOLOGY

larymatter,
growth ; but

and

the

of the

has

of

minute

been

1 !j

BRAIN.

of

slow

and

progressive

of sudden
amount
appreciable
blood, the effect of the ruptureof one

cerebral

hemispheres,or

o/jfici,
pom

THE

the smallest

extravasation
of

OP

varolii,
or

vessels
on

the

on

the

corpus

surface of

one

striatum,thulami

medulla

is immediately
oblongata,
followed either by paralysis,
and often by
or
convulsion*,
death itself. A considerable extent of pulpy disorganization,
o
f
or
softening the cerebral structure,a large

of fluid effused into the ventricles,

a

amount

tent
great ex-

of

vesting
inthickeningand opacityof the membranes
the encephalon,
well as largecollections of
as
encystedpus, in the shape of abscesses,may, however,
exist embedded

in the substance

of the brain, without

to any
marked,
apparently,for a period,disordering
and serious extent, its functions.
It is necespalpable,
sary,
for a rightappreciation
of this subject,
that we
should fully
of the laws regulating,
and
one
recognise,
action of the brain.
governingthe physiological
The encephalon,
althoughadmitted to be the material

instrument

of the mind, the

sensation,the organ

fountain

head

of

takes

cognizanceof impressions,
extremities of the
made either upon the peripheral
of those conveyed
from the encephalon,
or
nerves, remote
directlyto the sensorial
through the specialsenses
is,when in a state of health, insensible to any
ganglia,
kind
The

of stimulus,

which

seat and

or

even

laceration of its substance.

brain, whilst destined to

the painful
acutely
perceive

of other organs, is itselfnot conscious,in the

impressions
ture.
strucincipient
stageof disease,of the lesions of its own
acute
most
Its sensibility,
however, becomes
of the
when
is diseased.
its structure
Large portions
hemispherical
gangliahave been removed by the knife,
and
have even
sloughedaway, without givingrise to
appreciabledisturbance of cerebral phenomena,
any

10

INTRODUCTION.

obvious inconvenience

pain,or

but any

however,
injury,

inflicted upon
the sensorial ganglia,
whether
the result
is invariably
of a morbid
process, or artificialirritation,
turbance
disby great cerebral disorder,and unequivocal
of their special
functions.*
has no difficulty
in prediphysician
physiological
cating

followed

The

the immediate

effect of

of,or mechanical

alteration in the structure

an

pressure

the

upon

thalami

opiici,

varolii,corpora

medulla
or
quadrigemina,
oblongata.
The
functions,as well as pathologyof these, and other
well ascertained,and fullyestablished.
are
ganglia,
When
to this subject,
a
referring
distinguished
siologis
phy"Considered
should exwe
pect,
theoretically,
says:
that the sentient fibres,
which
proceed from the
and expand themselves in all partsof the
medulla oblongata,
greaterand lesser brain,would bestow on these formations,
well as upon the medulla oblongala,
of sena highdegree
as
sibility.
But experiencegivesresults for which a satisfactory
deficient ; thus, if the
explanationis stillentirely
cerebral hemispheresbe laid bare in a mammal
or
bird,

pons

"

As

to the

in those parts of
sensibility

of the intellectual

Sir Charles
faculties,

the brain

supposed to be the seat

we
ought not to

Bell observes,that

expect the

of the brain
same
or
phenomena to result from the cutting
tearing
The function of the latter is to transmit
injurydone to the nerves.
sensation ; that of the former
is higher,and this is inferred from its being
insensible.
If on examining the structure of the brain,"says this eminent
of white medullarystriae,
and fasciculated
physiologist,we find a part consisting
as

from

"

"

like
transmit

nerve,

should

we

sensation,such

of the brain.
pai'ts
of the

partshave
rather

which

that,as the

If

masses

are

are

found

media

use

of the

look upon
the same

such

as

authority,
"

at

different times all the

tend

to confirm

the conclusions

which

anatomy, viz.,that the cineritious and

seat

of the intellectual functions."

the

experimentsmade

I should

be

tance,
impor-

; we

may

internal parts of the

loss of sense, but I have never

disease
seen
the hemispheres without derangement of the mind.
then
subject,

of

that such

I have found," continues

higherpowers.

brain diseased,without

the surface of
correct in this view of the

necting
con-

in the brain unlike the matter

yet occupy

the seat of the

is to

nerve

of communication

a placeguarded as
an
organ
holdingevidently
importantrelations,we may presume
different from that of merely conveyingsensation
uses

nerves,

and

and

conclude

tracks of matter

upon

generalon
If I be

the brain

inclined to draw

superficial
parts of Jhe brain

from
are

the

PHYSIOLOGY

OF

THE

which
in itself in
operation
of perceiving
capability
pain,we
an

touched

and

the animal
trifacialnerve,

no

the
degreedestroys
find that they can be

transfixed without

even
;

17

BRAIN.

in the least disturbing

it onlystruggles
and cries out when

the

crura

the

cerebri,the optic
thalami,or the

medulla

touched.
oblongataare accidentally
Again,if
hemispheresbe removed by slices down to the centrum
ovale or to the cavityof the lateral ventricle,
the

the

animal
hair

or

remains
a

nail.

as

indifferent

The

same

as

if

we

phenomena

were

cutting
o

have

also been

in man
observed
repeatedly
; thus, a
portionof the
hemisphere
througha wound of the skull has
projecting
been removed
without producing
any action ; and, again,
have been taken
partsof the substance of the hemisphere
bodies
away by the surgeon in removing pus or foreign
without the patient's
consciousness."1
This sad neglect
of well-marked
symptoms of brain
disorder may, to a degree,
arise from
the fact,that the
abnormal
mental
state of the patient
is,in many cases,
viewed in the light
of heal thyexaggerations,
eccentricities,

thought. It is
difficultforsome
to understand the importantphysiological
relation
has the same
that disturbed intelligence
principle,
has to the lungs,
to the brain,that disordered respiration
the earliest
and heart. The importanceof detecting
pleura,
disease of the brain,
or existing
symptoms of approaching,
extravagancesof

or

natural conditions of

pointof view, be over-estimated

practical
and special
or
exaggerated. Consideringthe peculiar
lished
functions of this organ, and the close sympathy estabtissues ;
between the sensorium, and other organic
how slight,
minute, and infinitesimala degree
appreciating
both
vesicle paralyzes
of structural change in the nerve
the
in estimating
body and mind, we can have no difficulty
cannot, in

"

Lehrbuch

Valentin.

der

des
Physiologie

Menachen."

Band

11.

Von

P. 743.
C

Dr. G.

18

INTRODUCTION.

should attach to the

value which

at the earliest
detection,

of the faintest scintillation of any actual

possible
period,
in the delicate nervous
disease existing
organization.
and closely
should the phyHow
sician
zealously,
cautiously,
chief
watch for the incipient
dawnings of cerebral mis! Who
gence,
can
guaranteethe integrityof the intelliand healthy
condition of the sensibility,
normal
action

of the

if

power,

is the seat of morbid

structure
to

motor

action ?

with certainty
the
predicate
of the periphery
of the

lose

sightof

action

can

the

fact,that

exist for any

Is it not

result of

possible
mation
neglectedinflam-

brain?

We

irritation or

no

vesicular

delicate

the

lengthof time,

should

never

inflammatory

in the

of the brain,without
tissues,
or ganglia

more

portant
im-

seriously

life!
the reason, and endangering
perilling
How
do these observations applyto the detection
forcibly
of the incipient
symptoms, of all typesand degrees
of mental

disorder !

It is

if not eighty,
seventy,
per

well-established fact, that

admit of
insanity
easy and speedycure, if treated in the earlystage,provided
there be no strong constitutional predisposition
to
cerebral and mental affections,
cranial malformation;
or
existing
and even
when an hereditary
taint exists,
derangement
of mind generally
to the steadyand perseyields
vering
of therapeutic
administration
agents,combined
with judicious
tions
the firstscintillamoral measures,
provided,
of the malady are
and, without
fullyrecognised,
loss of time, grappled
with, by remedial treatment.
A vast and frightful
of chronic and incurable
amount
of our
exists at this moment, within the precincts
insanity
traced
county and private
asylums,which can be clearly
cipient
of the disease,in the first or into the criminal neglect
when
much may be
so
stage. It is at this period
effected in preventing
those destructive alterations in the

structure,and membranes
after

cent, of

of the

death,in those who die

cases

of

brain,so ofton witnessed

of chronic mental

alienation.

20

INTRODUCTION.

patient.There have
themselves, from the
been instances of the magistrates
for the admission
kindest motives, refusingto grant warrants
after he has heen examined
of a patient,
even
by
a medical
gentleman,who has givena certificateof his
because when
broughtbefore them he has been
insanity,
The consecertain questions
quence
able to answer
correctly.
to
is,that from this delay,instead of returning
his friends in a few weeks, which, in all probability,
not confined

would

been

have

remedies

had

remains

and

parish. In

to the friends of the

at

the

been

once

in
some

case

the

if proper medical
he becomes
applied,

Asylum

instances

for

delay has

moral

incurable,

life,a burden

similar

fatal consequences.
It is sincerely
hoped that

and

to the

been

tended
at-

with

knowledgeof these
will induce
circumstances
to be
an
earlyapplication
if the
made
for the admission
of patients
as, even
;
ciple
neglectdoes not prove fatal,it is contraryto every prinof justiceand humanity that a fellow-creature
should,from the want
deranged,
perhapsonlyon one point,
of the earlyattention of those whose
duty it is to watch
from allwho
out his existence separated
him, linger
over
"

dear to

are

be

him, and

prisonerfor

the

condemned,

without

any crime, to

life."

the grey porpremonitorystage of insanity,

tion
is frequently
in a state
of the hemispherical
ganglia,
I
condition
of capillary
congestion.This pathological
what I have to say on
remark, without anticipating
may
of the incipient
the subject
of the medical treatment
toms
sympdealt
is
and
of cerebral
mental affections, easily
with,
and
the further progress of the disease arrested by
A few leeches and cold applications
measures.
therapeutic
of plethoric
in young
the head, particularly
to
persons
and freedom from all excitement,
habit,active purgation,
quietude,
and mental ; counter-irritation to the
physical
head, the administration of the tartrate of antimony,and
In

the

IMPORTANCE

the

OF

EARLY

judiciousexhibition
has

into

been

of

opium

relieved,and

21

TREATMENT.

after the

the

local

secretions

gestion
con-

brought

healthycondition,will,in eightyper cent, of cases,

and arrest the further progress of the
the patient,

cure

mischief.
In
of

certain

type of

is in
insanity,

an

the brain, in the

case,

an

sheet-anchor

the vital and

condition,and

antic

feeblymanifested.
is undoubtedly
opium in

force but

nerve

earlystage*

In

these

cases,

its various

our

formula4,

cipate
not antiBut I must
generous diet,and blood tonics.
what I have to advise in its proper placefor the
of

insanity.
of recognising
"The
importanceor rather necessity
disorders of the head in their earlystage,"
says Dr. F.
is obvious from the consideration that they
Hawkins,

medical

treatment

"

then

can

In acute
power

alone be attacked with

the

cases,

whether

But

of

chance

brief indeed

periodis

of art is available.

any

the

success.

in which
case

the

be acute

chronic, it is only in the earlystage that its precise

or

nature

admits

of

with
being distinguished

its further progress, from the extensive

brain with all parts of the body, so

accuracy.

In

of the
sympathies
many

functions

the symptoms
and so various are
implicated,
which arise,as to precludearrangementor classification,
aid which in most
and defythe art of diagnosis. The
of
are
capable
the sensations of the patient
other cases

become

us
affording

is lost to

us

too

head, until in their advanced

another, and

presentalike

soon

in disorders of the

they all resemble

dreary abolition of

state
a

one

the

highly
tinguished
of being dispreciousin which these affections admit
treated with any hope of
or
with precision
powers

of animal

life.

The

periodtherefore

is

advantage."1
of Physical-,M.y,
Lectures, delivered before the College
1829, by Francis Hawkins, M.D.
"

Croomian

22

INTRODUCTION.

Let the

then estimate,in all its vital importance,

physician
and
necessityfor prompt treatment
grave

the
decisive
enemy

remedial

is at the

gates,and

satisfied that

when

measures,

has

attacked, or, is

on

the

the
eve

of

these circumstances,
the citadel !
Under
assaulting,
in bringing the
hesitation, delay, or procrastination
is fraught
patientwithin the range of curative measures,
with

the

direst

results,and

Let

not

the

with

saddest

quences.
conse-

close our
wilfully
monitory
eyes to the presigns,however apparently
insignificant,
slight,
transient,and fugitive
they may appear, of actual mental
disorder and brain disease,for it is in this earlystage
much
when
be effected by judiciousmedical
so
may
treatment

us

to obstruct

the

of the fatal cerebral

advance

mischief.

Having

dwelt

at

some

lengthon

stagein all affections of

importance of watching for the
precursory

the

the

existence of

brain,and

on

the

threateningsof
in
to investigate,
premonitorysymptoms

first

cerebral disorder,I propose

incipient
the generalcharacter of the
detail,
It will be well,
of encephalic,
disease.
and mental
however,- to premise,that I cannot, in this work, do more
than generalize
this wide and expansive
on
subject.
When
I address myself,in the succeeding
volume, to
the consideration
of specific
typesof brain disease,it will
be my object
into detail,and to
to enter more
elaborately
the diagnostic
premonitory
pointout, as far as practicable,
signsof the various organicaffections of the encephalon.
Many of the symptoms to which I shall refer as valid
evidences
of incipient
brain disorder will be found common
to several lesions of this organ, each presenting
an
different aggregategroup of symptoms, as well
essentially
phenomena.
as distinctive anatomical, and pathological
that a generaldescripNevertheless, I am of opinion,
tion
of the incipient
or
resume
signsof morbifl.conditions

DIVISION

of the

OF

THE

SUBJECT.

individual forms of cerebral

brain,beforeconsidering

disease,will not be without

this

Agreeably to
analysethe subjectin

2. Morbid

This
three

followingorder

States

tance.
impor-

propose

to

"

of Intelligence.

of Motion.

Conditions

Morbid

3.

the

arrangement,

Phenomena

Morbid

1.

its practical
value and

of Sensation.

the
subjectfullyrecognises
of the
functions
cerebro-spinal
physiological

classification of the

system,viz. :
ft.Motion.

Thought.

a.

Phenomena

Morbid

4.

y.

Sensation.

of the Special

Senses.
Viz.: S.
e.

Sight.
Hearing.

i.

Touch.

6. Smell.

" Taste.
5.

of Sleep,and
Dreaming.

Phenomena

Morbid

Phenomena

6. Morbid
or

Viz.-,a.

Nutritive

Digestionand
Assimilation.

of Organic,

Life,
7.

Respiration.

9. Generation.

/3. Circulation.
7- General

of Pathology,Treat.
Principles
ment, and Prophylaxis.

24

PHENOMENA

MORBID

OF

INTELLIGENCE.

II.

CHAPTER

Morbid
THE

Phenomena

of Intelligence.

brain, being the material

the

manifests

of the intelligence,

through which the mind

the
it is in conformitywith

physicalmedm

its varied

instrument

powers,

and, in obedience to the laws of inductive

logic,
vesting
to infer,that no changes in its structure or inreasoning,
rules of

membranes

qualityof
calibre

the

of the

can

take

no
place,

alteration

anatomical

vital fluid,or

in the

character

or

bloodvessels that circulate and

numerous

ramifythrough its substance can exist,without, to some

tions.
funcextent, interfering
with, or modifyingits psychical
Cases, however,

record, in which

on

are

serious

injuryhas been done to the brain during life without

and considerable encephalic
damaging the intelligence,
(as the result of disease)has taken place,
disorganization
no
aberration, exaltation,depression,
or
impairment of
the mind, having been observed, previously
to death. If
such cases
be considered either
have occurred, they must
of a rare
and
character,or, as pathological
exceptional
curiosities,
unless, in
structure

every
is strictly
confined

to the

fibrous,or

instance,the alteration of

or
stricted
rehemisphere,
conducting
part of the nervous

to

one

structure,the vesicular matter, and its minute

vessels

maining
re-

free from all morbid change,

entirely
abnormal
Is it possible
to conceive any
modification.
or
in the medullary
great extent of disorganization,
even
portion of the cerebral mass, to exist, witliout impli-

intact,and

EFFECT

DISEASE

OF

THE

BRAIN

ON

THE

MINI).

the grey matter of the brain,and,

degree,
the phenomena of thought
?
consequence, deranging

eating,to
as

OF

some

It is not

my

intention

to

discuss

in this work

the

and
volved
incomplexquestions(physiological
metaphysical)
in an
relation or
analysisof the psycho-somatic
union between
and organization.
mind, and matter, life,
It is sufficient for my purpose
to affirm,as a general
that all structural lesions of the encephalon,
its
postulate,
and
bloodvessels, are associated
investingmembranes
with some
derangement,modification,or altered action
of the psychical,
notarial,or sensorial functions of the
the scnsorium
AuiOtiTi)pioi")
greatcerebral ganglion(trpwrov
commune.

Softeningof

the

brain, abscesses,tumours, atrophy,

induration,and other forms of cerebral disorganization,

been
discovered in the brain after
have, it is alleged,

having disordered,or
intelligence
during life. But are not
death, without
anomalous

cases

If the mental

even

impairedthe
and

these unusual

?
and cerebral condition of those who

have

organicdisease of the
of their intellectual,
full possession
to a
sensorial,and motorial powers, had been subjected
pairment
close and rigidanalysis,
some
degreeof disorder,or im-

been

to
represented
in
brain, apparently

of
M's

form
that

have

these

been

have

died

functions

detected.

We

of

would, I believe,in many

are

too much

to
disposed

in these cases, and to infer,

hastygeneralizations
for a time, on ordinary
talks rationally
because the patient
is under the influence of no appreciable
subjects,

illusion,hallucination,or aberration,that, therefore,the

sound
perfectly
healthypsychical,
Such apparently
state.
manifestations,are quiteconsistent with the
of
and even
disease, impairment,
encephalic

intellect is unclouded, and the brain in

and

normal

and

cerebral

xistence

nal

of

latent,and

concealed mental

aberration.

Tl

26

MORBID

conditions

OF

PHENOMENA

of the

brain, and

INTELLIGENCE.

mind, would, I believe,be

devoted
detected,if sufficient time were
frequently
to their analytical
and, accurate, pathological,
investigation,
and
tests,were
scientifically
psychical
diagnostic
employedby experts,practically
acquaintedwith the art
of examining the subtle phenomena of insanity.
more

It has been

workings

observed,

of

such

that could

"

cerebral

are

conditions, but
and

notice.

Yet

wherever
cerebral

in this way

the

the rule will be

there

has

from

dependentupon

are

pass for mental

disordered actions

liarities,
pecuescape

true, that
logically
the trace of organic

found

found

been

also will

change,there

mental

which

way

be recollected

It should

oddities which

many

some

found

not be discovered

condition,althoughit may

in their external manifestations.

that there

be

intellects,they would

limited,perverted,
altered,
or
changed in
their normal

the interior

see

we

been

have

disturbed

manifestations."

affirm,that

in

case

every

of disease

if the organicchange or
phalon,particularly

established in the vesicular

matter,

or

of the

ence-

pressure be

in the membranes

the brain,a disordered,or abnormal

immediately
investing
state of cerebro-psychical
cipient
phenomena may, in the in-

stage,on

careful examination, be detected.

remarks, I proceedto
Having made these preliminary
the investigation
of the first,
section of the
or
psychical
subject.
The

mind

may

be in

state of morbid

"

1. Exaltation.
2.

Depression.

3. Aberration.
4.
These
their

Impairment.

exhibit in
unhealthyintelligence,
origin,progress, and termination, a 'varietyof
conditions of

28

MORBID

INTELLIGENCE.

OP

PHENOMENA

frequently
urging its unhappy

victim to the commission

of suicide.*
is in this state of insane

It

thought, that

terrible

between an intensely
morbid,
struggle
ensues,
occasionally
and often,irresistible impulse to suicide,and the natural
well as
instinct of love of life,
and
as
self-preservation,
and
of worldlyprudence,
religion,
antagonistic
principles
that are
to retain a
happilyseen
morality,
occasionally
mastery, and exercise a controllinginfluence over the
mind, goaded on by disease,to self-destruction.
In the
heads

morbid

mental

affections

under

included

of,aberration and impairment,are observed various

each

with
almost imperceptibly
gradations
(blending
of

psychicaldisorder,
*

the

It is

to
fallacy

suppose,

weakness,

and

state of ennui

to be

other)

extending from
of brain

one

rest, and

active condition of the mind,

psychicalinactivity.It is, in many
cases, an
the
and, consequently,
unaccompanied by
healthygratification,
pleasurable,
usuallyassociated with ordinaryphases of intellectual labour, and emotional
In life,"
excitement.
always believe that we are seeking
says Pascal, we
in
is
all that we seek
reality,
agitation." Is," says Sir W.
repose, while,
find
is that doing nothing in which so many
Hamilton, the 'Jar niente
in
sincere a gratification,
and
in reality
of
not
truth
so
a
negation activity,
is simply
itself an activity
intense and varied ?
To do nothing in this sense
to do nothing irksome, nothing difficult,
to do
especially
nothing fatiguing,
outward
while
work.
t
he
But is the mind
no
unoccupiedand
internally
inert ? This, on the contrary,
be intently
be vividlyalive ; may
engaged
may
in the spontaneous play of imagination; and so far,therefore,
in this case,
from pleasure
the activity
is,on the contrary,
being the concomitant of inactivity,
*
*
*
*
at once
Ennui is a state in which
vigorousand unimpeded.
find nothing on which
is a state of
to exercise our
we
; but ennui
powers
All
all
In
the former,
i
s
labour.
pain.
occupation, either play or
energy,
the energy appears as free and spontaneous ; in the latter,as either compultinued
sorilyput forth,or its exertion so impeded by difficultiesthat it is only conforced
and painfuleffort,
in order to accomplishcertain ulterior
by a
ends.
Under
certain circumstances,
playmay become a labour, and labour
"

"

"

"

"

become

may

play."

mind

in the contemplation
of
be occupied
ennuyed, may unconsciously
and physically
laborious and depressing
mentallydistressing,
thoughts. Let
A

us,

that
not flatterourselves with the illusion,
therefore,

is necessarily
one
inactivity
How

true

want

of

mind

thoughts.
"

of repose, rest, and

it is

freedom

lifeof idleness and

from

"

occupation
givesno
quitevacant, is a mind

rest ;

distressed."

"

painfully
turbed
-per-

SYMPTOMS

EARLY

forms

shadowy

tin*

derangement

and

from

brain-fag,

tone,

weakened

the

earliest

health,
and

resemble,

transient

psychical

affection

of

action,

cinations,
hallu-

positive
delusions

of

mental

and

actual

loss

stamina,
of

attention,

to

be

mind,

ordinary
conduct.

of

symptoms

important

remarkable
of
the

memory
obvious

natural
first

of

cerebro-

remember,

tliat

from

degree,

recognised
phases

to

deviation

appreciable

being

or

sense,

idiocy.

in

of

states

loss

of

powers

exaggerations

from

deviations

lassitude,

will

of

moral

to

insane

precursory

it

signs

often

or

modes

the

the

and

disease,

psychical

of

(dysmnesia),

imbecility,

ment,
judg-

erroneous

thought,

manifested

flagging

analysing

In

of

cerebral

and

perception,

confusion

29

DISORDER.

perversions

memory

(amnesia},

MENTAL

false

clearly

and

of

of

volition,

paralyzed

states

OF

and

mental

temporary

healthy
of

symptoms

by

certain

thought,

ditions,
con-

and

marked
normal

the

30

PREMONITORY

SYMPTOMS

CHAPTER

OF

INSANITY.

III.

PremonitorySymptoms of Insanity.
THIS

subjectis

too

important and comprehensive,to

be

to embody
analysedat any lengthin a work which professes
only an outline of incipientmorbid cerebral,and
psychical
phenomena.
order :
This section will be considered in the following

1.

Anomalous,

and

masked

affectionsof

the mind.
2.
3.
4.
5.
6.
This

Stage of consciousness.
Exaltation
of mind.
Depression of mind.
Aberration
of mind.
Impairment, and loss of mind.
classification of the

phenomena of disordered
thought will embrace the more
prominent and salient
pointsconnected with the subjectof incipientinsanity.
however, to my consideringany one of the
Previously,
precedingsections,I propose to discuss cursorily,
1. The present limited knowledgeof the physiology
of the
nervous
system,and ignorance
of the phenomena of mind,
and life.
and dreaming.
2; Analogybetween insanity
3. State of the mind, when passing into a condition of
deduced from the written confessions
as
alienation,
ofpatienta
afterrecovery.

K.NORANCE

Morbid

4.

the states

OF

THE

NATURE

OF

31

INSANITY.

as
phenomena of thought,
manifestedduring

of transition,and convalescence from

attacks

of

insanity.
In order to obtain

of the
rightappreciation

mind

in

well as matured
conditions of disorder,
it
as
incipient,
will be requisite
for the psychological
to analyse
physician
with metaphysical
medical
exactness, and scientific,
the intellect,
when in the preceding
states of unhealthy
precision,
manifestation. These are four philosophical
points
d'appui in this important inquiry,and if elaborately
clearer insightmay
a
and, faithfully
investigated,
yet
be obtained of morbid
psychicalphenomena, hitherto
deemed
inexplicable.
very obscure, if not, altogether
of the premonitory
to an analysis
Before proceeding
symptoms of the various types and phasesof mental and
cerebral disorder,it will be well to refer to, the following
selves
interrogatories:
theysuggestthemimportantpreliminary
or
as
startingpointsin this inquiry.
prefatory,
covered;
disIs its nature known
?
What
is insanity
; its essence
the laws governingits phenomena understood ?
its

is the constitution

What

of its materies

morbi

the exact

emotions,
condition of the moral, and intellectual faculties,

during, to
passions,
languageof Coleridge,
suggestive

instincts,or

"

use

the

significantly

the mind's

revolt

own

what does mental derangement consist?

upon itself ? In
emotional, or
Is it an affection of the moral, intellectual,
"

faculties,and
perceptive
memory,
the

malady ?

itself

more

Is there

in conduct,than

nature, where
which

and

and

The

reason,

in the ideas ?

where

is the

is the

What

alienation of mind

faculties does the disease

brain, of the latent insane

"

the

the seat, of the

of the mental

its ravages,

parison,
judgment,comin
imaginationmost implicated
a
type of insanitymanifesting
are

In

commence

in
position,
precise

nidus,or germ

of inanityWM
description
poetical
subjoined

the

?"
written

by

lunatic

32

PREMONITORY

SYMPTOMS

OF

INSANITY.

Has

a centripetal,
or
a subjective
insanitya centrifugal
do
or, an objective
origin? In less technical phraseology,
the disordered
ideas of the insane depend upon
centric
of irritation and disease,operating
from within to
causes
of eccentric or, objective
without, or are theythe consequences
influences,
actingfrom without to within; in other
words, are we to consider the symptoms of mental alienation,

as

emanations

(to borrow

from

the

brain, similar in character

appropriateimage)

an

the

to

"

rays of

light

proceedingfrom a body which is itself ignited,"

or, are
they analogousto the rays reflected from a polishedsurface,
in intimate organicsympathy with disordered action
established in a remote
part of the body ?
Is insanity
affection of the minder
se?
Has
the
an
disease a psychical
for
? Is it possible
or, a somatic origin
confined in the State
from

the pen of

Asylum, Utica, U.S.A.

in

man

It is

state
unquestionable

an

"

maniac

as
interesting
proceeding
derangement.

of mental
!

Know

ye the meaning of that word,

art possess "d ?
Ye, who of health and reason
Can
tumult

The

ragingin

Could'st thou

And

behind

see

Then

To

Be

'neath

those,whose
see

His

see

bars of iron,heated

Enkindled

it is not

poor

them.

he doth conceive is real,

him

scorch'd

red
On

by fire,

quench'd.

doth

Should

distracted soul,will, by
Then

side

every

office 'tis (itso

tempest toss'd.

man

distracted soul,

it,what

might'stthou

'Pon

Are

the inner

aside the curtain

envelopehis

doth

That

draw

scan

ye

seem

to

him),

this delusion leave

some

new

him,

fear,

will he

fancy
Everything that he doth see or hear,
And cannot comprehend, is but some
method
To destroyor harm
him.
Thou

canst

not

know

nor

feel,

God hath bless'd with reason,

0 ! ye, whom
A tithe of what he suffers :
For thus to know
Thou

must

or
feel,
become, like him,

Asvluin,Ftica, N.Y.

maniac

!"
*

J. M.

B.

IGNORANCE

OF

THE

MENTAL

AND

NERVE

FORCE.

33

thought,in the abstract,to be diseased,

of
independently
iniages occupyingthe consciousness ?
Does alienation of
mind depend,not exclusively
somatic
or
upon a psychical,
but

cause,

disturbance

upon

in

the

normal

relations

(instates of cerebral,and mental health)between

existing
the mental, and physical
functions of the brain ?
Before endeavouringto solve these subtle and abstruse
problems,it will be necessary to ask what
psychological
is mind?
Have
we
any knowledge of its nature, clue to
idea

its seat, accurate

to

as

its mode

of

action,or anything

of its essence?
rightconception,
the modifications,the metamorphoses,
What
are
organic
and nerve-force
functional,which the vital principle,
or
undergo,during their passage through the exquisitely
vesicular
and highly vascular cineritious,
or
organized,

approximatingto

brain structure?
does

How

to
physiologists
of the

matter

occult mental

the

be

evolved

brain, become

or
so

believed by
principle,
eliminated

in

and
mysteriously

the grey
lously
marvel-

changed from nerve, to mental force, and vice

in the hemispherical
ment
ganglia? Is the developversa,
of psychical
phenomena the result of what is termed,
of dynamical
of the two precedingmodes
a correlation
or
creation,essence, principle,
action,or, is mind a new
in the vesicular portions
power, organizedor elaborated
of the cerebral

mass

AVliat is the nature

of the vis

nervosa

of Haller ? Is the

constituted,
galvanicbattery,and are the nerves
like electric wires ?
for the transmission of impressions,
"fluid,"or "force,"
Is the mysteriousand undefmable
in the nerve
tubes, a voltaic current, in other
circulating
or one,
identical with that of electricity,
words, a principle
sui generis?
entirely
and operations,
in its essence,
origin,

brain

What

is the vis vita, and

is it associated with, and

the
are
structures? What

how

dependentupon, organized

34

SYMPTOMS

PREMONITORY

INSANITY.

OF

and vital manifestations ?

the intellectual,

relations between

and psychical
greatproblemsof organic,
arrived
sub judice?* Have
we
physiologists,

not all these

Are

with
life,
still,

knowledge of the substratum of nervous

of the
matter ? Are we not obligedto confess our ignorance
?
of vitality,
ultimate principles
well as of intelligence
as
Is
Do we
know
anythingof their nature or essence?
not
our
knowledge of mental, as well as of vital,
confined to an
with
phenomena, entirely
acquaintance
these powers, as manifested
during life?f If our ignoat any

says

matter, St. Austin

Speaking

of the

Materiam

et ignorando
spiritumquecognoscendoignorari
cognosci."
in
he
unable
is
for
to conceive
nature,
mightiest
prodigy

of mind

mysterious union

and

"

"

"

exact

is to himself the

Man

body, stillless what is mind ; but least of all is he able to conceive

how a body can be united to a mind ; yet this is his proper being." (Pascal).
ject,
A contented ignorance,"
to this subHamilton, when referring
says Sir W.
is
indeed
wiser
but
this
lesson
is
than a presumptuous knowledge;
a
the last that philosophers
which seems
are
willingto learn. In the words of
of the acutest of modern thinkers, Magna immo maxima
ijeest
one
pars sapient
is

what

"

"

"

'

quaedama;quo
f

"

"

nescire velle.'

notion

The

we

merely relative.

to

annex

the words

asked what

and

matter

mind,"

matter, I

Reid,

says

"

is

by
only explain
coloured,moveable,
myselfby saying it is that which is extended,figured,
hard, rough and smooth, hot or cold that is,I can define it in no other way
than by enumeratingits sensible qualities.It is not matter or body which I
colour,and certain other
perceiveby my senses, but only extension,figure,
which the constitution of my
nature leads me
to refer to something
qualities
The case
is precisely
similar with
and coloured.
which is extended,figured,
conscious
of
its
mind.
We
not immediately
but we
are
existence,
respectto
which imply the existence of
of sensation,
are
thought,volition operations
thinks,wills."
something which feels,
Isaac
Newton
clined,
Sir
was
asked, why he steppedforward when he was so inand from what
his arm
cause
obeyed his will ? He honestlyreplied
If we were
to follow the example of
that he knew
nothingabout the matter.
admit
and
this great philosopher,
our
ignoranceof those subjects
modestly
have no knowledge,we should have a justconception
of
about which we really
of man.
No undertakingwould perhapsprove more
the shallow pretensions
If I

am

mean

can

"

"

beneficial to mankind
demarcation

Our

between

is

what

notion of the nature

substances.

metal," says
but have
but

than that which

what

we

is

"

When

greatFrench

any

we

endeavoured
and

reallyknown
is

of mind
wish

limited

as

to have

philosopher, we

crucible wherein

?
no
Assuredly
spirit

"

to

to draw

that

as

rude

which

correct

is

line of

jecture.
merely con-

rial
knowledge of mateknowledge of a pieceof
our

put it on

the fire in

crucible;

Is it spirit
? says one ;
put the soul ?
This is a word so void of
knows.
one

36

is sensible its

Reid, when

Dr.
.

knowledge, and
of

observes
thread

OF

its

dependson
utility

land, and committed

firm

if

SYMPTOMS

PREMONITORY

to the

to
referring

care

INSANITY.

being placedon

the

of others."1

the limited

the difficulties attendant

of

nature

upon

our

the investigation

well as
somatic phenomena,
as
psychical,
be too intricate,
and the
The labyrinth
may
fine to be traced through all its windings,but
"

"

too

stopwhere we can trace

ground we have gained,there
we

it no

farther,and

is

harm

no

done

in time trace it farther."

eye may
be foreign
It would
to the designof this

secure

; a

work,

the

quicker
were

and pathological
tion
investigapsychological,
in a state of fully-developed
of the
mind, when
insanity.This is a profoundand intricate subject.Its
and undivided
entitles it to separate,
vast importance,
I propose therefore to reserve
consideration.
tion
any exposito institute

I have

to make

in reference

to it for another

occasion.

duty to analysein detail,the mind in

and complex morbid
its simple,
types of alienation,and
of those
the nature
to consider, as far as practicable,
served
conditions, obdeviations,from normal psycho-somatic
in certain forms of mental disorder. Importantas
it does not exceed
I consider this section of the subject,
in interest or value,the careful studyof the pointswhich
examination.
I have suggestedfor further psychological
in the incipient
I refer to the condition of the mind
stage of disorder,when passinginto one of its numerous
emergingout of
phases of disease,and to its state when
of healthy
a morbid, into one
thought. It is by pursuing
of psycholowell as an Muctive, course
a Reductive, as
gical
sideration
inquiry; in other words, proceedingfrom the conand particulars
to
of universals to particulars,
universals,thus ascertaining(to use the technical lanIt will then

"

Essay

Beattie,LL.D.

on

be my

the Nature

and

of Truth,"
Immutability

p.

J9, by Dr. Janu-s

LAWS

GOVERNING

of the

guage

THE

OPERATION

schools)the relation

stands to the
the

OF

in

37

THOI'UIT.

which

the

and vice versa;

subsequent,
rigidprocess of analysis,
as

dent
antece-

it is

by

adoptionof a
well as of
in relation to the insane element,or
synthesis,
germ
evolved duringthe stage of incubation,as well as
by a
careful study of the laws governingthe general
tions
operaof the mind, at the approachof convalescence,
and
duringthe process of cure, that we shall be enabled to
the
appreciate(if such a result be at all practicable)
character,and
automatic

The

when
intellect,

reduced

to

an

condition,and, deprivedby disease,of

of

powers

state of the

its

healthyco-ordination.*

laws

co-ordination

or
governingthe operationsof thought,

of the various states

of the

of mind,

which

essential to

so

are
understanding,
supposed by

producethat
healthyequilibrium

Cousin, after Aristotle,to be

their nature

in

to act
impersonal. They are considered by metaphysicians,
and
knowledge acquiredby experience, are designated,
and
native mental cognition*,
as
by Sir W. Hamilton and other authorities,
conditions
T
his
of
constitutes
what
the
same
authority
intelligence.
primary
the
and is said to correspond
terms
or
regulative,"
faculty,
legislative,"
with the Aristotelian phrases Nouc
(intellectut,
rove
meru), as well as the
used
and rernunft,a*
the
term
"reason," as
earlyEnglishphilosophers,
by
The Regulative
adoptedby Kant, Jacobi,and other German metaphysicians.
force,evolved in
or
facultyis analogousin its effects to that subtle principle,
nizes,
harmothe cerebellum,which establishes a unityof action in,and adjust*,

of the
independently

"

"

"

and
is

the

co-ordinates the varied muscular

psychicalas
patientis not

these

the

cases,

well
under

as

phraseologyof

physicalchorea,

William

St.

body.

There

Vitus" dance, in which

In
transient delusion.

depend upon a disordered state of the

in the cerebrum),
in allprobability,
(eliminated,
the
executive,
or, to adopt the
be designated,

insanity
appears

Sir

or

fixed,or

the influence of any

psychicalco-ordinating
power
of what
and paralysis,
may

of the

movements

to

Hamilton,

regulative and
"

"

"

"

legislative

faculties of the mind.

The

deal
affected,
so
patients

horrible
Filthyejaculations,

of ideas.

absurd combinations
inexplicably
wild
oaths, blasphemousexpression*,

in the most

obscene,
and contempt, allusions the mot
of love,
sentiments
exalted
with the most
often singularly
are
intermingled
fenrent,
affection,
virtue,purity,and religion.United to the impassioned,
and
tionable
eloquent, unexcepand piousappeals
to the Deity,clothed in appropriate,
frantic
and
character,
diabolical
of
denunciations

of hatred,revenge,

language,are

that cannot
imprecations
terror

phrases
be

truly

listened to

without

excitinga feelingallied

duty it U
painful
degradedhuman nature.

in the breast* of those,whone

and
bitions of poor, fallen,
this rkoreic
from
whilst suffering

bite,caress,

aud
beat,kiss,vilify,

type of

to observe

I have

"uc

known

to
alternately
insanity,

those
praise,

near

them

to

pat its,
cow,
spit,

and to utter

88

SYMPTOMS

PREMONITORY

Without

from

refrain

cannot

special
theoryof
attention, en
directing

elaborate

attemptingto

I
insanity,

passant, to the close resemblance

forms

many

during the

mind,

obtains, between

that

alienation,and

of mental

brain, and

INSANITY.

OF

state of the

the

conditions

of

sleep,and

dreaming.
The
view

of

well

as

facts recorded in this volume, with

singular
the subject
of incipient
elucidating
insanity,

many

as

of obscure

diseases

of the

brain, constitute,

strikingillustrations,
accordingto my apprehension,
good and valid evidence, of the remarkable
analogy
these psychical
between
existing
phenomena.
How
describe the
does Sir W. Hamilton
accurately
transition
state of the
mind, between
sleepingand
does it correspond
with the condition
waking,and how closely
of the intellect,
during the stage of incubation,
when the mind, losingits sane
consciousness of objects,
approaches the confines of mental alienation ? When
"

roused

from

the

sleepingand
"

state, (intermediatebetween

transition

find, says Sir W.

waking,)we

ourselves conscious

Hamilton,

of a
being in the commencement
dream ; the mind is occupied
and
with a train of thought,
this train we
stillable to follow out to a point when
are
it connects
itself with certain actual perceptions.We
still trace imaginationto sense,
and
show
can
how,
of real
departingfrom the last sensible impressions
of distorting,
the fancy proceedsin its work
objects,
and perplexingthese, in order to construct
falsifying,
out of their ruins its own
grotesqueedifices."
In dreaming,as in certain forms of disordered mind,
sentiments

moment

and

of the most
is often

illusion.

and

that would

afterwards
immediately

mouths

of

use

do

honour

to

orthodox

depravedof human
unassociated

beings!

disease of the uterine system.

This

of divines,

proceedfrom
phase of mental

languageonly expectedto

with any form

It is generally(inwomen) connected
seen

the most

the
nation
alie-

of delusion, hallucination,
or
with

some

obscure

irritation

INSANITY

AND

I) HI

39

\MINO.

intellectualvigour,
and states of mental

phasesof

acuto-

which
developed,
not normal
were
tions
manifestaduring the waking hours, and were
not
known
in
to exist,
conditions of healthy
thought. The most
creations of the poeticfancy,
have been
exquisite
dered
engenunder
these
circumstances,and
conceptions
the
to
suggested
dreamy consciousness,which have
paved the road to fame, and fortune. During the hours
of sleep,
the intellect has, with
solved
rapid facility,
subtle questions,
which
had puzzled and perplexedthe
mind, when in full and unfettered exercise of its waking
faculties. Difficult mathematical
problems; knottyand
disputedquestionsin the science of morals ; abstruse
points of philosophy,have (accordingto accredited
their
testimony) found
right solution
during the
solemn
darkness
of night, and
periodsof profound
sleep.*
ness

are

"

Strictly
speaking,"
says Rosenkrantz,

"

intellectual

problemsare

solved in dreams, because intense thought is without image*,whereas

is a creation of images. I perfectly
recollect having dreamt of such

not

dreaming
problems,

and, beinghappy in their solution,endeavoured to retain them in my memory.

I succeeded, but on awaking discovered that they were
quiteunmeaning,and
could

only have imposed upon a sleepingimagination."

man's
the madInsanityit"said to be a waking dream," with this difference,
with the delirious
conduct (as a generalprinciple)
is in corre"}"ondence
suggestion*of his disordered, unbridled,and uncontrolled fancy. If every
"

person

were,

the

enter

Cicero says, to carry

during the act of

as

mind

the
into operation
practically

neee"*ary, before
of motion.
Majorca
"

going to sleep,mechanicallyto
enim
'

restrain all power

ulli insani efficerentmotus
Homniantes."

quain

If,"says Pascal,
affect us

if an
was

artisan
a

as

we

pursued by

were

should suffer almost

as

great dread of sleepas

these misfortunes.
that
dream
"

much
we

an

artisan.

enemies, and

harassed

he

was

be

should
It is

Lectures

on

can

Metaphysics.")

happy

If

we

awake, that

dreams
we

dreamt

"

king

every

who

night

by horrible phantoms,w"

were

onlybecause

"*

haps
perAnd

that he

hours

twelve

as

true, and
of waking, bad we

if that

as

we
say when
littlelens inconsistent.""
we

be almost

that he would

convinced

things,it would
perceive
every day.

same

object*which we
dreaming every night for

certain of

am

every

nightthe

the

as
powerfully

were

king,I

dreamt

we

dreamt for twelve hours that

that

69.)
(" De Divinatione,"

"

"

ideas that

be

dreaming,it would

should stand in

we

are

real

cause
hend
appreincondifferent and sistent,

have dreamt,

(As quotedby Sir

as

to

William

for life

"

"

Hamilton, in hi*

40

PREMONITORY

Sir Isaac

SYMPTOMS

OF

INSANITY.

mathematical

allegedto have solved a subtle

and Condorcet
problem whilst sleeping,

recognisedin

his

is

Newton

calculation which

dreams
had

the

final

steps in

difficult

puzzledhim

duringthe day.
Condillac
that when
Cours
engaged in his
says
d*Etude" he frequently
developedand finished a subject
in his dreams which he had broken off before retiring
to
"

rest.

Khan," was
poeticalfragment,"Kubla
Coleridge's
composed duringsleepwhich had come
upon him whilst
which
on
readingthe passage in Purchas's Pilgrimage,"
the poeticaldescription
written
was
founded, and was
down
immediatelyon awaking ; the images risingup
before him as thingswith
a
parallel
productionof the
without
sciousness
correspondent
expressions
any sensation or con"

"

of effort."*
In

so

dreaming,the mind is occupiedwith

and fantastic combinations
conceptions

of many
characteristic,
There

ideas, one

is

conditions

gruous
incon-

of

images,

of disordered

also,a similar want

lect.
intel-

of

in the coherence

conceptionfollowinganother,

rapidly
by a

the

and

this

ceeded
suc-

series of mental

in oppoimpressions,
sition
to all the legitimate
laws, governing associated
of the will,
thought. There is also a completeparalysis
over
subjective
phenomena, this facultyexercisingno
influence over
the train of suggestedideas.f
controlling
In the act of dreaming,the most
trivial circumstances,
*

t In states of

Carpenter's
Physiology,"
p. 643.
imperfectsleep conditions existing
midway
"

"

fulness and

between

wake-

the will does not appear

profoundcerebral and psychicalrepose
STEWART
has comaltogetherto be suspendedin its operations. DUGALD
mented
this
fact.
He
when
to the phenomenon,
observes,
It
referring
upon
be proper to remark, that,if the suspension
of our
may
voluntaryoperations
in sleepis admitted
as
which can
a
fact,there are only two suppositions
be
formed concerningits cause.
The one
is,that the power of volition is suspended
"

"

those faculties of the

; the other,that the will loses its influence over
of the body,which during our
mind, and those members
waging hours are
to
subject

its authority.If it

can

be shown

that the former

suppositionis

INSANITY

AND

41

DREAMING.

givea decided character and direction to the current of

of a bottle of hot water to the
thought. The application
feet of a person whilst sleeping,
has givenoriginto the
that he was walkingon the crater of a volcano
impression,
;
and upon a blister beingapplied
to the head,under similar
states of

mind, it suggestedto the person,

an

idea that he

being scalpedby Indians.

ring
Any sudden noise,occurin the immediate
neighbourhood,
or, within hearing
of the dreamer, will,in many cases, originate
in the mind,
idea of beingexposedto the crushing
effectof a terrible
an
avalanche,or suggest the notion, that he is wandering
some
over
drearymoor, during a fearful hurricane. In
was

instances, in

many

that

dream

has

beyond a minute, or, even a second, the

and
and chequeredlife have elaborately,

continued

not

of

events

long

in their minutest

relation,occurred to the mind, and, in the smallest ciable

appreof
able
remarkfull
periodof time, an eventful history,
incidents, has, in the imaginationof the person,
taken
The
where

place.
of
rapidity
events, which

in their

hours, days,nay,

occupy

occurringin dreams,
actual developmentwould
and
years, are compressed

action

mental

even

in a few
minutes, or even
comprehended sometimes
of Count
seconds, is finelyillustrated in the dream
I was
Lavalette.
"One
night,"he says, "while
the clock of the Palais de Justice struck twelve,
asleep,
I heard the gate open to relieve the
and awoke
me.
not

agreeableto fact,the

consequence.
"
That the power
the efforts which we

truth of the latter

of volition is not
are

conscious

dream, for

we

The

in

emit

example,that
attempt,indeed, in
are

feeble and

are

in

seems

to

follow

as

n"*wry

suspendedduring sleepappears

making while
danger; and we

of

the sounds

and
generalunsuccessful,

but this onlyconBrms,

indistinct,

from

in that situation. Wd
call out for innitnni

or

rather i* a

whi"
neoe*

that in tleeptht connexion between the i

of,the supposition,
consequence
The oontinuan
and our
is disturbed or interrupted.
voluntaryoperations
huMIW
M
of the power
of the volition is demonstrated by the effort,
Mind.")
tual."" (" Philosophy
of the Human

42

PREMONITORY

sentry,but

SYMPTOMS

INSANITY.

fell

sleepI

dreamed

Honore,

at the

asleepagain immediately. In
that I was
standing in the Eue
of the Rue

comer

darkness

sudden

OF

spread around

low

at
perceived,

and

towards

uncertain

me,

de 1'Echelle.
all

sound

soon

the bottom
a

still.

was

their hands, the flames of which

the

held

men

theless,
Never-

both

in the
sides.

and

overflowed

dishevelled

disappearedalternatelyat

faces without

the

street

with

eyes
from
their
own

blood

on

appeared and

women

the

silence ; low, inarticulate groans

in

in

"

kennels,which
Pale

and

men

Their hollow
bloodymuscles.
rolled in their largesockets,their mouths
opened
to ear, and
of hanging flesh covered
helmets
ear
hideous
heads.
The
horses dragged along their

skins

lancholy
me-

torches

illuminated

skin, and with

vancing
street,and ad-

troop of cavalry;

horses,however, all flayed. The

St.

All of

arose.

of the

tins

windows
filled the

with
alone, petrified

in

dismal

air,and I

mained
re-

horror, and

deprivedof strength sufficient to seek my safetyin

flight.This horrible troop continued passingin full
and casting
looks on me.
Their march,
gallop,
frightful
I thought,continued
for five hours, and they were
lowed
folof artillery
full
by an immense number
wagons,
of bleedingcorpses, whose
limbs still quivered. A disgusting
smell

of blood

and

bitumen

almost

choked

me.

At

length the iron gate of the prison,shuttingwith

me
great force, awoke
again. I made my repeater
strike ; it was
little more
than
midnight,so that the
horrible phantasmagoriahad lasted no
longerthan ten,
that is to say, the time necessary for relieving
minutes
the sentryand shutting
the gate. The cold was
severe,
and the watchword
The
short.
next day the turnkey
:

confirmed

my
one

which

I have

calculations.

singleevent
been able

more

I, nevertheless, do not
in

my

life the

exactlyto

duration

calculate."

member
re-

of

44

tions to be found
to

be

during the

in this

of the

mind

the

pears
ap-

insane,

patientappearing,

disease,the

of the

months, and

after many

illness,and

work) all idea of duration

obliterated from
continuance

INSANITY.

OF

SYMPTOMS

PREMONITORY

years, of sad

sometimes

to awaken,
isolation,
distressing

as

it were,

healthyideas
to
that had occupiedthe mind, a short periodpreviously
themselves to the
the accession of the insanity,
suggesting
out of

fanciful and troubled

consciousness,with

all the

of

sane

received
recently

In

dreaming,as
the mind

its

well

as

the

the

freshness,vividness,and force

in

some

forms

of mental

ration,
aber-

of
a clear apprehension
has, occasionally,
condition.

morbidly automatic

under

contemporaneously
impressions,
to its healthysupremacy.
reason,

of

with the restoration

dream

influence

of

person,

whilst

series of fanciful occurrences,

by dreaming, or insanity,will, occasionally,

with
to the
himself
as
realityof the
acutelyreason
images occupyingthe attention, and be fullyconscious
I
that he is insane, or dreaming. Dr. Johnson
says,
sions,
often duringsleepengaged in controversial discuswas
that my
and whilst recognising
sionally
antagonistoccahad the best of the contest, I entirely
forgotthat
own
arguments, as well as those advanced by my
my
supplied
by myself!"
opponent,were
has
the mind
formed
in cases
Even
of fully
insanity,
and scintillations
occasional
gleams of healthylucidity,
of sane
conditions,(in
consciousness, during which
the lunatic
accordance with the confession
of patients)
normal
the disordered state of his ideas,and abrecognises
fully
created

"

condition
makes

of

the

emotions, and

instincts,and

the predominant
repeatedeffort to crush, or dissipate

impression.I have often been informed

from long,and distressing
by patients(afterrecovering,
attacks of mental
derangement)that they have had, at
clear conviction of the
varying intervals,a perfectly
morbid

INTERMISSIONS

LUCID

insane

character

ments,

and

DURING

of

ATTACKS

OF

45

INSANITY.

their

thoughts. These lucid moconditions of mind, were,

sane
transitorily

however, of

character,appearinglike

evanescent

an

flash of

lightningacross a dark, and drearyheath.

of insanity,
of long duration, and
some
cases

In

of

chronic

character,the

known

suddenlyto be
onlyduringthe course
I have

before death.
of the

"There

light of
the

those
But

When

In

to
referring

observes

not

cure

or

this

menon,
pheno-

:"

and

of the

fevers

trations
illus-

melancholywhere

or

now

body, there occur

of
interruption

for its

remarkable

some

of mania

does

clouds.

mere

mistaken

of the

cases

reason

of the
the

few

are

its

to

witnessed

kind.

has

reason

not
sovereignty,
malady,but immediately

accomplishedwriter

an

the

restored

apparently
been

then

shine

mind,

well

as

tween
beas

frequentintermissions.
a

disorder

is not

to be

conclusion.

its ultimate

Little

tain
ought to be laid upon those occasional and uncerin which
the patient
of intellect,
ments
disentangle
is for a time only extricated from the labyrinthof his

stress

morbid
more

hallucinations.

court
with

show,

may

which

deficient in the steadiness of its lustre."

employedas
lengthsunk

who
was
woman,
young
servant, became insane, and at

apparently
perfectdementia.

continued
of

the flashes

But

betraytoo often the ruins of wisdom, and the mind

will frequently
is conspicuous
for the brilliancy,

be found

of

starts,

than

other theatre of intellectual exhibition.

of wit

at

There
is, perhaps,
as
ordinarymen.
genius confined as at large; and he who should
to meet
coruscations of talent,might be as likely
for lunatics as in almost any
them
in a receptacle
sense

much

Madmen

years.

many

typhus fever.
*

"

domestic

into

state

this condition,she

in life she

who
physician

The

Dr. Reid's

Late

In

was

had

an

attack

in attendance

Essays on Hypochondria*!*."

46

SINGULAR

TEMPORARY

her,

upon

surprised

was

the

exists,

this

patient

the

face

of

in

related

she

But,

alas
It

the

like

came

desert,

obscurity,

and

her

bodily

health

her

mind,

and

of

idiocy,

terminated

and

her

so

leaving

reason

flash

of

obliviousness

she

sunk

continued

sufferings.

into

so

hopeless
As

dark

returned,

in

lightning

behind

her
for

the

clouds
former

many

of

his

her

of

across

state
fever

again

and

family,

and

days

short

tion.
dura-

the

of

lectual
intelmental

abated,

and

enshrouded

deplorable
years,

old

before,

earlier

but

was

recognised,

years

herself

to

of

many

place.

generally

son

respecting

happened
reign

the

vanced,
ad-

took

She

rational.

known

fever

the

as

delirium

attendant,

had

had
!

entirely

REASON.

powers

when

circumstances

many

that

mental

fever,

medical

she

that

others

the

was

her

whom

master,

the

of

of

height

TO

observe,

to

development

During

RESTORATION

until

state

death

INDIVISIBILITY

OF

CHAPTER

47

MIXD.

IV.

Confessions
of Patients afterRecovering
from Insanity
; or, the Condition of the
when

Mind
THE

in

autobiographyof

state

the

of Aberration.

insane, embodyinga faithful

record of the state of the intellect,

emotions, and instincts,
whilst

fadinginto

accurate

account

condition of alienation,
well
as

of the condition

of the

mind

as

an

after its

from the pens

completesubjugation
by disease,proceeding
of persons who have passedthroughthe terrible ordeal of
and profoundly
interesting
insanity,
page,
opens a new,
well as philosophy,
of
in the history
of the pathology,
as

the human

mind.

for the insane,accurately

It may be asked, is it possible
of
to describe the state of their mind, duringa paroxysm
mania

? Can

theyhave

any recollection of their incoherent

horrible and
wild and fanciful imaginations,
ramblings,
hallucinations ? In many
cases, such is the fact.
frightful
overthrow, and alienate,all
Insanitydoes not invariably
of the understanding. It is often a mixed
the powers
This
and insanity.
state of reason,
condition,a combined
the view, that I have
idea does not at all militate against
using
insanity,
elsewhere propounded,
partial
respecting
The mind is
tliis phrasein its strictly
legalacceptation.
and indivisible." A partof the intellectcannot be
one
and
affected,without, to a certain extent, influencing
of thought; nevermodifyingthe whole of the operations
theless,there are in derangementof the mind occasional
is conscious of his stat
lucid moments, when the patient
"

48

STATE

MIND

OF

DURING

INSANITY.

is able to describe his sensations

disorder,and

to
clearly
about him.
Again, after recovery, patientswho
are
sionally
occapassedthrough acute attacks of insanity,

those
have

with
able to recollect,
that occurred

remarkable

clearness,everything

during their long,and painfulillness.

Patients,however, have frequently

very
notions

that

themselves

with

insane.

of events

We

are

as

have

well

confused

and

in
transpired,
with

as

correct
innexion
con-

others, whilst

bound, therefore,to exercise

extreme

admittingand acting upon evidence of this

if it materially
affects the motives,
character,particularly
and compromisesthe actions,of others.
With
of analysingthe phenomena of morbid
a view
to detail the actual
thought,I have often requested
patients
of the mind
well
as
duringthe incipient,
operations
caution

as

in

advanced

stages,of

its disorders.

have

not been

with

great minuteness,

In

cases,

many

able to obtain any

representation
trustworthy
could not,
of facts ; in other instances, the patients
without
considerable and painfulrevulsion of feeling,
for a single
revert, even
moment, to the past. In a few
in persuading
instances I have had no
difficulty
patients
not onlyto talk about their past condition, but to write,
mental

and

whilst
bodily,

I cannot, without

of

account

an

of their

sensations,

insane.

violation of

good faith,and
of these
confidence,publishsome
professional
confessions.

however, revert

may,

to

breach

able
remarkthem

in

Before doing so, I would

refer
generalterms.
briefly
to the fallacy
pervadingall the poetic,dramatic, and
of insanity,
and exceptingour
artistic descriptions
save
and immortal
whose wonderfully
illustrious,
own
Shakspeare,
truthful delineations of the different types of disordered

mind, embodied

beauty, must

holdingthe

ever

foremost

in passages
entitle him

rank

among

of

rare

and

less
match-

to the distinction of

the

mo'st eminent

FORMER

BARBAROUS

that
psychologists

TREATMENT

have

conferred

OF

THE

lustre

49

INSANE.

the annals of

on

this, or any other country.

The

of insanity
descriptions
proceedingfrom the pens
of novelists,as well as of poets,constitute,
unquestionably,
clever
and
strikingly
graphicmelo-dramatic sketches;
but I hope,the accomplishedwriters to whom
I refer,
will not be offended by my
suggesting,that their portraits
of insanity,
do not exactlycorrespondwith the
character
Thanks

of the
to

revolution

the

disease,as

PIN EL,

immortal

in the moral

exhibited

treatment

in

who
of the

modern

effected

times.
a

great

insane, a lunatic

by high
longerresembles a bastile surrounded
serrated walls, and
protectedby iron-barred windows.
bed upon
We
at the sightof the straw
not shocked
are
in the habit,
of former
which
Poor Tom"
days,was
with littleor no covering
like a wild animal, of crouching,
inclement
from the cold, during the most
to protecthim
asylum

no

"

seasons

which

of the
lunatics

We

year.
were

cease

to

observe

formerlycaged like

the dens

in

ferocious beasts

longerwitness the iron chains with which their

manacled.
attenuated and palsiedlimbs, were
frequently
earthly
The sense
of hearingis not painedby the wild and unwailingsof bitter anguish,caused by the whip of
the back of the
the keeper,as it fell unmercifully
across
God!
Pinel, and
unruly and excited patient. Thank
those who have followed humbly in his wake, have given
we

no

and to such
proceedings,
liberal,and
a
Part passiiwith
horrible barbarities.
of treatment,
of the great principles
enlightenedrecognition,
ceived,
conwhich the geniusof the illustrious Frenchman
and boldlycarried into effect,has the character of
of its most
insanitybeen altogetherdeprivedof many
modern
The
principles
painfuland repulsivefeatures.
and
of moral treatment, based upon kindness, gentleness,
the death-blow

to such

brutal

50

OF

STATE

MIND

DURING

INSANITY.

modified the
soothingtenderness, have very materially
manifestations
of insanity.
In estimatingthe circumstances, that have led to the
great improvement that has taken placein the condition
of the

insane, in modern

onlyto

the

abolition,thanks

forms of mechanical
the

times, I
to Dr.

am

bound

to

of
Conolly,

refer,not

the

but to the progress

restraint,

severer

made

in

of insanity.Compare
therapeutics
for one
the opinionentertained by medical men
of
moment
and of high professional
eminence, who
great distinction,

pathologyas

well

as

about sixty
despotic,
years ago, with
the enlightened
views that are, in the presentday,almost
I refer to the
adopted and acted upon.
universally,
enunciated
of treatment
as
by the celebrated
principles
Dr. Brown
(authorof the "Bruonian
theory"of medicine)
entered the arena, and successfully
who, for a short period,
nourished

and

ruled

contested, with

the

illustrious Dr.

Cullen, the

when
of the medical republic. Dr. Brown
sovereignty
The
speakingof his method of curingmania, observes :
patientshould be struck with fear and terror,and driven
in his state of insanity,
to despair. As a remedy against
of the organs of voluntarymotion,
the greatexcitement
the labour of draft cattle should be imposed upon
him,
continued.
The diet should be the poorest
and assiduously
In water, as cold as
and his drink only water.
possible,
should be immersed, and kept under
the patient
possible,
killed !"
it,covered all over, for a long time, tillhe is near
"

It is evident

that Dr. Cullen

himself, entertained the

views with regard to the treatment

unenlightened
of insanity,
for,he says, when
speakingof the management
it has appearedto be
of lunatics, in most cases
to employ a very constant
impressionof fear
necessary
and dread of some
to inspirethem with the awe
cular
partiis therefore by one
and dread
persons, this awe
other to be acquired,sometimes it may
be
means
or
most

"

52

scribed

by

persons

phasesof the
A lady,
who

MIND

OP

STATE

who

DURING

have

INSANITY.

passedthrough the

various

disease.

eighteenmonths insane,detailed
terized
after her recovery, the symptoms that characto me,
the approachof her derangement. She informed
that for nine months
to her being considered
previously
me,
she was
mentally afflicted,
fullyaware, that she
bility
not
was
quiteherself." She manifested extreme irritacircumstances.
She had great
at the most trifling
her attention
in directing
to, and steadily
occupying
difficulty
her mind, with any train of thought. She, to a
morbid
of her
degree,secluded herself from the society
old friends,and, to avoid all intimacywith
her former
she had never
associates (with whom
she left
quarrelled),
England,and resided for several months in a continental
with
her relatives,
town, having little or no communication
and friends. She, however, found change of country,
effect no radical alteration in her feelings.Occasionally,
she had sad, depressing,
and melancholyforebodings,
as to
sulted,
approachinginsanity. With this conviction, she conFrench
when
in Paris,an eminent
psychological
physician. At this time, she was quite able to conduct
herself with greatpropriety,
and to manage
with prudence
her own
affairs. She was
not then, the subjectof any
insane delusion,although,at times, she had serious doubts
the first sign,of
to her personalidentity.This was
as
threateningalienation of intellect. On her return to
I felt my mind
much
less disturbed
England,she says,
for a period,
and
by morbid apprehensionsof insanity,
I was
all the absurd impressions,
as to whether
actually
one
else,ceased to trouble
some
myself,or representing
me.
My generalhealth then became much out of order,
I had a severe
and
attack of English cholera, followed
which confined me to my bed for several
by greatdebility,
weeks.
It was
that my foolish fancies
duringthis illness,
had

been

"

"

SUGGESTIONS

MORBID

INCIPIENT

IN

""'-\

INSANITY.

At this time I used to talk out

began to annoy me.
did before. This waa
loudlyto myself,a thingI never
irresistible. I ejaculated
the most foolish remarks, and
of speech. I did
at times too, with wonderful
volubility
in this particular,
but found it
my best to control myself,
I was
difficultto do so.
quiteconscious that my mind

affected,and

be

must

yet

delusion

no

of my intellect.
strong effortsof thought,in
For

several daysI

checkingthis
but
expressions,

to utter absurd

taken

had

session
pos-

succeeded,by
clination
ridiculous inI awoke

one

nightin an excited state,from a troublesome dream, and

incoherent
of most
I then began to vociferate a number
No you
shall do it.'
to this effect, You
expressions,
He is like Satan.'
shan't/
Why don't you say the
'

'

'

'

devil.'

'Ah!

ah!'

ah!

'It

is beautiful.'

'No

he-

hope.'
'Suicide.'
'Poison.'
'Hang yourself.''They are
after you.' These strangeremarks continued for nearly
much relieved.
and arose
I fell asleep,
two hours, when
My mind, however, was for some time afterwards,not in a
rightstate, althoughI had intermissions from the misery
I became quiteinsane, and, I am
I suffered.
Eventually,
During
informed, remained so, for nearlyeleven months.

devils/

'

by
be

can't

of that

the whole

to

evil

devil.

be

saved.'

East

You

time, I fancied I

was

have

in

no

mented
hell,and tor-

spirits.I thoughtevery person near me

restored to a
My mind was gradually
I first began to feel
I cannot
say, when

healthy state.
that I was
recovering."
for nine
A gentleman,who
an

'

encountered during a voyage

Indiaman,

of

command
years had the

from

of
Calcutta, great anxiety of mind, in consequence
the passengers, i
quarrelthat had taken placeamong

apprehensionshe
among

the

crew.

entertained, of
A

few

weeks

mutiny

occurn

after his arrival in

Eng-

headache, and
land,he suffered from attacks of agonizing

54

one

STATE

MIND

OF

DURING

day,whilst gettingout

of syncope.
he became

About

month

of

INSANITY.

bed, he fell down

in

fit

after the attack of

fainting,
depression

This
in spirits.
greatlydepressed
associated with
continued for nearlya fortnight.It was
of life,and intense longingfor death.
a greatweariness
He left home late one night,with the full determination
of throwinghimself into the London
Docks, and thus
When
near
putting an end to a miserable existence.
the East India House, he met an old friend,also a captain
of a vessel.
each other, and stood for
They recognised
some

time

in close conversation.

The

friend

then

posed,
pro-

theyshould adjournto an hotel,and take some

To this suggestion,
refreshment.
raised,
was
an
objection
but upon
the question
being asked, as to where the gentleman
was
going,he became confused, and incoherent in
burst into
his replies,
and beingpressed
the point,
upon
commission
tears,and made a full confession of his contemplated
of suicide. His friend then insisted upon taking
him
in tow, and theyboth proceeded to a neighbouring
in his
him safely
hotel,and he subsequently
saw
deposited
with
his family. This mental depression
own
lodgings,
that

continued, without

any

intermission, for several weeks.

During this time he had no delusion. The case was, at

this period,simply one
suicidal melancholia,
of acute
sistible
accompanied by an overwhelming and apparentlyirredesire,for eternal destruction.
the subject
this patientfancied that he was
Eventually,
of generalremark.
He arrived home
usual
one
day,in an unthat he knew certain
state of excitement, affirming
partieswere
watching him in the street, and that a
He then
distance.
policeman had followed him for some
imagined,that particular
paragraphsin the Times, and
skits in Punch, were
In about a
directed againsthim.
week from this time, he was
acutelyinsane.
A professional
after his recovery, that
gentleman stated,

CASES

for nine months

OF

INCIPIENT

INSANITY.

55

before his wife noticed

anythingwrong
with his mind, he was
under an impressionthat
everythinghe eat and drank, was either drugged or poisoned.
He was occasionally
able to master this delusion,
and then
eat and drank heartily
he frequently
subsisted on
; but
the minimum
amount
of nutriment.
When
engaged in
in the habit of taking,
the City,he was
almost daily,
for
luncheon a basin of mock-turtlesoup.
For a longperiod,
he
moment, suspectedthat the soup contained
never, for one
matter; but one
morning, he left home
any injurious
and, mentallymore
feeling,
physically
very indisposed,
than ordinarily
depressed.He went into Birch's (Cornhill)at

one

He

one

eat

o'clock,and

another, the

had

his usual

tried at the

time

without

to

reason

effect.

food

being poisoned took

mind, and he nearlystarved
months

it was

found

of the

by means

lady informed
commenced
insanity
chaste

number

and
feelings,

out

me

by

This

and

well for many

He

of this delusion,

his
his

years.

that her
recovery),
to
morbid fancy suggesting
of
images. Being naturally

(after her
her

of lewd

she
refined intellect,

perfectly

was

to her.

thing
Every-

heard,appearedto be associated with

physically
impure notions. So acute
to
that she endeavoured
sufferings,
horrible thoughts,
by an act of suicide.
she threw

more.

patientultimately

at the ideas that occurred

horror-stricken,

she saw,

no

the idea of
Eventually,
complete possessionof

stomach-pump.

himself

eat

himself to death ! For many

necessary to administer nourishment

recovered, and has continued

her mind,

of soup.

and whilst in the act of taking

spoonful,
idea of its containingarsenic,forcibly
gested
sug-

itself to his mind, and he would

but

basin

herself into

the water, but

were

her

mental

her
escape from
For this purpose,
was

fortunately

observed,and draggedout of the pond before life waa

extinguished.This

state of mind

inexplicable
appeared

56

OF

STATE

her, because

to

ideas

and

books, she
could

have

MIND

DURING

INSANITY.

indulgedin any improper

taste, for a high class of
having a literary
that
not in the habit of readinganything,
was
laid the foundation, for so fearful a perversion

of the animal

she had

never

instincts.

clergyman,remarkable for sweetness of disposition,

and purityof thought,suffered severely
from
the same
distressing
symptoms. At an earlyperiodof an attack
of insanity,
his unhappy mind
tortured by the most
was
his
obscene, and blasphemous suggestions. Such was
than
twelve
months
condition, more
to an
previously
attack of acute mental derangement. Two
years before (so
he informs
but
in a somewhat
me) he had experienced,
modified form, similar symptoms.
For about two
could engage
in familyprayers, read
mouths, he never
the lessons in church, or preacha sermon,
without having
the most dreadful thoughtsenter his mind.
It appeared,
as

ifhe

or,

as

were

if he

under

had, to

use

his

the words

phrase,
"

own

(or the evil self) urging him

and
expressions,

consciousness,"

the influence of "double

"

to

utter

actual words

one
selfs,"
certain impure

two

"

were,

as

he

thought,plainly
spoken;the second (orgood self),
begging
and beseeching
him to resistthe machinations
of the devil,
and to refuse compliancewith his horrible suggestions.
On my advice he leftEngland,and went abroad,residing
short time at Spa. He then visited Baden-Baden,
some
and remained
the Continent for six months, returning
on
home, apparently
quitefree from all nervous
symptoms.
For four months, previously
of the pecuto the recurrence
liar
morbid
overworking
thoughtreferred to, he had been greatly
school
himself, in attemptingto establish a new
in connexion
with his parish.He was
also much annoyed
and irritated,
by an unkind and, unexpectedopposition
that had been raised by some
neighbours,upon whom
he relied for support. This gentleman's
in
insanity,

CASE

SINGULAR

of time, became

course

under

him
to place
he

OF

appearedto

return

so

INCIPIENT

obvious,that it was

necessary
In less than twelve months

control.

recover,

to ministerial

57

INSANITY.

but

stronglyadvised
eighteenmonths.

was

duty,for

not

to

ever,
How-

in defiance of such

instructions,and in direct sition

oppoof his wife and friends,he insisted

to the wishes

resumingclericalwork. In less than three months

this time, his mind, againbecame
deranged,and,

upon
from

whilst under

of

the fearful dominion

horrible hallucination

most

by cuttinghis throat !
writes a patient,I was
than four years,"
For more
and curious mental
the subjectof the most inexplicable
sensations. They commenced
by attacks of what I thought
associated with
These feelings
to be, sick headache.
were
ters,
I began to lose all interest in matof spirits.
depression
and occupied
that had previously
pleased,
my mind.
and friends,
of my relations,
avoided the society
I carefully
having a morbid craving for solitude,and yet,when so
I was
isolated,
trulyunhappy. I could not understand
for the
unable to account
I was
what
possessedme.
strange ideas, that often suggestedthemselves to my
he committed

suicide

"

"

mind.

two

my

These symptoms
felt,at times, very wretched.
for nearly
continued, in varyingdegreesof severity,
I

By

years.

night,as

many

sat in

relations.

I awoke

dream.
frightful
not why. I got out

alarm, and yet I knew

lighteda candle, and

from
quiteestranged

was

of my
I thought,out of a

friends,and

much

this time

chair in

all
one

I felt
of bed,

state of extreme

ing
mornOn the following
agitation.
ally,
Occasionto me.
hear voices speaking

mental, and muscular

I firstbegan to

the words

they uttered

consolation; then
verses

from

pieces of
I

texts

of

were

those of comfort and

Scripturewere
to

repeated;
favourite

hymns, that were familiar me;

racter.
of a consoling chapoetry" all, happily,
was

certain,that the voices

were

internal"

58

STATE

that

OF

MIND

INSANITY.

DURING

is, originating
within, and

did

proceedfrom

not

myself. But, alas ! the character of

the voices changed in about a week.
They then gave
to the most foul,coarse, and abusive epithets.
expression,
I was charged
with having committed
the most abominable
sins, and the most
repulsiveand morally degrading
crimes.
At other periods,
I was
told I had better cut
take prussicacid, and thus save
my throat, hang myself,
dreadful punishment; and, strange to
myselffrom some
instructions were
given to me how I could
say, particular
best destroymyself,
without detection
where I could procure
the fatal poison,
of the chemist,
mentioningthe name
external

persons

to

"

well

as

as

street,in which

appeared to

he resided.

be better, and

mind

my

and

Now

quitefree

was

then

from

such

illusions. For several days,

to my great
distressing
the happy voices returned, and again passages
delight,
from the Bible were
and comfortinghymns,were
repeated,
and melodiously
sweetly,
During the whole of
sung to me.
this time, I was
fullypersuaded,that the voices were only
mind, and did not proceedfrom
suggestionsof my own
other persons, nevertheless,they gave rise,at times, particularly
to greatmental
duringwhat I term my 'bad days,'
This state of mind
existed for three years, and
suffering.
eleven months.

At

of the brutal murder

mental
an

in

greatforce,and

too

of

attack of jaundice.The
the

horrible to narrate.

extremelynervous,
murdered

than

more

my

This

was

distress of mind,

voices then

great

ending

back to

came

me

suggestionsmade
In about

by them, were
I became
fortnight,
to be

was

said)in order

to

sacrificed

bring my

poor

back again to life. I then conceived,

relative,

that I heard

enter

relative.

fancyingthat

the voices
(" crucified,"

on

a near

shock, and producedsevere

in

of this time, I heard

the termination

strange noises
one

bed-room

in the

house

occasion,I imaginedI
and

at
saw

pointa knife,covered

night,and
an

assassin

with blood,

CO

MIND

OP

STATE

DURING

INSANITY.

day. My head aches, and the mind gets

confused, if I try to follow a complex train of reasoning,
do not read any work, that is likely
and I,therefore,now
to producetension of thought."
addressed
The
to Dr. Awl,
followingletters were
of an American
asylum. They
superintendent
physician
who
had formerlybeen under
written
were
by patients
his care in the institution.
They illustrate the subject
of the

ture

under

consideration.

"

am

engaged (saysthe patientwhen

now

Awl),

Dr.

in

asylum ;

and

from

yet I

me,

to you,

course

remember

friends

there, I should
of

Should
I

which
became

I undertake

your

that

those

and

to be

she

tion,
institu-

the

placed

torments

had

eaten

All
horrid

imagination of
months.
a

delusions

child of ten

were

that

she
to

can

in

I
my

was

our

delusions

same

dered,
mur-

say,
there

brought
make
an
anatomy
hundreds

more

of

enter
possibly

the

haunted

husband, and

my

far

so

was

brain, had

crazed

years,
earth knew

fall

say her children were

Another
would
them.

alive,and

My brother,

everybodyon

the

after

of it ; but

idea

these, togetherwith
the

anguish

to

under

boiled,and the doctors

most

you the
for several weeks

no

were

would

to be burned

of her, "c.

son,

from

language would

convey

that

One

was.

was

to describe

patient,my

I should

hall I found

the

family.

my

I not been

had

recovered

suffered before, and

short, that

she

of Providence,

derangedmind.

a
"

have

never

and

tions
obliga-

trulybenevolent

at that

letter

when
affections,

least in my

confident,that
fully

am

myself under

health, reason,

do not rank

my

for I

to

at the

expectinga

the instrument, in the hands

as

you

be

consider

ever

me
restoring

in
Of

must

friends

of my

writingto some
though you may not

ing
address-

even

afraid of.

thoughts,and

me

my
I

for
own

thought

that I

was

CONFESSIONS

OF

THE

INSANE

AFTER

01

RECOVERY.

being; that I was the devil ! and that I

ought to kill myself and children. I once told my husband
I would
kill my
boy, for he had alreadybeen
murdered, and he was
only the ghostof my child. The
to me,
came
and
said, Yes,
poor boy cried, and
mother, I am your boy ;' so I could not do it then ; but
myselfI was fullydetermined to murder, before I got
to the asylum ; for I believed the peopleof
had
called a meeting on my account, and had resolved to send
not

human

'

"

to be

to Columbus

me

I found

but when

burned, and

others in the

degreethe same
led to try to think
I was
things,until graduallyreason
suffer in

made

anatomy of;

an

asylum,who

fears and

"

torments

seemed
as

to

myself,

be wrong
in some
returned, and with it the

might

affections of the heart.

"

I entered the

When

cannot be
asylum,my sufferings
described ; and though I do not believe that any being
suffered anythingto be compared with my
earth ever
on
anguishand torments, yet,if persons who are deranged
do suffer even
a thousandth
part as much as I did, I am
from my
I pitythem
sure
very soul."
After recovery this lady says
:

"I

arrived

friends
"

and

well,and

Before
ever

spoke to

afraid of

little astonished

to

children
see

me

so

and
soon

I could

to them

convey

and

mother

has

so
come

was

under.

children
my
happy,and say to the
home, and she is not

it is to have

they are

faint idea of

some

delusions

horrid

thing

Now

neighbours,My
'

try to

dreadful
me

my

and

know
make
them
me.
scarcely
and since last February I scarcely
of them, and they seemed
prised
surone
I suffered ; and they
much
tell how

awful

many
a

any
me

when

wonder

What

I left them

to hear

the

not

well,too

so

found

safe home,

had

'

crazy at all.'
Another
patientwrites,

"

As

you

desired

me

to

give

62

STATE

DURING

of the

account

some

you

MIND

OP

of

near

as

lection
recol-

my

thingswill permit.
I

In the fall of 1839

"

as

taken

was

long affliction,

attendingmy

to state them

endeavour

now

in which

manner

sick,and the circumstances

I will

INSANITY.

much

was

laboured

and
exposed,

attack of fever
an
hard, which brought on
exceedingly
in my
that seemed
head.
to spend its force principally
I also had a severe
cough,and at one time spit blood.
of stuporand
As the fever increased,I experienced
a kind
the most
In this state I had
derangement of mind.
singulardreams, or visions of tilings.One peculiar
thought that entered my mind was, that my body was
into four parts,
divided
the legs being cut off at the
knees, and my head and breast severed from the body,
which
appearedto be real and true ; and I suffered great
anxietyas to how the parts of my body should be
re-united,and made to grow togetheragain. A physician
to be applied
was
employed,and he ordered plasters
to my

ankles

top of

my

head,

enough

the

render

to

the

in

constitution

best

the

distress of the

the

and the

fever

in

my
with

strongestman,
senseless

world,

the

on

one

several emetics

me

gave

these, and

was

breast,and

blister to my

head, and

all

pain of

and

and

delirious.
in this condition

I continued

"

prettysensible
itselfbefore

friends,I believe I
as

there
me

the

was

no

four

walking

up

I entertained

cityof

Home

the
the
;

of

asylum.

As

I remember

steps into

on

your

had

to

the

from

the

take

room.

building,and
At

this

opinion of having just landed

and

near

firstvisit,seeing

my

front of

some

first time

The

father

my

presented

advice

twice.

and

me,

in
pillars

round

to your

taken

was

for

room

again.

home

taken

was

I
recollect,

can

what

length,throughthe

At

me.

indifferent to

others

and

time, sometimes

some

circumstance

of

time
in the

noticing

CONFESSIONS

these

OF

and
pillars,

THE

INSANE

AFTER

the immense

03

RECOVERY.

size of the

I was
building,
induced to entertain the belief of its beinga house used
Catholics for their religious
services. I
by the Roman
thought it was a monastery. I also thought the piece
of ground in front of the building,
was
crated
holy and conseground,used by them for the interment of the
I suppose,
the reason
dead.
why I thought so, was,
the gate and the house had
because the ground between
been fresh ploughed,and it looked yellow. I had an

idea that the

Romans,

and

other

some

denominations,

and old;
their authorityupon
exercising
young
and I thought I was
broughthere to be scourged,and
I arrived the second
taken through purgatory. After
time, I thought that the buildingwas used for a medical
and the inmates
were
going through a certain
college,
or
renderingthem
preparation,
process of experiments,
After that,
for dissection,and investigation.
6t subjects
of
of a fort for the protection
I concluded
it was
a kind
the peopleof the country,for I expectedthat France
were

had

united

and

we

war.

parts of

the southern

with

the unpleasant
suffering
consequences
other curious and
These, and a great many

through the winter and

get better.
My greatesttrouble
"

and

the true

of

my
information.

I asked

they

them

incidents
am

placein

I made

was

connected

me

long

told.

with

was

gular
sin-

to

which

ries
inquicorrect

When
my

but

the

to disbelieve every

time before I could

I reflect
sickness

on

and

the
very,
reco-

amazed."
State of
born," writes another patient,in the
"

"

began

various

I was,

often, where

induced

gave

they said ; and it

credit anything I was

word

to the

as

of it.

made

use

until I

spring,and
was

of

mention, I entertained

to

companions (the other patient*)for

which

answers

many

States,

were

notions, not necessary

was,

the United

64

STATE

Maryland,and

MIND

OF

DURING

INSANITY.

forty-four
years of age. From my earliest
I was
of a quietand steadyturn of mind, and
recollection,
have seen
nothingbut hardshipand trouble all my days.
I was
married
in my twenty-fourth
to
year, in opposition
the will of my parents,
attached to the
but was
devotedly
in his shoulder,
of my choice.
He received an injury
man
time after our
some
marriage,and I was in the habit of
him with his work, on the farm.
I worked
commonly
unassisting
hard
at making fence, burning brush, and
clearingup the land. The stooping,heat of the sun,
and hot fires of the burning brush, appeared to affect
On a certain day, while engaged
head very much.
my
in the field,I was
suddenlystruck almost blind, and
felt

an

am

stiffness in

uncommon

accompaniedwith
eyes

and

drawing down

forehead, and

passingthrough
felt able

to

domestic

the

head.

my

return

duties.

the

to

I had

the

sensation

It

was

the world.
and
I

could

not

of

our

for three

or

tight

time

before

attend

for
sleep,

my
cords

two

to
or

felt troubled

my
three

in my

difficulties in

completelyderanged.

was

over

gettingalong in
On
tressed,
the followingnight,I was
greatlydisthought somebody was coming to kill me.
and, by morning,I believe I
go to sleep,

account

on

of

neck,

my

skin

some

house, and

lost much

of

of the

weeks, previousto this attack, and

mind

back

four

I continued

out of my

months, and suffered much

head

distress and

anxietyof mind, from the apprehensionthat I was to

be killed ; but through the attention of the physicians,
and kindness
of my
husband, I began to recover
by
well.
and eventually
got entirely
degrees,
After I got well, we
concluded
to come
out to the
We
State of Ohio.
were
very poor, and the journeywas
in March, and the three
foot.
It was
on
accomplished
from
cold and fatigue.
children and myself suffered greatly
"

Husband

had

taken

to

drink, and

we

had

hard

OF

CONFESSIONS

work

get along;

to

I had
following,

PATIENT.

and

another

AFTER

in the
attack

05

RECOVERY.

month

of November

of

got
derangement. I forto tell you, that my health hegan to fail previous
to
my firstattack, and I think this hroughton the second
attack also. I continued
ill for several months, during
which
time we
removed
to the north-west
partof the
State.

I did

know

not

what

to become

was

of

me:

mv
"i

distress

was

so

and

hide where

had

to make

most

no

mortal

said to my

husband,

I've got to go

all I could do.

There's

but

talkingso,
thoughtswould

dreadful

'

come

mind

as

troubled

myselfand the children ; I did

to happen to their father.
was
At

husband

this time

but he could not

not

get drunk.

for he

was

kind

again

born, and
children,

poor

Frequentlyit

beaten
I

hail and fire

rain
to

did, once

pieceswith
in

great

suddenlystart
before my face,to keep
all,however, respecting
not think that anything

I would
sleep,

hands
with my
up in a fright,
the awful danger off. It was

"

been

my

if it would

be
I should
my head, and
when
thunder and lightning
; and
a

fretted

fence.

upon

while, fall into

I cried and

me.

tried to drive it out of my

I sometimes

my

escape,

having them;' he would

I could not help it,such
into my head, in spite
of

head, by beatingit againstthe

appearedto

my
We

had

never

to hell for

for

me

make

find

journeyon foot,and

our

I wished

scold

longed to
could

of the road.

often
and

great,that

was

sometimes

liquorin

get

any

was

as

and

good man

much

them

littlecrabbed,

parts,and did

attached to him
to

me.

as

ever,

I don't think

be fonder of each other. At last,

persons could
that he was
going
however, I took it into my poor head
my
idea continued to torment
! This painful
to kill me
two

three weeks.

mind

for two

lived

togetherso

to kill poor

or

me

many

years,

It

was

and

dreadful,

why

should he want

GO

OF

STATE

"

One

Sunday, I

and

about

twelve o'clock

husband

coming

and
It

was

and

there

agitatedwhen

of the

one

children,and

together.I got the

thought
in

to be done.

work

but

mind

my

into

came

puttingit
born

was

head

my

down.

to be

lost

was

in
I

was

into my

thought came

anybody exactlyhow

tell

with

after me,

the

kill him

cannot

that

of

dreadful

was

must

prairie,

supper,

familywent to bed as usual. I could not sleep.

About
terrible night to me.
a
daybreak,I got
built a fire. Something appeared to tell me

the

up

to the wild

during the whole afternoon,

returninguntil near night. I met

to the house

all returned

we

off on

ran

ing,
morn-

about

did not think

and

INSANITY.

full of this idea the whole

was

wandered

where

DURING

MIND

it

very

head

much
I

that

so

much

excited, I

felt.

The

the
had

night,but
a

confused

appearedlike

same

ceeded
suc-

notion
a

hidden

born to be lost
mystery ; but the thought that I was
time, I supposed he would
was
uppermost. At the same
made
thought that everybody was
beside myself.
righteous
I stood alone by the fire. All were
sound asleep.
Husband
partlywakened when I first got out of bed ;
he merelyopened his eyes, and then went
to sleepagain
sound
and I felt
asleep,
immediately. I knew he was
kill him
to save
that I must
myself. I accordingly
the children
to where
went
lay,and drew out a broad
saved.

be

I often

"

axe

from

under

their

bed, that he had

borrowed

from

neighbour. I went right to his bed, with the axe in

like a leaf. He was
layingon his
my hand, trembling
rightside,with his neck bare, and I immediatelystruck
him

the

one

fatal lick

across

his

neck

He

kind

struggled,and partly raised himself to his knees,

the children,a dying. My daughtercame
and wakened
and
took the axe out of my
running to me in a fright,
hands, screaming that I had murdered* father ! and
o'

63

OF

STATE

do

willingto

the flash of
The

he
:

to Dr. Hood

far back

periodso

to take

disease first made

my

of my

some

his

fever and

of

at

until that

accidental

was

loss of

appetite.

in Londonderry,

its appearance

the time of my
of
and want
illness,despair,

when

day

subjectto

livingthere,from

of

way

with excess,

of givingyou
liberty

I shall take the

the

strong drinks

the

As

for

was

the latter end of 1849

as

only complaint I was

accompaniedby
constipation,
"

before."1

as

for one moment

to this year, 1851, I never
I must conmental
fess,
although,
derangement,

that I commenced

time

but

was

"

suffered from

calm

It

Hospital. After
the following
account

of Bethlehem

wrote

Previous

"

was

followingnarrative

the

inmate

an

recovery
his case

of

to hell for !'

go

and all

moment,

INSANITY.

DURING

somethingto

writer

period

MIND

an

account
arrival to

pecuniary

compelledme to leave it.

In August,1848, on my return from France, whither
I had gone to spend my
vacation, I was, on the most
of the Manager of the Bank
at
pressingrecommendation
Larne, who knew me, appointedFrench master at Foyle
Mr. Henderson,
College,
Londonderry. The Reverend
resources,
"

who

head-master, after the trial of

still is the

and

was

to the test,agreedwith
days to put my qualifications
that I should receive my board and lodgingin the
me
establishment, in return for French tuition impartedto a
of pupils
lessons were
limited number
to be given
; my
few

four times
"

my

For

week, and to last two

three

hours

I lived in the

months

every time.

college,
attending

accordingto the agreement, and also

gentlemenand ladies in town ; but finding

classes there

other young
that I could not meet
with

takingup
*

the
my

fering
every one's wishes without intermeal-hours
I resolved on
at college,

residence

Extracted

from

"

in the

The

city. The

American

Journal

of

to
principal,

Insanity."

CONFESSIONS

whom

OP

each

AFTER

09

RECOVERY.

determination,gave

my
desired me

establishment

quarterfor
"

PATIENT

communicated

full approval,
and
in his

to continue

for the

my

salaryof

one

his

me

attendance

pound

per

pupil.

I therefore removed

the 1st of December, and

on

got

of four
lodgingsin a most respectable
family,
consisting
sisters. They were
ladies,and nearlyrelated to
elderly
a gentlemanwhose
daughtersI attended.
There I spent,until June, the most happy months
T
ever
enjoyed. My health was excellent,I had as many
"

scholars

I could wish

as

like sisters than

more

of my
about

conduct

Deny

word, I

as

honour

before

saw

me

ladies of the house

strangersto

teacher

to

the

most

the steadiness

the best families in and

caused
we

and

me,

were

with

their

esteem.

In

encouragingprospects,but

sober as I was, the seed of many

steady,
for religion.
sins,a profounddisrespect
of my countrymen,and though brought
Like
many
pious mother, I was a Christian only by
up by a most

there

in me,

was

"

from

me

my conduct was
of
that the discharge

Never

calculated
did I

upwardsof
"I

to

two

returned

out

I shamefully
forgot
irreproachable,
our

duties towards

render

our

conduct

church
go either to

once

rooted

Thus, whilst in the sightof

of God.

all notion

men

alone

almost

life in Paris had

college
o

The

name.

or

our

Creator

is

irreproachable.
to chapel
during

years.
to

France,

as

usual, in June, 1840, and

August next, alter a stay of a few weeks

with
family and friends; but there too I was so
my
obstinate in my
refusingany attendance at church, on
diwatiifiedat
Sundays,that I left my poor mother quite
fort. Many, many
esprit
what she called my deplorable
day
that I should one
did she prophesyto me
a time
weep on my impiety.
the realizationof that preI was
to experience
soon
back

came

"

in

70

STATE

diction.

OF

When

INSANITY.

DURING

MIND

back, I found

came

on

arrival,a

my

She had been

room.
occupiedin my sitting
engaged, during my absence, to replace the elderly
servant

new

who

woman

to wait

used

ever
table,and to do what-

at

me

on

might require.I was very much satisfied with

attendance, and sincerely
regrettedher discharge.
asking why she had been dismissed, I was
my
I

her

On

answered

active

young,

The

"

of

girlwas

enough

not

that

assert

indeed, and
foolish and

was

possessed
imprudent

it,may

be traced
young,

in her

that

was

knowing enough

was

power

openlytold me so more
to
time, she took great care

money
whisky mixed

she

as

with

could.

I then

she

than

more

She

much

say
can

troubles and misfortunes.

all my

girl,
though

to which

attention

for my

but

preferable.

young
I

work, and that

punished. Let it suffice to

severely
that time, I
yieldedto temptation. From

since been

mean

far

was

resist

to

have

mine.

by

servant

new

do all the

not

attractions,which

some

The

could

that she

than

to

in

was

In the

once.

from

obtain

ceive
per-

as

me

to drink

commenced

quantityand

water, first in small

The libations
only at night,after my business was over.
became
especially
frequentand copious,
by degreesmore
when
that she was
with child,and conshe apprised
sequently
me
expectedthat I should marry her.
"

I cannot
into

state

describe

which

might have been,

was

le

to you, Monsieur

that

expectedas

unpleasantnews,

threw

my

unavoidable, whatever

mind.

saw

that

planI might adopt.

her, said I, she will

marry
shall be obligedto leave the town.

not

Docteur, the

make

fall into discredit,and to lose

Instead

better sentiments,and

to
returning

If I do

If,on the other hand,

the

of

ruin

scandal,and

I marry her, I am
sure
most of my pupils.
"This
happened at

to

my

it

latter end

of

March,

1850.

prayingto

CONFESSIONS

God

OF

PATIENT

AFTER

that he would

with the means

me
inspire
catastrophe,
by sendingthe girlout of

the

sufficient maintenance, until I should

71

RECOVERY.

of

averting

town, with

be able to atone

for

fault in the

only honest way, that is,in marrying

her, but so as to keep our marriagesecret, I became the
reckless of the time to come,
more
went
on
drinking
of those who
whisky,and hoped in chance,the providence
my

have

none.

Despite my endeavours to drive remorse

away, the
thoughtof what I had done did not cease to pursue me.
troubled with painful
dreams ;
or
My nightswere restless,
I could no
longerindulge in readingor in walks, as
The
tuitions to
before ; my
lost.
too, was
appetite,
which I had fortunately
to devote a considerable portion
of the day,were
little tranquillity,
alone able to afford me
a
removing the annoyingidea from
by temporarily
"

mind.

my

"An

girlto

incident
be removed

that she would

was

presence

little

which

the

led

hope

house, and

the

from

caused
anticipated
me

to

her

town, where

objectto leave the

permanent danger for me.
not

She, either

on

(as she told me), or otherwise, got drunk, and

purpose
received her immediate
discharge. It was in May, two
before her

months

of her

home,

go

quarter

and

to wait

The

ladies of the

assured

me

state.

that
was,

annoyed when
not

made

"At

house

tion
precipita-

to direct her to

the next
see

the

what

Sunday,at
best

was

an

to be

consented to accept,for

of the services of her sister,

employment. The girlhad always

of her
suspicion
had the slightest
no
one
and
therefore, not a little surprised

then out

was

on

I should

remaining months,

the two
who

for me,

In

only time

dismissal,I found

appointedplace,when
done.

over.

was

of

I learned from

the

new

comer

that the had

her pregnancy a secret with all her family.

to the girlmy
first interview,I expressed
our

72

OF

STATE

MIND

INSANITY.

DURING

imprudent disclosures,and, as the

willingnessto send her away to some

dissatisfaction at her

onlyremedy,my
distant place,
until vacation, when
her

take

to

me

to

France, and

I should

whom
family,

hut without

inform

word

saying a

Had

it would

such

leave her

to

of what

about

be

had

her

easy
with

taken

for

my

place,

having been

my

plan been put into execution,

at least the impendor
everythingcould stillbe repaired,
ing
There
removed
danger was indefinitely
might be
about
her absence, but nothing more.
rumours
vague
I should
have left off drinkingwhisky,in consequence
of my mind
attended
at ease, and
to my
being more
Such
is, at
dailyoccupationswith a new
courage.
least,what I then intended to do.
Unfortunately,
my
she
would
not go away ;
proposalwas
drilyrejected
;
servant.

she

afraid I should

was

town, "c.
"

gave

or

she would

I submitted
her

retired

money

part

leave her

she wanted

to live in

make

everythingknown.
in despair
to her haughty wishes, and
for lodgings. She hired a room
in a

of the

alone, but with her

town, and
mother

and

to

came
a

live there, not

niece,the

two

latter

brance
saddlingthemselves on my shoulders,as if one encumof money
not sufficiently
were
heavy. Demands
succeeded
each other with
fearful rapidity,
that I
a
so
found
myselfquiteunable,for want of cash,to take my
usual tripto France.
At that periodof the year (July),
the harbour
of
of French vessels,which
Deny received a number
gave
of
a daily
me
between
opportunity acting as interpreter
the merchants
and the captains
time I
; but at the same
neglectedmy privatelessons,a fault which had never
occurred before.
Being a constant prey to sinister presentiments
"

about

the

future,I used

to

drink

wine

and

brandy on board, without, however, beingeve^r sick (this

fact I cannot account
for); only,every morning when I

CONFESSIONS

OF

there

got up,

was

PATIENT

AFTER

kind of tremulousness

73

RECOVERY.

I could

in my limbs.
mouth
without

take up a glassto
scarcely
my
a
spilling
part of its contents ; my walk was unsteady,
and my
difficultthan usual, unless
speechbroken, more
I got animated.
The mind seemed to preserve itssoundness;
I had

several

took
scarcely

times

draw

to

reports,which

up

than that of

time

writingthem down.
In this manner
did I pass the month
of July,be it
said to my shame and deep regret. My visits to the girl
also frequent
if an evil geniuscarried
were
as
; it seemed
me
there, though I well understood their danger and
impropriety.I think that by that time I had lost a
greatdeal of control over myself.
In August,the re-opening
took place
at FoyleCollege
more

"

"

and at three other schools which

Rev.

Mr.

Henderson

sent for

I used
I

me.

The

to attend.
not

was

home.

at

also kepta school,and who

a gentlemanwho
Fortunately,
Italian
board
an
was
on
greatlyattached to me, came
said that he
He
most justly
ship,where he found me.
could

month.
did

understand

not

There

not

must

my
be

business

resume

way

of

something wrong.
he
immediately,

He
pupilsin town.
painfulto him, about

should

lose my

very
drink ; but he did not believe that.
to his house

for dinner.

reportedin

was

town

livingfor

There

I had

he

married

had
my
He

That

now

then

informed
my

if I

afraid I

was

been

last

the

told

thing
some-

taking
carried
me

servant.

to

me

that it
This

I denied.
"

for

My

friend's lecture seemed

to

shake off my

time; I left off visitingvessels,to

some

torpor
resume

business.
"

what
Notwithstanding

received
could

me

number

increase

was

had been rumoured, every one

that
so
to me,
came

pupils
if this
But
upwards of fiftyof them.
calls
repeated
to me, there were
gratifying
well.

New

74

STATE

MIND

OP

DURING

INSANITY.

my purse which produced a very different effect. I

continued to drink, and drank the more,
on
thinkingof
on

the

time when
fast-approaching
proofof my guilt.
This took place in November

there would

"

school.

lost my
I

myself

that

still in

situation

quence,
rigorousconse-

as

and
dSllege

at

living

in

another

repine. I acknowledged within

deserved
it. My remaining pupilswere

did
I

not

sufficient number

livelihood. In

order

advised
earnestly
I rented

be

for her

from

town.

with

his advice

avoid

to

and

afford

to

the

house

in the

of

means

girlto

scandal, I

further

any

on
prevailed

the

me

leave town.
four miles

country, about

thought that marriage would not

have made
have married
thingsworse, I would certainly
I spoke on the
her, but out of all the persons to whom
Mr.
to understand
alone
Henderson
subject,
gave me
honest
that it was
from an
of atonement
the only means
I asked him if my compliance
It is true that when
man.
in

Had

entitle

would

his establishment, he

me

to

answered

employ me

any longer,on account

families whose
children were

would

objectto

Matters

"

me

out

the

to

when
eat

one

which

symptoms

so

of

and
college,

who

if led

28th
of the

to

January 13th,

disease,I did not

daily. My only food was whisky,

to say they were
always ready to

bread

sorry

am

able
respect-

exhaustion, that I could not

I felt the real

at

not

by my evil
for several days,joinedto
demands
of money, brought

December

ounce

could

of the many

country (as

From

bed.

minister to
"

such

and

sickness

leave my

he

of my tuition there.
in this state until December
28th,

spirit).Hard drinkingthere
from constant
arising
quarrels
on

that

attendance

the continuance

remained

I went

when

further

me.

Until the

tired of the

12th, I continued

extremelyweak,

bed, that I got up.

but felt

70

STATE

I
sleep,

INSANITY.

DURING

MIND

replacedby two
positionI

anxiety,
press
seem

the

to talk about

with

better have

I attend to
and

mother

and

me

the

ever
What-

room.

pered
whis-

conversation

the

daughter. They

affairs. I several times

my

France, and my

the word

name,

panied
accom-

alludingto the
returningalone to my native country,
let it be done ; they will prevent my
old woman
says that her daughterhad
I think

curses.

of my
possibility
but they will not
departure.The

about

turns

me.

fancythey utter

is often
Sitting

take, weariness, discouragement,

may

on

between

three

or

and then, I

Now

I feel well nowhere.

cup of tea.

shall,from

hope that

very late, in the

sit up

exhaustion, enjoy a little rest.

mere

take

OF

they are

herself.

drowned

then

recollect that she

money

days has been very moody, because my

(I imagined)was drawing to an end. Yesterday,

I sent

the

for the last few

and

son

of the two

brother

women

for

some

brought back a cheque,

which
I alone can
get cashed. I go on walkingas if I
did not listen. I am
cially
very far from being at ease, espewhen I recal to mind that this is a lonelyhouse,
in a bleak, deserted partof the country,and that I should
but with the
have to deal not only with the two women,
invitation to
no
brother, a stout fellow,who has required
due to

money

take
much

up

his

me,

abode

but

has

he

with

us,

and

who

seems

rather too

over,
are, moreMy apprehensions
tioned
the above-menroused by the fact of my possessing
cheque. They might believe that theytoo can get

inclined to idleness.

it cashed

at the Bank.

to take another

stillup, and

cup

At

about

of tea with

near
sitting

the two

the fire.

o'clock,I want

twelve

women,

They

who

are

prepare it ; but

bacco,
slipsome black thing,like toI approachthe fire;and againthe
to her daughter;
mother tries to hand another lump of black stuff,but she
the
on
'lying
dropsit. I see the objectof my suspicions

fancyI

see

the mother

CONFESSIONS

ground ;
she

OF

the mother

PATIENT

tries to

stretches out in that

AFTER

?7

RECOVERY.

get it under

her

direction,hut she

foot,which
cannot

ceed,
suc-

and

I suppose
she is afraid I should notice her
The daughterlooks
movements.
I am
sitting
uneasy.
between both of them, watchingtheir motions in
deep
silence.

At

the obnoxious

pickup

to

last, I avail myselfof the firstopportunity

black

lump, and I thrust it

into my overcoat pocket.I am trembling
from fear ; I feel
that I should hardlybe able to speak. The sinister idea
strikes me that they want to administer me
poison,and
the word
I

vomica

often

nux

presents itself to my

from

seat, and
my
unsteadywalk, until the old

get up

two

bowls

and

in

full of tea.

see

the

out

hand,

of the

house,

wanted

you

house, in

bowls, but before

pursue
my
way.
door
the
should
entreatingthat

(theonlygrown-up

woman

house) asks

to

fall,and

let them

me.

of the two

contents

house,

at the

me

what

I want.

be
I

person

In

most

been nearlypoisoned,
say that I have
to the magistrates
I shall make
an
application

agitatedtone
and that

of

I seize the

I take the direction of the nearest

knock

in the

them
wretches

two

are

openedto

with

run

reachingit,

has been
am

As

that.

that I

tremulous

confirmed.
suspicions

my

You

order to show

He

I take it with

one

voice say to the daughter,Drink

it ; I
not ; she does not
to drink it ;' but she would

full bowls, and

about

presentsme

woman

broken

crying out :
poisonme.'

see

this time very

my

'

wish you
it. I then
want
two

resume

mind.

speaking,the brother comes

by the two others. Assures

am

awakened
'

mistaken.

Well,' said I,

'come

with

mo

up.
me

to

and I will show

may find a light,
I have in my pocket
an
not mistaken.
you that I am
proofof what your friends intended to do
unquestionable
any

with

placewhere

me.'

wishes you

we

'You
harm

are
;

come

wrong,

you

he; 'nobody
sir/ replies
back to the house/

78

STATE

DURING

MIND

INSANITY.

accedingto this request. I

off through boggy 'groundsin the direction of a
ran
on
Derry road, about half a mile from the
public-house,
I have lost my
place. From the beginningof my flight
The night
and have but a pairof stockings
on.
slippers,
I have
in torrents.
is very dark, and the rain is falling
to make
through poolsof water, dikes, rills,
my
way
fences, and hedges. By day the task would be difficult,
and uneven
there is but one
as
pathleading
very narrow
I do not keep the rightdirection for a long
to the road
"

Fear

OF

from

preventsme

"

time
and

I hear

sister ;

increases

they are

my

which
pursuit,

and

continue

close behind

terrors.

me

engaged in my pursuit. This

In the hope of escapingfrom

I ascribe to bad
my

less than

run

the voices of the brother

at random.

half

hour

idea
that

motives, I leave the path,

I

can

assure

you

that

wanderingabout, often
stumbling in the marshes, often findingmyself back
againat placesI justleft a few minutes before. I once
keep myselfhidden in a ditch with water up to my knees ;
Here is the
the voices are but a few yards behind
me.
and the darkness
road at last,but I see no public-house,
it is situated on
to ascertain whether
does not permitme
I take to the left,which is the
my rightor on my left.
direction ; I pursue my flight
; the thoughtmany
wrong
that God has this time more
times striking
me
obviously
from
saved me
than ever
an
untimely grave. I pray
of my
past errors ; I
along the road for the forgiveness
promise henceforth to behave like a true Christian,"c.
*
*
*
I feel not only refreshed and encouragedby my
stronger than I could have expected
prayers, but much
I felt on the preceding
from the extreme weakness
days.
in the opposite
After half an hour at least of this run
I begun to think that I must
direction to the pot-house,
I therefore
found it,if I had taken the rightway.
have
'determined
retrace my steps,with unabated
speed,
I

am

not

an

CONFESSIONS

to knock

OP

at every

PATIENT

door, and

AFTER

RECOVERY.

79

to

speakout concerning
my
escape from the lonelyhouse.
Strangeto say, out of
at least five or six houses where
I stopped,knocking
repeatedlyfor several minutes, and crying aloud for
admission, I receive
the

to

door

without

only words,
"

On

my
and

the

door,

alone

but from

answer

unboltingit,and

Cut away.

arrival at the

nowise

am

in

am

need

great

man

comes

rudelysays

the

disheartened.

pot-house,I

beggingthat theyshould
for I

one.

be
of

recommence

kind

so

ping,
rapto open

as

shelter. A

dog

by his barkingfrom inside.

my knocks
The
fact is, that my
got to the tavern before
pursuers
and there askingif anybody had called,said there
me,
was

answers

who

man

perhapswould

better
to

the road, who

on

not

let him

in.

Such
went

move

caudles.
from

The

the landlord had

given since
along with her

to the house
on

pretencethat they

landlord, beingwarned, does

his bed, and lets

that he has

and

is the account

brother,and obtained admittance

wanted

of his senses,

out

ask for admission

by the girlwho

me

was

me

stand

until I

out

not

perceive

been

prepared for my visit. I then make

to return to Deny, where I should inform

up my mind
the police
of what, in my fancy,
has taken place. Indeed,
I have not the least doubt
but a criminal attempt has
been

made

againstmy

life.

altered my
road where

resolution.

"When

lane

lonelyhouse,

an

see

from

As

if 1 foresaw

outside

branches

however,
Curiosity,
I reach a placeon

off in the

unconquerabledesire
the window
some

bad

what

is

encounter,

soon

the

direction of the
bids

me

go and

passingin
I

break

there.
from

hedge a short stick,which is to be my weapon, in case of

danger. I have not proceededmany yardsin my new
sticks.
I am
when
direction,
stoppedby two men carrying
Who
are
they? The brother,and a fellow of his acquaint*
of the dummy (he
under the name
who
is known
ance

80

STATE

dumb).

was

I feel

me.

The

to the

return

make

MIND

DURING

former

INSANITY.

imperiouslyinvites

house, where

harm

no

the

in, I find there the

come

firstapplied. She appears

others, and

I learn

that

to be

wish

to

the

night,
pocket,and, though

the black

When

of

to

me

against

I do not

events

stuff out of my
follow the two men.
reluctantly,
"

is intended

show

that, to
frightened

so

disclosures about

any

I throw

OF

to whom

woman

good terms with the

This
dummy is her son.

the

on

about her.
raises my
She endeavours
to make
suspicions
understand
that I am quitemistaken
about what I call
me

poison,it

nothingbut

was

is true, I cannot

say

soda.

How

but cannot

far this assertion

helpthinkingthat

soda

is not black.

make

"They

sit down

me

and

change

clothes,

my

drippingwet. The brother goes out for some

good. On his
whisky,which, they say, will do me
return from the public
-house, I take a small glassmixed
that it should be
with
water, taking previouslycare
I do
tasted by the others.
Contraryto my expectation,
which

are

feel weary

not

at

all.

look

at my

feet and

hands,

which, to my greatwonder, bear not one singlemark of

scratch, althoughI have been running for two full
a

sharp

hours, shoeless, treadingon

obligedto jump over ditches

thick thorn-hedges.
This

"

consider

the

as

I reflect that

am

to force my

often

through

way

greatestproof that

supernatural
Being. I
reassured
by no means

by some
guidedand protected
but I am
to the people,
so
mind.

or

stones, and

in

sinful state,without

was

say
in
any

before the
I to appear now
were
hope of forgiveness,
the
as
Supreme Judge. My fears increase in proportion
I fancythey
to prevent my escape.
others endeavour
are

all decided

them

to let

me

away with
I confess that I

to make

go

my
am

life.

entreat

afraid of them, "c.

CONFESSIONS

OF

visions

Strange

PATIENT

throw

ray

AFTER

81

RECOVERY.

mind

into

ment
great excite-

takes a hideous shape,and

every object
I look at the windows
about.
; diabolic faces are
;

ing

at

Their

me.

whichever

me

laugh'

shudder.

On

side I may turn, a chilling

wind is hissing
by
with unearthly
shadows passing
before my eyes.

my ears,
If I look towards

laughtermakes

moves

imagineI

the door, it is

and
opening noiselessly,

somebody whose terrifichead is peeping

I start painfully
at the least noise,and utter lamentable
cries. This lasts for hours,while I am
sitting
by

in.

see

the fire.
I

"

to retire to bed.
Do not feel
prevailed
upon
Vainly do I shut my eyes, in the hope of
any better.
horrid phantoms
avoiding the sight of everything
;
I feel as if I were
pricked
appear amidst the darkness.
behind
The
with a sharp instrument.
itchingsare
insupportable.I am a prey to continual restlessness,
mixed now
and then with the cries produced
pected
by an unexnoise, such as the fall of a chair, or by new
am

visions.

day the excitement subsides a little,

For
fit of short duration.
and givesplaceto a fainting
time no new
starts occur
some
; but the confused ringing
of bells continues ; my
sight grows very dim ; I see
nothingbut monsters calculated to keep up my fright.
of them throws
Starts soon
one
return more
painful
; even
down
knees, compellingme, as it were, to
me
on
my
Lord for the pardonof
address a fervent prayer to our
At

"

the break of

past life.

my

From

"

my

this

state.

remove

that

day (13th)to

I look

the

house

as

no

herself at

were

home.

amelioration in
and
place,
misfortune, by
all reasoning

cursed

Deny, again followed,for my

I dread, in spiteof
family,whom
to

As if their number
made

on

the 27th

the sister had also

not sufficient,
I say

I don't

that
repeatedly
o

STATE

OF

MIND

DURING

INSANITY.

their presence, that there is but one

I ought
whom
to providefor ; they stick to me
like harpies,
and take no

want

notice

of my

remonstrations.

They most likelywill not

go so longas there is anything to eat.
Driven
if I take no food, I keep on
to desperation,
drinkingwhisky, not so copiouslyas before,but yet a
I wonder
how eagerly
great deal too much.
they give
it to me, and advise me
to take another
drop whenever
I complainof
On my arrival in
weakness.
extreme
my
in
fits of faintness : I sent for the priest,
Derry,new
order to receive his consolations ; for I do not expectto
live much
longer. The reverend gentleman who has
to see me, perceives
that medical assistance
at once
come
is to be had immediately. He
therefore leaves me, and
shortlyafter returns with a doctor, to whom I explain
what I can
about
are
women
braided
upmy complaint. The
for havinggivenme
much
so
strongdrink in my
The two
present state.
gentlemen advise me to leave
the placeand the company,
and to come
alone with them.
hotel, where
They take me to a respectable
they get a
comfortable room
is also engaged to sit
for me
; a nurse
up all nightin case of need.
I have
now
Despitethe excellent accommodation
Besides
moment's
rest.
obtained, I cannot enjoy one
the
other sufferings,
to complicate
a
new
came
one
my
It is the fancythat I hear
symptoms of my disease.
the
in the hotel speakingill of me, and even
every one
dreaded
alarming
familyis here too. They all proffer
life. It is wonderful
to have my
threats; they want
how
their voices are
reproduced. I would
faithfully
that mother, daughters,
niece,brother, and even
swear
"

"

the infant
undeceived
even

so

are

below

by

foolish

the
as

stairs in the kitchen.

kind
to

words

believe

of the
that

she

I cannot

be

landlady. I am
has given them

admittance,contraryto the orders of tile doctor.

The

84

OF

STATE

Grandmother.

"

MIND

is away

He

'

Child.

"

Grandmother.

'

'

Hold

let

alone.'

me

D. ?'

is Mr.

Grannie, where

"

INSANITY.

DURING

is

tongue, he

your

killed,killed

dead.'

minutes, being repeated

many

lasts for several

This

"

of

All

times.

lyingbeside

'

me

I hear

sudden

a
:

Does

girl

ask the

the mother

sleep?'

he

Girl. 'Yes.'

"

Mother.

"

him.

It

haste off then, have

Well, make
o'clock

is two

time

shall have

we

with

done
to

run

away/
"

Girl.

'

is,I have

I cannot

'

got it

"Then

! here it

Ah

find that cursed knife.

I feel twice

into
penetrating

my

is silent.

mother

The

something like
I utter

back.

again

all

feeble cry, then

Well, have

'

says

pointedknife

you

done ?'
"

"

Girl.
And

and

the

time

Yes

'

it

seems

hear

They
to

come

inanimate
French
in

if the mother

as

from

were

'

say

the

Quick, or

At

mine.

shall be

the

'

"

Le

Alors il nest pas

carry

pouls

Non,

mort.
me

bat-il

away,

non,

and

The

encore

doctors
is

lying

says in

other also,

Voyons.

il nest pas

another

'

caught

// est mort, il est bien mort'

'

same

sister and

of the

voices

we

get off.'
leavingher bed,

immediatelyafter two
examine
body, which I fancy
my
in an adjoining
One of them
room.

"

They

outside

us

all escape, and

French

"

Let

enough.

from
girlslipping
cautiously

brother,who
"

he has

Oui.

mort.'
offers itself

scene

to my
"

eyes.
The mother

latter

my

ex-servant

the

are

tragictheatre by the
leadingthe little girlby

supersededon
the

and

former

She is

used

it on

holdingthe infant.
She finds
againstme.

gone

they are

sister and brother

the

arm,

and

the

lookingfor the knife

the edgeof a small well

CONFESSIONS

door.

oppositethe
but

the

in

missed

the well.

so

PATIENT

AFTER

her

The

killed Mr.

are

hat)

servant

not

forgotten,

wide

open) the

stifle his cries,she,

to

out

littlegirlis also

theyhave

well awakened

tongue

have

eyes

infant,and,
his

tears

into the water,

flight,
ray

(for you

see

85

RECOVERY.

to be thrown

was

Docteur, that my

the poor

curse,

cries that

It

aim.

le

sister stab
with

of
precipitation

her

Monsieur

OF

and

got

D. and

throws

rid

him

into

of,because she

her cousin.

am

that I relate to the

night-nurse
culars
partitakingplace. My
night,such a degree

after

as
particulars,
they are
this
of hearingacquires,
on
sense
that I hear every quarterof an hour striking
of quickness,
by the town-clock, and every time I say, It is halfFor me
past two, it is a quarter to three,'"c
these are
are
hardly perceptible
very audible sounds, which
by others.
I think
A few minutes
after,when
they have all
the dummy's mother
to fetch water ;
here comes
escaped,
she discovers the infant's body,and cries out, Murder!
her appearance
The
sister makes
again. The woman
the result of
her of murder
accuses
ensues,
; a struggle
is strangled.
which is that the woman
I hear a confused noise producedby voices,
Then
and the sound of heavy steps. It is the police.They
I
back.
have arrested the murderers, and bring them
'

"

"

is the mother, there are

There
of them.
every one
watched by the
the tliree others,handcufled, and closely
see

who
officers,

are

with

armed

carbines,and

have received

attempt to escape.
should the prisoners
firing,
is discovered,and I
Now, too, the body of the woman
cursed place
;
a
hear several voices say : This is really

the order of

'

of murder/

the house

the

"Again
bed, who

genius;

scene

speaks to
he

has

come

changes.
He

me.

to

I feel

says

protectme

some

that he

one

is my

in my

good

from the wicked

86

STATE

but

I must

OF

be

DURING

MIND

INSANITY.

therefore pray for a

from exhaustion.
voice,until I fall asleep
I

trulyrepentant.

long time in a low

My slumber
before daybreak.
I hear

short and

is very

the

Now

criers in

of the

scene

the street

have

been

sentenced

executed
under

the

on

death, and

to

the

It

day.
strange sky. The
on

same

to

seems

fog is

tinued.
con-

that the
persons

of

awake

night is

announce

murder

of

convicted

family

agitated. I

me

to be

are

that

very thick.

am

I hear

nothingbut the cries of sinister animals, such as wolves,

dogs, and the shrieks of geese, the croakingof frogs,
I again
voice of the criers.
mixed with the monotonous
until it is light. I have been
fall into unconsciousness
but not so noisy as to prevent the other
very restless,
alone knows what
patientsfrom sleeping.The nurse
has seen.
imagination
my
On awaking,my
from one
to another,
object
eyes wander
and remain
fixed on many
piecesof wood, used by
and
the doctors in their surgical
which
lie
operations,
I first
of the room.
topsy-turvyon a press in a corner
shrink
the top of the press is
from
the sight,for now
occupiedby livingbeings: here are the mother and my
servant
again; then, on their rear, the sister and the
brother.
But in what state ?
My good geniustells me
that such is the visitation of God
on
great criminals.
The mother
face ; her eyes are sightless
has a cadaverous
"

and white

her hair has

rest of her

body

is closer to

me

is nearlybald
few hours.

peoplewho

from

is concealed
she is dressed

the hair has

There

her brow, and

beside her.

is

candle

They
look but

the colour of flax

assumed

for

as

The

me.
a

the

daughter

fete,but

fallen off in the

her head

space of

of blood

impressedon
(likea sepulchral
lamp)is burning

both

largestain
stare at

do not

see.

me

The

now

two

and

then, like

others,sitting

exactlybehind, presenta disgustingaspect.

The

sister

CONFESSIONS

is

paleas

as

thin

corpse

the forehead

on

lent foam

that of

the head

she

to

OP

is

PATIENT

AFTER

87

RECOVERY.

her hair, too, is white,and

very

the

lipsemit a kind of sanguinoperforms the oscillations of a pendulum

;

idiot.

The

brother's appearance is
head has decreased
cripple
; the
nearly

an

hideous

nothing,and

would

be visible,
it not
scarcely
were
two green eyes, obstinately
fixed on me, but without
He
reminds
significance.
of what I have read
me

for

any
about

cretinism.

forgotto

actor in this

say that there

is

fifth

with curling
tragictableau the young girl,
hair, neatlyclothed, leaningsometimes
her grandon
mother,
"

sometimes
'

heraunt,and repeating
at intervals:

on

Grannie, or Auntie, where

the

only

away,
This
'

whole
those

given is

answer

he is

is Mr.
'

D. ?' to which

Hold

question
tongue ; he is

your

dead, killed dead/

spectacle
keepsmy

mind

day. Visitors come

strange beings,from

in and

removed.

Those

with

wonder

on

my

eyes

cannot

be

whom
'

"

of the

out

the next

for the

look

visitors say
It is
In order to escape from

strangeindeed!'
run
sight,I once
happensto be in
persuademe
I fancy that an

in excitement

room.

strange
"

the

At

back, but

not
can-

another time,

that

iron

bar, placedto support a curtain

me
somethingwhitish,like melted

am

mistaken.

frightful

doctor, who

The

ward, bringsme

very

above my feet,pours on
lead,which burns all my
tube is sometimes
turned
to

produceon

them

I think I hear the

the committee, who

body. The same imaginary

againstthe family,and seems
effect as on myself. Again,
the same
of
the head man
voice of a gentleman,
visited the

wards

few

hours

ago.

upbraidingthe doctor, in most unbecoming terms,

for having given me
admittance, while there are so many
and of
of medical cares
poor Irish dying out for want
the result of which
bread.
and a fight
A quarrel
ensue,
is,that the doctor is shot dead. I hear the reportof the
He

is

88

STATE

OF

MIND

DURING

INSANITY.

and
the cries of many
pistol,
persons
who, after much
police,
delay,arrive

murderer.

Before

the

arrival

of

callingfor
and

the

the

capture

I
police,

the

once

imagine that he is ascendingthe stairs to kill me; I

jump from my bed, and conceal myself under another.
I am
draggedfrom under it by a day nurse ; then I run
off again, at the risk of killingmyself in rolling
down
the stairs. I am
caught at the bottom.
They carry me
obstinate struggle
not without
an
up again to the room,
visions.
afraid of new
The strait
on
my part; for I am
waistcoat is resorted to.
They fasten me so tightthat I
peded
can
no
longermove
breathingis even greatlyimmy
by a leather strap pressingon my chest. Night
has come
I
because
; I begin to utter cries of distress,
from the press quit their immobility,
the unavoidable
see
figures
and joinin infernal fits of laughter.
I
Exhaustion
again delivers me from consciousness.
of the
aroused from
am
torpor by the endeavours
my
:

"

attendants

to

make

swallow

me

medicine.

some

The

idea

immediatelystrikes me that the potionforced into

is poison,and I spit it out.
No
rest
more
my mouth
duringthe night. My eyes emit sparksof fire which
fillthe room.
My persecutorsare stillthere; no longer
the

on

resumed

press,

his natural

They

me.

however, except the

are

form, and

lyingin

brother, who

readyto springon

seems

the other beds

has

there

seems

to

me

carryingto them my inmost

thoughts,which they repeataloud. On the other hand, I
can
get,through the same imaginarythread,a knowledge
of their designsagainstme.
My good geniushas not left me ; he bids me look
for strengthin a sincere
on
pours
my
prayer, and
white
fluid alreadymentioned.
It is
enemies
the same
side to the placesthey occupy,
and
directed from my
time to time,
reduces them
to silence. From
instantly
if

as

"

an

electric thread

were

CONFESSIONS

also,when

OF

burns

PATIENT

I pray without
about my
good

any doubt
turned
againstme,
directed

to

all

genius'power,

This

over

so

iron

has

89

RECOVERY.

fervour,or when
the

head.

my

body

my

from

AFTER

I entertain

the shower

bar, and
the

is

especially

effect of fire; it
I

sorelythat

help

cannot

crying.
"

The

smoke,

heat is

oppressive
; the

at intervals chased

blast of wind.

out,

tell the

nurse

is

opened,I am afraid we
does not put out the gas
occasion for it,as

we

will
;

she

in

are

no

is full of

room

reddish

through the door, by a

that, althoughthe door

soon

blown

be

that

answers

danger,and

up,
there
I had

if she
is

no

better

In my
at my command.
sleepwere to come
I fancythat there is the head of a wolf,with
restlessness,
for a long time ; the
glaring
eyes, on the bolster ; I pray
cannot
head disappears. I am
a little refreshed,but
sleep. My mind soon turns to other fantastic thoughts.
I am
no
longeran inmate of the infirmary.I am kept
a
prisonerby my persecutorsin a small house, where
they endeavour to smother me by shuttingthe door,and
The
in the middle of the room.
a fire of straw
lighting
than the others,
mother and sister are more
implacable
"Whilst I am
a prey
and appear to enjoy my torments.
able to breathe, I hear
and scarcely
to great sufferings,
to be
know
from the street a voice,which I immediately
as
sleep,

if

brother-in-law. I
the voice of my
He
from
Paris to Ireland.
come

wonder

that he has

answers

that he has

as a French
with my sister for the purpose of settling
ble
miseraI turn then his attention to my present
teacher.

come

state.

the

name

deliver

me

joinswith
no

mercy

nobody

implorehis

assistance

I entreat

him, in

to
sister and of our former friendship,
of my
and evei
he laughsat my supplications,
; but
he also excites to show
whom

my

and

persecutors,
to take

at hand

to

no

hear.

heed of my
I

hear

him

cries,as

there

walkingup

and

90

STATE

down

the street

DURING

OF

MIND

he

is with

INSANITY.

sister ;

they
perdu.

my

both

say,

Eh bien !
repeatedly // est perdu, il nest pas
Oui, il est perdu. Tant pis pour lui!
for a little time.
At daybreakthe visions disappear
cold.
My lipsare parchedfrom crying; my feet are now
I complain to the nurse.
They give me a drink of milk,
I remain
thus
and placea jar of hot water at my feet.
in on
until the doctor comes
and as if prostrated,
quiet,
his round.
He
inquiresof my state ; feels my pulse;
asks if I could sleeplast night. He is told that I was
noisy,speakingabout dangers,prayingaloud, "c., and
He
take no
that I would
laudanum.
strates
kindly remonis prescribed
for
with me, sayingthat everything
well known
to me,
was
my good. (That medical gentleman
and he also knew
me
very well,as I used to givelessons in
the subordinates
French
to his family.} Unfortunately,
their duty. They, in
have a rough way of discharging
with
ill-treat me,
threaten me
now
a
helplessness,
my
with the red-hot
stick,now
poker,which they approach
*

"

"

In

mouth.

to my

and

these ill-treatments

menaces

my
continuation of

nothing but a
I loqk
the tortures
inflicted on
me
by my enemies.
the night-nurse,
the day-nurse,and
on
especially
upon
the infirmier,
as
peopleunder the power of Satan, whom
Their drugs,too, I
my
prayers alone can drive away.
lated
consider as being made
by an evil hand, and only calcudelirious

imaginationsees

soul.

soil my

to

acceptof nothing,exceptwater
"

In the

mother

is

and

wants

and

my

dead, and
to

see

me.

that
She

other

sister ; but

about

the

re-appear
unknown

of the

course

to

me.

made

have
or

day,I
my

up

mind

my

to

milk.
come

eldest

to think

that my

sister has

arrived,

brother-in-law

stopswith

my

she cannot

obtain

any

mation
infor-

placewhere I am kept. My persecutors

I find myself in another
house, quite
there are strange
Besides the family,

92

OP

STATE

taken

into consideration.

Roman
time

Catholic, I
in

and

struck

repent ; they are

In atonement

"

DURING

by

to pass

the

sins

have

murderers

damned

for my

INSANITY.

According to

doomed

am

purgatory. My

overtaken
not

MIND

as a
my belief,
certain lapseof

alreadybeen

justiceof men.
for eternity.

did

They

earth,and before I may

on

obtain the

kingdom of heaven, I must be put to the test,

and
for several hours
tempted by the infernal Powers
every night. I am, therefore,carried into the dominions
of Satan, who
of magic operaendeavours, by a display
tions,
that his puissanceis too greatto be
to show
me
resisted successfully,
later I shall give
and that sooner
or
make
He also tries to persuademe
that he can
way.
me
more
happy than I am in purgatory. He points
I recognise
whom
to a number
of his subjects,
my
among
who
to enjoytheir presentposition.
seem
persecutors,
For

"

the first time, I feel

an

invincible

in
with-

courage

that I despisehim, his

firmlyanswer
God's assistance,
and that,with my
threats,and his promises,
I fear nothing,and
defyall the monsters in
may
his dark
then assumes
a
more
kingdom. The room
phuric
gloomy appearance ; it is vaulted like a cellar ; a sulthick as to
smoke comes
out of the fire-place,
so
and
conceal
to stifle me.
objectsfrom my sight,
many
The
walls
with
covered
over
are
grimacing,horrid
I now
monsters, at all of which
saying
laugh fearlessly,
I saw
that this is nothing compared with what
a
many

myself.

time

when

Now

theatres.

attended

and

then,

if I

againstme are too powerful,

to prayer.
I am, as it were,
to have recourse
inspired
aloud, and in any
I therefore repeat uninterruptedly,
language I know, our Lord's Prayer,which I had nearly
I sign myself.
or
forgotten,
togetherwith Glorybe, fyc.;

that
perceive

I remark

that

the attacks

no

one

himself, dare to touch

made

of the devil's
me

while

am

attendants, or

praying.

On

even

the

CONFESSIONS

OF

they seem
contrary,
sliiik away,

in

to

PATIENT

suffer

utteringcurses

AFTER

93

RECOVERY.

great deal inwardly,

and
but

theyreturn to the
praying. After a long,a
;

I leave off
as
chargeas soon
I grow
weaker
and weaker ; I can
very long struggle,
hardlyspeakfor want of a drop of water, which I would
not, however, accept from
I am
unholy hands.
smothered
flows down
cheeks ; my
;
perspiration
my
strengthis exhausted ; the evil spiritsprofitby my
about me, and on me, repulprostration
; I feel crawling
sive
animals, such as serpents,
or
toads, frogs,
reptiles
There are myriadsof them.
Their size
rats, mice, "c.
is so largethat I must see them
through a microscopic
to my deliverance.
glass. Here my good angel comes
I am
I fall asleep.
carried back to purgatory. Now
I have sleptuntil eighto'clock
three or four hours,
I should think.
less
My head is clearer ; I am not so restis lighter.The
other
two
ears
; the noise in my
that I had a very bad night. My eyes
tell me
patients
in their sockets,like those of a madman.
were
rolling
I
for a longtime.
to fight
I was
very noisy. I seemed
in English,but
spoke sometimes in Latin, sometimes
night-nuise
language. The
mostly in an unknown
"

"

wanted

to make

me

drink, but I could

the assistance of the cook

(man).

It

was

not,

even

with

fortunate that

I could not stir.

"

The

doctor

comes

in, and finds that ray pulseis less

agitated.Notwithstandingthe nurse's reportabout my

he orders that I should be free in
excitement of last night,
my
rotes

movements.
are

taken

The
off.

strait waistcoat
No

visions until

and

other

cour-

night,when

side. I alao
fancy that Satan himself is lying by my
have resumed their places
imaginethat my persecutors
I am
in the other beds.
They say that it is a shame.
his long flat f(M*
sleepingwith the devil. They see
which I try in vain to
hanging out of the bed, and from

94

STATE

OF

mine.
disentangle
shapeof a wolf.

DURING

MIND

In my
His

horns.

The

whole

the two

feet,which

INSANITY.

Satan
opinion,

of the

body,with

are

cold

as

as

by two short
the exceptionof

ice,is covered

to

is,that I

My only answer
God

because

his power,

is my

low

with

smell.

He

I do not

longerfear

no

protector. Then
in

sometimes

pray,

the

is remarkable

head

long yellowhairs,emittinga most nauseous

again speaksto me in a threateningmanner.
listen to him.

taken

has

mence
com-

voice, sometimes

if I felt quitesafe.
as
aloud, but alwayscomposedly,
still hear
have
"

the

returned
This

dreaded

once

she tells me

"

was,

voices

Monsieur

le

but

reason

seems

I
to

not to trust sounds.

Docteur, the third nightI had

into

admission

the

infirmary;it was
From
that time the visions completely
also the last one.
still very far from being
It is true that I was
vanished.
restored to health.
My sight was
greatlyimpairedfor
did not return all at once,
more
some
days. My appetite
and accompaniedby a good sound sleep.
but by degrees,
I here must
acknowledgethat nothingwas sparedby the
medical
likelyto accelerate my
gentlemen which was
completeguerison. They told me I had been very ill ;
and indeed I think they entertained
very little hope of
I asked for
when
I left the infirmary,
recovery.
my
my
dismissal,towards the 20th of February.
since my

visions

"

On

my

return

to town, I felt much

Christian.

live

as

the

events, either real

will

or

inclined to

that all
helpbelieving
imaginary, had taken place
conversion.
My first care

for my
and
to consult the priest,

through
was

God's

could

more

not

to

take

his

advice about

tions
notwithstandingmy gloomy recollecmarrying the girl,
concerningherself and her family. The reverend
suitable,
ungentlemanowned that the connexion was altogether
But I had a great
"c.
that it was
a great pity,
sin to expiate.Marriagehad become
a necessity.

CONFESSIONS

"

We

OF

PATIENT

AFTER

95

RECOVERY.

therefore

I had forgotten
married,although
nothing. I first wanted to quiet my conscience,and
were

like

very much
however
safety,

who

clingsto any plank of

rotten, to avoid drowning. In consequence
of my
connexion, now
new
openly known, I
lowered my usual charge,
thus hoping that many
pupils
would avail themselves of it to learn French.
ness
My busi-

was

resumed

was

from

without

any loss of time.

drink, and should have most

any strong
enabled to maintain
been

"

reasons

any

means

from
I

those

then

going

saw

the

her

had
family,

friends,who

house, but whom

For

Deny.

little

my

badly advised by
to my

come

man

I abstained
been
likely
not

my

wife

did not dare to

she visited.

out
they,withexplainto myself,
in
livelihood,had taken up lodgings

I cannot

of

her

found

visits,in
that
wrong

the

way.
drank

several times, when

she returned

state

bordering on

intoxication.

fruit

of

my

lalxmrs

was

again

got discouraged disgusted

"

appetite,
experienced
fits of faintness (no visions),accompanied
new
and finally
by want of sleep. My little
by diarrhoea,
resorted to ; my
was
being gone, the pawn-office
money
until
watch and clothes were
pieceafter piece,
engaged,
that my
I saw
only
there was
nothing left. Then
to risk my return to France, after gathering
was
resource
for tuition.
due to me
up two or three poundsremaining
left to my
furniture, were
My books, togetherwith some
wife, who, it was
agreed,would try to live with her
after my
familyuntil I should be able to get a situation,
in England. She did not
recovery, either in France or
the
look much
annoyed at my departure; but it is not
duty as a husband
less my intention to dischargemy
the means.
to giveme
is pleased
Providence
as
soon
as

with

life.

I would
for

now

work

myself. May

again,lost

my

for her and the child much more

this also be a lesson to her !

than

96

STATE

"Having
of my

DURING

MIND

OF

what

described

disease,I will

INSANITY.

call the

give an

now

first

period

of the second.

account

for two
or
Derry, I had kept my room
with my
to go on
lessons,
three weeks, being unable
of my
mind
paired
imnot once
was
though the soundness
I resume
exhaustion.
againthere,but from mere
my diary
When

left

"

"

Left Ireland

on

the 26th of June, with

some

cakes and

savingexpenses, took the

steerage could not eat ; drank the whisky ; no sleep
much
from
during the passage ; very feverish ; suffering
27th ; no food,but one
Arrived at Liverpool,
diarrhoea.
For
two
or
pints of porter. I feel very, very weak.
and placed
in the
fear of being taken sick on my journey,
I take the mail-train,in order
of proceeding,
impossibility
I have
to pay 4*. 6d. more
to get home
sooner
; there
ings
than I expected. In the carriageI endure greatsufferfrom vomitings. My stomach
pectorate
being empty, I exNo
nothing but bile. I can hardlysit up.
more
sleepthan on the precedingnight. On the 28th,
arrived in London, with about 10*. in my pocket. I am
exceedinglydepressedin mind, and wearied all over.
I
I want
to apply at a relation's temporary residence.
Their information
inquire of many persons about my way.
last I reach my destination,
is very conflicting.At
a

little bottle of

whisky.

For

after

peopleof

walk

the house

to Paris three weeks

"

This

sad

of
answer

than

more

me,

three

that my

hours.

cousin

The

returned

ago.

announcement

to my
adds, if possible,

spondency
de-

bility
hope gone, as to the possia
stoppage on my way.
in my
I can, however, through great economy
expenses
for my passage
to save
of the day,manage
eightshillings
Once in
to-morrow, on board the Boulogne steam-boat.
Boulogne,I shall at least be in France, and, as I carry
is my last
without
of gettinghome
There

CONFESSIONS

about

OF

PATIENT

AFTER

97

RECOVERY.

my passport,
my degreeof A.B., with a great
number
of excellent testimonials,
I may hope to interest
the authorities in my
favour,and to obtain from them
the

me

of

means

on
proceeding

I continue

"

my

walk

my journey.
for many
hours, now

and

then

to take a glassof ale,or

steppinginto a public-house
when I feel too thirsty
ginger-beer,
; but I do not taste

substantial nourishment.

any more
stomach

It

seems

if my

as

could not

digestit. Though broken down with

and hardlyable to stand up, I
fatigue,
very seldom stop
for a few minutes' rest. I feel that stoppingis still
than walking; because the absence of objects
worse
stantly
conmind
of diversion,and
renewing deprives
my
makes
it a more
easy prey to thoughtsof despair.I
tion
of the directherefore go on, unconscious and unmindful
In a narrow
and dark-looking
I may take.
passage
I wander,

throughwhich
ears

in

;
a

round, and

I turn

small

who
stall,

few

find that

sells

words

French

at

one

bed-room

Being anxious to get a modest

and in the hope that the man

can

man,

night,
mation
infor-

some

ask

my

each.

penny
for the

give me

it,I enter the stall and

about

from

theycome

cheap ices

fallon

for

an

ice

of sitting
a chair; for,said
on
beg the permission
I, I have been walkinga greatdeal,and feel very tired.
of me
The ice-dealer givesme a chair ; he then inquires
he says
if I am
a
; on
foreigner
my affirmative answer,

then I

that he is
well.

for several years.

speak English,or at least

He

as

it.

there

was

he does not
know

see

in the stalltwo

and with
assistants,

Italian.

class,and

whom

of
an

not to
pretends
grown-up boysemployed

the Swiss

in bad

converses

mostlyof the poorer

in
little prepossessing
appearance, come
customers,

greatmany

and ask for

the man,

France very
that
I perceive

native of Switzerland,but knows

ice.

Some

although he

has

appear to be

just told

me

with
acquainted

that he
H

com-

98

STATE

OF

MIND

menced

DURING

business this very

mind.
I
strike my

state

I should

be very

INSANITY.

No

ever,
howsuspicions,
franklyconfess my distressing
much
obligedby his taking me

morning.

where
I may
obtain
bed for thd
a
lodging-house
night; I want to take the Boulogne steamer to-morrow,
and
I have just enough for a bed, in a
very modest
lodging-house.The Swiss, after much
musing, takes
to a placewhere, he said,I shall be well.
me
"Despite his assertions,however, I have no sooner

to

foot in the house

set my

This

is

than

I wish

I had

never

come.

place,situated in a
miserable-looking
neighbourhoodwhich can have no claim to respectability,
from the number
of rags and repulsive
individuals I have
I am
met on my
conducted, through a dark alley,
way.
the first story. The
landlord
and
on
up to a kitchen
I am
handed
landladyto whom
by the Swiss, in a few
Italian words, are not likely
to confidence.
to restore me
The former is a tall,lean fellow,about
ing
fifty
years, wearplace.
moustaches, and smoking a claypipe by the firejarret.

most

Were

I in

France, I would

His

wife is

an

old

take

him

coupe-

face has been

whose

woman

for

greatlyinjuredby the small-poxand the loss of one eye.

I find her very ugly. There
two
in
are
women
young
the kitchen
engaged about I do not recollect what.
have bold looks. Several oryues de barbaric
They certainly
and grosses caisses let me
guess the kind of companions
I shall have for the night,if I have nothingworse.
"

The

old

woman

invites

me

to take

cup

of tea.

of anything,
and express my
desire of
accepting
for I cannot
sit up any
retiringto rest immediately,
She leads me
longer,from weariness.
up a very steep
and dirtystaircase to a room
containingthree beds.
have.
she wants me
One of them I may
Before leaving,
the usual charge, sixpence.When
I
to pay in advance
find myself alone,I take a survey of the place. One

decline

"

100

OF

STATE

DURING

MIND

INSANITY.

dagger or a sword, concealed under their

bolster. They seem
each other in their
to encourage
much
murderous
has he got?' asks the
design. 'How
the woman.
answers
man.
Onlyeightor nine shillings,'
It is a poor job; but we
must get it.' Moreover, there
clothes,with a small parcelin which they will
are
my
arguing,
perhaps find something better. After much
they at last agree to wait for the arrival of other friends
who
to sleepin the third bed.
are
such

as

'

'

"

Such

is

the

now

life is

of my

state

in danger.
actually

would

mind, that
I

pretendto awake
suddenly; I don't appear to have overheard any part of
I cough, and
their conversation.
often complain of
I keep myselfin constant fidgeting,
weariness.
if it
as
for me
I thus
to sleepany more.
were
quiteimpossible
and,
hope to deter them from their criminal intentions,
and imprecations
indeed, I hear them
utteringcurses
I do not sleep
again.
because"
At a late hour in the night,there is a greatnoise
below.
Many people,males and females, are uttering
this
coarse
jokes,or singingand disputing.Decidedly,
I feel more
house.
afraid than ever.
is not a respectable
Two
men
come
upstairswith a girl. They talk such
I
it is
English that I cannot understand.
suppose
argot (slang).The girlstopsat the door of our room,
and shows her two companionsinto it. Owing to darkness,
swear

my

"

the

countenances

What
distinguished.
is very

comers

Should

I be

to

are

is,that
perceive

can

with the

language unknown

fears.

new

tall,and the other of middle

into conversation
a

of the

man

me.

and

size.
woman,

This

not
one

to be

of them

They enter
but theyuse

fact increases

my

I feel that I must

not sleep,
sleepy,
After a long
because I am
not in a safe placefor rest.
talk has been going on
in a low whisperbetween
them
all,exceptmyself,
they bid one another good night; but

CONFESSIONS

OP

I observe that
show

to

them

that I

of

is

Voices

is far advanced.
all

never

and

once,

each

from

outside

noise

on

to have

there is

address my
done,because the night

that the noise

when

part,will

from

nate.
alter-

outside

snoringat all. Again, the

bility,
they imagine,from my immo-

with

me

They

no

asleep. I come
agreedto layhands on

my

the door

pretendto snore,
but one
snoringat

am

smother

if produced

that these

remark

placewhen
snoringceases

they have
They will

storyabove,as

together. There is
from the others.
differently

moreover

that I

about

move

or
pieceof furniture,
by the rolling

I remark

takes
said

not

am

companions,urgingthem
but

101

RECOVERY.

wide awake.

noise from the

fall of

bowl.

AFTER

either. They
asleep
pear
apand
utter
disappointed,
oaths.
frightful

times,there

by the

PATIENT

they remain

to be much

At

stab

me

that

during my sleep.

bolster,and, in

the
me

to the conclusion

in the bed.

case

I hear

of

that

it will not

requiremuch time for them to digup a grave

in the yard.
I givemyself up as lost. I pray that the day may
But tfcenightis stillfar from being at its end.
come.
A clock from a neighbouring
church strikes every hour.
if it were
It has juststruck one.
a signal.
It seems
as
The silence of the nightis suddenlyinterrupted.
People
"

in the street

men

"

and

women

"

raise their voices to

stunningpitch. They swear, sing,laugh,and dance.

They shout out that it is quitetime that Ike cat skotild
be bled. Then a mourningtune (un air de devil)is sent
dered
forth from an orgue de barbaric,and bringsto my bewilmind
assassinat

de

most
Fualdcs

sinister recollection" the

which

occurred in the

horrible
South

of

tion
thirtyyears ago, and during the perpetraengaged
to the murderess was
of which, an accomplice
to keep the
playingairs on an orgue de barbaric,in order
theatre.
from the tanglant
attention of the passers-by
France

some

102

STATE

Though

remember

now

My

memory
make

but

me

the

me

more

if the boisterous

As

passedsince I read of it, I

most
insignificant
particular.

the

serves

of ferocious

with

is to be done

the individuals
time

rattlingof
at

furious

the

There

quota

to

that infernal

made

to

drown

is

But

disturbance.

the street wanted

contain

placesaround
are

well

often address

haste

reluctantly
givethe
At

go.

but

every
riable
inva-

same

intervals,too, the

tumbril, passingand repassing

concert,which, in my

cries
no

of what

aware

voices

make

to

no

soning.
rea-

any

rough,hard stones, contributes

speedover

that there

of
incapable

sides,howlings,barkings,

all

room

"

cart,like

any

and

Rude, angry

me.

in

"

all

animals, who

the latter,however,
answer,

in

scene

lections
recol-

well, for such

too

uneasy

accompaniment,I hear, on
that
whistlings. It seems
swarm

INSANITY.

DURING

have

years

many

can

"

MIND

OF

on

my

part.

am

opinion,is
first

night-watchto put a stop

soon

observe

that

its

prised
sur-

to the

whenever

the

approach of heavy footstepsis heard, the gang receive

information
of it, and the noise is immediatelyhushed,
to be continued

have

died

as

soon

as

the

sounds

of the

said

steps
foot-

away.

My mind is thus tortured until daybreak. A faint

I cast stealthy
looks
hope penetratesinto my heart.
about me.
My companions do not sleep,for they are
I suppose
they have not yet given up
very restless.
if there is
their bad designs. I then examine
carefully
confirms
of escape.
no
means
Unfortunately,
my examen
in reference
On
the worst suspicions
to the house.
my
and
the
secured
iron
overlooks
window
is
bars,
by
right,
small, dirtyyard,surrounded
a
by nothing but walls.
My eyes turn to the other window, which is oppositea
red tile roof,and so close to it,that I imagine I might
not the window
exactly
jump out on that roof,were
"

CONFESSIONS

OF

situated between

the

PATIENT

AFTER

beds

two

103

RECOVERY.

occupiedby

the other

lodgers.
Being therefore convinced that all hope of escaping
through the windows is to be abandoned as chimeric,I
resolve to defend myselfto the best of
my power against
"

the

attack

expect

minute.

every

There

are

in the

small

parcelI brought with me two razors and a penknife,

in the pocket of my trousers.
I take out one
of
and the penknife,
the razors
which I open in silence,
and
which I placebeside me
the bed.
on
My companions
have perceived
these preparations.They seem
to laugh
of defence.
1 think they say
in disdain at my
means
will not be a longone.
The idea of a
that the struggle
such as a dagger
longerweapon being in their possession,
I then venture
mind.
to
to my
or
a sword, againrecurs
audible voice,
speak. In a most tremblingand scarcely
their intentions
I say that I know
againstme, "c. I
determined
to sell my life dearly. Perceivingthat
am
do not appear to produceany effect on
my
my words
audience, I appealto their humanity. I entreat them
for such
hands in my blood, especially
not to steep tlv.'ir
as
sum
a trifling
eightor nine shillings.I am to return
to
to my country this very morning. If they allow me
closures
without making any disLondon
go, I promiseto leave
about

this house.

and

them

take my

Let them

if theylike ; I shall not complain.

money,
strain ; and at
time in the same
for some
1 go on
to remain
seem
last, seeingthat all my supplications
"

and
unsuccessful,

I
as

beg of
a

favour.

fall on
in

There

them

now

longer fear

men

will not alter their minds,

to grant me onlya few

permission
I hastily
slipout of
No answer.

my knees
low voice.
is

that the

by

the

bed-side,and say

I feel
so

death.

great deal

more

minute*
my

Mt

short prayer

compWid

that
in me,
much^resignation
companionsthat
I tell my

I
1

90
am

104

OF

STATE

terrors

are

harm.
no
say that they wish me
believe in their friendly
protestations,

hours' rest,until
The

other

the

same

are

not

men

o'clock strikes

leads

He

he is the landlord's

He

takes

request,when

the house

of

ever

been taken

onlyto

yesterday.
night; he says
a

go

door,

desire to be
therefore

leaves

in

me

on.
straight

cards,to

two

me

narrow

to the street

me

minutes, and

some

mend
recom-

friends,should any of them come

intencards I took, but without
any tion

using them
from

at

to my

Those

to London.

clock.

saw

I express

that he handed

mention

three

gets up

London-bridge. He

to

street,sayingthat I have

forgotto

last

I remarked

son.

put in my rightway
accompanies me for
wide

or

steep and

the

the kitchen

myselfin

accedes to my

asleep.

church

by the
of them

one

down

me

tall man

My guideis the

taking two

preventmy
;

while

me

do, because, says he, the doors below

I find

strike

them

stillin bed

as

open.

not

seven
are

time

staircase.

and

Let

gone.

reflection does

This

INSANITY.

DURING

time

ready; they this

Though I do not
my

MIND

me

as

where

at the house

landlord's

The

beingbroughthere.

directed.

was

name

They

have

before my
is Cassanello

was

(an Italian).
"

I have been

about
is to

told

by

my

shortest way for me

I therefore forget
state of
my

good mile off,and

keep straighton.

that

exhaustion, and

walk

time for the steamboat

is
guidethat London-bridge
the

brisk pace in order to be in

is to sail at nine o'clock.
which

at

alreadyproceededfor not less than one hour,

endless
street.
taking great care to follow the same
There is,however, no
London-bridgewithin sightyet.
I venture
it. He informs
to ask a policemanabout
me
I have

that I

am

pointsto
"On
succeed

three miles
another

at least from

direction

the

my

destination,and

rightone.
this day,Sunday, 29th jofJune, disappointments
as if Loridon-bridge
disappointments.It seems
as

CONFESSIONS

OF

PATIENT

AFTER

before me as I
moving and retiring
I think
Despiterepeatedinquiries,

were

it.
have

reached

littleboy
twelve
with

it,had I

at last and

not

to
sixpenny-piece

one

o'clock when

her my

I arrived

take

105

RECOVERY.

advance towards
I should

in

never

despair
givena
there.

me

the steamer

was

It

gone,

was

and

last

hope of leavingLondon on that day.

I see everywherepeoplegoing to their places
of worship.
An
interior voice tells me
that it would
be right
need
on
; for I stand in extreme
my part to do the same
Lord's assistance.
of our
But on
castinga look on
of my wretched appearance,
and
myself,I feel ashamed
content myselfwith prayingto God that He may
deign
"

not to abandon

I go

me.

at random

on

until the divine

for the purpublic-house

pose
them
and apprising
of my
of writingto my family,
by illness,and unable, for
being detained in London
of pecuniarymeans,
to proceedon
want
journey.
my
marche
I have done, I recommence
When
my wandering
without food, until night. I have
without interruption,
been all day exposed to a scorchingsun : I feel quite
like a machine, an
worn-out; but J continue walking,
automaton, without caringabout any direction whatever.
It is my intention to apply for lodgingsto any police-

service is

over

then

I enter

officer I

meet
on
may
gettingdeserted. I thus

way,

my

hope to

the streets

when

obtain

bed in

are

able
respect-

house.
"At

where
the
of

fare,
myselfin a wide thoroughmoving along
promenaders

about ten o'clock,I find

I

see

thousands

of

footpaths.From distance to distance, the landlords

of chairs and
have placed
rows
several public-houses

forms,with tables,in the street.

and

eatingcakes.

not take any

beer, because

people,
drinkingbeer
but I would
no

good.

pump.

There

buy

cake, and draw

sit many,
am
am

very
sure

littlewater

many

thirsty,
it dots
out of

106

OF

STATE

I then

"

resume

MIND

that the streets

that it will

now,

walk

my

for

not

are

so

hour

one

perhaps;

I perceive

filledwith people
thickly
for

be time

soon

INSANITY.

DURING

to think

me

of

some

night. Were it not that my

trembling,my
step is more
unsteady,my voice more
ming,
to a constant humsightweaker, and my hearingsubject
to believe
I feel nothing which
induce
me
may
that I am
this morning.
than 1 was
worse
and all of a sudden, the real scene
changes,
Presently,
This is the same
street,
so far as
peopleare concerned.
indeed,with the same
buildings; but the promenaders,
the women
no
are
longerstrangersto me:
especially,
I am
forms with which
acquainted
;
they have assumed
I shudder on recognising
in two females the faces of my
wife and
her sister passingand repassingbeside me;
out
they are laughing a diabolical laughter
; they cry
that I am
mad
very.
yes, mad, and this time mad beyondreco-

accommodation

for the

"

"

I shall die the death of

brute

I shall be damned

for

eternity.
to
There is justenough presence cfespritleft in me
think that I am
tion,
again the sport of a delirious imagina"

and

that I

destined

am

to

suffer under

Notwithstandingthe unceasing threats

about

me,

I wont

helpbeingmore
I

answer

those

at the

believe,but
and

trials.

hear
distinctly
time

I cannot

of myself
excited,and in spite

more

menaces

same

new

as

if

they were

real.

It is time

minutes' walk,
policeman. After some
whom
I beg to
I find one
I get no
relief,
I may
in which
conduct me
to a decent lodging-house,
find a bed for the night. I am
a
quitea
foreigner,
but would
not
strangerin London ; arrived yesterday,
house I sleptin last night,
like to return to the same

apply to
during which

to

because
The

I think

it is

bad

one.

am

ill,
very tired,"c.

kindly takes me to a place where

that
The peopleof the house, perceivirig

officer

known.

is

he
I

am

108

STATE

sleepin

OF

her house
I

consents.

DURING

MIND

INSANITY.

again,a proposalto
leave

take

of

her, with

short walk, and, in order to

takinga

cumbrance,

entrust

her

with

she

which
the

readily
of

intention

rid of any inof a small

care

get

the

other things,
parcel,
containing,
passport,my
my
among
of testimonials.
though
Aldegree of A.B., and a number
I have avoided strolling
from the
too far away
the
to find it again. That
place,I vainlyendeavour
is close to

house

trains from
to ask the
At

street.

railroad,and

bed, is all I

my

landladyfor

her

last I discover
like the

appearance,

one

can

I
say

the

of my

anxious

the

see

forgotten
of the

name

railwaywhich is quite,in its

am
lookingfor. Indeed, the

streets,cut, as it
aspect of the adjoining
that I have
halves,makes me almost sure
end

to

for I have

and

name

able

was

were,

into two
to

come

the

rambles.

Unfortunately,
appearances
were
never
more
deceiving.I walk over and over again
of the railroad,
through some twenty streets in the vicinity
I give up, for fear of being
all to no
purpose.
I
looked upon by the peopleas a. suspicious
character.
thus

have

been

on

foot for at least five

or

six

hours,

the only
being sustained by nothing but ginger-beer,
last nightthat I should taste
sort of drink I made
a vow
again.
In the hope that an application
to the police
may lead
to the discovery
of my papers, I hurry on to the nearest
"

station,where
;

After

for

I state the

have

hearing my

very

to the

case

little

met

the

strengtheven

statement, the

that it is very unfortunate, he

let him know
at least the name

policemanwho

took

best

can

me

chief

do

of my
to

ties
abili-

speak.

officer tells

nothing unless

of the street where

to

me

the

I
I

lodging-house.

opinionthat it would be easy to

find out the said policeman,
at all stations,
by inquiring
which of the policeconducted
about eleven
last night/

I venture

to express

my

CONFESSIONS

OF

o'clock,
a Frenchman
reasons

not

are

to

must

back

come

The

soon

as

officertells

it has

109

RECOVERY.

I therefore submit

again.

as

AFTER

lodging-house
; but

listened to.

find the street

can

PATIENT

been

me

all my
to try if
that I

found, and

that he will
spare
restored to me.
I leave the
assures

nothingto have my parcel

policestation,not at all
in my ignorance,
despairing,
to be able, by dint of turningsand windings about the streets,to find at last the
me

one

I have
'

instructed to look

am

kept a

Without

detailed

much

as

to

suppose

vivid recollection.

wishing

narrative

only beg

for,and of which

say
sit down

of

to

weary

that, on
for

that

more

kind of food whatever

reader

with

I
perambulations,

new

my

the

day,I

did not

than twelve

hours.

shall

even

so

I had

thirst alone

compelledme to
stand
from time to time at a ginger-beer
shop,en plein
air,where I had a glassof the refreshing
drink,and then
I went.
I could not
on
stop; it seemed to me as if
pering
somebody were
againprickingme from behind,or whisinto my ears : Walk on, walk on.
The objects
I heard imaginaryconversations
confused.
held
grew
in French.
They related to me and my insanity.At
times the prickings
became
so
painfulas to make me
no

shed

tears,and

it

was

with

the

greatesteffort that I

could

help utteringcries. Towards

eveningI was
prompted,I cannot say by what invisible force,to go
to the issue
and givean answer
at the police-station
as
of my errand.
to get to it. It was
The
was
difficulty
a
Frequentwere my
good distance away.
very likely
to policemenon
applications
duty in the streets,but
either I gave them
or theydid not know
a wrong
name,
mation
obtained the inforthe place. The fact is,that I never
de cause, I
In fine,and, en dhespoir
I wanted.
way, and asked to
be taken, if possible,
to Finchburystation,(so far as I
called at the firststation-house

on

my

110

STATE

OP

MIND

remember,) where

DURING

INSANITY.

desired to

speak to the chief

officer. They kept me
waitingfor a good while there,
dark
and
when
it was
I was
requestedto follow a
tion.
policemanwho, they told me, was going to my destinacan

I purpose

to detail at

lengththe strange
that took placeon
real,partlyimaginary,
events, partly
the night of the 30th of June, from the moment
when
I left the station-house to accompany
the policeman. I
"

now

some

resume.
"

This

officer looks
I ask him

malefactor.

if I have

Nothingthat

he answers,

with

angry
I know

done

were

anythingwrong

We

of.

if I

as

me,

have

not

ceeded
pro-

men
come
yardsout when two ill-looking
by my side. Their language is most
up
abusive ; they make
threatening
gesturesat me.
They
going to the station alongwith me, and
say they are
before the magistratethat I created a disturbance
there swear
I call the policemanto witness
at their house.
that the accusation is quitefalse I entreat him, with

many
and walk

in

tears

The
room

said

men

my
I

now

eyes, to disbelieve such

take for two of those

who

not

pay

much

the

he
contrary,

my

accusers.

going away,
which

attention

He

now

on

leaves

soon

says that
is

to be

seems

we

shall

within

very

me

meet
few

on.
have, says he, onlyto go straight

in

my

characters,
The

me.

to my

report.

sleptin

be bad

Saturdaynight. They must

I, for they wanted to layhands on
on

does

wicked

officer

supplications
; on
good terms with
a

street,and,

again at
minutes'
The

two

the

on

tion,
sta-

walk.
men

I
are

standing
they still abuse me ; but, notwithtention
what
they have just declared,about their inof having me
brought before the magistrate,
they also leave me, and proceed on their way at a
quickerpace. To my greatdismay,I hear them crying
still

by

my

side

CONFESSIONS

aloud

Here

"

OF

is the

PATIENT

madman

AFTER

cominy.

madman.

This
The

to be

appears

two

Here

if Ike

d'ordre for every

mot

un

Ill

RECOVERY.

enemies.
new
certainly
They
try to set all London
againstme.
Indeed, everybody
is standingat his door, laughingat the madman
; some
speaking with compassion, others assertingthat he
ought to be locked up for the safetyof all.
The unavoidable cry is repeated
from distance to distance, as if to invite the peoplewho are in doors to
one.

men

are

look

out, for there is the madman.

'

make

haste and

understand

cannot
upon

by a

who

does

that

resistance

only

set of

how

and
slanderers,

remember

not

on

is

resource

peoplemay

be

thus

rise

havingdone
part

my

suffer

to

would
with

so

harm.

I feel

be great

folly
; my
resignation.I,
the walking-stick

new

wall I pass

by.
I now
go on in a slow, quietpace, with my hands in
pockets. I am entirely
composed. Though I would
of whatever
I hear about me, there
to the reality

"

my
swear

is in
up

I carry

easily
imposed
up againstone

any

therefore, thinking it useless,throw

which

me

in

over

invisible adviser

an

who

commands

to bear

me

silence

however,

against any kind of abuse. Sometimes,

cannot
help exclaiming: Je vous reconitais

lien la, M.

Diavolo

mais

vous

je ne

encore

crains pas

que le bon Dieu est pour

Once, thirst obligesme

un

dc

je

votts

moi,
"

vos

moi

centre

di'jie
je
; car

and

to enter

fours

SHIS

sur

like sentences.

many
tavern

for

glassof

in
on
a bench
ginger-beer.There are three men sitting
the bar-room ; I imagine theyspeak of me, for I have
viour
I complain of their behacaught the word madman.
of
who
is onlyguilty
towards a helpless
foreigner,

being poor.
mistake.
tion.
with

under
that I am
answer,
They politely
not at all the subjectof their convenaam

I then
the

for
apologize

conviction

that

my

blunder, and walk

every

one

has been

away
roused

112

STATE

againstme.

loaf

penny

OF

on
closing

now

food

it

seems

need

ascribe to Satan's power

God,

I pray

"

but

no

buy a
shopswere

will sell

one

universal
I have

bad

the

me

feelingI

full confidence

fervently,
being assured
How
long did my

on

abandoned.

be

not

that

This
;

I feel inclined to

on,

and

of.

INSANITY.

if all tbe bakers'

as

purpose,

in

am

DURING

littlefurther

but

MIND

in

that I shall
walk

last,

it is difficult to
throughhundreds of streets,
say exactly.
of the shops had
Most
alreadybeen shut for a long
time ; the thoroughfares
are
no
longer crowded with
is it that I am
promenaders. It is very late. How
neither weary, nor
cold, nor
hungry ? To these questions
of

I know

the

of Divine

care

"I

meet

of mine.

They

College. He

have

whom

There

is

passes

by

master

There

he is

again.

He

wont

to have

done

with

me

his voice
I

defy

wonder
death

brown

exciting
every
all in
what
what

loud

interest

benefit he

acquaintances

presenton

I knew

whom

I call

what
at

speaking. There
justpassed. I know

I have

He

come

under

am

without

well.

I take for

to be

come

whom
brother-in-law,
has

than that I

answer

Providence.
persons

many

Passion.

my

other

no

overcoat

one

tone
my
is

on,

leave

and
me

but

at

me

is my

him

cigar.

he

says he has
hear
presently

at last.
to throw

smokes

Foyle

into

the

brother-in-law

the

same

has

river.

time, I
in

my

to derive from it. I

likely
also feel much
words,
surprisedat his utteringfilthy
mixed with oaths and blasphemies.This was
not his
He
is extremelyexcited.
He
habit.
says, that since
Satan has got his soul,he must
likewise get mine.
On my side,the excitement becomes greater; I speak
aloud to the crowd.
The meaning of my speechbeing,
that I fear nobody; that God
that I am
is with me;
I feel
proud of having returned to better sentiments.
quiteable to fightagainstSatan himself,because I am
"

"

CONFESSIONS

assured

OF

that

made

fear,and
"

the

darker than

hide.
and

RECOVERY.

US

ready
alall-powerful
assistant,
total absence of fatigue,

an

the

talkingin

am

there.)
spilt

by

AFTER

of food.

damp placein
much

INSANE

shall have

manifest

want

Whilst

THE

street

this strain,
my
lane.
The
or

the rest.

fancythat

eyes fallon a
said placeii

(Water had
it has

It is the devil's skin.

am

faith have

been
probably
shape of a large

the

told that my prayers

Satan.
I repeatedly

triumphedover
trampleon his remains,and onlyleave off to address the
multitude around
me.
Fortunately
my harangue is in
French.
They perhapsdo not understand what I say ;
but they well enough perceive
that I am
not all right.
is hard by, in which
A public-house
I hear music and
The airs are French.
They are interrupted
only
songs.
by the voice of my brother-in-law, who exclaims that
they must have my life,because lie is sure I am not yet
my

out
man
comes
proper state for salvation. A young
and
recollect this incident),
of the tavern
(I perfectly

in

glassof porter,which I decline

because,said I, I have promisedto my God
drinks.
to abstain horn fermented
offers

"

me

Some

others among

the crowd

are

not

so

to

accept,

henceforth

posed
kindlydis-

They would perhapshandle me

discourse,
were
somewhat
rudelyfor my incomprehended
who
it not for the timely interference of a policeman,
I am
that if noisy,
has doubtless been enabled to perceive
to his questions,
In answer
not a dangerouscharacter.
the sportof the infernalpuitI inform him that I am
of my soul,and who
to get possession
want
sance, who
in this citylike ft
have caused me
to be hunted down
in

favour.

my

The officershows

malefactor,a madman.
He
fear
on

he

to prove

endeavours
sees

that I

that account

let

am
me

be

me

that I have

much

ness.
kind-

nothingto

stranger,and would the lew

insulted. I then say that I
i

114

STATE

OF

DURING

MIND

homeless,without

INSANITY.

in London,
acquaintance
single
but with money
enough to pay for a bed. The policeman
if I should
have no objection
to sleepin a
asks me
whatever
to
poor-house. On my replythat I have none
he takes me
to
any placein which I may
pass the night,
am

one

with

the station,to communicate

what

with

is to be done

accueil

but

the

chief officer about

Here, too,I receive

me.

poor-house
; I

sleepin a lodgingI am,

house.
therefore, conducted
by the policeman,
who
has brought me
to a decent
place,where I am
recommended
Before proceeding
to the landlord.
any

to send

to the

good

himself

take upon

chief officer cannot

the

me

must

further,I shall here state that several times in the streets,

and

in the policestation,I most diswhilst

tinctly
especially
heard againa ringingof bells,as if coming down

from

The

above.

sound

sweet, harmonious, and

was

producedby silver bells. Another strange

the
sky appeared to be illuminated by
particular,
round
immense
and innumerable
lamps,while there was
and then something like the noise created by the
now
seemed

to be

fall of hailstones.
"

This

nearlyone.

house

keepsopen
coming from the
is very

conducted

five

contains
am

He

of my

same

mine

Then

let

get into
I

when

brother-in-law

will not

he will
death.

theyare carriers. I
all night,on account
country. The room
and of neat
spacious,

beds, three of which

in
scarcely

the voice
ever.

an

They inform me
for many
eating-house,
food or
a
glass of

believe that

should

is

table,taking some

at

are

o'clock it is.

I ask what

me

the

fancythat

noise
rattling

as

are

hear
more

am

told that the

to which

am

It

appearance.

Satan's

he will torment

once,

alreadyoccupied.
again from outside
than
threatening

he is in the

I heard

persons
I
beer.

of the customers

sleep. With
room

that it is

tance,
assisme

to

the
yard,creating

by furiously
driving

116

STATE

the

revelations

relate to
world

MIND

that

DURING

INSANITY.

being made.
They generally
familyand friends in the
my

are

destinyof

the

to

OP

uncles,aunts,
Parents, brothers,sisters,

come.

fates unfolded
respective
before me.
Every life is minutelyreviewed one after
the other ; every action, good or bad, carefully
weighed.
It is incredible how
there is nothing forgotten
or
looked;
over"c

the secret of their

all have

it

had

as

seems

an

account-book

moment

every

kept,not onlyconcerningthe

been

of

intentions

thoughts and
doomed

if

to suffer for

each.

deeds

of them

Most

for

the

but

are

lengthof
time, and one, only one, is to obtain the kingdom of
do I recollect a passage
heaven.
of the scripture,
Then
I thought I had forgotten
Multi enim
which
:
vocati,
ever

some

certain

'

verb electi.'

pauci

long time since

still listening.Sometimes
"

It is

as

to

future

my

receive kind

the

sinners,who

As

they appear

forms.

tribunal, I

hear

have

hitherto

scene

one

an

tion
ques-

unknown.

invisible hand

cipitates
pre-

all

their human
preserved
by one before the Supreme

redoubtable

these

to venture

am

Every time I
guidance. Lastly,my

of fire,into which

sea

to

got up.

of conduct.

for my

me

have

men

I presume

line

instructions

imaginationcarries
I behold

the

words

from

the

Almighty : Allez,filsde Satan, allez bruler dans le feu

de Z'enfer.'
claiming
Although free from fear,I cannot helpex*

than

more

est
justice

but

terrible /'

do

now

The

voice lets

short
must

me

once

'

feel that

mon

Dieu
should

que

votre

like to

sleep
God.
not dare, for fear of displeasing
that I can
know
rest myself after a
therefore pray until I fall asleep. It

I
prayer.
be at least five o'clock.

not at all troubled

"My sleephas been quiterefreshing,
It is breakfast-time when
I
dreams.
by bad, terrifying
The
voice on
right is gone; but my
my
get up.

CONFESSIONS

OF

THE

INSANE

AFTER

117

RECOVERY.

guardianangelis stillhere. He says he will not leave

After dressing,
I kneel down
me.
by the bed-side and
morning prayers. My mind is much at ease.
say my
I have more
confidence in myself; but no arguments
could persuademe
that the many events of last nightare
not real ; everything
must
be true.
I have
When
done
down-stairs.
praying,I come
There are peopleengaged in breakfast.
I ask for a cup
of tea, with toast.
They also bringme a little slice of
"

ham, which

leave

to taste it.
appetite
the night. It is not

it has

abated.

untouched,
The
over

Then

because

rain has been

yet.

I wait

resume

my

have

no

a part
falling

in the

random

room

of

until

strolls. I

imaginethat everybodyknows what took placelast night.

reach my ears.
Again the cries of there is tkc madman
"\Vliatever way I may
go, they follow me ; I cannot get
rid of them.
several hours passed in moving
After
about, like a mere
machine, I find myself out of town,
in the open
with only a few scattered houses in
fields,
though
quiet. Alsight. Here I hope that I shall be more
I was
I had not dared to step into
very thirsty,
nised
any placefor refreshment, because I feared to be recogof yesterday.My guardianangel,
as the madman
take gingerwhose
advice I ask, tells me
that I may
beer,but nothing else. The sky has cleared up ; I sit
down
the grass to rest myselfa little. The placeI
on
'

of a railroad. A train is
vicinity
and repeatedly
coming,and, as it runs by, I distinctly
if
h'-ur the same
annoying cry, there is the madman,' as
with my history.
all the passengers were
acquainted
little
am
extremelytired ; I should like much to stop a
and
longer; but an invisible force bids me leave the spot
have

chosen

is in the

'

move

on.

I thus continue

to the
listening

ball1aloud.

on

voice within

I bend my

my

feet for

me,

stepsback

more

some

answering
whither
again,

and at times
to town

hours,

118
I

STATE

OF

MIND

accompaniedby

am

submit

with

about
down

The

I remain

at the door.

sudden

idea strikes

beginto be anxious
and sit
find a chapel,

there for

that I

me

about

am

to

die

somethinglike two lobsters creepingup

chest.
They are sucking my blood ; and a
that I have

but

me.
frightens

where

of

The

I don't

"

to drive

wishes

are

apply to
about

to

now

get to

An

cannot

about

one

old woman,

tell me

There

is the

entrance-door

he is.

wearisome

is locked

to do ?

I ask for

object of
It is

inquire
I

but

am

I direct
no

priest

him, says that she

chapelto look
nearlyone hour.

leave this
stroll of

search, at

my

My

there to

Thither

open,

well

so

worship;

for
possibility
The
growing dark.
:

in the

therefore

off.

I find the door

whom

where
new

miles

two

found

away.

chapel,and

priestfor confession. I
nearest
place of Catholic

to

for another

Catholic

This

ening
any strengthposed
a cordial com-

death

imminent

an

I have

littlebetter,but not

tells

voice

I swallow

which

"

inside my

rightstate yet ;
a chemist's shop,

givesme

what,

I feel

tottering
steps:

in.

chemist

all fears of

the

directed

What

in search of

on

know

confidence.

utmost

my

hope to obtain some relief. When

complain of exhaustion, and ask for
medicine.

as

I go

indeed,

to live.

more

one,

minutes

conscience is not in

My

afraid to die.

am

few

The

time.

some

I feel

me

now

late in the

be

It must

last I

At

rest.

to which

unceasingcry,

sky is overcast.

placeof

the

less reluctance.

afternoon.

INSANITY.

DURING

no

last; but
me

to
rain

the

get in.
falls in

largedrops; I have no shelter,and I would not step

for fear of beingat once
into any public-house
recognised
the madman,
and, as such, exposed to the abuse,
as
viction
perhapsto the blows, of the people. I come to the conthat

found

there shall be

out the inn

in which

that I shall be able to find

no

rest for

me

until I have

last night. I imagine

slept
it,and it is only after much

CONFESSIONS

OF

THE

INSANE

AFTER

119

RECOVERY.

time has been

my
the
to

spent in walkingat random that I perceive

mistake.
all
the
presumptuous
time,
During

harassing
cry of
sound by my ears.
beside

me;

'

there is the madman

I

and hear my persecutors

then, too, the voice of my

againsee

and

now

has not ceased

chime
guardianangelkeeps me up, as well as the silvery
from
above : this especially
takes placewhen
I have
been praying fervently.Meanwhile, the rain has not
abated ; I am
wet through; it is a late hour in the night,
for I see
lightsnowhere except in very few publichouses.
for a bed
I have made
repeatedapplications
tion
all in vain.
There was
accommodation.
no
My resoluis now
to pass the night out, and, as the rain prevents
from sitting
down, to walk on until daylight.
me
I reach a sheltered place,
where, for want of a seat, I
have been standingup for some
time, when a policeman
there at
it is that I am
how
passes by. He asks me
"

such

late hour.

He

"c
lodgings,

see

can

that my
by the gas-light
to be extremely
appear

very wet, and I

fatigued.He wishes to afford
clothes

are

of the

but the head

nightat

kind

requestof
to

me

my

is

liquidfrom
dreaded
is

who

shower

burns

accompaniedwith

few

On the
to send

consents

words

to that purpose,

policeman. On our way to

imaginationagain works on my
followed by an evil
are
closely
we

throws

which

him

stop in,

I should

chargeagainstme.

no

mainder
re-

to the

he hands

poor-house,my
mind.
I fancythat
under the shapeof
spirit,
I often complain to the
us,

shelter for the

guide,he, however,

the

behind

allow that

workhouse, and writes

which

me

I follow
police-station.

the

officer cannot

because,says he, there

find any

that I could not

I tell him

at

wolf,and with
officer that
me

the

same

human

there is

voice.
demon

white-coloured

formerlysuffered so much,
all my body like boilinglead ; it
and fits of laughter
imprecations

120

STATE

from my

OF

DURING

MIND

We

INSANITY.

arrive at the

poor-house.They
giveme a bed, in which I soon fall asleep.
I awake in
This firstnight has been quiet. When
the morning,I expectthat they are going to dismiss me ;
pursuer.

"

but

wait

must

medical

The

doctor's visit.

for the

that I am
not so well as I
gentleman easily
perceives
He cannot
unless I have a
think.
grant my discharge,
at the answer.
placeto go to. I feel quitesurprised
I giveway to despair,
and reason
leaves me
altogether.
much
The sightand hearing,
so
impairedalready,
may
be termed

now

there
a

attacks from

In

room.

Besides mine,
of them, I

one

victim, like myself. The

others

four

see
are

infernal

brother-in-law.

my

his voice and

hear

He

of delusions.

of the first order.

They are
spirits
rebellious angels who
presumed to revolt against
Almighty. Here, also, I shall meet with new

occupiedby
God

organs

five beds in the

are

miserable

the

mere

said that it

with

oaths

as

if he

himself

was

the

who

when
burningliquid,
with the policeman. I

I
were

last

don't
in

see

him

below.

room

night pursuedme

on

my
way
shall not so

to

the workhouse

easilyescape
shut in, and he has powerfulfriends with
now
; for I am
he means
the evil spirits.
He then discloses to
him,
the secret and uncomprehended motives
of his unme
ceasing
ever
persecutions.I have done him no harm whatto be still on the same
terms
ought,therefore,
; we
of good friendship
as
we
were
formerly. All this he
cannot
deny. However, he hates,he abhors me, and will
only be happy when he sees me a corpse. My death
"

be

must

the

time left for

his
mine.

sinner's death.

repentance; because, not

own

soul to

The

condition

is,that I shall
appears

that

There

Satan

must
content

not

be any

with

ing
sell-

of
Satan, he has likewise disposed

ness
imposed by the Prince of Darkdie in my present state of sin.
It
soul.
sets a great value upon
my

CONFESSIONS

My

OP

THE

INSANE

brother-in-law informs
of the

terms

AFTER

that 15,000 francs

me

in which

agreement

I am,

unknown

I wonder
concerned.
seriously
soul may be so eagerlysoughtfor by the
brother-in-law's soul fetched only 80/.

much

so

better ?

I then

learn

wisdom,

kingdom
knows

of heaven.

that, after

departingthis

how

my

Is

My

mine

any

of

aware
am

the

placein

it.

also

He

destined to endure

repentancebefore

sincere

gives here another

presumption; though he is

life. He

of his

is

show

to

to myself,

Evil One.

obtain

life of sins,I

the

arc

has decreed, in his inscrutable

shall

Satan

and
great sufferings,

instance

that God

that

121

RECOVERY.

therefore

well-known

obligedto confess that his own power cannot prevent the

he wants
to
more
once
accomplishmentof my destiny,
the divine vigilance.
try if he will be able to surprise
During the first days my fears of a sudden death are
"

Twice

extreme.

because

fancythat one or
lifted up to givepassage

are

face I don't
with

me

see, but

I also

imaginethat

as

soon

as

form
he

the melted

has

of

and

flaming eyes

black rat with

red

says, he

have

must

scenes
frightful
assume
spirits,

the

horrid

motion, and all throw

my

soul.
whom

men,

shapes;
at

me

into

the

got

lead is

body from above my bed, through a

He
by Satan himself. I see him.

small animal,

into

swears,

and

if he

my

room.

pouredover

my
small tube worked

has token

the form

laughsat me,
night I behold

he

At

burning liquid,

I have alluded as a
patientto whom
like myself,
to struggleagainstthe same
: I
patience
of extraordinary
He is possessed
never

the

Satan

I suppose to be evil
they are in perpetual

other

he

will shoot

He

from

received

pistol.He has
changinghis natural
it

brother-in-law,whose

to my

threats I hear.

whose

bed,

my

of the floor

of the boards

two

power of
and to resume

from

I escape

three times

or

does not

victim

has,

tormentor.

remark that

pray, his frequent

122

STATE

OF

exclamations,such
that he
favour

is
;

'

as

the

I have

rest

no

shall

go

bring relief.
nightswithout

on

from

to
presented

be

me

upon me/ show

interested in his

voice

tells

I therefore

(in words)

defence

styleshimself

who

in order to reduce him

me

pray

to silence.

that
for

prayer alone

hours, for days

I cannot

interruption,
exceptwhen

exhaustion.

is loathsome

it would

I become

help taking his

and another
Infirmier

the Ductor beat him

and

Lord, have mercy

cannot

whenever

"

INSANITY.

DURING

believer.

true

MIND

to me,

I wont
and

take

any

me.

thing
Everyis

besides,the food which

is the usual nourishment

poison for

food.

and

Now

of the devils
then

I drink

;
a

drop of water, but every time after prayingthat it should

be changed into a wholesome
beverage. The conduct
is not calculated either to alter my
of my co-patients
has
opinionin their respect. One of them especially
The
words in his mouth.
nothingbut oaths or filthy
I make a noise
himself is not better. Whenever
infirmier
strikes me
and
in a low language,
he abuses me
even
far
and ill-treatments,
with his fist. Their imprecations
to silence,onlytend to redouble my
from compelling
me
Unlike to Andrews, I often upbraid them
excitement.
for their rudeness ; I say that I don't fear them.
They
kill me
demons, I know ; they may
are
they shall
;
I am
resolved to
have my body ; but my soul,never.
to repentanceby
suffer and to forgive.I exhort them
le
car
;
saying, Repentez-vom,repentez-vous
repeatedly
des deux eslproche'
"c.
royaume
aloud
My prayers and exhortations,beingexpressed
other effect
and in French, produce on my hearers no
for sleephas
the more;
them
than that of irritating
I have
become
quiteimpossible.From the beginning,
*

"

tied up, head, hands, and

would
think that all movements

been

feet,in my

bed.

One

ever,
impeded. I, howit is truly"
surprising
fidgeting;
keep constantly
are

124

STATE

Many,
not

MIND

few

whom

are

INSANITY.

DURING

whom

persons

many

and

OF

expect to
looked

I have

be

saved, are

on

as

If in my

worldlythought crosses

the

prayers any
immediately hear

else,
or
cTorgueil*
richesses'

All

commanded

Then

to

window

say

cousin

my

see

kingdom

made

be

for

have

Almost

I know

where

Sometimes

which

me.

des

before I

with

away

of heaven.

prayer

prays

idees

say, 'Encore des

V amour
de Tenvie ; encore

this must

the

enter

can

mind,

my

voice

Encore

Jesuits.

forgotten.

night

every

is

that there

am

There

none.

Almighty God, and our Lord Jesus Christ,such

tercedes
in Catholic pictures.Christ inas they are
represented
down
for me
notice a tear falling
; I distinctly
his cheek, as if he were
weeping over my sins. There
I behold

also
Jesus
them

favour.
a

lurid

contrite

John

or

the

doubtful

confinement

my

be admitted
fear

not

in the house

into

My
longer.

trials
I

fancythat
world.
shall

on

God

The

understand, but
reveals

to

kingdom

of Heaven

by

soul is

souffle.I

too, I

Now,

destinies

is at hand

need

to the

that my

believe.

the future

me

feel very

chariot.

own

taken

to be

am

of

that I shall
over

are

happy. Shortlyafter,the voice tells me

My body is now
only animated
gone.
well

latter end

the

informed

am

heaven.

doubt

or

Towards

heart.

any
celestial palacesin God's

cannot

Infant

for the

take

Baptist. Their mothers are with

in my
they all want to imploreGod's forgiveness
The sky outside is now
bright,now it assumes
from a
as
my prayers come
appearance, according

and
;

children, whom

two

come

of the

mankind

tion.
perishwithin a few days by a generalconflagraand many
The plagueis ragingin London
cities
In

the Continent.

suicide exercises

his

sway

Last

in

Paris

revolution

the demon

France
over
;

the

the

of murder

whole

soldiers

and

population.
are
fighting

then against
each other,until
againstthe people,

there is

CONFESSIONS

but

THE

man

it says,
may God

AFTER

RECOVERY.

125

shoots

himself.

Many

INSANE

who
surviving,
imagine that I hear a

one

times

OF

sinister voice in London

Visited such, such,and

'

forgiveus

"Such

the

were

such

streets; all dead:

!' "c.

strange thoughtshy which

my

mind

engrossedwhen I was removed from the poor-house.

The gentlemen who came
for me
did not surprise
in
me
the least on announcing that I must
get up, for theywere
to take me
I firmlybelieved that I was
dead, and
away.
about to be admitted
into heaven.
likely
Nothing,in
could be expected. On our
my imagination,
way hither,
I saw
houses, trees, carriages,
passengers, all as it is on
was

earth

but I would

they did

not

between

earth and

"

When

have

belongto

been

another

world,

idea that

kind of medium

heaven.

alightedhere, I

we

to the

averse

came

to think

that I

was

limited space of time.

This was
the
for my
sinful life. I kept in sullen silence,
last expiation
to be shut in for

because
sine

it was

my

attendants
as

and
new

to resist.

Thus

and

the

down

belief tliat mutism

the

was

condition,

The
speedy ascent to heaven.
I was
I conwith whom
sidered
placed,
patients
temptators,whose attacks I should have
to walk up
I fancied that my duty was
the least possible
with
rest,and
gallery

for

no*,

qua

my

boards.
I also
alwaysto tread on the same
considered it my duty to obey the attendants whenever
they said,/ will. In the yard the trial was of another

takingcare

kind.

'

I must

not,'said I, let any

'

make

one

his way

path as I do ; I must drive him away by conhim with

stantlywalking around him, and surrounding
his net around Hie*.'
invisible lines,as the spiderweaves
I took
Once, I recollect,they retired to the shed.
them, and stood up for a long
up my post rightagainst
and forward.
time there, moving three steps backward
the

on

same

"

It seemed

to

me

that I

was

ordered to do

so

some

hundred

126

STATE

OF

MIND

DURING

INSANITY.

times before

allowingmyselfany rest. On the three or

four first nights,
I was
in an excited state.
A French
book was
kindly lent to me, which I did not dare to
soul.
set againstmy
peruse, for fear it should be a snare
I used to pray and speakaloud,as I had done
In my room
in the pauper-house,
for I felt convinced
this establishment
(the purgatory)was swarming with invisible beings,
in need

of my

others of my
person approachingat that time and

some

prayers,

exhortations.

Any
be quiet,
was

to
me
inviting
I
to be taken for a temptator,at whom
sure
threw the malediction,'Fade retro,Satanas' Fortunately,
enabled to see thingsin their proper light."
I soon
was
We
narrative,written by a
append another interesting
This
lady after her recovery from an attack of insanity.*
possessed
great accomplishments.Her imagination
patient
was

active,and

her

character

was

most

marked

in

and abandon
them as
to conceive projects
disposition
Her insanity
formed.
is said to have resulted from
as
soon
that arose
when
at a moment
she was
a misunderstanding
hopes. The conjunction
alreadythe victim of disappointed
the exciting
of these circumstances
became
of
cause

its

her mental

largesum
remote

affliction. She

had

in

Holland

claims

to

but the date of her rightwas

of money,
at a
while another
family,and with all the
period,
had
of justice,

made

good their titles to the

same
possession.Advantageousoffers,and the expectation
of succeeding,by being present on
the ground,
After many
useless
urged her to proceed to Holland.
all her efforts fail,she
plans,and after having seen
with
her feet very damp.
returned one day home
The
much
from
day she felt out of order,suffering
succeeding
Instead of
cold feet,and painsof the head and throat.
in her bed, and promoting perspiration
to recover
reposing
her health,she sat at her desk to arrange 3i very long

appearance

"

Annales

d'Hygifene."

CONFESSIONS

paper on her
and means,

OP

THE

INSANE

business,to which

AFTER

J 27

RECOVERY.

she devoted allher mind

to

prove the justiceof her claims.

the paper was
written with great
notwithstanding

But

power,

and

so

as

she

had

under
presentedthe subject

of aspect,
it had
variety
memoirs.
she called

No

the

on

soured, and
determined
her

in

made

was

whom

to escape

than

success

it had

to it ;

been

seeingher.

the ceding
preand when

transmitted,

Impatient,

irritated at this cruel treatment, she

to

return

when
lodgings,

which

answer

peopleto

they alwayscontrived

better

no

every

induced

Holland.

home, and

she received

her

to

The

memorial

had

had

protracther
which

proposedleaving
letter from her family,
time longer
staysome
we

have

mentioned

which engagedthe disordered mind

subject
of this ladyduring the illness she had at that period.
We
now
append the written detail which she gave of
her feelings
duringher attack. Some few pointsin her
historyhave been suppressed.
retired
During these transactions, I hired more
and less dear.
My landlord, a shoemaker,
apartments,
and obliging.I
and all his familywere
worthy people,
took them for Christians,though they were
Portuguese
the chief

was

"

Jews.

When

was

informed

of that

circumstance, I

affected. I began to be under constant

painfully
of my
rob me
that they would
money.
apprehension
me
This fear increased to such an extent, as to deprive
At last,I fancied that my host mightsome
of my rest.
and assassinate
day make me swallow a narcotic draught,
during the night,to get
along with my daughter,
me,
tional
received addiof my money.
My suspicions
possession

became

confirmation

from

the

circumstance

that these
the

at
to inscribe my name
me
on
prevailed
H. B.
H. A., and not Madame
Madame
as
police-office
I
Tortured by fear,for the periodof eightdays, scarce
of
sleptfor a few instants. My food was composed eggs,

persons had

128

STATE

fruits,and

tea, and

OF

bread which

some

MIND

INSANITY.

day,after having partakenof

diately
landladybroughtme, I was imme-

one

my

attacked

DURING

by

diarrhoea, and

severe

had

no

rest.

more
"

hostess

explainedthe accident by a statement

that the police,
in order to prevent an
epidemicwith
which the countrywas
threatened,had directed the bakers
to introduce into the bread designed
for the lower orders,
medicines
which
would
act as a generalpurge.
My body and my head broke down, weakened by
the low diet, and by the continual
watching. Fear
I felt my
carried them
judgment going apace
away.
alongwith the power of reflection ; and at last I was
unable to draw from any givenfact conclusions in accordance
My

"

the

with
around

the end

was,

Two

"

became

me

of that

relations
still more

one

The

fullysuspected
by

the loss of my

dreams,

fact.

persons
me

and

reason.

of my

daughter,the other about

night,broughtmy disease

in the same
myself,occurring
fullyout. My daughtertold me, that she had witnessed
me
throwingmyselfinto the street from the third flat of
a

in the town, and

house

the

pavement

try and
dream

broken
the

discover
;

it

dream, it

was

the

remained

and
pieces,

house

Court

which

dead.
she

of Judicature.

had

stretched
We
seen

As

went

on

to

in her
for my
entered

bearinga purse, had

the house of the Portuguese Jew, and had cut my throat.
The
clothes,when
busy washing some
day after I was
wide
(and I was
awake) a long
raisingmy eyes I saw
of my room.
Struck with
knife passingover
the ceiling
alarm, I bade my daughterto be silent. In great haste
in my
I placedall my
work-bag,I closed my
money
trunk, and hurried my daughterinto the street, taking
with
all my most
me
important papers. I cannot say
.whether some
passeda
person had not, by way of joke,
was

that

in

that

man,

CONFESSIONS

OP

knife

through a slit in
a vision,the
altogether

PATIENT

the

AFTER

whether
or
ceiling,

creation

of my

and

in full possession
of all
my
the instrument
of death.
I had met

it was

excited

This, however, is undoubted, that I

awake,

129

RECOVERY.

not

tion.
imagina-

quite

was

wits, when

saw

before,in
shortly
largepurse under

with a
descendingthe staircase,a man
his arm,
The
of that
probablya barber.
appearance
out of
man
deprivedme of my self-possession
once
; and
the Jew's house, reason
I then
deserted me.
completely
of the body-guard. I addressed
went
to one
a young
with
diately
fervour to carry immeand begged him
officer,
to the king the packetof letters on me
; but as he
the pretext of callinga
under
hesitated,and left me
I hastened away from him, and went to the
officer,
superior
German
Chancery,where I compelledthe worthy keeper
of the records,M. Z"
to take my
packetand preserve
"

it for

me.

I also told him

for alarm, and

of my
causes
He
the danger I dreaded.

acquaintedwith
after having offered some
took leave of me
commonplace
consolations,and I found myself again in the street.
was
changedas far as regarded
Here, however, everything
in the
but a moment
The city,
so
ago, was
me.
tranquil
in
heightof an insurrection. Hie regiment quartered
The prince
Jewish.
the garrison
royaland the king
was
The
and condemned to death.
had been made prisoners
had broken groundat Schevelingen. The Asiatic
enemy
Of what
use
commanded
hordes
by the Jews.
were
and I returned
could the goldbe to me ? I said to myself,
made

him

to my

landlord's door.
down

money

on

I called his

wife.

I threw

the work-table, advisingher to

my

begina

humble
a
petty trade' with it ; and I concluded by
to Germany.
requestfor one louis,that I might return
"

seen

been
face of the poor Jewess must have actually
a
she received so unexpectedly
at the instant when
effect it had on
conceive the astonishing

The

to
largegift,

130

OF

STATE

DURING

MIND

INSANITY.

became
actually
purple. She could
divine how
to explainthe matter; hut she concluded
in offering
a
me
piece of gold,and would have

her countenance
not

allowed

without

to go away

me

husband

her

not

it

"

in.

come

any

He

remark, had

further

took

of the

handful

ness,
consciouslouis,and slippedthem, almost without
my
restored
into my
bag. The louis,however, were
which

late,from

too

highlyhonourable.

insane

an

killed you

have

it ;

may

return

they

clear to my

money,

account

on

will

home

I supposed,

dread of
with

nated
being assassi-

tolerable

the
myself,

of your

any

by

Arnheim

and

Madame

at
,

let them

assassin,and
I

Emerich.

Munster, and

this all

made

have
I

you

to Delft.

travel

by the
proceededto

was

desirous

explainto

her

duty she owed to her husband

recal him
to
immediately from Holland, as he ran
individual
the hazard
of being branded, as
had
one
had
who
put in his claims for a
alreadyexperienced,
property.
I had changedmy louis at the banker L
's,and I
was
alreadyclose by the gate of the city,when I saw a
Jewess
followingme ; and though I had made
young
different turns to avoid her, she nevertheless
hung close
I then went up to her, and exclaimed,
on
my footsteps.
in a menacing tone, Accursed
pagans ! you have already
crucified Christ, and this day you vent your wrath
on
Jewess saved herself from this
the princeroyal!' The
and from
that moment
I was
dreadful apostrophe,
fully
who
satisfied that the prince,
beloved,
was
universally
that

it

was

sacred

would

precision
peoplewould

money

daughter,and I took the road

pass the night in that town, and
I

as

manner,

fear.

Rotterdam, whence

see

this

without

boat

to

family

the

to

Munster

led to believe the

countermand

wished
to

my

I said to

person.

have

in

I reasoned

vanished, and
for

was

Having

rid of my

got

cause

"

'

132

STATE

excited

OF

of

consequence
resided,carried
house.

On

the

me

in

under

which

the

in the

distance
care

far

so

of

called

was

extravagantnature,
with

persons
of the

course

the

from

Z.

he

to

me

of M.

in, and

at the

"

of

having

occurred

to pass three

answered

conversed

when

we

at the

were

I
days; still,

with

to

put

sician
phy-

of three weeks
expiration
guardiansno longercould
ideas still clung to the

thoughts,though my
same
subject.
After having left the house of M. B
fellinto a state of profound melancholy. I
which onlythe extreme
to be in positions
conceive.
can
My recollections are by no
had

was

trace my

we

came

ment
establish-

an

street,where

old servant

an

recovered, that my

clear of what

whom

night,to another
despatched
subsequentday,a letter was

me,

the

the

was

INSANITY.

keeper of the records, M.

and took
closed carriage,
a

at

DURING

furious delirium of the most

in

to

MIND

have

different

at
,

Delft,I

fancied

myself
of madness

means

very

hotel,where

idea
floating
people,and that I
a

different

questions.I think, also,that when

I went to bed, a great many
to observe me,
peoplecame
and they talked togetherabout my condition,but all the

rest
"

was

as

The

night

dream.

condition,however, in which

spent

the

first

worthy of attention. I thought myself

unable to make any
a-bed,perfectly
conscious,but totally
in an immense
movement,
abyss,in which I believed I
had

seems

been

buried

alive,and

tomb, in the condition

was

had

now

awakened

to live for all

in

the

with
eternity,

the

consciousness of my condition,to reflect on

perfect
awake
few hours
a
myself. My mind, which, when
had
been carried away
vagant
previously,
by the most extraclear.
I
frenzy,still enjoyedall its perceptions
discussed with myself whether
I deserved* so
stern a

fate,and

as

was

unconscious

of any

crime

done

with

CONFESSIONS

OF

PATIENT

AFTER

133

RRCOVF.RT.

I concluded by supposingthat this sevepremeditation,

rity
of punishment had been awarded
to me
because,
though I had fulfilledmy duties as much as layin my
power, I had yet neglectedto do any good beyond my
line of duty,"c.
In other respects,
I was
in the same
condition
"

as

affected with

person

tetanus.

I recovered

myself,however, though I was in a state

of extreme debility,
not having sufficient strength
almost
to support the weight of my
body. Scarcelywas I
awake
I relapsedinto
illusions. I began to
ere
my
scrutinize my room,
that I might discover whether
I
had

fallen into

not

('Query,Armi').
this
prosecuted
a

smile in the

into the

The

search

house

the house

person, and

of stones, it could not

demolished.

was

of souls

merchant

burlesquemotions with which I

would
undoubtedlyhave provoked

serious

most

of

chimney,reasoningthus

made

was

the

My

last I went

at

that
myself,

with

fears

further

were

it

when

down

be thrown

as

mented
aug-

In
the walls.
which
ornamented
pictures
the approachof the
that posture I waited in trepidation
A
inmates
of the house.
girlappeared,who
young

by

gave

me

the

confidence,but when

some

emotion

enter, my
when
lastly,
who

and

I broke

"After

garden;
around

to

leave

window
time

some

the open

air

source

me

was

me,

not

saw

my

my

wrath

lady
old land-

concealed

be

brought

keeperswere

two
not

were

could

into

was

the
fired

and

room,
anew,

might escape.
I was
permittedto go to the
soothed me, and yet everything

that I

of illusion to

me.

The

houses

filledwith
garden seemed to me to be prisons
in
prisoners.I fancied the kitchen of my landlady,
soners
the placewhere the priboiling,
which a largepot was
of the pot
water
were
put to the torture. The
in which
going to throw me, I thoughtwaa
they were
the sleeve off iny
boilingoil. Full of that notion,I tore

around

the

134

STATE

OF

DURING

MIND

INSANITY.

robe, desirous to retain it that she might not

daughter's
incur the hazard of beingboiled alive.
All this receives its explanation
in the condition of
influenced by
actions are
a phrenetic
lunatic,all whose
dreadful fancies ; so it is always with me, that
so
many
it is impossible
those agonies,
to alleviate,
little,
a
even
For if I
except I am
completely
enlargedfrom them.
had been shut up on that day,or even
down
bound
by
have stoppedthe flow of the
would
chains,either fright
"

blood in my veins,or it would have circulated with such

all the
intense rapidity,
that, with undoubted
certainty,
arteries would

have

burst

I
luckily

Most

brain.

in my

left in the

was

were

the

garden,though a violent storm was approaching.

I felt myself very well when
my keepers
of
forced to retire by the rain under the protection
template
alleyof the house, leavingme at full libertyto conthat
the rising
different was
But
how
storm.

storm

from

witnessed
horizon

that

I had

since.

The

appearedto

me

seen

before,and
billows

the

I
from

rolled up

clouds which
to be

those

of the

have

the

deep,

risingo'er the banks of the Schevelingento the skies,

fightingin the air togetherover my head ; while a
flotillaof the enemy,
the margin of the river,carried
on
last
The
on
a
deadlycombat againstthe inhabitants.
I did
hour had struck for the prosperity
of Holland.
witness any lightning
not hear any thunder
;
; I did not
blazes of
but I perceivedthe explosion
of a hundred
fire,the
from

which
and

ear

cannonade, ceaseless,reverberated
we

the eye of the insane

is heard
"

my
were

The

same

that the
certainty,
ever
amplifyand enlargewhat-

seen.

or

remark

occurred

to

symptoms appearedbetter,my
restored to

arrangedthem

ears

all

infer,with

may

in my

I took

me.
on

my

table.

me

linen and my
out of my.

them
I

afterwards.

was

struck

As

property

trunk, and
with

their

CONFESSIONS

OF

greatnumber,

and

and towels, which,

PATIENT

with

even

however,

AFTER

185

RECOVERY.

the appearance
of a cloth
I had left behind at C
.

lowing
joy did not continue long ; and when the folday I again examined
my linen,a great many
objectsappearedto be wanting,which I hud fancied
the previous
to have had in my hands
evening; so much
I supposed I had been robbed.
I did not,
so, that
to any one.
however, communicate
my suspicions
that
in affirming
These two circumstances
me
justify
have
which
and hears objects
the lunatic fancies he sees
But what
I am
real existence.
tion
now
no
going to menportunely
proves the importantinfluence of an individual,opto
seen, in givinga proper degreeof assurance

But

this

"

the sick person ; for the earliest symptoms of my recovery

I saw, amongst a
the day when
take their date from

others, a form

greatmany

that

caught my
particularly

attention.
"

the second
well say whether it was
in the
to talk with me
several persons came

I cannot

day

but I

insolent
extrenrely

was

to whom

owe

to every one,
At
my life.

even

the

or

third

garden,
to Captain
end two

opened the gate,and looked on my side of

and
garden; one was dressed in a deep blue overcoat,
dressed
almost immediatelywithdrew ; the other was

the

men

he
in

also retired. After that

uniform
; he
very beautiful
entered,having all
of a very good expression
man
young
health ; he spoketo
the outward
appearances of perfect
guage.
lanin the same
and I answered him
in

French,

me

and
princeroyal,
all of a sudden
I felt myself
my eyes.
before the princem i
for appearing

I took this person

bandage fell from

in greatconfusion
costume

that

he

so
was

unsuited

for the

for the occasion.

still alive,and

health, the anxieties I had

conceivingthat

the enemy,

was

surprw

in perfe
appeared
his ace
on
experienced
which had beleaguered
an

he

136

STATE

country,had
in

OF

made

life,and

from

that

INSANITY.

DURING

suffer

him

I felt

moment.

MIND

great torment,

hour

inspiredwith

if

myself as

of horror

visions

the

all vanished
new

were

no

more.

It will

easilyunderstood that this young person

little like him.
not the prince,though he was
was
a
the
What
be conferred
of good would
on
an
infinity
lunatic could his thoughts be anticipated,
of
and scenes
be brought before him.
to affect him
a nature
favourably
Had
to leave that day, I
permission been given me
would
have committed
assuredly
nothing either that was
ridiculous or
But
attended
with
injury to any one.
"

there

were

which

be

still
not

was

cruel trials in

more

until I had

to escape

gone
days'illness.

ordeal of three additional

"

coach

of the

records,conveyed me

placedin

with

house
M.

the

near

gate we

same

that he had
in

had

mistaken

the

same

increased
said to it that

and

room,

with

Haye,

then

not

where

his

As
was

when

on

by

show

him

offended

continued
lips,

the rod, which

the

ascended

again
saw

servation
ob-

paying any attention to my

we
stopped,this irritation was
perceivinga child looking at us.

it deserved

thrown
that

caused

stairs I counted

into

the door

distress

on

could not

was

rence
diffe-

leave the town

I felt much
on

had

attemptedto

smile

keeper

route, without
When

away.

did

the road, and

that he,
perceiving

the
,

castle.

entered.

through the

La

to

we

as

the

M.

ordered, in which

was

from

for me,

reserve

ther
furI

it to
the

steps;

gettingto
be locked

run

my

from

within.

My alarm, however,
believed that I thought
"

nurse

before

became

extreme, when

firmly

in the person of my
recognised
time
individual
whom
I had seen
an
hanged some
another
at La Haye, along with
criminal, and

CONFESSIONS

OF

PATIENT

AFTER

137

RECOVERY.

whom

I took for a spirit.In the solitude

accordingly
of night,I perceive
myself alone in company with this
person, full of the most
agonizingapprehensions. I
would
allow
not
the shutters to be closed at
nightfall
;
and as, when
I thought I had seen
the prince,
I had no
longerany dread of war, I was fullypersuadedthat our
soldiers had

been

this idea stirred

victorious,
so

breast the fears of

worked

was

to throw

being assassinated.

in the

the water

moment

to

it

yard

I fancied that

into my

up

When

room,

in

up

the pump

they were

and

going

I looked

every

rushingin.

Noticingthree nails in
I supposed that they intended
room,
to hang us
them, myself,my daughter,and my nurse, because
latter had
"

see

been

condemned

Restingon

my

couch

one

in the

wall, whence

from
it

on

the

evening,but quiteawake,

with
every step of the nurse
the candle ran, but
thought her a spirit;
flow

my

to death.

I watched

the tallow

my

that

was

my

I did

candle, but

dischargedin

not

from

as

eyes,

serve
obhole

enormous

an

quantity,
resemblinga furious torrent which has burst
through its banks, so that I screamed aloud, and pretended
that they were
cident
The ingoing to suffocate me.
made
me
suspectthat they had the intention to
I
that moment
from
poison the atmosphere,and ever
though sweet
constantlyexperienceda disagreeable
smell.

All the viands

thought that
and

insisted

"

the meat
the idea

me

had

they brought was

that they desired

that

taste.

human
to

flesh,

poisonme.

vered,
complete restoration to health I have discowhich had
in one
of my
walks, a poisonousplant,
odour I allude to.
disagreeable

Since

the

on

offered to

my

The

circumstance

I have

referred to, of the tallow

running down the wall,is a convincingproofto me that

of the mental faculties,
persons labouringunder disorder

138

STATE

OF

MIND

DURING

INSANITY.

which
have no
real existence,and that
perceive
objects
the sightof particular
matters
produces,spontaneously,
images in the eye of the diseased person.
"Even
when
I was
at a later period,
improving,I

stillsaw
the

Dr.

voice of my

then

brother-in-law

my

sister,as

I heard

voice, which,

also another

bade me
speakingto me by my name,
lay down the
petition.'
I often requested
of my keepersto have my clothes,
; but
they answered me that
my
papers, and my
money
who
to be kept till my husband
they were
appeared,
for me.
On several occasions
and inquire
ought to come
I objected
the expense it
to this arrangement (pleading
'

"

would

be

detained

with) to interest the persons who

to permitme
to travel alone ; this,however,

attended
me

they would
more

calm.

state

of

with

dreadful

Several

dreams

condition.

below,

There

which

examined

in

this

realms

the

with

on

appositely

very

in

was,

much

become

broke

however,
tranquillity,
tallying,

my

Pluto

to, though I had

accede

not

of

remarkable

I saw,
over,
moreself-possession.
the aqua tolena prepared. I had read an
account
of this horrible torture, the frightful
details of which
all reproduced
in the dream, and my children were
were
of the Italiani. I
the unhappy victims of this barbarity
would
rather suffer in reality
every kind of imaginable
On
that horrible dream.
torture, than again experience
I.found that I had been
dreaming,but
being awakened

degree of

still one
kind

the

firmness

idea

uneasy
was

and

on

my

succeeded

the last of

another, and

return, after having been

in

diligence.
"

We

might

be

these

facts,that every

from

the

eye

gave rise to

persuadedto
should
visible object

almost

of the

lunatic

but

on
misinterpretation

conclude

if what

my

from

be withdrawn
I

witnessed

part,those things

140

STATE

the

passedby
the castle

mode

of the air
inferred

house

DURING

long

tube

having

INSANITY.

the house

not

was

nearest

operationfor
pipe was the only

the house.

to

of

the court

mental

of that

access

individuals

all the

that

So

who

wise
I like-

entered

the

be suffocated.

would

insane

and in his prearriving,

sence,
whole
a
specialchange.
system underwent
my
of feeling
I had in him a proa satisfaction that
tector,
I was
harassed
by the idea of being considered
by him, and beingplacedunder the control of a

person

whom

"

On

it

that the

to conclude

me

MIND

chimney of

and

OF

the

Instead

day of

husband

my

1 distrusted.

fear,I exercised

all my

Under

the influence of that

that
self-control,

he

might not
stillfar from being in
adoptedthe precaution

insanity,
though I was
full possession
I also
of my wits.
to procure secretly
I swallowed
a strongdose of rhubarb.
it all at once, and felt myselfmuch
better after.
I had
done so formerlywith benefit.
Some
days after the arrival of my husband, we
We
secured
began our arrangements to return home.
though we would have done
placesin the diligence,
better by hiringa carriage,
had to pay
for three
as
we
We
then fairly
seats.
road, and the shocks
on
our
were
vehicle in which
travelled
and joltsof the wretched
we
of no
small service in restoring
addled brain.
were
my
suspect my

"

found

soon
"

We

where

arrived
we

were

but
had

reason

my

restored.

nightat a town beyond A

staytill the morning. We had

to
was

and

lest he

them, and

double

was

for the

no

gone

lock to it.
to

room,
bed-

husband

my

bed, I noticed

the door, which

louis,of those which

and, in addition,the

When

that

he

had

ajar,and I
in his pockets. I
had
left money
found, to my great delight,
thirty-

pantaloonsnear

afraid

searched
two

there

undressed

left his
was

that

sum

of two

I had
hundred

was

taken

with

me

in
reichsthaler,

CONFESSIONS

OF

singlelouis.

PATIENT

AFTKR

I4l

RECOVERY.

immediatelyconcealed the thirty-two

double louis in my clothes,intending,
if my
husband
did not adopt better arrangements for our
to
journey,
start alone on
the gold coins myself.
foot,and manage
This money,
which
I had worked
hard for in my early
and
life,

which

that,
so
spirit,

had

from

recovered, impartedto
that

me

instant, I felt that

new

had

life.

My fears all vanished,and everything

about me
appearedunder a new light. Desirous
husband
little annoyance, as a punishto givemy
some
ment
I placedin his bed the
for his 1/ant of prudence,
which belongedto him, retaining
The
my own.
money
followingmorning his alarm was great when he found
the
his pocketsempty, though his pantaloons
on
were
the previous
chair he had put them
forted
on
evening. I comhim, restoringto him the money, and told him
of travelling,
travagant,
that his manner
though it was highlyexnot the more
was
pleasanton that account ;
to the general
contribute any more
not
that I would
but r*iy only for those of myself and
my
expenses,
daughter. Notwithstanding my remonstrance, as he
I left him in a village,
in travelling
by diligence,
persisted
and proceededalone as far as the gates of Westphalia.
I should undoubtedlyhave lost my way, had it not been

entered

for

on

new

incident which

an

the

much

has

of the

appearance

marvellous.

"Arriving

at

going to follow that

to the pointwhence
tracks of

man

of Minden

town

who
:

three

placewhere

have

roads

broughtme

which

would

I had

started,when

had

cross,

burst, and

was

back

I noticed the

conveyedcorn
probably

sack had

to the

considerable

escaped.My head was still

readyfor this adventure
feeble,and I had an explanation
this time, that this
I conjectured
then, and very luckily
amount

of the

corn

had

corn

had

been

spreadon

the road to enable

me

to escape

142

STATE

OP

MIND

DURING

INSANITY.

in which I was
I followed
involved.
labyrinth
the marks with perfect
confidence,and treadingsteadily
the corn, I passed over
roads almost
on
impracticable,
into the high
and through several villages,
gettingfinally
road, where I met the diligence,
which, takingthat route,
had made
husband
and
a long circuit : there I joined
my
my daughter.
At
Minden, I took the arrangements for the continuance
of our
hands, and hired
journeyinto my own
for ourselves.
a privatecarriage
Notwithstandingthis,
the most trivial circumstance
fancies;
suggestederroneous
in a state of perfect
but as I was
I examined
liberty,
very
which
the subjects
had awakened
in
attentively
surprise
became conscious of my errors.
breast,and I gradually
my
I still recollect several of these very singular
visions.
At the periodof which I now
speak,I was in no way
to my
fate,or that of my family,but I
as
own
uneasy
distressed by a feelingof sympathy for the Jews,
was
discomfited,as I thought,in Holland, and scattered in
in the neighbourhoodof C
the woods
where
they
were
perishingof hunger and cold, along with their
I dailyresorted to the woods and
wives and children.
bread and money,
the crossnear
roads.
particularly
deposited
from

the

"

"

"

regimentspassingthroughthe cityat

Two

time, had
affected

the

with

me

in the

was

coffin in

circumstance, I

I understood

this

ran

same

circumstance
their

king

convince

myself of the truth of

the garden to meet
the
and afterwards
disappeared,

across

body had

was

tenantless.

I called

the regiment at a distance

following
the subject,
several questionsto him
on
answer
saying
me, but went
away, without

I made

word, to

To

that the coffin

but he did not

one

the

soldier,who

young

alarm, for I thought that

coffin.

procession
; but

their escort

the

was

hillock covered

with

verdure

and thorns

CONFESSIONS

OP

he there made
cane.

He

him

whether

banks

PATIENT

hole in the midst

still declined

of the Rhine

the silent soldier

was

of the thorns with hit

not been

was

when

buried

I asked

on

of the

one

however, satisfiedthat

soon,

which
spirit,

143

RECOVERY.

answering me,

king had

AFTER

idea made

me

ceedingly
ex-

uncomfortable.
"

Fear, probably,and

had

as

the

to
stormy season
constantly
exposed,again disturbed

been

of my intellectual powers.
From
I arrived in the country, I observed

all the
machines

which

drivingit

the Rhine,
anxious

back

beat

barbarous
show

mind

army

deep,and

that

so

loaves
of

they took
poor."

and

recruits
the

bottle of
on

their

brandy,and

soon

of

horizon,

hatred

for

far

as

they were

againstthe

deed

and to

being a partyto

into my

came

as

corpses of the
victory.This

their

atrocious

that I could not be blamed

execution, the strange notion

some

the

determined

capableof

men

the

Prussian

of
as
so
destroyed,
trophies
parties

idea excited in my

day,as

and I
telegraphs,
enemy, after having

vessels and

preserve the

to

the

into the

mony
har-

to be

me

conclusion, that the

canal, had

the

the summit

on

circumscribe

appearedto

the

fancied,at
cut

which

mountains

that

which

head

its

to send

ments
brandy to several detachroute
through the town :

handed

the loaves

over

to the

lady returned to her native city,her

visions,though not exhibited by outward signs" as she
sufficient self-controlto conceal them
has now
acquired
She rerenewed.
stillfrequently
are
from the world"
had
tained the notion for a long time, that the Jews
She also saluted with
resolved to destroythe Christians.
the Jewesses ; if they
much
courtesyand humility all
Since

were

treme

this

in terms of exclothed in rags, she addressed them

her kind offices,and
oflered them

politeness,

endeavoured

to comfort them.

She sometimes

gave the

144

STATE

last,she gave

convinced
chimerical
This

but

is

contrast

as

noticed

often

in

the

great number

there

she became

daily
altogether

apprehensions were
the
adopteda notion exactly

fancied that

She

insane.

she

she conceived

this notion,

up

her

that

INSANITY.

in which

some

At

DURING

pieceof money,
virtue.
particular

poor Jews
was

MIND

OF

reverse.

of the

dreams
of Jews

were

forest behind
mountain
in
a
encamped in an immense
the vicinityof the town
she lived
that the
where
government kept them prisonersthere, and watched
condemned
to perisha wretched
them, and that theywere
death by hunger. Actuated
fortunate
by sympathy for those unbeings,and indignantat the cruel measures
several times out
enforced against them, she ventured
the forest,and placedat different parts by the waynear
side,
"

all kinds

of

food,such

that these

unhappy

that

of them

some

to which

death
The
his

own

followingis
When

case.

pursuedby

as

creatures

loaves,fruits,
eggs, "c., so

might pick them

at least

might

escape

theyhad

been

doomed.

an

and

ful
the dread-

account, written

deranged,he

demon.

from

up,

He

had

of
by a physician,
imagined himself to be

also other delusions.

He

fancied himself

from street to street,and his

transported
imaginationwas active enough to exhibit to him every
different publicplace,
his guards
in which
moment, some
I almost continually
detained him on his bed.
cated,"
supplisays the author, to be onlycarried to my house
about
the patient,
The
in Holy Ghost-street"
persons
in endeavouring to pacify
him, without complyingwith
the delusion under which
he
his wishes, only confirmed
"

"

laboured.

Their

"

cry was,

it shall be
it is

done

in

night."

He

few

lay
piningin vain for the end of these few hours, and during
the time, his fancycreated places
not the most agreeable
it pitchedhim between
Sometimes
for his residence.

hours,

or

earlyto-morrow,

as

now

CONFESSIONS

OF

walls,so

two

PATIENT

close that he

AFTER

could

145

RECOVERY.

heave

not

an

arm

sometimes
the court
burial-ground;
on
he attended.
before the hospital
All the arguments of
Ins friends availed nothingto
prove to him that he was
When
in his own
room.
really
theypointedout to him
us
own
books, close beside which he lay,or the prints
that hung opposite,
he took it for a trick. Sometimes hi"
sometimes

did not

on

for his

recognisethem

theyhad

conceived

own

been removed

and sometimes

to his

he-

present place of

abode.
It

observed that the sound

was

him

of

horn

transported

in

to a publicplace for music

and
imagination
dancing;the neighingof a horse in the street,to a
stable ; the bad odour of his own
to a buryexhalations,
ing-ground.

He

under

was

by
and
forsaken,

his

raised,arose

was

"With

and

The

tion
founda-

of despondency
superstructure

this

f-om

who
friends,
him.
upon
mistrust he

him.

renounced
patients

which

on

hated

was

world, that all his friends had

the whole

deserted

of fact

delusion that he

mate
missingthree of his most intiof attending
absent or incapable

his

were

this

must

be

towards

entertained

considered

natural

mankind, which

his

theyhad observed when he was in health.

from
of unpleasantthingshe experienced
The number
those about him, such as their refusal to let him quithis
bed, forcinghim to take medicines,applyingblisters,
must have added force to his morbid impressions.
My other fancies were," he observes, probably
friends told him

"

"

those

most

flowers

on

common

my

curtains

in

every

and

form

of delirium.

tester,I took for

in

men

there

tin

in.

tinual
con-

-They all went towards the wall ; and

I often joined
but my acquaintance,
none
were
raneous
We
found ourselves in largeilluminated subterchambers, where I learned such familysecret*,

movement.
as

The

146

every man
in the recesses
wife

of his bosom.

involvingtwo

of

have

storywith

lity,
probabiI must

fact,which

real

air of

an

in

learned

had

illness."

before my

known

it such

gave

her take it for

to make

I related the

assemblies.

and
consistency,

much
as

friends,which

our

these subterraneous
so

keepsclose locked up
called my
Once, I really
her a shockingtransaction,

bedside, and told

to my

INSANITY.

above

the world

in

as

DURING

MIND

OF

STATE

passedthrough a painfulattack of
was
requestedby the medical gentleman who
insanity,
of
liad charge of the case, to put in writingan account
he experienced
of
the sensations
at the commencement
that the patientimagined
I should premise,
his illness.
A

had

who
patient,

that

his

among

relations there

and

friends

grand conspiracyagainsthis

life.

also under

was

administered

delusion,that poisonhad been

the

He

existed

him

to

escapeddeath onlyby drinking

liquid. He thus describes the

in his tea,and that he had

a

portionof

small

the

he

whose

supervisionhe

with

pityfor

lean

back

under

person

to

of mind.
his

couch, close

the

on

affected

unhappy state

my

to

temporarilyplaced.

was

sometimes

attendant

says, the

reference

in

entertained

fancies

smile

Then

at

me

he would
them

open

eyes;

He

be seen
that the eye could barely
little,
so
through the
lashes,and so as to preventhis being observed, as he

thought.
looks

At

other

or

I could

see

not

his muscles

used

he would

put

what

"From
says the
of

to

answer

July,1847,
Mr.

Rev.
"

insanity,

was

for

begun

also

from

some

the latter

looks, and the

but

infernal

the

hardness

posture

vered
into, ready to jump, if he disco-

himself

would

his

assume,

the room,

he had

to finish what

only from

cast the most

round

afterwards

and

at me,

weapon

times, he would

those

Wai

his

purpose."

to November

ford, when

of the

same

year,"

describinghis attack
highlynervous, and experienceda

148

STATE

OF

MIND

DURING

INSANITY.

quently,being unable to restrain my feelings.About

this period,
I began to see
like gnats,floating
objects,
before my eyes, and thought they were
wicked
spirits
watchingme; however, I feltsatisfiedthat I was anointed
in a very high degree,and that my
mission
from
the
about, and convert
Holy Spiritwas to walk incessantly
As I passed near
the people I met with.
to them, I
believed the Holy Spirittransferred itself from
to
me
in
them ; so I selected the most crowded thoroughfares
the metropolisfor the work of conversion, and extended
into the adjoining
walks daily,
sometimes
even
counties
my
I thought the peopleoften turned
round, and
; and
with
I passed,
if
looked at me
as
as
great satisfaction,
conscious of the blessingI had conferred on them.
To
the crowds I had
converted, greatly
see
encouragedme
I had
in my labours ; and now,
delightedwith my office,
One night,
while in bed, I saw
the
specialrevelations.
like a horizontal pillaracross
It was
gloryof the moon.
the

moon,

which

bedroom

approached my
I

to

was

Saviour.

be

increased

Upon

window.

prince, and
the

in size and
I

the

approach of

once

was

sensations

laughedand wept. One

that I
to me,
me
telling

go

it

high-prince,of our
the morning, I felt a

alarmed
frequently

afraid I should

as

believed that

now

burning flame around me, and conceived

for the work
me
glory of God sanctifying

My

radiance

that it
I had
me.

was

the

to perform.
ore

than

mad, and then I alternately

day I

heard

feet

speaking
should be a king,and reignat
that
Jerusalem ; and I also heard other voices,telling
me
I was
Dan, the son of Jacob, and should have largepossessions
at Jerusalem.
Thus, having left my home, I
miles of ground,imagining that I was
Wandered
over
stand still; and, after having
forbidden to sit down
or
walked the whole night,one
morning I arrived in Sionlane,and was, by one of the cottagers,con'ducted to the
my

CONFESSIONS

where

house,

look

the

at

first

been
and

quite

and

under

my

came

became

delusions,

which

mental

restored.']

health

is

while

might

brain

my

be

prietor,
proI

pected
ex-

with

happily
I

am

converted.

new

conversed

that

passed

grateful

many

my

conscious

have

asleep,

was

there,

gentlemen,
quite

now,

and

residence

my

medical

gradually

The

rest.

they

of

weeks

and

come

that

149

RECOVERY.

churchman

would

across

the

and

companions,

freely,

few

food

high

order

in

me,

fancies

strange

was

AFTER

find

to

inhabitants

the

During

PATIENT

expected

supposed,

all
and

OF

to

had

away,

believe,

150

STATE

OF

RECOVERING

WHEN

MIND

CHAPTER

State

of the Mind
Attack

FROM

INSANITY.

V.

nhen

from
recovering
of Insanity.

an

sometimes
the descriptions
are
deeplyinteresting
given by the insane of their state of mind when passing
condition of intellect. In some
out of a derangedinto a sane
is restored suddenlyto its sovereignty
;
cases, the reason
and
in
cases, however, the mind
appears gradually
many
tastic
out of a fanalmost imperceptibly
to awaken, as it were
and fairy-like
sciousness.
dream, into a healthystate of condescribed his mental
In one
case, the patient
considered to be in
when
it was
condition duringthe period
the Delu"I felt as I was
sions
recovering,
transitu,
as follows
losingtheir hold upon my fancy. I then
gradually
began to entertain doubts as to their reality. I felt
advice of my
to the judicious
to listen patiently
disposed
physician.I was no longer irritated at being told that
false, and began to appreciate
were
perceptions
my
the absurdities
of other patients.One fellow-sufferer,
with superendowed
who
natural
firmlybelieved that he was
I had
and whom
and divine authority,
power,
alwaysconsidered as sane, and improperlyconfined,and
and deep reverence,
treated with greatawe
had invariably
I now
thought,must be mad !" The dark clouds that
had
so
long obscured, enshrouded, and embittered this
and the bright
mind
were
dissipated,
gradually
patient's
its joyous and
shed
of reason
effulgent
light
sun

How

upon

"

his hitherto darkened

As

he

and

towards
progressed

bewildered

ing.
understand-

recovery, 'his mental

ILLUSTRATIVE

151

CASES.

perceptionsbecame

clear and intelligible.

dailymore
Whilst in this intermediate phaseof morbid
thoughthe
reminded
was
of Milton's majestically
forcibly
poetical,
and profoundly
philosophical
passage, in which he makes
Adam

relate to the

"

angel what passedin

after

awakening into

Whilst

thus I call'd and

From

where

This
On

stray'd

I firstdrew

happy light,when

life :

answer

diately
imme-

"

I knew

air and

his mind

whither,

not

firstbeheld

return'd,

none

green shady bank, profuseof flowers,

Pensive I sat me
down ; there gentlesleep
a

First found

My

drousea

I then

was

and

me,

sense;

with sod

seiz'd
oppression
untroubled,though I thought

passingto

aud
Insensible,

my

forthwith

fonner

state
"

to dissolve
"

Paradise

Lost,"b.

8. 1. 2*3.

Another

patientdescribed his state of mind when

ness,
follows
as
recovering,
During the whole of my illwhich
lasted for eighteen
months, I alwaysfancied
could
I never
myself surrounded
by a dark cloud.
and
that there was
appreciate
any difference between day
it produced
night. Even when the sun shone most brightly,
alteration in my feelings.I fancied that I was
no
doomed
to live for the rest of my days in a state of perpetual
ment
gloom, and never- ending darkness, as a punishin earlyyouth. No
for sins I had committed
"

alas !
brightobject,

looked

so

to my

mind.

I found that

I could gaze, without the least inconvenience, at the sun,

at its height. It did not, in the slightest
when
even

degree,dazzle
"

time

me.

of my
darkness
this mysterious

I date the commencement

when

recovery

from

the

to
began gradually

continues,
gettingwell,"the patient
and lesa
clearly
I fancied I saw
objectsmore
tressing
this disthrough a haze. My mind appearedduring
covered, if I may so speak,
as if it were
illness,

fade

away."

"

When

was

"

by a

dark

veil.

This

is the

onlycomparisonthat

occurs

] 52

to

STATE

It

OF

MIND

WHEN

if I

RECOVERING

FROM

INSANITY.

lookingthrough a pieceof
glassat every object. This cloudycondition of
green
mind
did not disappearaltogether
for some
months, but
I began to see things with my
natural
as
vision,I felt
that I was
very
recogettingwell. This state of progressive
continued until I saw
everythingthrough a clear
and sunny
and then my happiness
and peace
atmosphere,
me.

of mind

was

as

restored

were

were

in other

words, I

was

well."

dation
foungentlemanwho imagined,without the slightest
for such an impression,
that his wife had been unfaithful
in entertaining
this delusion for
to him, persisted
whole
He declined,duringthe greaterpart of
a
year.
his illness,
with, and rarely
having any communication
to her when
she called to see him.
His
speakingcivilly
generalhealth was much shattered by a sedentary
occupation
of the ordinary
and neglect
rules of hygiene. His
mind had also,for a longperiod,
undergone much anxiety.
mental depression.His
At times he suffered from severe
of time, became
proved,
generalhealth, in course
greatlyimbut there were
symptoms of local disturbance in
of the existence
the head that at firstled to the suspicion
form of organicdisease of the brain.
of some
before his recovery, a largecarbuncle
A few months
made its appearance in the lumbar
region. This caused
great pain, and confined him to his bed for some
weeks.
numerous
Subsequently,
furunculibroke out in
with
various parts of the body, attended
great general
A

irritation and

He

was

serious disorder

of the

invalided for many

assimilative

months.

tions.
func-

ever,
He, how-

the
recovered, still,
however, entertaining
entirely
delusion with

regardto

himself
founded

wife,but in

At

firsthe

somewhat

fied
modi-

with
began to reason
as to the
realityof this impression. He asked
Is my
the
followingquestions
suspicion
What
fact ?
on
proof have I of the infidelity

and lebs acute

himself

form.

his

"

"

SINGULAR

of my

wife ?

Could

againsther, in
divorce

CASE

the

I establish
of law ?

court

OF

ground

153

RECOVERY.

an

accusation of the kind

If I

were

to

applyfor a

of

who
would be ray
infidelity,
witnesses?"
tained
mainUp to this time, he had resolutely
a firm belief in his wife's gross acts of immorality,
and it was
not until after his serious bodilyillness that
he began to waver
the subject
of his delusion.
on
For nearlythree weeks, a contest of this character took
It was
a
placein his mind.
strugglebetween healthy
and disordered impressions.Occasionally,
he appeared
It then recurred
to lose the delusion.
to his
entirely
than before. 1 advised a commind, but much less strongly
plete
change of air and scene, and suggesteda residence at
lie obeyed my instructions,
Boulogne for a few weeks,
in the amusements
it
went to this place,participated
of sea-bathing,
and returned in a
afforded,had a course
few weeks to England,in the full enjoyment of the
men*
informed
that one
He
in corpore sano."
me
sana
day
when returningfrom a tepidsalt-water bath, which had
greatlyexhilarated him, all idea of his wife having
from
with
behaved even
indiscretion,vanished entirely
I felt,"
he says,
his mind.
a
gush of joyous feeling
scribable
that producedan indeof my thoughts,
take possession
almost leap
which made me
state of happiness,
on

"

"

"

for joy."

lady who had been for a periodof nine months

forsaken of Qod, appeared
that she was
insane, believing
Her restoration to health of mind,
suddenlyto recover.
at firstled
not so rapidas her friends were
however, was
A

She

to suppose.

home,

gave
detailed and

gradualreturn of
been carrying
on
For
with
struggling

her

husband, after she returned

account
deeplyinteresting
battle
and of the steady
reason,

for two

more

the

months

with

of the
she had

the insane

lusions.
de-

eight weeks she had been

which had w"
morbid impressions
than

154

STATE

MIND

OF

her

poisoned

WHEN

RECOVERING

mind.

The

FROM

INSANITY.

of

commencement

this

contemporaneouslywith a return of
the uterine functions, which
had been suspendedfor a
considerable period. This improvement in her general
health appeared to shake her belief in the
existingdelusion. At that period,
she said, I,for the firsttime
the quesduringmy long illness,asked myselfseriously
tion,
Am
I under
For some
delusion ?'
a
days the
morbid
caused her less mental
distress,but
impressions
disorder,passed
having,owing to an attack of stomach
two or three sleepless
nights,the delusion returned in
full force to her mind.
After the lapseof a week, she
with
herself as to her
again began quietlyto reason
She
insane religious
notions.
to
then went
regularly
that
she did previously,
church, without
as
feeling,
she was
only mocking God by so doing." I felt,"
contest

occurred

"

'

'

"

she
with

"

said,

"

repose

at this

comfort, in the prayers, and

and

satisfaction to the

time, her mind

was

could

sermon."

much
occasionally

But

listen
even

distressed

manifested, morbid and gloomy

by some, but less acutely
tinued,
apprehensionsas to the salvation of her soul. She constate of
to recover
however, gradually
a
sane
in refusing
to adopt
thought. She no longerpersisted
the remedial measures
suggestedfor her cure, and part
did I witness
passu, with an improvement in the physical,
the return of a healthystate of the intellectual functions.
She

informed

me

after her

recovery, that she

was

pelled
im-

by an internal voice to refuse compliancewith

everythingthat was
proposedby myself in the way of
She fancied that she was
treatment.
doing God service
made
all the attemptsthat were
to improve
by resisting
her bodilyand mental health.
I have, in a previouspage, referred in detail to the
historywhich has been publishedof
deeplyinteresting
desthe Rev. Mr. Walford's
state of morbid
religious

156

STATE

OF

MIND

WHEN

RECOVERING

FROM

INSANITY.

friend,though for the precedingfive years I could not

of his habits,
bear the sightof a pipe. My wife, aware

smoking set before him, which he

him,
pressed me to accompany
employed,and earnestly
which
refused to do.
On
the evening of.
I passionately
the only person
his departure,
when, as usual, I was
sittingup, it occurred to me to try if I could smoke,
had the materials

which, for four

of the

for

or

five years,

manifest

bad

had

discontinued,

effects it

on

producedon my
pulse. I instantly
procured for myself the smoking
out
withapparatus,and found I could perform the operation
the injurious
had induced
results which
to relinquish
me
the practice.Soon after this experiment,I
under
resolved to try if I could read, though I was
a
to select a book that did not seem
likely
great difficulty
shunned
to awaken
painfulassociations,and I especially
mined
all such as treated of religious
subjects. Accident deterI had not relinquished
a book
society
my choice.
of which
I was
member, though the books that came
a
notice.
concealed from
to my
house were
carefully
my
I found that a
At the time of which I am
now
writing,
History of the Cotton Manufacture,' by Mr. Baines,
was
broughtto my house, and as it seemed not very
I
that anything in it would
excite my
feelings,
likely
to try this
resolved,though with extreme apprehension,
In a day or two, I found nothing in it that much
book.
It amused
distressed me, and I perusedit to its close.
and after reading it again,I wrote
out a pretty extensive
me,
abridgmentof it. I then attempteda work by
Mr.
is, I think, The
Babbage, the title of which
Economy of Manufactures.'
these works, I was so
After readingand epitomising
much
quietedas to regret I had no others of similar
character : and I then engaged in writinga translation
Before I had completed
of the history
of Herodotus.
account

'

'

"

CASK

OF

translation

my

THE

REV.

of the

springbroughtthe

MR.

first book

month

K,7

WALFORD.

of that

the
history,

of

May. My son entreated

his mother to take a ride in a carriage
with him, and I
joinedin the entreaty,as I greatlywished she should
refreshment
of this kind.
The carriage
.enjoysome
was
brought to the door, when my faithful wife positively
refused to go, unless I would
both thought and said,was
her

in
persisted

with

remonstrated
thus

was

refusal

her, and

a
engagl-d,

Why I could
for my
calling

not

and

sudden

go ?

them.

This, I
impossible. She, however,
accompany

for

time I

some

urged her going.

inquiryoffered

I could discover

no

warmly
While

itself to
reason

me

and

when
I
hat, I jumped into the carriage,
directed the driver to take us to Epping Forest,through

Wanstead
I had

and

Woodford,

often taken

with

ride

which, in former

great pleasure. The

years,

verdure of

with the fineness

the grass, trees, and country in general,
quietudes,
of the weather, so affected me, that all my
fears,dis-

and

sorrows

vanished

well, entirelv relieved, and

was

as

if by a

miracle,and I

filled with

transport

before experienced.
such as I had never
My
delight,
restored,and all my
hope and confidence in God were
of destroying
myselfor others were
drearyexpectations
ing
entirely
forgotten.On my return home from this revivexcursion, every desire to shut myselfup and exclude
friends was
departed,and I could with difficulty
my
restrain myselffrom being always abroad.
I
took place,
as
This extraordinary
change of feeling
lowing
the first day of the folhave said, in May ; and on
and
with my
son
August, I set out in company

of

"

an

active friend, who

for

had

before travelled

France, Switzerland, and

on

the

Germany.

tinent,
con-

The

enhanced by contrast
so
journeywere
in
with the events of the five preceding
years, that I was
I felt no
of rapture throughoutthe whole.
a species

delightsof

that

158

STATE

OF

MIND

WHEN

RECOVERING

FROM

INSANITY.

apprehensionsof danger in going so far from home ; and

the gloriousscenes
I witnessed
enchanted
so
me, that
my pleasureoverflowed the limits of ordinaryenjoyment.
One onlyregretwas
occasioned by the unavoidable
sity,
necesunder which my companions in travel were
placed,
of

the

returningat

which
and

hurried

was

interest,before

with

I had

of

body
the

been

had

and

mind, before

case,

wishes

no

half

have

fascinated

of my
sad
my

part

from
it took

of my
had

to business

by
of surpassing
grandeur
gratified
myself with

and

no

free
entirely

friends,would

my

scenes

this tour, I attribute

as

been

from

Enchanted

them.

gazing upon

of the month

end

power

nor

to

as

was

to

recovery

it,

condition, both

place;

own,

if this had

any

not

entreaties of

persuademe

to set

it, so

brance
deeply was I affected by the rememof former
disappointments.Immediatelyafter
seized with
most
a
return, I was
unexpectedand
my
I thought would
diarrhoea,which
terminate my
severe
alike : it yielded,
however, to skilful
joys and sorrows
medical treatment, after some
of my
days; and one
medical attendants, who had long been acquaintedwith

out

upon

constitution,assured

my

paroxysms

was

beneficial than
and

he

me

when

the vehemence

abated, that the effects of it were

any

medical

treatment

could

of the
far

have

more

duced,
pro-

the
a
anticipated
disease. This anticipareturn of my distressing
nervous
tion
has been verified by several successive years of established
health ; and though I am
in
now
occasionally
of the minor
disturbed by some
measure
some
symptoms
of my disorder,for short periods,
chiefly
duringthe hours
of night,my
generalhealth is remarkable for my years ;
and the condition of my
tranquiland cheerful,
feelings
though seldom much elevated."*
*

John

"

perfectfreedom

of the Rev. William

Autobiography
1854.
Stoughtoa(ofKensington),

Walford."

Edited

from

by

the Rev.

IMPOSSIBILITY

OF

DEFINING

CHAPTER

Anomalous

and

159

INSANITY.

VI.

Masked

Affections
of the

Mind.
BEFORE

proceedingto the discussion of the various

stagesof incipient
referred to,I proinsanity,
previously
certain anomalous,
pose to consider .briefly,
observed,
ungenerally
because
I would,
of

masked

however, premise,that

it is
insanity,

firstinroads and

healthyand

of brain

in the

difficultto trace back

dawnings of

demonstrate

to

conditions

when

disordered

preciseperiod certain

morbid

mind.

majorityof cases
to its origin,
the

and

insane tion,
percepbetween
boundary-line

the

idea has been

normal

and

states

traversed,at what
of

of
eccentricity
and oddity of conduct,have passed
thought,
singularity
into actual insanity.Unfortunately,
there is no
chical
psytest to which
with
we
tion,
can
safetyand satisfacand psychologically
judicially
appealwhen difficult,
of suspected
doubtful, obscure, and subtle conditions
mental

disorder

are

submitted

to

for

us

physical,
medical, meta-

and

mined
legalanalysis.Each case must be exaand not in reference
by, and in relation to, itself,
to any preconceived
of
definition,
a priorihypothesis
or
insanity.*The vain attempt to frame a definition of this
for the greatdifference
account
disease,will,in a measure,

speakingof the degreesof departurefrom presupposedcondition!

latitude would be " man
of health,either of body or mind, perhapsthe term
correct expressionthan the phrasettandard, now
commonly
philosophically
transitions
from
the
and
are
gradual
adopted. How imperceptible shadowy
d
efine
their
teristics
characWho
of disease !
can
accurately
a state of health to one
there is any positive
when
P
We
able,however, to appreciate
are
*

When

deviation

remarked,

colours,it has been well

blue and red perfectly
well, but they may be

either bide of the line.

on
"

that

we

know

In the

case

of

ICO

of

MASKED

AFFECTIONS

THE

MIND.

bited
unhappy conflict of testimonyexhiin courts
of law
by medical men
supposedto be
with the phenomena of disordered mind.
conversant
Before enumerating the symptoms characteristic of the
of insanity,
I would premisethat mental
commencement
and signidisorder often first manifests itselfin a marked
ficant
at a very early period of life. Decided
manner
of insanity
have
children
occurred in young
paroxysms
as
opinion,

when

well

OF

as

school, and

at

whilst at

in

there

of

under

age

all traces of the transient attack of mental

college,

disorder

having passed,like
being no recurrence
Several remarkable

years.

in

advanced

more

persons

observation.

dark

cases

In

cloud, entirely
away,

the

disorder

for

of this kind

have

many
come

instance,a young
singular
honours
had
gentleman whilst studying for university
attack of insanity.He was
an
sitting
up late at night,
he was
when
busilyoccupiedin reading,
suddenlyseized
within his reach.
with an impulseto destroyeverything
He
first broke
the
lamp on the table, then a piertore up and destroyed
number
a
glass. He subsequently
did
of books, and
great injury to several articles of
my

value in the

room.

He

one

left home

about

three

o'clock in

the

back
at eight,covered
with
morning, and came
He
filth,apparentlyin full possessionof his senses!
refused to give any explanationof his conduct, or to
he had been.
When
ject,
pressedupon the subsay where
he became

irritable,
sullen,and

continued

mentallywell for
insanityagain developeditself,and
.

This

morose.

tleman
gen-

ticelve years, when

he

has

remained

in forming a purplecolour,and it
together,in an infinite variety,
be impossible
the red and where
the blue prevails. Yet
to say where
may
of forming a very distinct conception
this does not depriveus of the power
of
is
The
both colours, apartfrom each other."
experienced
physician able to
and insanity
when
the boundary-linebetween
has been trareason
versed,
appreciate
frame
definition
that
he
is
be
to
used
not
a
can
aa
although
competent
an
unerringtest in all doubtful cases of mental disorder.
blended

INSANITY

from

that

AMONG

period in

101

CHILDREN.

deranged state

of

mind.

insane, manifested, at the age of ten,

patient,now
decided symptoms of mental
aberration,and to such an
for days it was
extent, that, occasionally,
deemed
sary
necesto confine mechanically
the hands, so mischievous
were

child's tendencies.

the

appearinglike

other

and

until

it

not

was

manifested

placehim

the age

of

fifteen,
he,

boys,was sent to a publicschool,

he was
that his insanity
thirty
again

and then it
itself,

under

At

considered necessary to

was

restraint.

When

to this class of case, and of the possireferring

bility
of insanity
commencing at a very earlyage, then
becomingarrested,and even remainingdormant foryfir,
ten, twelve,and twenty years, Esquirolremarks, I am
of
than ever
convinced
that the existingcauses
more
do not act abruptly,
except when the patients
insanity
are
stronglypredisposed.Almost all the insane exhibit,
"

alterations in their functions,

before their disease,some

and
years previously,
greaterpart had had convulsions,

commenced

alterations which

many

infancy. The
and menstrual
colics,or cramps, constipation,
cephalalgia,
with
been endowed
Several had
great
irregularities.
and had been the sportof
in the mental faculties,
activity
vehement, impetuous,and angry passions.Others had
in

even

been

in

fantastical

their

ideas, their affections,and

and
had had an extravagantimagination,
; some
passions
of continuous
been incapable
study; others, excessively
circle
obstinate,could not live,exceptin a very narrow
whilst many,
of ideas and affections,
had

indifferent to everytimid, fearful,irresolute,

been

thing.

With

these

had

Pinel
been
*

"

was

a mere
dispositions,

the

is sufficient to make
M.

void of moral energy,

insanitybreak out.'

with
acquainted

going

on

Dictionnaire

accidental cause

unnoticed

case

for

den Scieucea M6dicale"."

that
insanity
periodof Ji/tee*
of

T. 10, p. 106.

162

MASKED

years !

In several other

years

OF

THE

MIND.

the maniacal

cases,

and

choly
melan-

had

and twenty
begunfour, six, (en,fifteen,
previously.It is often easy to go back months or
in this way, and we
finish by discovering
cumstances
that cirtaken for causes
by the friends,are frequently
state

years

AFFECTIONS

only the
it often

consequences

happens

of unobserved

at that

period of

disease.

In

fact,

the

malady,that a
cause
equally
anger, or some
good health, provokesthe

slightcontradiction,or fitof
in
to a person
insignificant
and completesubversion of their reason,
immediate
and
givesrise to mistakes as to its true cause and duration.
It does not, however, necessarily
these
follow that when
in early life,that
the
symptoms of insanityappear
disease will recur
at a subsequentperiod. Children, as
well as
adults, are subjectto sudden, transient, and
paroxysmalattacks of temporary mental disorder,which
retainingits healthystate
pass entirely
away, the mind
for the remainder
Dr.

Brierre

remarks

upon

dissertation

the

of life.

du

Boismont

the
of

Dr.

has

publishedsome
recently
the
earlylife,in noticing

of
insanity

This

Paulmier.

able

and

plished
accom-

(Dr.Boismont) accounts for the compaphysician

rative
exemption of childhood from mental aberration,by
absence of many
of the causes
so
potent in its production
in

but
acutely,

adult

life; not

their sensations

in this lies their

that
are

of

children
a

do

not

feel

nature, and
fleeting

protection. Nevertheless, children

who

to mental
disease,or who possess
disposition
a highlynervous
temperament, and who are exposedto
manifest undoubted
favouringcircumstances,occasionally
symptoms of the malady. Haslam, Perfect, Franck,
Burrows, and Spurzheim,have recorded cases of insanity
occurringin children under eleven years of age. Greding
gives an account of a child of eighteenmonths, who
She was
died of marasmus.
brought into 'the asylum at
inherit

164

MASKED

examples,three

AFFECTIONS

OF

years of age.
Paulmier's work, Dr.

turns

MIND.

three sixteen,
fifteen,

fourteen,two

are

and five seventeen

Dr.

THE

Before, however,
Brierre

du

lysing
ana-

Boismont

formation
authors for inEnglish,French, and American
the subject.In Dr. Thurnam's
tions
Observaon
and Statistics of Insanity"
there is a table of 21,333
Under
and from
ten years, eight cases,
ten to
cases.
twenty,1161 cases are noted. Accordingto Dr. Thurnam,
the greatestnumber
of cases
of insanity
between
occurs
thirtyand forty. In the United States,however, physicians
have remarked
the disposition
to mental disease
is strongerbetween
twenty and thirtythan between
ascribed to the earlier
thirtyand forty; and this is fairly
to

"

at which

age

business and
said to
life which
go

on."

enter the world

men

young

and

One of these beardless

politics.
his physician,I am
convinced
"

I lead will drive

In

four

me

mad

American

or

kill me;

engage

of business

men

this kind
but

asylums,which

in

of

I must

contained

33 '73 per cent, were

between
patients,
twenty and
thirty,and 24'41 per cent, between thirtyand forty
2790

years

of
in

age.
the

That
United

the

kind

States

of education
receive

has

which

the

powerful
influence on
is provedby
the development of insanity
Evans
and Worthington,in their reports
of the Pennsylvania
in his unpublished
asylums. Dr. Wigan gives,
writings,an account of crimes committed
by young
people without any object. The age of the youthful
sixteen and
malefactors was between
for girls,
seventeen
and between
and eighteenfor boys. There
seventeen
this in common,
that
there had
not
was
previously
the
existed the slightestanimositytowards
persons
outrages. Accordingto
againstwhom
they perpetrated
of these young
people had
Wigan, the great number
the females,appearedwith the
which, among
epistaxis,
The crimes Were
of menstruation.
generally
regularity
youth

STATISTICS

committed

OP

INSANITY

after the

AMONG

105

CHILDREN.

temporarycessation

of this habitual

flux.*
Drs. Delasiauve and

Schnepfhave also published

some
relative to the insanity
of early
particulars
life. The statistics
of Dr. Boutteville exhibit insanity
amongst children
in no insignificant
The maximum
is presented
proportion.
between the ages of thirtyand thirty-four.
From
five
to

nine, 0'9 per cent.; ten

nineteen,20
in the

one

fourteen,55; from fifteen to

Drs. Aubanel

per cent.

Bicetre,in the

and
children,

to

and

Thorpeobserved

1839, eightcases of mania in

of melancholia, from the
age of eleven
year

eighteenyears. Mental disease is undoubtedly

more
ditary
frequentin childhood than is generally
supposed. Heretendency to disease,and ill-directed education,
playan importantpart in its production.A writer in
the Revue dcs Deux
Mondes, for August, 1848, has with
much
in
accounted for the frequencyof insanity
ability
France.
Dr. Paulmier recognises
three forms of maniaexcitement
maniacal
(excitation
maniaque),mania, and
sociation
incoherent mania.
In the firstgradeof mania, the disof ideas is not always recognisableit nearly
resembles the earlystage of drunkenness
; in the more
advanced
the dissociation of ideas is remarkable ;
degree,
tences,
while in the highestit is such, that nc
longertwo sentwo partsof one sentence,
and sometimes
not even
of the mania of children
connected.
The diagnosis
are
with
is at times difficult ; meningitis
may be confounded
it ; but in generalthe headache, the dilatation of the
and repeatedvomiting,afford
pupils,and the nausea
Mania with
of fixingthe line of demarcation.
means
closely
approaches
stupor((Tunesorte de stupeur exaltique)
to

"

forms

certain

of mental

in which

seizures,and
epileptic
with obtuseness
"

Dr. Wim,low'"

"

alienation
the

which

excitement

and hallucinations

Journal,"ToL
Psychological

after

occur

it

ciated
asso-

kaUn(obltuion
xl p. 407.

1C6

MASKED

AFFECTIONS

OF

THE

MIND.

of
the insanity
cinatoire). With
respectto prognosis,
earlylife,
accordingto the observations of Dr. Paulmier,
ends in recovery
remark, that a

however, Dr. Delasiauve

made

the

and
to a
disposition
great susceptibility

of the mental

return

has

disease often remains.

Accordingly,
to
patientsare found in the wards appropriated
many
been successfully
treated as insane
adults,who had formerly
in the division assigned
to children.
Dr.

Brierre du Boismont

Paulmier's

his

concludes

notice of Dr.

dissertation,
by givingthe results of his

own

experience. He
peoplein whom

-two
young
says, that in a list of forty
between
disease commenced
the mental

fourteen and

years of age, eighteentimes

their parents. In by far the

inherited
number

sixteen

from

of cases,

the disease manifested

the

of the
has

and
hereditary
predisposition,
age of pubertyand menstruation.

parents the

almost

always been,

sometimes

cause,

character

sad, and

of the

that
at

was

times

the

connected

On

inquiring

children,the

they were,
other

greater

itself under

influence of
with

it

was

answer

without
wild

and

any
governable.
un-

They could never applythemselves steadily

to work.
They had no talent, or if it existed, it only
flared up brilliantly
for a moment.
They would submit
themselves to no rules.
and were
Some
were
apathetic,
tility
not to be excited by emulation.
Others exhibited a volawhich
could not be restrained.
Many had been
to spasmodic
attacks. The incubation periodwas
subject
often protracted. In eighteeninstances recovery took
but the persons were
liable to relapse.There also
place,
remained

to
inability

remarkable
assume

afforded insecure
The
number

strangenessof character, and

any fixed positionin life. Some

evidence of the recovery being permanent.

conclusion

of cases,

an

recovery
of children and young

though, in a certain
tion
alienathe mental
takes place,
peopleis a most serious dis-

is, that

INCIPIENT

SYMPTOMS

OF

107

INSANITY.

and partly
account
partlyfrom their antecedents,
on
of the imperfect
developmentof the cerebral and other
organs.*
At the commencement
of insanity,
the derangement
of the intellect is so slight
and transient in its manifestations,
to render
its recognition,
formidable
as
as
a
the patient,
task of grave
a
malady impending over
To the unskilled,untutored,
doubt, and great difficulty.
and untrained eye, the disease is,in its early
sionally
occastages,
invisible. Even to the practised
altogether
hension
apprecernible,
of the experienced
it is almost indisphysician,
ease,

or, at

least,of

dubious

and uncertain

character.

incipient
stage,mental disorder is characterized,
physicaland
generally,by acute morbid sensibility,
tion.
of fixingthe attenmental, accompaniedby a difficulty
it is necessary, as a
In investigating
this subject,
to trace the disease
to endeavour
inquiry,
preliminary
nutely
and miback to its origin,
and to examine
accurately
that degreeor stageof the malady in which it is
not yet,but from which it may become, insanity.At an
complains
stage,the patient
earlyperiodof the incipient
of beingvery ill,
and exclaims that he is losinghis senses,
is not his
that his mind
often pertinaciously
asserting
In

its

own.

These

symptoms

will be

considered

more

in

detail,

proceedto speak of the stage of consciousness.

have become
of those who
the history
On investigating
insane, it will be ascertained,that long before any mental
disease was
subjectto fitsof apathy,
apparent,they were
in a
for hours together
had been in the habit of sitting
study,and this,too,
state of moody abstraction,or brown
other
at a time when
they had importantdomestic and
when

duties to occupy

their attention.

antecedents
Upon analysingthe patient's
"

Vtdt Dr. Window's

"

Journal,"No.
Psj-chdogioal

XIII.

still more
(New S"ric").

1GS

MASKED

it will
closely,
existed

AFFECTIONS

be found

OF

that, for

much

THE

MIND.

there has
long period,
absurdityof thought,

and
irregularity
and singularity
of conduct.
He has been
eccentricity
considered as an oddityin his family,
being rarelyseen
in the

domestic

engaged

are

in

circle.

When

social union

his friends

and

converse,

and
he

relations
retires

where he is discovered musing,

quietlyto his own
room,
At other
to himself.
brooding,and muttering nonsense
loud and vociferous,
times, he is forward and obstreperous,
On these
wild, ungovernable,and untrainable.
brilliant aspect,and
occasions,the eyes exhibit a bright,
the physiognomyis lightedup by an
unnatural
degree
of intelligence.
At other times, the patientis restless,
abstracted,and moody, during the day, and at night,
slumbers and sleeps
often,when awaking,complaining
uneasily,
of headache, mental confusion,or vertigo.
During
his sleep,
he is occasionally
attacks of
to slight
subject
muscular
convulsion,somnambulism, temporary illusions
of the senses.
He
is liable to frightful
and distressing
dreams.
All these symptoms are often indicative of the
of organicdisease of the brain,as well as
commencement
of alienation of mind.
In

the

ments
the most
material eleearlyperiodof insanity,
of character undergostrangetransformations.
The
for his caution and circumspecremarkable
man
naturally
tion,
becomes
and imprudent. If
reckless,extravagant,
orderlyand economical, he is confused and prodigal.If
noted
for his preciseness,
he exhibits greatcarelessness
and negligence.If gay and communicative, he is sullen
and morose.
If previously
in his dress,
neat and particular
he becomes
slovenly,
dirty,and indifferent as to his
attire. If timid, he is brave, resolute,overbearing,
and
presumptuous. If kind, gentle,and affectionate,he is
and insulting
in his intercourse
rude, austere, irritable,
and communications
he bewith others.
If benevolent,

1A

UHJERAT10N

OP

NATURAL

STATES

OF

109

MIND.

parsimoniousand miserly,
hoardingup, with the
of money,
greatestcare, the smallest sums
sometimes
under the insane apprehension
that he will eventually
be
obligedto go into the workhouse.
If,when in health,
the patientis known
for his attention to his religious
is casting
duties,he becomes, when insanity
its dark shadow
the mind, sadlyneglectful
of them, not paying
over
decent respectto the ordinances of religion.The
even
comes

of business,who

man

from

his

when

never,

or
counting-house,

well,was

known

shows

now

refuses to

great indifference
take any part in,or even

to
as

found absent

neglecthis
to his

to

tion,
voca-

and
affairs,
about

converse

them.
often
Insanity
diseased

firstshows

itselfin

morbid

exaggeration^

in the

developmentof normal healthy

The
mental
conditions.
naturallytimid and reserved
from the
shuns society,
himself altogether
man
isolating
companionshipof his familyand friends. The bold man,
is boisterous,noisy,
presuming.The courageous, officious
conscientious
and talkative. The strictly
person exhibits
his moral,
exaltation
of conscience respecting
morbid
a
and religious
duties,and, when insane,or becoming
social,
ing
the notion of thinkso, will manifest the acutest miseryat
at variance
in the remotest degree,
or doinganything,
of Holy Writ.
with
his strict and literal interpretation
from
In this condition of mind, the patient,
suffering
will refuse to comply with any
feelings,
j0*m"-religious
scientious,
morbidly-coninstructions that are opposedto his own
of right and
notions
and sadly-perverted
cautious and suspicious
The naturally
wrong, good and evil.
a

man

excess,

manifests

an

excess

of

these

mental
He

will

in an abnormal state of mind.

when
qualities,
and
exactness, cautious prudence,
weigh with scrupulous
that is said, and done.
watchful vigilance,
everything
and
surmised,and hinted at, in his presence, hesitating

170

MASKED

doubtingas
remarks

In

OF

AFFECTIONS

to the

MIND.

THE

of
tendency,truth, and sincerity,

addressed

all

to him.

type of morbid
thought,the patient(his insanitystill consistingin a
diseased perversionof a state of mind
normallyin an
a

stage of

advanced

more

this

often has delusions as to his food

development),
for a time all sustenance, occasionally
beingpoisoned,
refusing
(as I have heard patientsconfess after
resisting
of

excess

recovery)the
time

efforts made

to

induce

them

to

eat, at

they were tortured and agonizedby the acute

exhibits
cravingsof hunger ! The naturally
jealousman
his insanity
and even
his wife's affection,
by suspecting
The man
of active poetic
manifests
fidelity.
imagination
in his disease a disposition
wild
to indulgein the most
the
and
fantastic excursions
into
regions of fancy,
of morbidlyexcited imagination,
often,in his paroxysms
seeing,
when

"

"

of

More

devils than

vast hell

In

investigating,"
says an
the first caution
insanity,

confound

disorders

of

mental

acute

can

hold."

observer, "the nature

to be

observed

is not

with

functions

to

natural

strongly resemble them.

able
Many men, in the full enjoyment of health, are remarkfor peculiarities
of
of character,and idiosyncrasies
which
contrast
thought and feeling,
stronglywith the
not on
generaltone and usages of society
; but they are
that account to be held as insane,because the singularity
is with them
natural
for which they are distinguished
a
and not the product of disease ; and, from the
quality,
which
qualities,

very unlikeness
actingand of
common

from

sometimes

of their manifestations

to the modes

of

such persons are, in

of other men,
feeling
language,said to be eccentric. It is the prolonged
without
an
adequate external cause,
departure,
the state of feeling
and modes of thinkingusual to

the individual when

in

health,that is the

true

feature

172

MASKED

AFFECTIONS

OF

THE

MIND.

the variations of

or the strengthof digestion,

appetite,
with
any fixed or imaginarystandard, but always
judge of their value, as symptoms, in relation to their
which
former state ; because the moderate
is
appetite,
natural
to one
constitution,occurringin a person who
had previously
been remarkable
for keenness, and power
of digestion,
be considered as an indication
would justly
of loss of health, while the voracious appetite,
natural to

pare

third,would, in

index
In

different

constitution,be

as

sure

an

disease."*

of stomachic

ordinarypracticeof medicine we occasionally

of bodily
disease which
meet with cases
at variance
are
with past experience
and a priori notions, set at defiance
physical phenomena,
preconceivedviews of morbid
resist every attempt to embody them
within the nosologicalchart, and repudiateall reduction to any of the
standards or tests.
acknowledgedorthodox pathological
racter,
These affections are anomalous
or
pseudo in their chawith
defined,not easily
are
difficulty
diagnosed,
altogetherescape observation, and often
occasionally
the operationof the best directed
too successfully,
resist,
the

remedial

measures.

the

If, among

diseases

particularly
implicating
these pseudo
the ordinaryorganicfunctions,we witness
eccentric deviations from the recognised
or
pathological
in anticipating
not justified
character,a fortiori,
we
are
often
in
the
that
subtle, complicated,varied, and
affections of the cerebral structure, deranging
obscure
have
should
the operationsof thought, we
brought
within
the
extraordinary,
sphere of our observation
anomalous, and

more

eccentric deviations

from

certain

conditions
morbid, cerebral,and psychical
I presume

the mind

may
*

it to

be

Dr. Andrew

determined
pre?

that
axiom
admitted
generally
disordered without
being insane,using
be

Combe

on

"

Mental

Derangement,"1831.

LATENT

this

phrasein

AND

UNRECOGNISED

173

INSANITT.

its

strictly
legalacceptation.These conditions
of morbid
intellect may be considered by some
ad
but I would suggest that this
only degreesof insanity;
term be restricted to those mental disorders,
accompanied
with positive
loss of control,clearly
the exercise
justifying
of moral

restraint,and to those morbid

intellect which

sanction

influence of the law.

remarks

my

said to be

to those

In
cases

conditions of the

appeal to

an

other

the

protective

words, I would

in which

the

disordered, but
pathologically

mind
not

confine
may

be

invariably

insane.
legally
Have

we

in

this distinction
practice
sufficiently
appreciated
Fearful of committing ourselves to an opinion

might authorize an interference with the free agency

and justify
the use
of legal
of the patient,
there
restraint,
the presence
has existed an
of
to admit
indisposition
in cases
where it has been
mental
disorder,even
positive
obviously and painfullyapparent? This excessive
to
caution
originatingin motives that, do honour
of
human
has
nature
often, I fear, been productive

that

"

"

serious,fatal,and irremediable

mischief.

admit,
under consideration is one, I readily
subject
of extreme
but, nevertheless, of incalculable
delicacy,
importance to all sections of the community,
by
is, I admit, beset with difficultiesand ^urrounded
the ignorant,
dangers. In the hands of the inexperienced,
the facts
designing,
indiscreet, and the wilfully
about to
which I am
that I have to record,and principles
of much mischief; but,
enunciate, might be productive
of this nature to deter the
I ask, ought any apprehensions
from enteringupon so important an inquiry?
philosopher
morbid mind
of latent and unrecognised
The subject
The

is

yet in

its

untrodden
a

vast

said to occupy, at present,

may be
ground. What
almost untouched

infancy. It

field is

and
here

to
presented

the

truth-seeking

174

MASKED

OF

AFFECTIONS

THE

MIND.

knowledge of human nature,

practical
adds an
acquaintancewith the higher departmentsof
mental and moral philosophy,
as well as of cerebral pathology.
much
of the bitterness,misery,and wretchedHow
ness
observer,who, to

so

often witnessed

concealed
do

from

and

such

the canker

alienation ! How

often

and death
ruin, beggary,disgrace,

result

mental

unrecognisedmorbid mental conditions ! It is

worm
gnawing at the vitals,and undermining

the

happinessof

be

done

to

many

the

arrest

hurlingso
This

extent

morbid

in real life.

and

mental
It is

and it therefore behoves

hearth.
progress

of the

course

to ruin

many

type of

domestic
fearful

avalanche, or arrest the

is

of families arises from

in the bosom

undetected

witness

we

Can

of this

moral

rapidcurrent

destruction

unhappilyon

that

disorder exists to

the members

nothing

the

ful
fright-

increase,

of the medical

fession,
pro-

guardiansof the

publichealth,as philosophers
engaged in the loftiest and most ennobling of human
called upon
to unravel
as
physicians
inquiries,
praqtical
the mysteriousand
complicatedphenomena of disease,
relief to human
and administer
to
suffering,
fearlessly
grapplewith an evil which is sapping the happinessof
to disseminate
families,and to exert their utmost ability
of pathologyand therapeutics
sound principles
a
upon
associated and so closely
matter
interwoven
so intimately
with the mental and social well-being
of the human
race.
These
unrecognisedmorbid conditions most frequently
and
moral
propensities,
appetites,
implicatethe affections,
In many
instances it is difficult to distinguish
sense.
between
normal
of
or
healthy mental irregularities
thought,passion,appetite,and those deviations from
as

natural

and

conditions

moral

both in its intellectual

intellect,

manifestations, clearlybringing those

affected within
Are

of the

there any

so

of pathology.
legitimatedomain
diagnosticsymptom'sby means
unfailing
the

PSEUDO

of which

disorder

we

FORMS

may

with

OF

detect

MENTAL

175

DISORDER.

these /ww/o-forms of mental

sufficient exactness,

and distinctness
precision,
to justify
the conclusion that theyresult from
diseased cerebral conditions?
This questionit will be
The
my duty to consider.
phasesof mind of which I
speak are necessarily
obscure,and, unlike the ordinary
of

cases

mental

aberration

of

every-dayoccurrence,

manifest themselves in either an

they frequently
alted,
exvitiated state of the moral faculties.
or
depressed,
The
disorder frequentlyassumes
the character of a
of some
mere
exaggeration
singlepredominantpassion,
or
emotion, and so often resembles, in ite
appetite,
prominent features,the natural and healthyactions of
of developmentor
thought,either in excess
irregular
in its operations,
that the practisedeye of the experienced
the state to
physiciancan alone safely
pronounce
be an abnormal
I do not refer to ordinary
instances
one.
of eccentricity,
of thought and feeling,
to idiosyncrasies
in which the mind
or to cases
appears to be absorbed by
some

one

conduct

idea, Vhich

exercises

an

influence

over

the

trinsic
to its inthoughts quite disproportionate
Neither
do I advert
value.
to examples of
and
natural irritability,
coarseness
violence, or passion,
vicious inclinations,criminal propensities,
cessive
exbrutality,
ditions
or
extravagance of conduct, for these concaprice,
and healthy
of mind
may, alas ! be the natural
of the intellect. These strange phasesof the
operations
of the
bizarreries of character,vagaries
understanding,
and oddities of
irregularities,
intellect,singularities,
in every day
mix
who
to so many
conduct, common
life,and pass current in societyas healthyminded
present to the moralist and philosophical
persons,
and
pointsfor grave contemplation
psychologist
many
natural and normal, although
often suspicion. Such
eccentric states of the intellect,do not, however, legitiand

176

MASKED

AFFECTIONS

OF

THE

MIND.

within the provinceof the physician

unless
matelycome
to be morbid
results^
they can be clearlydemonstrated
and positive
and clearly
established deviations from cerebral
mental

or

These

health.

mental disorder are

not
unrecognised
alwaysaccompaniedby any well-marked disturbance of
the bodilyhealth demanding medical
attention, or any
obvious departurefrom a normal
state of thought and
conduct such as to justify
legalinterference ; neither do
these affections alwaysincapacitate
the party from engaging
business of life. There
in the ordinary
be no
may
morbid
alienation of affection.
The wit continues
appreciable
of its
to dazzle,and the reparteehas lost none
the
fancy retains its playfulness,
brilliancy.The
its power, the conversation
its perfectcoherence
memory
mixes as usual in
and rationality.The afflicted person
sits at the head of his own
table, entertains his
society,
the counting-house
guests,goes to the stock-exchange,
in his professional
or bank, and
duties,
actively
engages
without
evidence, very conclusive to others,
exhibiting
mental
of his actual morbid
The
condition.
change
have
and stealthily,
progressed
insidiously
having
may
induced
cular
importantmoleslowlyand almost imperceptibly
forms

of

modifications

in

the

delicate vesicular

neurine

of

aberration of
brain, ultimatelyresultingin some
the ideas, alteration of the affections,
or
perversionof
the

the

and instincts.
propensities
The party may
be an unrecognised
monomaniac, and,
actingunder the despoticinfluence of one predominant
morbid
idea,be bringingdestruction upon his home and
and
affections
family. His feelingmay be perverted,
concealed
alienated, thus engendering'much
misery

the sacred

within
may
upon

be

brutal

his

to

circle of domestic
those

who

love,kindness, and

have

life. His
the

conduct

strongestclaims
forbearance,and yet his

SYMPTOMS

OF

LATENT

177

1N8ANITT.

mental

He may recklessly,
and
maladybe undetected.
in opposition
to the best counsels and most
pathetic
appeals,
squandera fortune,which has been accumulated
after many
and anxious
toil.
years of active industry
He
a

may

become

drunkard,

vicious and

suicide,and

brutal, a tyrant,
a criminal,
as
spendthrift,

the result of

undoubtedlymorbid state of the brain and mind, and

yet pass unobserved throughlifeas a sane, rational,and
healthyman.
witness in pctual practice
all the delicate shades
We
and
gradationsof such unrecognisedand neglected
an

mental

alienation.

affected are

It often

that

occurs

whilst those

so

performwith praiseworthy
propriety,
and
singularexactness, most of the
scrupulous
probity,
and
importantduties of life,they manifest extraordinary
and suspicions
unreasonable antipathies,
dislikes,
against
So cleverly
their dearest relations and kindest friends.
is this mask of sanityand mental health
and successfully
is allsuspicion
sometimes
disarmed,
so effectually
worn;
that mental disorder of a dangerouscharacter has been
the slightest
known
for years to progress without exciting
notion

able to

of its presence, until

some

sad and

terrible catastrophe

awakened
attention to its existence.
painfully
often affect singufrcm latent insanity
Persons suffering
larity
of dress,gait,
conversation,and phraseology.The
stimulate their excitability.
circumstances
most
trifling
They are martyrs to ungovernable
paroxysms of passion,
inflamed to a state of demoniacal furor by insignificant
are
of feeling
of delicacy
lose all sense
causes, and occasionally
has

and sentiment, refinement

Such
are

moral

of

manifestations of undetected
often

of
qualities

seen

the

associated with

highestorder.

maladyshows

itself in

tion.
conversa-

an

order
dis-

mental

intellectual and
Neither

rank

infmnitu'S.

station is free from these sad mental

the

and

manners

nor

sionally
Occa-

disoverbearing
N

178

AFFECTIONS

MASKED

.OF

THE

MIND.

unhappily disordered, browbeat

whom
cising
they have the power of exerwhat
and, forgetting
a little short-lived authority,
is due to station,intelligence,
and character,
reputation,
within their circumscribed
become
spherepetty tyrants,
of Eastern
pulsive
despots. They are imaping the manners
in their thoughts,
often obstinately,
unreasonably,
absurd
and outand pertinaciously
riveted to the most
rageous
dogmaticin conversation,and litigious,
opinions,
and opposingevery endeavour
a controversial spirit,
exhibiting
made
within the domain
of common
to bring them
and correct principles
of ratiocination.
All delicacy
sense
and decencyof thought are occasionally
banished
from the
does
the spiritual
in these
mind, so effectually
principle
instincts and passions.
attacks succumb
to the animal
The
naturallygentle, truthful, retiring,and selfcunning,and selfish the
denying,become quarrelsome,
the modest
obscene.
We
observe
diffident bold
frequently
these pseudo-menialconditions giving undue
minence
proto a particular
or
seizinghold of one
faculty,
it manifests
itself in a
passionor appetite. Occasionally
of veracity,
in a disposition
want
to exaggerate,and
or

position. Persons
and bullythose over

so

"

"

tell absurd
disordered

and

motiveless

lies.

in morbid
volition,

It may

show

imitation,in

an

itself in

inordinate

insane
an
vaultingambition, an absorbinglust of praise,
fests
manicravingfor notoriety.The disorder occasionally
itself in a depressed,
exalted,or vitiated state of the
function ; in morbid
views of Christianity,
reproductive
and is often connected with a profoundantesthesia of the
moral sense.
Many of these sad afflictions are symptomatic
of unobserved, and, consequently,
neglected
in the brain itself,
cerebral conditions,either originating
or
producedby sympathy with morbid affections existing
in other tissues in close organicrelationship
with the
centre.
greatnervous

MASKED

AFFECTIONS

OF

MIND.

THE

duringthe month ; but for a short periodshe had them

more
preceded
frequently.They were almost invariably
and a dimness of
pain in the occipital
region,
by vertigo,
the presence of these physical
vision.
It was
symptoms
that led to the suppositionof the existence in this case
of

leeches

I ordered

cerebral mischief.

undetected

some

of the expected
days in advance
regulatedthe bowels and secretions,and
paroxysms,
of the passionate
the intensity
thus greatlydiminished
excitement, but failed in entirely
curingthe case.* Dr.
He
similar instance.
Cheyne refers to a somewhat
one
man
day ridingwith a clergysays, a friend of his was
the

to

head,

of refined
devoted

few

who

manners,

of God.

to the service

years had

for many
To

his

been
his

amazement

fell into a
adequateprovocation,
of ungovernablefury,swearing at a woodparoxysm
because he
ranger, and threateninghim with vengeance,

companion, without

had

Ira

"

fact,if

furor

brevis

condition

arises from

An

but

or

compared the
dangerous road. Urged

Such

axiom.

of

course

onwards

tries in vain to restrain the

to that of

man

"

by

the

passions,the

fiery

coursers.

steady,undeviatingtransit
into

modus

never

wide,
of

threatening
equaldanger in the
course

maintained

avoidingScylla,he
and he loses sight
is disregarded,

is attained.

in rebus

on

feeble hand

Destruction

one

Charybdis. The
that there are
altogether
runs

is

chariot

side,she snatches at the reins,and rushes into

is the
oppositedirection. Thus, by a series of gyrations,
the

on

re-

the will.

old writer

Reason

had

the
certainly
or
passion,
out
is prolongedto an unreasonable
degree,is withand governed
to be controlled,
kept in subjection,
admitted

est,"is an

inadequatecauses,

reason,

he

which

of violent,unjustifiable,
ungovernableanger,

and refuses
intermissions,

by the

order

in obeyingan
dilatory

been

any

In

"

Quos
PINEL

ultra

Certi

denique fines,
citraque
nequitconsistere rectum."
"

observes, That he who has identified anger with fury,or transient

less disposed
of which I am
more
or
a truth,the profundity
expressed
"

madness, has

of insanity
the subject
as my
on
experience
acknowledge,in proportion
of
no
more
less extensive.
a
re
more
or
generally
Paroxysms
insanity
than irascible emotions prolongedbeyond their ordinarylimits ; and the true
character of such paroxysms
frequently
dependsmore
upon the various influences
of the passions,
than upon any derangement of the ideas,
"or
upon
any whimdeal singularities
of the judging faculty."
to

has been

TEMPER

ceived relative to

DISEASE.

matter

of little importance. Had

(observesDr. Cheyne) this fact become

devotedness
man

his

to

for
profession,

would
distinguished,

was

sidered

assumed,

as

by

which

have

his habitual

of his

sense

been

had
which

conscious
that his
I had

of the brain.

He

this gentleman
a
was

of the

of his conduct.
It
incongruity
only brother had died in an asylum.

child,"tat. 12, under my

meanour,
de-

unworthineii,

own

hypocrisy.It appeared that

short time previously
undertaken

led to over-excitement

con-

humilityof

the result of

as

the

this excellent

many

and

from
arising

all
public,

duty
quite

appears

whose

only
was
to
beingsubject
violent and uncontrollable fits of passion.These attacks
occurred
frequently
during the night. The poor little
creature
conscious
was
of her sad infirmity,
painfully
and assured me
that she struggled
heroically
againstit.
We
in practice
sometimes
form
of this
see
a modified
affection exhibiting
itself in a bad, morose,
and capricious
called by the late Dr. Marshall
disposition,
Hall, who
young

morbid
appreciable

had

seen

condition

that of

several of these cases,

"

affection is not, however, confined

*

"

The

most

frequent,
yet the
in young

most

care,

temper disease"*
to females.

This

member

of these perversions
of
extraordinary,

It is a species
lect,
of aberration of the intelfictitious,
factitious,
enough, but exaggerated,
and real at the same
time. It frequently
has its originin dyspepsia,
hysteria,
other maladies,and in emotion
of various kinds
such as disappointment,
or
Its objectis frequently
and to maintain, a state of
to excite,
vexation,Ac.
active sympathy and attention,
for which there is, as
it were, a perpetual,
rather aptlydesignated,
morbid, and jealousthirst. It was
by the clever
it
relative of one
mania.
I
do
a
not
a
n
regard as entirely
patient, ego
of
the
result
of
at least,
some
malady,or
feigned disease. It is, originally
mental
hysteria"hy"t"rio
or
; and
bodilyaffection. It is allied to hysteria
for example is a real disease. It is best illustrated by the effects
palpitation,

temper,are

seen

but short of

females.

insanity
"

real

"

"

derangementof the stomach and bowels in infants, and who would think
parable
the immediate, natural, and inseof correcting
was
a child for temper, which
insaniola,
an
originating
effect of bodilydisorder P It is a perversity,
gence
in bodilydisorder or
mental affection,and perpetuated
bj a morbid indulObservations in
of temper,and desire for sympathy and attention."
P.
No.
I.
87-9.
Series
Medicine,"by Dr. M. Hall.
of

"

"

"

182

MASKED

of the House

AFFECTIONS

of

attacks

had

been

friend

of

him

THE

OF

Commons,

years

many

of this nature,

deceased,had periodical

after his brain

particularly
informed
by a particular

overwrought. I was
the gentleman to whom
terrible paroxysm

refer,that

he

once

furyafter making an
conscious that at
electioneering
speech,being perfectly
these periodshe was
temporarilyderanged. He was
in the habit of dashingcold water over
the head during
when
the fit,and occasionally,
from much
suffering
sical
physaw

in

MIND.

of

exhaustion, he has been known,

drink

great benefit,

draught a pint of port wine.

SpanishGeneral Galvez was subjectto

to

at

as
probably,

Dr.

morbid

bottle

healthyexcitement
A

his head.

been

His

in

For

attacks

mental

he

and
case

the

appropriate
remedy ?

from

his

horse, and fell

after the accident

do

of

most

equanimity of
of a lady,who,

he

Since his recovery he has

fits of passionateexcitement.

coma.

not

continues

painfulebullitions
exhibited

been the

headaches.

generally
precededby severe

faculties

but

not, adds Dr. Rush,

minutes

furious

are

Would

thrown

ten

state of

subjectto

These

have

gentlemanwas

continued

attacks of

claret

of brain.

of laudanum

young

upon

of

brated
cele-

generallycured him,
Rush
remarks, by overcoming a weak,
action, and producing agreeableand

cerebral

dose

The

this nature.

with

appear

to

paired,
much, if at all im-

suffer from

these

Prior

the

temper.

to

morbidly
injury,he

extraordinary
degree of self-control
temper. Dr. Beddoes refers to the
after her recovery

from

an

attack

of

brain fever, became

extremelyirascible. This was the

of her natural disposition.
She made herself so
reverse
that her husband,
to all her family,
disagreeable
offensively
amiable and self-denying
a most
was
pelled
comman,
to

once

separate himself

happy

from

her,

and

abandon

his

fireside.

somewhat

similar

case

I visited in cons\dtation with.

INSANITY

SHOWN

Dr. "Webster.

IN

ACTS

OF

BRUTALITY.

In this instance the

ladywas in the habit,

duringher paroxysms of passion,of seizing
hold of her
husband's hair,and tearing
it out by the roots in large
quantities.This poor fellow has often come
to me
in
of his wife's insagreatdistress,
having a full assurance
nity,
to protecthim from her acts of insane
me
beseeching
violence.
She was
disordered in her mind, but
clearly
could not

we

detect,in

our

examination

of

her, evidence

conclusive to justify
in signinga medical
sufficiently
us
certificate authorizing
her being placedunder control.
We
lamented
thai,owing to a defective state of the law,
could not grapplewith the case.
In this,as in nuwe
merous
anomalous

instances of disordered mind, it

felt that
of the

be done
nothingcould legally
and the disease must be
patient,

for the

was

protection

allowed

to take its

mental

condition,

course.

I have

referred to

certain morbid

and
in acts of cruelty
exhibitingitself exclusively
disorder may
This form of unrecognised
unassociated

with

and undetected
within

delusion.

of
precincts

the sacred

of conduct

misery.

of mind

alienation

and

is

and
philanthropy
conversation

The

the exercise of active

ordinaryactions

affected,in many

so

of domestic

great talents and high

with
compatible

of those

of this latent

life,
larities
greatirregu-

fearful amount

benevolence.

exist

in existence,producing,

domestic

It often co-exists with

attainments, and

is much

There

tality.
bru-

cases,

or

would

idea of the existence of such

convey to a strangeran
sad state of the intellect. Howard, the celebrated
illustrationof thia
affords

not
a

philanthropist,

an

unhappy
to
is represented

tvpe of disorder.

He

tyrant in

house.

the death

his

own

of his wife.

He

His
was

have

cruel treatment
in the

been

cauaed

habit,for many

before her picture.

years after her death, of doing penance
oflence,he
He had an only son, whom, for the slightest

184

MASKED

AFFECTIONS

OF

THE

MIND.

punishedwith terrible severity.He was in the habit of

making this son stand for hours in a prescribed
grottoin
the garden. The son became a lunatic,as the result of this
brutal treatment.
Several similar cases
have been brought
under
In one
instance,temporary confinement
my observation.
resorted to, but without positive
was
advantage.
A
lady,moving in good society,happily married,
well educated, of sweet
accomplished,
temper,and with
a mind
under the benign influence of religious
principles,
and an exmanifested, at the age of forty-five,
a sudden
traordinary
changeof character and habits. She became
irritable from trifling
causes
quarrelling
continually
; was
with her husband
and servants ; discharged
men,
her tradesoffended
accusingthem of acts of dishonesty
; and
of her most intimate friends and relations by her
many
This state of mind
cold, and often repulsivemanner.
continued
for two years, duringwhich
periodshe played
the capricious
tyrantwithin the sphereof the domestic
circle. Her
husband
became
nearlybroken-hearted ; his
friends and

relations could

not

enter

his house

without

beinginsulted ; he neglectedhis business,and his health

became
impaired from constant anxiety. A
seriously
new
phase of the malady,however, exhibited itself. She
Proofs
one
day accused her husband of gross infidelity.
She immediately
demanded.
were
producedseveral anonymous
letters which she had received,containinga minute,
circumstantial,and apparentlytruthful account of her
stantiate,
husband's misconduct.
These
letters appearedto subsuch documentary evidence
as
as
conclusively
could

do, her

accusation.

No

person

doubted

the

fused
genuinenessof these letters. Her friends,however, reat this time, her actual morbid
to recognise,
even

had an epileptic
seizure,
subsequently
the case.
Her
I then saw
by partial
paralysis.
condition being at this time apparent,she was.

state of mind.

followed
cerebral

She

CONCEALED

removed

from Lome.

1 v"i

MONOMANIA.

It

was

discovered,beyond a

now

doubt, that this ladyhad written the anonymous

herself,accusingher husband

to

and

posted them,

and

of

had

letters

had addressed
infidelity,
become
eventually

ally
impressedwith the conviction that the letters were actuwritten by a stranger,and contained a true statement
of facts. They had, as it afterwards appeared,
been
concealed about her person for nearlysix months !
I was
requestedto visit a lady,who, after a painful
and dangerous accouchement, exhibited, without
any
of hatred
adequateexcitingcause, an inveterate feeling

towards

great

of her children.

one

and

She treated this child with

systematicbrutality.To

did she carry this morbid

husband was
obligedto

and

unnatural

such

that
feeling,

the child from

remove

extent

an

the

her

house,

placeit under the care of a relative in a distant

part of the country. I had no doubt at the time that
disordered. Such was
mind was
this person's
my written
by nearly
opinion. The idea was, however, repudiated
closed
who obstinately
of the family,
all the members
The
their eyes to her sad and melancholycondition.
order,
of mental disonly evidence that existed,at that period,
and

brutal conduct

towards

Three

ideas.

first consultation

It

ladyhad

was

weeks

this

in

made

then obvious

had

an

her

and
of affection,
This

of her children.

one

appearedunassociated

of mind

this

alienation

her unnatural

was

state

sive
deluappreciable
elapsedsince my
scarcely
with

any

when

case,

was

informed

unsuccessful attempt at suicide.

that she

was

not in

sane

state

of

her
longerhesitated in placing
observe
occasionally
under close restraint. We
privately
of
evidences of this morbid state at a very earlyperiod
organicdefect in
life,and it is indicative of an original

mind, and her familyno

the constitution of the intellect.

Thomas

Pepper,fourteen

years of age,

a
pot-boy,

186

MASKED

clever lad, but

OF

AFFECTIONS

of sullen

and

MIND.

THE

mitted
comdisposition,

morose

by hanging himself in an arbour in his

master's bowling-green.It appearedfrom the evidence
that the mind
of the deceased was
formed, his
peculiarly
conduct frequently
to cruelty.
evincinga predisposition
and
He
had been frequently
known
to hang up mice
other animals
for the purpose of enjoyingthe painwhich
they appearedto suffer whilst in the agoniesof death.
He
would
often call boys to witness these sports,
exclaiming
Here's a lark ; he is just having his last
suicide

"

"

kick."
throw

He
them

had

often

been

into the

known

that
fire,

he

to

catch

might

flies and

observe them

burning. He had also been observed, whilst

passingalongthe street,to pullthe ears of the children
them
off the ground by their ears ; and when
lifting
they cried out with pain,he would burst out into a
nesses
fiendish paroxysm
of delightat their sufferings.Witwhen
deposedthat about four years previously,
himself,
only ten years of age, he attemptedto strangle
He
in consequence
of his mother
having chastised him.
whilst

"

locked

himself

up

in

room,

and, when

discovered,life

nearlyextinct.* I refer to this as an illustration of a

type of mental depravity,
occurringin earlylife,arising
tellect.
of the brain and infrom a congenitalmal-organization
be either connate,
This morbid disposition
may
be the sequelaof disease
affectingthe
or
hereditary,
healthycondition of the brain. It occasionally
supervenes
of the head.
injuries
upon
whole moral
I saw, some
years ago, a youth whose
character had become completely
changedin consequence
of a severe
injurythat he had sustained. This young
gentleman,when of the age of eighteenor nineteen,
he
of delirium
attacked
was
by fever. In a paroxysm
cut his ankle ;
out of bed, and severely
sprung violently

was

From

the Times.

188

MASKED

AFFECTIONS

young

gentleman,who

at the

head

OF

THE

had

MIND.

been

greatlyindulged
and petted at home, exhibited, shortlyafter going to
He
school, a morose,
cruel,and revengeful
disposition.
several petty
quarrelledwith the other boys, committed
acts of robbery,
accusing others of being the culprits.
He pursued his studies with intelligence,
and was
rally
geneof

his

conduct

His

class.

became

so

brutal, savage, and untruthful, that his

systematically
father was
him
from
to remove
requestedperemptorily
the school.
the youth
The gentleman under whose
care
was
induced, by the earnest persuasionsof
was
placed,
the father,to alter his determination
and retain the boy.
For several days he was
noticed to be unusuallymorose
and taciturn.
He
was
perceivedto be busilyoccupied
one
morning in writing. Being called suddenlyout of
the

his letter

room,

contain

the details of

for the murder

he

of

plan

had

he

of the

one

it

examined, and

was

other

entertained

found

was

to

concocted
carefully
boys,towards whom
animosity. His

feelingsof rancorous
written
letter was
had
left the school for
to a boy who
misconduct, and who
appeared to be in his confidence.
He had procureda long,sharp-pointed
bodkin, which he
intended,whilst his victim was
driving into his
asleep,
with which he had armed
of a hammer
heart, by means
himself ! In the letter,
of the
givinga minute description
delinquencyof
in the

of the storm

ravages
the

along with
the Great

Drama

should

be

is

in the

short

one

have

scene

beyond us)

we

on

earth motived
not

may

to the end

now

Morals.

attempt
1855.

to

guess.

popularize Ethical

P. 113.

of what

reason

To

place

and, when

a"k further,

to askingwhy there
equivalent
We
deem
""c.
must
infancy,
dying
which
of
all
life
(whileignorant
by reasons
The
children at a school marvel
why a

"

an

its

in

his son
after entrance, or
soon
parent withdraws
with them; but it is all understood at home."

being

the

behold.

than

more

takes

of creation

shall understand
we

it,any

mischiefdone

been created,is

intellectual idiots,
children

their existence

sin without

no

The

is necessary

is further advanced, we

idiots should

moral

there

and flood.

which
suffering

unaccountable

seems

why

free creature, and

does not

"Essay on

Science."

suffer him

to learn

Intuitive Morals,

Part

I.

Theory of

ILLUSTRATIONS

OF

contemplatedmurder,

he

the littledevil"

boy

the

care

of his

This

MORAL

says,

father,and

I
to-night

*"iU do

for

immediately
placedunder

was
on

"

180

IDIOTCT.

the advice of

an

eminent

he was, without
provincial
loss of time,subphysician,
jectedto close restraint. I am informed that there is
doubt of his insanity.I did not see this
now
no
case
myself,but I obtained these particulars
from the father
of the young
gentleman who had so providential
an
of
his
life. If this youth had committed
escape
murder,
what would
have been the pleaurged in his defence,
and
the verdict of tile jury?
N. B
ajtat. sixteen,of singularly
tractable
unrulyand incharacter,selfish,
and without
wayward, violent,
when under paroxysms of his
ground or motive, was liable,
inoodiness,to do personalmischief to others. He was
bold character.
He was
not, however, of a physically
of
fair understanding,
and exhibited considerable acuteness
in sophistical
apologiesfor his wayward conduct. He
made littleor no
progress in any kind of study. His
with sarcastic
fancywas vivid,supplyinghim profusely
at different times to a firmly
imagery. He was subjected
mild and to a rigiddiscipline.
confinement was
Solitary
tried,but to this he was
impassive.He was sent to
,

school, where

he drew

knife upon

one

of the officers of

of aversion
produceda deep feeling
his companionsby the undisguised

the establishment, and

in the minds

which he
pleasure
placein the town

of

showed

at

some

bloodshed

which took

He
disturbance.
political
careful of
and was
sensual disposition,
manifested
no
property. His conduct became worse, and more savagely
violent to his relatives. It is recorded that,at the early
himself naked, and exposed
age of thirteen,he stripped
his person to his sisters. Dr. Mayu cites this interesting
moral idiotcy
or
illustration as a type of what I term
to this painfully
depravity.When referring
congenital

during

190

MASKED

OF

AFFECTIONS

THE

class of affections,
the

anomalous

the State Lunatic

Physicianto

MIND.

late

Dr.
of

Asylum

Woodward,

Massachusetts,

observes,
"

"

seems

Besides
to

me

disease of the

to be

cases

intellectual powers

of moral

or
idiotcy,

state of the affective faculties from

such

birth

there
an

becile
im-

to make

as

for his actions.

The persons
irresponsible
much vigourof mind, although
I refer have rarely
to whom
idiots in understanding."
they are by no means
A boy under Dr. Haslam's
care, only thirteen years of
of the moral
one
faculties,
age, appearedto possess no
conscious of his lamentable state. He
and yet he was
had
him
often asked, why God
like other
not made
men."
Has
not Shakspeareplaced in Edgar'smouth
of this class of case?
When
ating
delinea faithful portrait
his own
character,Edgar exclaims,

the individual

"

"

"

was

That
And

servingman,

proud in

heart and

mind,

served the lust of my mistress's heart,

did the act of darkness with her ;
oaths

spake words ;
dearly:
false of heart,lightof ears, and bloodyof hand
I was
fox in stealth,
wolf in greediness,
Hog in filth,
lion
in
in
madness,
prey."
Dog

Swore
Wine

as
many
I loved

as

deeply,dice

struck violently
the
boy,in earlylife,was
upon
at school by a brutal fellow employed as an
head when
He was
usher in the institution.
stunned, but
partially
of sufficiently
recovered from the effects of the injury. When
advanced
age, he joined his father in business.
He became
subjectto attacks of headache, particularly
months
he conif exposedto much
tinued
anxiety. For some
often absent from the counting-house,
sullen,was
the associate of the lowest class of society,
became
and
several largesums
of money
detected in abstracting
was
his father's privatedesk.
In
this condition he
from
remained for seven
or
eightmonths, no one suspecting
morbid
state of the intellect. One
a
morning whilst
A

LATENT

in
sitting

CASE

OF

191

MONOMANIA.

the

he suddenly
seized one
counting-house,
of
the clerks by the throat,and attemptedto throttle him.
A severe
scuffle ensued.
tants,
Upon separatingthe combait was
discovered that the gentleman'smind was
obviouslyaffected. He became suddenly,as it were,
demoniacallypossessed. He poured forth a volleyof
of obscenity
filthyoaths, and an amount
terrifically
those
who
witnessed
his paroxysm
of
appallingto
maniacal furor.
There appearedno
impairment of the
reflective faculties.
or
reasoningpowers, the memory,
He suddenlylost all perception
of truth, and all notion of
decencyand propriety.I saw this poor fellow in several
of his attacks, and, must
confess, if I were
disposed
of demoniacal
to believe in the possibility
possession
I should cite this case as one
conclusively
demonstrating
I have
the phenomenon.
referred to instances
previously
of unrecognisedmonomania
the
floating
upon
surface of society.I am
acquaintedwith two cases
of mental

of this form

disorder

where

disease of the

suspected.These latent and masked at tacks

lead to overt acts of violence,
of monomania
frequently
tion
and suicide,and
crime, brutality,
very often to alienafrom health of mind being
of property,no departure
suspected.
mind

is not

few

years

back, I received

summons

from

London

of allegedinsanity.
to examine
case
a
policemagistrate
several
had committed
It appearedthat a labouringman
serious
consequentlyarrested by
assaults, and was
examined
was
by a medical
the police. This
man
gentleman,who said he had no doubt as to his insanity,
without, however, being able to assignsufficient reasons
than
had, on more
for such an opinion. The magistrate
had
the case, and
occasion, himself investigated
one
taken

the

could detect

referred to,
surgeon
in the prisoner's
appearance
insanity

evidence
no

of the

but
or

192

MASKED

AFFECTIONS

conversation.
his

OF

THE

MIND.

gentleman asserted it to be
belief that the prisonerwas
insane, basinghis conclusions
unreasonable
conduct,
upon the man's apparently

and mad

The

acts

medical

of motiveless

violence.

examined

the

in court, and it was

not until after the
prisoner
publicly
that I
of an
hour
expirationof nearlythree-quarters
I then
obtained a key to the actual state of his mind.
discovered that he was
insane.
He was
unequivocally
under
delusion
that a strangerhaving evil designs
a
his life,
in the habit of placing,
a small
was
daily,
upon
this
of his bedroom
pillupon the mantel-piece
; that
gredient
pill(which he was compelledto swallow)contained an inthat greatly
excited him, destroyingall power of
and leading
the acts of violence
him to commit
self-control,
he stood charged. His
of which
insanitythen became
for his
obvious, and the magistrate signed a warrant
committal
to an asylum. It appearedthat this insane
had been
man
punished on previous occasions
severely
for different acts of unexplained
violence,no one suspecting
the existence of mental

disorder.

It

was

not

until

I had

him to a close and rigidexamination

for
subjected
the
of an
hour, during which
nearlythree-quarters
his
lunatic showed
extraordinary
ingenuityin concealing
delusion, and greatcleverness in fencingwith my questions,
that I could establish,with satisfaction to myself,

the presence of

insane

an

idea.

of
estimate, in our
appreciation
sufficiently
the character
disease upon
others, the effects of physical
Do

and

we

actions

of those

called to
How
how

slightare
subtle

of the

the

adjudicateand
the changes in
variations

brain, that

alterations

in

The

and

brave

conduct

whose

upon

the

moral

heroic

and

become

are

times
some-

judgment?
pronounce
the corporealhealth,

in the

precede and

we

delicate

organization

accompany
intellecttud
as

timid

remarkable

character?
and

bash-

EPFECT8

THE

fill as

coy

OP

DISEASED

maidens

in

BRAIN

ON

states
particular

and humane
Mild, inoffensive,

men

are

193

CHARACTER.

of ill-health.

driven to act* of

and crueltyunder the influence of certain

desperation
and derangingthe operaphysicaldiseases disturbing
tions
of thought.
has
Men
been
(it
observed) have
their ebbs and flows of bravery,and some
distempers
bringa mechanical terror upon the imagination."
The
celebrated General
CUSTINE, possessing
at the
dreadful battle of Mayence,high health and vigour,
could
with heroic courage
advance
to the mouths
dauntlessly
of the Austrian
cannon,
yet after having suffered
from bodilydisease,and loss of nervous
severely
energy,
he proveda dastardly
poltroonand coward at the sight
!*
of the guillotine
A
gentleman was, for many years, remarkable for
and violence of temper. He was
stantly
congreatirascibility
mestics
with his relations,
friends,and doquarrelling
for beingan illnotorious
fact,he became
; in
"

conditioned

man,

with

whom

no

could for many

person

He
suddenly
days live,or associate on amicable terms.
of greatuneasiness in
became ill,
complainedof a feeling
followed by a violent attack of
This
his head.
was
epilepsy.He recovered from the paroxysm, and, to the

astonishment

of all his relations

and

racter
friends,his cha-

completemetamorphosis.He
and placid
disposed
man,
became a mild, good-tempered,
with everyunderstanding,
body.
to live,on the most
friendly
This
state of mind existed for eighteenmonths,
he
carriage,
when, in the act of gettingout of a railway
succeeded by a return
fit. This was
had a second epileptic
He againexhU
of his former violence of conduct.
had

undergone

occasional paroxysms of
mental condition continued for*
ungovernable
rage. This

bited

six

with
great irritability,

months, when
"

Referred to

he had

by

Dr. Thoma*

recurrence

Ifeddoe* in hi"

of the
"

epileptic

Hjgeu."
O

194

AFFKCTIONS

MASKED

OF

THE

MIND.

fits,followed, singularto relate,by

mental

condition

of

great self-control,and astonishing

composure,

In a
provocation.
attacks of epiweeks he had a succession of severe
lepsy
associated with maniacal symptoms. It was
sidered
constraint,
renecessary to place this gentleman under

when
equanimity,

few

he is

and
In

exposedto

in confinement.

now

conditions

some

extreme

of

disorder,the slightest

nervous

alternations
meteorological
changes give rise to singular
of despondency,
hope, and joy, so completely
despair,
I have
does the mind
succumb
to physicalinfluences.
cholia
known
a
subjectto attacks of suicidal melanperson
pressing
deduring the prevalenceof a cold, blighting,

appearedhappy,contented, and
free from all desire to injurehimself under
other and
more
congenial conditions of the atmosphere!* An
Italian artist never
could reside a winter
in England
idea of self-destruction repeatthe distressing
without
edly
mind.
suggestingitself to his morbidlydepressed
I have known
natives of France, accustomed
from early
life to the buoyant air, and brightazure
sky of that
country,sink into profoundstates of mental despondency
weeks
in London
if compelledto reside many
during
A
the earlier portionof the winter season.
military
mental dejection,
from severe
in the
was
suffering
man,
and forward in a cerhabit of promenadingbackward
tain
track,towards evening,on the ramparts of the town
wind, who

east

in

which

face fronted

black,

as

resided.

he

the

When

he

east, where

the

alas ! his

was,

presseddoublyand
*

"

should

of another, whom
fate, at a moment

impeded
"

the

An

secretion.

Feuchtersleben's

former

when

"

him

foundation

of

endeavoured

the frame
hour

Medical

to

of mind

man

caused

with

his

was

grief
hopeless

human

events,

by the
was

have

we

intestines

with sympathy
inspire
of the latter

later,and his fortune would

Psychology."

hung

Then
he

one

forwards,his

was

heavilyupon

we

sky

soul.

poor

penetrateinto the secret

find the misfortunesof
frequently

Could

walked

in his

affected

by

been made."

MASKED

AFFECTIONS

OF

MIND.

THE

phenomena differ from the

in insanity
state of the mind
exceptin their temporary
and transient character ?
Suppose a continuance of the
irritation accompaniedby the same
nephritic
psychical
In what

respectdo

manifestation, and
actions, and
violent

loss of volitional

observe

we

often

witnessed

the condition
of chloroform

illustrations could

be

state

could

we

for any

effect of the anaesthetic

the

not

advanced

nistration
followed the admi-

to be in existence

after the acute

subsided, would

which

of violence,

acts

in the

of mind

the

irritability,
tendency to

earlyas well as
derangement. Again, if

mental

stages of

of time

that

over

power

to motiveless
conduct, disposition

so

conceive

these

of

one

length
agent had
insanity?

be

multipliedad libitum.
conditions
of eccentric thought,
There are many
sient
tranof
states of intellect,temporary manifestations
and erratic emotion, and
evanescent
irregular
phasesof
would
constitute
violent, ungovernablepassion,which
and insanity,
too, of a formidable
type,if such
insanity,
of a persistent,
and not of a fugitive
states of mind
were
These

and transient

character.

Psychicalphenomena, analogous to what has previously

been
observed
referred to, are
in
occasionally
patientssufferingfrom temporary attacks of delirium
into the blood of some
form of
caused by the absorption
poison. There is upon record a remarkable, and deeply
I offer
interestingillustration of the kind, which
no
apologyfor quoting in detail. The case was one of
occurringin a female aged twenty-one. A
hydrophobia,
gining
few days after the attack she commenced
raving,imathat
which

she

she

had

in

was

delusion she sprang

throw

herself

agitation,I
"

out

have

been

prison.

accused

Under

up

to make

of

the

done

no

of
the

some

crime, for

influence

her escape, and

of this
tried

window, saying with

harm."

It

was.

then

to

great
deemed

SINGULAR

confine

to

necessary

CASE

OF

her

by

197

HYDROPHOBIA.

of

means

strait waistcoat.

About

eighto'clock at night,upon Dr. Lister and Dr.

Hamilton
of the hospital),
(the physicians
enteringthe
ward, they heard a female voice speakingthick and
eagerlyin the dark (for the other patientsin the hoipitalhad been removed). A candle was brought to the
bed, and
woman

the

curtains

her back,

lying on

was

The

undrawn.

were

young

all her force to

exerting

glistening,
pupilsmuch dilated,whole face and neck uniformlyred,
swift and
steaming with perspiration
; pulse incredibly
get

up

small.
and

in

terror

She became

saliva

She

her

countenance,

eyes

was

looks,and

Her

restless.

very

clear

tongue was

of her mouth.
running from the corners
in a state of great terror,with fear in her
Let me
out,
to get away, calling
struggling

was

"

too quickto be marked,

go ! let me
go !" By transitions,
of some
she seemed
to fancy herself at the entrance

horrid

"

exclaiming,
place,

will enter."

Quick

to the violence

look,and
you are
these

in
a

her

as

of

earnest

an

Her

and
thoughts,

own

alnrm

ruffians,with
will not leave

agony

of terror

well, I

as

if

posed
ex-

stillin her

she

imploringmanner,

gentleman,
you
"

in first;

do go

now,

"

said,

as

girlto
helpless
she

increased,and

don't

and wildly, don't leave me, sir ;

peremptorily
in a moment
leave me, I beseech you." Her mind was
she
where
hurried from this idea to an imaginaryplace,
by a woman.
fancied she was
going to be used cruelly
"

cried

!" she cried,with

my bones
then
terrified looks,exertingall her force to escape. She
"

She will tie

sunk

into

me

up ! break

state of calmness

minute, but

averted head and neck

conflict with
danger. Her mind

looks, and
frightened
renewed

soon

her

a
expressed

became

but stillunhappy from fancying

tranquillized,
order of her
detained by force from obeyingsome

little more
herself

for

198

MASKED

mistress.
me."

AFFECTIONS

Let

"

The

me

OF

she

MIND.

mistress wants

(she cried) my

go,

mistress's

her

apprehensionof

and

THE

vociferated,"I

beseech

creased,
in-

anger
let

you

go,"then, with imploringlooks, added, I pray, as

Heaven's
gates,let me go, hut for five minutes ; I
return

to you, indeed

While

she

will

then

occupiedwith
pieceof orange

"

will,do let

received

the

thoughtsof

the

offered to her

was

me

will

calls me."

mistress

my

thus

was

her mistress's anger,

to eat.
She said,
She

me

if at

"

to

go

into

orange

tress."
mis-

my
her

own

Then struggling
hand, muttering, It will choke me."
hard, as with an idea to get home, she, as if designedly,
"

dropped it

under

fold

of the

blanket, exclaimingin

do
"As
despair,
you are a gentleman,
she fancied
not hinder me, I must go." In a moment,
for with sudden
herself againexposedto acts of cruelty,
cried
terror she
out,
they are breakingmy legs1"
in her excited fancy,
to
After this emotion, she appeared,
where
she layquieta
have reached a place of safety,
gers
minute
two, as if breathingfrom the toils and danor
she had escaped.
The
opportunityof her being calmer was seized to
her attention to a presentobject. A teaspooiiengage
ful of gruelwas
offered her to drink, and she was
urged
.to take it. She said,as if returned to the knowledge of
her real situation,she was
not dry,and then began to
said it would
It was
rave
again about her mistress.
do her good. Upon which she seemed by her manner
as
accents

of wild

"

if she

It

was

in

her

wanted

given
hand,

mistress,until
on

the

to
to

have

her;

spoon
she

but

requestingto
the
she spilled

bed-clothes.

called to

the

Her

herself.

her

the

allowed

go

contents

seemed

to

hand.

own

only kept

attention

present objects,she

knowledge of

be

in

spoon
to

by littleand
having been
to

return

her

little
thus
to the

SINGULAR

Another

CASE

teaspoonful

OF

offered to her,
upon which
prevented from properly

was

she

that she was

signified
takingit by her hands being confined.
sleeves

of the

waistcoat

requestedto swallow
hand, beginningto be

100

HYDROPHOBIA.

The

cords of the

slackened,and

were

she

waa

the

gruel. She held it in her

intent again to get to her mistress
it was
remarkable, that without knowing
; and
what she was
doing,or at least without givingattention
to the act, she put the teaspoon into her mouth, and
swallowed
the contents.
As she was
miserablyrestless,
and sometimes
it was
said,if she
violently
struggling,
would

be

still,her

liberty.She
cords
and

she
the

seemed

untied

were

hands

and

to assent

but

should

arms

to this

the moment

be

set

the

and
proposal,

she

felt her

at

arms

the bedclothes.
she began to turn down
body at liberty,
that
Her looks kindlingafresh,and expressing
bent on escaping,
was
or
doing something dreadful,
drawn
cords were
fined.
tight again,and her body con-

The

medical
at

gentlemen remained

bedside, and

her

in that

about

short

time

nutes
twenty miwent
she under-

previouslyenumerated, and many

sufferings
ness
to witnot described.
It was
more
deeplydistressing
and agitations.It was
painfulto
her appearance
leave her in such poignant misery,without
being able
went out
to givethe smallest relief. As the physicians
if in a
as
of the long ward
they heard her exclaiming,
fresh conflict with some
new
overpoweringdanger ; and
shut after them, her eager, interesting
when
the door was
the

voice

ing,
beseechdistance, complaining,
and solitude ! She
in darkness, despair,
shrieking,
was

stillheard

died about
Is it not
"

1815.

"

Morbid

one

at

o'clock that

that, in
possible
Anatomy

morning.*
this

case,

of the Brain," by A.

the mechanical
Manlwll, M.D.

re-

London.

200

MASKED

straint which

her

doing

paroxysms

AFFECTIONS

MIND.

resorted to,with the view

was

serious
of

THE

OF

mischief

to herself

excitement, may, to

of

preventing

duringher

violent

extent, have

some

gested
sug-

morbidly agitatedthoughts,the idea of

parties physicallyoverpowering her ? Dr. Gratiolet,
after relating
several cases
illustrative of the influence of
temporary physicalirritation on the intellectual ideas,
to

and

her

moral

duellists,what

assassins

crueltyto similar
to physiologywill
who

have

remarks

emotions,

been

causes

be

"

"

What

ferocious

have, perhaps, owed

!

great the interest

autopsiesof those

How

attentive

executed, and

their

who

have

been

urged

by inexplicableimpulsions! There, also,

is doubtlessly
of those suicides which
the reason
found
finite
nothing explains,if it be not this profound and indewhich
inquietude,
gives to every incident of life,
to conditions
of perfecthappiness,a sombre
colour,
quietude
and repulsive
let us
conceive an inaspect. In reality,
individual
An unfortunate
pushed to its acme.
This inquietude,
feels vaguelythe presence of an enemy.
of which the objectis not defined, demands
explanation
;
the anger that it excites requires
to be satisfied. Who
desired an
has not, in certain hours of indefinable anguish,
adversaryto combat, and sought an objectfor his blind
One
anythingserves.
fury? In these terrible moments
kills the dog that caresses
tears his vestments; another
of whom
him; while a third cuts the throat of a passer-by,
the dress displeases
him, and who by chance has regarded
Here is,without
him.
doubt, the point of departure
of fixed ideas, and delirious impulses.
of a great number
These
ideas, when
they do not incite immediatelyto a
fatal result,are transformed, and very often change their

to

crime

object,so

that

we

can

generaltendencywhich

consider
seeks

an

them

as

end, and

the result of

often attains

MORBID

it

by chance."*

relates the

201

'

RELIGION.

the influence of

of

case

pteudo and

clergy,

morbid

gious
reli-

in the habit of

was
opinions,

himself

OF

Dr. Darwin

who, under

man

VIEWS

for the

sake, as

ing
bruisingand woundsaid, of
mortifyingthe

he

"

This

fash"

tions,
patientoccupiedmuch time at his devoand continued
whole
nights alone in the church.
As he had a wife, and a familydependent
him, an
upon
unfavourable
prognosiswas formed of the case, it being
supposed that the sympathizing affection and devotedness

manifested

tion

of

mind

in

its

to

an

died

towards

well

as

afforded,might have

so

the

as

pre-occupa-

checked

nity
the insa-

early stage. This gentleman was removed

asylum. He subsequentlyreturned home, and
combined
of self-inflicted injuries,
in consequence

with

the

continued

in
practised

of

his

abstinence

obedience

food, which

from

his

to

He

delusions.

once

he

cinations.
religioushallu-

insane

endeavoured

Darwin

Dr.
out

him,

to

reason

told him

that

him
"

God

delight in
cruelty;but that he (Dr. Darwin) supposedthat he
(the patient)
worshippedthe devil." The clergyman was
that he
struck with this idea, and promisedDr. Darwin
beat himself for three days. He, however,
would
not
only abstained from so doing for four-and-twentyhours.

was

merciful

Dr. Darwin

adds
been

have
and
the

into

Being,

of

public nature,

has

massacres,

world

not

these works

When

"

:"

could

and

this

not

of supererogation

cruelties,murders,

what

insanityintroduced

very active
tholomew's
encouragingthe bloodydeeds of St. Bar!"

person

who

had

been

leadingand
day at Paris, on confessingon his
asked,
was
his sins to a worthy ecclesiastic,

in

death-bed
have

"

"
avec

M.

"

Compart
Par
I'lntelligence."
Anatomic

P. Gratiolet.

Pari-

du

Nerreox,
Syitfcne

Fr.

Leuret

1839, 1867.

et

coiukWrf

P. Uratiolet,

d*n"

MM

Tom.

you

*""**
J

202

MASKED

nothingto

say about

"

that occasion

on

AFFECTIONS

God

any person
Ravaillac entertain

the

THE

day ?"
obligedto

Almightywas
acquainted with
doubt

at the
irresponsibility,

as

time

the

to

he

Fourth, of France, for which

and

MIND.

St. Bartholomew's

Can

moral

OF

replied

He

/"

me

of

confession

his

insanity,and
assassinated
Henry

he suffered

the

longed
pro-

agonizingtortures of the rack, followed by

to pieces,
by four horses drawing in opposite

beingtorn
directions ?
A

died of congentleman,aged twenty-nine,

of the body was
sumption. A post mortem examination
young

made.

The

from

brain

health, but

evidences of
found

itself showed

the

marked

no

deviation

dura,

and

pia mater, presented

organicchange.

The

former membrane

to be three

healthyconsistence. In appearance,
it was
of
tanned
leather
!
like a piece
There
the pia mater.
also tubercular depositions
The
were
on
alterations discovered in the meningesimmediatelyinvesting
the

these,no
for

times

was

brain,

have

must

existed

many

doubt, disordered his mind.

time, been

some

its

This

of much

cause

years, and
person,

unhappinessto

had

his

He
family,without their suspectinghim to be insane.
drank
to a frightful
indulgedin the societyof
excess,
the most degraded,depraved,
vicious men,
and women,
and squandered,in a few years, a splendidpatrimony.
He married
much
below him in social
a respectable
girl,
rank and station,whom
illhe, in a short time, brutally
treated.

He

leavingthem
relatives.

ances.

his

his

on

infant

an

child,

wretched

affection.

in years,

was

His

father,who

subjectedto

occasion,because he refused to

one

signatureto

This

and

charityof friends,and distant

he manifested
immediate
own
family,

very advanced
assault

her

to the

Towards

man

murderous
attach

both

kind of interest,or

no
was

deserted

then

one
man

of his
was

son's reckless

accept*

accused
eventually

of

204

MASKED

AFFECTIONS

conversation, strange
of disordered
and

mind.

restored

was

recovery she
her.
Upon

OF

the medical

met

her

sir,I'll tell you

me,

that he would
you
when

was

the matter
as

ever

and

am

now

I mind

the

man

no

The

medicine

the love-madness
calomel

was,

me.

else."

was

The

state

of her

an

folk is very comical

wench

cured

one

mad

the

"

first sent to you,

with
but I was
me,

poor

long,and

not, she

give those

to

attended

had

asylum,she hung
will not
said, "If you
betray
secret." Upon his assuringhei*
said, Why, sir,that physicthat

and

head,

who

man

being questioned as
health,prior to being placed in
down

symptoms

placed under treatment

A short periodafter her

was

health.

to

MIND.

"c., decided

manner,

She

THE

an

so

sort of

stuff,for

nothingin the world was

most
in love
desperately
tirely
your physic has quiteenas
happy as the day is
than

I do you or
any
effectual in the removal
of
more

emetic, and two

fact was,

or

three active

the

love affair was

girl's
of her insanity,
the first manifestation
which
the medicine
successful in arresting
and curing!*
was
A merchant, fifty-five
years of age, father of a large
family,of a strongconstitution,althoughof a lymphatic
who
temperament, mild and gentlein his disposition,
had acquireda considerable fortune in business, experienced
domestic troubles,not sufficiently
serious,
some
mind, and
however, to affect any one possessing
a vigorous
About
he
a year
previously
healthily
organizedbrain.
of his sons, and
formed
a
largeestablishment for one
shortlyafterwards became very active, and expressed,
which he felt at
contraryto his usual habits,the delight
his increasing
frequently
prosperity.He was also more
purges

his warehouse

absent from

and

business

than

usual

but

notwithstandingthese triflingchanges, neither his

suspectedthe existence
family,friends, or neighbours,
"

Binghanion

"

Mental

Diseases."

P. 137-8.

SINGULAR

of mental

home,

CASE

OP

disorder.

CONCEALED

One

205

INSANITY.

day, whilst
brought to

he

from

was

merchant
his house two
travelling
and asked fifty
louis for them, which he said
pictures,
the priceagreed upon by a
was
man,
gentlevery respectable
who
had given his name
and address.
His sons
both the pictures
sent away
and the seller. On his rehis purchase,
turn, the father did not mention
but the
children began the conversation,alluding
to the roguery
a

of the

merchant,

father

became

were

very
determined

and

very

their refusal

purchase them.

dispute became
uttered

dear,and

not

In

the

warmer,

threats,and

him.

pay

assertingthat

angry,

beautiful, were
to

to

the

he

was

evening the

patientflew

at last became

pictures

that

the

The

into

delirious.

sion,
pasOn

His
care.
day he was confided to Esquirol's
and alarmed
at their lather's illness,
children,frightened
he had
at the purchase which
made, looked through
their
astonishment
their accounts, and
at
great was
blanks
seeingthe bad state of his books, the numerous
there
and the immense
which
deficiency
they presented,
had existed for
morbid
of cash ! This
irregularity
was
Had
this discussion respecting
than six months.
more
and his actual state of mind
the pictures
not taken place,

the next

been
houses

in France

and
of

The
a

would, in

taken

conduct

amount
to

consulted

as

about

grave
the case

bill of

due, and

ously
seri-

exchange
no

means

payment.*
of a gentlemanholding

commercial

the

of his relatives

for

become
its

been

days,have

few

conversation

minds

an

had

providefor

and

in
high position

was

mercantile

honourable

most

compromised;
fatally

considerable
been

had

of the

detected, one

world, excited in the

to his sanity.
as
suspicion
and gave
by the family,

character
of such*
opinionthat the symptoms were
condias to his mental
their apprehensions
to justify
"

Euquirolon

"

The

Illuiion* of the Insane."

P. 34.

206

MASKED

tion.

closelyobserved, but
personalrestraint should

MIND.

should

that

no

actual

of

measures

be resorted to until the disease

The
obviouslydemonstrated.
contraryto my advice, permittedto be at
and previously
kind of supervision,
to any
no

mind

more

was

patientwas,
under
large,
stepbeing taken

to exercise control

known
him, he had, un-

over

friends,and family,(without being able to

to his

assigna

THE

gentleman'sconduct

that the

advised

be

of the

OF

AFFECTIONS

for

motive

sane

so

for
doing)disposed,

an

amount

less than its value, of a small but beautiful

considerably
estate in the country that had belonged to the family
made
to set
for nearly a century. An
attempt was
the ground of insanity,
but it was
aside the sale on
argued,that the gentleman in questionbeing permitted
allowed to go to his counting-house,
to be at large,
to
draw
cheques,and execute, unrestrained, other important

of business, the transaction

matters

relative to the

propertymust be considered as one made by

fullycompetent to understand the nature of
was
doing,and was therefore valid in pointof

sale of his
a

person
he

what

law.
In

another

doubtful

of

state
an

familyhad
this

In

case,

of

mind,

to

continue

important character
been

state

of

allowed, in

gentleman was

advised
mind

he

as

to

for

to

embarked

mental
in

very
ness
busi-

periodafter

some

his

transact

the

incapacity.

wild

and

mad

by which he lost fifty thousand

railway speculation,
pounds.
I saw
last year, in consultation
A
gentleman whom
with Mr. John
Propert,made purchasesof stock to the
thousand pounds,when
extent of one hundred
clearlynot
in

condition

of mind

insane
yet sufficiently

to manage

his

own

but not
affairs,

the familyin interfering

justify
his free agency
with
by preventinghim from going
a
near
regularlyto his counting-house.Fortunately,
to

CASE

relative

true

UNDETECTED

informed

was

transaction
and

OP

alluded

207

INSANITY.

of the nature

of the

monetary

after its

being completed,
to the parties
enabled, after representing
the
was
state of the gentleman's
mind, to cancel the investment,
but

to,

soon

without

not

the

sacrifice of

considerable

of money.

sum

in the
requestedto visit a clergyman residing
north of England,whose condition of mind had caused his
insane.
familygreatanxiety.I found him unquestionably
His derangement was
marked by clearly
manifested delusions.
His conduct for many
to any
years previously
symptom of mental aberration being noticed,had been
'characterizedby actions quite irreconcilable with the
of the existence of perfectsoundness of intellect.
supposition
was

had, for

He

four

five years, before his state

obvious to those constantly

or

of disordered intellect became

him, ordered

associated with
to be cut down

on

number

of valuable

the estate, without

trees

his

beingable to
ing.
outrageousproceed-

for such an
justification
joining
He had also sold a quantityof valuable land adhis glebe,to a neighbouringsquire,that had
(unfortunately
generations
belongedto the familyfor many

offer a

sane

partedwith
to form

At

his conduct

had

sane

in

he been

judgment

was

marked

of mental

he

would

never

state of mind

of the character

liave

to enable him

of the

ings.
proceed-

subsequently,
and caprice.
by greateccentricity,

this time, and

Nevertheless, he did

symptom

which

entailed),and

not

for many

years

exhibit in his conversation any

miied
derangement or impairment,
not

attended the annual visitations of

society,
and
his diocesan, wrote
preached capitalsermons;
dutie*.
to all his parish
and zealously
attended faithfully
the offspring
of his actions were
clearly
at a time when
many
of a mind decidedlyoff its balance, if not closely
as

usual with

vergingupon

actual

insanity.

208

MASKED

saw

AFFECTIONS

OF

THE

MIND.

belongedto
years back, who
of America
he was
then
suffering
;

gentleman,some

the Southern

States

associated with ideas of high rank,

generalparalysis,
I ascertained,whilst investigating
and great wealth.
the case, that the gentleman had, for nearlyeightyears
been guilty
to his insanity
being recognised,
previously
with
the hypothesisof sanity
of conduct
incompatible
reckless
He
had in a most
and moral responsibility.
involved himself in a number
of law proceedings
manner,
of his familyupon
the
members
againstnumerous
most frivolous and ridiculous grounds. He had unjustly
of having robbed
accused his servant
him, and had%
initiated legalproceedings,
with a view of prosecuting

from

in

court

friends for

of law

one

libel,without

of his
any

oldest

and

most

valued

for such
of justification

kind

proceeding. On another occasion he assaulted a

he accidentally
met on board an American
strangerwhom
that he had grosslyinsulted him
steamer, alleging
by
between
his looks and gestures. A quarrelsoon
arose
the
nearly ended in a fatal rencontre.
parties,which
time he became
At one
and, in fact,miserly
niggardly,
of considerable
in his habits.
man
a
Although he was
property,he refused to supply his family with the
a

common
was

and

necessaries
in the habit of

of life.

When

flyinginto

blaspheming those near

This
symptom

asked

furious

him

in

for money,

he

passion,
cursing
a

most

dreadful

for
insanitycontinued
he suddenly lapsed into the
several months, when
He
became
opposite extreme.
recklesslyimprovident,
and
countable
extravagant. He squandered,in an unacnearlyfifteenthousand dollars in the
manner,
of all counsel,
of six months, utterlyregardless
course
of this
and protest. During the whole
expostulation,
his mental
time (strangeto relate),
no
even
one
suspected
not
was
sanity. His conversation, on generaltopics,
manner.

of

MOTIVELESS

ACTS

OP

BRUTALITY.

Jll!)

only coherent and rational,but it was

marked
by
and great sagacity.II is letters
vigorousintelligence,
also

were

free from all

symptoms

of aberration of intellect,

and

he attended publicmeetings,
and
occasionally
spoke with great eloquenceand effect. His state of
mind
did not excite suspicion,
until one
day, whilst
attendinga railwaymeeting as one of the directors,
he
the chairman, offered to purchase,
arose, and addressing
his own
on
shares in the
account, all the disposable
of the company,
and this,too, at a time when
possession
it was
believed to be, and literally
the verge of
was, on
!
bankruptcy
Let us charitably
and
hope that many extraordinary
unreasonable and motiveless acts of brutality,
apparently
violence, cruelty,
passion,and crime, that result from
and inadequate
trifling
excitingcauses
actingupon conweak
and badlyorganizedintellects,
have
genitally
may
in some
their origin
form of latent disease of the brain,
disorder of the mind.
Is not
concealed,or unrecognised
the sad historyof crime
fraughtwith illustrations of
*

this kind ?
Let it not, for

one

the least desire to

moment,

screen

be conceived,that I have

the criminal from

the

justand

violations of the
punishmentawarded for flagrant
legal
to raise a false issue,or encourage
law, or that I am disposed
maudlin
or
sympathy
a morbid
sentimentality,
Whilst desiring
Such are not my views.
in his favour.
fence
be said in dethat can scientifically
to urge
everything
is
of what
I am
not unmindful
of the culprit,
well aa what is
as
necessary for the safetyof society,
the criminal has so
due to those whom
righteously
injured.
grievously
I ask, to be advanced in the way
But is there nothing,
of apology,
for the poor, wretched, heart-broken lunatic,
driven by a diseased brain,and a perverted
irresistibly
p

210

MASKED

AFFECTIONS

OF

THE

MIND.

to an
act of murderous
violence, whilst
imagination,
under the overwhelming dominion
of a fearful illusion
of the senses,
or
crushinghallucination of the intellect,
of healthyreason,
the power
and paralysing
destroying
all freedom
of the will?
Poor
Cowper, himself the
when
subjectof a severe form of ItypocJiondriasis,
writing
letter to a friend who
had recently
a congratulatory
recovered
from
attack of severe
an
bodilydisease,says,
Your
illness has indeed
been a sad one,
causing,no
and considerable anxiety
doubt, greatdistress to yourself,
"

to

relations

your

and

friends

but, oh ! what

are

your

acute as they undoubtedlywere,

to the
bodily
sufferings,
unceasing mental torture I suffer from a fever of the
mind?"
I am
afraid,in our
sympathy (naturalthough
it be) for the murdered
of
victim, and in our
feelings
moan
bedeep compassion for those who survive to bitterly
his loss,we
are
occasionally
disposedto ignorethe
extent of acutely
agonizingsufferingthe lunatic often
before he yields
to the delirious impulse,and
experiences
commits
a crime
so
opposed to the strongestinstincts of
his nature.
In homicidal

the victim is,alas ! frequently

insanity,
lunatic by the closest,the fondest, and

related to the
dearest

ties.

morbid

desire to

shed

human

of the

affections
(caused by particular

blood,

brain,) from

somethingdreadful must be done to relieve

of its terrible pressure, occasionally
the mind
overpowers
It
all feeling
and love.
of fraternity
must be done
it
conviction

that

"

"

*Jiattbe done

"

and

must

"

dear

my

must

has

"

my

and

was

the sad description

the most

loving

fathers.

destroyhuman life,
by a fearful
obtained a completeascendancy
over

lunatic,driven

delusion,which

wife

hand, before this

affectionate of husbands

The

be shed

perishby my own
anguishcan pass away." Such
of
givenof the morbid feelings

darlinginfant
mental

blood

to

212

AFFECTIONS

MASKED

OF

THE

MIND.

compassionI
to an
nominio
igmay
express for the unhappy lunatic doomed
death, to be otherwise than keenlyalive to
from the once
the wailingsof distress proceeding
happy
dwellingmade desolate by the ruthless hand of the
murderer ; sorry should I be, if I could ever
ignorethe
the
terrible sufferings
often entailed by crime, on
so
The fearful rehearth and the orphan's
widow's
home.
sults
Far be it from

"

lost

the

sad

in any

me

of

sentiments

of

consequences

crime

should

"

considered
sightof,whilst endeavouring
by carefully

scientific

of medical psychologyto
principles
from
the plea of insanity,
criminal, under
attached to his act,but no
amount
penalties

odium
no

be

never

to which

extent

of

the

medical

witness

scurrilous abuse

be

may

which

shield the

the

legal
of public
exposed
"

be

may

levelled

againsthim, should influence or deter him, when called

of alleged
criminal insanity,
to give evidence in cases
upon
less,
fearto the weight of a hair, in the steady,
even
portant,
imand unflinching
of one
of the most
discharge
sacred,and
to

solemn

functions that

can

gated
dele-

responsible
being.
"

Ambigusesi quando eitabere

rei ;
Incertseque

Et

dictet

perjuria
tauro,
prseferre
pndori,
vivendi perderecausas."

nefas animam

erode

Suinmum

testis

Phalaris licet imperet,ut sis

Falsus,et admoto

proptervitam

"Juven."Sat.

The

be

positionof
Which

must

psychologicalexpert"is one
"

be false,
or

heaven

would

pass

In

shudderingsto one formless mass.

Why, look in one another's eyes
How
calm they are ! You tell me
lies,
"

Or your
I dreamt

own

tears would

fleck the

ground !
"

it,if this brain be sound.

*****
"

I wail and

wander

like

a ghost,
glimmering coast,
lost face makes red the night.
one
dawn ! Oh, day ! Oh, light
!"
lingering

Houseless, about
Where

"Oh,

8, v. 80.

not

DUTIES

OF

THE

PSYCHOLOGICAL

213

EXPERT.

to be

coveted.
In cases
ambitiously
of alleged
insanity,
he is occasionally
w
hen
compelled,
in court*
elucidating,
of law, the phenomena of mental
to enunderangement,
ciate
of truth, in advance of the
as
a pioneer
principles,
knowledgepossessedby those who sometimes examine,
and
often severely,
criticise and
calumniate
unjustly,
him.
"When givingevidence on
scientific points,
he is
and unavoidably
in the expression
occasionally,
of
obliged,
his opinions,
to go counter to what
is termed
the
nerally
gereceived" notions on the subject
of insanity.0
If
it be his desire,in imitation of certain dilettanti
logists,
psychoto sail with the popularbreeze, and to
panderto
the opinionsof the vulgar,
sanity
by making his views of inentertained by the
square with those ordinarily
cally
non-professional,
uneducated, and, medipsychologically
inexperienced,
part of the community,his task is a
"

facile and

an

easy

one,

but

if he

forms

mate
just esti-

of his

cultivator of science,
as
a lover and
position,
and possesses a philosophic
of his responappreciation
sible
vocation
citizen
the
of
and
as
a
state,physician,
medical jurist,
and is resolved not to yieldone
inch of
ground, in his honest expositionof scientific truth, in
deference to popularfallacy,
in slavish obedience
to
or
ignorantabuse and noisyclamour, he must expect to pay
the penalties
to his exhibition of moral cpurage,
attaching
and firm and unflinching
adherence to the pathof public
and professional
duty. He may be maligned,misreprethat the
remark*.
Science*")
it
rarely
generalvoice of mankind, which may often serve as a guide,becauae
in
who
thoae
of
it*
estimate
are
in
prominent
errs
or
widely permanently
the
to
of
i
s
region
it
publiclife, of littlevalue when
speaks thingsbelonging
within the
of exact science."
The opinionof the majorityupon quentious,
natural
and
of ordinary intelligence,
comprehenflionand graap of men
and
It
be,
and
deference
reaped.
may
sagacity,is entitled to profound
what
in
that
establish,
often is,right. But does not historysatisfactorily
the
common
as
generallyreceived opinion u,
parlancei* designated
P
truth
from the
occasionally,
very remote
Interdum
vulgusrectum videt,est ubi peccat Hoc.
*

Dr. Whewell

(" Historyof

"

the Inductive

"

"

"

"

"

214

MASKED

AFFECTIONS

sented, and traduced

of

for

conduct, but

the

OF

THE

MIND.

adoptingthis
cause

he

honourable

has

espoused

ciple
prinmust

all difficulties,
structing
triumph over
eventually
temporarilyobits steady,
onward, and advancingprogress.
and
Expertsin madness ! mad doctors !" indignantly,
exclaimed Mr. Baron Bramwell, in his charge
offensively,
to the jury at York, in the celebrated
of William
case
Dove, the insane necromancer.
Expertsin madness!"
We
have recourse
to able, skilled, and
Why not?
scientific witnesses
to elucidate difficult and
disputed
architecture,mechanics,navigation,
pointsin engineering,
and many
of the exact, as well
feignedwriting,
chemistry,
as
sciences,and upon what ground should we
speculative
repudiatethe testimonyof learned and experienced
men,
?
acquaintedwith the phenomena of insanity
practically
What
think
of judgment would
of publicly
ing
throwman
discredit upon
the well and
considered
deliberately
opinionsof a Faraday,Brande, or a Graham, when called
vexed and subtle questions
of analytical
to unravel
upon
better fitted than
these eminent
are
chemistry? Who
"

"

and

learned

Should

to

decide

such

doubtful

matters

in repudiatinga Stephensonor a
justified
Brunei
(if still among
us) if selected to throw light
in a court of law, upon
obscure, and litigated
an
point
with
vated
culticonnected
the science they so
successfully
and adorned
?
Why then speak contemptuously
of the opinionsof an
educated
and
and
disparagingly
when
class of specialists,
requestedto solve
experienced
connected
with
alleged
knotty,and recondite questions,
Is insanityso obviously
alienation ?
states of mental
apparent,so glaringlyself-evident,and so palpablyon
uneducated
and inexperienced
the surface,that medically
tence
exispersons are competent,immediately to detect its
without
being assisted in their judgment by the
we

be

men

POPULAR

testimonyof men
careful study?

IGNORANCE

whose
Does

OP

215

INSANITY.

lives have

been

devoted

to iU

knowledge of the morbid pheno*

of mind
mena
(the most profound,and abstruse,of all
come
subjects)
by intuition,and is it dependent upon
the minimum
of time, that has been appliedto
amount
their investigation
?
Is the competency to
a
pronounce
and trustworthy
sound, scientific,
subtle forms
on
opinion,
of disordered
with the
thought in exact correspondence
smallest extent
of opportunity afforded of becoming
practically
acquaintedwith their phenomena? Such, I
fear,is the too cdEamonlyreceived view of the matter.
Agreeably to vulgar and popular notions, a person
allegedto be insane, is expectedto exhibit all the usual
teristics
characartistic,poetic,and melodramatic
stereotyped,
If a genuine lunatic,she must reof madness.
semble
and have piecesof straw permeating
poor Ophelia,
various

parts of

her

hair, and

tied round

the waist, and

and incoherently
by singingplaintively
insanity
would be considered as bond
snatches of melody. No one
fde insane, that did not foam at the mouth, gnash the
show

her

teeth, tear

hair, clench the

the

talk gibberish,
rave,
frenzy,"
foul fiend,"as
possessedby the
"

fine

"

Lear,"
on

is heard

the

to

and
Poor

converse

Tom

eyes
of
in

"

in

being
King

man
acting the part of the madthe ordinarycharacteristic
were

do, when

stage. If such

manifestations

fist,roll the

of the forms

of

with
insanity,

which

juries
in

to deal (in civil as well as

generally
inferenin the opinion,
criminal courts) I quiteconcur
the evidence
by Mr. Baron Brain well,that
expressed
tially
be disand may safely
of experts is quite superfluous,
of cases
usually
pensedwith. But this is not the type
The annals of our court*
Mil .initted to legaladjudication.
the criminal and
of law establish,beyond a doubt, that
belong to the class
lunatic almost invariably
homicidal

and

judges have

216

of

MASKED

AFFECTIONS

OF

THE

MIND.

quiet,cunning, subtle, clever, and what Esquirol

it is to see
How
a
madmen,
terms, "reasoning'
rare
tried for a capital
under acute insanity
person labouring
crime ?
of criminal cases, the lunatic,
In the majority
from a dangerous and homicidal form
althoughsuffering
of mental
and
derangement,has sufficient self-possession
control
his disordered thoughts,to converse
and
over
of
comport himself like a person in healthypossession
his reasoning powers.
that so
This is a type of case
often deceives
the most
conscientious judge, puzzles
panelled
imand perplexes
the most
painstakingbody of men
or insanity,
(as a jury)to try the issue of sanity,
like these present but few
Subtle
life,or death.
cases
difficulties to the practical
sant
thoroughlyconverphysician,
and well acquainted
with the phenomena of insanity,
of the insane.
with the physiognomy, and idiosyncrasies
and
He, alone, is competent to scientifically
accurately
obscure forms of mental derangement; he,
test the more
above allothers,is best able to discover,unmask, and bring
to be
It is,therefore,likely
to lightthe latent disease.
of justice,
fatal to the administration
to deliberately
most
tions
condisuch recondite
ignore,when analysingjudicially
of men
the valuable co-operation
of mental alienation,
of admitted
experience.
science,greatobservation,and of enlarged
demonstrative
The coarser, and more
symptoms
telligence
inof common
of insanity
are
obviously
patent to men
fested,
and ordinaryknowledge,but the less maniobscure and hidden types of mental disease,
more
elucidation,an intimate and
requirefor their satisfactory
well as
with the physiology,
as
profoundacquaintance
mind.
the aid of the
Without
of the human
pathology,
much
witnesses,juries
are
more
testimonyof experienced
than a right conclusion.
It
to arrive at a wrong,
likely
when
is irrational to expectany other result,
consider
we
difficultieswith whioh they have
the great and peculiar

EVIDENCE

IN

CASES

OF

ALLEGED

217

LUNACT.

to combat, when
generally
and disputed
subtle,
forms of
criminal insanity,
submitted to their consideration
are

and

decision.*

I do

not

venture

to

reconcile with

known

and admitted

facts,the singular
inconsistenciespervadingthe
public mind, on the subjectof insanity.A man
commits

suicide.
that

murderer

and

If

the

observed

inquestit is
the
catastrophe,

the

have

to

been

odd

blished,
esta-

self-

in

his

in spirits.
These symptoms
depressed

expertpropoundsin

an

coroner's

to
previously

was

manner,

At

are

court of law

in relationto an alleged
an
opinion
in strict conformity
with the experience
insanity,
of the great
bulk of men
practically
engaged in the study and treatment
of the disease,
and givesexpression
to views in harmony with the principles
of enlightened
science,he is exposed to the imputationof entertaining,
psychological
and
inculcating,
dangerous,
and, forsooth ! crotchettytheories. This insinuation
in often made
by ignorant,presumptuous, and conceited men, just as
a

of criminal

case

"

"

competent

appreciatethe

to

derangedthought,as

the

obscure,recondite,and subtle
house, sign painter,or scene

more

common

forms

of

dauber,

would

be, to estimate,
to their full artistic extent, the delicate and beautiful
colouring,
shading,and tints of a Raphael, Claude, Correyyio,Titian,
Carlo Dolce, Guido, "c.
Whilst
if I

this subject,
considering
perhapsit would
to correct

were

attemptingto
who

gross

from

the

in the

that
witness-box,

sanityof

gallows,a

at the

credited,that
generally

of the

not be deemed

of an
misrepresentation

tried for murder

was

and

rescue

who

idiot of the

Assizes,in

guiltyof the

was

I made

poor

York

it

opinionI

rule

expressedwhen
of Atkinson,

name

It

1858.

irrelevant,

reported,
when
declaring,
givetestimonyin support
was

of
imbecility
to

never

committed, and was tried for murder ! If

any
I had given expression,
I cerat the time, to such a
monstrous"
tainly
absurdity,
man

had

"

should be
than

the poor demented

to
evidence,

The
false an
were

to
disposed

believe that I

criminal,whose

was

farther advanced

much

life I

then

was

in

idiotcy,

by
endeavouring,

my

save.

statement

I made

the occasion referred to, and which gave

on

in
was
interpretation,

accused

and

tried for

substance

as

follows

murder, committed

"

some

I remarked,that if a
time

with

bond
t he

and
previously,

so

man

the

conceived to be the

urged in his defence, upon what was

quainted
practicallyacfide evidence of competent eye~tcit*etiet,
the
committed
time
he
crime.
tke
at
prisonertttate of mi*d,

pleaof insanitywere
strong, and

rise to

in a court of law (the life

duty to hesitate in pronouncing
of the prisonerbeingdependent
opinionof
upon my evidence)a tptculatici
direct
to
in
his perfectsanity
moral
opposition
of mind, and
responsibility,
I should consider it a

the
had

positivetestimonyof others, basingray

made

of the

of the

state
prisoner's

imputedcrime, and

conclusions

of intellect,
some

on

the examination 1

time aA*r the

to his trial.
immediatelypreviously

perpetration

218

MASKED

AFFECTIONS

OF

THE

MIND.

sufficient to

the jury as to his irresponsible

state
satisfy
out
is withof mind, and a verdict of
temporary insanity"
It
returned.
hesitation,in many
instances,properly
is notorious, that in these cases, jurieseagerlyavail
evidence
of mental
themselves of the slightest
ment,
derangeand appear pleasedto find,that they have a fair
and reasonable
for a verdict of lunacy. The same
excuse
jury,however, impanelledto try a similar issue before
another
tribunal, the question raised not being the
insanityof the self-murderer, but the soundness of
of a person
himself and
mind
and capacity
to manage
his
refuse
to recognise
property, will perseveringly
if estaand
the existence of insanity,
blished
even
incapacity,
by the clearest,and most conclusive medical
and
generaltestimony. The faintest,and minimum
mines
in the former
of proof,
amount
case, immediatelydeterthe verdict of the jury; the maximum
degreeof
evidence, adduced before a different court, is generally
required,and often set aside, as totallyunworthy of
fluenced
regard. The jury,in the one case, is most anxious (indoubt, by rightand charitable motives) to
no
of
of the suicide from the imputation
protectthe memory
ignorant
sanity; and in the second instance (totally
of the extent of desolation and miserythat are, alas ! so
families by an
tion
determinaoften entailed upon
obstinate
the existence
of insanity,)
not to recognise
they
stretch a point to shield the subjectof inquiryfrom
is unphilosophically
what
termed, the stigma of mental
derangement. If the evidence in the former case, so
of the coroner's
conclusive to the mind
demonstratively
blish
adduced, to estajury of the presence of insanitywere
"

unsoundness
tico

it would
Inquirendo,"

such

those

at

bring

commission
severe

attemptedto
inadequate
testimony.

upon

upon

of mind

who

"

De

and

censure

obtain

Luna-

proach
re-

verdict

220

MASKED

AFFECTIONS

OF

MIND.

THE

clearlyrender the person, allegedto be insane,

dangerousto himself as well as to others. A
positively
constituted,is incompetentto estimate
jury,as ordinarily
the delicate colouring,
tints,and shades of the ever- varying
phasesand degreesof disordered and unsound mind.
It often requires
educated
the well- trained and exquisitely
the
medical
artist to appreciate
eye of the accomplished
to

as

subtle

manifestations

forms

of mental

of

the

alienation.

and

obscure

more

person

whose

latent

ment
derange-

prominentlymanifested, has
therefore a reasonable
chance of obtaininga verdict in
his favour,and this probability
is very much
enhanced, if
he has been fortunate enough to retain for his defence
the services of an
and an eloquentand
astute solicitor,
and
sagaciousadvocate, fullycompetent to deal skilfully
them in
with the facts of the case, presenting
successfully
a most
lightto the jury.It is not my province
convincing
the lawyerfor doing his best to establish the
to censure
sanityof his client,even in the teeth of evidence clearly
proving him to be insane.* My objectis simply to
diable
attention to the serious and 'irremedirect professional
to
injurythat is likelyto accrue, unconsciously
of

intellect

is not

Much
of the legal
the members
vulgar abuse has been directed against
for the assumed
readiness they are allegedto exhibit in accepting
profession,
brief that may
be presentedto them, irrespectively
of the actual and
any
bond fide merits of the case
The counsel is
they are retained to advocate.
bodied
presumed to know nothingof the matter to be litigated
except what is emin his instructions.
It is his duty
With
these alone he has to deal.
such instructions,
and to do his best to conduct the case entrusted
act upon
It is not
rules of evidence.
him, in strict conformitywith the recognised
fore
of
his
vocation
in
of
the
sit
the
facts
to
case
a part
placedbejudgment upon
should he perceive,
him ; neither is be called upon to throw up his brief,
in the course
of the trial,
of the case is concerned)
that (as far as the justice
he is unfortunately
the wrong
on
side,and that the evidence is telling
against
to

to

the interests of the party he is engaged to defend.

Dr. Johnson
this matter in a correct light. In answer
to a question
put to him

has placed
by Boswell,

business
a lawyer has no
pointmooted, he remarked, that
with the justice,
of the cause
he undertakes,unless his client asks
or
injustice
his 'opinion,
and then he isbound to give it honestly.The justice
or
injustice
iu relation to the

of the

cause

is to be decided

"

by

the

judge."

"

DECISION

the lunatic

OP

JURIES

IN

himself,as well

CASES

OF

to the

as

interests of those

nearlyrelated to, and dependentupon

decision
at

as

command,
of

amount

him, by

to the state of his mind.

and

under

221

INSANITY.

an

man

his exclusive control,a

propertyis, upon

clear and

undoubted

neous
erro-

ing
hav-

large
dence,
evi-

allegedto be insane. It may be the wife, the

in the head of the
who, recognising
son, or the daughter,
familya state of mental unsoundness, has, with a view
of savinghim, as well as his familyfrom the
workhouse,
mooted
the question of his mental
capacity. The
allegedlunatic,unless acutelyderangedand demented,
denies the imputation,
indignantly
(a common
occurrence
in such cases)exhibiting,
at the time, much
natural irritation
and anger againstthose with whom
the allegation
has originated.The
becomes
case
matter
a
eventually
of judicial
to try the issue,
inquiry. The jury,sworn
confounded
by the eloquentand impassionedappealsof
counsel, confused
racter
chaby the frequentlyconflicting
of the medical evidence, puzzledby the apparent
of the party affirmed to be afflicted with
rationality
mental

alienation,
are

decision

the

unable

to

come

to

an

unanimous

insanityof the person

whose
is the subject of their investistate of mind
gation.
Nevertheless, if there be a majorityof the
jury in his favour, the person allegedto be insane is
fullyentitled to their verdict, and being declared of
sound
mind, is consequently
dischargedfrom all supervision
to deal
in a position
and control,and placed,
legally,
with his person and property.*It is not
as he pleases
as

to

sanityor

sion
presentstate of the law, there must be at a commiseither
before
of
verdict,
the
twelve
a
of
jury
way,
a majority
be received by the Master.
It often happens that the jury in number
can
amounts
to fifteen,
twenty, and five-and-twenty.In many cases, there an
and eight cr ten entertaining
often twelve jurymen for the sanity,
strong
Under these circumstances,
soundness.
opinionsadverse to a verdict of mental
*

Accordingto

De

the

Lunatico

the
appreciate
such
an
insane,escapingthrough
obviously
the

reader will be

able to

facilitiesthai
ordeal.

exist for persons,

222

AFFECTIONS

MASKED

difficult to conceive

been

able, thus

the

OF

which

course

cunninglyand

MIND.

induced

well

testamentary,as

influence

the combined

has

after

interests of

involved

by

under

acts, executed

other

as

take

to

being so liberated,and to what extent the

and
be fatally
his familywould
imperilled
his

who

person

to mask, from
cleverly,
jury, all evidence of his

eyes of a section of the

mental derangement,might be

the

THE

and
undetected insanity,
legally
towards
those who, influenced by
of

natural anger, directed

the kindest and most honourable

motives, have

incurred

proceedingsin the
displeasure
by initiating
view
of enforcing(for the
of Chancery, with
Court
a
man's own
advantage,)a statute of lunacyagainsthim.
be useless,if the claims of relationship
It would
to
were
after the execution of
be ignoredin a will,made
soon
the commission, by a person
smarting under what he
pute
conceives to be an unjustimputationof insanity,
to disIf
the death
of the testator.
its validity
upon
tamentary
such an attempt were
made, by raisingthe plea of testhe verdict of sanityrecorded
by
incapacity,
of Lunacy would, exceptin
the jury at the Commission
be viewed
valid and
and exceptional
extreme
as
cases,
conclusive evidence in favour of the will. Thus, misery

his

severe

be entailed

and

destitution of the acutest kind, would

the

ability
survivingrelatives of the unhappy man, by their inmade
of propertyclearly
to upset a disposition

on

of exercising
manifestly
incapable
a sane
judgment,and reflection.
memory,
I would
point out another anomaly in reference to
the state of the law as well as to the condition of public
subject.A man
opinionin relation to this interesting

when

the testator

commits

was

pleaof insanityis
conceived
mental

He

murder.

to

be

raised

bo/id

for the crime.

is tried
in

his

defence, upon

Jide evidence

derangement at

the

time

of the

of the

what

existence

murder.

The
is

of
The

ANOMALOUS

STATE

OF

THE

LAW

OF

223

LUNACY.

attemptthus made to protectthe criminal,immediately

the publicindignation.Such
rouses
is not in
an
excuse
instances listened to, and the unfortunate
medical
witnesses who have been called
to exercise

many

upon

portant, and

often

thankless

duty

in

support

an

im-

of

the

plea,are exposed,for giving an honest expressionof

to the most unmeasured
opinion,
ridicule,and vituperation.
In defendingthe
of the suicide from the
memory
that would
disgrace
verdict of felo de "et
a
accompany
the

evidence

of

the

medical

regardedwith great respect and

deference
the

but in the effort to

agoniesof
much

painfuldeath
strongerthan was
a

mentioned
abuse.

court, the

Instead

is
proving insanity

man

treated

rescue

adduced

expert is

profound

poor lunatic from

the

upon

with

scaffold,
on
before

dence
evi-

the

exposed to

viously
pre-

tigated
unmi-

of

beingconsidered as an angel
of mercy, engaged in the exercise of a holyand
righteous
and often treated
mission,he is viewed with suspicion,
with contumely,as if he were
attemptingto xacrijice,
instead of to save
human
life. Again, the attempt to
and
mental capacity
at a Commitprove sanityof mind
sion of Lunacy,with the objectof preservingintact the
of the subjectand establishing
his rightto an
liberty
unfettered management of his own
property,is applauded
to the very echo

but

the

endeavour

to

excuse,

on

the

act of crime consigningthe unhappy

an
pleaof insanity,
to be an
lunatic, to penal
wretch, alleged
irresponsible
of the public
servitude for life,or, alas ! to the hands
in unqualified
language,as a
executioner,is denounced
interference
and iniquitous
most
monstrous, unjustifiable,
will
of insanity
with the course
of justice.The
excuse

not, in many

by
to

cases,

tenanced
degreecounpress, in the slightest
the judge who triesthe criminal,or deferred

portionof

by

under these circumstances, be tolerated

the

the

by
jury,whose

duty it is to

decide the fate of the

224

MASKED

prisoner.

The

commission

AFFECTIONS

viewed

in

horrible

is

and

abstract

the

atrocity,

mind

public

of

OF

as

an

raised

eye

for

!""

forgetting,
of

frenzy
of
that

MERCY

!"

"vengeance
tooth

"

the

in

of

one

must

ever

sanctifies

"

The

throned

shout

The

! ""

tooth

of

be
and

monarch

"

is

the

Attribute

tenuating
ex-

the

majesty
with

enshrines

better

than

his

of

God

Himself."

for

eye
blood

!";
and

emotion,

by

tempered

an

for

indignant

the

cry

"
"

blood

*****

And

barbarous

The

is,

crown,

is

act

concomitant

engendered

violation

The

considerations.

of

feeling,

dreadful

which

its

the

at

and

great

all

paroxysm

excited

JUSTICE

for

shocked

murder.

brutal

medico-psychological
is

MIND.

violently

from

altogether

apart

THE

tion
contemplaof
that

the

law,

DIVINK

NEGLECT

OF

HABITS

OP

CHAPTER

The
IP

we

of
mysteries

VII.

Stageof
to

were

225

SELF-INSPECTION.

Consciousness.

scrutinize
closely

the inner mental

into the

fathomless

and
life,

fearlessly
analyse
the nature of the terrible conceptions,
that occasionally
throw
their dark phantasmal shade across
the anxious
and troubled breast,what
a
and
melancholy,
degrading,
revelation most
would
have
profoundlyhumiliating
men
make, of the dark

to

crevices of the human

and
faithfully,

were

secret

corners,

heart !

creatures

terror at the

of such ideas
possibility
soul's solemn sanctuary.*

neglectof

said to be
of

the

one

most

serious

would

cause

shudder

to

with

into
intruding

ever

and
of self-inspection
practice

of the

hidden

If this self-examination

executed, it
honestly

the best and fairest of God's

the

and

recesses,

self-interrogation,
is

moral
imperfection*,

and

intellectual,

and education.
present system of mental discipline,
confined, it is alleged,to listless,vacant persons, who
and waking dreams, but
glideover them amidst frivolities,

The

the

defect

permit life
is
to
perceived
with
themselves
external
those
and
who
objects
actively,
employ
intenwely,
among
An
able moral philosopher
observe*,when alludingto
to themselves.
is not

this

subject that, after a

For
to look within.
sternly
"

certain
a

periodof life,few

high degree of

moral

have

th"" hardihood
is

courage

requiredto

it is thus turned inwards

the mind, when
of years and years that
result
be, of the
a
disclosure,it may
itself;
which yields
nothing to reflection
passed over it in listless inactivity,

face the disclosure which

upon

have

awaits

which are seen

to be
of objects
in the eager pursuit
de"tructive
be
felt
to
of habits which are
worthies* ; or in the acquirement
be, of importantduties
of the health of the mind ; the disclosure,it may
overlooked,and the conviction that lifeis
and importantpursuits
neglected,
to begin. Few have moral
business is
while it*
to

but

empty void

an

drawing
courage
some
are

; or

close,

to meet

by

and, when

it is met

with

an

attention in

interest,the imprewionswhich
the force of confirmed moral habits,which seem

degreeadequateto
encountered

yet

great

this disclosure

its supreme

it yields
to

claim
Heoos

bondage.
and feeling
of the mind as theirs by hopeless
every faculty
habit of looking
the
life
in
the supreme
importance of cultivating early

226

STAGE

Moral

anatomy

OF

CONSCIOUSNESS.

intimatelyacquaintedwith
philosophers,
heart, have

of the human

often asked, who

the
has

pursuingwith remorseless
his every
footstep,
suggestingto his ever
impetuosity
and
active, and often morbidly disturbed
perverted
dark deed of crime,
of some
the commission
imagination,
he has at the time
from
the contemplationof which
mind is alleged
shrunk
What
back aghastwith horror ?
to be so pure and untainted, that has not been
disposed
when
and moral sense
the reason
to yield,
have, alas! been
and God's grace ceases
to influence
paralyzed,
transiently
gered
seduction
of impure thought,linthe heart, to the
with
the
contemplation
apparent pleasure on
nating
of physically
unchaste
images,or delightedin a fasciWho
has
dalliance with
criminal thoughts?
how
not conceived
easilyhe might, with his own
shuffle off this mortal
hand,
coil,"and penetrateinto
the dark and
mysterious secrets of futurity? What
heart has been, at all times, free from malevolent passion,
emotion, lustful feeling,
unnatural, and, alas !
revengeful
?
Is not
devilish impulses
pollutedby a
every bosom
dark, leprousspot,corrodingulcer,or portionof moral
?
Does
there not clingto every mind
some
gangrene
of the past,which
throws, at
melancholy reminiscence
times, a sombre tingeover the chequeredpath of life?
We
natter our
pharisaical
vanityand human pride,
may
by affirmingthat we are exempt from these melancholy
and sad states of mental
conditions of moral suffering,
firmity,
inbut, alas ! we should be belyinghuman
nature
if we
to ignore the existence of such, thank
were
God,
only temporary, paroxysmal,and evanescent conditions
had
not, occasionally,

demon

"

within

of rigidly
ourselves as to what we
practice
questioning
are, and
what
and
what our
are
are
we
our
mental
doing,
leadingpursuits,
habits ; what are our
and what influence over
the
plans and prospectsfor life,
moral discipline
have the solemn realities of a life which is to
whole of our
Dr. Abercrvmbie
the
Culture and Disciplineof the Mind."
come."
on
;

what

the

"

"

"

228

CONSCIOUSNESS.

OF

STAGE

themselves to and influencing

suggesting
my mind,
condition of thought,
and a sane
consistent with a healthy
?
I in possession
of my senses
state of the intellect? Am
this condition of weakened
tion,
voliIs this state of feeling,
and
these strange inclinations that appear, blindly,
of overt acts,
to the commission
to drive me
irresistibly,
to my natural character,so antagonistic
to my
so adverse
and knowledge of what is right and wrong ;
are
sense
of sombre
these scintillations of
these flittings
melancholy,
thought,so contraryto my nature, and opposed
perverted
of my being, the dawnings obscure,
to every principle
?
of approachinginsanity
faint tints,shadowy outlines
I mad
Am
and frantically
or
becoming so ? emphatically
the unhappy person subjectto this incipient
interrogates
and
disturbed
manifestation
of disordered
thought.*
sad doubts, fearful apprehensions,
Such
plicable
inexmysterious,
and distressing
forebodings,
misgivingsas to the
broken
healthycondition of the mind, often induce the heartsufferer,convulsed with pain, and chokingwith
and in accents of wild and frenzied
anguish,prayerfully,
with King Lear,
to ejaculate
despair,
those

"

"

"

O, let

"

Keep
This
*

In

not

poet

between

asks

the stoic

the former,

"

Heaven

be mad

"

of the presence

Damasippus

in what

kind

of

and

Horace

do
folly

you

of

mor-

(Sat.iiL
think

my

consists ?"

Qua

stultitia (quoniam non

me

Insanire

est genus

unum),

putas?"

adds,
"

"

in temper, I would

me

conversation

"

and

be mad, not mad, sweet

agonizingconsciousness

lib. ii.),
the
madness

not

me

Quid

?"

Ego

uam

videor mihi

sanus"

respondsthe Stoic,
"

Caput

abscissum

demens

Gnati

infelicis,"

cum

portatAgave

(and then immediately

asks),
"

It would

thus

Sibi turn furiosa videtnr ?"

this illustrious poet had a clear

the phaseof conscious insanity
of which I am
now
speaking.
appear,

that

of
conception

FORE8HADOWING8

bid

and

insane

OP

INSANITY.

229

ideas, painfulrecognitionof the first

approaches,and

of insanity,
foreshadowings
are
sionally
occaso
acute, and the mental
misery induced BO
and overwhelming,
crushing,
that relief from the terrible
sufferings
they occasion is occasionally
sought for in

self-immolation.
In the

I repeat,
incipient
the patient
stageof insanity,
is fully
sensible of entertaining
and unnatural
exaggerated,
impressions;is acutelyconscious of the mind
dwelling
morbidly,and sometimes
tain
irresistibly,
upon certrains of absurd,
and it may be, alas !
unhealthy,
very unholyand impurethought; he painfully
recognises
the fact,
that insane conceptions
are
strugglingto master
his reason, obtain an
ascendancyover his judgment,an
abnormal influence and control over
his passions,
and the
of his instincts.
In some
subjugation
(and this is
cases
and dangeroustype of insanity),
a distressing
pelled,
he is im(why and wherefore he knows not,) to commit

suicide,and
him

by

even

to sacrifice the lives of those related

to

the closest ties of

well as to give
as
relationship,
utterance to blasphemous,
and impure expresrevolting,
sions
! He finds it,occasionally,
and
difficult,
extremely
almost impossible,
to dismiss from the mind, and keepin
these morbid impulses
to acts of homicidal and
subjection,

suicidal
in

violence,or

grosslyobscene

to conquer

the insane desire to clothe

from
language,conceptions,

of which

his

delicate and

the

sensitive

templation
con-

nature

by disease, have instinctively

!
shrunk with horror,loathing,
and disgust
of high order
A gentleman of greataccomplishments,
and of admitted
of intellect,
of known
reputation,
literary
personalworth, had his mind for years tortured with
morbid
suggestionsto utter obscene and blasphemous
himself; and in a
destroyed
expressions.He eventually
letter which he wrote to me a few days before committirg
would, when

unclouded

230

STAGE

suicide, and

OF

did

which

death, he said his life was

by

CONSCIOUSNESS.

not

reach

until

me

embittered

and

made

after his
wretched

God that
suggestions
; but he thanked
he had never
once
yieldedto them, and that, although
ning
he was
in principle,
he felt he was
not sina Christian
with
againstGod by committing self-destruction,
the objectof effectually
destroyingall chance of his
giving utterance to thoughts that might contaminate
these terrible

the minds
In

and

the

morals

of others !

as
incipient,

well

as

in the

conditions of

fully-developed

the instincts, the coarser

parts
insanity,
of animal
mined,
bold, detera
nature, make, occasionally,
and vigorouseffort to forcibly
seize the sceptre,
and
exercise supreme
dominion
and despotic
authority
man's
An
over
awful, terrible,
sovereign reason."
tween
beensues
deadly, hand to hand" strugglesometimes
these antagonistic
elements.
The
reason
may
to this appalling
resist,"
(when referring
says Coleridge,
contest,) it does resist for a long time, but too often,
alas ! at lengthit yields,
and the man
is mad
for ever
!"
"

"

"

"

"

"

BISHOP

BUTLER

records

that

he

againstthe horrible morbid

struggling
them
termed
which, he
"devilish,")
maddened
of his
A

reason

him

if he
for

had

relaxed

singlemoment

the

was,

all his

life,

(he
suggestions
have
says, would
stern wakefulness

lady writes, can I obtain no relief for my acute

and horrible sufferings?Hell, with all its torments,
cannot be equal to the tortures I endure ! I feel all the
!
misery of a lost soul, all the agony of the damned
With
this heart-breaking
misery,I know I cannot be in
tered
adminis! Would
that I could have
right senses
my
of my
to me
some
opiateto deaden the sensibility
mad, and thus destroyall
me
poor brain, or to make
has given me
of suffering
! Dr.
consciousness
a
powerfulmedicine, but it is of no service. Night and
"

MORBID

APPREHENSIONS

OF

231

INSANITY.

day is my mind bewildered by this intense feeling

of
being,or going mad ! Do tell me
franklywhat your
I
opinionis as to my state ? Is this insanity,
or
am
known
becoming deranged?* Have
you
any case
similar to mine, and if so, did they recover
die in a
or
madhouse
? I am
advised to separatemyself,
for a time,
from
family. It breaks my heart to think of so
my
cruel

If I went

severance.

abroad, could not Col.

and

preciouschildren go with
my
travel is decided upon, where
would
go ?

Paris

years

ago,

poor H
would

did

never

miserable

am

with

agree

aggravate all my

the

me.

foreign
to

me

spent,a

associations

mental

If

advise

you

there, when

winter

sure

me

few

lost my
of the place

Last

symptoms.

night

sleep.Would
of
suggestions
diseased
and
sensitive nature
terribly
exquisitely
my
imagination. I cannot sustain this state of mind long.
struction
I have a nervous
horror of death, and yet I sigh for deI

closed my
that I could cease

in
eyes for five minutes
to think of the horrible

never

I had

I often wish

committinga sin if I were to commit

present condition of intellect? Would
I did whilst tortured
for what
sponsible
despairby these dreadful thoughts?"

suicide in my

I be

"

mind

Sir James

Minister

of the

Sir James
"

letter to Robert

in his celebrated

We

writes:

all accustomed

from

be

held

re-

driven

and

to

unhealthyand distempered

Hall. addre**ed

his recovery

Gospel,after

Mackintosh
are

of

alludes to this form

Mackintosh

Should

born.

been

never

this

to

distinguished

his firstattack of

insanity.

"

of
the suspension
with pleasure
contemplate

to

and even
to be amused
of the understandingin sleep,
ordinaryoperations
From the commanding
by its nightlywanderingsfrom its course in dreams.
the

you will
you have gained,
consider its other aberrations as only more
eminence

which

process of time they will

willthu* be delivered from
very evil dreaded;
a

and

the coiutatt

which,

greater calamitythan

darkened

any
the days of Johnson

realized
stantly

to appear

cease

themselves."

as

min"

dreams

; and

rare

than

sleepor

much
you
r*/c*
dread

more

to

it clouds the whole

temporary
;

familiariieyour
gradually

disease.

to

homble.

and the feaw of Rot"e"u

lot

often bnmgtot

of human

Some

in

life,u

dread of thu
seem

to lure

sort
coo-

232

STAGE

from

CONSCIOUSNESS.

that
ladyprayedpassionately

she

might be

relieved

the horror of the fearful delusions that tortured

imagination
by
of

OF

and
of reason
completedeprivation
consciousness,
exclaimingwith intense emotion,
Come

"

madness

Come

unto

I cannot

suffer this !

Scatter

these brains,or

her
loss

senseless death !

me

rocky wall,

Here

dull them

!"

"

JOANNA

BAILLIE.

Another

patientconfessed that she had resolved upon

committing suicide on six different occasions,and once
had a dose of deadlypoisonto her lips
; but her courage
failed when

thought of her dear children, the

youngest beingonly a year and a half old ! This lady
in possession
of her reasoningfaculties,
was
apparently
and was
perfectly
capableof managing, and did superintend
with
great skill,a large domestic household ;
hut she was
subjectto paroxysms of intense
occasionally
mental
associated with horribly
picions
impure susdepression,
respectingher husband, which she knew and
and entirely
confessed to be morbid
visionary! These
attacks
of some
were
days'duration, and on
generally
one

occasion

she

she

weeks.
talked

to

those

was

in this

Whilst
about

state of mind

the

her,

paroxysm

for four

tinuous
con-

existed, she

describingwith

painful
acutely

exactness, her
extraordinary
informed
me, that he
agonizingfeelings.Her husband
of
could detect the slightest
defect in her powers
never
in the reasoning faculty,
reflection,
or
judgment, or
At
time, whilst sufferinggreat mental
one
memory.
distress,wringing her hands in wild despair,and praying
for instant
annihilation,it was
sary
necespassionately
for him
her attention
to persuadeher to concentrate
to some
importantmatter of business,involvinga
that had occurred
circumstances
retrospectof minute
struck
with the
nearlyfive years previously.He was
minuteness

remarkable

and

accuracy

of her memory,

clearness of percep-

INSIDIOUS

tion, and

ADVANCES

soundness

OF

of her

MORBID

judgment.

with

Yet

this state of intellect did this

poor
impressions
to detail)
(too disgusting
about
which

she

knew

233

THOUGHT.

conjoined
ladyentertain
her

husband,

and

admitted were
creations of
readily
*ier distempered
imagination.
A gentleman,after recovering
from an unquestionable
state of lunacy,
confessed that for two
to
years previously
his believing
and actingin conformity
with his
tions,
concephe was
conscious of their being morbid.
perfectly
his mind
wavered on the subject
Occasionally
a
; but on
littlereflection,
he was
in the habit of saying to himself,
"nonsense!"
"pooh, pooh!" and then laughingat the
disordered thoughts. On
absurdityof his own
one
occasion,he attended
a
political
meeting where there
much
was
speaking,and great accompanying noise and
excitement.

about

him, took

active

an

in the

and
in the agitaproceedings,
participated
tion
that so generally
prevailed.This broughtmatters
crisis. It was
after returning
home
from the meeting

part
to

He, like those

referred

to, with

that he

his

mind

imagined he

in
saw

state

the

of

tion,
great exalta-

heavens

open,

and

revelations made
Then
to him.
a firm belief in
special
the reality
commenced
of his impressions
; he, in fact,
at that time emerging out of a morbid, but not yet
I am,"
!
insanity
deranged state, into one of positive
said a man
subjectto attacks of alienation of mind,
and of the
of thought,
fullyconscious of the operation
insidious advances of absurd, unreasonable, and
gradual,
when I am
no
morbid
thought,up to a certain period,
then passing
the mind
longer conscious of anything,"
into a disordered condition.
out of an unhealthy
Such
state as mine," writes a patient,you arc
a
with, notwithstandingall your
probably unacquainted
experience.I am not conscious of the suspensionor
"

"

"

"

decayof

any

of the powers

of my

mind.

am

as

well

234

STAGE

able

as

ever

suppose

CONSCIOUSNESS.

to attend to my

was

in

me

OF

health, yet the horrors

staringme in the face. I am

from within, which
persecution
I am
urged to say the most
and

obscene

words

tongue. Hitherto, thank

but

shall be
assure

often think

that I hear

God

ever

with

afraid that

you

would

of

my family
madhouse
are

martyr

to

of
species

becoming intolerable.
phemous
shocking things. Blasthe tip of my
ever
on
is

are

! I have

able to

been

sist
re-

yieldat last,and then I

I solemnly
and ruined.

voice which

prompting me to utter
disgustif uttered by

me,

I must

disgracedfor

you

business

what

to be within

seems

another.

would
If

turn

from

were

not

say there is no
articulate
extraordinary

smile, I should

of

accountingfor these
evil spirithas
but by supposingthat an
whisperings,
obtained possession
of me
for the time.
My state is so
I suffer,pain or
wretched
that, compared with what
evils."*
sickness would
appear but trifling
"with
"I have met," says a distinguished
authority,
confessed
than one
who
more
patientin privatepractice
that his life had for many years been rendered completely
miserable
by the constant effort requiredto suppress
their manifestation tended
morbid
when
even
impulses,
only to acts of follyand not crime."
A
pended
clergyman,who exvery active and meritorious
a large
portionof his small income in works of
told Dr. Wigan in confidence, that after hard
charity,
study or want of rest, this state of mind made him
and
that often when
greatlyapprehensiveof insanity,
there would seem
to be placedbefore his eyes
preaching,
some
profanebook, which the devil tempted him to read
he prayedfor aid
! That the more
in lieu of his sermon
himself ophe found
the more
againstthe temptation,
way

with

"

Essays

on

Partial

Religion."By

Derangement

the late John

of the Mind

Cheyne,M.D.

in

supposed connexion

Pp. 64, 85.

236

STAGE

CONSCIOUSNESS.

OF

sightof him, but was informed that

his fits became
great sensual indulgences,
aggravated,and he at last died of what
brain fever.
knew

moments

brain
A

not

was

The

persons

who

nothing of

his

he

into

entered
and

more

more

his friends called

at the last

him

attended

and
previoushistory,

the

examined.*

from
gentleman after recovering

attack
protracted

than
derangement,assured me that for more
nine months
priorto his losing all voluntary
power over
of his aphis thoughts and actions, he was
conscious
proaching
and of the presence of certain morbid
insanity,
trains of thought ! He was
in the habit of
frequently
when
acting in a most singularlyeccentric manner
walking in the publicstreets, grinning at strangers,
at
putting his tongue out, and laughing hysterically
he accidentally
He
involved himself
met.
persons whom
occasion in a serious altercation,
one
on
having hustled
ladies coming out of a placeof
againstsome
violently
which
led to an
publicamusement,
explanationand
apology. The patientinformed me, that at the moment
lie knew what he was
lost
about, and had not altogether
of self-government.At another
the power
time, when
of mental

it must

\"zpresumed he

was

on

the brink

of

an

attack of

he began repeatingwith extraordinary

insanity,
and accompanyingenergy
of muscular
action,a
rapidity
words.
He continued
stringof unmeaning and unintelligible
for nearlyan hour utteringthis jargon as he was
walking towards the city. He was fullyconscious of
and recognisedthe folly
the nonsense
he was
of
talking,
his conduct, but the disposition
to so indulge,he says,
was
defyingall power
fascinatingand quiteirresistible,
of control ! At other times he was
quitefree from these
oddities,and comportedhimself with singular
propriety
actual

and

decorum.
*

Wijjau's Dualityof
"

the Mind," pp. 237, 238,239.

ILLUSIONS

On

another

PREMONITORY

he

occasion

OF

237

INSANITY.

ters,
printedin largecharacridiculous and unusual name
a
a placard.For
on
hour and a half he kept repeatingthis word until he
an
of muscular fatigue
!
was
obligedto stop from feelings
This gentlemanbecame, at the expiration
of nine months,
quite insane, imagining that he was pursued by the
policefor the commission of an offence he had committed
againstpublicmorals. This was a completedelusion,
which
of treatment
after a few months
sipated.
diswas,
entirely
'A
three

gentlemanwho,

when

he

his paroxysm,

in

insane,attemptedto murder
assured

different persons,

heightof

saw,

felt

that

me

if his mind

as

In another

dark cloud

during the

case

were

of homicidal
sacrifice

whilst being impelledto

the patient,
insanity,
the incontrollable desire

lifeunder
that

might

divert his attention from

to commit
his

veloped
en-

own

some

act

harrowing

confessed that for some

days before the murder
thoughts,
He believe!
tinted with blood.
was
everythinghe saw
faculties first sugof the perceptive
that this perversion
gested
the

to his mind

dreadful

crime

which

he

quently
subse-

perpetrated.
patientoccasionally
scious
suffers most
acutelyfrom phantasm*. He is quiteconillusions being dependent
of the spectral
upon a
faculties
disordered state of the visual and perceptive
and hepaticderangement),and
(oftencaused by gastric
In

this

is able

to

stage

reason

of

insanity,the

with

himself, and

talk

to

others,

their nature and origin. I have often been

respecting
cination.
from this type of halluconsulted by patients
suffering
These

cases

are

not

difficult to

cure.

One

followed by
gentleman,for three months was constantly
to a remarkable
terrible spectral
image, resembling,
a
had
brother who
degree,in figureand countenance, a
whilst at sea!
himself twelve years previously
destroyed

238

In this

that he

CONSCIOUSNESS.

to
patienthad, previously

the

ance
appear-

hallucination,complainedof headache, great

and
depression,

nervous

took

the

case,

of the

the

OF

STAGE

for

never

moment

one

When

image.

he

sat

opposite!

his seat

lowness

of

spirits.He confessed,
believed in the reality
of
down
to dinner, the spectre

If he walked

in

the street,the

phantom was by his side ! When

travelling
by rail,the
seated in the same
! The patient
was
apparition
carriage
of good strong sense, possessing
a
man
was
fortunately
and severely
standing.
undera vigorous,
well-cultivated,
disciplined
He

was,

therefore,competent to

reason

with

himself

in relation to the illusion,

and to
philosophically
that might occasionally
exist
keep in check any disposition
of the spectral
to believe in the reality
ally
image. He eventuwith his mysterious
partedcompany
phantom,but not
until he had a severe
attack of confluent small-pox,
which
nearlyprovedfatal. After recovery, he never complained
In a second case, a lady said,that
of the hallucination.
made
wretched
her life was
by a similar illusion of the
She was
tortured by a number
of singusenses.
constantly
larly
dressed in most fantastic costumes.
grotesquefigures,
These
phantoms danced round her during the day, and
at night,appearedabout, and sometimes
in her bed.
It
with
she could obtain continuous
was
great difficulty
and
for one
refreshingsleep. This patientnever

believed in the material character of these tral

specillusions.
She was
in the habit, occasionally,
of

moment

taking sketches
many
A

back

of which

was

these

curious

permittedto

phantasmal figures,
see.

ject
worthyclergymannow under my treatment, is subto the most
singularaural illusions. Several years

he had

the neck.

in the

severe

attack of carbuncle

at the nape

of

from this affection,

he beganto
recovering
audiblyspeak to him.
They often addressed
Welsh
language,
occasionally
usingparticular

After

hear voices
him

of

SINGULAR

CASE

OF

HALLUCINATION.

239

phrases,idioms, and

that he had
endearingepithets,
in fortyyears previously
indulging
to his wife.
He
is rarely
free from

been in the habit of

when

paying court

the influence of this conscious

The

of
particulars

illusion.*

the

followinginteresting
of
case
hallucinations were
communicated
in writingby the
to the physician
lady who was their subject,
who
young
attended her, a gentlemanof great experience
in mental
affections
"I

"

born

April9th, 1840,

and

just

19.

My
think, though
child I was
a
as
delicate,owing to over
study. My
temperament is melancholy though not gloomy. I
seldom, if ever, suffer from what peoplecall the blues.'
My mother's uncle drove himself mad tryingto solve
the problem of perpetualmotion.
My father never
exhibited any peculiarities
of mind, or saw
until
visions,
his last illness. He alwayshad a presentimentthat he
was

health is

good,and

constitution

am

strong,I

'

should

die when

about

43

or

years of age.

44

but alwayslaughedat
superstitious,
"

The

first time

alarmed

was

I think, in 1855, when

One

day

gone

to my

On

one

writinga
he

was
room

occasion

was

preparingto
earlyin the
he

waa

seated

by

by

then heard

the voices

visit to

a
a

side whilst

layout

to
I

wax

had
my

occupiedin

asked, whether
tinctly."
replied, Yes, quitedis-

abstracted, I
He

speukingto him r"

are
they saying?"
they are not very

Ireland.

party, and

afternoon
my

not

apparitionwas,

an

attend

Appearing somewhat
prescription.

was

visions,as fancies.

my

on

He

"

"

rejoined, I would rather

not repeat the words, as
complimentaryto yourself."
what
observations these unseen
After begging him
me
spirits
to inform
t
hat
he
were
about
ejaculating,
they
were
replied
us
making,
hovering
abroad ; remain in England ; don't do
don't leave your living
; don't go
I said, "what

He

"

"

what

he

recommends, don't take the medicine

he

I
prescribes."

had

deavoured
en-

importanceof his relieving

to impressupon
clericaland parochial
duty.
himself for a time from all anxious and responsible
I advised a continental tour, with a view of trying the eflectof a thorough
having found in cases similar to his, roorh
change of air and scene,
this

benefit from this mode

of treatment

Whatever

the

for the
suggested

health,these imaginarypersons
clergyman's
to oppose !
uncourteously,
of this

most

mind
patient's

lishment
re-estab-

did their best,

240

CONSCIOUSNESS.

OF

STAGE

readyfor the evening; also to sew some rosettes on

shoes, in which I was
engaged just in front of the
my
where, glancingup, I saw reflected a face
looking-glass,
shoulder.
not
I was
with
my
grey hair, looking over
!' worked
foolish I am
on
a
afraid,but thought, How
still there.
and looked up again. It was
little,
Trying
clothes

'

to believe

had

looked

then

seconds, and

deceived, I worked

been

and

again
"

uncle, who

my

When

then.

month

had

of the

brother

youth of
hazel

like to tell
I

He

appearance.

Arrived

that he liked

for fear of

me,

returned

England,

to

I went

One

of
altogether

remained

the

home

placeso much,
was

to visit

that

us

very unfor about

in

India, he

regularly,
saying
it agreed with him

better in his life.

never

morning, either

with

appointment

an

there he wrote

well, and that he

"

two

or

three

days

after what

Guy Fawkes' day/ (5th of November,) I

clear,which
suddenly with all my senses perfectly
call

we

"

the

strange as

more

The

arouse.

could

inches
not

being about

had

opened
bending over

of mine, his eyes

withdraw

my

so

to the curls of his

my

saw

woke
was

difficult to

most

eyes, I saw
my
his
within
face
me,

fixed

It

gaze.

eightor after,and

dress,and, even

been

ever

moment

friend,George B
few

were

the face in the

seen

lady whom

young

months, when, having

left us.

so

I had

curlyhair, and

eyes, very

mistakeable
two

if anything

that all

me

re-

He was
a fine
stay at our house for a time.
and peculiarly
earnest
twenty, with very large,

to

came

to

better
very ill,but was
later I returned, I learnt that he

just about the time

glass; but that they did not
spoilingmy pleasure. When
the

to ask

was

been

died

had

not

room,

few

it

there

I ran
from the
Thoroughly frightened,
Next day I wrote home
enter it alone.
the matter.
was
They answered

well but

for

on

was

he

into mine

broad
was

that

daylight,

in his usual

hair,lookingas distinct

SINGULAR

in form

CASE

and colour

OP

C II

HALLUCINATION

living
figure.Much surprithough not in the least frightened,
but, on the contrary,
most
a
experiencing
unearthlycalmness (as I always
do when
He

also

see

as

these

I arose
visions),

till he

to

sitting
posture.

stood

and still looking

upright,
at me, he receded a few steps,
then disappeared.
earnestly
I did not feel alarmed,but got up and dressed at once,
I told my friends theyshould
for fear that when
say it
All that day,wherever I went, a ceaseall a dream.
was
less
knockingfollowed me ; and, thougliour house was
I heard it in every part. If I went
into iny
very large,
I heard it there on the toilet-table,
and
dressing-room,
in the drawing and dining-rooms,
ferent
though each on difstories. Going throughthe halls and passages, it
rappedalongthe walls. In fact,I heard it everywhere,
exceptin the streets. My friends laughedat me, when
I should htar some
I said I was
evil of George.
sure
A
to
room
day or so after, I went from my own
sleepin that of a young ladywho was stayingwith us
and
double-bedded
It was
at the time.
a
large,
room,
the nightwas
brightand moonlight. The candle had
littletime, and my friend was
been out some
as
asleep,
I could hear by her heavy,
regularbreathing.Suddenly
the door at the foot of the
I saw
white figure
near
a tall,
close to me.
bed.
It walked rightup on it,and came
I
walking in her sleep,
Thinking it was Miss B
! where
! oh, Miss B
sprang up, saying,Miss B
her.
time tryingto clasp
are
you going?'at the same
and then I knew it
My arms went through the figure,
I cowered
Somewhat
mortal.
now,
was
frightened
no
than ever convinced
more
down, and ere long fellasleep,
either dead or dying. Very
that my friend George was
arose

"

'

on
on

afterwards
the

8th

of

heard

that

November,

the

we

he

had

date

of

died of fever
the first ap-

irance.

242

STAGE

This

"

CONSCIOUSNESS.

OF

happenedin November, 1855, and

mamma,

I asked
sister,

her

to

settled in

Canada, and

May we came
evening,papa,

the

following

One
.

myself,were invited
to spenda social evening,
to the house of an acquaintance
with cards,music, "c.
inclined to jointhe
Not feeling
I sat down
ably
unaccountat the piano,
feeling
card-players,
sad.
The door was
just,or rather nearlyopposite
to me, beingon
the left of the piano. Of a sudden I
looked up, and was
astonished to see poor George B
standingin the doorway,the lightsshiningfull on him,
and
he lookingearnestlyat me.
Thinking I had
I playeda little,
and looked up.
deceived myself,
Yes,
there he was, without doubt.
I turned away, playedon,
then
there.
looked again; still he was
Callingmy
Not

went.

the

looked to

we

told

place. I
the 8th

was
"

The

see

rather

or

"

"

occurrence

the month,

day of

had

nobody

"f the

mamma

the

hall with

into the

go

we

We

me.

been
and

found

near

when
that

it

of November.
time that I

next

just before

to

soul

sister,and

left G

we

anythingof

saw

to
,

to T

come

the kind,

was

I had
.

something. The girlwas in

the garden,
and I distinctly
a
saw
woman
standingin
all
the doorway. A few evenings afterwards,we
were
burned
two
which
the supper-table,
around
on
sitting
dressed in
I saw
when
a
woman,
largespirit-lamps,
chair. Leaning on it,the
black, standingbehind papa's
lightfell full on her. She was a strangerto me, and
gone

bore
the

into the kitchen

no

resemblance

time, but

do

for

to any
now

one

think

it

knew.

was

I did

warning

not at

of my

papa'sdeath. I told him, and, as usual, he laughed at

and
tilljustbefore my papa's
I saw
me.
nothingmore
delicate at the time,
sister'sillness. My health was
at this
owing perhapsto change of climate. We were
time in T
in Ann-street.* One evenand residing
,

244

OF

STAGE

four

disturb

nervous

nor

but

mamma,

tillpapa
longer,
nervous
see

think.

fancyI was
may
excited,when I tell you I did not
four hours
sat there for three or

seconds,I should

neither

or

Papa

was

illwhen

lookingso

me

in.

came

excited.

CONSCIOUSNESS.

You

own

shocked, but not

was

and
surprised

he

grievedto

and attributed

came,

it to

I
beingup too late. Not wishing to frightenmamma,
said nothingabout the vision tillnext day ; when
papa,
anxious to dispel
child,
my fears,said : Why, you silly
what nonsense
! Here am
I, strong and well,and yet
since,when I went to bed, I saw opposite
a nightor two
bed, myselflying dead on it ; and every time I
a
me
opened my eyes I saw the same.' Within a week from
and died in a few weeks.
this he was
taken ill,
During
the last week of his illness scarcely
a nightpassedbut I
saw
some
apparition.The^first time I was disturbed
was
justabout a week before his death. I was lying
'

awake, not at all

for I had

nervous,

that I should lose my

papa.
wall, when I felt the pressure
Ice-cold
pillowbehind me.

face

My

the

not

turned to the

was

heavy hand
touched me,
fingers
as

of

encircled my neck.
Such horror
that I must have become insensible,for sense

women

in

bedside.

What

saw

that

papa was
besides mamma

looked

care,

nurse,
no

was

poor

room,
or

white, and

up

saw

and

more

ill. She
influenza

from

the

papa, who

strangewoman

another

at the
;

time of

this to

night
in

women

the

entered,

requiredour unceasing
in black standing behind
After

till my

She

his death

sister

papa'sdeath

nothingserious.

lection
recol-

all the

When

nurse.

at the door.

of them, at least not

two

saw

me

black, at my

in

strange,too,

dying, I

and

papa'sdeath,I

of

sometimes

very
and

time

the

and

seized

mentioned

morning

that week, to the

All

mamma.

Next

me.

on

cold hand

left

least idea

was

had taken

saw

seriously
.poorlywith
a powder to

was

SINGULAR

OP

245

HALLUCINATION.

the previousnight;
perspiration

induce

about

rushed

round

from

her,and

herself down

her

hearing,

cries,that papa

our

bed without

kissed him

but

justas

was

throwing anything
he breathed his

she refused to go to bed again,

threw
with her head
the rug in the parlour,

Then

sigh.

on

in lying,and
kept
persisted
which
was
foolishly
callingfor brandy-and-water,
brought her by the servant and nurse, we being too
distracted to notice anything. The consequence
was,
she became feverish,and was
obligedto take to her bed.
In the meantime, I bore up as well as I could, feeling
vour
that as eldest child I should not give way, but endeato

the

morning,from

next

seven

going,she
last

CASE

fire,where

the others,and

to comfort

nightI

she

shed

never

mamma

poor

till

so

in with every

tear, but went

one

lay. But in the evening,I

and had hysterics.
could not restrain myselfmy
longer,
On one of these occasions,a gentlemanfriend carried me
when
into the street for air. It was
very quiet,
fainting
suddenlywe both heard a loud voice,coming from we
in distressed and agocould not tell where, an4 saying,
nized
to
as
tones, Fanny, Fanny, Fanny !' as much
so !'
distress yourself
say, Oh, do not, I entreat you,
called to where

who

papa

'

'

In

said

once.

him

moment

the voice,but

word

about

Next

day he

had;

was

women

'

stairway.I

was

about
a

seven

lamp in

in black at the
waa

day or

to sit with

sister'sroom

the stairs with

robed

better,for nothingcould be

I knew

to my

lonely.It

I ascended

at

I told

if I had heard it.

me

the voice and words.

distinct than

afterwards,I went
she

entered the house

us

and, seeing that the thought greatly

one
some
he added, Oh, I dare say it was

me,
agitated
callingHarry !' but
more

asked

neither of

strong. We

calm and

was

in the

my

top,one

two

her,M.

evening. A*

hand, I

saw

two

each side of the

too deeplyto feel fear, so

suffering

246

went

The

on.

I entered

As

behind

each

the

to

make

time

saw

knew

spectre.

until
figure,
one

some

the

was

the house
we

went

at the door-bell woke

me.

papa
several

deceived, and
the bed

on

I could bear

else to take my
could

house

the
next

them.

saw

I looked

down

sat

day

at once,

or

the

see

said

too, should

we,

of

it

place,

doctors

the

to the house

a few
days after
evening,

One

"

the

else in

it

so

lay,I

been

not

there.

one

I think

have the fever

had

I called

all leave

must

we

him

no

sister

my

neared

lookingvery pale.

sure

when
longer,

for

where

room

back towards

with my

CONSCIOUSNESS.

as
figuresdisappeared

the door,

times

no

or

STAGE

friend.

a loud ring
arrival,

my

I started

up, and

as

saw,

imagined,one of the ladies of the house by my side. I

and it vanished ; and
at the same
spoketo the figure,
time I heard my friends saying something about
poor
called
I
to
alarmed,
fireatly
Sophia,'
my sister'sname,
I had seen
I was
them to bringa light,
some
one
as
sure
'

in my
that

room.

then

who

asked

earlyhour (about four

or

five

it

that

was

rang

o'clock).They

at

told

change in
favourable change,
sister. I thoughtthey meant
a
my
so fell asleep,
hopefulthan I
happierand more
feeling
The same
had felt since papa'sdeath.
day my friends
broke the hidingsof my sister'sdeath to me
as
gentlyas
possible.It had taken placeabout three o'clock in the
had at once
sent to acquaintus
morning,and mamma
with the melancholyintelligence.
From
that time till last May I saw
nothing. Last
I had been out, walking about with a
Queen's-birthday
in, and I
eveningwe came
gentlemanfriend. Towards
I had
to change my walking-dress.
to my room
went
and had
only to get on my
nearlyfinished dressing,
when, turninground, I saw papa standingnear
slippers,
it that I felt frightened,
the door.
So distinct was
and,
it

me

"

was

one

sent

out to say that there

was

SINGULAR

snatchingup
I reached

the

CASE

OP

the

lamp,I rushed from

where they were
parlour,

re-assured and somewhat

247

HALLUCINATION.

ashamed

the

When

room.

all sitting,
I felt

and,

in my

as

hurry

I had

I determined
to return for
forgotten
my slippers,
them.
So, takingthe lamp,I opened the folding-doors
between the front and back parlours,
and ran
up against
the figure.I met no resisting
power ; had I done so, T
should have hurt myself severely,
doubt.
I was
no
I saw
it, and rushed back to
greatlyagitatedwhen
who
mamma,
inquiredwhat was the matter with me,

I looked
"

One

called.

so

ill. I told her what

some
night,

He

had

months

I had

seen.

after this,a

gentlemanfriend

been

long present before I had

for something. I did not take a
occasion to go up-stairs
lamp,not being afraid,but went in the dark. Coming
down, justas I reached the bottom of the stairs,I saw
A
soft
a
papa standingwithin
fgptor two of me.
He was
phosphoricradiance seemed to surround him.
distinctly
by the strange light,
very pale,as I saw
I was
though all was dark around me.
very much
I should
have to pass close to him to reas
frightened,
I ran
to reel as
enter the parlour. My brain seemed
where they were
desperately
past and gained the room
all sitting. When

not

told

how

them

had

been

alarmed,

some

one

went

into

passage, but

saw

horrible vision I

ever

the

nothing.
"

The

had, was

last,and by far the most

on

the 8th of December

last

(1858). I woke

burns a
morning before dawn, but, as mamma
had
lamp every night,it was quitelightin our room.
been awake
about ten minutes or a quarterof an hour,
Howev
I would.
do what
and could not go to sleep,
I did not
occupied,
was
as
very pleasantly
my mind
Of a sudden I heard a heavy stamp, as if
mind much.
were
some
one
tryingto attract my attention by stampup

one

248

STAGE

ing with
saw

OF

the foot.

CONSCIOUSNESS.

raised my

head, and to my

horror

old person, who might have been

a
man
or
a
figurehad on a white dressing-gown,
; for the

an

woman

and

not

see

kind

of

skull

black

hair, or

any

I could

Glengariff
cap.

or

should

have

been

better

able to

The
face was
that of a
judge of the sex.
corpse,
and
drawn
The
illness
and
old
pinched
by long
age.
turned towards
and was
delicate and
profilewas
me,
and clearly
defined againstthe wall at the side
regular,
of it.

other

One

hand

was

the chest

across

down.
hangingstraight

better to make

hanging in
have

been

my

that

rose

observations.

part of

the

or
on

There
so

room,

waist,and the

were

no

that

the

elbow

my

clothes

could not

by anythingof that kind. It stood

each
side,and as I gazed took three steps,
by mamma's
accompaniedby a heavy stamp, and stoppingat every
cal^ while taking in all these
step. I was
perfectly
but after the third step I was
overcome
particulars,
by
terror, as the figurewas
coming round my side ; and
if even
her tinyform would
as
clasping
my littlesister,
I prayed that the Almighty would
yieldme protection,
I only
the vision,and cause
to wake.
remove
mamma
heard

deceived

step after that.

one

to tie
as
pillow,

all

was

woke.

I knew

knot

would

Just

as

few

minutes

handkerchief,under

in my

mamma

dream.

After

was

say in the
about

this

spoketo her,and takingcourage looked at

about
watch, and found that it was
twenty minutes
six.

I did not

mention

or

rather until it was

forewarningof

what

light. I
either

my

death, as theyhave

had

seen

tillnext

feel convinced

the
it

morning
do

to

termined
de-

she
my
to

day,

that it was

or
mother's
grandgrandfather's
of
both been failing
rapidly

late.
"

forgotto

last,and which

mention

one

should have

case

had

happenedbefore the
the precedence.One

that

INCUBATION

OF

morning,in March, 1858,

in blue cloth

coat, with

by

the side of my
Mr. G
the

poor

my
and
startled,
at the

it vanished.

Next

day we

about

the time

that he
he

time

saw

case

told

to

knew

loud

in

mamma,
'

Why,

few

of the

ters
mat-

notice it

to
I

got home.

told

was

hear.'

my bed-head.
minutes
heard

for

I could

saw

been

not

heard it

than

more

enough,a

father had

few

it

sound

again.

I told
some

quarter of
that

I could

the window.

if there had

see

nothing.

been any
I

mamma
one

It

we

was

one
sure

knew

and

heard that my aunt's

dead in his room,
justabout the

weeks

been found

again at

hear of the death of

should

my
After I woke

'

awake

and
daylight,
but

from

'

Afterwards

aroused

was

"

hour, and there has

been

Hear what,
you hear that ?'
that loud knocking.'She said, Why,

an

sure

was

it till I

Do

have

we

nothing of

knockingat

there

us.

forgotto mention, occurred,I think,

'

child ?V-

was

face I could not

when

mamma

in last November.

listened,and

said

His

just like

that poor G
had died at just
his figure.I had not even
heard

and
ill,

was

sleepby a
I

violinist.

heard

Another

some

velvet collar,standing

dead.

was
"

turn-down

between
pupil'shead came
screamed, thinkingit was
one
first glance. I just had time

as

when

was

pupil. His figure

was

see,

249

givinga lesson at Miss

here,and, looking
a thin man
up, I saw

'8 school

INSANITY.

after

we

knocking. I was a favourite of his

when he was
living.
remember
I cannot
anythingmore now ; I think I
that I have ever seen."
have mentioned
every apparition
Accompanying the other symptoms characteristicof
the following: The
the stage of consciousness, are
mind is harassed and bewildered by odd notions,unusual
time I heard

the

"

"

"

"

American

Journal of

Imanitj."

Oct

I860.

250

OF

STAGE

CONSCIOUSNESS.

tions,
unnatural
trains of thought,strange inclinafeelings,
intense irritability,
unequal powers of attention,
disturbed, and sometimes
confused, irregular,
painful,
ings
ludicrous association of ideas. As these unhealthyfeelare
forcingan entrance, and tryingto obtain a
tated
settlement in the mind, the patientis vexed, and irriwith himself for permitting
them to intrude upon
the sanctity
of his thoughts. An heroic effort is often
tions
scintillamade
and dislodge
these morbid
to dissipate
be accomplished,
of insanity,
this cannot
or, when
conceal
their
and ingeniously
to studiously,
artfully,
existence from
morbid

others.
of

aversion

itself into the

parent to

secret

his children
of

recesses

twining
en-

thought;

"

growing,unreasonable, and unaccountable dislike to the

companionshipof old friends,(often to those formerly
and
dearly and tenderlyloved,) creepinginsidiously
givings
misinto the mind ;
stealthily
strange,inexplicable
"

motiveless,unaccountable, and

"

unreasonable

to the affection of a loved son, a favourite

as
suspicions
to
and tenderly
attached daughter; apprehensions
as
doubts as to the constancy
the chastity
of the wife;
and fidelity
of the husband, flit sometimes, like a thick
"

"

shadow, and

mist, dark

morbidlydisturbed and
is imagined to
*

There

whilst

no

delusions

so

commenced

have

across

the

its

ravages.*

fatal in their consequences, as those

Many valuable lives have been sacrificed

sad and

the

from
suffering

in his

dream,

sanity
mind, years before in-

anxious

of the wife.
fidelity
frightfully
dangeroushallucination.

to
relating

to this

are

troubled

this delusion.

For

man

many

was

months

confined in
this idea

an

was

asylum
most
upper-

mind, and appearedto absorb all his thoughts. At the expiration

appeared to be much improved in bodilyand

less hold of his imagination.
mental health,and the delusion had apparently
mind
h
e
that
his
declared
was
quiteat ease respecting
Eventually, cunningly
his wife,and that he no longerbelieved that she had or could have been unfaithful
in pressionthat he had recovered,the
mistaken
Under
to him.
a
In
home.
to return
patientwas dischargedfrom the asylum,and permitted
of

eight or

about

week

nine

or

months

ten

he

daysafterwards,he

murdered

his wife and child,believ-

252

OF

STAGE

will,for

time

CONSCIOUSNESS.

playwell

to

his

part,and

thus

disarm

all suspicion
to his actual condition of inebriation.
as
Such

is often the state of

person in the

incipient
stage

of

and it may be successfully,

insanity,
battling
courageously,
with eccentric,
unnatural, odd, singular,
impureand
mental impressions,
the firstbeginnings
unhealthy
clearly
and earlymanifestations
of derangementof mind.
A clergymanof the Church
of England,who
had led
and active benevolence,became
a life of Christian purity
the subject
of this type
(as a consequence of over-study)
of mental
He was
in the habit frequently
disorder.
of
knocking his head violently
againstthe mantelpiece,
until

the

skin

covered

was

with

contusions, in the

fruitless

impure
struggleto dissipatethe physically
that originated
luntarily
invoimages,and blasphemousthoughts,
in his mind.
This patiententirely
recovered
his reason
after the lapseof nine months.*
*

With

what

knowledge of the human mind has Dr. Johnson

when the intellect,
to a certain
still,
incipient
stage of insanity,
degree,conscious of the dawnings of morbid thought,endeavours to struggle,
of a disordered
and, for a time does so successfully,
againstthe suggestions
and rampant imagination. I refer to his account
in
Rasselas"
of the
astronomer's
well as
as
of,and conflict with, delusive impressions,
recognition
his description
his
of their eventual and melancholy
over
reason.
triumph
for five
I have possessed
Addressinghimself to Imlac, the astronomer says,
of the weather and the distribution of the seasons
; the
years the regulation
has listened to my dictates,
and passedfrom tropic
tion
directo tropic
sun
by my
flowed
call,have pouredtheir waters, and the Nile has over; the clouds,at my
command
I
of
the
and
at my
have
restrained
the
Dog-star,
;
rage
the
fervours
of
all
the
elemental
of
the
Crab.
The
wiuds
alone,
mitigated
and multitudes have perished
by
powers, have hitherto refused my authority,
which
unable
restrain."
I
found
to
o
r
equinoctial
prohibit
myself
tempests,
other cause," said Imlac, "produce this concurrence?
Alightnot some
Tbe Nile does not alwaysrise on the same
day."
consummate

portrayedthe

"

"

"

"

Do

escape

could
believe,"said he, with impatience,that such objections
"

not
me

againsttruth

reasoned
with

madness, and should

you,

capableof

long against my

the utmost

obstinacy.I

have dared to

not

sometimes

impartthis

the wonderful
distinguishing

laboured

conviction, and

own

from

suspectedmyself of

secret but to

the

man

and
impossible,

like
the

incredible from the false."

"

Why, sir,"said I,

think you
"

know

"

do you

call that

incredible which

to be true ?"

Because,"said he,

"

I cannot

you

know,

or

prove

it

by any

external

and
evidence,

INSANE

In

IMPURITY

OF

THOUGHT.

the

if it be of
insanity
(particularly
the puerperaltype) is characterized by a
singularly
of thought,
connected with a mordistressing
perversion
bidly
exalted state of the reproductive
instincts. The
conversation
is, in these cases, occasionally
tinctured
with expressions,
from the contemplation
of which the
have reunhappy sufferer would, like a sensitive plant,
coiled
when
in health.
The
gentlestof the sex, the
purest and most delicate of feminine minds, pious,
refined,
some

women

and

the

cultivated of moral

natures,

often,alas!

are

firstto exhibit,when

from particular
suffering
types
of mental derangement,
this painfulmoral and psychical
degeneration.Such melancholymanifestations of poor
human
and often destroyed
nature, fallen,crushed, perverted,
of the world,
by disease, suggest to the man
and moralist,sources
of
theologian,
medico-psychologist,
for grave philodeep and profoundthought,and subjects
sophical
to reflect,
meditation. It is,however, consolatory
that the mind
terious
may
pass throughthis terrible and mysphase of alienation intact, emerging from the
of moral
remnant
fieryfurnace without the slightest
! How
true it is that,
contamination
taint,injury,
or
"

May
And

minds
pass through
leave no stain."

analysingthese

When

forms

of excited

are

Thoughts impure

angel*and

sad states

of disordered

we
passion,

of

of

man

of morbid

emotion, and

tressing
idea,dis-

painful
types

alas ! to confess,that
obliged,

to elevate,
there is very little in connexion with them
and
expand,and purifythe taste,or to charm, captivate,

fancy. In this malady,the emotions,

poet's
unhappilyin a melancholy
are
sensations,and appetites
enchain

know

the

too well the laws of

to influence

another,who

demonstration to think that my

conviction

of its """*
cannot, like roe, be conscious

attempt to gain credit by dUput*t.on.

and every day txerUd
I have long possessed,
power, that

fore shall not

feel this

it

ought

254

OF

STAGE

CONSCIOUSNESS.

and alienation,
and, as a
perversion,
degradation,
generalrule,the conversation and conduct of those so
and are in unison with this derangement
afflictedreflect,
state of

of the

The

intellect,and

disordered
and

is dethroned

reason

state

taken

of the

instincts.

forcibly
captiveby

in a state of
impulses,and these, when
sovereignty
undisputedand tyrannical
supremacy, exercise an
the judgment, conscience, and the will.
over
cated
tone of thought (as indiHence, the sad and distressing
in the conversation,)
referred to as occasionally
previously
in attacks
of mental
observed
derangement,
uterine
caused by,or complicated
with, ovarian irritation,
and disorders,among
women,
irregularities,
very young
the most
refined, innocent, and
possessingnaturally
organizedminds.
sensitively
in one
of the most
touchinglyaffecting
Shakspeare,
creations of his transcendent
genius,threw a poetic
around
the character of
charm, a brilliant flood of fancy,
Ophelia,

animal

the

"

redolent

so

but

as

flowers,"
spring-time

gentleness,
purity,and
and
nature, this greatmagician,

of feminine

true to

ever

Sweet

inspired
poet,could

not sacrificetruth to

he therefore makes

grace

all but

fiction,
fancyto

this love- sick

girl,during
that
her insane warblings,
give utterance to conceptions
themselves to her exquisitely
could have suggested
never
and
chaste and delicate mind, before it was
prostrated
by disease.*
perverted

fact,and

early life and carried off to London.

eloped,findingthat she had 110 children,cruelly
man
and ultimately
her.
She became
abandoned
depressedin spirit**,
dreadfully
losingher reason, was confined in an asylum. The narrator of the following
this poor girlshe was
he first saw
apparently
particulars
says, that when
She had a pretty bouquet of flowers in her
about eighteenyears of age.
hand, and whilst arrangingthem, like poor Ophelia,she sung very sweetly,
On being asked why she left her
snatches of various favourite melodies.
Because I was
she answered,
late habitation,
obligedto do so." She was
*

The

young

woman

with whom

was

seduced

she

"

in

THE

INSANITY

OP

OPHELIA.

When

almost unconsciously,
herself,
addressing
to the
in
king,
reply to his question,"How
do you, pretty
after plaintively
lady?" Ophelia,
Lord, we
exclaiming,
"

know

what

utters the

we

but

are,

know

what

not

we

be,"

may

following
rhapsody
:

"

"To-morrow

in Saint Valentine's

All in the
And

day,

morningbetime,

maid

window,

at your

To

be your Valentine :
Then up he rose and dnn'd his cloaths,
And dupt the chamber door,
Let in the maid, that out

Never

I have

"

been

child,"said

maid

departedmore."

careful in the education

most

of

my

to me
gentleman,in deep distress,
one
day,
whilst listening
to the incoherent
ravingsof his poor
nineteen years of age !)
She has,"
daughter(scarcely
a

"

he continued,

onlybeen

"

seldom

been

of the

out

to associate with

allowed

select circle of friends and

our

house, and

lias

limited and

own

relations,all of whom

are

knew
a
morally,if not religiously
disposed.I never
mind
than she
more
pure, delicate,and unsophisticated
when
ranged,
deto her illness; and now,
possessedpreviously
not only
she manifests an accurate acquaintance,
with
the most
corrupt ideas, but with the improper
uked, how

she

employedher

time last

night
No

"

I walked

all about

Dow."

I could not close my eye*.

I will be your watchman.

bed P"
no
go to
and
nice
and
lantern,
stick
a
strong
let me sleepin the day,
You
must
watchman.
I
shall
make a very good
Oh,
and these she called
her
in
hand,
She had some
slipsof paper
you know."
she
"
in the yard,whom
tha poultry
she distributed them among
fairings:"
"The
commenced
then
singing,
She
children.
emphatically
styledher
into " Push about the
wide," "c., and then burnt out in*tantaneom"ly
ocean
! did you

What

Give

me

"

not

joram." Findingat lengthher littleheedlesn chargeof

morning sun, she tenderlyexclaimed, but ID a wild
children

sleep.

are

all gone to sleep;

has murdered

Macbeth

not?"

A young
here's your lover
will break my

her,
approached

man
ccnie

heart !

they have no
Met-p. Ah

"

baskingin

accent,

the

My pretty

"

hard -hearted lovers ;" but I can't

! he

when

Oh, now ! do
fate,
you know,
My

"

fowls

not
u

WM

naughty man

; was

be

somebody observed. L"*k.

giveme too many lovers,they
"

very hard,u

it not

?".

256

STAGE

CONSCIOUSNESS.

OF

used by
phrases ordinarily

the

walkers
depraved street-

most

!"
sad

These
instinct

manifestations

of

and disordered
perverted
:"
subjoined
explanations

of the
susceptible
in the first place,
bound
to consider the orthodox
we
are
doctrine of the innate corruption
and natural depravity
scriptural
of the human
heart. The prophetJeremiah says,
above all things,
and desperately
that "the heart is deceitful
wicked: who can know it?"*
Again,our Saviour himself
ders,
murdeclares, that out of the heart proceedevil thoughts,
phemies."^
blasadulteries,
thefte,
false-witness,
fornications,
are

"

As

longas

reason

reignssupreme,

and is unclouded

disease,and whilst the will retains its normal

by
healthy

and

the

higherfaculties of the mind, and its

the natural tendencythat exists
control of the instincts,
towards evil thoughts and vicious actions is kept,by
man's
efforts,aided, if not happily by Divine
own
Grace, by exalted moral considerations,in a state of
but contemporaneously
with
a
paralysis
subjugation
;
of the co-ordinating
principle(the executive element
of the reasoningfaculty,
of mind), and a perversion
it may be, cerebral discaused by some
ease,
type of physical,
does the effect of earlytraining,
pline,
educational discicultivated habits of thought,strictly,
carefully
and zealously
considered social companionship,
directed
moral and
influences,cease, alas ! (in many
religious
cases) to restrain the passions,and curb the animal
instincts and appetites.
Hence, the painfulcharacter of
almost unconsciously
used by some
the expressio?is
young
over
sovereignty

when

women

Jeremiah, chap.xvii. v.

t
our

in sane.

"

need

Why

nature,

reason,

no

were

we

9.

talk of

withdrawn

other hell could

from the anarchyof our

feel,

f
fieryhell ?

from

our

equal,for

St. Matthew,

v.

9.

is the law of

and
fancy,understanding,
what
should
then
we
spiritual
being,
memory,

powers." Coleridge'sTable
"

"

chap.xv.

If the will,which

Talk."

SOURCES

am

diseased

now

OF

EARLY

MORAL

257

DETERIORATION.

only addressing
myself to

brain,and disordered mind.

There

the results of
are, of course,

often witnessed many sad exhibitions of depraved

thought,
and vitiated taste,the effect of a voluntary
and sinful
abandonment

of the

and

reason

to
passions

gross

habits

of

crime.
vice,and even
These melancholy
sensuality,
manifestations of pervertedintellect have no
necessary
relation to the conditions
am

now

There

of diseased

mind,

of which

particularly
speaking.
are,

however, other

sources

and mental deterioration in

vigilant
parentsare

of moral contamination

which
operation,

the most

alwaysable to detect or guard

their children from. I refer to the pernicious
and
example,
of depraved,
wicked suggestions
and profligate
irreligious,
of moral pollution,
servants (a frightful
well
cause
as
as of mental
idiocyin earlylife,)
occasionally,
unhappily,
admitted
into the bosom of families by false characters,
to a perusal
of vicious books,
(alas! too easily
procured,)
surreptitiously
smuggled into the nursery, as well as of
the details of gross acts of impropriety
and indecency,
made matters of judicial
so
investigation,
minutelyand
of the ordinarychannels of
faithfully
reportedin some
records of vice and crime,
communication.
These frightful
and artisticallydeveloped,
so palpably
exposed,
elaborately
in all their naked depravity
and deformity,
are
fearfully
and fatally
to the minds of the young.
suggestive
however, from this view of the quesApart altogether,
tion,
we

are

bound

not

to consider the effectof

(as the effect of diseased brain,as well

organs) of natural

morbid
as

altation
ex-

of other

into
instincts,inciting
prematurely

a certain
(until
and inclinations normally
feelings
activity
and latent state. We may hence
in a torpid,
periodof life)
for the developmentof natural
account, pathologically,
manifested at, and after the
tendencies,usually
physical
the actual knowbut it does not explain
age of puberty,

258

STAGE

ledgeand

OF

CONSCIOUSNESS.

use

of

not

be misunderstood.

particular
prurientphrasesand obscene
modes of expression.
This phenomenon can onlyproceed,
either from the parties
havingheard the identical words
used by persons with whom
ciated,
assotheyhave unfortunately
from havingseen
them in print,
or
or heard them
uttered in the publicstreets.
Let

me

In many

of sad

cases

mental

alienation,the unhappy patient,

although a prey
of distressing
delusions,often exhibits greatelevation of

sentiment, exquisite
taste,profoundelevation,and purity
of

heard givingutterance
thought.The insane are frequently
that would
to expressions
reflectthe highest
honour
The light
upon healthyand cultivated understandings.
of reason
is occasionally
seen
permeatingwith undiminished

the
lustre,

dark

cloud

that has

threatened, for

its effulgence.
to overshadow, if not to eclipse,
time, altogether

Natural

sweetness, unaffected

and
gentleness,

marked

of disposition,
often witnessed
are
amiability
triumphingover fearful typesof mental disease,struggling
of the mind, obliterate
to crush the loftyinspirations
and to pervertand paralyze
the noble
kindlysympathies,
of the heart.
aspirations
The

which

unselfish consideration

towards

manifest

persons

like themselves, of unrestrained

affectionate and

assiduous

companionsin

affliction and

to assuage

act of unnecessary

often

so

quently
fre-

temporarily
deprived,

freedom

attention
sorrow

of action

they pay
;

"

"

the

to their

their endeavours

repeatedassurances
home
from
an
(althoughapparently
harshness, and unkindness, on the part

could not, under the circumstances

relatives)

avoided, and would

of

tend to
ultimately
establish, that insanity
advantage, conclusively
of the best principles
that enleaves intact some
noble
I haVe known
nature.
and dignifyhuman
men

be
their illness,

their

insane

their bitter anguish,by

that their removal

of their

the

260

STAGE

The

CONSCIOUSNESS.

described,
unhealthyfeeling,
previously
is occasionally
symptomaticof incipient
insanity,
of

state

often

as

OP

observed

in certain anomalous

and
system allied to hysteria,

from

conditions of the
exist

may

are

in young

seen

when
girls,

pubertyinto womanhood, and

mature
age at the critical periodof

apartaltogether

to derangea tendency
ment
any actual disorder,or even
of mind.
These
nervous
distressing
symptoms

sometimes
of

age

nervous

exaltation of the
found

to females of

occur

life. This

and mental

nervous

the

passingat

functions

morbid
is generally

associated with visceral

easily
complications,
curable,however, in many
cases, by remedial measures.
In some
these symptoms are the effect of longpatients,
and neglectedstomach
and hepaticderangecontinued
ment.
In other instances,the uterine system is the seat
of the mischief; and in some
typesof the malady which
have

was

He

observation,the condition of mind

my

congestionestablished
the brain itself. In one remarkable case, the patient
his senses, comtortured by an intense fear of losing
bined
tives,
with confusion of ideas,
strangedislikes to his relaand a disposition
to conceal himself from his family.

could
in

under

come

be traced to irritation and

for

had

time

some

this

avoiding(whilstprayingon
of mind.

The

Magazine"
Simon

became

of

case

was

His

insane.

only,in

headache, and

occasion),
alludingto
Brown,

for 1762, illustratesthe

Brown

as

recorded

his
in

The

pointreferred to.
greatintellectual

was

that he had

fallen under

had caused his rational soul

common

with brutes,an

animal

unhappy state

own
"

minister of
dissenting

delusion

of God, who
left him

Simon

suffered from

Gentleman's

He

powers.

the sensible displeasure

and
graduallyto perish,

life; that it

was

therefore

presentat the prayers of

inflexible. Being once
In this opinion he was
others.
importuned to say
excused
table
of
the
he
at
himself,but the request
friend, repeatedly
a
grace
and
he discovered evident
the company
kept standing,
being still repeated,
profane in

tokens

him

to pray,

and

and after
of distress,

some

incongruousto

be

irresolute gesturesand hesitation,

expressed

"
Most
with great fervour this ejaculation
mercifuland Almighty God !
:
when
the face of the waters
there was
no
moved upon
let thy spiritwhich

light,descend
to

praisethee

upon

I"

me,

that from this darkness

there may

rise up

man

MORBID

PRESENTIMENT

of
generalfeeling
after

head, and

two

few
or

OP

This

malaixc.

vered
reco-

taken from

were

his

three active calomel

tered.
purges adminisfrom the time he placed

In less than three weeks

himself under

gentleman soon

of blood

ounces

201

INSANITY.

treatment, he

able to

was

resume

nary
his ordi-

the
occupations.In the case of a lady,presenting
discovered in the
same
was
symptoms, greatcongestion
neighbourhoodof the cervix uteri. This morbid state of
the vessels was
removed by the local application
of leeches.
The blood so abstracted,
with other treatment,
conjoined
relieved the mind of all fear and apprehension
of
entirely
insanity.In another case, the mental disturbance could
be clearly
traced to engorgement of the liver,
consequent
climate.
Calomel,
upon a long residence in a tropical
with
combined
taraxacum, nitro-muriatic acid,internally,
of the
nitro-muriatic bath,"as recommended
a persevering
use
and described by Mr. Ranald Martin, in his able
all mental
treatise,*very speedilydissipated
dency,
desponand morbid anxiety,
as to the existence or approach
of mental derangement.
of
Closelyallied to the state of conscious insanity
the language of
which I have been speaking,
or, to use
of madnets" is,
Coleridge,the mind's own anticipation
of
morbid
be designated
what
a
presentiment
may
This
alienation of mind.
and approaching
threatening
recognised
condition of disordered thoughtis occasionally
The patient
in cerebral,as well as in mental diseases.
"

"

has, in

few

instances

exhibited

vation,
my obserearlystage of brain disease,

that have

in the

come

under

presentiment
prophetic
power, a singular
mysterious
insane attacks. In one
or warningof his cerebral and
weeks
the patientassured his friends,for some
case,
be
seizure,that he should soon
priorto an apoplectic
of the malady,and that it would be fatal!
the subject

"

"

Diseases of

Climates," by
Tropical

J. Ranald

Martin,F.R".

1859.

262

STAGE

OP

Alas ! he

provedto be a
said that he
a patient
advent of insanity,
and

CONSCIOUSNESS.

In another

prophet!

true
had

received

case,

warning of

the

that he should be
positive
I knew
attacked.
three instances of patients
who, for
several years, predicted
the accession of mental derangement,
and who ultimately
became insane !
"

We

was

cannot," says Portal, hear

the

threatened

remarks
with

sometimes

attacks

perfectand

appear

ment,
astonish-

without

"

by those who are

apoplexy. All their senses

of

made

entire,but

their

minds

to

appear

have

and a prophetic
Their
an inspired
acquired
power.
first impression
is,that theyare about to quitthe world.
Then
theypredictthe future by the present; and the
event justifying
the prediction,
they are regardedas
who foretold his death
true prophets. I saw
a
patient
six dayspreviously
there being
to its actual occurrence,
at the time no symptom in connexion with the case that
unfavourable
at all justified
so
a prognosis."
Sir Walter
Scott had sad forebodings
to the final
as

close of his active,eventful,and

to have
brain

had

when

son-in-law

"

more

"

above

the

he died.
Mr. Lockhart,
biographer,
says,
of the great magician's
final scene

difficult and

any man's
He
encounter.

upon

hour

and

to
referring

life,

life! He

appears
melancholypresentimentof the attack of

disease of which

His

anxious

delicate task

friend,than
could

not

all,he could

he

had

watch
not

never

about
Scott

write

devolved

this time
from

to

hour

to his dictation

to
"

most reluctantly,
takinghome
gradually,
slowly,
the conviction
that the mighty mind,
to his bosom
which he had worshipped
throughmore than thirtyyears
had
lost something,and was
of intimacy,
dailylosing
somethingmore, of its energy. The faculties were there,
and then displaying
and each of them
was
every now
itself in its full vigour; but the sagacious
judgment,the
without

SIR

SCOTT'S

w.

ANTICIPATION

brilliant fancy,
the
to occasional

Along the
And

and

unrivalled

he

anon

The

sad bewilderment

and

other

him, like

round
with

shadows.

men.'

and

Then

he

was

the

came

as if
dispersed
all was
of purer air
bright
then it closed againin yet

will

aroused

"

the clouds
"

of old, and

as

wonder

looked

passingfrom him,

like unto

deeper darkness.
no

fingerstrayed,
warblingmade.'

irresistiblecurrent

serene

subject

the

dream, mocked

strengthwas

becoming weak
strongeffort of
an

all

were

of his gaze showed a momentary

listine,
in the lapof the Phithat, like Samson

consciousness

before

memory,

paused and

half-wakingfrom

his

chords

uncertain

an

one

'

203

BRAIN-DISEASE.

eclipse.
'

Ever

OF

Under

these

circumstances, it

advisers assured him

that his medical

was

edly
repeat-

in working
that, if he persisted
emphatically
his brain,nothingcould preventhis malady from recurring
As for
with redoubled severity.His
answer
was,
bidding me not work, Molly might as well put the

and

'

don't boil'
say, Now,
foresee distinctly,
to be idle,I should
that if I were
kettle

on

mad!'

the fire,and

before his eyes ; and in

of his fear lest
that he

and
destroylife,
a

show.

'

I do not

go
also

Marlborough was
pressive
there is an entry exhis journal
blow should not
the anticipated
might lingeron, a driveller and
and

fate of Swift

The

...

think

my

head

is weakened

"

(this

subsequententry) yet a strange vacillation

makes me
suspect. /* it not thu* that men beginto fail"
as it were, infirm
ofpurpose ?
becoming,
was

"

That
No

way

more

lie*" let me

madneat
of that.'

ahon

that

"

Jedburgh he faced
the same
and braved their hootings,
the rabble populace,
stillpresentto his nniul,
idea of impendingcalamitywas
of
he greetedthem
turning away, in the words
on
as
And

when

at the Court-house

of

264

STAGE

the doomed

Moriturus
gladiator,
'

ploughneared the end

expressivephrase,he
habits of labour.
he

had

sustained

or
palsy,

CONSCIOUSNESS.

OF

"

saluio?

furrow,'to

of the

still urged

was

Under

three

vos

or

the
four

As

Scott's

use

by

on

'

the
own

his fixed

full consciousness

strokes of

that

apoplexyor

both

dant
combined, and tortured by various attenin half his joints,
ailments,cramp, rheumatism
daily

of late gravel,
lameness, and now
(which was,
increasing
he retained all the energy of
though last,not least,)
his will, and struggledmanfullyagainstthis sea
of

troubles."
Dean

cility.
of his imbesingularpresentiment
Dr. Young, walking one
day with Dean Swift
short distance from Dublin, suddenlymissed the
some
Dean, who had laggedbehind. He found him at a distance,
gazing in a solemn state of abstraction at the top of a
loftyelm, whose head had been blasted by a hurricane.
He directed Dr. Young's attention to the summit
of the
tree,and heaving a heavy sigh,exclaimed, I shall be
Swift had

"

like that tree, I shall die at the

first."

TOP

It is not difficultto account

as well
as
physiologically
for the singular
ferred
repathologically
phenomena previously
I had under
to.
a
care
ladywho informed
my
to her becoming insane,
me, that for six years previously
she was
convinced, from her mental and bodily
perfectly
sensations,that the seeds of the malady had taken root,
and that insanity
to
had, even at that time, commenced
germinate.
when
lege,
Another
at colsaid,that in earlylife,
patient

he
termed
many

was

convinced

twist" in consequence
sleepless
nights,caused

it,a

had received,as

that the mind

of his

"

by

havingpassed

several

weeks

laborious mental work.

continuous,and unremitting
conscious was
he, at the time, of the mischief that
been

done

to

his

brain, that

he

he

of
So
had

exclaimed, whilst

MORBID

anxiously

friend.

to

of

approaching
is

life

done

moral

by

the

head,

the

within

(engendered
the
rise

some

after

brain),
to

period

anticipation
of

disease
of

in

would,

life.

of

of

the

the

or

case,)
stand
under-

easily

sensations

sions
impres-

necessarily
to

developing

of

tissue

nervous

cases,

insanity,

material

mental

the

in

the

usually

morbid

many

brain

singular

physical

in

changes

period

structure

can

we

of

as

is

have

disorder.

and

(as

long

these

cerebral

abnormal

well

by

which

the

type

growth,
of

as

is

mental

causes,

and

insane,

for

had,

delicate

nature,

existence

became

He

college

suicide.

and

physical
its

to

insanity,

brain

progressive

and

slow

have
of

or

be

whatever

lesion,

he

!"

lunatic

commit

to

the

die

expression

same

who

to

INSANITY.

shall

forty-eight

patients
manifestation

damage

early

of

the

warnings
If

the

occasions

several

"

age

several

on

known

of

the

OF

room,

repeated

At

prior

the

pacing

subsequently

tried

ANTICIPATION

the

give

dread

itself

of
at

an

266

OP

STAGE

EXALTATION.

VIII.

CHAPTER

Exaltation.

Stage of
THIS

stage

will

be

considered

tion
rela-

its twofold

viz.,

1.

Psychical Exaltation.
Exaltation.

2. Somatic
1. PSYCHICAL

the

in

active

more

EXALTATION.

symptoms

"

For

periodbefore

some

of cerebral and mental

tion
exalta-

is observed to be wayward,
manifested,the patient
and impulsive. He
is irritable,
passionate,
capricious,
are

what
exhibiting,
pettish,
would
states of mind, and
more
(under less suspicious
of bodilyhealth) be termed, an
favourable conditions
of temper." These
"unhappy infirmity
symptoms of
associated with
psychicalexaltation, are occasionally
and mental confusion.
alternate fits of vital depression,
The
patient is subsequentlymorbidly anxious about
trifles,
slightruffles on the surface,and trivial annoyances,
in the familycircle or duringthe course
occurring
of business,worry, flurry,
tease,and fret him, nothing
to his
or
satisfying,
soothinghis mind, and everything,
distempered
fancy,goingwrong within the sacred precincts
of domestic life. He is quickat fancying
affronts,
and most
and greatly
trifling
exaggeratesthe slightest
The least irregularity
acts of supposedinattention.
on

and

fractious,peevish,and

the

part of the domestics excites,angers, and

He

is

of,and
suspicious
and

mistrusts

his

with
quarrels

his

best,kindest,and

often harbouring
the
friends,

most

absurd

him.

vexes

nearest
most

and

tives,
rela-

faithful

unfounded

268

The

STAGE

OF

EXALTATION.

often exhibits,
of an
at the commencement
patient
attack of insanity,
what, to a superficial
observer,would
be considered onlyan unnatural
He
elevation of spirits.
is at other times loquacious,
and talks loudly
and dogmatically.
He
becomes
subsequently
peevish,
querulous,
and undecisive,not being,
for two consecutive
irresolute,
He
frame of mind.
minutes, in the same
quarrelswith
his best friends,argues with greatwarmth, pertinacity,
and vehemence, the most
matters, is excessive
trifling
and extravagant
in his expressions
of friendship,
bitter and
in his feelings
of dislike,
rancorous
hatred, and aversion.
In this state of morbidlyactive brain,and unhealthily
excited mind, the fancyruns
rampant,taking discursive
and airyflights,
every circumstance beingviewed by the
couleur de rose.
patient,
There is associated with this exaltation of the imagination,
forming a
great exaggerationof expression,
usual modesty and
contrast with the patient's
striking
sobrietyof conversation, strict urbanity,repose, and
of his
talks ostentatiously
He
proprietyof conduct.
vast wealth, boasts of his elevated social position,
speaks
he can
of the profoundrespect
command, apexultingly
pears
vain of the high rank which
has been conferred
upon him, and is proud of the stillgreaterdistinction he
is destined to acquire
!
As the insanity
in direct oppoadvances, the patient,
sition
in
low
to his usual habits and tastes, delights
is neglectful
of his personal
society,
appearance, drinks
stimulants
to excess,
is extravagant in
pecuniary
matters, and often squandershis propertyin visionary
exhibits some
and absurd speculations.
He subsequently
He is lost
form of mental obtuseness,or moral obliquity.
of truth,respect
for decencyof thought,
to all sense
regard
conduct.
for good breeding,
and all notion of decorous
He
twists,distorts;and falsifies
magnifies,
exaggerates,

EMOTIONAL

everythingconnected

EXALTATION.

with

209

himself,beingthe hero of

mentioned
in his hearing.
every incident accidentally
These mental characteristicsare often in direct
opposition
to

his natural

and
healthymodes of thinking
for some
acting. Occasionally,
months
before any positive
morbid alienation of mind is
the intellect
recognised,
is clearly
off its balance.
The
patienthas violent paroxysms
of extreme
and passion,
irritability
producedby
the most insignificant
causes.
he swears, deals in
Contraryto his ordinary
practice,
loose inuendos, talks obscenely,
and acts indecently,
breakingout in loud fits of sobbing,or in wild paroxysms
of laughter,
under
the influence
being alternately
of agony, and hope,joy,and despair,
or

"

Moody madneM,

Laughing loud,amidst
The

attack

excessive
kindled

of

and

woe."

ushered
is,occasionally,
insanity

boisterous

into

paroxysms
the most

by
activity
gentleman,naturally
quiet,of
and of reserved

aevcreat

grave

(who had

manner

of

animal

in

by
spirits,

A
causes.
trifling
habits of thought,

never

been known

to

indulgein any demonstrative act of merriment) was

uncontrollable disposuddenlyseized with an apparently
sition
to indulgein loud and immoderate
jit*of laughter.
The most trifling
cumstance,
cirobservation,the most insignificant
excited his mirth to
such as a look or gesture,
intense and inordinate degree. For several days prean
viously
he had
to this remarkable change of disposition,
and analysing
been sitting
a
up late at nightperusing
to some
respecting
relating
property,
li-ngthened
correspondence
and vexatious
which there had been a disagreeable
familydispute.He had complainedto his valet of
'

These
of headache.
as well as
sleep,
only observable symptoms that precededthis
want

of

were

the

unnatunil

270

OF

STAGE

EXALTATION.

and, in fact,outbreak of insanity.

spirits,
of his relations could perceive
For nearlya week none
to false
anythingin connexion with the case approaching
aberration of idea,or illusion of the senses.
perception,
He
at
indiscriminately
laughed,like a hysterical
girl,
overflow

of

occurrence.

every

day from

the tenth

On

the seizure,he

uncontrollable paroxysm

and

himself,whilst
world !

the

insanityto
friends

solemnlyprolaughter,)
claimed

church, to be

this palpable
demonstration
of
required
to this patient's
bring conviction home

of

cases

itself in

I have

disorder.

in
insanity
occurring

loping
deve-

women

similar manner.*

morbid

stage of

In the

Saviour of

the

It

to his actual state of mental

as

several

seen

in

of

(aftera violent

exaltation

referred
previously

exhibits a talent for poetry,

patientfrequently
and elocution,quiteunusual
consistent
and inmechanics, oratory,
with his education,and opposedto his normal
bursts of fervid
habits of thought. His witty sallies,

to, the

speaking of

entered the church

StrasburgCathedral,

"
I
says :
with the intention of climbingto the top of its spire
: but

Trollope,when

Mrs.

"

It is on record,
the sacristan's account of the ascent.
gave it up on hearing
that three females have been, at different times,so overpoweredby the giddy
eminence which they had reached,that they have thrown themselves off in a

momentary Jitof delirium,and

been dashed

to

The

atoms.

latest of these

in 1833); and
awful accidents occurred within the last ten years (she wrote
recounted
the
tale
to
who
son), while he
the man
Henry (Mrs. Trollope's

standingon

was

He

it.
and

the

the self-same

told
pinnacle,

said that the unfortunate

of the

she

first

him

creature

that he
was

girl;
young
excessive
wot

suicidal delirium

gave
symptom
and having reached a
laughed and shouted as if in ecstasy,
of
the
she sprang off,
view
her
below,
abyss
nothingintercepted

pointwere

screamingwildlyas she fell."

Exuberant gaiety,"
says Dr. Mayo,
"

state is extreme
to

constitutes
depression,

suicide

is

suspected.The

burstingforth in one whose ordinary

ominous symptom, when
the tendency
has
that
often, at
moment,
patient

"

an

justthat state of orgasm which will enable him

in the consciousness of this."
he exults fearfully

achieved

"

Furor

to commit

est,agnoscere solis

Quern liceat quos jam tangitvicinia fati."

Mind," p, 79.)
of the Pathology of the Human
,

"

himself witnessed

She

mirth.

and

had

quite a

(" Elements

the act,

WIT,

AND

INGENUITY,

CUNNING

OF

THE

271

INSANE.

and

readiness at repartee,
impassionedeloquence,
power
of extemporaneousversification,
and mechanical skill and
those who
amaze
were
ingenuity,
acquaintedwith his
and educational attainments.
ordinarymental capacity
unusual displayof vigour of mind ; an
There
is an
not previously
to converse
on
fluently
subjects
ability
familiar to the mind, and an
to discuss matters
aptitude
tion
situawholly unconnected with the patient's
particular
in life. A quicknessof perception,
and
a facility
of utterance
quite unusual, become, in some
propriety
manifested.
cases, as the disease progresses, dailymore
The records of wit and cunning of madmen," says
in every country. Talents
Dr. Rush,
numerous
are
and
for eloquence,poetry, music, painting,
mon
uncomingenuityin several of the mechanical arts, are
A gentleman
often evolved in this state of madness.*
in 1810, often delighted
I attended in an hospital
whom
and officers of our
the patients
well as astonished
as
hospital
by his displaysof oratoryin preachingfrom a
table in the hospital
yard every Sunday. A female patient
in the
of mine who became insane after parturition
of her own
composiyear 1807, sang hymns and songs
"

"

"

ing,
imagery,genuinefeelexquiaite
poetry,repletewith splendid
and
has been composed by the inmate* of asylums,
and touching pathos,
The
were
insane.
followingsimpleyenes
by those, too, unquestionably
written by a ladyconfined as a lunatic in the Okio Asylum, U. S. America.
of
in the lattice window
They were addressed to a rose justbuddinginto life,
"

her

The

most

sitting-room.
I have often

"

I have
And

seen

wall
mould'ring

"

grace the ruin'd hall.

scenes

This littlerose

of human

ray of mercy

Some

woe,

intends to blow.

So in life'sshades,however

"

spring,

blossoms cling
clust'ring

the

here,'mid

But

"

the flower

seen

out the

From

drear,

will appear.

Bloom, tinyflower,a gracioushand

unfolds thy leaves
Invisible,
O'er

scenes

Joy

of

by
grief,

stillwith

sorrow

his command,

interweaves."

272

STAGE

tion

duringthe

and

voice

so

delight
every

OF

latter

soft and

EXALTATION.

stage of

her

that
pleasant

time I visited her.

with
illness,
I

hung

upon

She had

never

tone

it with
vered
disco-

previous
partof
her life. Two instances of a talent for drawing evolved
by madness have occurred within my knowledge. And
for mad peoplein which, elegant
where is the hospital
and completely
chinery
riggedshipsand curious piecesof mahave not heen exhibited by persons who
never
discovered the least turn for a mechanical art previously
observe in mad
to their derangement. Sometimes
we
peoplea resuscitation of knowledge; hence we hear them
describe past events, and speak in ancient or modern
or repeatlong and
languages,
interesting
passages from
of which, we
books, none
are
capableof
sure, they were
in the natural and healthystate of their
recollecting
a

talent for

poetryor

music

in any

mind."*
A

gentleman,whilst insane, and confined in an asylum,

and critical essay on
wrote
able philosophical
an
Sin."
his MS.
found among
It was
Original
papers
He was, when he penned the dissertation,
after death.
under
delusion that there was
to
a
a
familyconspiracy
he admitted that he struggled
poisonhim. Occasionally,
resolutely
againstthis delusion,but never
thoroughly
succeeded in masteringit. After his decease,the valves
of the heart were
found to be ossified. As asphyxial
sensations are known
mental
to give rise to erroneous
it was
impressions,
presumedthat the idea of poisoning
was
suggested
by the uneasiness which he felt whenever
"

the

stomach

was

overloaded

and

distended

with

food.

Everything he ate disagreedwith him ; the heart

laboured to propelthe blood through its ossified and
constricted passages, the lungsbecame engorgedand congested,
and the breathing
spasmodicand difficult. When
*

"

On

the Diseases of the Mind."

By BenjaminRush,

M.D.

1835.

MENTAL

in this state

ACUTENE88

OF

TIIE

273

INSANE.

of

he was
wont
to exphysicalsuffering,
claim,
The villains have been poisoningme
again!"
in his happierand more
Nevertheless,
lucid moments, a
more
charmingcompanion was never met with. No one
in his society
sat down
without being amused
ever
and
interested,or havingderived some
information from his
vast erudition,and great literary
and scientific accomplishments.
But while he could reason
and ably
clearly
his moral
on
and
philosophical
subjects,
apprehensions
affections were
still perverted. If the name
of one
ticular
parof his familywere
member
alluded to, he would
utter violent imprecations
againsthim, and accompany
them with the most bitter homicidal threats. Among
his manuscripts
found another document, which conwas
trasts
somewhat
strangelywith the theological
essay
alluded to.
It was
entitled
ment,"
My Last Will and Testaand clearly
indicated the morbid
state of his
at the time it was
penned.*
feelings
I have known
dull of apprehenmost
men
naturally
sion,
in fact,nearly
half-witted,exhibit,both in the early
advanced
considerable intellectua
as well as
stagesof insanity,
acuteness and capacity,
f
"

"

"

"

troubled

was

The

will

was

follows

as

"

"

"

"

"

In the

of me,

last Will and Testament

of

sometimes," says Pinel,

in the Three

of God.

name

"
.

about

Amen

bequeath all

per Cent*., and

"

Kutate of

to follow

"

This is tin-

sisting
property,con-

my

"

"

in Messrs.

in the count/
artist.

a
securityupon the
securityis in my brother's de*k, to Mr.
for having administered,and
To all my own
familyI bequeath my curse
reduced to
to
bribed other persons to administer,poison me, by which I am
me
insane,
doctors
to certify
weak state, and for having bribed two
a very
and
six
I have been confined for two years
when I was
not so, by which
months
without having been insane.
May Jehovah visit these wrongs upon

Rank, and

of

them

which

is the last prayer of

."

subjectis considered at length with

f This interesting

great philosophic

in two
by M. Octave Delepierre,
ability,
-men,
eleganceof taste,and literary
fa
tmr
"l*"U* Biobilli^rapket
entitled : 1.
published),
essays (privately
Jet
I.ittrraire
FH'utoire
fur
Estai Biograpkique
Fout Litttrairct;" 2,
ac

"

"

fout."

An

of tho*e
analysis

(New Series)of

"

my

brochures

and XIV.

will be found in Nos. XIII.

Journal."
Ptychological
T

274
the

STAGE

OF

EXALTATION.

and
incorrigible
garrulity,
and

words

incoherent

other times, fell into

pieceof poetry,in
suggested itself to his

of

stern and
which

sort
an

of flow

old

savage

of

nected
uncon-

scholar,who,
silence.

at

When

he had

formerlydelighted,
he became
capableof
memory,
continuous
attention,his judgment seemed to regainits
and he composed verses, in which
there reigned
rights,
of order and of justnessin the ideas,
not only a spirit
but also a regular
supplyof fancyand some
very happy
author observes :
sallies." In another placethe same
Certain
facts appear
that they
so
extraordinary,
mony,
have need of beingborne up by the most authentic testiin order not to be called in question. I speak of
is said to have characterized
the poetical
enthusiasm, which
any

"

"

certain
verses

recited

of mania, even
paroxysms
be regarded
could nowise
I

when
as

an

the
act' of

myselfheard a maniac declaim,

with grace and exquisite
discernment, a longeror shorter
of Virgilor Horace, which
succession of the verses
had
been a long time effaced from his memory,
inasmuch
as,
after his education was
terminated, he had been twenty
colonies,given up to the
years absent in the American
occasioned
pursuitof wealth; and the reverses
by the
reminiscence.

revolution

had

of mind.

An

cited,attests
and
that

have

alone

thrown

him

into this

distraction

I have
English author, whom
already
that a young
of a feeble constitution,
girl,

had become
affections,
insane,and
subjectto nervous
during her delirium she expressedherself in very

Englishverses, though she had before shown

for poetry." Van
Svvieten relates the
no
disposition
of mania,
of a woman
who, during her paroxysms
case
for versification,
showed a rare
facility
though she had
with manual
standing
labour,and her underbefore been occupied
been enriched by culture.
had never
Tasso composed his most
eloquentand impassioned
harmonious

276
acute

symptoms

OF

of his

maniacal

his mind

employ

to

STAGE

found

that

This

talent

in

EXALTATION.

attack, and when

reading and

able

conversation, it

was

had been
arithmetical power
extraordinary
evolved
ful
able, with wonderduring his illness. He was
to solve several rather complex problems.
facility,

and

continued

wonderful

attended

was

talent for

who

nurse,
so

the

wife

rapidand

in constant

was

struck

relapsedinto his
dulness, ignorance,

health, he

exhibited, during her paroxysms

a

with

his

after

!
incapacity

generalmental
year

to

but

months,

state of arithmetical

natural

Last

for several

restoration

complete
former

an

the

of

clergyman who

of maniacal

excitement,

clever versification. The

attendance

the

upon
she

phenomenon, that

patient,

had

scribed,
tran-

before
of

callingmy attention to the fact,a number

racter.
evidencingpoeticalpowers of no ordinarychaThe
manifested
to improvise was
disposition

verses

mostly at night. After her recovery, all capacityfor

I understand
that, prerhyming appeared to subside.
viously
her

to

mental

illness,she had

inclination
slightest
poetical

Insanityin
often

young

our

of

and progresses

commences

has called

women

or

attention

to this

exhibited

not

the

ability.
a

certain

as

follows

type of

temperament
:

mental

(Df. Haslam
disease,and

delineated its insidious approaches). It

graphically
by prompt
usuallymanifests itselfin persons distinguished
who, in general,have
capacityand livelydisposition,
been the favourites of parents and tutors, by their facility
of attainment
in acquiringknowledge,and by a precocity
This disorder commences
about,
they have manifested.
or
shortly after, the period of menstruation, and, in
"

has

many

instances,has been unconnected,

as

far

as

could be

The
attack is almost
taint.
hereditary
months
Some
usuallyelapsebefore it
imperceptible.

ascertained, with

PECULIAR

TYPE

OP

MENTAL

277

DI8EA81.

the

notice ; and fond relasubjectof particular

tivi-s are
deceived by the hope that it is only
frequently
abatement
of excessive vivacity,
an
conducing to a prudent
and
steadiness
of
character.
A degree of
reserve,
and inactivity
apparent thoughtfulness
precede,
together
with a diminution
of the ordinarycuriosity
concerning
that which
is passing before them ; and they therefore
and pursuitswhich
neglectthose objects
formerlyproved
of delightand
instruction.
The sensibility
sources
pears
apblunted ; they do not bear the
to be considerably
affection towards
their parents and relations ; they
same
become
unfeelingto kindness, and careless of reproof.
To their companionsthey show a cold civility,
but take
interest whatever
in their concerns.
If they read a
no
book, they are unable to give any account of its contents.
Sometimes, with steadfast eyes, they will dwell for an
"

"mes

hour

on

one

minutes.
most

do

much

letter is

and

It is very

which
so,

page,

then

turn

difficult to

is consumed

number

persuadethem
state of mind

readily
developestheir
time

over

little

and

in
to
;

few

write,
if

produced.

they
The

they seldom advance

The
beyond a sentence or two.
orthographybecomes
and, by endeavouring to adjust the spelling,
puzzling,
As their
the subject
from the mind.
vanishes altogether
apathy increases,they are negligentof their dress, and
inattentive
to personalcleanliness.
Frequentlythey
out these have
transient impulses of passion,
experience
no

at

in sentiment

source
one

repeatedlybegun,

time,

succeeds

them

are

as
;

and

but

the

tears

unmeaning
it often

trickle down

laugh which

loud
a

momentary

invectives,ceases

before

symptoms of insanity,
analysingthe incipient
manifested
during the stage of exaltation and excite-

Whilst
as

the

happens that

".nger, with its attendant

the threat can
be concluded."

gust of

as

which

278

STAGE

OF

EXALTATION.

ment, it will not be irrelevant for

me

to consider

an

portant
im-

connected with the matter under

subject
closely
consideration,but perhaps more
immediatelybearing
a medico-legal
pointof great interest to the jurist,
upon
to the practical
as
as well
psychologist.I refer to the
subtlety,
quicknessof apprehension,
ready wit, biting
extreme
sarcasm,
great power of self-control,
cunning,
and
of the insane, as well as
shrewdness
extraordinary
the wonderful
been seen
mastery they have occasionally
to exercise over
their acknowledged delusions, whilst
under the searching
complished
analysisof the ablest and most acit has
advocates of the day. In many
cases
been proved to be useless to possess the
key note" to
the insanity
of the person
under
examination, or "to
touch
the chord," supposed to be in unison
with, and
into activity,
to awaken
the latent insane delusion
likely
and
The
lunatic,if
cunninglyconcealed hallucination.
he be carefully
trained
and skilfully
tutored, having an
masking
importantpurpose to accomplish,by effectually
"

his mental
with

disorder,will,under

wonderful

and
ability,
in the teeth of

and,
defensive,
make
insane
the

"

no

have
(ti'ho

acumen

members

of

these

circumstances, act

the
on
singularingenuity,
nation,
examithe most stringent

I seen
often have
the
sign." How
well prepared]thus baffle
been previously
the most
experiencedand sagacious

of the bar.

notion,that the delusive idea

commonly accepted
will immediately
developeitself,
providedits character be
reference made
to it by those engaged
known, and special
in testingthe sanityof persons
ranged
allegedto be of demind.
considera
Nathaniel
Lee, who
acquired no inknowledge of the phenomena
degree of practical
of insanity,
during his long incarceration in
Bethlem, and prolongedassociation with the inmates
of that hospital,
appears to have been inoculated witli
It is a

ART

OF

ANALYZING

this
of

for he
fallacy,
Caesar Borgia,
"

Like
And

reasons

He

TOWS

says, in his

well.
the

Jittt ifyou
Hit

CASES

OF

279

INSANITY.

of the
description

madness

a poor lunatic that make*

hit moan,
for a while beguile*
his looker* on,

He

The*

SUBTLE

His

eyes

their wildnew

keeper his wronged

kit the

came

that

hurt*

lone.

abuse

SOIIHO

hit

brain,
foams, he ihates hit chain,

his teeth ynath, hf

cyiballtroll,and he

it mad

again."

It

of tact and skill,

no
requires
ordinaryamount
as
well as practical
acquaintancewith the subtle psychology
of insanity,
to fully
ravel
qualifya person to examine and unof lunacy. I have often
a complexcase
successfully
found it necessary to
visits to
pay two or three protracted
with him on generalsubjects,
a patient,
before
conversing
I have considered it prudent to make
any reference to
the alleged
delusions.
By this process the confidence of
the patientis effectually
disarmed,
secured,his suspicions
and the expert able gradually
to
to direct the attention
the pointsupon which
ordered.
the mind
is thought to be disIf the lunatic clearly
perceivesthe objectof
addressed
the physician's
visit,the drift of the questions
to him, and
fullyrealizes the importance of concealing
eased
that are represented
to be creations of a disimpressions
genuity
inimagination,it will require much persevering
to extract from him
anythinglike an admission
of his actual state of insane

mind.

by placingthe
of chloroform.
Might not
the same
anaesthetic agent be found serviceable in analyzing
be
of cunninglyconcealed lunacy? There can
a case
in a partidoubt as to the effectof chloroform in giving,
cular
no
type of case, greattemporary prominenceto insane
I have occasionally
observed, that when it has
delusions.

Feigned insanityis often

patientunder the influence

unmasked

this anaesthetic agent

necessary to administer
itsimmediate
by inhalation to persons mentallyderanged,

been found

280

STAGE

effect has been

OF

EXALTATION.

developeand drag from their hidingif not

in a
place,hallucinations that were
previously
and feeblymanifested state.*
latent,but faintly
Dr. Haslam

to

remarks, that

insane person

is not

"a

successful

of

examination

to be effected

selecting
by directly
the subjectof his delusion,for he will immediatelyperceive
the objectof such
and endeavour
to
inquiries,
evade or pretendto discover them ; the purpose is more
answered
effectually
by leadinghim to the originof his
and tracingthe consecutive
series of his actions
distemper,
and
the association of ideas; in going over
the
road
where
he has stumbled
he will infallibly
trip
again."
confessed
The
of concealingdelusions which
power
and even
to possess
dangerous lunatics have been known
under
the strictest and most searchingexamination,
when
an

has often astonished

with

of

observes, in

one

"

that in all the

to deal

unaccustomed

fullyconversant with the subtle

insanity.The illustrious LORD ERSKINE
of his most able and eloquentspeeches,

them, and

phenomena

persons

not

cases

which

have filled Westminster-hall

complicatedconsiderations,the lunatics
have
been the subjects
of
and other insane persons who
them have not only had the most perfect
knowledgeand
recollection of all the relations they stood in towards
with

the

most

others, and of the

but

acts and

remarkable

been
have, in general,

acuteness.

These

are

the

of their lives,

circumstances

cases

which

and
subtlety
mock
frequently

for

trials; because such

judicial
which
with
a
puts in the
subtlety
persons often reason
of mankind
shade the ordinaryconceptions
; their con-

the wisdom

It will be

of the wisest

importantnot

to

in

confound

the

hallucinations

induced, in persons of healthy minds, by

occasionally
w
chloroform,ith those that are clearly
symptomaticof

the
a

and

illusions,

administration

state of mental

of

rangement.
de-

SUBTLE

elusions

CASE

OF

HOMICIDAL

"1

INSANITY.

just,and frequently
profound; but the premises
from which
when
within
the
they reason,
range
of the malady,are uniformlyfalse ;
not false from any
defect of knowledge or judgment, because a delusive
is
image, the inseparable
companion of real insanity,
thrust upon
the subjugatedunderstanding,
of
incapable
are

"

because
resistance,

unconscious

of attack."

(fora short period)of the existence of

repudiation
insane thought,admitted
and
known
by the patient,
by
existed ; the ability
to converse
others,to have previously
and
with great shrewdness
and
continuously
rationally,
for their comprehension
matters requiring
on
a
sagacity,
conclusive
no
are
vigorousand well balanced intellect,
and demonstrative
of
tests, per se, of legalsoundness
mind, or of recovery from an attack of insanity.In the
of this character
great majority of cases, evidence
bond Jide
should,however, be viewed as establishing
a
restoration to health of mind.
Some

years ago, I had under

who
had
tried, on
more

murder

his sister when

my

care

than

a
one

young

man
gentle-

occasion, to

the delusion that she had

under

his marrying
interference,
unjustifiable
a
lady of large property and of high rank. The idea
For
was
nearlya year this
altogetheran insane one.

prevented,by

notion

was

manifested

her

never

other

absent

He, however,

his mind.

from

of

symptoms

mental

derangement.

peared
regard to the sister aphis imagination.I
from
been removed
to have
and he declared
to him on the subject,
spokefrequently
with regard to his sister no longer
that his impressions

the
Eventually,

existed.

H*"

once

delusion

with

observed,

"

wish

to

see

my

dear

for perof cravingher forgiveness

sister for the purpose
mitting
To all
such bad thoughtsto enter my mind."
health,
to be restored to mental
appearance he seemed
at least to be convalescent,yet I had (from a variety
ur

282

STAGE

EXALTATION.

OF

circumstances,when viewed by themselves)

trifling
of
as to the bondfde character
my doubts and misgivings
his apparentrecovery.
For more
than a week his mind,
I called one
free from
he alleged,
all delusion.
was
day
that I
to see him, and placedmyself in such
a position
could closely
observe his conduct and hear his conversation,
without
his beingaware
When
of my presence.
I firstsaw
him
he was
reading. In about ten minutes
he left the sofa where
he was
and approached
sitting,
towards
the looking-glass.He gazedfixedly
at himself
He then began,whilst in this posifor a few minutes.
tion,
to indulgein the most malignantgrins. At last he
of

his

clenched

fists,and

walked

about

the

in

room

an

creant,"
exclaiming, the villain," the misthe viper," the snake in the grass," I'll do
for her on
the first opportunity."I was
satisfied
now
that the lunatic had been playingan artful part for a
that he was
still in a dangerousstate of
purpose, and
with him on this occasion,
insanity.I did not converse
but did so on the following
day,when, strange to say,
in declaring,
he persisted
that he had no
delusions with
of the family. I
regardto his sister,or any member
"

agitatedmanner,

"

"

made

reference

no

"

"

to what

had

day,and beingconvinced, in
that

it

was

he
large,

not

threw

my

intention

off his

to

observed
the

course

allow

and
disguise,

him

the previous

on

of

week,

be

to

at

his

then
insanity
became evident to every person who approachedhim.
I remember," says the late Sir Henry Halford,
hearingLord Ellenboroughexpress, in the strongest
"

"

terms, his conviction

that

an

insane

recovered,after having observed

person
him

had
to

pletely
com-

sustain

lengthenedconversation upon an important subject

and sobriety.Nevertheless, this
with greatgood sense
detected,a few days afterwards,under the
patientwas
full influence of his delusion,using Latin^
however, to

284

STAGE

In attacks of
and

OF

EXALTATION.

the cerebral circulation,

fever,accelerating

in the

incipient
stageof the brain affections of early
the patientoften exhibits an
unnatural
life,
acuteness,
of intelligence.
amounting to a brilliancy
occasionally
There is also great sensorial activity.Analogous phenomena
cerebral
observed
forms of ordinary
in some
are
disorder affecting
the operations
of thought,and on this
and philowe
principle
sophicall
physiologically
may, in a measure,
sane.
and cunning of the infor the subtlety
account
But, does not the fact admit
The

instinctive

the intellectual

solution ?

of another

from
as
contradistinguished
appetites,

generalrule,in a state
of activity,
in many
exaltation,and ascendancy,
types of
defective,and impaired
deranged,as well as originally
and in
mind.
In the various gradations
of imbecility,
of profoundidiocy,
often observe a high
some
cases
we
manifestation
of the instincts.
In the lower gradesof
and congenital
bited
exhiwe
see
occasionally
stupidity
idiocy,
that extraordinary
sagacityand cunning which is so
characteristic of the higherclass of animals.
Mechanical
of hearing,seeing,
and smelling,
acute sense
ingenuity,
well as wonderful
of adaptationto all possible
as
powers
physicalconditions, are often observed among a certain
class of the insane utterlyincapable
of appreciating
a
rational

idea.

faculties,
are,

Hence,

we

the subtle instinctive

seen

associated

derangedmind.
the reasoningand
latent,and

as

to

may,

certain

sagacityand
with

It would

the

appear

reflective powers

extent,

acuteness

forms

various

that
are

in
hi

so

plain
ex-

quently
freof

proportionas
an

arrested,

(as a

state,do the instinctive propensities

compensating balance) ascend the scale,occupy the

seat

of

dormant

reason,

and

and
undisputed,
*

"

arrogate and

often unbridled

Madness," says Coleridge, ia

sleepof

"

the

with
spirit,

not

exercise

the

right of

sovereignty.*
simply a bodilydisease.

It is the

certain conditions of wakefulness,that.is to say, lucid

8T7BTLETY

Mr.

OF

THE

INSANE

Dugald

METAPHYSICALLY

Stewart

for the

thus

285

EXPLAINED.

attempts,metaphysically,

of the insane.
subtlety
He maintains that the phenomena may, to some
extent,
be attributed to the physical
influence of the disorder in
with
increased propensity
to
together
an
occasioning,
excitation of the
and morbid
a preternatural
controversy,
to account

and

acumen

and of some
other intellectual faculties;
power of attention,
but much
in his opinionto its effect in removing
more
the check

of those collateral circumstances

sober

more

the reasoning
understandings,
powers

retarded

and

controlled

in

their

are

in

petually
per-

operation.

circumstances,it is sufficient,
says this able

these

Among

by which,

for the sake of illustration,

1. "That
writer,to specify,
teaches,of the accudistrust,which experience
racy
gradually
in which
of the phraseology
our
sonings
reaprecision
are
expressedaccompaniedwith a correspondingof involuntary
mistakes from the ambiguity
apprehension
that
and vagueness of language; 2. A latent suspicion
of all the elements on
in possession
we
may not be fully
which the solution of the problemdepends; and 3. The
of propriety,
habitual influence of those first principles
and of common
which, as longas reason
of morality,
sense,

and

maintains
over

ascendant, exercise

all those

connexion

with

restraints on

our

any
or

her

paramount

rity
autho-

which

have

conclusions
speculative
the business of life.

reasoningprocess,

none

Of these checks
are

cultivated

either by the rules of the logician,

or by
strengthened,
On the contrary,in
the habits of viva voce disputation.
is confirmed, that
their regulating
as
power
proportion
of judgment are
encouraged
hesitation and
suspense
of true philosophy,
to the spirit
which
are
so
congenial
and

but such

fatal incumbrances

whose

objectis

not

contendingwith an
truth but victory. In
in

be

mad-

bridal
tne loirfr,
or
recession of the spirit,
or
During this sleep,
is
awful thingto
an
action and prominence. It
of liferue
up intu

intervals.
tfatet

gonist
anta-

temptedby
eternally

the

tenses."
perverted

286

STAGE

OF

EXALTATION.

entirelythrown off,the
stops to analysethe
merelylogical
process (which never
to go on
more
rapidlyand
meaning of words) is likely
of speech,
than
before,producinga volubility
fearlessly
which
and an apparentquicknessof conception,
present
to

their

where

men,

control

observers

common

superiority.It
the

same

mental

all the

are

characteristics

scarcelynecessary

is

which

appearances,
aberration

is

in

displayedon

this
so

tual
of intellecto

add, that

extreme

of

case

greata scale,may

less,wherever
or
expectedto show themselves, more
in those qualities
which constitute
there is any deficiency
of judgment/'*
depth and sagacity
EXALTATION.
In the incipient
2. SOMATIC
stage of
of the motor power.
there is great disturbance
insanity
This
is often,in the first instance,only indicated
by a
of
agitationproducing a brusquerie
general muscular
forming a strikingcontrast to the patient's
manner,
natural state of quietnessand repose.
disorder
self
As the mental
progresses, he comports himlike a person in a state of incipient
intoxication.
It
the impressionof his being under
is difficultto remove
be

of vinous

the influence
his erratic

stimulants,from those who

conduct, and

listen to his wild

observe

conversation.

of deportment,excited physiognomy,
singularities
incoherence and extravaganceof language,his unnatural
elevation of spirits,
paroxysmal attacks of exaltation,
muscular
indicated by his eccenmovements,
tric,
irregular
and
odd, rolling,
unsteadygait,naturallysuggest
is he drunk or mad ?
the question,
During the stage of physicalagitation,previously
referred to, the patientresembles a ferocious animal
moved
re-

His

from
cage.
in

He

paces

condition
*

his

wild
and

native

"PhUosophy

of the Human

the

confined

in

night and day,

perturbation,
rarelysittingor

repaces

of extreme

forest,and

Mind"

room,

(1848),p.

431-2.

THE

PHYSICAL

AGITATION

standing in
minutes.

of

state

OF

INCIPIENT

287

INSANITY.

for many
consecutive
from home, being tormented

repose

He

suddenlystarts
irresistiblerestlessness,a constant,
by a peevish,
unwearied, never-satisfied desire for change, walking,
long distances with greatapparentfixedness
unfatigued,
of purpose
and
of gesture,
accompanying vehemence
without
having in view a sane or rational object. These
rapid strides,forced and violent movements, appear to
in an
instinctive desire to throw off a morbid
originate
accumulation
of muscular
an
unhealthy
power, disperse
of irritability,
abnormal
excess
an
dissipate
redundancy
of nervous
energy, and keep in a state of subjugation
thus relieving
anxious, and perverted
corroding,
thoughts,
"

"

the mind

of,
"

In vain

whirlinggulfof phantasy and

flame."

the

to obtain peace
so
unhappy man
struggles
of mind by yieldingto an irresistible and uncontrollable
from place
desire to rush, almost unconsciously,
to place
;

fruitless are

"

to arrest the creation

his endeavours

of the

and bewildering
gloomy imagery desolating
his reason,"
his thoughts, perverting
sibility,
deadeninghis sensearinghis conscience, benumbing his moral
his judgment, deludinghis senses,
distorting
sense,
abortive are his efforts to
and paralyzinghis volition ;

morbid

and

"

"

"

"

"

"

"

the

from

escape

"

mockeries," that

torture

flyfrom

Alas ! he cannot

shadows," and

horrible

"

with

Patriffiquisexul

melancholy,that

"

he had derived

"

mutual

the philosophy,
"for
at that," replied
surprised

not

afflicted
acquaintance
his traTels."

benefit from

no

HOB.

fugit?"*

to
to Socrates, alluding

friend oboerred

!
imagination

his

alio calentes

terras
"

Se quoque

"

unreal

himself.

Quid

Sole imitaimis

disorder

and

"

he travelled

"

am

along vitk

kimtetf."
Sterne
from

"

says,

the learned

Paris to Rome, and

and

every

so

Smttfu*g**
on

trayelled

but he tet out

objecthe patted by

wot

from

tcitk

tkt

ditcvlvurcd

Boulogne to Paris,
tpleen and jaundice,
or

distorted.

He

2SS

STAGE

EXALTATION.

Diemen's

in Van

convict

with

OF

of the overseers,

one

murdered
brutally

with
immediatelyescaped,

the wild

solitude of the

time, like

some

armed

distress
physical
a

dangerous

be under

the

to which

lunatic.

rush

to

bush, house

to

and

murderer

The

it

of

The
severe

He

the dominion

him.

occasionally
making
food.

to

imagined that he
ghastlyphantom

clothes

teeth, at various

demanded
peremptorily
succumbed

few

bush.

savage,

to the

Land, after quarrelling

was

lived,for
his appearance,

huts, where

convict's mind

he
mately
ulti-

mental

and
agony
exposed,and he became

terrible hallucination.

constantly
being pursued by

was

of his murdered

from
frantically

house, from

to

gun,

eventuallyperceivedto

was
a

He

victim.
tree

part

one

to

He

was

He
the

served
ob-

tree, bush

of the

district to

another, endeavouring to fly(like an animal hunted

death
by ferocious bloodhounds) from the clutches
some

in
constantly
path. The maniac

person
his

into

the

hands

his

of the

wake, and

to

to
of

ing
tracksteadily

self
surrendered himeventually
that annihilation
police,
alleging

of mind
which
preferableto the agony
suffered.
In
he
fact (although insane), he prayed
for death at the hands
of the publicexecutioner,
earnestly
from
the spectral
in order to extricate himself
!
absent from his mind
image that was never
and unWho
ceasing
can
escape from the never-dyingagony
and perturbedconscience ?
tortures of a wicked
What
that
there of effectually
means
are
obliterating
"damned
spot"that must ever appear in terrible judgwas

nothing but the account of his own

miserable
feelings. I met Smelfungus in the grand porticoof the Pantheon.
I popped upon
said he
Tis nothingbut a largecock-pit,'
Smelfungus
of
tale
sorrowful
adventures
and
sad
he
a
again at Turin on his return home,
He had been flayedalive,and bedevilled,and used worse
had to tell
wrote

an

account

of them, but

'twas

'

than

St.

Bartholomew,

'to the world'

at every

You

stagehe

had

had

come

to.

'

fungus,
I'll tell it,'
cried Smel-

better tell it,said I, to YOC*

PHYSICIAN."

TORTURES

ment

OP

WICKED

CONSCIENCE.

and unrepentedcrimes,unforagainstinexpiated

givenby Heaven,
"

and

"

unwhiptof justice"
upon

Exemplo qnodcumque malo committitur,

ip"i
I Hsplitvt
auctori.

Judioe

nemo

I'rima e"t ha"c ultio,

quod M
abaolvitur ; improba quatnvu

noccna

Gratia fallaciPrwtorU

I liad

earth ?

vicerit urna."

"

Jut-en.

Sat. 13,

v.

1.

of seeing,some
opportunity
years ago, a
of confirmed
case
singularly
distressing
quent
insanityconsea
long,sad, and eventful career of vice and
upon
immorality.The patienthad lived,for fifteen years, a
most
life. He had been accused (but not
extraordinary
of crime.
convicted)of almost every description
legally
He eventually
went
to Australia,and resided for a long
time in an unfrequented
sequently
part of that country. He subreturned to England, discarded by his family
in consequence
of his gross and inexplicable
propriety,
acts of iman

and abandoned
all kinds

of

vice, and
debauchery,

supposed(upon what
evidence)to

himself,without

was

have been

at the time

guiltyof

accused of havingcommitted

an

to
restriction,

He
profligacy.

was

conceived to be valid

barbarous

unnatural

murder

was

offence;and

was

and theft !
perjury,
chargedwith acts of forgery,
publicly
life he squandered,
in a most reckless manner,
In early
a

fortune which

he

had

obtained

with

his

wife, and

then

deserted her and a familyof three children,after

cruelly
of a most
forming a connexion with a depravedwoman
whom
he met accidentally
hideous and forbidding
aspect,
he
streets! During the whole of this period,
in the public
tion.
of the^rdinary
exhibited none
symptoms of mental alienainsane,if he
he became
At the age ol fifty
clearly
His insanity
had not been so for many years previously.
existed,
of a most
was
type. There evidently
painful
mental
his
associated with
derangement, occasional
reminiscences of his former
sane
lucid,and apparently
horror of seeingany
vices and crimes. He had a perfect
u

290

STAGE

the

enter

one

into

untamed

He

then

where

his

up

with

don't

near

come

stare

at

so

accused
falsely

like

of frenzied

in

the

attitude

wild

despair.
of

wild

"

"

"

if

screamed, "away, away!

literally
! I don't know
you ! why do you

me

me

crouch

agony

hands

and

immediately rushed

would
an

confined

w.as

of perfectterror depicted
expression

an

his countenance,

on

he

animal, in

held

and
distress,

he

introduced, he

corner,

and

EXALTATION.

in which

room

stranger were

OF

"

not

am

him

the

man

"

out !

innocent

am

!
"

I wont

speakto him !
I will confess nothing!" When
contemplating this
reminded
of the
unhappy man's condition,I was forcibly
in Macbeth,
the
where
scene
spectral
image of
gory
Banquo is conjuredinto existence by the guiltyconscience
of the king.
No disease of the imagination,"
says Dr. Johnson,
is so difficult of cure
that which
is complicated
with
as
the dread of guilt.Fancy and conscience
then act interchangeably
upon the mind, and so often shift their places
that the illusions of the one
not distinguished
from
are
If fancypresentsimages not
the dictates of the other.
drives them
moral
the mind
when
or
religious,
away
theygiveit pain; but when melancholynotions take the
form of duty,they layhold on the faculties without
position,
opturn

"

"

"

"

"

because
For

them.

this

melancholy,and
Abbe

The

of

of

de

frantic

see

the

reason,

the

up

exclude

to

became

banish

are
superstitious

melancholy almost

Eance

or

always superstitious."*

insane from

insanity was
grief. To this

often

the

manifested
succeeded

effects

by a
profound

all his friends, and

shut
away
he refused to
in his mansion
at Veret, where

melancholy. He
himself

afraid

are

His

remorse.

state

we

sent

singlecreature.

His
*

whole
llasselas.

soul

absorbed

was
"

in

292

STAGE

reason,

and

normal

(comparingtheir

condition

of

question,which
"

EXALTATION.

OF

In this

been

mind) have
the

was

with

their abnormal
ask

disposedto

the

of the two?*

happierstate

stage of exaltation,"
says Pinel, the patient
"

overwhelms

those

loquacity.If
upside down,

he

about

him

into

comes

with

his
he

room

extraordinary
turns everything

and
shakes the chairs and
displaces
tables,without
seeming to have any particularmotive
for so doing. Scarcely
have you taken the eye off him,
him on the promenade, and there, as
when
you perceive
he chatters, throws
aimlesslybusy as in the room,

walks

stones, and

the

hearer

rambles

time

to

his

about

moment

next

with

relations

follow

his

his servants

absurdities

longer knows

no

over

way

grounds like

torments
fatuus,cries out, gabbles,

orders, his

same

and

of his horses,
speaks alternately
his wig, without
waiting for an

dogs, garden, and

or
givingthe
answer,
He

down

and

up

Another

again.

over

he

what

he

an

montade.
rodo-

ignis

with
;

has

and

said

fling
tri-

the
or

done."

precedingresume
precursory symptoms
The

morbid
*

Horace

of reason,

him,
transported

from

the

to the

of

Et

This

state of

of a lunatic,brought down, by a restoration

feelings
into
which
his
morbid
happy Elysium
fancyhad

regionsof

poor

Pol !

"

Xon

excitement.

mental

cerebral,or
describes the

generalidea of the
far as theyrelate to
as
insanity,
conveys

common

me

humanity :"

occidistis,
amici,

sorvastis,ait,cui sic extorta

demptus

per vim

voluptas
error
gratissimus

!"

the
patientto Dr. "Willis, with impatience,
of insanity,
since I enjoyed,duringtheir presence,
accession of the paroxysms
lasted
hours.
of
ten or twelve
a high degree
pleasure. They
Everything
in
themselves
No obstacles presented
theoryor in pracappearedeasy to me.
tice.
of
of
all
a
sudden,
a
acquired
d
egree
singular
perfection.
My memory,
In general,I have
Long passages of Latin authors occurred to my mind.
but then I could write in
in findingrhythmical
terminations,
greatdifficulty
I
with as much
was
malicious,and fertile
as
verse
facility
cunning,
prose.
in all kinds of expedient." "A Treatise on Mental
J^erangement." By
1843.
Francis
Willis.M.D.
"

said
always expected,"

mentis

"

"

PREMONITORY

8ION8

OP

298

APOPLEXY.

mind, however, is also premonitoryof other

of the

great

centre, not

nervous

affections

associated with aberration

of the ideas.
It
and

attacks
frequently
precedesordinary
cerebritia. It is observed

encephalonthat

occur

in

in the

associated with

meninyitin

affections of the

childhood,and

is characteristic of those conditions

of

the

symptom

of the brain

attacks of acute,

as

well

as

so

monly
com-

of low

of the cerebral
typhoidfever,producinggreat rapidity
of the vital,
and exhaustion of the
circulation,
depression
nerve

force.
state of mental

excitement

is

frequently
precursory of
ease,
days priorto an attack of this dis-

apoplexy. For some

the patient
has been known
to exhibit symptoms of
unusual
and irascibility.
irritability
A gentleman,
mind
had been severely
whose
harassed
by anxious business, complainedfor some
periodpriorto
attack of apoplexyof odd sensations in his head.
He
an
said,he felt as if his brain were a
lump of lead,"and as
if thousands
of insects were
creepingover it." He had
headache.
before being seized with serious
A week
no
cerebral symptoms he became extremelyirritable,
spoke
of the kind in a
angrilyto his wife (the first occurrence
with, and aplong and happy wedded life),
quarrelled
peared
"

"

disinclined

to

have

the children

about him.

It

to
of business,unknown
matter
thoughtthat some
his family,
had worr.'ed him, or that he had experienced
loss. On the day before his attack of
a serious pecuniary
he showed
tal
cerebral hemorrhage,
symptoms of acute menalarmed his wife and family.
excitement,which greatly
On the following
day,after a disturbed night,he rote
in the morning and entered his bath-room, and,
very early
about half an hour afterwards,'wias found by his valet in
The pulse
beingscarcely
insensibility!
a state of profound
was

"

and
perceptible,

the

action

of the heart

feeble,stimu-

294

STAGE

lants

and

restoratives

the examination

of

found

were

of the brain

the corpus

on

in
softening
A

EXALTATION.

immediatelyadministered.
the lapseof an
turned;
rehour, consciousness
partially
of the evening.On
he, however, died in the course

After

was

OP

the

after

death, a clot of blood

striatum,with slightevidences

rightcerebral hemisphere.

fell from
tradesman, setat. forty-seven,

omnibus

in Oxford- street,injuring
his head.

of concussion

followed.

consciousness

until

He

continued

late in the

in

of

course

business.

About

difference

was

he
fortnight

twelve months

observed

Symptoms

evening,when
"

was

an

state of semi-

his eyes, gazed listlessly

about him, and, in
of voice, asked, "where
I?
what
has
am
In the

top of

the

he
a

opened

faint tone

happened?"

able to

resume

his

after this attack,a marked

in his mind.

He

became

peevish,

his principal
quarrelsome,
discharging
managing clerk for
inaccuracies. A short time subsequently
to
some
trifling
this changebeingobserved, he had, whilst in his countinghouse, an attack of epilepsy.His mind appearedclearer
and more
composed, after recoveringfrom the acute
He exhibited
effectsof this seizure,than it was previously.
and acuteness in matters of business,
greatself-command
and appearedto be less irritated by familyaffairs. In
about six weeks
he showed
sion,
symptoms of mental depreswhich were
followed by uncontrollable paroxysms
soon
passion! His wife was much alarmed
ofviolent and furious
the
that he was
at his altered mental
on
state,considering
of the night
of an attack of insanity.In the course
eve
recovered
from
seizure.
He
he had a second epileptic
from under a
this fit,and
the mind
appearedonce more
and
dark cloud, and his natural kindliness of disposition
warm-heartedness
again showed itself. The change in

the

state

of his

and
intellect,

affections after each attack

He

had, duringthe

of

altered condition

was
epilepsy,
six months,
succeeding

of his

remarkable.
eleven simila

INSIDIOUS

SYMPTOMS

OF

GENERAL

295

PARALYSIS.

seizures,and in one of these attacks,which was

epileptic
of an
than of an epileptic
more
he
apoplectic
character,
died.
The epilepsy
was
tability
alwaysprecededby great irriand excitement,but without
lusions.
deany appreciable
After death, the righthemisphereof the brain
found to be considerably
was
indurated,and in the left
the seat of the injury,
near
found a small
hemisphere,
was
scirrhous tumour
of the size of a pigeon's
egg.
In one
a
nd
often fatal type of insanity,
peculiar,
known
of
General
by the name
progressive,or
the premonitory stage is
Paralyxisof the Insane"
marked
(in many, but not in all instances)by exalted,
to
grand, and ambitious ideas, referringprincipally
wealth,social position,
worldlyhonours, mental and physical
capacity.For a long period,before any mental
disorder is generally
the ideas are observed to
suspected,
be only of an absurd and extravagantcharacter.
The
of money
he has made ; of
patienttalks of the amount
the success
of his commercial
his good
speculations,
fortune, extraordinary
luck, and of the bright future
in store
and
for himself
family. He magnifiesthe
whether
of his dailyor weekly receipts,
realized
amount
in the practice
of a profession,
in trade, or in commerce.
I have known
this tendencysimplyto distort facts and
look extravagantly
at the bright side of everything,
cause
through an intensely
magnifiedand highlycoloured, be"

morbid

the

mind

medium,

(when the

actual circumstances

of

such sanguine
slightest
degreejustify
to exist for^fr*
ten years, before the
ideas,)
or
even
symptoms of
presentedany decided and recognised

partydid

not

in the

alienation !
of
sixty-two,
to his being
seven
years previously
position
disconsidered as insane,manifested a most extraordinary
with which
and exaggerateeverything
to falsify
A

gentleman,who
for
generalparalysis,

died

at

the

age

of

296

OF

STAGE

he had

of existing
rightappreciation
his constant and singularuntruthfulness,gave
facts,
his relations,to much
rise,among
anxietyand distress
of

to do.

EXALTATION.

mind.

His

Some

estrangedfrom

of his
him

of

want

most

intimate

in consequence

friends

of his gross

became
want

of

his
progressed,
mind
became
more
disposedto indulgein
perceptibly
He
and
wild, visionary,
eventually
illusorynotions.
imagined that he had discovered the philosopher's
stone, the art of making gold, was
possessedof great
wealth, and had the coffers of the Bank of England at
his disposal
!
his death, he
A
before
few months
metical
was
busilyengaged in a scheme, exhibitinggreat arithcleverness and
ingenuity,for paying off the
national debt, out of his own
vast, but, alas ! imaginary,

veracity.As

hoard
In

the

of wealth

another

disease

of the

brain

case,

the

disease could

be traced back

for

and dispohabits,thoughts,
patient's
sition
observed to undergo remarkable
alterations,
were
what was
at that time thoughtto be, a severe
following,
an
epileptic
faintingfit,but which, undoubtedly, was
this genseizure. Previously
to the attack of epilepsy,
tleman
noted for being a prudent,
cautious,careful,
was
and unimaginative
man.
A few days after the attack referred to,a marked change
observed in the patient's
was
tion.
deportment and conversaflow of animal spirits,
He exhibited an unnatural
of mind, and subsequently
unusual buoyancyand elasticity
or
indulgedin the most absurd, but still not irrational,
insane notions of grandeurand wealth. This condition of
mind continued/br
picion
a year, without
exciting
nearly
any sushealth.
He
as to his real state of mental
or bodily
then visited the United States of America.
During the
and his
from sea-sickness,
voyage out he suffered greatly
ideas (perhapsas a consequence)were
subdued,
more
ten years, when

the

OBSCURE

toned

CASE

down,
in

OF

GKNERAL

less

manner

condition

297

PARALYSIS.

and
restless,

his

versation
generalcon-

of

healthyrepose. He remained
in America
for several years, indulging
in many
innocent
and eccentricities,
but continuing,
oddities,
vagaries,
parently,
apin healthypossession
of his intellectual powers.
He

amused

and

the value
talked

of

busied
of

his wish

houses, and

made

acquainted with

himself, whilst there, in

propertythat
to

make

all the

in

business

sale,

land

and
well

manner,

particulars
respectingseveral

largetracts

of waste

land

sold.

returned

to

He

offered for

was

investments

himself, in

taining
ascer-

that

were

advertised

be

to

England (singularto relate)

without
committing one act of what might be termed
of extravagance. His wife could not be
even
or
insanity
otherwise than diverted at the absurdlyexaggerated
and
sometimes
ludicrous tone of her husband's strangely
wild
and often flighty
for one
moment
conversation,but never
from
a
suspectedthat his mind was suffering
phase of
scure
afflicted with obalienation,or that he was
incipient
disease of the brain
A

few

months

after

his arrival in

had

England,he

fit. It was,
however, transient
epileptic
character,and accompaniedwith but littlemuscular
second

or

convulsion.

his mind

manifested

Tinder

the

influence

On

his recovery

decided

from

symptoms

of medical

of

this

in its

tation
agi-

attack,

aberration.

treatment, all signsof

ment
and to the astonishrapidlydisappeared,
!
he appearedto entirely
of every one,
recover
A
few months
subsequently,the extravagant ideas
He
proposed
again took possessionof his mind.
he was
in which
the pursuitsof commerce
to abandon
engaged, and to study for the bar. He expresseda
of the English universities,and
desire to enter one
He talked wildlyof
selected Oxford for his alma mater.
of
in his new
profession;
what he should accomplish
mental

disorder

298

his

having

read

gifts

rapidly
!

demented

long-existing
membranes.

of

The

convolutions.

elocution
and

!
he

disorganization,
was

also

this

became

particularly
considerable

conjoined

with

oratory,

period

paralytic

death,
in

his

(never

of

powers

From

after

of

evidence,

of

magical

revealed,

brain

hemispheres,

law

the
his

progressed,

There
the

!) of
of

witnesses

examining

of

law-work

EXALTATION.

adroitly

knowledge

marvellous

disease

one

of

capabilities

extraordinary

and

OP

STAGE

the
and
of

evidences
its

investing

softening

atrophy

of

of
the

300

one

STAGE

recorded

case

others

OF

that

vision.

MENTAL

is but

DEPRESSION.

occurringwithin

are

If the

of

faithful record of hundreds

the

range

of

own

our

adduced
at the coroner's
generally
inquestis to be credited, in nearlyevery case of
and the mind
suicide,cerebral disorder lias exhibited itself,
has been clearly
and palpably
deranged.In many cases, the
mental
disorder had clearly
existed for weeks, and, occasionally,
for months, without
givingrise to the suspicion
of the presence
of any dangerous degree of brain or
to lead to so disastrous
an
psychicaldisturbance likely
issue.

There

in their

evidence

few

are

results

morbid

mental

conditions

so

fatal

these

evanescent,
trifling,
apparently
and
attacks of depression.They
occasionally
fugitive
almost
ciated
invariably(in certain temperaments) are assoI am
with a disposition
to self-destruction.
never
consulted in this type of case, without fully
impressing
the relatives and friends
the importanceof the
upon
careful and uninterrupted
most
vigilance.These slight
ruffles on the surface,apparently
unimportantattacks of
of morbid
mental
despondency,and trifling
paroxysms
intense
as
ennui, accompanied,
they frequently
are, with
weariness
and

of

as

life,a desire for seclusion,love of solitude,

longingfor death,

brain,and
to

disorder,and

mind

reason

are

and

to life !

indicative
are

How

of

acute

fraughtwith
much

states

of

chief
fatal mis-

of this character

only escapes observation,but is

!
subjectedto no kind of medical treatment or supervision
it may
rence!)
Occasionally
happen (but how rare is the occurhave exhibited no
that the unhappy suicide may
appreciable
symptoms of mental derangement ; but even
in concludingthat
in these cases
should be cautious
we
perfectsanityexisted at the time of the suicide.
struction
that a person is impelledto self-deIt often occurs
by the overpoweringand crushinginfluence of
of disordered

some

mind

latent and

not

concealed delusion,that

has

for

weeks,

SUBTLE

and
the

TYPES

OF

SUICIDAL

301

INSANITY.

perhapsmonths, been sittinglike an incubus

imagination. Patients confess that they have

under

influence

the

hallucinations

for

of monomaniacal

ideas and

upon

been

terrible

long periodwithout their existence

being suspectedeven by their most intimate associates.
For six months," writes a patient, I have never
had
the idea of suicide, night or day, out of my
mind.
I go, an unseen
Wherever
demon
me,
impelling
pursues
to self-destruction ! My wife,friends,and children
me
observe my listlessncss and perceive
but
my despondency,
that is gnawing within."
they know nothing of the worm
Is this not a type of case
more
prevalent
generally
than we
imagine? May we not say of this unhappy
with a mind
tortured and driven to despairby a
man,
concealed hallucination,or unobserved
delusion, urging
of suicide,as the only
him to the commission
escape from
the acuteness of his misery,
a

"

"

"

HE

hear*

Which
HE

stt's

Which

This
observed

morbid
as

of .the brain

one

voice

says,
hand

HE
WE

beckon*

cannot

WE

must

not

cannot
HIM

away

bear,
stay,
see,

r"

condition of the
of the
unallied

is commonly
intelligence
disease
precursory signsof organic
with insanity. Acute
softening,

and
cerebral
hemorrhage, generalparalysis,
in the earlystage,assoseen
ciated
tumours, are
occasionally
with severe
mental depression.
of inflammatory,
I have observed several cases
as well
of the brain, precededby great lowas white
softening
cholia.
of spirits,
amounting to acute melanness
occasionally
had lived,what
In one
case, a gentleman who
is termed a hard life,showed
symptoms of hypochondriasis,
precededat first by ordinaryattacks of profound
This was
ennui.
so
opposedto his usual temperament

cerebral

that the alteration in his natural character

was

made

the

302

STAGE

subject

of

hipped,

refused

He

to

his

of

the

apoplexy

the

existed

gave

society,

former

lapse
of

of

for

some

of

by

recluse.

years,
mental

and

modifications,

time

disease.

great

of

state
before
I

tleman,
gen-

which

health

went
underof

white

depression,

sensor

or

known
of

him.

upon

during

mental

have

appeared

This

died

the

depression

quite

always
called

some

His

brain.

evidence

preceded

quite

and

and

associates

physical

changes

softening

powers

his

condition

many

however,

into

became

suddenly

afterwards

soon

after

DEPRESSION.

He

go

of

any

became

period

MENTAL

observation.

if

unhappy

OF

spirits.

motor

cases

of

OBSCURE

PROGRESS

OF

ABERRATION

CHAPTER

OF

MIND.

303

X.

Stageof Aberration.
INCIPIENT aberration may
1.

The

manifest

Intellectual

itselfin,

Faculties.

2. The

PerceptiveFaculties.

3. The

Moral

Faculties.

quently
alreadyalluded to the contests which so fretake placein the mind (some extent off its balance)
with impressions
clearlyof a morbid character,
fixed and insane ideas. This is clearly
but not actually
an
incipient
stageof aberration.
FACULTIES.
How
INTELLECTUAL
THE
obscure,gradually
subtle,and insidious are the inappreciable
progressive,
approachesof insane thought! At what perioddoes the
traverse the
false,and eccentric conception
exaggerated,
the sane
from the deranged
fatal boundaryline separating
I have

"

mind, and

become, instead of

an

erroneous

gical
notion, illo-

judgment,mistaken conviction,
sion,
absurd and extravagantthought,a bondfde insane delucreation of the distemperedand diseased
a morbid
?
imagination
the firstperiodof the
An attentive observer,tracing
conclusion,error

of

"

evolution

of

fixed idea, witnesses

one

of

the

most

imaginable. He sees a man, the prey

spectacles
of a disposition
imposed by this malady,strivingfrom
back
time to time to rid himself of it,but ever
falling
under its tyrannical
influence,and constrained by the
curious

304

STAGE

laws of his mind

OP

to seek

ABERRATION.

for

some

under

form

which

to

He will be seen
giveit a body and a definite existence.
the divers ideas which
and to repel,
to adopt,
successively
to
to him, and
laboriously
striving
present themselves
deliver himself of a delirium which shall be the expression,
he
internal condition of which
the exact image, of an

himself, after all,suspectsnot the existence !

This

first

phase in the evolution of the fixed idea, this gradual

and
progressivecreation of delirium, constitutes the
*
periodof incubation of insanity."
has received an
A
offence,perhaps a series of
man
His mind
in their character.
at first
offences,trifling
the fact ; he then allows the impresdwells slightly
sions
upon
mensurate
the attention
to a degreequite incomto absorb
other trains of healthy
with their importance,
excluded from his mind.
tually,
Eventhought being rigidly
these notions become
extravagantand exaggerated.
The
injurywhich was, in the first instance, considered
however, (as the
a trivial and
one, assumes,
insignificant
racter
chamental disease progresses,)
a
grave and significant
in

the

of the

estimation

person

whose

mind

is

occupiedin its morbid contemplation.

exclusively
to the pressure, and the general
The intellect at last yields
the idea which was, originally,
health becoming deranged,
becomes
fested
mania clearly
only an extravagantconception,
delusion ; in other words, afxed and settled insane
not in a creation of the
idea, the insanityconsisting,
and insane
fancyde novo, but in a morbid exaggeration,
of actually
existingcircumstances.
jjerversion,
of insanity
"It
is the character
not only to call up
but
also to
impressionswhich are entirelyvisionary,
almost

distort and
them

exaggeratethose

to consequences

of a
*

sound

Falret.

which

which

theydo

are

true, and

not warrant

to carry

in the estimation

mind"^
t Abercr"mbie.

DISORDER

OP

Dr. Johnson
tin- insidious
"

Some

THE

has

PERCEPTIVE

traced with

advances

of

FACULTIES.

the

hand

of

master,

derangedthought:
"

train of ideas fixes upon the mind,

particular
intellectual gratifications
the
are
rejected
:
weariness
leisure, recurs
or
constantlyto the
and
feasts on
the luscious falsehood,
conception,

all other

mind, in
favourite

whenever

it is offended

with

the

bitterness

of

truth.

By degrees, the reign of fancy is confirmed.

first imperious,
She grows
and in time despotic.These
fictions begin to operate as
realities,false opinions
fasten upon
of

or

often

battled
senses,

from

He

FACULTIES.

The

"

the first to

yieldto the
became
eventually

gentleman,who
hand,
by his own
delusion

life passes

in dreams

of

ture
rap-

anguish."1

PERCEPTIVE

THE
are

mind, and

the

for

perceptivepowers

influence of disease.

insane, and died, alas !

before

months

he

that led to his confinement, and

stronglyand
which

he

was

with
heroically

conscious

had

an

no

yieldedto

the

self-destruction,
illusion

existence

of the

apart

himself.
often conversed

with

his wife

the

subjectof
mockery,"she trying,

upon

unreal
phantasy,and
of devoted
affection,and
by soothing expressions
the terto dissipate
rible
arguments addressed to his reason,
image that pursued him, like an evil eye, night
not made
state of brain was
and day. This gentleman's
until his insanity
of investigation
was
obviously
a matter
and life would, in all probability,
His reason
declared.
have
been saved, had timelymedical aid been obtained
horrible

his

"

for his relief!

wife of a merchant, well educated,
lady,aotat. fifty,
luad
experienced
large,temperament bilio-lymphatic,
rise to much
ral family misfortunes, which
gave
bodilyill-health,and to a restless and irritable state of
A

306

STAGE

mind.

The
was

ABERRATION.

OF

first indication

of actual

the

of

appearance

delusion

sanity,
in-

around

halo

transient

and

engaged in reading,and ultimately

regarded. Her
encircling
every objectshe steadfastly
became
false perceptions
numerous.
more
subsequently
in consequence
of the impresShe walked
with difficulty,
sion
she

whatever

which
one

floor,over
of

she
;

had, that

that

deep

which

it

height of

the

was

one

smooth

chasms

was

was

the stair

another, or that she tottered

on

for her
was

to

gular
irre-

an

occurred
constantly

necessary

step of

surface

in the

stride,that

greaterthan

the brink

of

that

pice.
preci-

to others,
scarcely
perceptible
annoyed her very much, both from their supposedloudand
harshness, as well as from their resembling
ness
Her language
voices addressed
to her in conversation.
in relikewise
She
had
affected.
a
was
calling
difficulty
and misapplied
or
misplacedsuch as
expressions,
of facts was
much
she used.
Her
impaired.
memory
in her habits,or careful as to the arShe was
not cleanly
rangement
of dress, "c.
These
sionally
occasymptoms were
absent, when she regainedher original
entirely
and
but
when
acuteuess
even
intelligence,
they were
present,and inspiredher with fear and anxiety,she
doubted
of the sensations
the reality
she received,and
ance.
appealedto those around her for confirmation and assistWhile
in bed, or restingrecumbent, she was
rarelyannoyed by these delusions,but upon getting
she was
rounded
surchange of position,
up, or upon any sudden
in her gait,and
by luminous spots,vacillating
for an
interval,incapableof attendingto any exwas
ternal
her mind
of disabusing
of those percepor
object,
tions,
of the fear and agitationwhich
or
they created.

Noises, which

This

circumstance

were

led her

former

suspectorganicdisease

of the

of

the

exquisite
pain across

medical

brain.

lower

She

part of

attendant

to

complained
the forehead

308

STAGE

OF

ABERRATION.

years previouslyto the attack in the

of light before the eyes
and to these
"

added, pains in the

vision

head, and

were

diminished

of flashes
afterwards
distinctness

gradually increased
till his sight was
totallydestroyed. The morbid phenomena,
tunate
however, which
chieflyannoyed this unforgentleman consisted in a series of the most
dazzling images, perpetuallyplaying upon the optical
was
apparatus,by day and by night. Their brightness
unspeakablydistressing.Sometimes they would assume
the forms of angelswith flamingswords, every motion
of
of

This

seemed, like

which
sear

last

form

the brain

by

symptom

electric flash,to blind the eye and

of their light. The
the intensity
forms
an

shades, however, of these

spectralimages were
petually
perchanging, but without any mitigationof the
which
they produced. With the exceptionof
sufferings
of temper, there was
not the slightest
irritability
some
The memory,
affection of the intellectual powers.
nation,
imagiand the judgment were
unimpaired. He was
of his servants ; and he
the streets by one
led about
his sightwas
not engaged,
attended to all matters where
The eyes themselves
with the greatestpunctuality.
sented
predisease.
of
no
physicalappearance
from
The
were
mitigated,
symptoms above-mentioned
to the nape
of the
time
to time, by counter-irritation
neck, leeches to the temples,and aperientand diuretic
In the springof 1 835, however, he was
seized
medicines.
with all the usual symptoms of apoplexy. He layin bed
The
insensible state.
and
in a motionless
pupilswere
nishment
dilated,and the power of speechparalyzed.To the astosmd

of his medical
of

condition

weeks, he
business

was

as

severe

able

usual !

attendants, he rallied from

cerebral
to

walk

But

the

disorder; and, after

the

this
few

city,and transact
spectral
images,of dazzling
to

ILLUSIONS

PREMONITORY

OF

809

APOPLEXY.

and

returned,with, if potexquisitely
painfulbrightness,
sible,increased intensity.
In the month
of August, he was
suddenlyseized again
with
the apoplectic
symptoms above-mentioned, and,
the same
means
were
notwithstanding
employed as on
the former

occasion,he died

"laysfrom
The

the commencement

body

There

of
nearly two ounces
was
occupied by a
various

sizes,and

and

the

of

three

or

four

membranes

ventricle

fluid.

series

filled with

colours.

the ventricle,by

clear

of

invasion.
apoplectic
day after his death.

the

on

in
nothing unusual
The
right lateral

brain.

end

of the

examined

was

was

the

at the

The

of

contained
left ventricle

hydatid-like
cysts of

fluids of various

This

cluster sprung

kind

of

from

cies
consistenthe floor of

and penetratedinto
peduncle,
cavity,pushing its branches

sinuosityof the
to pass over
and before the thalamus
as
so
anteriorily,
nervi opticiof that side, and
into the
even
opposite
terferin
hemisphereof the brain, destroyingthose portionsinevery

with
a

pulp,as

the

its march.

was,

were

reduced

of the anterior

to

lobes of

the

ling
handslightest
fallinginto a state of deliquescence.The
were
pressedupon by the cysticor hydatid

without

opticnerves
and

thalami

indeed, the whole

brain, which

mass,

Both

reduced

would

bear
scarcely

to little more

than

the

There
these of very soft consistence.
in the coats or humours
of the eye.
and

size of threads,
was

no

change

choly
phenomenon in the above melanwhich
of brightness
the intensity
always
case, was
their
were
images. Whatever
accompaniedthe spectral
forsook
shapes,the dazzlingand painfulsplendournever
The

them.
a

symptoms rendered
dreadful suffering.

These
of

scene

It

remarkable

most

was

considered

remarkable

his

for
life,

that

the

some

years,

intellectual

310

STAGE

ABERRATION.

OF

faculties should have

remained

lobes

were

entire,while the anterior

undergoing the process of

which theydisplayed
Did this
dissection !
on
softening
ramollissement
take place,"
asks the narrator of the case,
"duringthe three or four daysof apoplexypriorto death?
If it existed long before the fatal event, there will be
in accountingfor the integrity
of the
some
difficulty
intellectual faculties up to the time of the apoplectic
seizure. Was
the serous
effusion into the rightventricle
the cause
of the apoplexy? or the consequence
of it?"
it a gradualaccumulation, and not mainlyinstrumental
or was
?
in the final catastrophe
the cause
What
was
of the firstattack of apoplexy,
and why did he recover
of the

brain

"

it?"*

from
A

farmer

another

tomed
neighbourhoodof Edinburgh,accusinvited to the funeral of
was
freely,

drink

to

friend.

in the

He

took

before

of his

house

the

at

dram

he

left

home,

and

He

had

friend.

deceased

he conat dinner, with whom

tinued
acquaintances
until late at night. On the following
to carouse
morning, he imagined he heard five hundred
people
He
compared what he heard to the
talkingat once.
confusion
of tongues at Babel.
Portendingthe utmost
the farmyard,
danger from this sensation,he hurried across
who
attended
his family
and desired the surgeon
and soon
afterwards
he became
to be sent for without delay,
of his

some

insensible.

When

the surgeon

came,

he bled

him

and sent to Edinburgh for a physician. When

freely,
that gentlemanarrived,the patient
was
a littlerelieved,
laboured

but still he

under

considerable

stupor; he

was

morning ; and in a day

two, he felt himself restored to good health.f
A lady,
to an attack of paralysis,
a few
dayspreviously

again bled, and

or

Recorded

"

Cases

by
of

third time

Dr. James

Apoplexy

next

Review."
Medico-Chirurgical
J.
Lethargy." By
Cheyne,jtf.D.p. 83.

Johnson, in the
and

"

ILLUSIONS

PREMONITORY

thrown

was

into

that she had

OF

state of

DISEASE

OF

THE

311

BRAIN.

greatterror by

apparition

an

fancied

appearedto her in the night

A young
child,a short periodbefore beingseized with
acute meningitis,
imaginedthat a brother who had been
dead for several years re-appeared
In a case of
to him.
fatal hydrocephalus,
the first symptom
that directed
attention to the state of the
of
expression

child's brain, was

intense alarm which

sudden

he exhibited,occurring

from an
duringthe evening,arising
impressionthat an
in the room,
and
the bed.
In
was
near
apparition
another case, an attack of meningitis
ushered in by
was
illusion of the senses, the patient
an
fancyingthat the
!
about the room
ghostof a deceased relative was gliding
who, working
Morgagni mentions the case of a man
suffered
at night in a cesspoolattached
to a hospital,
from

hallucination.

an

He

he

fancied

spectre

saw

quicklysupervened,
it was
discovered that he was
labouringunder
and cerebral softening.
venous
congestion,
Some
months
ago,"says Dr. Alderson, I attended
from
who had been attacked, duringa voyage
a patient,
relieved by
He
was
America, with violent headache.
abscess beneath the integumentsof
the formation of an
affected by other
somewhat
the skull ; his breathing
was

clothed

On

in white.

his death, which

"

"

of

in

formed

the

dreams,
havingfatiguing

awake.

when

had

which

tumours

short

time

He

throat.

and

of

even

afterwards

plained
com-

dreaming

he told

me

that

thoughthe saw his

that
by his reason
impressionon his mind

hour or two he
for the space of an
wife and family,
although convinced

they
was

his

were

so
son

his

America.

strong,and
so

The

the conversation

circumstantial and

tellingit in
followingday. He
wife and familyhad

not resist
the

in

he

had

held

that
important,

with

he could

all its details to his friends

also desired to
not

arrived from

be

informed

on

if

America, and

312

OF

STAGE

whether
for

they were
second

considered

ABERRATION.

in the

not
he

induce
'

perfectly
sane, and
acknowledgedhim to be so, with
had
"

he

ever

now/

Until

he

spectres,

he, I had

said

mind

was

me,

'

He

knew

his friends

that

was

lie

belief in

stories of this character.'

faith in all the

that

sent

was

quicklyperceivedthat
deranged,when, turning towards
time

inquiredif his disease could

and figures?
apparitions,
no

house.

same

also

strong as

as

it

been.

to
Having explained

visions,and

told

him

that

both he
bodilysufferings,
But the phantoms became

until he could

him

not make

the nature

and

they would

and

cease

of his

with

his

his friends grew

more

up

cause

his

and
mind

composed.
importunate,

more

to

retire to rest,

immediatelyharassed by the souls of the

to him.
dead, or visited by persons disagreeable
Having
the visions ceased for some
time ;
changed his room,
but he soon
perceivedhis friends of the New World
picturedas on a pieceof polishedmetal.
Designedlyoccupyingmyselfwith a book, I detected
him
mentally conversingwith them, and at times
and heard them.
imagining that I also saw
evidently
When
he looked away
from the polishedbar, he talked
At length
medicine, and politics.
on
religion,
sensibly
the purulentmatter
he changed his residence, when
his condition was
He
ameliorated.
being discharged,
is now
convalescent, and
entirelyrelieved of his
phantoms."1
relates the particulars
Dr. Hibbert
of the following
he says the learned and accomplished
case, which
interesting
Dr. Gregory,of Edinburgh,used to refer to in
because

he

was

"

his lectures
"

"

patientof

advice, made
*

"

some

the

Edinburgh Medical

rank

tor's
having requestedthe docstatement
extraordinary
following
and

Journal,"vol.
Surgical

VR

p. 29 L.

SINGULAR

CASK

of his

OP

SPK

ILLUSIONS,

THAI,

13

in the habit,'he said, 'of

complaint: 'I am
jected
diningat five,and exactlyas the hour arrives I am subto the following
painfulvisitation. The door of
tlu' room,
when I have been weak
even
enough to bolt
"

it,which

I have

hag, like

one

enters

with

straightup

sometimes

haunt

frowningand

incensed countenance,

which
indignation

the

heath

of

with every demonstration

of
could
characterize her who

Abudah

in the

oriental tale

old

; an

of those who

to me,

the merchant

done, flieswide open

Forres,
comes

spiteand
haunted
rushes

she

but so hastily,
that I cannot
upon me, says something,
discover the purport,and then strikes me
blow
a
severe
with

her staff.

I fall from

chair in

my

which

swoon,

is of

To the recurrence
of
longeror shorter endurance.
this apparition
I am
dailysubjected.And such is my new
and singularcomplaint.'Doctor Gregory immediately
asked whether
his patienthad invited any one
to sit
with him when
he expectedsuch a visitation?
He was
in the negative.The nature
answered
of the complaint,
he said,was
it was
so
so
singular,
likelyto be imputed
to fancy,
to mental
or
even
derangement,that he had
shrunk from communicatingthe circumstance
to any one.
'Then,' said the Doctor, 'with your permissionI will
dine with you to-dayIdte-a-ttttc,
and we will see if your
will venture to joinour company.'
malignantold woman
The patient
tude,
acceptedthe proposalwith hope and gratifor he had expectedridicule rather than sympathy.
They met at dinner, and Dr. Gregory, who suspected
some

disorder,exerted

nervous

well known

his

powers
varied

to be of the most

of
and

tion,
conversa-

brilliant

character,to keep the attention of his host engaged,and

prevent him

from

hour, to which
so

much

than

he

terror.

he had

thinkingof

the

was

accustomed

He

succeeded

hoped.

The

hour

approachof

the

to look forward

fated
with

better
purpose
almost unof six canie
in

his

314

STAGE

noticed,and

it

ABERRATION.

OF

hoped might pass

was

evil consequence

when

of the house

the

owner

voice, The
*

chair in

hag

but

it

scarce

exclaimed, in

in the

way

he had

any

struck,

moment

alarmed

an

again!' and dropped back

comes

swoon,

was

without

away

in his

described.

himself

These

established to arise
shocks were
periodical
clearly
from a tendencyto apoplexy,and after the brain was
relieved by the abstraction of a small quantityof blood,
the patiententirely
recovered."
A gentleman,
to being seized
immediatelypreviously
with epilepsy,
in a
imaginedhe saw a littleold woman,
red cloak,run
blow on
up to him and give him a severe

the head.
A

for nine years to epilepsy,

gentleman,who was subject
to his attack, was, as he expressed
it,
previously
train of thought,which
suddenlyseized with a peculiar
intense
not
to him, but caused him
was
intelligible
character,
anxiety. The ideas were
alwaysof the same
and whilst he was
in the act of making an
effort to disembarrass
of epilepsy
himself of them, the paroxysm
took place.
The
followingcases, as recorded by Dr. Devay (of
Lyons) constitute good illustrations of those psychical
states which so frequently
precedeand accompany brain
affections
"

"

I have known

to that time

himself

led

to the

age, and

was

who havingup
agedfifty-seven,

man,

grave and

pursuit of
few

months

even

austere

amusements

abandoned
life,
unsuited

after seized with

sudden

foudroyante).A
completeapoplexy(apopkxie
estimable
of his

for mental

heart, called

endowments,
one

day to

and

converse

man,

for the

with

to

me

his
and

most

qualities
on

jects
sub-

His
conversation was
to his health.
relating
but he
indicated in his gait,
clear,nothingmorbid was
for work.
had for a long time complainedof inaptitude
not

310

STAGE

have been

known

ABERRATION.

OP

their usual

(contraryto

in gross sensual

decadence, weakened

dulge
in-

states of moral

to exhibit

excesses,

habits,)to

and

volition ; to be guilty
paralyzed
of acts of privateand publicindecency,
bauchery,
dedishonesty,
and beastly
intemperance.These symptoms
exist for years, before insanity
has clearly
occasionally

declared itself.
A

lady,of good familyand of affluent circumstances,

able
accompanied by her maid, entered the shop of a fashionThe lady,as
jewellerat the west-end of London.
well as other members
of her family,
in the habit,
were
for years, of dealing with the tradesman
referred to.
After examining many
articles of jewellery,
she left the
shop without
purchasinganything. Soon after her
arrival home, the master
of the shop called at the house,
and requestedan interview with the husband
of the lady.
This was
at once
compliedwith. He then informed him
that his wife had been to his shop,and had, as he suspected,
abstracted

found, and

returned

liberal and

had
a

it

arisen

either
fit of

temporary

with
acquainted

his firm

was

the

of

be, for

felony!
a

suggestedan
number

an

had

and,
investigation,

of

chains,"c., were

and

diamond

found

This
to

No

ladycould, for

too

was

stance
circum-

mind.

senses) committed
idea

spirit

the result

was

(whilst in

entertained.

of her husband
a

her

Such

moment,

of

the

that

mistake, or

alienation

she

of
possession
act

character of the

believe that

moment,

in

belief

true

the

was

the distressed

to
affirming

man,

suspicion

bracelet

he, in the

to its owner,

humane

husband, that
of

the

was

of the

The

bracelet.

diamond

and
immediatelyinvestigated,
tradesman
proved to be correct. The

matter

of

valuable

full and
a

one

one
clouded
un-

deliberate

preposterousto

unhappy episode
great

ment
astonish-

of her

family,
rings,valuable bracelets, gold
*of which
in her possession,
no
all the members

INSANE

PILFERING

be

could

account

AND

given.
lady'sconduct

atlair,this

About

began

to

disorder

could

articles

most

parts of

stolen

her

were

after this

remarkably and

so

first time, her

husband

of al"erration of mind.

exhibited

pilfereverythingshe
so

the

suspect the existence

mental

Il.r

nine months

became

patnitlysingular,that, for

317

CONCEALIXO.

itself in

to
disposition

The
lay her hands upon.
concealed in various
cleverly

dress,in beds, and

in

parts of the house

-rally
frequented
by the family.
the state of the patient's
Such was
mind

not

LT'-in

I had

firstconsulted.
the

It

case.

decided

was

my
of

symptoms

In three

be observed.

doubt

no

to the

as

opinion that
would,
insanity
months

from

health

mental

Her

in

and

was

more

short

time,

first seeing this

indications of aberration,
be removed

to

re-established

was

character of

other

my

her mind
exhibited
decided
patient,
renderingit necessary for her
home.

when

from

in about

eighteenmonths.
of

wife

respectabletradesman, for twelve

before her mind
months
was
imagined to be disordered,
in the habit of entering her husband's
was
repeatedly
of money
from
the till.
shop and stealingsmall sums
of useless articles of
AYith this she purchased
a number
The

dress, with which

her

wardrobe

silk and
shoes, gloves,
petticoats,

she had
to

no

use,

She

wear.

in
had

purchasinguseless
jM-rson

in

her

fact,which
mania

crammed.

was

satin

she

She

had

dresses,for which

never

wore

or

intended

and
stealing,
secreting,

for

quiteunsuitable for a
This patienteventually

articles of dress

station

of life.

hallucinations,and, under a delusion

religious
had
she
committed
the unpardonablesin, made
that
an
attempt upon her life.
in fashionable life,
A lady,well known
was
repeatedly
detected in the act of purloiningarticles of value from

exhibited

her friends.

When

she

returned

home

from

dinner

318

STAGE

partyor

ball,her maid

handkerchiefs

and

of

obtained
morbid

until
mental

manifested
A

the

found
invariably
about

several

suspectedthat

intellect,but
she

exhibited

excitement

no

pocket-

her person.

temptationof pickingand

family sometimes

disorder

ABERRATION.

fans concealed

could not resist the

Her

OP

there

medical

decided

She

stealing.
some

was

advice

symptoms

accompaniedwith

was

of

clearly

delusions.

mitted
gentleman,connected with the army, comtime
numerous
pettyacts of theft,which for some
contrived to conceal from those about him.
he cunningly
detected in stealing
pagne
He was
a bottle of chameventually
he had a superabundance
at a time when
of this
wine in his possession.
His conduct was
made the subject
of formal inquiry. Many of his friends were
of opinion
that the young gentlemanwas
of sane mind,
not altogether
raised.
It was
and, in his defence, this pleawas
proved
time
been in the
by his servant that he had for some
habit of walking about his room
at night,frequently
talkingto himself and laughing loudly at his own
found
in a moody and
thoughts. He was occasionally
sit for several hours staring
abstracted state.
He would
At
times
he was
at vacancy.
unreasonablyirritable,
occasions when
of temper
on
particularly
greatcommand
and freedom from all passionwere
essentially
important.
On these,and other grounds,
he was
honourablyacquitted
his mental condiof the criminal charge,
tion,
but, considering
him
advised to remove
from
his familywere
the
This
gentleman died six years afterwards of
army.
but the
disease of the brain, supposedto be softening,
ascertained as no postmortem
fact could not be positively
examination
was
permitted.
in a provincial
A clerk,holdinga confidential position
accused
of repeated
dence
acts of theft. The evibank, was
againsthim was conclusive. On searchinghis

young

PILFERING

INSANE

AND

lodgings,
nearlyall the missingmoney
concealed in the liningof some
out and

worn

He

useless.

treated the matter

He

319

STEAM

found, carefully
old clothes,
rently
appawas

did not

with

denythe

nonchalance

those occupiedin
a character,that
peculiar
of a private
character,as
(which was strictly
questionwas connected by marriagewith one
were
disposedto questionthe soundness of
He
a

was

the
the
of

sation.
accu-

of

to

inquiry
party in
the firm)

his intellect.

circumstances,his salarybeing
Independentlyof this fact,his wife had a

not in necessitous

liberal one.

His habits
placedat his disposal.
He was
of a simplecharacter.
believed to be
of lifewere
conscientious man,
most
exact
in
a
being scrupulously
with his tradesmen.
On one
all his dealings
occasion he
in an account that had been rendered
found an inaccuracy
to him by his wine merchant, and he at once
pointedout
the mistake, and immediatelysent a cheque in payment
The gentlemanwas
due.
of the extra amount
obliged
The private
to resign his appointment in the bank.
the matter affirmed that they
juryselected to investigate
mental alienation,but declined expressing
suspected
any
quently,
authoritative opinionon the subject.Two
years subseand professionally
under
the case came
formally
At this time, the mind
was
manifestly
my observation.

fair income, which

disordered.

He

she

believed himself to be

person of rank,
establish a state
a

by the Almighty to
of religious
throughoutthe whole world. The
equality
I advised to be adopted in this case, after
treatment
the lapseof a few months, appearedto be promoting his
He
however, manifested great mental
suddenly,
cure.
and
confusion
excitement, and ultimately,
suddenly
found, after
died in an
apoplecticfit. There was
death,great thickeningas well as adhesions of the dura
of the arachnoid.
There
mater to the skull,withopacity
was
a slight
patch of softeningin the left hemisphere,
and

destined

320

STAGE

contained

which
of

ABERRATION.

clot of extravasated

blood of the size

bird's egg.

small

I have

OF

had

under

stole
invariably
whatever
she could
lay her hands upon during certain
uterine
changes,and another patientalways manifests
at the periodof utero-gestation.
the same
propensity
"A
high in office,"says Dr. Brierre de
person
had performedthe duties of his station up
Boismont,
I was
when
to the time
consulted, and yet the details
furnished
which
to me
were
by his wife left no doubt
care

my

lady who

"

that his moral

had

for

actions

mean

the

named

houses

acts

of

consultation

some

and honest,

licentiousness.

great

With

the

manifested

was

his

so, and

in

debts, maintaining

purloinedobjects
acquaintances. Until the last-

his

no

Some

disordered.

was

for

exhibited

years

to pay

committed,

were

been

generous

disease,his avarice
he refused

six

unbridled

alreadydone

that he had
from

than

and

of the

progress

havingbeen

more

avarice

sordid

mind

affective faculties had

impaired. From

time
he

and

even

had

one

time

that
suspected

after,I

his

called in

was

retired

whose thefts
publicofficer,
much
noise some
had made
years previously.The particulars
I was
with
which
furnished
regardingthis
labouring
patientinclined me to believe that he was
under the premonitorysymptoms of general paralysis.
to

I felt certain
to

see

that

the

such

the
patient,

fullyestablished the
His
delinquencieshad
His

mental

the

was

first words
of

correctness
been

fact.

observed

alienation

was

On

my

that

he

uttered

anticipations.
eight years previously.
only recogniseda

my

ago."*
A
gentleman,whilst on a voyage from
Indies
to England, attempted to commit
few

duction
intro-

months

assault

one

upon
*

"

Gazette

of the female
Medicale

passengers

de Paris."

1847.

the

West

criminal

Up

P. 303.

to the

INSANITY

periodof
observable

EXHIBITED

IN

the

of
sailing
symptoms of

friends in the West

ACTS

the

OF

vessel he

mental

Indies

had

821

IMMORALITY.

had

shown

derangement.
""

never

in this

case

no

His
pected
sus-

weeks, however, priorto his

insanity.For some
sailingfor England, he had been exposed to great
mental labour and anxiety,
having to settle and arrange
matter
of business.
a complicated
At

the

conduct

time

of the

commission

of the

assault,his

and irrational. The

singularly
inexplicable
offence was
in the broad lightof day, at
perpetrated
time, and under circumstances
a
renderingdetection,
evitable
inexposure, and punishment,prompt, certain, and
! For the rest of the voyage
he was
closely
was

confined to his cabin, under

arrival in London, he
insane state !

was

strict surveillance.

On

in
pronounced to be clearly

his
an

the case, and as far as

saw
subsequently
I was
enabled to unravel
its history,
satisfied that
was
of which he had been guilty
the act of immorality
during
the voyage was
the firstdemonstration
of his insanity.
A young
situation
gentleman,holdinga responsible
in a bankingestablishment of repute,was
walkingin the
on
a
neighbourhoodof Regent-street
Sunday afternoon,
when he suddenlycommitted
act of gross indecency.
an
taken into custody.When
He was
asked for an explanation
in
of his singular
conduct, he appearedlike a man
could oiler no satisfactory
a state of delirium,and
excuse
character was
His previous
for his outrageousact.
impeachable,
unhe never
having been known to be guilty
of any palpable
universally
immorality
; in fact,he was
most intimately
admitted, by those who were
acquainted
of thought,
and
with him, to be a person of greatpurity
of conduct.
He was, however, accused
strict propriety
of the offence,but before the matter came
by the police
bited
exhiunder the cognizanceof a court of law, his mind
and he was
decided symptoms of disorder,
conseY

322

STAGE

OF

ABERRATION.

quentlyreleased from the hands

properlyplacedunder medical
Was

the immoral
did the mind

offence the

of the civilauthorities,
and
and

treatment

frst OVERT

act

restraint.

of i/ixn/iily,

become

derangedin consequence of the

I am
dread of exposure, disgrace,
and punishment?
clined
into the former hypothesis.It appearedthat there
to a considerable extent, in the family,
was
insanity,
and
that this gentleman had
received,when
a
boy,a
severe
injuryto the head, from the effects of which he
covered
disIt was
to have recovered.
was
supposed never
that for some
to the commission
days previously
or

of the indecent

been
of

singularin

offence,he
his manner,

headache, restless and

A

the age
of acute

health.
to her

with

been

and

was

disturbed

observed
heard

to

to

have

complain

nights.

lady,up to the age of nineteen, comported

with
the greatestdecorum
and propriety,
dencing
eviin her conversation
tone.
Between
a high moral
of nineteen
and twenty, she had several attacks
but was
restored to
hysteria,
soon,
apparently,
She then became
often
pensiveand sad,retiring

young

herself

tears.

had

own

She

room,

where

exhibited

she
a

was

often

found

bathed

in

to associate
great indisposition

with those about her.

family,or to converse
Apart from these symptoms she manifested no positive
signof mental aberration.
With
of rousingher from a state of recognised
a view
of the family
mental
torpor,she was taken by a member
whilst there, and in the act of
to a publicball,and it was
bited,
dancingwith a comparativestranger,that she firstexhiloose character of action
by a marked and painfully
and conversation,unequivocal
symptoms either of grave
moral depravity,
of serious mental disorder. The genor
tleman
with whom
she was
dancing observingsomething
wild in her physiognomy, had his suspicions
peculiarly
in
awakened
to her condition, and had np difficulty
as

the

324

IMPAIRMENT

OF

CHAPTER

MIND.

XI.

Impairmentof Mind.
I

to

PROPOSE

order

consider

this

subjectin

the

following

"

1. General

Weakness

2. Morbid

Phenomena

3. Morbid

Phenomena

GENERAL

WEAKNESS

of Mind.
of Attention.
of Memory.
MIND.

OF

The

intellect often

and
presents evidences of general prostration
to
long anteriorly
or
beingdiagnosed,
cerebral

to

serious

disorder

of

the

brain

suspected.This condition of
weakness
sluggishness,
psychical

gous
impairment,is,in many of its features,analothe torporof mind
that so frequently
supervenes

certain

those

even

lassitude,mental

and

upon

any

debility,

of

acute
febrile

forms

of

bodilydisease,particularly
implicatingthe nervous

character

functions.
In

of
and

the patientis conill-health,

scious
of brain tone, sluggishaction of mind,

this state of mental

of

want

deviation from

his

normal

and
acuteness,activity,

condition

vigour.

He

of intellectual

is

painfully
recognises

feelingmentallybelow par, and

his powers
of mind.
his inability
to use efficiently
He
suffers from
a
a psychical
torpidstate of the intellect,
him for any kind or degreeof cerebral
malaise unfitting
work.
The effort to think is irksome and.painful,
caussensible of

INSIDIOUS

ADVANCES

OF

MENTAL

IM!U."

325

II.ITY.

ing,if perseveredin,vertigo,
headache,painful
confusion
of thought,and acute mental depression.
In this condition

of

exhaustion,the patient

nervous

is

of exercising,
for any
incapable
lengthenedperiod,
of thought,and is at times quite unable to
continuity
think

at all.

This

mental

him
apathy,disqualify
active operationof the
aside

of

of

source

interest,and

for any

the
occupationrequiring

intellectual powers.
the
books, and even

his favourite

the
formerly

and
listlessness,
prostration,

much

so

throws

newspapers,
devoid
become
pleasure,

distasteful

even

He

him.

to

He

then

neglectshis ordinaryvocation, feelingin mind blase,

and only able to sit quietly
in a state of gloomy abstraction
in his
in

room,

condition

these

or

about

saunter

the

of

dreamy reverie.
symptoms consequent

house
have

upon

an

or

streets

often

nessed
wit-

overtaxed

and

unduly exercised mind.

of
of the most
active understandings,
Men, naturally
when
in health,
and capable,
a high order of intelligence,
of a considerable degree of sustained
tellectua
and vigorousinlabour,have been

to this sad state of

reduced

the
as
psychicalimpairment,and "precocioussenility,"
result of anxiety,
excessive and severe
or as the effect of an
cerebral and
Under

mental

strain.

these circumstances

fatigued.
easily
This condition of failingintellect is recognised
by the
which
in preserving
the person
difficulty
experiences
intact the sequence of ideas and chain of thought. The
either wanders, or
memory
its associations.
All power
is either

has
of

no
an

fixed hold

enfeeblement

accidental

is vague

is

and

incoherent

in

nation
combihealthypsychical
lost, or greatlyimpaired.The mind
and in consequence
upon its conceptions,

attention, the ideas

and

the mind

of

of the will, and

are

influenced

circumstances.

weakened

power of
casual
the most

by
In generalterms,

all

326

IMPAIRMENT

OF

MIND.

appears to be

balancingor co-ordinating
psychical
power
gone.*
This

morbid

condition

with, and, in
a

of intellect is

great

measure,

debilitated,and
depressed,

vital and

force.

of

is

being deprivedof

some

organic elements,
from

exhausted
blood

nerve

consequence

The

associated
generally
dependentupon,

The

aluemia.

and

the

state

the

in
impoverished
of its important

whole

countenance

of

system

assumes

suffers

pallid,

and
haggard,lifeless,

lative
exsanguineaspect. The assimifunctions are
disordered,and the patientsometimes
Such
is often the
becomes
emaciated.
seriously
physicalstate of those whose minds have been prematurely
This phase of mental
exhausted.
and bodily
in the majority
of cases, speedily
to the
ill-health,
yields
administration
of stimulants
and blood tonics
judicious
associated with appropriate
moral treatment, provided
no
serious structural mischief has commenced
*

Among

the

incipient
symptoms

observed
occasionally

are

of

torpor,and

softeningof the brain,and apoplexy,

exhibited in
of intellect,
prostration
The patient
degreeof mental work.

to undertake
inability
any kind, and
of psychical
complainsof a deficiency
power,
an

energy, and of
and stamina.

want

an

state of the

exhausted

appearingto have

nervous

lost its healthy

tone,

"
for some
days by
Apoplecticattacks are often preceded
says,
unusual
tion,
attenf
or
in
intellectual
work, by an incapacity
difficultyexecuting

M.

of vis,the brain

in the brain.

Gendrin

by an extraordinary
irascibility,
by a
and producesterrors without
impressions,
ourselves
concerning

or

morbid
a

cause,

weakness
or

by

which

exaggerates
anxiety

unreasonable

those related to us."1

premonitorysymptoms are not demonstrable in every case of cerebral

for many
brain or mind work
hemorrhage,
patientsappear capableof severe
the
to
the
moment
or
fit,but
paralytic
immediatelypreceding
apoplectic
up
in many
this conscious diminution of vigour of brain and impairment
cases
of mind are importantpremonitorysigns of approaching
and
acute paralytic
in
other
of
is
seizures.
The
states
apoplectic
present
symptom, however,
disease of the brain.
be associated with gidShould
this condition of mind
diness,
aberration or impairment of vision,or a
headache, depressedspirits,
in any part of the body,
slightsensation of numbness (even if circumscribed)
These

the

patient
may

well be anxious

as

to the state of his cerebral health.

"Traitd Philos. de Me"d. Prac."

Tom

I.

487.
p.*

SUBTLE

The

CASE

OF

SOFTENING

OF

THE

327

BRAIN.

detailed,
symptoms, however, previously
are,

of formidable
attacks
precursory
disease of the brain,and are to be viewed, in

of
some

casionally,
oc-

organic
cases,

pathognomonicof the existence of cerebral tumours,

abscess,induration,and other formidable types
softening,
of encephalic
disorganization.
A
who
died of softening
gentleman,aged fifty-four,
of the brain, associated with hemiplegia,
had for nearly
twelve months
to his loss of motor
previously
power,
complainedof no other symptom than painfulprostration
of mind.
He
had the greater portionof his life
been actively
engaged as principalof a largeacademy,
having under his scholastic supervision
nearlysixty
and of an
conscientious man,
boys. Being a strictly
anxious
temperament, he was
always in a state of
feverish excitement
and
painfulapprehensionlest he
should fail in the dischargeof the serious and responsible
thus
mind
him.
His
duties devolvingupon
was
and
kept in an unceasingcondition of mental inquietude
this severe
of cerebral presUnder
amount
perturbation.
sure
and mental anxiety,
he was
conscious,as he admitted
at the time lo his medical
attendant, of ///*mind gradually
capable
became
He eventually
quiteinfading away from him.
his establishment.
of personally
superintending
On one occasion,fancying
that his intellect had in a great
he entered the
recovered its original
measure
strength,
school,and occupiedhimself with his usual duties. He,
of directing
however, soon found that he was quiteincapable
to any one
his attention for five minutes
continuously
subjectconnected with the business of tuition,and he
and seating
room,
immediatelyretired to his own private
himself in a chair,burst into a flood of tears, exclaiming,
as

in wild

despair, my
"

this

case

was

detected

no

mind

symptom

of

until twelve

In
altogether
gone T
physicaldisease of the brain
to death !
months
anteriorly

is gone!

328

OF

IMPAIRMENT

The

condition
for

of

mental

MIND.

ruptedly
impairment existed uninterfour years priorto the attack

periodof
hemiplegia,which occurred

of

shortlybefore death.
In another
solicitor was
case
a
obligedto retire for a
ness,
busiperiod of five years altogetherfrom professional
enfeebled

in

un

of an
consequence
associated with aberration

the

sensor

or

motor

that for
continuous

days absent

duties of his

office!

from
Two

ledged
gentleman acknow-

This
he

had

not

the anxious

years

mind,

lesion of

of intellect,or

power.

thirtyyears

of

state

for

been

and

seven

responsible
his decease,

prior to

and he
recognised,
nearlylost all visual power.
During this time, he was
subjectto acute attacks of headache, accompaniedwith
and distressing
great depressionof spirits,
paroxysms
of vomiting. He
of extreme
sometimes
and
nausea,
and
one
suddenly,
day after dinner, became hemiplegic,

symptoms

of cerebral amaurosis

in

weeks

few

died !

were

tumour

found

was

in

close

proximityto the opticthalamus, undoubtedlyinterfering

with the special
functions of this ganglion. In a third
officer who
had
an
through
successfully
case,
gone
imbecile.
several East India campaigns,became
gradually
All
the faculties of the
were
mind, simultaneously,
debilitated

itself at first in
such

of

This

deteriorated.

and

loss of any

did

not

manifest

mental function,
particular

the memory
attention,but the whole powers
or
mind
appeared to graduallyfade away, and

as

the

tive
destrucand
mysterious,inexplicable,
This
influence.
patient continued in a chronic
After death, the
for many
condition of imbecility
years.
succumb

to

brain

found

dura
and

was

mater
on

and

in

state of sad

tunica arachnoidea

the former

of tubercular

was

discovered

! The
disorganization
were
a

much

thickened,

considerable

deposition.The calcariuw was

the
(the clip/oe
obliterated),
being entirely

extent

indurated

brain much

SINGULAR

and
atrophied,
this

CASE

OP

some

in
portions,

in

instance,there

of aberration
In the

were

until

no

329

PARALYSIS.

delusions

softened state.
other

or

In

symptoms

halfbefore death I*
cerebral or generalparalysis,
the

year

earlystage of

patientoften

CEREBRAL

and

if he had

dence
(mentally)lost all confiin himself.
He rarely
acknowledgesthat such is
the fact,but exhibits in his conversation and deportment
evidences of a state of enfeebled mind, paralysed
lating
or vacilwill. These symptoms I have known
to exist for
to the developmentof any
clearly
years antecedently
manifested
sign of disease of the brain or disorder ot
the mind.
A gentleman,who
died of cerebral
eventually
of
two years before there was
paralysis,
any recognition
disease of the brain, was
reduced
to a state of complete
childish and slavish dependence
upon those about him.

It

was

as

unusual

an

replyto

acts

His

one.

wife

these duties for him.

was

eldest

to write

letter,
or

discharged
generally

son

Letters addressed

to

him

on

portant
im-

sometimes

unopened
his wife
several days. In consequence
of this neglect,
in the haMt, occasionally,
of searchinghis pockets,

and

letters with

when

oh dear

how

me,

seals

unbroken

merely exclaimed,

he

hand,
"

or

of business remained

matters

for

for him

occurrence

with

careless I have

were

put

into his

apparent surprise,

been

1"

neither were
capacity,
in this case, until
there marked
symptoms of imbecility
of the period
the expiration
Strangers
specified.
previously
There

"

When

was

no

obvious

of

or
that precede,
accompany,
intelligence
remark*
Andral
lating
recapitu(when
an
type,
apoplectic
cerebral
affections)
in
observable
phenomena
psychical

of
speaking

disease* of the brain

the morbid

want

the lemons of

of

"

"
Many patient*preserve all the clearness and strengthof their iuivlligvnee
In others there are olwenred,a
attack.
of the apoplectic
up to the moment
some
changes in the inU-llectual
shorter
time before this period,

or

longer

Many, on the contrary,

theyare, as it were, benumbed.
lose their memory
Some
;
degreeof excitement.
an
extraordinary
what
or
do,
where
neither
when"they know
they
theyare,
moments

faculties ; sometimes
manifest
th.-re

are

what

MMicab.
theywy.""A*dral'i Cliitiyuf

330

IMPAIRMENT

observed

never

vigour;

in this

OF

MIND.

diminution

patientany

but those in constant

of mental

and

lovingassociation with
him, and well acquaintedwith his previouscondition of
observant of the gradualand insidious
mind, were
painfully
advances of his brain disorder and mental decrepitude.
tural
They could not but notice his singularand unnaof interest in his professional
want
shown
affairs,
and neglecting
by his absentinghimself from chambers
other importantduties.
His marked
indifference to his
out
children,and apparentloss of affection for his wife,withalso
was
exhibiting
any insane alienation of feeling,
a significant
symptom, quoad his state of mind, for he
caressed

his wife and

when
affection,

his attention

by other*,and
in the

was

he

of

with

his usual

warmth

of

to them
specially
He
coolness and neglect.

directed

was

twitted for his

was

habit of

the pages

over

children

for hours, turninglistlessly

sitting
number

of favourite

ing
books, and look-

through portfoliosof engravings and drawings,

without
apparentlyknowing what was
occupying his
attention.
During the whole of this time he was fully
when
the subjectwas
capableof discussing,
suggested
book
to him by others, the merits of any particular
or
of great taste, and had a
a
man
painting(forhe was
first-class works
of
and many
largeand valuable library,
art in his house),but associated with this apparent,but
his mind
dering
factitious power
of concentrating
to, and consiand
his intellectual brightness
any given subject,
vigour were
graduallyfadinginto the dark regionsof
imbecility!*
*

After death, the relations found

in the house,

clothes and
of

matters

letters

were

stolen
with

fourteen
or

number

lost.

his brain

Bank

months
At

or

England
and
previously,
of

this time

mind.

note

none

of the

pocketsof

the

man's
gentlerelatingto important
unrepliedto. Many of these

of letters

business,unopened, and of course

contained
of old date,and some

envelopecontained
mitted

secreted in the

remittances

for 100/.,which

which

was

of money.
had been

supposed to

have

One
trans-

been

familysuspectedanythingwrong

332

MORBID

PHENOMENA

Morbid
THIS

CHAPTER

XII.

Phenomena

of Attention.

subjectwill
1.
2.
3.

The

ATTENTION.

OF

be

follows

analysedas

"

Impairment of Attention.
Heightened or Exalted Attention.
Concentration
of the A ttention.

of
faculty

attention

of the varied powers

is

of the

of the most

one

important
its possession,

Without

mind.

the

If we had no
would be a blank.
understanding
of
to direct the thoughts to objects
voluntarycapacity
abortive would
be the
consciousness, how
attempt to
and improve the intellect?
expand,discipline,
"

The

difference,"
says

ordinarymind and
in this,that
principally
a

Newton

is

while

to break

or

the

one

series

thread

'

who

to

made

patientattention
*

any
than

"

Lectures

the

tion
applica-

towards

is
capacity

that

inference

determinate

obliged
begun to

soon

he had

Newton,

with

admitted.

To

genius,he replied,
discoveries,it was
owing more

complimented him

that if he had

consists

connect

which

between

the other

than

spin. This is, in fact, what Sir Isaac

equal modesty and shrewdness, himself
one

"

Newton,

capableof

to
fatigue,

long

let fall the

of

is

one

of inferior

man

Hamilton,

attention

able, without

with inference in
end

the

continuous

more

W.

mind

the

an

of

Sir

on

to any
on

his

other talent.'

Metaphysics."

"

'

IMPORTANCE

No

OP

THE

PACCLTT

OP

333

ATTENTION.

sound

knowledgeof objectsexterior to ourselves,

of normal conditions of consciousno
ness,
rightappreciation
accurate insightinto the morbid
or
phenomena of
thought,can be obtained, without the power of concentrating
by an act of volition,the attention to subjects
under the immediate
of the understanding.
contemplation
Observation
and reflection (two of the most importantof
the mental
the
the

and

would
faculties)

of
possession

have

the power

existence

no

apart from

of

and controlling
directing
The
attention.
able,intelligent,
learned,and sagacious
has
tliis
o
f
mind
man
faculty the
fullymatured
developed. It is essential that such should be the

The

dull, vapid,and

uninformed

hibits
understandingex-

intellectual power
in a very feeble state of
The absence of this faculty
"manifestation.
causes
great
this

intellectual weakness.
no

power

are

seen,

of
but

The

concentrated
not

obaerved

organized has
thought. Objectsof sense
mind

and

so

of reflection
all power
who
has this faculty

destroyed. The man

is best fitted to
and subjection,
greatestactivity
acquireand mentallyretain the knowledge which, if
elevates him to political,
professional,
properlyapplied,
rity.
of influence,usefulness,and authoand social positions
of thought,
of continuity
the power
Without
effort of the
and ability
to direct the attention, by an
effectualintellectual
of contemplation,
no
will,to subjects
be made.
progress in knowledge can
Genius," says Helvetius, is nothingbut a continued
attention (une attention suivie)." It is,"says Buffon,
patience(une longuepatience)." In
only protracted

appears
in the

to be

"

"

"

"

"

sciences,at least,"says Cuvier, "it is the

invincible, which
patienceof a sound intellect when

the

exact

trulyconstitutes genius." Lord Chesterfield says, that

and undisthe power of applyingthe attention steadily
"

334

MORBID

to
sipatedly
genius."
How

PHENOMENA

OF

singleobjectis the

desirable then

it

ATTENTION.

sure

of

mark

superior

should
is,that this faculty

be

cultivated,and when fullydeveloped,

fully
careperseveringly
and zealously
preservedfrom injury!*
"Attention
and

forms

moral

and
percipient

he

what

makes

chooses

emotions
"

The

to

which
mind

great

departmentsof

It is the
that
faculty

the

has been
control

link
our

nature,

named

the

which

the intellectual

between

the

or

between

the

pathemicdepartments.
will has

over

this

for the objectswhich

responsible
for the
entertain, and so responsible
result from them.
pathologically

can

affections,by the

man

be weaned

from

withdrawrnent

the
of

influence of evil

its

thoughts from
supply the means

both
excite and
which
objects
and wooing the attention to other
of their gratification,
by which good emotions are awakened to occupy
objects
and
the whole man,
displacethose hurtful sensibilities
which war
againstthe soul. It is thus that attention
of moral discipline
the great instrument
becomes
; and it

those

is because

of the command

which

the will possesses

responsiblefor

over

that man
becomes
the
faculty,
government and regulationof his thoughts.
of attention,when
The faculty
employed on external
pline
things,is just as mighty an instrument of moral discifluence
as it is of mental
discovery.It fetches that infrom without, which
bears with
the
on
efficacy
and of action.
springsof feeling
this

"

Sufficient

importanceis not
of the
discipline

attached

in the education

of

women

to the

facultyof attention. Great injury is on*

mind
the
with which
the
done
to
hurry and rapidity
by
doubtedly
thing
everyin this express
railroad era.
Until the
is requiredto be accomplished
form an integralpart of female education no really
science of mathematics
mental
efficient plan of
trainingcan be said to be adopted. Men in this
by being obliged to go steadily
women,
respecthave an advantage over
of
mathematical
the
mind
a
study,
through course
being thus earlyin life
and trained by the severest of intellectual studies.
well-developed,
disciplined,

cultivation and

IMPAIRMENT

It is

"

heart

by

the

OF

attention

335

ATTENTION.

that
shiftingits objects,

shifiteth its emotions.

The

mechanism

but it is in virtue of
operatingrightly,
without.
It is by lookingoutwardlyand
in fact,that the mind

hath

been

set

not

it

as

the

there
touch

'

is

from

inwardly,

were

to the

whose
rightobject,

moving influence it is that brings

the mind into its rightstate of emotion : and thus the
cultivation of the dispositions
is manifested to be a more
than many
in the
are
simple and intelligible
process
habit of conceiving
it.
The wayward tendencies of the heart are conquered,
not so much
by an operationat home, as by an operation
abroad.
The most
in
effectual refugeis,
the contemplation
of that ethereal and unclouded
purity,by
which
the throne of heaven is encircled
of the
a lifting
thoughts to the august and unpollutedsacredness which
dwelleth there
the dailyand diligent
consideration of
that awful sanctuarywhich
is above, where nought that
is unholy can enter
and a solemn
invocation
to Him,
"

"

"

"

before the rebuke

of

of whose

countenance, all the vanities

distemperedimaginationwill

IMPAIRMENT

flee away."*

once

incipient
stage of
capacity
indisease of the brain, the patient complainsof an
of attention.
direct the faculty
to control and
He finds that he cannot, without an obvious and painful
his usual mental work, read, or master
effort,accomplish
the contents
of

two

ATTENTION.

at

OF

of

In the

"

letter,newspaper,

book.

favourite

The

even

or

become

ideas

page

or

restive,and

condition,exhibiting
no
lapsesinto a flighty
for continuity
of thought.
capacity
his impairedand failingenergies,
Fullyrecognising
hold
he repeatedly
tries to conquer the defect,and seizing
the

mind

of

book, is resolved

of intellectual
"

not

to

succumb

to his sensations

and
languor,
psychical
incapacity,

Dr. Chalmer's

"

Sketch*

of Moral

and

Mental

cerebral

Philosophy."

336

MORBID

OF

PHENOMENA

ATTENTION.

weakness, but, alas ! he often discovers

(when

it is too

grapplewith the mischief)that he has lost all

tration
steadiness,and normal concenpower of healthymental
of thought! In his attempt to comprehend the
under contemplation,
meaning of the immediate subject

late to

he reads and

re-reads with

determined

resolution,and

apparentlyunflaggingenergy, certain strikingpassages

and pages of a particular
book, but without being
the
understand
able to grasp
or
simplestchain of
an
elementary process
thought, to follow successfully
of reasoning; neither is he in a condition of mind
fitting
consecutive
him
to comprehend or
retain, for many
seconds, the outline of an interesting
story,understand
of facts.
narrative
or
a
simple calculation of figures,
if it be a sustained one,
to
The
attempt, particularly
which
and converge
the attention to the subject
master
increases the prehe is tryingto seize,very frequently
existing
confusion
of
mind, producing,eventually,
ache.
headof brain
lassitude, and
physical sensations
Going through a train of close reasoning,"
speakingof this condition,
says an acute observer, when
is an
Indeed,
undertaking absolutely
impracticable.
is a task, and a
to dwell upon
thoughtsteadily,
any one
tervals.
task, too, that can
only be gone through at long inan

"

"

Some
of

King
that

on

Whether

acute

observer

Prussia, that

his

has remarked

conceptionswere

contemplating a subjecthe
it be

true

in

this

grew

of

former

quick,but
confused.

instance
particular

or

not,

individuals
good of many
disposed
prewho
those
to epilepsy.They are, generally,
have
tampered with their sensibility. They seize
but
their
hausted
strength is exa
question dexterously,
If you
in the first assault.
try to make
them grapplewith a difficulty,
they immediatelyflinch.
To any proposition
requiringthem to contemplatea

the

observation

holds

MORBID

number

DISTRACTION

of ideas

AND

337

REVERIE.

unintelligible
steadfastly,
theywill yielda flat,
their want

assent,or to mask

of

bottom, as the

jockeysterm it,they will endeavour to flyoff to another

topic. To conceive the condition of the head in such
we
cases
more
distinctly,
may recollect how it fares with
weakened
eye when
instant it is cast upon an
the

but
perfectly
plain,
into each

run

that

in

such

the
inscription,
in

that the

manner

characters

are

little time

they seem to
and
undistinguishable,

other, they become

at last vanish

of the
misconduct
altogether.From
understanding,all frivolous peoplemust be troubled
of attention.
We
need no other
with some
flightiness
to enable us to understand
quisite
reason
why it becomes recircles to change the topicof converin polite
sation

every second minute."*

often these symptoms
How

ing
premonitoryof softenand even
of the brain, paralysis,
epilepsy,
apoplexy!
and is
This weakened
power of attention often precedes,
associated with, impairmentand loss of memory.
and reverie are
States of brown
study,distraction,
demonstrative
often precursory of more
symptoms of
and
impairedattention. They are but shades, degrees,
of the
varieties of that morbidlytorpidmanifestation
which so often accompanies
unhealthyconditions
faculty
and abnormal
of the intelligence,
states of the cerebral
are

tissue.
of thought are
selfirregularities
frequently
mination
created,often owing their existence to an obstinate deterto succumb
to their
the part of the patient
on
and seductive influence.!
fascinating
exhibited symptoms of
A medical gentleman,who
These

"

"

Reverie,"says Locke,

reflection
dreams"

Dr. Beddoes1

or

are

Locke,viz. :

regardof the
distinct from
as

"

"

is when

"

Hygtta."

idea* float in

understanding."
that

state of the

thoughtswandering without

What

mind

mind*

our

without

termed

any

waking
described by
previously
are

"

connexion."
Z

338

MORBID

PHENOMENA

OP

ATTENTION.

mental

derangement,informed his medical adviser that

his ill success
in his profession
filledhim, as may well be
subsistence and that
supposed,with anxietyfor his own
of his family. He would
for hours ruminating,
sit at home
and in a state of profoundabstraction ; and when
he found, day after day, no
arrive, he would
summons
saunter

abroad

wishes.

These

and

himself with
occupy
wishes he would
sometimes

reverie of

arrange

into

in the
worthy of the glass man
Spectator."At length he would direct his footsteps
that some
homeward, under a kind of persuasion
person
of consequence
had actually
sent, duringhis absence, to
climax

of events,

"

call him

in.*

This

indulgencein

^ition to

^erious mischief
and

castles in the

build

"

the

to

prolongedreverie

the brain, and

the

is also

mind.

the

air,"is fraught with

Excessive, continuous,
of

is often precursory

softeningof

symptom commonly observed in

some
types of mental disorder.

incipient
stages of

Hence

reverie,or dispo-

state of morbid

earlyeducation, of carefully
tention,
and masteringthe atregulating,
directing,
disciplining,
and trainingthe mind
to combat
thus fitting
with
those mental
influences and physical
successfully
great value,

states of ill health

often

so

in

which, when

sap

and

undermine

its

dued,
unsub-

and

uncontrolled

prostrate
energies,

and

destroyits powers. f
"Reverie
is a
and
castle-building
*

"

hours

There

is hardlya

has not

of the

romance.

them,

are

obligedto

"

person,"says

some

our

they are

occupy

our

mind,

so

dispersed
by some
But
thoughts.
suppose
soon

as

to make

us

dislike

everythingthat pleasedus

of

that
grief,

our

1803.
Beddoes, M.D.
the Abbe" de Condillac, who in his idle

reverie,in which he has imagined himself the hero

which are called castles in the air,generally
fictions,
slightimpressionon the brain,because we seldom give way

had

that

so

seizes
and

Thomas

waking

These

produceonly a
to

Hygeia,"by

"

of

kind

our

favourite

real
some

with
objects,
sudden

which

we

choly
fit of melan-

of our best friends,

avoid the company
port
before,we shall then find in the trans-

romance

will be

the

only idea

that

can

340

MORBID

be convinced

PHENOMENA

that I had not been

these times

there

in my

was

an

ATTENTION.

OF

dreamingof myself.At

incredible acuteness

or

intense-

sensations.

Every objectseemed animated,

The only way that I
and, as it were, acting upon me.
devise,to express my generalfeeling,
can
is,that I seemed
to be sensible of the rapidwhirl of the globe."*
ness

HEIGHTENED
attention

CONCENTRATED

AND

is

or
occasionally
heightened,

unhealthyexaltation,as
is observed

ATTENTION.

when

the

well

mind

in

condition

of concentration.

as

has

The

"

of

This

been

normally,
abcontinuously,
and sometimes
directed to certain
involuntarily
vivid impressions,
trains of thought,classes of ideas,conditions
of emotion, or
states of physicalsensation.
That
psycho-somaticdisease termed
hypochondriasis,
which
manifests itself principally
in a morbid
anxiety
to the health, is, in its primitivenature, essenas
tially
a

diseased concentration

of, organic conditions

often
resulting

from

to, and consequent exaggeration

of

physicalsensibility,

slightbodilyailments, which

tually
even-

distemperedand deluded imagination

of the hypochondriac,
and significant
racter,
chaa
grave
of the disturbed thought,predominance
f Much
of insane ideas,consisting
in wretched
illusions as to the
be traced to an
state of the health,may
unequivocally
assume,

undue

in the

convergence

and

misdirection

of the

attention

to

unimportant mental

nervous
impressionsand trifling
sensations. The mind often dwells uninterruptedly
upon
certain
of
states
particularemotions, fixedlyupon
classes of ideas,to the
thought,continuously
upon specific
rigidexclusion of matters of healthyconsciousness,and
until it loses all right,or
sound
sane
contemplation,

Fleming" by the Eight Hon. B. Disraeli,M.P., D.C.L.

1. Strained
into three stages:
tion.
attenf Dubois divides hypochondriasis
induced
innervation.
3.
organisation
Dis2. Disturbed
condition!
psychical
by
of tissue caused byfunctional disorder of the "und.
"

Contarini

"

OF

CONCENTRATION

MORBID

and
appreciation
of subjective

341

ATTENTION.

phenomena.
objective

The

condition of intellect,
referred to, often exists,
previously
to

certain

indicates
a

extent, as

normal

state,and

as

such

only

It is, however, often

presence of health.
disease.
signof cerebral and psychical
It is

have

the

alterations of tissue

well established fact that

been the result of

attention

morbid

of the

concentration

ings
Certain feelparticular
organicstructures.
of uneasiness, or even
pain,originatein the mind
of disease existing
in particular
a suspicion
partsof the
body,it may be the lungs,stomach, heart,brain, liver,
and functional
or
kidneys. Some slightirregularities
disturbances in the action of these organs beingnoticed,
at once
of serious
are
(to the hypochondriac)
suggestive
and fatal disease being established in the part to which
to

the attention
state of
structural

is directed.

from

normal

functions,frequently
lapsesinto actual
of attention
disease,as the effect of the faculty

certain

being,for

lengthenedperiod,morbidly concentrated

to their action.
to vital

This deviation

The

continuous

direction of the mind

tissues,imaginedto be in

unhealthystate,
tions,
funcexaltation of their special
causes
an
undoubtedly
and
increase of sensibility,
an
by (it may be
abnormal
to them
an
presumed) concentrating
tity
quanof blood, this being followed,successively
by 1,
undue
vascular action ; 2, capillary
congestion
; 3, an
in the evolution of nerve
excess
force,and 4, appreciable
an

structural alterations.

Thus, the mischievous

is
agencies
organism,
psychical

influence of moral

exercised upon the physical

as well as
layingthe foundation of lesions of structure, and sions
perverof thought originating
in the mind itself. Morbid

results
tangible
tissues.
of mental influences on the various physical
How
much
of self-created bodily
voluntarily
suffering,

attests
anatomy painfully

the visible and

342

MORBID

PHENOMENA

OF

ATTENTION.

courted

and
alas ! zealously
physicalpain, carefully,
and incurable disease of the mind,
trained,distressing,
arise from a lengthenedanxiety,
and continuous
fret and
and mental health !
worry as to the state of the corporeal
The
unceasing dread of the presence and constant
morbid
of approaching disease (whether of
anticipation
creates the mischief so
body or mind) very frequently
much
and
so
anticipated,
greatlyapprehended. Non
ab hoc sensu, et medicum
ab cegro falli,
cum
raro
aeger
agrum
hausisse
hinc
inde
ex
sensu
communi,
adfirmatquod imagiis advice that
illisuggessit"*
natio et pracepta etiam opinio
should not be incautiously
neglected.
ing
Health," says an able divine, is an importantbless"

\
\

"

"

of which

ought
bestows
even

be

to

should

we

it,but in the

at the expense
I

of

care

for which

careful,and

thankful

most

thought

be

the

to

taken

sometimes
serious

more

of

health,

duties,I have

the
exemplified

saw

who

God

generous

we

words

times
some-

of

the

satirist,
"

'

For

the

life is

Et

vivendi

proptervitam,

perderecausas.'

sake of life,
the very
neglecting

"

Juv.

causes

for which

granted."

It is not

difficult to

the
explainsatisfactorily

operandiof heightenedand
certain trains of

concentrated

healthyas

well

as

of

attention

modus
upon

morbid
incipient

thought,exalted emotions, disordered conditions of the

instincts,and pervertedstates of the appetitesand
false or erroneous
passions.Impressionsthat were originally
conclusions
that could only be termed
absurd,
;
with
and illogical;
judgments that might,consistently
fact,be designatedmerely as defective,and impaired,
"

"

become
*
"

evidences

Hartman's

Medical

of actual

disease

Pathology,"p. 261,
Psychology,"
p. 216.
"

as

of the

brain and

disorder

quotedby Feuchtersleben

in hu

ON

THE

OF

CONTROL

of the mind, consequentupon

THE

an

unhealthyand

direction of the attention to these mental

delusions

unbroken

operations.Insane

the extreme
originate. Hence
like trustworthysentinels,
danger of not exercising,
a
watchful supervision,
and active controlling
influence over
every thought,and the evil that arises from not keeping
in

The

often

843

IMAGINATION.

thus

state of strict subordination

fearful mischief

resolute mental
of

that

ensues

the

mental

from

emotions.

neglecting,
by

to battle with the erratic suggesefforts,

tions

unduly excited and flightyimagination,to

in their birth,
to strangle
keep in abeyance,and even
unhealthy impressionsstrugglingto fix and engrail
themselves upon the easily
and yieldmoulded, plastic,
ing
fancy,cannot be over-estimated, or exaggerated.
Vide ne funiculumnimis intendendo aliquando
abrumpas"
to the danger that arises
referring
says Lucian, when
of the
from an excessive and prolongedconcentration
of contemplation.
mind to any one
subject
an

"

Whenever
effort is

there exists

requiredin

consciousness

that

order to master, converge,

decided

and

rivet

the attention to any particular

train of thought,
subject,
be
and class of emotions, the patientmay, cteterisparibus,

venous

that

the

functions of the brain have

psychical
been overwrought,
or that
they are not (fora time) in a
healthyor normal working condition. This symptom
of the arterial and
often accompaniesslight
irregularities

assured

cerebral circulation.

It is also the effect of transient

capillary
congestionon the hemispherical
tional
funcsurface of the brain, dependent,
occasionally,
upon
and liver,
disorder of the stomach, heart, kidneys,
be
and need excite no alarm unless the mental paralysis
in its origin,
and
of some
duration, is clearly
encephalic
lesions
headache, loss of memory,
associated with vertigo,
order.
and other well marked
of sensibility,
signs of brain disNevertheless,it is a symptom entitled to serious
states of

344

MORBID

PHENOMENA

anxious

am

evidence
eyes

to

and

mental

not

to

of morbid
a

fact, so

ATTENTION.

tions
manifestaanalyzingthe incipient

when
consideration,
of cerebral

OF

disease.

attach undue

but
intelligence,

often noticed

importanceto
I

cannot

by myself as

this

close my
well as

by others whose observations have been directed to the

that a debilitated power
of attention is a prominent
subject,
I have
symptom in the earlystageof cerebral disorder.
brain disease in which
known
of incipient
cases
patients
of other symptoms,
to the manifestation
have, previously
lost all ability
to read, continuously,
twenty lines of a
printed book without a strong and painfuleffort of
thought. This state of mind has continued for months,
of all intellectual work,
the abandonment
necessitating
been
succeeded
and
has
by obvious
symptoms of
and even
has
organiccerebral disease,loss of memory,
pairment
passedeventuallyinto mental imbecility.If an imof memory
of attention
and debility
exist,
for the patientto imagine that he is able
it is illusory
condition of ill-health is attended to)
(untilhis physical
by repeatedand perseveringefforts to resuscitate the
lost powers.

In

his

attempt

to

do

so, he

still further

morbidlyimpairedstate of these faculties,and,

and often,
instead of invigorating,
debilitates,
prostrates,
the intelligence.
alas ! entirely
extinguishes
this condition of intellect,
when
A patient,
describing
I cannot
read as I used to do, I am
obligedto
says,
and re-read a
repeatedly
go through a page of a book,
sentence, without having any idea of its purport. The
attempt to fix and concentrate the thoughtsrequiresa
and vigorouseffort of the will."
continuous, painful,
serious irreparable
In this state of ill-health,
injuryis
of the brain and* mind,
done to the delicate organization
vity,
by an attempt to exercise,stimulate,and force into actiand sluggish
mental power.
this morbidlyflagging,
taxes the

"

The

OF

EFPECT

MORBID

existence of

3 1 ~)

ATTENTION.

CONCENTRATED

detailed,
previously
brain is quiteunfit for

like those

symptoms

establishes that the

conclusively
fect
any degreeof sustained labour,and that conditions of perand states of prolongedand uninterrupted
REPOSE,
REST,

essential to

are

restoration of its enfeebled

gies.
ener-

by overtaxingthe
in enfeebled states of the bodily
of attention
power
health,is well illustrated in the followingcase, drawn
is as follows
The history
himself.
up by the patient
I was
this morning (saysthe patient)
engaged with a
each
other
followed
of people who
great number
I was
and to each of whom
obligedto givemy
quickly,
of writing
I was
the necessity
attention.
also under
various, and of a trivial
much, but the subjects
were
had
connexion
and
no
uninteresting nature, and
The

danger so

often incurred

"

"

the

with

one

the

attention therefore was

other; my
the stretch,and it was
continually

constantly
kept on
from one
to
shifting
subject
necessary that I should
had received on account
and

wrote

that I

was

the

presentin

the

two

write

another.
a

for
receipt

mind.

I
money
seated myself

some

I
poor.
first words, but in a moment

of the

for
incapableof proceeding,
words
which
belongedto the
my

last it became

At

I strained

my

found

I could not
ideas that

attention

as

collect
re-

were

much

and tried to write one letter slowlyafter the

possible,
other, alwayshaving an eye in order to observe whether
to each other ; but I remarked
they had the usual relationship
ters
and said to myself at the time, that the characI wished to
I was
not those which
writingwere
write, and yet I could not discover where the fault lay.
I therefore desisted, and partlyby broken words and
the person who
I made
and partlyby gesture,
syllables,
that he should leave
waited for the receiptunderstand
For about half an hour there reigneda kind of
me.
as

tumultuous

disorder of my

senses, in which

was

inca-

346

MORBID

PHENOMENA

OF

ATTENTION.

pable of remarkinganythingvery particular,

exceptthat
series of ideas forced themselves

one

mind.

my

The

of,and

several efforts to

by

better

of

nature
trifling

aware
perfectly

into
involuntarily
these thoughtsI was

also conscious

was

get rid of them,

that

I made

supplytheir place

and

I
of my soul.
lay at the bottom
endeavoured
much
as
as
lay in my power, considering
the great crowd
of confused
images which presented
themselves to my mind, to recal my
of religion,
principles
of conscience,and
of future expectations
; these I
found equally
There was
correct and fixed as before.
no
in my
external
and knew
for I saw
deception
senses,
everythingaround me, but I could not free myself from
the strangeideas which
I endeavoured
existed in my head.
to speak,in order to discover
whether
I was
connected, but
capable of saying anything that was
althoughI made the greatestefforts of attention,and
proceededwith the utmost caution, I perceivedthat I
uniformlyspoke other words than those I intended. My
soul

at

was

speechas
Thank

present

it had

God,

about half

and

hour

head

my

tiresome
I

could

desire him

but I found
exercise

command

words

I had

I had

with

my
wished

now

to inform

the

to say, and

her

was,

on

my

to

very

writing.
long,for in

grow

clearer,the

less vivid and

became

it still necessary

myselfin

continue

own

to

bulent,
tur-

thoughts with
vant,
ring for my ser-

wife to

to wait

of

organs
in

hand

of my

began

ideas

I
interruption.
and

before

been

of the

little master

as

this state did not

an

strange and
less

which

ones

to

come

little

me

longer,to

rightpronunciationof

the

few

the firsthalf hour's conversation

my

with
part,preserved

slow

until at last I gradually

circumspection,
found myself as clear and serene
as in the beginningof
headache.
the day. All that now
remained was
a slight
I recollected the receipt
I had begun to write,and in
and

anxious

348

MORBID

others

PHENOMENA

the false

corrected
;

by

any

and

in

OF

ATTENTION.

impressionis constant, and

effort which
a

is made

third modification

condition,he mixes

up

to

direct the attention

of this remarkable

hallucinations with

his

be

cannot

external

is still
He
impressionsin a most singularmanner.
that is,
his impressions,
however, of describing
capable,
he
of talkingso as to be understood, though what
or
speaks of relates only to his erroneous
conceptions,
mere
bodilyfeelings.In the next stage he either does
not attempt to express himself
intelligible.
unat all,or is entirely

He
with

is

now

cut

off

from

communication

external

things,and with other sentient beings;

and the highestdegree of this is what
call coma,
or
we
stupor,which resembles profoundsleep.
in the
This description
refers chiefly
to the gradations
"

state

of the mental

functions

which

we

observe

in

tinued
con-

to trace them
interesting
particularly
in this disease,because we
the various gradespassing
see
into one another, and thus showing in a connected series
the leadingpeculiarities
in other affections we
which
have to contemplateseparately."
I have previously
referred to the morbid
phenomena of
distraction (etredistrait}.This is an importantand significant
incipient
symptom of disease of the brain. The
whilst engaged in conversation,suddenlypauses,
patient,
is puzzled,confused, and
lost the
to have
appears
dition
connectingmedia in the chain of thought. This conof mind
is occasionally
and
precursory of epilepsy
itself in the
to manifest
apoplexy. It is also known
early stage of softeningof the brain, and in cases of
ordinaryas well as of generalparalysis.This symptom
has often,althoughexisting,
been unobserved,until

fever.

It is

the cerebral disease has made

A

led

considerable

progress.

professional
gentleman,who had for fifteen years
most active life,
encountering,
during^thatperiod,

CASE

OF

MORBID

819

DISTRACTION.

vicissitudes of fortune,occasionally
many
prosperous, and
at times reduced to great extremities in consequence
of

heavy pecuniarylosses

sustained

by becoming security
for a near
relative,exhibited symptoms of declining
his going abroad
for a few
generalhealth,necessitating
months

to

of the German

At this time there

spas.
in connexion
with the case that jusnothingspecial
tified

was

one

to his ultimate recoas

very.
any serious apprehensions
He appearedto be much
benefited by change of

air and

scene,

as

well

anxieties of business.
manifested

symptoms

of disease of the brain.

as

Ou

from

his

exemption from

his return

all

home, however, he

that betokened

the commencement

Although generally
sbowinggreat

of intellect,
unenfeebled powers of attention,unimpaired
activity
for continuous
ble
thought,and consideracapacity
of application
and complito the minute
capability
cated
details of subjects
for their right comprehension,
requiring,

much

of

concentration

mind, he, at times,

gave indication of cerebral disturbance that could not fail

to attract the anxious observation of the acute practitioner
who

then

had

charge of

headache, transient
of

loss
vertigo,

and

occasional
of

would

of

the

He

case.

fits of mental

complainedof

confusion, paroxysms

of temper,
self-command, irritability

in the consecutive
interruptions
tions
operathought. Whilst engaged in conversation, he

for

minute

or

two

appear

much

distracted,

suddenlystop,as if he had lost the link in the

This patient,
chain of ideas passingthrough his mind.
the judicioustreatment
under
adopted,appeared to
his cerebral health, for he, duringseveral subsequent
recover
business without
a complicated
years, conducted
paired
manifestingany indication of brain disease or imSix years, however, did not elapse
intellect.
serious signs of "1
before his health again showed

then

dence, and

his state of

brain

was

once

more

made

350

MORBID

matter

PHENOMENA

OP

ATTENTION.

of

observation.
It was
at this period
professional
that I had an
The
opportunityof seeing the case.
patientexhibited many
symptoms of serious and fatal
of the brain.
There was
loss of memory,
disorganization
much
merest
at the
trifles,
occasionally
irritability
slightthickness of the speech, defective articulation,
a
singularmisplacementof words, and loss and want
in the
muscular
of co-ordination
His
gait
power.
was
rollingand unsteady. All these symptoms gradually
in
increased,until he became
generallyparalytic
and body, and
mind
afterwards,in a
died, ten months
found much
diseased.
His brain was
state of imbecility.
There
was
softeningboth of the cerebrum (the left
ing
hemisphere)and cerebellum,with considerable thickenand
opacityof the meninges, evidentlyof some
duration. It was
supposedthat the disease of the brain,
of which this patient
ten years predied, had commenced
viously
to his decease.

of

The

relaxation

from the anxieties

business, involvingcomplicatedcalculations

and

for a short time appearedto arrest

responsibilities,
the cerebral disorder. His subsequent
was
relapse
owing
work.
ever,
Howto his premature return to active mental
time suspended
the disease was, evidently,
a second
by the local abstraction of blood (for the purpose of
evident congestion
of the brain),mild mercurials,
relieving
grave

and

afterwards

mineral

hesitation in the
of

thought,were

the

disease

reason

and

of

tonics.

The

mental

distraction,

and occasional want of sequence

speech,
the earlier symptoms of
clearly
among
the brain which
ultimatelydestroyed

life.

resembles in its main

closely
features that of Oscar, the late King of Sweden, the particulars
of which are detailed with greatminuteness
by
in ordinary
to his
Dr. P. 0. Liljewalch,
first physician
late Majesty.
The

precedingcase

very

CASE

It appears
account

from

OF

that

OSCAR,

the

Dr. W.

KINO

OF

851

SWEDEN.

King (I abridgethe subjoined

D. Moore's

translation of the official

as well as the pout mortem

King's last illness,
examination) had enjoyedthe greater part of his life
good health. He had, earlyin life,a severe
tolerably
attack of typhus,and, subsequently,
of rheumatic fever.
He rallied,
from these seizures. His
however, completely
and cleverness in the
Majesty exhibited great activity
of his regalduties.
His generalhealth was
discharge
of a slightirregularity
in
excellent,with the exception
the heart's action,observed generally
in the springof
His
in the habit of making
the year.
Majesty was
yearlyexcursions to remote parts of his kingdom,and
From
returning to the capitallate in the autumn.
these journeys he derived great benefit. In 1851, his
health againshowed
Majesty's
symptoms of failure. The
in its movement,
heart became
and the
very irregular
functions
creased
were
digestive
impaired. The liver also inin size,and the brain manifested
order.
signs of disHis
Majesty,on the advice of his physician,
took to the baths of Kissengen,and, subsequently,
made
He again returned
home
a tour
through Switzerland.
afterwards lost a
much
improved in health. He soon
The shock caused by this heavy bereavement
beloved son.
induced
another
attack of typhus fever, which
nearlyprovedfatal. The King, however, recovered from
and would, it was
this severe
illness,
tinued
thought,have conwell, had he not, zealouslybut indiscreetly,
devoted his mind
to anxious
matters, omitting
political
his annual
In 1857, his Majesty's
excursion.
summer
to his
health againgave way, causinggreat uneasiness
gestion
family. The symptoms, at this time, were those of conDr. L^ljewalch
of the brain.
says :

reportof

the

"

"

The

lower

extremities,the muscles

always weak, began

to

totter

under

the

of which

were

weight of

the

352

MORBID

body,and
for

at the

the

same

OF

of

troubled

with

the movements

of

symptoms,

strengthand

the

in

ATTENTION.

time that the power

motions

Majesty was
which

PHENOMENA

these

tion
of combina-

his
impaired,
panying
accomvertigo,
particularly
the head, and with vomiting,

parts was

combination

with

diminution

of

of

involuntarymuscular
deeply-seated
spasms, indicated the existence of a more
in the central nervous
affection,probablya softening
system. Incapacityto dischargehis royal functions
now
brought on a deep melancholy,and his Majesty,
of his illness,
in the commencement
his
even
expressed
conviction of its incurability.
Although this conviction
but be participated
in by those
could not, unfortunately,
who were
to be his Majesty's
we
privileged
physicians,
did not at that time consider it our
to express
duty publicly
it. The
means
employed to combat the disease
essential efficacy;
without
the
moreover,
were,
any
which
in the lower extremities,
commenced
paralysis,
graduallyincreased, and after the King, feelinghis
to which
inability
any longer to fill the high position
Providence

had

occurrence

called him, transferred into the hands

of

ment
Royal Highness the Crown Prince the Governof the United Kingdoms, his deepmelancholy
gave
for those things
indifference,
even
way to a progressive
he had
in his health
which
regarded with the most
livelyinterest. The disease,henceforward,progressed
slowlytowards its end, and the paralysisbegan so
to extend to the other voluntary
muscles, that
steadily

his then

towards

the end of last June

both lower

and

upper

tremities,
ex-

of the excretorypassages
sphincters
while involuntary
almost entirely
were
paralysed,
spasms
the rightleg. The appetite,
from time to time agitated
and, althoughdigestion
continued
disappeared,
too, had now
undisturbed, the body had greatlyemaciated,
while the hitherto superficial
wliich had often
bed-sores,

and

the

CASE

teen
six

OP

OSCAR,

OP

KINO

353

SWEDEN.

than
nearlyhealed,and had alreadyexisted more
months
without causingany great pain,began to

extend and to

Under
appearance.
sank ; the power
all this the patient's
strengthgradually
of speech,
was
previously
ther
altogevery limited,latterly
assume

gangrenous

lost ; the

quence
lungs filledwith mucus, which, in conseof incipient
of the muscles of respiration,
paralysis
could only,with increased difficulty,
be expectorated
;
and, on the 8th of July,at eighto'clock in the morning,
his Majesty quietly
of
expired,
supportedin the arms
than two years'
his RoyalConsort,who, duringhis more
left his side, and surrounded
never
illness,
by all the
of the Royal Family,kneeling
with her
other members
around the death-bed of the neverand weepingbitterly
head of their illustrious
and long-tried
to-be-forgotten

House.
"

The

firsttrace of the

of which

I have

now

disease,the ment
developdescribed,and which brought

nervous

King to the grave, manifested

althoughit was not until within the
life,that, as
years of his Majesty's

itself

the late

occurred with

more

symptoms.

last
we

long since,
six or eight

have

seen,

it

and at last with such threatening

definite,

No

one

who

had the

good fortune

to

approachhis Majesty'sperson, and who had an opportunity

of observinghim
during a long periodin his
dailyintercourse,could avoid beingamazed at the very
his Majesty always exhibited of
extraordinary
power
the most varied details,
in his memory
or could
retaining
the unerring
cease
admiring the rapidapprehension,
which
clearness of statement
judgment,and the singular
time
exhibited whenever he spoke. Hut at the same
were
in
he would not failto recollecthow his Majesty
sometime*,
all
the middle of a conversation to irhirh he iras directing
would
his attention,
irould

of a sudden

appear

to
his thoughts
tranxfrr
really

to be abstracted and
t

some

other

on
subject
A

354

MORBID

PHENOMENA

OF

ATTENTION.

which, unless he wightbe disturbed,he would allow them

rest,usually
onlyfor
minutes

afterwhich

if it had

but sometimes

few moment*,

the conversation

be

would

his

his look
Majesty'sfeatures,particularly
such occasions,and the spasmodic state,or
which

that

at the

this

system,render

distraction,which

recurrence,

due to

was

time took

same

part of the muscular

other

or

many

resumed, as

interrupted.The peculiar
expressionof

not been

movements

for

to

at times

was

affection
incipient

an

assumed

on

tary
the involun-

placein one
it probable
of frequent
of the

tral
cen-

of

thought. This symptom, referrible to the

most importantorgan of the nervous
system,was of late
years accompanied,as has been alreadymentioned, with
ties,
increasingweakness in the muscles of the lower extremiand witli uncertainty
in the combination
of movement,
probablydepending on a commencing organic
change, either in the organ alone, on which the power of
motion
tion
depends^or else in that by which the co-ordinaorgan

is effected." *

of movements
I

consulted

was

in the

gentleman,connected

suspectedto
at the

with

of

Exchange, who

was

brain.

His

first seeingthe case,

of my
muscular

weakness,

in the

case

1857

occasional

symptoms,

were

as

follow

paroxysms

of

of the superior
headache, slight
paralysis
palpebrae

severe

of the left eye, occasional

right foot. The mind
He
consulted

continued

was

up

me

that, at times, he

Mortem

of the brain.

in the

paired.
at all imapparently,
to the period of my
being
dischargeall his commercial

and
ability

"//stracted; that whilst

Post

to

of numbness

not,

to his accounts, and

with his usual

The

sensation

competent
fully

duties,attended

the Stock

disease of the

have

time

general

springof

wrote

letters of business

clearness. His
was

brother

greatlyabstracted,and

engagedin conversation,he

examination of

King

formed
in-

Oscar

would

revealed extensive disorganization

356

had

attack
to

be

or

no

caused
notice

and

and

night,

was,

great
an

after

brain,

in

early

rising

after

death,

supposed

his

of

arrival
disease

chronic
to

have

been

to

In

disease
in

Paris.
of

the

of

long

little

proceeding
hard,
late

up

affecting
There
membranes

existence.

at

acted

he

fact,
and

imprudence,

brain

and

syncope,

sitting

morning.

and

indiscretion

attack

the

this

unusually

working

sparingly,

very

As

temperature,

Previously

been

chambers,

July.
of

one

of

state

it.

had

he

of

been

high
of

drinking

acute

fortnight

then

the

taken

was

have

his

at

month

the

to

continent,

eating

with

by

whilst

seizure
in

day

considered

was

the

on

hot

very

ATTENTION.

OF

epileptifon*

slight

during

PHENOMENA

MORBID

the

result

the

mind,

was

found,
of

the

MORBID

PHENOMENA

OP

357

MEMORY.

CHAPTER

Morbid

Phenomena

THIS section will

embody

of Memory.

of,
analysis

an

A cute Disorders

1
.

2.
3.
4.
5.
6.

of Memory.
Chronic
of Memory.
(Modified)Affections
Perversion
ofMemory.
Exaltation
of Memory.
Memory of the Insane.
Psychology and Pathology of Memory.

The

memory
or

may,

the effect of natural

as

dent,
decay,acci-

disease,be,
a.

Disordered.

/8. Weakened.
"y.

Lost.

J. Perverted.
".

I propose

Exalted.

to consider

in this

in

section,somewhat

not onlythe impairmentand aberration of memory

detail,

which

may

disease of

properlybe
the

brain

considered
and

symptomaticof

disorder

of

the

acute

mind, but

of total
cases
obscure, and inexplicable
singularly
and modified paralysis
of the faculty,
consequent upon
inflicted on the delicate nerve
vesicle,either by
injuries
in
inflammation
resultingin adventitious depositions
those

the

substance, or

on

the

surface of the brain

and

its

358

MORBID

membranes,

PHENOMENA

mechanical

OF

violence

MEMORY.

to

the

head,

by

or

atheromatous

cerebral

vessels

the

changes in the structure of the

disordered states of
(fatty
degeneration),

and
circulation,
This

conditions

division of the

nutrition.

of mal-nerve

will
subject

nial
cra-

involve

tion
considera-

of,
1. Acute
2.

Disorders

of the Memory.
Affections
ofthe Memory.
Chronic(modified]

What

is memory

of volition to
revive

mind

past

How

are

we

enabled

by an effort
conceptions,

reproducepreviousmental
of consciousness, and

states

recal

to

the

obliterated
long and complex train of apparently
and forgotten
thought?
Are
the ideas carefully
and classified
housed, registered,
in hidden and mysterious
cells,
vesicles,
or chambers
of the brain?
If so, what
is, to adopt the language
a

of Cicero, the nature

where

of this

situation of the

the

"

thesaurus

vesicular

"

omnium

mental

rerum

repository

and cerebral treasure-house

and

protectfrom

into the

entrance

an

destined to garner, preserve,

injurythe myriadsof ideas that obtain

through

the

media

of

the

senses

Is

mind

distinct

memory

independentautocratic
results of
the mental

combined

or

sovereignpower, exercising
of the
authority,
or, is it one
complexoperationof several of

faculties?

detailed,and

enunciated
principles
in the subsequent
pages will,I hope (toa limited extent),
the importantpreceding
answer
tories
interrogasatisfactorily
in relation to the metaphysics,
or
psychologyof
memory.*
The

When

facts to

speakingof

distinction between

be

this

what

we
faculty

recognisethe philosophical
fully
of the mind
automatic
operations'

should

is termed, the

Before

359

IDEAS.

OF

analysingin detail the morbid phenomena

the
as
illustrating
incipientsymptoms

memory,
obscure

CLASSIFICATION

NATURAL

TI1K

diseases of the brain

consider

to

the

mind, it will be

and

natural

order

sary
neces-

classes of ideas stand in relation to each other, not

to the

as

priorityof

their admission

of

various

which

in

of

only

the mind, but

into

of their impression
the sensorium.
on
durability
of
that qualities
Metaphysicians
agree in the opinion,
and events, are more
retained in the mind
objects
easily
than

dates and

takes

names

in other words, that

tenacious

more

of

grasp

the intellect
of

than
adjectives,

substantives.
Gratiolet considers that the ideas of
less allied to the notions

they

effaced

are

associated and

the mind
ent.
tiny
aeneric

first time,

him, from
known.

his
He

the

General

certain

is

The
and

distinct

names

is

former
a

idea

one

more

is

man

seen

is formed

before his name

qualities,
blond
particular
yreat or little,
man,

aspect and
a

dark, before he becomes

Thomas.

two

When

latter.

that

less

only after those that are

An
object,he affirms, has
and
the other spccife. The
than

or

they are thus

ideas disappearfrom
particularand eon-

easilythe

more

identified.

easilyretained
for the

the

more

of ourselves,and

have

we

thingsare

to the

relation of

is

to

names

arbitrary.There

generalorder,it

observer, John, Peter,

thingsis

is not

in

this

fortuitous association of

often

of
is
or
or

dental
acci-

respecta
a siynand

to the coni"ciou"reproduction
involuntary
nected
and that condition of the intellect conimpressions,
of ideas by an act of volition,the former state being

involved in the spontaneousand

of former

ness

with

termed
properly
"

Memory,"

is made

mental

the revival
memory,

and the latter recollection.

logician,is not an original

power
and
the
rt'mcinbcred
the
thing
ingredient*,

"ays

an

able

"

faculty.It
idea of having
or

up of two
The last ingredient,
teen
however, consist* of three component parts,our
presentrememberingself,our past rememberingself,and these being united
it

by

unite the two

certain trains of consciousness,

called by

which
selfs,

identity."(James
metaphysicians
personal
"

form

compound,

3GO

of

MORBID

PHENOMENA

That
tiring.

which
the

alone remains

is conceived

proper

names

There

are

that

in
readily

the memory

natural

order.

enfeeblement

is

regard to
first apparent.

differences among
with which
to the degreeof importance
according

respectmany

are

One
appreciated.

the

fact,and

If

enfeebled, it is with

this

in this

MEMORY.

accordingto

becomes

memory

OF

men,

words

facts,
investigates
particularly
from whence
results a spontaneous definition of things,
and the name
of objectsor persons
of
will be but
will touch slightly
on
accessory importance. Another
man

himself

pre-occupy

with

the

This

name.

is witnessed

naturalists.*
Some
constantlyamong
best acquainted
with objects,
others with names.
If (according
the memory
to the same
authority)
enfeebled
has the most

in two

of this

men

are

comes
be-

character,he who

vivid

image of facts,will lose the memory

words
before that of things,whilst the other, contented
with the sign,
will forget
in losing
the
everything

of

I cannot

help,"says an eminent metaphysicalphilosopher,taking

this opportunity
of expressing
that medical writers would be at more
a wish
than
have
been
at
hitherto,to ascertain the various effects which
pains
they
These
effects are
are
producedon the memory
by disease and old age.
In some
it would seem
that the memory
widely diversified in different cases.
is impairedin consequence
of a diminution
of the power of attention ; in
"

"

others,that the
The

power

of recollection is disturbed in consequence

of

ment
derange-

of that part of the constitution on which the association of ideas depends.

effect of age, seems
to arise from
decay of memory, which is the common

the former

of these

of
capacity

attention is weakened

probablethat as we advance in years the

by some
physicalchangein the constitution ;
to think that it loses its vigourpartlyfrom the effect
and the extinction of our
passionshave in
sensibility

causes.

but it is also reasonable

It is

which the decay of our

diminishingthe interest which we feel in the
That no derangementtakes placein ordinarycases
on

which

circumstantial

youth.

In

some

common

occurrences

of life.

in that part of the constitution

the association of ideas dependsis clear from the distinct and
recollection which
diseases this

stroke of

old

men

retain of the transactions of their

affected. A
evidently
destroythe power of speech,

partof the constitution is

palsyhas been known, while it did not

of the most familiar
the names
of recollecting
patientincapable
has been known
is
of
What
still
the
name
an
objects.
more
remarkable,
object
t"" suggest the idea of it as formerly,
althoughthe sightof the objectceased to
suggest the name."
Duyald Stetcari't "Elements of the Philosophyof the
to render the

"

Human

Mind"

MODE

of

memory

OF

But

names.

the firstresult of
a

of
species

themselves

in both

enfeeblement

an

dissociation between
and

of the

301

KNOWLEDGE.

ACQUIRING

the

and

one

the other

of the memory

the ideas of

names
arbitrary

which

will be

thingsin
designate

them.
A

"

with

savant"
distinguished
one

of

the

continental

Gratiolet, connected
"

says

academies, is unable

to

his confreres
designate
by their names, and he characterizes
them
by their works. If he speaksof one of them, he
who has written such
expresses himself thus, My confrere
book ; who has made
much a discovery.*
He designates
a
but
him, in short, not by his name,
by a quality.
of
to us by a certain number
Things are first known
which
affect us, the ideas of qualities
qualities
being
sidered
generatorsof the ideas which we have of things conof
In the order of acquisition
substances.
as
the accident, and
ideas,the substance predominates
over
Thus
the accident predominatesover
the foundation.
idea
the generalidea of being,united to the particular
tion,
suffices for a definiof a certain number
of properties,
and in practicethese spontaneous definitions precede
'

the

day.

'

names.

'What

What

is the

name

is this called ?'

of this round

we

say every
object of this
"

but afterwards,
comes
name
arbitrary
and added, it is then
is then secondary
the name
less essential,
and ought to be lost first in this process
selves
of interior dislocation in which the ideas separatethemfrom the
the one
with greateror less difficulty,
of the degree of their reciprocal
other, on account

green

object?'

The

affinities."
stand
theory,Gratiolet affirms,enables us to underthen substantives,
first,
disappear
why proper names
or
of things. Adjectives
which
the proper names
are
disappears
disappearlast,and everything
qualificatives
have an idea of a thing
cannot
with them, because we
This

862

MORBID

PHENOMENA

of
Independently

/the names

of

its

OF

qualities.We

thingsin the ratio of

thought,the coincident

the order of

the
gotten than the correlative,

than
readily
Dr.

the consequence

Itard

things,and
their necessity. In
is more
easilyforrecal

remote

consequence

more

immediate*

observes, that

the

generallyaccompaniesattacks
advanced

MEMORY.

life,follows in the

loss of memory

that

of

apoplexyoccurringin
there is
subjoinedorder
:

first a

of names,
then of substantives,
then
forgetfulness
of verbs, and next of adjectives.
Adjectivesappear to
retain their hold
with
the firmest tenacityupon
the

mind.

It is

well-known

idiots have

had

reared

other

fact,says Dr. Itard, that many

only for adjectives.

Some
lightmay be perhapsthrown upon this subtle
the underthe mode in which
standing
question,
by considering
is built up, the
intellectual superstructure
in

admitted

Vives,

memory

words, the

into the mind.

as

"

relation in which
The

translated

to the

senses

by Sir W.
and
imagination,

Such

is the order of life and

from

the

the

simpleto

universal.

This

order

from

of all express the several

is from

"

the

this to the intellect.

We

of nature.

the

in

observed

are

learning,"
says

Hamilton,

complex,from

is to be

of

ideas

thus

proceed
to the
singular

children,who

and
partsof different things,

first
then

Things generalthey call by a singular

of
name
by the name
; for instance,they call all Smiths
that individual Smith whom
they have known ; and all
meats
beefand pork, as they happen to have heard the
after
the other first when they began to speak.Thereone
or
and
the mind
collects universals from
particulars,
from universals."
The
then againreverts to particulars
doctrine,without any knowledge of Vives, is mainsame
conjointhem.

forts
M.

Anatomic

"

compare
"

avec

P.

du

V Intelligence Par

Systime
Fr.

Gratiokt,Paris, 1839-1857.

Nerveux

Leuret

consvl"ri

et P.

Gratiolet

dans

set

; ton.c

Sap*
2,

364

ACUTE

DISORDERS

OF

XIV.

CHAPTER

of the Memory.

Acute Disorders
IN
a

MEMORY.

THE

in relation to
the condition of the memory
estimating
portant
suspectedstate of cerebral or mental disease,it is im-

remember, that, as age advances, the power of

effort of the will, recent
to the mind, by an
recalling
to

events, becomes

says, when

destroyed. Horace
sad infirmities that sometimes
"

Multa

Quaeritet
quod

Vel

old age,

the

"

incommoda, vel quod

inventis miser abstinet,ac

res

alludingto

accompany

circumveniunt

senem

gether
alto-

is sometimes

and
impaired,

much

timet uti

timide

gelidequeministrat,
longus,iners,avidusquefuturi,
omnes

Dilator,spe
Difficilw,
querulus,laudator temporisacti."

the
few instances,however, in very advanced life,
exhibits an
extraordinary
degreeof
facultyof memory
In

and
elasticity,

of

amount
surprising

There

vigour.*

retains
with which the mind
charming illustration of the tenacity
in the lifeof Niebuhr, the celebrated Danish traveller.
occurs
earlyimpressions
infirm that he was
able only to be carried from his
and
When
so
old,blind,
*

bed

to his

chair, he used

visited in his

to describe to

earlydays with wonderful

his friends the

minuteness

at the vividness

and

vivacity.When

of his

he

they
explained,

expressedtheir astonishment
memory,
that as he lay in bed, all visible objectsshut out, the picturesof
"

had

seen

like
host
blue

floated before his mind's

continually

eye,

so

what

that it

he
was

them
yesterday.With
speak of them as if he had seen
the deep intense sky of Asia, with its brilliant and twinkling
vividness,
of stars, which he had so often gazed at by night,or its loftyvault of
his
in the hours of stillness and darkness, on
reflected,
by day, was

wonder

no

inmost
"

The

and

the

on

in the East

he had

which

scenes

he could

soul."
footmarks on
angelsof youth leave the deepest
often and
long ago and distant past is more

the soul than

the

distant future.

In

the

same

the rocks of
more

Memory,

deeplyimprinted

manner.the

firstorna-

PREMATURE

IMPAIRMENT

OF

:\C"~)

MEMORY.

is

much
difference among
the aged as to
undoubtedly
tlifir ability
to revivify
recent mental
impressions.We

sometimes, however, witness in old persons, greatpower

of

these
reproducing

well

former and

longantecedent
ideas. This state of healthypsychical
activity
depends
or
partlyupon natural strengthof the faculty
original
freedom
vigour of mind, earlyeducational discipline,
from

and

absence

great

as

strain

of

as

the

upon

functions

of the

brain,

lengthened worry and mental

anxiety. Temperate habits, an immunity from those
which
mine
so
youthfulexcesses
frequentlysap and underand mental constitution,and sow
the physical
the
seeds of premature psychicalimpairment and
bodily
of the
essential to the preservation
are
decrepitude,
any

memory.

Strange infirmities

"

with

of the

there
memory
cerebral disease, and justlyto be

are

ciated
asso-

regarded

largeblanks in the backward

gaze, fitful suspensionsof the remembering power ;
partialglimpsesof the past; resurrections of thoughts
long buried in oblivion ! I speak not of that natural
decayof the memory which is noticeable in most persons
of
which is one of the most affecting
as age creeps on, and
the many
warningsthen vouchsafed to us that the bodily
of this natural
is suffering
Even
frame
dilapidation.*
curious thingsto be noted. Recent
decay there are some
its

among

letters of

mental

symptoms

existence,like those in illuminated writings,

carry

our

their beautiful emblazonment*

Paul

Jean

"

"

The

the four sides of the

all round

F. Richter.

youn"j,"
says
in memory."

Aristotle,

"

"

live forward, I'M Ao/w, the old

Hoc

"

stand
we

The

by

of age
iiiibcx-ility

is not

so

priorefrvi." Martial.

lose the

conttionsnea*

of

our

happy, and

to
painful

the old content.

the

the old

as

of

our

return

it is to those who
second childhood,

loss of any of our

enjoyment. Thus, the blind are

prime.

accompaniedwith the oblivion of its

the deaf

"

With

and observe it* condition.

live backwards,

e"t

I'ivere bit,vita pottc

*

on

manuscripts."

So

The

that

we

are

temptedto

sense*

cheerful,
conclude,

306

ACUTE

OF

DISORDERS

MEMORY.

THE

and soon
difficulty
forgotten
;
and accurately
while those of older date are easily
recalled.
I believe, to the
This
has been
referred,and rightly,
degree of interest,and therefore of attention,
differing
which
the same
objectsexcite in the young and in the
if the effort of attention stamped
as
old. It would seem
characters upon the material fabric which
are
deep and
effaced in
lastingin the youthfulbrain, faint and soon
the aged. But disease may revive thingslongforgotten
;
a language long unspoken and
unthought in ; or blot
all traces of definite portionsof time gone
out entirely
by.
An accomplished
the subject
of
writer,when discussing
makes
the subjoinedremarks
Human
specting
reLongevity,"
the impairment of memory
consequent upon
often witnessed
in
that gradualphysicaldecadence
so
The memory
is undoubtedly
advanced life. He says
is first and
which
most
the mental
faculty
obviously
events

i_

retained with

are

5"*

"

"

that those

of Goethe,

lines
exquisite

noble translator,
express
'

Give

sightof
'

English by

their

reality
:

"

springof gladness,
pleasurestretched almost to pain;

Give
the

than

into

the active

love,in all their madness,

My hate, my
Although

ably rendered

so

poeticfiction rather

me

Of

"

me

the

She

sat

The

clouds

by

Over

"

my

youth

again!'

Margaret,as
angelic
the casement's

flyby, and she

citywall,

the

her love,were

chequer*d glass,
watches

them

pass

'

sufficient to enkindle

sparkof passioneven in
But
in the reallyold, the flame is
of an old dotard.
no
:
have
been
and
ashes
burnt
the
no
out,
sparkcan ever fire them again.
extinct,
An aged gentleman,
during the stunningand damaging effectof an apoplectic
seizure,lost all his money by the failure of a bank. On recoveringhis senses,
be awakened
of poverty,nor
to the feeling
the
he could never,
fortunately,
embarrassingconsciousness of being a poor dependent on the bounty of his
Another gentleman,daring a fitof apoplexyand its tedious consefriends.
quences,
into possession
lost two of his dearest relatives by death, and came
On his recovery, he neither regretted
considerable property besides.
of some
at his own
the loss he had sustained,nor
good fortune."-- Psychological
rejoiced
meditatingon
the icy veins

Journal.
*

"

Practice of

Physic,"by

Thos.

Watson, M.D.

ADVANCED

IN

MEMORY

OF

LOSS

3G7

LIFE.

between
affectedby old age. This wonderful intermedium
viduals,
body and mind, varying so greatlyin different indiand

from the

of

partakemore

to

mechanism

mere

It

the intellectual powers.

than

undergoeschangesmore

physicalcauses, and both its

which
and defects are marked
by peculiarities
belongto conditions of an organickind. The
in advanced

seem

any other of

life

plicitly
ex-

excellences

from

of memory

vidual,
indi-

in the same
capricious
strangely
accidents of the day or hour, would

so

anomalies

familiar to every

are

to

appear

one,

of names,
forgetfulness
especially
so, the facts of the early
and the frequentretention of thingslong past,while
recent events flit away like shadows, leaving
scarcely
any
still (though never,
trace behind.*
Or, more
strangely
*

sad is the

How

Rogers'state

picturewhich

Lord

in advanced

of memory

he
poet'sdecayof intellect,

says

John

Russell has drawn

life! When

of his friend

speakingof this illustrious

"

that was
In his ninetieth year his memory
beganto fail him in a manner
able
relate
his
He
shortest
to
no
was
stories,
longer
painfulto his friends.
"

or

began

forgetfamiliar faces,and

to

his usual

companions with

his constant

welcome

He

at last
when

however, even
poet. It was impossible,
her charms, to look
the poet who had sung
Faces

veneration.
that

what
had

once

were

what

and

other

times seemed

mind

had

that

Till

forgotthat
memory
him
upon

to crowd

faltering
tongue

he had

had at

those

saw

and

of all who

(Edinburgh Bevieic,1866,) observes

authority
ninety,Rogers was

near

before that of the

decay of the mind

body.'

and bodily,which
blessingor a curse

raises

that state, mental

life be

He

then

feelingof

lie sat, and

lifelesseyes
relate
knew

well,

so

him."

"

strikingexceptionto

as

now

once

lengthdeserted

him

could

been

ever

without

over

what

known,

once

now

thoughtsuppermost in the minds

Another
"

vacant

now

seen,

the

of

complimentary
expressions.

the

rule

'

of the

gradually
droppedinto

reasonable

doubt

whether

longed
pro-

"

'Omni
Membrorum
Nomina

damno
servorum,

major dementia, qune nee

vultum agnoscitamid,

nee

cucnavit
praterita
Quoe genuit,
quos eduxit."
Cum

quo

"

"

Although

forgotthe

his

names

its

same

Jurcn.

interview.

same

there

were

x.

as

fresh

as

oldest friends,
whilst

they

were

stories to the

Hut

illos,

Sat.

of long past events

impressions

of his relations and

with him, and told the

in the

nocte, nee

same

were

two
people,

with

him,'says

sitting

three times

of grace.
female correspondent,
I asked him after

'

'

over

frequentglimpses of intellectin

of tenderness,of refinement,and
originalbrightness,

drivingout

or

ever, be

all

Once

lady

80S

ACUTE

DISORDERS

THE

OF

MEMORY.

changes of brain),the
obliteration of certain classes of events or certain subjects
from
of memory,
as if by a sort of mechanical
separation
everythingelse abidingin this mysteriousreceptacle.
in its integrity,
The
importanceof preservingmemory
it can
be done, will probably
so far as
as long and
Some
be admitted.
may urge that an oblivion of things
for a tranquil
But this
old age.
past is the best security
to a mere
virtuallyreduces man
moiety of existence ;
and the same
reasoningmight be used to prove that
of mind
in this latter stage
is a blessing
utter imbecility
from natural causes
of life; such imbecility
often occurs
;
but we have no title to consider it a good,or to neglect
perhaps,without

morbid

some

"

which

means

any

venture

to

obviate

may

say that

As

these

or

retard it.

means

"VVe will not

are

many
in particular,
all that can

regardsmemory
this periodof life is

to aid

which

make

circumstances

in

or

certain.

be done

givingit

the

desirable,and

to

at

direction
it

spare

to weaken
painfulefforts at recollection which seem
the very faculty
they exercise. The latter remark we
believe to be of valuable
to other periods,
application
long antecedent to old age; but especially,
perhaps,to
is first felt to decline in
the faculty
that time when
clearness and power.* Recollection
that is the effort

those

"

of the will to combine

or

he could not recollect.

extricate what

is laid up in the

and appealed
to his
pulledthe check-string,
?'
The
servant.
Lady
Yes, sir.' This was
replywas,
to us both.
a
painfulmoment
Taking my hand, he said, Never mind, my
dear, I am not yet reduced to stop the carriageand ask if I know you ?'
*
Accordingto the theoryof Dr. Lordat (Professorof Physiology in the
does not always indicate a
Universityof Montpelier),a weakened
memory
decadence of the intellectual principle.Memory (orthe preservation
of ideas
in their full integrity)
this
and
accordingto
authority, the recollection of these
ideas are
complex functions executed in concert by two principles.The
of a fact is usuallycomposed of two elements,the one
remembrance
concrete,
whom

'

Do

He

I know

'

'

"

the

other

abstract.

The

first of these is rather the

force than of the intellectual

the

aged

principle.It

condition of the former

preserves its full

integrity.

should

is not

manifest

of the vital
offspring
therefore surprising,
that

while
itself,

the latter power

,

IMPAIRMENT

memory
without
the

"

MEMORY,

OK

SYMPTOM

be carried

cannot

OF

DRAIN

DISEASE.

309

beyond a particular
point

inducinga certain confusion of mind hurtful to

and probablyto others also. The conitself,
sciousness
faculty
of every one will giveproofas to these occurrences
afford warning
; and at the time,if dulyconsulted,

to avoid them."*

is often the power of the mind that first

memory
exhibits,in the acute and chronic affections of the brain
The

and intellect,
as well

as

disturbances

of the cerebral circulation,

and decay.
symptoms of disorder,impairment,
of the organicdiseases of the encephalon,
In many
modification or weakness
of the memory
is usually
some
cerebral
observed, and in cases of red and white softening,
tumours, as well as in those morbid changesin the nerve
associated with general
vessels,
or
matter, its membranes
this mental power shows, frequently,
marked
paralysis,
Instances,however, of
symptoms of earlysenescence.
disease of the brain occur, without,in
extensive organic
a marked
derangingthis faculty.In some cases
degree,
extensive pulpysoftening
of
of tumour, abscess,and even
the memory
to continue,intact,
of death ! Inexplicable
non
phenome-

the brain, I have known

up

to

the

moment

Impairmentof the memory is,however, often one

of the earliest symptoms, attracting
notice,and exciting
of cerebral disease.
at the commencement
apprehension
conscious of his failing,
The patient,
defective,
or impaired
!

of retention,feels anxious as to the state of his

power
brain and mind, and itoften occurs, when he firstconsults
that this is the only recognisedand
physician,
psychical
sign detected by himself and
appreciable
noticed by others,of any disorder of the greatnervous

his

centre.
to
Previously
patientis heard
"

the
apoplexyand paralysis
complainof a stunned, inactive,

attacks of
to

Edinburgh Review,

vol. cr. p. 76.

B

370

ACUTE

OF

DISORDERS

THE

MKMORf.

indicated by
sluggishstate of the faculty,
lection.
ideas to the recolin recalling
with facility,
a difficulty
former states of conThe
sciousness,
attempt to revivify
is accompaniedby a severe
sations
effort,and sendistress clearly
referrible to the head.
of physical
is often connected with
This impairment of the memory
of hyperamiaof the brain, and is occasionally
a condition
ing,
inflammation, softencongestion,
premonitoryof apoplexy,

confused, and

delirium, and

other

forms

of acute cerebral disease.

frequentlyprecedesand
insidious
so
accompaniesdisease of the brain is generally
for a periodaltogether
in its advances, that it occasionally
This mental
ciated
symptom is often assoescapes observation.
with
headache, vertigo,slightloss of sensation,
and unrecognised hidden
even
or
epileptic
epileptiform,
time
seizures.
however, it exists for some
Occasionally,
of the psychical,
before any serious disturbance
motorial,
The

or

loss of

memory

sensorial functions

that

is detected.

as well as in
stage of cerebral softening,
incipient
of the delicate nerve
those organicdisintegrations
vesicle
is termed
in what
observed
progressive,
general,and
the patientoften exhibits a debility
cerebral paralysis,
of memory
(longbefore disease of the brain is suspected)
in regardto the most
matters connected
ordinaryand trifling
with the every-day
of life. He forgets
occurrences
is oblivious of the names
of his parhis appointments,
ticular
friends,mislayshis books, loses his papers, and is
unable to retain in his mental
grip,for many consecutive
of the month, or day of the week.
He
minutes, the name

In the

sits down

to write

letter

on

some

matter

of

business,

being for a second diverted from what

he is engaged in, he immediatelyloses all recollection of
and leaves the letter unfinished.
In
his correspondence,
quiring
inhe will be heard constantly
this condition of mind
for articles that he had carefully
put aside but a
and

the attention

372

ACUTE

about

man,

He

was

He

no

from

to time

of

of

blood

brain.

There

extravasation

cerebral

the

dead.

relatives.

He

and

arduous

within
was

one

of

other

no

the
portant
im-

lesion.*

gentlemanwho

an

immediate

name.

days in this state,when he died of an

vealed
apoplexy. The post mortem examination re-

hemispheres of

in

of age, forgothis own

convinced that he was

fifty
years

time

MEMORY.

THE

fifteen

an

OF

longer recognisedhis

continued
attack

DISORDERS

had

years been engaged

anxious
contest for profespainfully
sional
for many

and political
advancement, strugglingat
position
time
with
the same
great pecuniaryembarrassments,
whilst addressingone
of the judges,suddenlylost all
in his brief.

recollection of the facts embodied

immediatelyobligedto
to his chambers.

retire from

Severe

the court

headache

and

He

was

return

ensued, accompanied

in a violent paroxysm
nausea,
terminating
by distressing
of vomiting. Other
symptoms denoting considerable
head disorder then appeared. Under
prompt treatment

recovered, and

he

able to

was

resume,

in

few

weeks,

On
duties.
three subsequentoccasions
professional
the same
This
sudden loss of memory.
he experienced
gentleman eventuallydied of softeningof the brain,
of mind.f
causingimbecility
his

of loss of memory
connected with
slightsympatheticdisturbances of the cerebral functions,

Cases,however,

occur

dependentupon disorder of the generalhealth,which are

amenable
remedial treatment.
John Hunter
to judicious
*

"

Andral's

"

Cliniqae."

of
always indicates precedingdisorders of the brain,especially
In
i
t
acute
disorders, generally
lobes,or very depressedpowers.

Amnetia

the anterior
betokens

fatal termination,if not

for the roost

and
epileptic

Partial amnesia
but not

instantaneous

an

crisis; in chronic diseases,

it occurs
suddenlyin
incurability
; or, when
violent
an
immediatelyapproaching
hysterical
patients,
paroxysm.

part,it indicates
fulness
(forget

of

always permanent,effecton

Psychology,"p.

194.

some

things)indicates

the brain."

"

probablyviolent,

Feuchtersleben's " Medical

CAUSES

IMPAIRED

OP

subjectto

was

PARALYSED

AND

kind.

affection of the

an

373

MEMORY.

Sir Everard

Home

and surgeon,
says, of this illustrious physiologist
visit at the
that he was,
occasion, on
one
a
on

"

residence of
the house
he

he

friend.

told,nor

was

nor

was,

He

the

even

his

where

in what

did ;jot know

of the street when

name

home

own

partof

He

was.

had

not
in

conceptionof anythingexisting
beyond the room
which he was, and yet he was
conscious of
perfectly

loss of memory.
and
impressions,

He

sensible to various

was

therefore looked

although rather dark,

to

in

of the

if he could

see

of the situation of the house.

subsided,and
gradually

out

The

few hours

be

his
of

kinds

window,

made

scious
con-

loss of memory
it was
perfectly

restored."
In

cases,

some

temporaryattacks

of loss of memory

are

temperanc
self-abuse,inindulgences,
of mercurials,
debaucheries, injudicious
use
and in one
instance that came
exhaustingdischarges,
under my observation,
the impairment of memory
was
ministere
adthe result of arsenical medicine incautiously
clearly
caused

excessive animal

by

for the

of

cure

an

obstinate cutaneous

disease.

Intemperancein eatinghas been known to impairthe

that the Roman
It is said by Suetonius
memory.
from this
so entirely
Emperor Claudius lost his memory
and persons of
that he not onlyforgotthe names
cause,
tended
of what he inhe wished to speak,
those to whom
but even
to say when attempting
to engage in conversation.*
A lady,after a protracted
labour, suffered a severe
for nearlya
attack of uterine hemorrhage,and her life,
of.
The loss of blood that occurred
week, was despaired
vital prostration
reduced her to a condition of extreme
and mental
depression.It was
necessary for the nurse
"

By

an

old

Spanishlaw

no

person

was

admitted

into the witnesa-box

to

give evidence in a disputedlegalcase, who was proved to indulgein habit* of

considered to weaken
intemperance,as an excessive use of stimulant* was
and

destroythe

memory.

374

ACUTE

DISORDERS

to feed and attend

her

was

had

ill,the

attemptingto

do

She

in

been

talkingin
native

French
of

to

was

able

find

that

had

where
forgotten
how long she
was,

children,and
her

in

fact,her

recollection !

She

In
anythingby its rightappellation.
mistakes.
she made the most singular
so
the habit, previously
of
to her illness,
than English(herhusband
more
being

France), but whilst

described, she

French,

she

to call

unable

had

of her

names

When

astonished

was

obliterated from

was

name

was

MEMORY.

! She
paralysed
who
her husband
residing,

been

own

husband

was

memory

she

THE

to her like a child.

her
articulate,

to

OF

for

languageshe

did

addressed
not

lost all

have

appearedto

when

in the

by

her

have

state

of

mind

knowledge of

husband

in

that

the

prehension
comslightest
he was
of what
saying,althoughshe could
A
periodof
speakEnglish without much difficulty.
or
nearlyseven
eightweeks elapsedbefore the memory
of
began to improve,and it was not until the expiration
months
to regainits original
that her mind appeared
some
strength.
Sir H. Holland
refers to his own
case, as an example
of transient
failure of memory
resultingfrom bodily
day,two
fatigue.He says, I descended on the same
deep mines in the Harz mountains, remaining
very
in the second
While
hours undergroundin each.
some
and inanition,I
both from fatigue
mine, and exhausted
felt the utter impossibility
of talkinglongerwith the
who
German
Every German
accompaniedme.
Inspector
and it was
word
not
and phrasedeserted my recollection,

appear

to

"

until I had

taken

food and

wine, and been

some

time

at

regainedthem."1
had
mental and physical
A gentlemanwhose
powers
been
severelyexercised,suddenly lost all recollection
of recent
His memory
events.
appearedto be pararest, that I

"

":

Mental

Pathology,"
by Sir

H.

Holland,Bart.,M.D., D.C.L.,p.

167.

EPPBCT

OF

STIMULANTS

IN

RESTORING

THE

MEMORY.

375

lysed. Whilst engaged in active conversation he was

able,by a strong effort of the will,to retain possession
of the ideas suggestedby others to his mind, but if
there were
the slightest
to the extent
even
interruption,
of

minute, in the conversation, he lost all recollection

of what

he had

been saying! This gentleman

previously
had been living
for some
weeks below par, with the view
of enablinghim to performan amount
of urgent mental
for its execution the lengthenedconcenwork, requiring
tration
of a clear and vigorousintellect. He
had been
in the habit of drinkinga fair portionof wine, but had
unwiselyabandoned the use of stimulants, fancyingthat
by so doing he would be better fitted for clear-headed
mental occupation.Under my advice he lived generously,
took iron tonics,
and zinc,and resumed
his daily
qiwnine,
restored his
quantityof wine. This treatment eventually
to a state of health.
memory
I have known
other instances

of

temporary

loss ol

cured within a short periodby a free exhibition

memory
of tonics and stimulants.
In these cases
the brain is

generallyin a starved and impoverishedcondition

(owingto povertyof blood),and suffers from a state of
innervation and inanition.
A gentleman,well known
for his intense passionfor field-sports
it may be
(living,
said,upon the saddle duringthe greater partof the year),
frequentlycomplainedof transient attacks of loss of
alter a hard day'srun
His
with the hounds.
memory
to a pintof port
remedy for this affection was half-a-pint
at a
wine, which he was in the habit of occasionally
drinking
dose upon
draught!The effect of this heroic stimulating
the depressedenergy
of the brain was
magical. The
recovered its vigorousactivity.
immediately
memory
In more
chronic cases of loss of memory,
a persevering
of iron combined
with small doses of strychnine,
use
minute
the sulphateof copper, cod-liver oil,quinine,

376

ACUTE

DISORDERS

OF

MEMORY.

THE

doses of

the shower-bath,electricity
phosphorus,
applied
to the head, as recommended
locally
by Dr. Darwin in
his
to circumstances,
found
Zoonomia,"all,according
are
beneficial,
providedno serious extent of acute organic
lesion has taken placein the brain,or the attack of loss
of memory
has not followed paralysis
or apoplexy. But,
in these apparently
even
hopelesscases, much good may
be accomplished,
all active head symptoms have
when
of tonic and stimulating
subsided, by a course
treatment.
A clergyman,
between
fortyand fifty
years of age, was
actively
employed in readingwith two young gentlemen
who
were
preparingfor their Universityexaminations
and degrees. He had been so engaged for eightcontinuous
at the rate of from eight
weeks, workinglaboriously
to ten hours de die in diem.
One afternoon whilst busily
engaged in explaininga subtle mathematical
problem
he was
to his pupils,
suddenlyseized with an attack of
severe
vertigo(unaccompaniedby any convulsive symptoms).
This was succeeded by a completeloss of
memory.
He could retain nothingin his mind.
On the following
He
day he was brought to London, and I saw him.
complainedof dull,heavy headache,and great depression
of spirits.
His generalhealth was
sadlyvitiated. The
cerebral symptoms beingsomewhat
active,and congestion
a few leeches
lowed
were
diagnosed,
appliedto the head, folby a blister to the nape of the neck. A state of
completebrain and mind quietude,repose, and inaction
were
enjoined.He had also administered to him mercurial
"

alteratives with

purgatives.In
improved. He

then took mineral

of taraxacum.

I then

of

attention

more

his
diverting
with

to mental

the

occasional

the view
work.

He

of

course

of

sent

him

from

warm

few

and

aromatic

weeks, he decidedly

acids with

abroad

the extract

for the

purpose

the anxieties of home, but

removing him from all temptation

returned to England after the lapse

DISEASE

of
He

OF

few

BRAIN

INDICATED

BY

LOSS

months, quite restored

has had
found

OP

377

MEMORY.

in mind

and

body.

ever,
of the loss of memory.
He, howit necessary to abstain from severe
mental
no

return

in deference to my
and consequently
advice
application,
declined receiving
pupils.
An eminent provincial
surgeon, of largeand anxious
failure of memory.
seized with a sudden
was
practice,
He forgotall his appointments,
and to such a degreewas
the faculty
of retention impaired,
that he was
obligedto
and minute
make memoranda
of every trifling
stance
circumwhich it was
importantfor him to remember, and
in order to refresh
to these he was
referring
constantly
his memory.
This attack was
precededby headache, of
which
he had complainedfor nearlya fortnight.Up to
the periodof the case being brought under
my notice,
entertained as to the existence of any
no
was
suspicion
prior state of cerebral ill-health sufficient to account
for his apparentlysudden loss of mental
satisfactorily
I, however, ascertained that about eightweeks,
power.
he was
seized,whilst
or
nearlythree months previously,
in the act of applyingthe stethoscope
to the chest of a
sciousness
vertigo. He lost conpatient,with severe
epileptic
succeeded
This was
for a minute.
by an
sequently
Three
attack of distressing
sick headache.
days suband
of vertigo,
he had a second paroxysm
he was
in which
sittingat
nearlyfell out of the carriage
pressed,
dethe time.
His spirits
subsequentlybecame much
but in a few days he againrallied,and flattered
himself that he had quiterecovered
He made no mention
and
of his family,
of these attacks to any member
the subjectof his
avoided all conversation on
carefully

health

with

his

medical

brethren.

When

saw

this

mental symptom was

an
gentlemanthe onlyappreciable
consecutive
to retain in his mind, for many
inability
minutes, any recent impressions.His pulsewas feeble

378

ACUTE

face

DISORDERS

MEMORY.

THE

OF

generalhealth shattered. His spirits

which
however, at times buoyant,and the prognosis

and
pallid,

were,

he formed

of his

case

own

favourable ! Alas !

was

as

the

prophet. I
had a consultation with this medical gentleman's
partner,
and gave
it as my
opinionthat the attacks of vertigo
of an epileptiform
and consequent
were
character,
clearly
subtle structural changestakingplacein the brain.
upon
Two
weeks after his return home
he had an epileptic
fit.
He then became
quently
rapidlyworse, and ten months subsedied in a deplorable
!
state of mental imbecility
A patientconnected
with a largecommercial
house as
result

established,he proved to be

confidential traveller consulted

false

the

me

before last,

year

He
had occupied
complainingof impairmentof memory.
a
positionof great trust and unceasinganxiety
for a continuous
ing
periodof ffteen years, always exhibitremarkable
acute sagacity
a
degree of intelligence,
and
For
about
six months
capacityfor business.
previouslyto my being consulted, he had foolishly
undertaken
of the principal
extra evening work, as
one
clerks in the

obligedto

house

leave

England

abroad,who
additional

for

of

work,
This

nearlytwelve

recovered
the

in

was

brain

camel's back."

with

the

use

acetate

a
was

which
to

he

visit

state of
the

connected

was

ing
relative resid-

near

alarmingillness.
"

that

straw

gentleman continued

months, by

was

which

broke

under

time

This

he

the
care

my

entirely

of his memory.
I found
small doses
of strychnia,
combined
with iron and

He had, however, previously

of great benefit.
quinine,
cod-liver oil and the phostaken, with much advantage,
phate
of iron, and had used the shower, and, eventually,
the douche bath to the spine,with evident service.
A. member
of the bar complainedsome
years ago

of occasional
this

attacks

mental

of enfeebled

impairment

memory.
the
to

He

buted
attri-

fact of

his

380

ACUTE

OF

DISORDERS

MEMORY.

THE

of

at a
his arrival at daylight
On
February,1857.
He drank a
wayside inn, he felt extremelybenumbed.
glassof hot brandy-andwater, and then partookof some
solid refreshment.
In the afternoon
of that day he
of so
headache.
The
complainedof severe
pain was
intense a character,
that the patientscreamed
during
the paroxysms
of cephalalgia.
This headache was
ceeded
sucment
by a violent attack of vomiting,and great impairand

confusion

of

sight.

extremelylethargic.A
the

In the

eveninghe

local surgeon

was

became

summoned

to

"

adopted was, as the result

chief
established,
extremelyjudicious. The acute brain misof a
was
arrested,and the man, at the expiration
well to London.
able to return apparently
was
fortnight,
A

and

case,

few

the

months

treatment

after this attack of cerebral disease he

brought under my notice

beingnearly
paralysed.He
of

man

matters

him, of

most

He

in

of the memory
consequence
had previously
been an active

ness
business,and had alwaysexhibited greatshrewd-

in
saw

was

of account

but

when
complained,

he

the
to retain in his mind
inability
in relation to fgures.
matters, particularly
trifling
unable to add up, with his usual facility,
was
a long

account, and

total

could not recollect for

of the calculation.

the result

second

one

impaired; the
action of the heart feeble,
and irregular,
the pulseweak
secretions depraved,
and
the renal functions unhealthy.
I advised a total absence from business for a lengthened
period. He continued, near London, under my care for
some
weeks, duringwhich
periodhe took the mineral
His

acids, taraxacum, mild

small

doses

combined

with

blisters

appliedto

ears,

He

and

then, by my

mercurial
of

the

used the

generalhealth

nape

tepidas

and subsequently
alteratives,
zinc

sulphateof

extract

the

was

of

nux

vomica.

of the neck

well

as

and

and

copper
He
had

behind

the

the cold shower-bath.

advice, removed

into the

country,

LOSS

and

OP

MEMORY

BT

BLOWS

UPON

THE

381

HEAD.

passivecerebral and mental state for

nearlynine months, attendingto no matters of business,
but takingregular
of
horse exercise. At the expiration
twelve months
he came
back to London
nearlywell. He
resumed
his ordinaryoccupation,
and since then
soon
has had no return of cerebral symptoms.
His memory
is sufficiently
strong for all business purposes, but not
to his illness.
so tenacious as it was
previously
A
tradesman
felldown a trap-door
at the back of his
blow
his
shop into a cellar,and received a severe
upon
head.
He was
stunned.
He
ever,
was
able,howpartially
in the course
of the afternoon of that day,to go to
the countryand joinhis family.For some
days after the
accident he complainedof considerable uneasiness in the
bone.
The sensation
neighbourhoodof the rightparietal
and heaviness.
not one of pain,but that of weight
was
I

saw

remained

CAUSED

him

in

in consequence

of unusual

manifestations

of

and damaged memory.

His
sleeplessness,
irritability,
pulse was
quick and sharp, the action of the heart
of uniformity
in the
want
laborious,and there was
a
movement
of the pupils. The
symptoms indicated
somewhat

active head

disturbance.

I ordered

him

to be

cupped to the extent often ounces, and to be well purged

of drastic cathartics. The loss of blood proved
by means
beneficial. The feeling
of weight and heaviness
decidedly
in the head materially
diminished after the cupping.
In the course
of five days,the brain againexhibited signs
of morbid
second time
and the patientwas
a
activity,
cupped. This was followed by more decided results than
the
first local depletion.I enjoined the strictest
and mental
and abstinence from both physical
quietude,
excitement.

After

all evidence

cerebral mischief

througha course
took quininewith
subsequently
able to return
He. eventually,
was

had subsided, he went

tonics,and

of acute

of mineral
decided

vantage.
ad-

to business

382

DISORDERS

ACUTE

OF

MEMORY.

THE

but slightly
with his memory
impaired. This
has for some
years occupieda tryingcommercial

free from

and

of active

recurrence

any

anxious

patient
position,
cerebral

symptoms.
A

solicitor
his head.

upon
and

He

at the

were

He

concussion.

that time

for

quite restored

to

after the accident

as

to

to his bed

weeks.

He

I had

informed

am

for

shop,

of cerebral
a

few

days,

able after

was

duties,apparently
professional

he

months
Seven
originalhealth.
called upon me
the state
respecting
found
it extremelydefective,particularly

dates and

of
independently

for.

There

names.

symptoms denotingmischief

mental

chemist's

his

of his memory.

slightsymptoms

some

to his

to return

into

sent

confined

was

house

to the

time

cab, and fell

hansom

removed

was

neighbouring surgeon

that there

and

out of

thrown

was

occasional

this

attacks

under

in the
of

were

no

other

brain,or mind,
mental

severe

pression.
de-

observation,at ing
varyfor
but
treatment
intervals, nearly
no
eighteenmonths,
case

my

than temporary relief.

adopted appearedto give more
This
gentleman eventuallyexhibited great general
mental
of the fourth
impairment, and in the course
and ultimately
hemiplegic,
year from the accident,became

died in
death

severe

attack

of convulsions.

exhibited evidence

The

brain after

of

chronic white
long-existing
also considerable
softeningin both hemispheres. There was
fattydegenerationof the vessels of the brain.
An
officer in the Hon.
East India Company's service,
to England with
returned
a
singularloss of memory,
caused by what
was
alleged to be a luoon
stroke, he
having incautiously
sleptone night for several hours
When
he awoke
exposed to the rays of a full moon.
his mind
and
acute

was

much

confused.

great gastricirritation.
cerebral symptoms, with

He

He
his

then

had

recovered
memory/

headache
from

the

however,

INSIDIOUS

much
he

OF

CASE

353

DISEASE.

BRAIN

of this state of mind,

In consequence
on
obligedto leave India and return home

affected.

was

brought him to me, and placed

I treated him by means
of counterhim under my care.
to the
irritants and tonics,after attendingparticularly
in a state of greatencondition of the liver,which
gorgement.
was
with
Cod-liver oil, combined
phosphorus
exhibited with decided advantage.
and iron, was
eventually
This
gentleman,after the lapse of eighteen
months, returned to India, apparently
quiterestored. I
months
after his arrival
regret to hear that, some
pairment.
there, the memory
again manifested symptoms of imbeen placedin an
He
has, unfortunately,
since his return to military
anxious and tryingposition
of his
duty, and this may account for the recurrence
His

sick leave.

father

enfeebled powers of retention.

for the seaside,accompanied
A gentlemanleft London

by his wife,who
months

been

was

in

an

in

the mental

of the

consequence

had

state of mind

anxious

Independentlyof

health.

He

serious invalid.

for

some

her
respecting
distress he

perienced
ex-

alarming character

of

his own
mind
had been for
indisposition,
and continuously
zealously,
actively,
many
years most
and professional
political,
pursuits.
occupiedin literary,
gerously
danA
few days after his arrival his wife became

his wife's

ill. This

gave

rise to

additional

worry
attack, he

anxiety. Subsequentlyto her acute

of his
and complainedslightly
indisposed,
of his family,that he was
said to a member
take
home

hot sea-water
he

went

He

did

his bedroom,

afterwards, in

hours

some

to

bath.

so,

where

and

confused
many

state of mind.

other absurd

He

asked

He

his return

he

but

felt

going to

on

profoundstate

sleep. Upon beingroused, he awoke,

in

and

head.

and

was

of

was

where

found,

lethargic
evidently
he

himself
respecting
questions

was,

384

DISORDERS

ACUTE

OP

THE

MEMORY.

from a complete
family. He appearedto be suffering
I was
of the memory.
to see him,
requested
paralysis
I found
for that purpose.
left London
and accordingly
his memory
to recent events seriously
as
damaged. He
under

was

no

aberration,neither
powers

in fact any form of

his perceptive
faculties or reasoning

kind of delusion, or
were

at all affected.

and
sagacity,
fluency,

He

conversed

with

great

but if
every subject,
in the conversation,he
to elapse
acuteness

on

a second
permitted
forgotwhat he had been previously
talkingof I
entirely
Beyond this period he could not retain in his mind a
suggestedidea,or train of thought. He never rallied

from

of intellect. For

this state

exhibited

mental

discuss at short

powers

of

the
intervals,

high

few

months

order.

He

he

could

subtle and abstruse

most

and literary
matters with appaprofessional,
political,
rently
ever,
unimpairedmental vigour. His memory, howrecovered its healthytenacity.This gennever
tleman's
became
much
intellect subsequently
weakened,
seizures which he has
the effect of several paralytic
as
of late years.

suffered from

informed

am

that up to

not
was
day of using the hot sea bath, his memory
he a fit immediatelyafter
affected. Had
appreciably
coming out of the water, or on his return home ? It
taken after an early
dinner,
appears that the bath was
of uneasy cerebral
and at the time of his complaining

the

sensations !*
died at the age of fifty-four,
of
of the brain,exhibited four years previously
softening
symptoms of undoubted cerebral disorder,which were
A

tradesman, who

dependupon disease of the liver.

periodof nearlythirty
years a greatstrain

considered at the time to

He

had for

bath is most
of the ancients,the warm
authority
and
destructive to voluptuaries,
hy producing fatal attacks of paralysis
Sine
rubitce
mortet
when
used,
turgide
epulit.
particularly
apoplexy,
*

Accordingto

the

"

intestata tenectus,"says Juvenal.

CONPUSED

STATE

OF

THS

885

MEMORY.

upon his mind,

havingto conduct,without any material

and complicated
commercial
business.
assistance,
a large
He
but not until
eventually
engaged with a partner,
his friends recognised
symptoms that made them anxious
as to the state of his brain.
He was, at times,unusually
agitatedand flurried. He would sit up late at night
to
looking
throughaccounts and readingletters relating
matters long since settled. He could not be persuaded
of the absurdity
of this proceeding,
and when
lated
expostuwith, would

I know
affairs best ; it
say,
my own
is necessary I should acquaintmyself with the state of
business."
occasion
On
he carried a letter
one
my
about with him
for the whole
of the day. It was
of
*'

long antecedent date, and related to a matter that had

been arranged many
previously.He appeared
years
puzzled respectingthe letter, and frequentlyasked
whether
it was
all right? It was
with
difficulty
he was
not of the slightest
portance.
impersuadedthat it was
On another occasion,he insisted upon going
most
into his banker's
minutely and unnecessarily
account, without sayinganythingthat would justify
a
that he thoughtany error
had been committed.
suspicion
He
restless and fidgety,
anxious to be actively
was
without havingany clear conception
as to what
engaged,
he was
doing,or wished to do. At this time there was
aberration of mind, failure of memory,
no
or
perceptible
positivesymptom of cerebral paralysis.He continued
in this condition for two years, duringwhich time he was,
His
better in mind.
eventually
occasionally,
memory
considered
showed signsof great impairment. This was
His
the first decided symptom of brain disease.
as
to read old
of manner,
restlessness,
disposition
agitation
matters
and annoy himself respecting
letters,
unimportant
of business, were

considered

at the

time, as

state of

and gastric
simple"nervousness" dependentupon hepatic
c

380

OP

DISORDERS

ACUTE

MEMORY.

THE

derangement.The result,however, established the error

it
of diagnosis
that had been committed, for at this period
evident disease of the brain had

was

In

much

many

forms

the

memory,

what

the

or

wishes

erratic in its manifestations.

and

patientrecollects

he desires

and

disorder,
psychical
incipient
stage,is not so

it is confused

impairedas
The

disease

of brain
in

commenced.

with

sufficient clearness,

to recal to

mind, but the

and in a state of
reproduced are disjointed
m"lee.
He complainsof his brain and intellect being in
I attended
and addled state.
who
a muddled
a patient
from this symptom, four weeks prior
suffered,principally
to his death from apoplexy.
In inflammatory
well as in white softening
of the
as

images so

brain,this confused
and
the disease.

condition

of the

symptom

common

is a promemory
minent
in the earlyperiodsof

died
literary
gentlemanof some
position,
of non-inflammatory
at the age of fifty-nine,
ramollisseof the
rnent
brain, complicatedwith epilepsy.For
to his death, his mind had become
years previously
many
complained of a loss of
manifestlyimpaired. He
mental
vigour and tone, but with these symptoms, his
for a time, exhibited no obvious signof actual
memory,
weakness.
It was,
however, occasionally
very much
in the habit, for some
He
confused.
was
periodpreviously
to the developmentof serious head
symptoms,
to a kaleidoscope
!
There was
of comparinghis mind
no
to revive, by an
effort
of vivid ideas or capacity
want
of the will,past states of consciousness,but the images
in a
so
expression,
reproducedwere, to use his own
confused and entangledcondition."
In certain states of perturbedand agitatedthought,
A

"

and connexion,
the ideas appear to lose their coherence
the memory) becoming
the mental faculties (particularly

quiteconfused.

This

often

occurs

to persons, in health

388

AND

PARALYSIS

IN

MEMORY

THE

CHAPTER

Chronic

CEREBRAL

SOFTENING.

XV.

(Modified)Affections
of

the

Memory.
modifications

EEMARKABLE

symptoms
Christian

of brain

one

pronounce
remember

disease,such

of

name

with

words

of

articulate

or

paralysisand

other

with

the

the

early
recollecting
only the

intimate

friends,confounding

another, being able only to

certain

as

and

relations

name

operationsof

connected

seen
occasionally

are

memory

the

in

sound

(arisingfrom

diseases

of

the

an

the

to
inability
effects

of

brain) particular

letters of the
A

alphabet.
who
had
several paralytic
seizures,always
patient,

knew

when

his

attack

approachingby forgetting
his own
Christian name.
When
asked to sign a letter,
he could only write his surname,
and
only
occasionally
half of that.
A gentleman,subject
to severe
attacks of
some
epilepsy,
days before his attacks, invariably
signs
half of his name,
not being able to do so in full !
of an
A lady,in consequence
attack of acute disease
of the

brain, lost,for
and

never

was

some

time, all recollection of her

could pronounce

it unless

she

saw

own

name,

it in

writing.
gentlemanof rank, when in the incipient
stage of
forgot his
softeningof the brain, occasionally
when
walking in the publicstreets,and sometimes

A
white
name

lost all notion

of his address.

He

was

in the. habit

of

LOSS

OF

LANGUAGE

CAUSED

BT

BLOW

and saying,
stoppingstrangers,
"

He

state of

am

head

confined to his bed

was

THE

389

HEAD.

what
so-and-so,

by

his

fall from

for several weeks

On

is

do I reside ?"

Sir So-and-so, where

in

recovery, it
that all recollection,
not only of the accident,

but of the circumstances

it, had

I live

imperfectconsciousness.

found

was

"

gentleman injuredhis

horse.
a

?" or,

name

my

ON

been

considerable

which

for

his

time

some

obliterated

entirelyfrom
periodelapsedbefore the

preceded

his mind
lost ideas

began

The circumstances
to the memory.
graduallyto recur
of his journey returned by degrees to his recollection.
As
he repeatedly
rode over
that part of the country
where the accident occurred, the sightof surrounding
objects
graduallyrecalled the evanescent trains of ideas
with which they had been connected, to his recollection.
He afterwards remembered
nearlythe whole transaction.
Mr. Abernethy has recorded the case
of an
injuryof
the head, which
happened to a foreigner,
twenty-seven
well ; during
years of age, who spokeEnglish perfectly
his illness this man
could only answer
in French, and
"

said he
A

man

was

but sixteen years old.

was
broughtinto St. Thomas's

had

received

from

which

he

considerable

injury of

Hospitalwho
the

head, but

recovered.
When
he became
ultimately
about
convalescent,he spoke a languagewhich no one
him could comprehend. However, a Welsh
milk-woman
stood
came
one
day into the ward, and immediatelyunderwhat he said.
It appearedthat the patient
was
a
Welshman, and had been absent from his native country
about thirty
In the course
of that periodhe had
years.
entirely
forgottenhis native tongue, and acquiredthe
he recovered from his
English language. But when
accident he forgotthe languagehe had been so recently
in the habit of speaking,
and regainedthe knowledgeof
that which he had originally
acquiredand lost.

390

(MODIFIED) AFFECTIONS

CHRONIC

French

MEMORY.

THE

countess, during the Eevolution, left her

resided

and

country

OF

attack of fever,in the

of which

course

this time

At

delirious.

She

England.

in

she

was

had

severe

she became

pletely
com-

heard
frequently

jargon,which at first was

and seemed to consist
to everybody,
quiteunintelligible
sounds without meaning. However, there hapof mere
pened
and

talk

to

cry

in

out

to be in the

house

that she understood

domestic, who

Welsh

the countess, and

declared

affirmed that

she

the lady
language. When
recovered
from her illness,
and againspoketo her friends
in an idiom intelligible
to them, they related the fact to
her, which had excited no small surpriseand curiosity.
They were then informed, that during her infancyshe
had
been taught the dialect of Lower
Britanny,by a
who
of that country,but had totally
was
a native
nurse
it many
forgotten
years before the attack of fever,which
that had
in so curious a manner
revived the impressions
been so long obliterated.*
A lady,fifty-one
years of age, of sanguinecomplexion
duced
and
plethorichabit, after a fit of apoplexy,which inin
spoke correctly

state

three
some

the Welsh

of unconsciousness, which

four

days,was found
respectsimpaired. The
or

have

to

continued

faculties in

her

remarkable

for

circumstance

to speak in
aptitude
English.This continued
and her nurses
and servants were
a month,
obligedto
self
The ladyherfor them.
employ a person to interpret
spoke to them in French.
of his
seized with hemiplegia
An
old gentlemanwas
right side,associated with profound sleep. The same
the ninth
the second day. On
side was
convulsed
on
day he recovered from the state of stupor,but his faculthat

she had

lost the power

which
her native language,
was
was,

The

Welsh.

language of

Lower

Britannyis

or

well

known

to

be

dialect of

EFFECT

OF

OF

INJURIES

THE

HEAD

ON

After several weeks he

gone.
his intimate friends ; then to remember

ties

the

began

were

of his

prayers

church, and

891

MEMORY.

THE

know

to

words, to repeat

read

few

of

words

German, (insteadof French, his native language)every

day. While making slow advances in knowledge,he

died suddenly
of an acute cerebral attack.*
The
followingfacts form good illustrations of that
modified

condition

speaking. After
at his command

I
of which
memory,
attack of brain disease,a

of

an

of
firstsyllable

only the

now

am
man

had

that

names,

is

of one
pronunciation
old
of it. An
word, althoughhe knew the firstsyllable
of persons, but appearedto reman
forgotthe names
collect very correctly,
a remarkable
epoch
every evening,
of his life,although it had occurred a long time previously.
When
with his wife he imagined he
sitting
at the house of a ladywith whom, many
was
viously,
years prehe was
in the habit of spending his evenings.
I
He
the wife, say, "madam,
would
then, addressing
cannot
stop any longerwith you, for when one has a
I must
them
wife and children,
a good example
owe
we
home."
After this compliment he endeavoured
return
to depart.
of a remarkable
There is upon record the particulars
of an
of a patient
who had, in consequence
injury
case
still
how to read, but who
was
to the brain,forgotten
After two attacks
and correctly.
able to write fluently
of apoplexy,
as well as that of
a man
forgothis own name
say, he

to

could

not

finish the

'

"

became

his wire, children,

and all his friends. He

restless,

his memory
and very irritable. Eventually,
suspicious,
restored.
He
enabled, however, to
was
was
partially
repeat only the followingexpressions"yes,""no,"
"much," "very well," not at all," it is true," "it
"

"

"

*
"

On

few of these illustration* are

the Disease*

of the

Nervotu

transcribed from

Syttcm."

Dr. Priehard'a treatise

392

CHRONIC

(MODIFIED) AFFECTIONS

OF

THE

MEMORY.

These
words, which he
just,""it is wonderful."
almost
generallyappliedwith tolerable accuracy, were
how
the only ones
he knew
to use.
After an attack of heraiplegia,
a
lady suffered from a
In speakingshe only used
defect of memory.
singular
the infinitive of verbs,and did not employ any pronouns.
For example,instead of saying I wish
you good day,
has just come," she would
remark,
stop, my husband
For
To wish good day, to stop husband
to come."
a
long time this patientcould not count beyond the
number
able to go as high
three, but eventuallywas
ledge
as
forty. She also succeeded in obtaining a knowof pronouns
without beingable to make
a
proper
of them.
application
A very intelligent
and highlyrespectable
lady,
young
after much
married
painfuland prolongedfamilyaltercation,
After her first
she passionately
whom
loved.
a man
confinement,she suffered from an acute bodilyaffection,
which was
and distressing
followed by protracted
debility.
found
that she had
it was
After her apparent recovery,
that
had
lost altogether
the recollection of the time
elapsedsince the day of her marriage. She remembered,
with remarkable
vividness, every previousevent of her
life; but, from the day of her marriage, every idea
When
appeared to have been obliterated from the mind.
all knowledge
her husband
made advances, she repudiated
She acted in the same
of, or relationship
to, him.
way
her
with regard to the child.
Her
friends
and
parents
by their authoritysucceeded in persuadingher that she
She
in reality
was
married, and had given birth to a son.
because
attached some
degreeof faith to their assurances,
is

"

"

she would
of her

rather believe that she had

than
wedding-day,

friends and relations

beheld

her

husband

were

and

entertain

lost the recollection

the notion

that

her

lyingimpostors.She, however,
able to
her child without beingf

OF

EPPECTS

ON

PARALYSIS

THE

393

MEMORY.

of
magic she has acquiredpossession
the one, and given birth to the other !*
In August, 1785," says Dr. Hertz,
called to
I was
officer of the artillery,
about fortyyears old,
an
a man
seized with a palsyin conwho, as I was
informed,was
sequence
of cold and violent anger.
His tongue,hands,
and feet were
paralysedby the attack. He was under
the care of one of our
first physicians,
at whose desire I
consulted concerning
of applyingelecthe propriety
tricity.
was
From
the time that this remedy was
first employed
until the following
him ; but he
saw
year, I never
then sent for me
he said,
again,as his own
physician,
what

imagine by
"

"

had

deserted him.

have

I found

him

much

so

recovered

as

to

the

completeuse of his feet ; his hands, also,were

but in regardto his speechthe following
stronger,
very
circumstance

remarkable
able

to

was

be

observed

he

was

articulate

which
either
distinctly
any words
occurred to him spontaneously,
or when
they were slowly
and loudlyrepeatedto him.
He
exerted
strenuously
himself to speak,but an
kind of murmur
unintelligible
to

all that

was

violent,and

could

be

heard.
in

effort he made

was

deep sigh. On the other

If a book, or
hand, he could read aloud with facility.
any
written paper, was
held before his eyes, he read so quick
that it was
and distinctly,
impossibleto observe that
fault in his organs
the slightest
there was
of speech.
if the

But

terminated

The

book

or

paper

were

withdrawn,

lie

was

then

one
of pronouncing
incapable
totally
of the words which he
had read the instant before. I tried this experimentwith

him
of

not only in the presence

repeatedly,
other people. The
effect was
many

of his

wife,but

uniformlythe

same."t
Dr.
"

Osborn, who
Vide Art.

"

has

publishedan

interesting
paper

M^inoire," Diet. de" Science* Mid. torn xxxii.,

p. 5.
vol.
viii.
t
Magazine,"
Psychological
"

394

(MODIFIED) AFFECTIONS

CHRONIC

MEMORY.

THE

in connexion
memory,
disease of the brain, considers that there are

of speechand
faculty

the loss of the

on

OF

with

of language; the first he

of loss of memory
connected with softening
of some
believes to be usually
kinds

two

portionof
advanced

but

far

as

This

age.
of

is

dates,names

muscular

the

as

witnessed in
frequently
characterized by an imperfect
recollection
of places,
as well as of persons,

brain, and is most

the

articulation have

of

powers

been

the faculty
of language
impeded by paralysis,
remains
unimpaired,and the individual speakswith his
usual facility,
involved in
until all the faculties become
the disease,and total fatuity
results.
he believes,involves language
The other imperfection,
in all its partsnearlyin an equaldegree,except in the
other words of less
forms when
or
slighter
proper names,
It does not
alone affected.
are
frequentoccurrence,
not

consist

in

of memory

want

but

in

word

of the

to

of the

loss of recollection

be

pronounced,
of
mode

usingthe vocal apparatus so as to pronounce it. This

affection comes
on
during all ages. Although
peculiar
appearingto arise from disease of the brain, yet it is
serious cerebral
not
the precursor of any
necessarily
affection.
Defective
results

of
of the

some

head.

or

is

perverted
memory

concussion

of

brain, and

the

of mechanical

forms
slighter

Numerous

of the

one

common

follows

even

injuryto

illustrative of this fact

cases

are

the
upon

record.
A
some

who
soldier,

portionof

that he
was

not

had

was

It

the brain.

forgottenthe

able until

some

of scholastic attainments

time

was

thrown

from

his

the

jiveand

numbers

to recollect them.

lost,after
horse, and

operation

afterwards discovered

an

fever,all knowledge of the letter F.

was

in

trepanned,lost

who

seven,

and
man

attack of acute

gentleman who
suffered from

306

(MODIFIED)AFFECTIONS

CHRONIC

"Have

you

"

"

"

of

eldest

your

Does

he

Do

your

on

M.

Strike

the table

it back

put

He

cap, "c.

pe

and

for

"

the

mere,

ma

back, and told him

required.Bid

the

he, and

away.

"

walked

put

military
were

free

won

merely

pere, he could
me

The

"
.

was

nounced
pro-

only
mination,
exa-

patientwalking off
Dupuytren called him

the

M.

gentleman

did

He
ad

adieu;

"

as

he
cu,

"

was

said

made to ascertain
were
subsequentday,experiments
whether the tongue,as the organ of taste,continued

On

perfectin
the

of

doff his cap.

to

su, he

si,so,

se,

he answered,

salutation,when

return

tongue

latter, and

two

head

your

nothing like paralysis

repeatsa,

Instead

u.

lift up

the most

of the

completed,and

was

without

to

it

turn

forwards

that

evident

was

? said the

struck

ground ;

motions

muscular

to articulate

answer

and

negative;

obeyed with

was

"

the

the

upon

hemiplegiaexisted.
On
being ordered

unable

his head.

shook

the

he

"

the left ; walk

rightside,to

precision.The
enough, and it
or

He

"

"

Oui.

"

your

Vitrier,

"

all he could pronounce.

what I am
understand
askingyou

you

foot

to the

Ver

was

"

surgeon.

"

Dupuytren.
bottles
Sign in

make

Ver

sister?

? asked
(a glazier)

"

MEMORY.

"

husband

THE

Out.
How
any brothers and sisters?
Trots.
Un.
sisters?
brothers ?
How
many
is your father ?
What
is the
Peintre.
profession

many
What

OF

substances
the

Salt,sugar, and pepper

its functions.

employed;

second

he

first of which

the

with

confounded

the

were

he recognised,

and the
first,

On
water he
he called rum.
giving him some
pepper
knew and drank it without the slightest
difficulty.
"

The

evinced
patient

no

signswhatever

and the muscular

intellect,

motions

free and

M.

affection

unembarrassed.
as

resemblingwhat

of feebleness of

of the

Dupuytren

tongue

were

considered the

occurs
occasionally

after

OP

EFFECT

WOUND

BULLET

chronic affections
or
apoplexy,
suffers loss of the memory
patient

ON

THE

of the

397

MEMORY.

brain,where

the

of

things,or particular
In
substantives, or adjectives.
words, as proper names,
of judging and comparing
individuals the power
some
objectsis destroyed. An old lady,after an attack
of hemiplegia,
tual
preservedthe generaluse of her intellecbut could onlyanswer
to whatever question
faculties,
she

asked

was

"

Saint

Antoine, Saint Antoine f"

M.

Du-

recorded,the
puytren considered, in the case previously
affection of the tongue (both as an organ of articulation
and of taste),as rather dependingon a generalaffection
of the brain, than
which

nerves

and

local lesion of the

the

endow

organ
of motion.''*

the power
A French
soldier

by

on

bullet at the

with the

sets of

two

of taste

sense

struck at the battle of Waterloo

was

exterior of the forehead, six

eight
responding
pointcor-

the left

or

eyebrow,and in the
to the curved line on the temporalfossa. He
fell senseless,
and remained
two days and nights on the
field of battle !
He
was
subsequentlyconveyed to
made
to
Brussels,and although many
attempts were
extract the ball, they proved fruitless. Bleeding and
other remedies were
the paralysis
of
adoptedto remove
the side and other existing
symptoms of brain compression.

millimetres

After

from

months

some

he

was

received

The wound, on
at Paris.
military
hospital
presentedan inflamed circumference,and
the ball

was

in the substance

imbedded

into the

examination,
in

of the

the

centre

osfr"ntisto

that

into the
depth that the half of it must have projected
cranial cavity.After a periodhe was
fitfor active service,
but

it

proper
powers
He

was
names

discovered
and

of

that

he

had

lost the memory

of

substantives,althoughall his

some

reasoningwere unimpaired.
the singular
died of phthisis,
mental
eventually
of

"

"

de-

398

(MODIFIED) AFFECTIONS

CHRONIC

OF

MEMORY.

THE

of his death.

feet referred to continuingup to the time

related the

Larrey,who

M.

skull with

Medicine, exhibited the

bone

the

place,the

mentioned
previously
having been fractured

in the

and

Academy of
fixed
ball firmly

the

at

case

internal

table of

inwards

at the

forced

of the accident.

moment

when
gentleman,after an attack of paralysis,
words, always transposedthe
attemptingto pronounce
For example,in endeavouringto say the word
letters.
flutehe said tujle,
puc for cup, gum instead of mug.
A

record of

is upon

case

at each

who

woman

young

all that
periodical
change in her health, forgotentirely
On one
occurred to her during the interval.
occasion,
at the time

injuryupon
The

case

to

court

the fact upon

whom

she

establish

oath.

oath what

that

the

was

had

serious

dispute.

days afterwards, when

The plaintiff
demned
being con-

few

costs, brought witnesses

charge,and
upon

with

person
into

came

she denied

intermission,she inflicted

of the

the

to corroborate

defendant

fact,but without

had

any bad

her

denied

object

in view.

Thucydides records,that
fever which

Athens,

followed

many

who

(inthe Dorian
recovered

lost
epidemic,
entirely
such the case, that

was

of their friends and

plague of typhus

war,) the

from

the

their memories.

they not

famine

at

effects of this
So

completely
onlyforgotthe names

relations,but their own.*

similar

has been
impairmentof memory
observed to follow all great epidemics
and severe
national
Dr. Gase, in his
disasters.
Historyof the Epidemic of
Wilna"
refers to this phenomenon. Sydenham remarks,
in 1673, the
that after the epidemicfever that prevailed
ill was
of those who
had
been
singularly
memory
A

somewhat

after the

"

affected.
*

"

lib.ii.,
Thucydides,"
cap.

49.

PARALYSIS

OF

MEMORY

THE

CAUSED

BY

INTENSE

399

COLD.

Prolongedexposure to a low, as well as to a highdegree

of temperature,
has been known
and permatemporarily
nently
the memory.
to paralyse
A gentlemanwho had made a successful ascent of one
of the high Alps,records,that for some
weeks
quently
subsehe found his memory
considerably
impaired,
made the most
as to dates and/y///r*. He
particularly
singularmistakes in this respect,
rarelybeing able to
the day of the week or month.
He also
name
accurately
found himself unable, with his usual facility,
to calculate
his dailyand weekly expenditure,
and made
the most
odd mistakes in addition,as well as in figures,
writing
7 for 5 and

3 for 1.

This

aberration

long duration.
In an account published
many
of a ship in the Pacific Ocean,
not
happily,

years back, of the wreck

it is recorded,that the

suffered from
passengers
and lengthenedexposure to
fatigue,
intense

was,

memory

of

and

crew

of

cold.

The

unhappy

crew

extreme

privations,

anxietyof

mind

and

and

were
passengers
whaler.
Several of

rescued from death by a

fortunately
the seamen
died, three became deranged,
subsequently
and a few who
escapeddeath and madness found that
their intellects were
much
impaired,particularly
as regards
the faculty
of memory.
One man
lost all recollection
of the antecedents

painfulevents
he could give no

recent

but

born, whether
The

of his life. The

was

memory
and
accurate
singularly

information

as

to where

to

as

vivid,

he

was

he had

where they resided.

or
any family,
of his life appeared like a blank, a
past history

tabula

"

rasa.

In the

retreat

of the

Russian
Buonaparte's

French

from

campaign, many

and officersfound that their minds

were

Moscow,
of the

during
soldiers

enfeebled,
greatly

their exposure to
consequent,as it was supposed,
upon
and intense
great mental anxiety,physical
privations,

400

(MODIFIED)

CHRONIC

AFFECTIONS

OF

THE

MEMORY.

became
temporarily
Buonaparte'sown
memory
and
dates.
For
to names
a
affected,particularly
as
time he was
other,
confusingone person with anconstantly
imin dates.*
This
and making odd mistakes
cold.

in his
tion
History of the ExpediPhilipde Segur has published,
the
under
the
Command
the
French
to Russia
of
Emperor
by
Army
details of the effects of the terrible
interesting
Napoleon, in 1812," some
that overwhelmed
that heroic band of soldiers,
calamities and severe
sufferings
mind
of
illustrious
chief.
When
these factsare philotheir
the
sensitive
sophically
upon
at the influence they exercised,
considered,we need not feel surprised
not onlyupon the intellectof the Emperor, but upon the minds of the marshals
who
fought so gallantly
by his side. During the battle of Semenowska, wheu
Count Segur says,
Ney sent an aide-de-campto the Emperor for instructions,
He merely made some
on
gesturesof melancholyresignation,
every occasion,
when
his
inform
him
the
loss
of
best
to
of
generals. He rose
they came
several times to take a few turns, but immediatelysat down
again. Every
around
him
astonishment.
looked
at the Emperor with
Hitherto,
one
but
here it
coolness
these
he
had
active
displayedan
during
great shocks,
;
fancied they traced
and sluggishinactivity. Some
was
a dead calm, a mild
in it that dejectionwhich
is generally
the follower of violent sensations ;
others that he had alreadybecome
indifferent to everything,
to the
even
*

"

Count

"

emotion

of battles.

which

great

of time, to
who

Those

phlegm

constancy and

froid
sang-

on

devoted

changinghis

extent, in order that

an

remarked, that the calm

display these great occasions,turn, in the course

and heaviness,when
out their springs.
age has worn

most

were

of not
necessity
such

Several

men

find him.

immobilityby the
was
commanding over
the bearers of intelligence
might know where to
others,who, on much better grounds,explained
to

him, accounted
much, when

placetoo

for his
he

there were
Finally,
the
shock
which
his health had sustained,and his violent
by
indisposition."
At another periodof the day,during the same
battle,Murat sent Belliard
he
Belliard informed the King of Naples that
to the Emperor for advice.
and dejected
with a suffering
had found Napoleon stillseated in the same
place,
the whole

"

air,his features sunk, and

midst

of these

dreadful

dull look
warlike

in the
givinghis orders languishingly,

noises,to which

he

seemed

completelya
Ney expressedin strong and unguardedlanguage,his sentiments
to the apathy of the Emperor, but, as Count
as
Segur observes, Murat was
calm ; he recollected having seen the Emperor, the day before,as he was
more
mount,
ridingalong observingthat part of the enemy's line,halt several times,disand with his head restingupon
time
the cannon, remain
there some
what
knew
restless night he had passed,
in the attitude of suffering.He
a
and that a violent and incessant cough cut short his breathing. The king
his
aud the first attacks of the equinox had shaken
guessed that fatigue,
stranger!"

"

weakened

frame, and that,in short,at that critical moment,

genius was,
the tripleload

manner,

of

chained

down

of fever, and
fatigue,

by

his

the action of his

had sunk under

body
a
malady which, probably more
than any other,prostratesthe moral and physical
strengthof its victims."
When
the
mental
of Napoleonduringthe
to
prostration
referring
temporary
calamitous
the Russian
retreat of the French
army, Count Segur remarks,
in

; which

of

"

EFFECT

OF

THE

RUSSIAN

CAMPAIGN

ON

however, onlyof short

]"airment
was,
his aides-de-camp
suffered from a severe
for several years.
unclouded.
respects,

His

memory

Sir Jos. Banks

relates

to
occurring

memory

to

rescue

children

intellect was,

from

One

of

attack of loss of

fireman,who, in

some

duration.

of sudden

case

1()1

BUONAPARTE.

the

in other

of
paralysis
an

heroic attempt

interior of

house

envelopedin flames, exposed himself for some

time to an intense degreeof heat.
Boerhaave
mentions the particulars
of a
of the case
Spanishtragicauthor, who in consequence of an attack
of acute fever so completely
lost all memory,
that he
forgotnot onlythe languageshe had formerlylearnt,
their alphabets.His own
but even
and compopoems
sitions
shown
it
to him, but
were
to
was
impossible
convince him that they were
his production.He afterwards,
however, began again to compose verses, which
had so striking
resemblance
to his former writings,
a
that he at last became convinced of his havingbeen the
author

of them.

Numerous

cases

recorded

are

failure of the memory,

of
straining
had

autumn

whole

triumphed

over

from
this
him

an

of sudden
undue

temporary

exercise and

gitimate
ille-

faculty.*
;

had

it not

been

for that,perhapsthe

of Russia would

have yieldedto our arms

of the Moskwa
the plains
on
;
its premature inclemency
seasonable assistance to their empire.
was
a most
It was
the 6th of September,
on
the very day before the great battle ! that a
hurricane announced
its fatal commencement
Ever since the nightof that

day, a buvning fever had dried up

-he was
spirits;
quiteovercome
by
he endured
suffering
his

genius.

tor

This

the
it

Emperor's blood,and oppressedhi"

the state of

duringthe battle,and

the five following

daysarrested his march, and

preservedKutusof from total ruin at

rallythe remainder of hit army, and
withdraw
it from our pursuit." (Vol.i.,pp. 338-9,342-3, 363).
*
It is a fact well attested by experience,
that the memory
be
may
in earlylife.
and continuously
seriously
injuredby pressing
upon it too hardly
Whatever
theorywe hold ax to this function of our nature, it is certain thut
its powers
and that if forced into premature
are
only graduallydeveloped,
the
indeed of great
This is a maxim
exercise,
dibit.
they are impairedby

up

Borodino, and

it

bound

allowed

was

him

which

time

to

"

"

import,applyingto

the condition

and culture of every

of body and
faculty
D

402

duty of

consisted in

which

had

of papers,

number

OF

MEMORY.

THE

held

who
intellects,

weak

of rather

man

the sole
to

(MODIFIED)AFFECTIONS

CHRONIC

signinghis

name

own

his memory,

weakened

so

office

an

of recollecting
the word
incapable
B
he ought to sign. Mr. Von
formerlyenvoy to
of
a
man
Madrid, and afterwards to St. Petersburgh,
means
serious
turn of mind, yet by no
hypochona
of visits.
driacal,went out one morning to pay a number
Among other houses at which he called there was one
the servants did not know
him, and
where he suspected
of giving
under the necessity
he consequently
where
was
but this he had at that moment
in his name,
entirely
forgotten.Turning round immediatelyto a gentleman
who
accompaniedhim, he said with much earnestness,
I am?"
The
who
God's sake tell me
"for
question
B
insisted on being
but as Mr. Von
excited laughter,
his own
forgotten
answered, adding that he had entirely
at last

that he

was

he

told it,upon which

in certain morbid
Occasionally
he

name,

connected

was

with

finished his visit.

conditions

organicalterations

or

of the brain,

disordered

ditions
con-

the
of the cerebral circulation,
his native

periodall knowledge of
a

state of delirium
in the Latin

been

have

patientloses for a
tongue. Patients in

known

language. It

to address their

is said that Dr.

sician
phy-

Johnson,

dying,forgotthe words of our Lord's Prayerin

English,but attemptedto repeat them in Latin. Dr.
Scandella,an Italian gentlemanof considerable scholastic
when

He

resided in America.
abilities,

master

was

of

the

Italian,French, and Englishlanguages.In the beginning

of the

mind, but
one

terminated

yellowfever,which

sense,

to
singularly

the foundation

the

and

laborious

etrengthenedto
Holland's

Mental

now

city

which
forms, in
considering,
regulatedexercise short of
to refrain from goading it by

of intellectual life. A

fatigueis improving to it, but

constant

are

we

one

his life in the

we

efforts in

its work,

or

Pathology.

it

are

bound

early life and

decays under

before
our

the instrument

hands."

"

Sir

is

Henry

401

(MODIFIED)

CHRONIC

AFFECTIONS

OF

THE

MEMORY.

them
designated
correctly
by mentioningtheir ages,
with which
he appearedto be well acquainted.
in consequence
A man,
of an attack of
aged sixty-five,
one
apoplexy,forgothow to read, or even to distinguish
word
letter from another, but if a name
or
or
phrase
but

mentioned

were

him, he

to

able to write

was

it imine-

and that,too, with the greatestaccuracy.

He was,
diatety,
of readingor distinguishing
what he
however, incapable
had

written, for if asked what

letters were
had
the
means

the
A

combined, it became

that the

the

writing

without
performedmechanically,
any exercise of
of the
reflection or judgment. In this case
none
which
successful in restoring
were
employed were
knowledge of letters to his mind.*
gentleman had a serious attack of illness. When
that he had

found

was

circumstances, but

recent

had

lost all recollection of

lucid

as

memory

to

earlyLife in fact,impressions
had long been
were
again revived. As
forgotten
his bodily health, a singular
patient recovered

events
that

this

that had

alteration

occurred

the events
A

of

in

an

of his memory.
entirely
forgotall

in the character

observed

was

again recollected
"

evident

how

or

been

restored,it

He

letter was,

recent

antecedent

gentlemanbetween

ideas,but

period!
and sixtyyears
fifty

temperate habits, nervo-bilious temperament,

moral

and

intellect

of age, of
and

with

predominatingover
duties
besides
his professional
the propensities,
as
a
had been for several years engaged in writing
clergyman,
a voluminous
county history. One day, in the month
mission
interof September,1839, he had been working without
of an
index for a volume
in the compilation
of
his history,
then about to be published.
Feelingdrowsy,
he laid himself down
time.
on
a sofa,and
sleptfor some
On awaking he felt extremelycold,and, seeinga female
the

sentiments

"

Ephemerides

Curiosts."

EFFKCT

in the room,

wife.

own

APOPLKXY

OF

he asked
He

her who

his

she

405

MEMORY.

knowing his
drowsy,but

not

was,

became

Since that time he

the

THE

giddy and
to sleepby medical
disposition

afterwards

'vered from

ON

can

seldom

of any article,
or
place,
recollect numbers.
Though he
name

remember

ment.
treat-

rightly

person, neither

he

can

recognisespersons

he

previously
acquaintedwith, he can seldom mention
their names.
In talkingon any subject
he constantly
calls one
of another, so as to render
thingby the name
his conversation nearlyuseless. On attemptingto read,
a dull pain attacks the regionof his perceptive
organs,
and
the organ
of language: he becomes
particularly
giddy,and before he can get to the end of a line,the
whole appears a blank.
His sighthe considers as not
of
to the attack ; complainsmuch
BO
good as previously

was

cold head

remembers

better when

when

stooping. He often showed

conversation and in readingfor many
or

the

attack.

his eyes are closed,

absence of mind in

years previousto
reflective,moral, and animal
organs

His

is good,his
appear unaltered ; his appetite
improved,and he enjoysbodilyexercise.

generalhealth
In

tion
conversa-

malady,and givesa clear account

of the attack.
When
he was
a boy at school he suffered
from a dull pain in the regionof the peroccasionally
ceptive
recurred duringhis
organs, and it has frequently
subsequentlife."*
of the case of a man,
Wepfer relates the particulars
who, after recoveringfrom the effects of an attack of
found to know
apoplexy,was
nobody and remember
nothing. After several weeks, he began to observe his
friends,remember
words, repeat our Lord's Prayer,and
he

to read

reasons

his

on

few words

was

his native

than

language.

few words
"

The

of Latin

at

rather

When

than

urged to

time, he said,with

Journal, voL
Phrenological

German, which

read

more

heavy sigh,

xiv. p. 55-56.

400

(MODIFIED)AFFECTIONS

CHRONIC

or

THE

MEMORY.

I do not.'*
but now
formerlyunderstood these things,
After some
time he began to pay more
attention to what
was
passingaround him, but, while thus making slight
and
gradualprogress, he, after a few months, suddenly
died of an attack of apoplexy.
Willis refers to the case of a man,
who, in recovering
from an attack of putrid fever,was
found to have so
faculties that he recognised
lost his mental
no
entirely
and understood
one, remembered
nothing. Fix supra
brut urn saperet"
A gentlemanwhom
Dr. Abercrombie
attended, after
from an
attack,knew his friends
recovering
apoplectic
but could not name
them.
perfectly,
Walking one day
in the street,he met a gentleman to whom
he was
very
communicate
anxious to
mutual
a
somethingrespecting
friend ; after various
ineffectual attempts to make
him
understand
whom
he meant, he at last seized him by the
and
arm
dragged him through several streets to the
house of the gentlemanof whom
he was
speaking,and
pointed to the name-plateupon the door. A lady,
after an apoplectic
her ideas
attack,recovered
correctly
of things,
but could not name
In givingdirecthem.
tions
respecting
familymatters she was
quitedistinct
"

"

to what

as

she

wished

herself understood
and

pointingto

the

man,

proper
"

of

names

his

accident, could

an

relations; another

woman,"

twenty-one experiencedan
it

house

not

recal to mind

could recollect

no

the assistance of his friends.

without

her convalescence

make

articles.

tellect,
Shapter, of weak inmal regUejat the age
attack of apoplexy. In

says Dr.
subjectto headaches and

young

could

done, but

only by going through the

the various

after
of

names

to have

was

observed

"

'

that

recollection of persons and occurrences.

her mother, without
the power

she

had

She

of

lost all

collected
earlyrecaHing her

OF

EFFECTS

by

name

MENTAL

at the end

SHOCK

of

words, though but very

herself involved

express

the head.

He

407

MEMORY.

pronounced some
and her efforts to
imperfectly,
her in almost
unintelligible

in

was

TIIK

she

month

periphrases."
A man
whilst grooming a
on

ON

restive horse received

unconscious

an

state

kick

for six

singularperversionof
weeks the only words he could utter
speech. For some
stable," horse," kick." He used these epithets
were

hours.

recovered

He

"

with

"

"

whenever

he wished

to

him.

effort was

made

An

induce

to

him

those
to

about

use

other

effect.

ideas,but without

He

language,but for nearly

in a very impairedstate.
was
year his memory
A well-known
after
lost his memory
pugilist
entirely
who had severely
contest with a man
severe
punished

recovered
eventually

with

communicate

his

words, and to connect

him

about

the

use

of

the head.

shock consequent
a severe
ladyof rank experienced
of the
the receipt
of the melancholyintelligence
upon
child. She
sudden death of an
only and much-beloved
and apparently
continued for several days in a stunned
For
dying state. She, however, recovered.
many
exhibited a singular
months
afterwards
her memory
defect. She appearedto have no
recollection of the
of her

cause

and
illness,

When

she

was

of

the

severe

informed

loss she had

of the

tained.
sus-

death of her

for the

periodof a minute she appearedto realize

the melancholyfact ; but the impression
almost instantly
nine months
About
from this time she
passedaway.
son,

found

was

brain

was

dead in her

bed.

said to have been

soldier received

discovered

of the

heart

and

after death.

compound fracture of the

sinus. There
cranium, openingthe superior
longitudinal
in the first instance, symptoms of compression.
were,
"When in the hospital
of Antwerp, he understood all that
A

French

Disease

(MODIFIED)

CHRONIC

said to him, and

was

AFFECTIONS

OF

MEMORY.

THE

But he
quiteintelligent.
rather
It was
to interrogatories.
evident vexation at his inability

seemed

could

onlyreplyba-ba
to observe his
singular
to give expression
to his ideas.
Dr. Shapter,
of Exeter, has publishedthe following
case, illustrative of the morbid
mena
phenovery interesting
of memory.
Case.

Pietro Gillio,LL.D.,

a native of
aged forty,
is,or rather was, a man
Italy,
possessinggreat comprehensiveness
of mind, much
of extensive
vigourof intellect,
and general
acquirements,
deeplyread in metaphysics
and the perfect
of several languages.
master
literature,
In consequence
of having been a prominent agent in
"

"

"

the

insurrection

of

Piedmont, he

was

condemned

to

death.

Fortunatelyhe effected his escape, and, since

that period,
has been a solitary
wanderer, for some
years
in Spain and the Channel
in EngIslands,but latterly
land,
where
he supported
himself by teachingthe Italian
and Latin languages.
Having been exposed to anxiety of mind, study,
and cold and damp, he became
nightwatchings,
fastings,
affected on the night of the 14th of April,1835, with
and vomiting,succeeded
scribable
headache, vertigo,
by an inde"

confusion,after which
"

On

the

with
"

We

these

15th, Dr. Shapterwas

Mr.

found

symptoms subsided.

called to

him, in

pany
com-

Froom.
him

in

state of

great excitement

and

irritability,
pacing hastilyup

and

with

of articulation,
incapable

and

unequal steps.
there

was

an

He

almost

was

down

his

chamber

total loss of the

of
memory
attracted
readily

language; for though his attention was

by speakingto him, yet the purportof what
appearedto be in no way understood ; if there
indistinctness of hearing,it must
have
been
slight. Deglutitiondifficult. The pupil of

was

said

were

any

but
the-

very

right

K!

MARK

ABLE

CASE

OF

DISORDERED

409

MEMORY.

answeringto the impulses

eye dilated,and but slightly
of light
sightdistant and indistinct ; that of the
; the
left eye natural

of the eyes restless,

generalexpression
and watchingwith anxious quicknessthose in the
Pain in the back part of the head, but apparoom.
rently
Pulse
not acute.
rapid,unequal,120; on the
right side strong,full,and vibrating,
especially
nounced
proin the rightsubclavian and carotid arteries ; on
;

the

the left side,the arterial action small and weak.

weakness

of the left side,but not

amounting to paralysis,

exceptingfor the firsthour or two

landladysays, that at breakfast
silent,irritable in

after the attack.

His

this

morning he
looking anxious ;
if to speak,and

and

manner,

General

was

that

effort as
then
suddenlyhe made some
rushed hastil^t-frtfiu
the house.
usual antiphlogistic
indicated was
treatment
ic
and purgatives.We
blisters,
pursued,such as bleeding,
earlyfound, however, that he had not stamina to permit
such

On

"

side

to be carried to any

means

greatextent.

the 6th of June, the arterial action

was

recollect

still tumultuous

portionsof

trials,could
without

write

some

in

the

of the

extreme.

He

right
could

words, and, after repeated

few

of the

shortest

ones

correctly,

words of
dictionary
; but
far beyond his powers
three or four syllables
of
were
concentration
were
; his efforts at composing a sentence
addressed
the understandingone
as well as
unavailing,
him:

to

the

he

assistance

had

no

of

command

of

tongue.

He

menced
com-

with the most

feverish anxiety,the
studying,
English lexicon,and, in great measure,
managed to
words ; but his
explainhimself by pointingto particular
for re-learning
languageappearedlimited and
capacity
confined.
"

After

membrane

this he
of the

had
nose

an

and

excessive secretion from

fauces.

In

the

October,lie com-

410

(MODIFIED)AFFECTIONS

CHRONIC

plainedof

tenderness

some

vertebrae, which
leeches and
books

he

drew

was

blister.

reportsof

up

MEMORY.

on

then took

He

had

said he

THE

the lumbar
pressure over
relieved by the application
of

diseases of the

on

which

OF

readingvarious

to

brain, as well

as

been

He

his

prone.

symptoms,

and

to

worms,

on

occasionally
which

one,

he

received about
In the

Christmas, is transcribed by Dr. Shapter.

beginningof December, he sent a memorandum,

in which

he took

comparative view

of his

symptoms,

hundred, and then

statingthe whole m;mb3r as one
giving each symptom its relative proportionaccording
to his estimate of its intensity
and importance. The
is the reportalluded to.
following
"'Sir
dear
have a symptom of illness viz. 1, spit
in nightand day
2, dry cough 3, an unequalpulse
4, no
sleep 5, uninclination to go to stool and nonof food and
evacuate thingquite 6, swoon
7, loathing
other times a voracious appetite 8, a privation
of speech
of the face
9, foot,hand bad, a hinde right paleness
"

"

"

"

"

"

"

"

"

"

"

and

times

(teeth,nose
"

'

red
"

of

face

colour

11, whitish

"

urine

throat).

In first attack

quitethe
privation.

evacuate

and

the

15

bowels

"

'

(Mr. Duval).

"

'

In child in is

had

April,I
;

and

painsof

sleepand

was

worm

in stool,not

swoon

"

was

medicine

"

awaken

rue

and

wormwood.
"

'

"

'

In 1 5 year, the same

pains,medicine,oil,"c.
in jersey no medicine exceptrhubarb
sey
; in Guern"

Plymouth no medicine ; in
Exeter is privation
of speech.
Mrs.
non
speak true to Dr. Shapter,viz.
medicine

"

"

"

calomel

in

"

'

1, 2, 4, 5,
"

In

'

(non speak" write).

September,1836, having received

P.
a

'

Giffio.'
free* pardon

412

(MODIFIED)

CHRONIC

The

late eminent

AFFECTIONS

OF

THE

Baillie* describes

Dr.

MEMORY.

curious

case

of

impairedmemory
producedby paralysis.A gentleman,
seized with symptoms of compression
was
aged fifty-six,
of the brain, and
became
completelyparalytic
the right side.
found that he had lost the
It was
on
recollection of the words of his own
language,except a
ness,
very few which he pronouncedwith the greatestdistinctand with a varietyof tones to
and
express pleasure
displeasure,
joy and sorrow, to explainthe circumstances
of his disorder,and to give directions
he
about what
not the proper
wanted, without beingaware
they were
words to express his meaning.
A gentleman,forty-six
had always
years of age, who
enjoyeda good state of health, after experiencing
great
uneasiness of mind, and being exposed to severe
bodily
seized with apoplexy,
followed by hemiplegia.
was
fatigue,
The apoplexy
but the hemiplegia
was
was
complete.
slight,
The power
of speech was
lost,so that he could
entirely
only utter the sounds ee-o, which, however, he so varied,
that with the assistance of expressive
gestures,he was
able to convey
his meaning very
to those about him
comprehended
distinctly
ordinarysubjects.He perfectly
upon
said to him, and clearly
everythingthat was
understood
but was
what
he meant
able only
to answer,
to utter the previously
sounds.
-mentioned
Believing,
however, that he actually
employed the words adapted
of his ideas, he often appeared
to the communication
when
he was
not understood.
surprisedand displeased
He
sometimes
endeavoured
to explainhis meaning by
writingon a slate ; but he generallysubstituted one
word for another, and almost always erred in spelling
what

he wrote. f

Dr.
*

T. K.
"

Chambers

Medical

has

Transactions
"

On

Nervous

intepublishedthe following

vol.
Collegeof Physicians,"
Diseases," by Dr. Cooke.

of the

iv.

SIM.t

of the brain

"

she had

delirium and

much

attendance, she
taken
had

with

fit,of

and
rigors,

of the word

'

Wine

as

repetition

constant

varietyof

every

was

intonation.

sorted
during her former attack, reto, but symptoms of slighteffusion in the brain
its suspension.She recovered after a few weeks,

and

caused

sinner' with

days'

few

delirium

The

for her

remarkable

returningthence,
character,
epileptic

again delirious.

was

and

undecided

an

symptoms,

after

However,

evening,on

one

was

monotonous,

so

to school.

low

cember,
De-

got about again,and

but, as is usual with children, soon

able to return

in

typhus fever

C., aged twelve, had

1845

was

disease

Harriet

"

413

MKMORY.

OF

language followingacute

of loss of

ing case

DKFKtT

OP

(ASE

I.AU

bark

to be

to pronounce

exceptthe

word

any

her

repeatedduring

with

dressed, but

and

up

as

were,

one

This

fever.

the

loss of power

she

had

she

made

often

so
serve

to

for denial she shook her head,

express all her ideas ;
and said 'sinner;' assent was
expressedby the same

word, and

and

bread

butter

called

was

sin-im-sinner/

all that was

said to her, and
understood
perfectly
appearedcapableof readingher usual lessons. Blisters
were
appliedbehind her ears, and small doses of mercury

She

administered, and

at

instructed

familywere

infant to talk.

the
to

same

time

teach

her

also took

her

deaf

and

dumb

are

and

they would an
of showing
opportunities
as

her, by exaggeratedmotions of my mouth

in the manner
the way of forming the letters,
the born

mother

instructed,and

and

throat,

in which

found

her

and
acquiredthe word
ready. She soon
intelligent
and by the end
yes/and other elementaryexpressions,
'to talk
of the springwas
able, as her mother told me,
old woman/
like an
Symptoms of consumption had,
under
and she died this last summer
however, appeared,
'

the

care

of

another

medical

man,

whose

kind

efforts

414

(MODIFIED) AFFECTIONS

CHRONIC

obtain

to

MEMORY.

THE

examination

post-mortem

OF

for

me

were

unavailing."
A

"

in the

farmer

circumstances, when

of

he has

The attack

speech.

of age, had

fiftyyears

fit. Since that time

affected side.

His

recovered

never

by

not

the

paralytic

the

of the

use

tation
hesiby a painftil
good for all partsof

succeeded

was

was

memory

speechexcept noun-substantives
latter he could

in comfortable

county of Wicklow,

and

proper names
This defect was

at all retain.

the

panied
accom-

he
followingsingularpeculiarity:

perfectly
recollected the initial letter of every substantive or
for which he had occasion in conversation,
proper name
the word
though he could not recal to his memory
of having
Experiencehad taughthim the utility
written in manuscripta list of the thingshe was
in the
habit of callingfor or speakingabout, includingthe
of his children,servants, and acquaintances
:
proper names
in a little pocket
all these he arrangedalphabetically
which
he used as follows
if he wished to
dictionary,
ask anything about a cow, before he commenced
the
itself.

sentence
word

'

he turned

to the letter C, and

and
cow,' and kept his finger

until he had

the word

in its proper

looked

eye fixed

finished the sentence.

cow

"

He

out for the

could

place,so long as

the word

on

pronounce

he

had

his

he
eyes fixed upon the written letters ; but the moment
shut the book it passedout of his memory,
and could not
be

recalled,
althoughhe recollected

refer to it when
came

to

necessary.

Dublin, and

he
physician,

wished

In

the

to

consult

and could
initial,

same

he
way when
Dr. Graves, his

dictionary
open to the halldoor, and asked to see Dr. Graves ; but if by accident he
his dictionary,
had forgotten
as
sion,
happened on one occahe was
unable to tell the servant what or
totally
whom

came

with

its

He

he wanted.

his

could

not

recollect his

own

name
"

unless he looked

out

for

it,nor

the

name

of any

person

CASE

of

his

at

loss
for
His

the

and

he

exaggerated

parts

of

the

their

and

his

acquired

speech,

or

which

verbs,
are

mon
com-

of

are

old

are

lected.
recol-

names,

proper
the

by

than

the

things

initials

substantives

first

of

diseases

persons

forgotten

sooner

degree
in

of

names

that

are

in

sought.

is

the

moment

him

guide

to

was

although

strange

for

never

observed
the

415

MEMORY.

was

which

memory,

are

other

he

forgotten,

which

childhood,

initial

which

It

and

but

remarkably

of
in

OF

word

was

frequently

words

the

for

defect

age,

IMPAIRMENT

acquaintance

search
"

OY

in

memory

adjectives,
much

later

recorded

by

acquisition."*
*

Graves.

Dublin

Quarterly

Journal

qf

Medical

Science;

case

Dr.

410

PERVERSION

OF

MEMORY.

THE

CHAPTER

Perversion

XVI.

Exaltation

and

Memory of the
MEMORY.

Andral

PERVERSION

OF

modification

of the memory

gradualloss
objectwhich

of the remembrance
"

universe."

becomes
There

"

"

of Memory.
Insane.
refers to

connected

to

of
the

with

M.

is,"says Andral,

"

has

related the

old soldier who

An

of

case
"

La

in the

was

Lambert, believed that he

Yon, named

battle of Austerlitz.
the

singular

very
in the

patient

He

has, as

he

speaksof

ME

or

it

are

vocabulary.

speakingof herself,always said,

in

one

"*

Leuret

mfane"

or

afflicted the

so

person

himself,it is in the third person, the words

in his

sudden

save
everything,

which
consists
of the memory,
perversion
remembering everythingexcept himself.
existence,and when
forgothis own
were,

not

curious

habit

of

When
"

saying,

who, in

woman

de

pcrsonne

Asylum
was

HIOI-

of Saint

killed at the

he

spoke of himself, he

This

machine, which

was

they

thought to make like me, is very badlymanufactured."

the personal
he spokeof himself, he did not use
When
pronoun

I, but

the

demonstrative

pronoun

inanimate

THAT,

as

if

object.
A man
seventy years of age was suddenlyseized with
the surface of the body.
and formication over
lock-jaw,
and a strange alteration
This was
succeeded by vertigo,
and fluency,
in his language. He spoke with ease
but
speakingof

some

Andral's

"

CliuiqueM6dicale."

SINGULAR

often made
He

CASE

mixed
in

this

have

which

numbers

he

was

of

417

MEMORY.

nobodyunderstood.
coined new
phrasesin the place
had
he
forgotten. Occasionally

respectthe
Hunter

OP

which

instead of words

altered in its mode

John

PERVERSION

of odd words

use

appearedto

of others

OF

in his

conversation,and

appearedto

memory
of action.

have

in the habit of relating

in his

been

lectures,

of
perversion

the memory
succeeding
attack of acute disease of the brain. In this instance,

case
singular

an

the
his

the circumstances of
who, besides referring
gentleman,
had to such an extent
earlylifeto the presentperiod,

lost all idea of the connexion

between

/?re#e;//,that
althoughhis

could direct him

be done

mind

in consequence

the past and

the

to what

as

of certain

impressions,
and would direct him rightly
to the partof the body
as
affected by them, he was in the habit, (havingapparently
lost all notion of his own
of constantly
identity,)
referring
his own
sensations to those immediatelyabout him.
and the bystanders
that he
Thus, he would tell his nurse
certain that theywere
was
on
hungry or thirsty
; but
evident
him food or drink, it was
offering
by his eagerness,
of hunger
that the idea had arisen from a sense
and thirst,and that the word theyreferred to him sell*
to

was

and not to others.

cough, and after each

he would, in very appropriate
and sympathetic
paroxysm
he had been conthe subjecton which
versing,
terms, resume
however, expressinghis feelings
previously,
of his
of distress from having witnessed the sufferings
friend, adding, I am
sorry to see that you have so
troublesome and harassinga cough."
in the habit of indulgingin
A gentleman,
who was
cated,
"potations,
pottledeep,"whenever he became intoxireferred his own
sensations in
perverted
invariably
about him.
to those immediately
a similar way
Hence,
He

was

subjectto

violent

"

418

upon

OF

PERVERSION

MEMORY.

THE

going home, he, imaginingall the familyto

the lamentable
would

insist

state

to which

all too

that they were

bed, declaring
themselves
Mr.

drunk

to do

so

to

for

Combe

forgotwhen
being drunk

puttingthem

and

undressing them

on

in

himself,

reduced

had

he

be

records the
sober

what

case

he

had

an

Irish

done

when

of

porter,who
drunk, but

recollected the transactions

again,distinctly
that had occurred during his former state of intoxication.
of some
On one occasion he had mislaid a parcel
value,and
in his sober moments
could
giveno account of its locus
He
in quo.
againbecame intoxicated,and then clearly
recollected that he had left the parcel
at a certain house,
there safely,
and, havingno address on it,it had remained
and was
immediatelygiven to the partywho claimed it.*
of erratic memory,
The
cases
followingremarkable
evidencingitself in certain morbid conditions of brain
disorder,are deservingof notice.
They are supposedto
illustrations of the phenomena of
form striking
double
divided consciousness,"or, as suggested by Mr.
or
double personality
bition
itselfin the exhiCombe,
manifesting
of two
lities
separateand independentmental capabiin the same
individual; each train of thought and
each capability
beingwholly dissevered from the other,
and
the two
states in which
they respectively
minate,
predoto frequent
interchangesand alterations."
subject
The patientwas
a
girlof sixteen the affection appeared
and
before
puberty,
disappeared
immediately
when
that state was
fullyestablished. It lasted from
"

"

the 2nd

of March

to the

llth of June, 1815, under

the

to
Dyce. The firstsymptom was propensity
fall asleepin the evenings. This was
followed by the
habit of talkingin her sleepon these occasions.
One
imagined herself
eveningshe fell asleepin this manner,

eye of Dr.

"

System of Phrenology."

420

OP

PERVERSION

influence of her

she

related

the whole

she

taken

was

on

know

she
when
paroxysms,
Next
mother.
Sunday

her

church

her.

She

the

mistress while

her

by

shed

dtiringthe
particularly

sermon,

did any
of it for several

of her

one

facts to

to the

was

paroxysm

in

was

the

had not

of that transaction,nor

in her welfare

interested

days, till

day she

complaint. Next

recollection even
slightest
person

MEMORY.

THE

tears

account

during
given of

the
the

had
at Edinburgh,who
men
young
described in their dyingdeclarations the dangeroussteps
of three

execution

with

which

their

she returned

When
in

quarter of
put

an

of vice and

career

hour,

was

that she had

been

in any

such

in Mrs.

and

but

that

and

next

she

tions
ques-

denied

nighton

had

been

at

text, and, in Dr.

Dyce's
of the tragical
tive
narrawhich
her feelings
had
this occasion,though

's house, she asserted that

at the

sermon,

place;

being taken ill,she mentioned

church, repeatedthe words of the
hearing,gave an accurate account
of the three young
men,
by
On
affected.
been so powerfully

mencement.
com-

home, she recovered

quite amazed

to her about the church

its

infamytook

she

was

in her

mother's.*
The

of
particulars

Dr. Mitchell

the

followingcase

are

detailed

by

:"

tion,
a very good constitupossessing
naturally
arrived at adult age without
having it impairedby
and enjoyed
excellent capacity,
disease. She possessed
an
of acquiring
fair opportunities
knowledge. Besides the
domestic arts and social attainments, she had improved
well
her mind by readingand conversation, and
was
and
versed in penmanship. Her memory
was
capacious,
stored with a copiousstock of ideas.
and
Unexpectedly,
she fell into a profoundsleep,
without any forewarning,
Miss

Combe's

"

Phrenology,"p.

225.

"f Medical Repository.

CASE

which
On
of
"

DOUBLE

OF

several hours

continued

term.
beyondthe ordinary

waking,she was discovered to have lost

a
was
acquiredknowledge. Her memory
all vestiges,
both of words and things,
were

and

It

gone.

found

was

421

CONSCIOUSNESS.

DIVIDED

OR

every trait
tabula rasa
obliterated

necessary for her

learn

to

efforts,
by new
everythingagain. She even
acquired,
the art of spelling,
and calculating,
and
reading,
writing,
graduallybecame
acquainted with the persons and
objectsaround, like a being for the first time brought
into the world.

after

herself restored

to

the state she

but

was

paroxysm

that

occurrence

and the latter the

her

double

On

her.

found

rousingfrom it,she
in before

was

the first

every event and

The
afterwards.

whollyignorantof
befallen

had

her

of her existence she called the old state,

former condition

of

few

fit of

months, another

But,
proficiency.
somnolencyinvaded
'

considerable

In these exercises she made

state

new

character

as

and

she

was

as

unconscious

distinct persons are of

example,in her old state

two

their

For
natures.
respective
she possessedall her original
knowledge; in her new
state, only what she acquiredsince. If a gentlemanor
introduced
to her in the old state,and vice
ladywere

(and

versa

of all other

so

she had
old state,she
in the
time

or

to learn them

to become

means

upwards she

underwent

these

to

of

in

states

the

both

factorily
satis-

them

states.

In

the

penmanship,while
hand, having not
poor, awkward
expert. During four years and
transitions from one
periodical

fine powers
possessed

she wrote

new

matters), to know

other.

of

The

alternations

were

always consequentupon a long and sound sleep. Both

the lady and her familywere
capableof conductingthe
embarrassment.
affair without
By simply knowing
in the old or new
whether she was
state,they regulated
the intercourse and governedthemselves accordingly.*
"

Combe's

"

Syitem of Phrenology,"
p.

173.

422

EXALTATION

EXALTATION

or

OF

MEMORY.

MEMORY.

In

"

some

duringthe

cases

earlyperiodof
morbid
of

brain

disease,the memory

is in

state of

exaltation,the patient
havinga vivid recollection
that

happened many
previously,
years
and which
been longforgotten.In the
had, apparently,
cerebral diseases of early
this symptom is frequently
life,
occurrences

observed, and

should

never

pass

unnoticed.

In

some

also observe an
acute condition of
we
insanity
this faculty.
In fever accompaniedby an active state of the cerebral
has been known
to exhibit to an
circulation,the patient
intense degree this symptom.
natural
Any sudden and unexaltation
of the faculty
of memory,
of any
or
other
should
mental
if associated
(particularly
power
with other symptoms indicative of brain disorder)immediately
of

cases

excite attention.
A

gentleman returned home from his counting-house

late in the evening. He
had been
occupiedfor nine
continuous
hours
in going carefully
through his books,
with
of finally
with a
a view
arranging a partnership
he was
in treaty. Soon
after
gentleman with whom
his

arrival

talkative.

home,

his

observed

was

to be

He

spoke of what he had been

day,making no complaintof

during the
then

he

unusually
occupiedin
fatigue. He

referred to the state of his accounts, and

abilityto

minute

boasted

great accuracy the

with the monetary and

recollect with

details connected
of

most
mercial
com-

the

house, extendingover

periodof

He

then

matters

calculation,evidencing
an

transactions

years.
many
and
of business
power

o'clock.

At
in

of

conversation

he

had

with

was

sittingnear
his

wife, he

to

several

about

traordinary
ex-

nine

the fire

gaged
en-

comp'ained

immediatelyafterwards vomited the

eaten about two hours previously.His

sickness, and

dinner

This

of memory.

eleven, whilst

referred

of

EXALTATION

OP

MEMORY

wife administered
be

FATAL

which
restoratives,

some

productiveof relief,and
sent for.

DIAGNOSTIC

The

post

rismal tumour

twelve

no

appearedto
medical

man

o'clock he

complainedof
headache
the occipital
and had
severe
over
a
region,
second attack of vomiting. About
half an hour after
he became
sank into a state of
drowsy,and eventually
He
died in the course
of the night,
profound coma.
ness.
never
havingrecovered from this state of unconsciouswas

About

therefore

423

SIGN.

revealed

examination

mortem

of the middle

with
a
suspected),
congestionof the brain.
Ilomberg refers to the

never

cerebral
of

state

aneu-

artery(which

was

generalsanguineous

girlwho, when very

had
lost
attack of small-pox. She
a
severe
young,
her
sight,but acquired an
extraordinarymemory.
She repeated
her return home
on
a long sermon
perfectly
she had recently
heard.
It is well known," adds Romthe rachitic
berg, that the scrofulous, and frequently
diathesis in childhood, is accompaniedby this phenomenon."
case

of

an

"

"

In

the

connected

state
incipient

with acute

of brain

disease of

earlylife

fevers, disturbed conditions of the

cerebral circulation and

vessels,and

in affections

of advanced

tion
years, there is often witnessed a remarkable exaltaof the memory.
Events that have occurred many
obliterated
apparently,
from the mind, have been distinctly
and that,
reproduced,
too, with extraordinary
accuracy and vividness.
A
sudden
and improvement of the
lightingup
to persons in advanced
life,
are
sionally
occaoccurring
memory,
crates
precursory of death and fatal apoplexy.Hipponotices this phenomenon. A gentleman, aged
seventy-six,exhibited,with other signsof brain disorder,
vivid recollection of a complicated
transaction
a remarkably
that had taken place
forgotten,
entirely
previously

years

and
previously,

"

which

were,

"

424

MEMORY.

OF

EXALTATION

thirty-five
years before. On
of which
attack of apoplexy,

the

followingday

he had

an

he died.*

symptoms of
incipient
to talk
cerebral
a disposition
hemorrhage and paralysis,
events that have
respecting
long since been
garrulously
apparentlyforgotten. An old gentleman surprisedhis
of an
particulars
family by recounting the minute
in earlylife,known
eventful epoch that had occurred
familiar to
were
only to himself, as if the circumstances
about
Two
those
of recent date.
him, and were
days
found
in bed in a state of apoplectic
he was
subsequently
Portal

has

from

coma,

An

which

other

the

among

he

rallied.

never

American
intelligent

and
Illinois,

"

observed

was

suffered the

in
travelling

from

lot of visitants

common

climates, in being seized with

fever.

bilious

very few live,"he remarks, to record the issue of

sickness like mine, and as you have requestedme, and

As

the State of

as

"

I have

of the

I will
particular,

of this disease.

circumstances

more

recorded

than

been, and that

have

predicamentsmay know that some

like theirs, and have
sufferings
had

had

fever before, and

but

day ;

infantile
was

And

relate

some

it is in my

desirable,in the bitter agony of such diseases,that

of the symptoms, sensations, and sufferings
should

view

be

be

promised to

in this with

the

felt with

weakness, and

survived

day

been
I

similar

in

before them

risen and
first

others

have

them.

I had

dressed

day,and

this

was

to

me

new

its first attack

state

every

prostratedto

was

that

thing very different from what I had yet

Paroxysms of derangement occurred the

had

of mind.

it

experienced.
third
That

state of disease in which

with

partialderangement is mixed
generallysound, and a sensibility

consciousness

excited, I
preternaturally
*

Hagcndorn,
"

should

Observations

suppose
M"licale."

the
Paris.

most

dis-

OF

MEMORY

THE

425

INSANE.

of all its forms.

At the same
time that I was
tressing
that my
unable to recognise
informed
my friends,I was
than ordinarily
exact and retentive,
was
more
memory
and that I repeatedwhole
in the different
passages
I recited,
languages which I knew with entire accuracy.
without
losingor misplacinga word, a passage of
poetry I could not so repeat after I had recovered my

health,"c."*
MEMORY

ordinarycases of insanity
the memory
is not, as a generalrule, impaired or lost.
Dr. Haslam
to think that this facultyis the
appears
first mental
that decays in insanity. I doubt
power
this. It is true that in
the patienthas but
cases
many
a

OF

feeble and

INSANE.

THE

confused

recent

date, but

scenes

of

In

of

of

recollection of the transactions

is able,vividly,
to recal to the

earlylife.

conversations

"

mind

the

It is,undoubtedly,
fact,that the
a

old,

lunatic

incurable

patientsrelate

to the events of past years, but, at the same

principally
time, they do not manifest that utter obliviousness and
of recent circumstances
that Dr. Haslam
forgetfulness

and others appear to believe.

I have
the
witnessed
some
singularinstances among
retentiveness
of memory,
relating
insane,of extraordinary
to recent

but
transactions,

am

bound

to

admit,

as

facultyis found, in the

majorityof cases, in an impairedand muddled state.
of the essential elements,
Accordingto Shakspeare,
one
in all cases
of insanity,
pressions
to revive past imis an inability
a

that
generalpostulate,

to

"

re-

word
"

But

"

that which

Madness

this

I
*

this

would

gamble from."

Shakspeariantest has
have, in a previouspart of
Flint's " Recollections of the

he says

been
this

Valleyof

the

long exploded.
work, spoken of the
Letter
Mississippi,"

xiv.

426

MEMORl

of

exaltation
cerebral

the

hysterical

of

the

activity.

forms

observed

of

is

in

in
is

insanity,

these

In

types.

memory

INSANE.

phenomenon

same

many

sensibility

psychical
and

The

of

THE

often

memory

disorder.

characteristic

OF

condition

generally

exhibits

of

remarkably
of

particularly
the

cases,

of

cases

extreme
marked

and

organic

tion,
exalta-

evidence

428

PSYCHOLOGY

frigid
phantasyof
admits

PATHOLOGY

AND

OF

MEMORY.

Nothing obvious
sceptic.

the

This

of destruction.

is

to

sense

well-established axiom

to destroy
physics. It is not in the power of man
struction
de"What is termed
the slightest
of matter.
particle
as
appliedto material substances,is nothing
tion
but a change in their elementarycomposition,
or alteraThe
of their constituent
atoms.
good and wise
in

"

Benefactor,the Beneficent Creator of the universe,has

not

the power of destroying

to poor puny man
delegated
any
universe by which he is surrounded,
portionof the physical
and which ministers so bountifully
and mercifully
to his
He may, by chemical or other scientific
every necessity.
combinations
processes, alter and re-arrange the existing
of organic matter, but, when
by such
disintegrated
stroyed,
dethe particles
and apparently
so
means,
dissipated
enter into

other

and

What

different forms, and

organisms,but

types and

nature

and

new

are,

assume

in their

original

annihilated.

elements, never

regard to material,holds good,a

the
fortiori,respecting
psychicalphenomena. Hence
is true

with

tonic, permanent

and

indestructible

of the

character

impressionsmade upon the cerebrum, and received and

in the mind
registered
duringinfancyand childhood, as
well as in adult age, as established by their resuscitation
in advanced
and at other periods
of life during certain
normal

abnormal

and

conditions

of the vesicular brain

structure,and cerebral circulation.*

*

use

there
mind

are

the
many

"

ideas that

"

settled hold upon

as received and
notions
upon,

which

and

in matured

in
registered
not

like shadows

old

their character,and
which

"

the memorial

cannot

over

therefore obtain

archives.

Such
so

the surface of the mind, in

the brain
facile

is

not

be

no

doubt

the
no

anatomicallyand

and
reception,
perception,

the fugitive
are
frequentlyfloat
earlyas well as

physiologically
of
registration

which
that the defective memory
certain
(aft
yet
age, is mainlydependentupon

can

that

be deemed
philosophically

objectsof perception,that

become

fitted for the

There

in

evanescent

life,when

organizedor
ideas.

are

the consciousness

do

pass

"

for it must
be admitted
phrase received
advisedly,
which
themselves
on
impinge
impressions
transiently

so

often

companies
ac-

unexplained)

MENTAL

OF

INDESTRUCTIBILITY

429

IMPRESSIONS.

images,"says an illustrious English moralist,

which memory
presentsare of a stubborn and untractable nature.
The
have already
objectsof remembrance
existed,and left their signaturebehind them impressed
the mind, so as to defy all attempts at erasure
or
upon
have once
of change. Whatever
we
as Dryden
deposited,
expresses it,in the sacred treasures of the past/is out of
"The

"

'

the

reach

either

by

of accident
our

or

violence,nor

it be

can

lost,

weakness, or another's malice."*

own

Non

"

irritum

tamen

Quodcunque retro est efficiet; neque

Diffinget,
infectumquereddet
semel hora vexit."
Quod fugiens
Horace, lib. in.,ode 29.

truth,"remarks

seeds of immortal

The

"

physicalnutrition

modifications in the

chemical

or

that vital,organic,and

with
interfering

I may

being either

defective
originally

constitution of the brain

add

essentially
necessary for its readyadaptationto
in reality
ideas are
that
the
received,but
be,

eminent

an

so
psychicalsensibility,
impressions. It may

mental
that

the

of reminiscence
faculty
by age or disease,it
diminution
atrophy,as well

enfeebled

or

of the will. The

obeythe commands
of the convoluted
surface of the brain, so often
in the depthand complexity
in
after
witnessed
/
death,
aged persons, undoubtedlyimpairs that organic
/
and sensibility
for
the
and
cerebral susceptibility
so
rapid
necessary
periuato

ceases

nent

as

of
reception

I had

of this fact.

gentlemanwho

that
impression

in advanced
struck

with

diminished
as

to

life.

illustrations

of the

body of

age of 84. Up to this

for great vigour of intellect,
and for extraordinary

the

During

quantityor
to what

examination

He

appearedto have forgotten

early as well as

his mind, in

of the brain I

was

remarkably

The

was
by no means
grey matter
The sulci were
well marked, and both
depth of its convolutions,the brain presentedan

appearance.
consistence.

volume, character,and

aspectsimilar

remarkable

examination

mortem

retentiveness of memory.
had been made
ever
upon

its anatomical

in

observingtwo

present at the post

was

been remarkable

had

of

died of visceral disease,at the advanced

and
elasticity
no

impressions.

last year,
opportunity,

an

periodhe

mental

would
pathologist

expect

to

dying in full intellectual power at the age of 30 or 40.

mind
had
examined
the brain of a gentlemanwhose

detect in
In

another

become

person
case, I

prematurely

He died at the earlyage of

to his death.
enfeebled for six years previously
diminished
in depthas well
The convolutions of the brain had greatly
56.
as
or

in

and
complexity,

the

atrophiedappearance.

I wit limit

a want
softening)

"

"

encephalicmans
The

brain

was

of coherence

The

Rambler."

also

presenteda general shrunken

also
unusuallypale,and there was
in its texture.
Dr. Johnson.

430

PSYCHOLOGY

PATHOLOGY

AND

OF

MEMORY.

in the loose soil

even
perish,
where they have long laid disregarded."1
the same
idea in the following
transGoethe embodies
beautiful passage
ceiidently

writer,

"

are

not

to

sown

Kein

"

Wesen

kann

zu

nichts zerfallen,

Das

Ew'ge regt sich fort in alien,

Am
!
Seyn erhalte dich begliickt
Das Seyn ist ewig,denn Gesetze
Bewahren
die lebend'gen
Schatze
welchen sich das All geschmiickt."t
Aus

How, it may

be

asked, can

reconcile with

this

and pathologist
physiologist
of
latencyand indestructibility

the
conceptions,
psychical

tear,destruction

and

the

fact of the constant

construction,waste

and

wear

and

reparation,

of nerve
-brain-matter?
Can
absorptionand deposition
the doctrine of the individuality
and indivisibility
of mind,
and the metaphysical
ness,
theoryof the unityof the consciousbe established on
a
basis, if these
philosophical
to alter
physicallaws are acknowledgedthus materially
the structural organization
of the brain, and
to produce
modifications in its recognisedintellectual and emotional

manifestations ?

gradualdevelopmentof the mind from

childhood to adult age, and its steadyand melancholy
decadence from a condition of youthfulvigour and advanced
maturity,to that of second childhood, and senile
connected with those subtle changes in the
imbecility,
compositionof the cerebral matter and modifications in
of the grey nerve
the organization
vesicle,which' we
?
know
to be in constant progression
How
can
we
explainthe expansion and discipline
the mind
which
undergoesas the effect of a system of
? By what physiological
and psychieducational training
cal
the memory,
attention,and reasoning
processes are
Is not

"

the

Amenities

of Literature,"
vol.li. p. 365.
by Isaac Disraeli,

"f Goethe's

"

Wilhelm

Meister's

Wanderjahre."

EFFECTS

OF

ORGANIC

CHANGES

ON

THE

MIND.

and invigorated
faculties,
by exercise ?
developed
is the

rationale of the

431
What

judgment being improved by

and careful cultivation,

the moral sense
elevated,
judicious
the taste disciplined
and chastened,the volitional power
increased ?
Are not these various psychical
changesthe
results of some
law regulating
new, and as yet inexplicable
the action of nerve-matter
? Is it possible
to suppose
that changessimilar to those previously
referred to, in
the manifestations of the thinkingprinciple,
be concan
sequent
May
upon any alteration in the mind per se ?
not these developments
and modifications in the psychical
attributes of the cerebrum, and gradualunfoldings
of
the mind which we perceive
through the various epochs
of life,be mysteriously
connected with and dependent
which
all
of nerve
matter
upon, that waste and repair
?
to be in constant operation
physiologists
recognise
Are these psychical
and
inexplicable
phenomena more
inscrutable to the philosopher
facts that
than the physical
the physiologist
is dailymaking matter
of observation
and

reflection?

How

can

we

for the

account

sion
transmis-

of

particular
typesof disease,certain modifications
from generaand eccentricities of physical
organization
tion
to generation? Are these phenomena less occult
than the descent of mental
modulations
idiosyncrasies,
of the voice and expressions
of the countenance, from
father to son, mother
to daughter? Slightdistortions
in the feet,peculiar
in the fingers,
malformations
lar
singudefects in the developmentof the muscles regulating
.

the movements
all been known

of the eyes, moles, mother's marks, have

to be physical
defects,or, more
properly

that have
development,
! How
existed in families for generations
can
we
cile
reconnotions of the organic
facts with our
these physical
in the animal economy
?
revolutions occurring
Again,if we turn to the consideration of pathological
is still more
bewildered in
phenomena, the physiologist

speaking,arrests

of structural

432

PSYCHOLOGY

OF

PATHOLOGY

AND

MEMORY.

attempt to penetratebehind the veil that conceals

laws rethe incomprehensible
from finiteunderstandings
gulating
his

and
of life,as dependent upon
operations
of the body. I refer to
connected with the organization
those
subtle
changes in the character of the blood
effected in infancyby the introduction into it of minute
portions of morbific matter with a view of protecting
the body from the influence of noxious and often deadly
poisons. I allude to the effect of the vaccine virus upon
the blood in producinga permanent and organicchange
the

in its constitution and

a

character,which continues

in
protective
influence
againstsmall-pox,

of cases, througha longlife,

duringwhich

the

to exercise

great mass
the

time

blood

have

undergonemany thousands,if not millions,of

! If we
could imaginea person
changesand modijications
of the introduction
into the system
armed, by means
so

must

of

ditions
healthyvaccine matter, under favourable bodilyconfor its reception,
to be drained of nearlyhis last
restored to his original
drop of blood, and subsequently

condition,we

vascular

force of its

should

sanitaryeffect

life; in other
for many

find

no

in the

diminution

the vital fluid in

upon

words, he would

continue

years, from the influence

early
tainly
cerprotected,
of the small-pox

poison.
How

can

this assimilative power

Is

the

than

less

phenomenon

of the blood

be

mysteriousand

plained?
ex-

scrutable
in-

ter
permanent and indestructible charac-

the

of all psychical
?
impressions
Mr.

Paget refers to

their elucidation.

these

When

ing
phenomena without attemptto the blood's own
alluding

After the vaccine and

power, he remarks :
it is most probably,
other infectious or inoculable diseases,

assimilative

"

"

not the tissues

more

than

and in many

alone, but

they,in
cases

which

it would

the

blood

as

much

or

much

the altered state is maintained,

seem

that,whatever

materials

OP

POWER

ASSIMILATIVE

added to the blood,the stamp

THE

433

BLOOD.

by one
impressed
diseases is retained ; the blood, by its
these specific
its
to itself,
formative power, exactly
assimilating

are

of
own

once

altered self,the materials derived from the food.

of many
of
explanation
because of
the most inveterate diseases ; that theypersist
the assimilative formation of the blood.
Syphilis,
lepra,
thus to be perpeeczema,
gout, and many more, seem
tuated,
form or other,and in ever varyingquanin some
tity,
whether
it manifests itself externally
or
not, the
material theydepend on is stillin the blood ; because the
blood constantly
makes it afresh out of the materials that
added to it,let those materials be almost what they
are
And

"

may.
these

must
this,surely,

tissues

The
cases

recover

be the

affected may
(and often do) in
theymay have gainedtheir rightor

once

still
; but the blood, by assimilation,
composition
perfect
retains its taint,though it may have in it not one of the
which
the taint first passed and hence,
on
particles
after many
years of seeming health, the disease may
break out againfrom the blood,and affect a part which
:

was

before diseased.

never

natural

And

this appears to be the

of these diseases,
unless the morbid
terial
ma-

course

be (as we
; or

cific
spemay suppose)decomposedby some
be excreted in the gradualtendencyof the blood

to regaina normal
(likethe tissues)

state

; or,

be,
finally,

starved by the abstraction from the

if I may so speak,
food of all such thingsas it can
be made from.
possibly
in the phenomena of symmeas
things,
trical
have proofs
of the surpassing
we
disease,
precision
of the formative process, a precision
that,as we
so exact
of blood,or
made
may say, a mark once
upon a particle
"

In all these

tissue,is not for years effaced from

this

seems

to be

hardlydoubt
made

truth of widest

its

And

successors.

application
; and

that herein is the solution of what

hindrance

to

the

of
reception

can

has been

the whole
F

truth

484

PSYCHOLOGY

concerningthe
the brain.

the brain

When

OF

MEMORY.

immaterial

an

is said to be

of the mind

mind

with

the
essential,
as

in its relations with

the

of sensations,
world, not only to the perception

external

to
subsequentintellectual acts, and especially
of thingswhich
have been the objects
of

but to the
the memory
sense,

of

connexion

instrument

or

organ

PATHOLOGY

AND

asked, how

it is

"

when

memory

the

of
the organ
its substance to be ever

can

you

suppose

how

is it that

brain be

assumed
nutritive
changing? or,
your
of the brain is not as destructive
change of all the particles
and knowledge of sensuous
of all memory
thingsas
the sudden
destruction by some
great injuryis ? The

is, because of the exactness

answer

of assimilation

"

in the formative

by

an

the

because

impressionupon

in intellectual

or

process

the effect once

the brain, whether

course

part,be it what
of

recollection of

it may,

brain

in

which

nutrition,succeeds

which

are

retained

the

the

to it.

things,the

sensuous

duced
pro-

in perception

act, is fixed and there retained

representedin
therebychanged,is exactly
in the

complished
ac-

has

been

partwhich,

Thus, in the

mind

refers to

effects,or

rather

the

lectual
likenesses,of changes that past impressionsand intelacts had made.
As, in some
way passingfar our
and took cognizanceof,
knowledge,the mind perceived,
the change made
by the first impressionof an object
wards
actingthrough the sense-organs on the brain, so afterand
it perceives
recognisesthe likeness of that
change in the partsinserted in the process of nutrition."*
How
fraughtwith interest of the most sublime and
exalted character to the metaphysicalphilosopher,
sician,
phyis the theory
and theologian,
referred to)
(previously
?
of the indestructible character of all mental
impressions
if
facts illustrate,
The subjoined
singularly
interesting
the truth of this theory. In
they do not demonstrate
,

"Lectures

on

Surgical
Pathology."By

J.

F.B.S.
Paget,Esq.,

Vol. i. p. 52.

436

PSYCHOLOGY

and

vast

is open

to the

PATHOLOGY

AND

MEMORY.

OF

unexploredregion of

scientific

inquiry
losopher
phienterprising

and

zealous,courageous,

the subject
of chemico-ccrebralinvestigates
tion
untrodden
ground exists in associapalholoyy. Much
and hitherto neglected
with this deeplyinteresting
mical
subject.Any attempt to unravel, by the aid of chescience, psychicaland nervous
phenomena so
of any
abstruse,may
prove, for a time, unproductive
results,nevertheless, some
advantage must
practical
from
these investigations.
Lord Bacon, when
accrue
mists
efforts of the ancient alcheto the persevering
referring
to discover the philosopher's
stone, remarks, that
the immediate
althoughthey did not succeed in obtaining
tigations
of their search,much
object
good resulted from the investheypursued. They did not, it was admitted,
the philosopher's
succeed in discovering
stone, but they
accomplishedby their efforts what might be considered
almost tantamount
to it in value. By the processes that
and persevering
were
adopted,
attemptsmade, to find the
hidden treasure, they turned up and pulverized
the soil,
it better fitted for the purposes of vegethus rendering
tation.
who

Sir W.

Hamilton

of extension
properties
a

point,only

all that

we

three
distinguishes

and

and
place,

aggravatethe

know

those

suppose

Admitting the
difficulty.

of the relation of soul and

with the latter in

who

way

of which

we

kinds

of latent

this seat to he hut

of mind,
spirituality

nected
body is,that the former is conare
wholly ignorant; and that

different both in
it holds relations,

degreeand kind, with different partsof the

right,however, to say that it is limited to any one

organism. We have no
if we
admit that the nervous
system is the
partof the organism; for even
is itself unistillthe
it
is
versally
which
to
nervous
united,
proximately
system
part
ramified throughoutthe body; and we have no more
to
right deny
consciousness assures
that the mind feels at the finger-points,
as
us, than to
In the brain.
The sum
of our knowledge of
assert that it thinks exclusively
cations
the connexion of mind and body is,therefore,
this, that the mental modificonditions
but
certain
of
the
of
nature
on
are
corporeal
dependent
;
know
For
these conditions we
nothing.
example,we know, by experience,
that the mind perceives
onlythroughcertain organs of sense, and that,through
in a different manner.
But whether the
these different organs, it perceives
be
whether
be instruments,whether
or
media,
senses
they
theybe only
the
mind
incarcerated
in
the
all
this
outlets
to
can
we
only
partial
body on
Lectures on Metaphysics,
vol. ii.,
theorise and conjecture."
p. 127.
"

"

"

OF

PHENOMENA

LATENT

MENTAL

437

IMPRESSIONS.

mental

1. Where
the greaterpart of our
impressions.*
treasures lies beyond the sphereof consciousness,
spiritual

and

hidden

2. When

the

mind

of

obscure

contains

mind.

certain

systems of

ledge
know-

consciousness

to

it is

conscious
whollyun-

its ordinarystate, but which

in
possessing

revealed

of the

recesses

habits of action which

certain

or

are

in the

in

certain

extraordinary
w

exaltations of its powers.

3. Consists in
modifications,i.e.,mental activities of

unconscious, but which

which

we

manifest

conscious.

are

This

how

can

know

we

which

existence

we

by

are

effects of

last appears a somewhat

Sir W.
Hamilton
asks,

for,as
ambiguousproposition,
"

ordinarymental

that to exist which

lies

beyond the

condition of all knowledge, consciousness ? how

one

can

"

knowledge arise

of

consciousness out of
ignorance,
out of the incognisaunconsciousness, the cognisable
ble ? i.e.,
how can one
opposite
proceedout of another?"
There are many things,"
which
says Sir W. Hamilton,
out

"

"

we

"

neither know

know

can

nor

in their direct and immediate

but
knowledge,
medium

are

state.

be

"

our

themselves

Consciousness

as

are

we

conscious

conscious of

through the

exist independent

of the mind
a

determinate

be conscious of

must

we

faculties of

cannot

modification
peculiar

some

onlyconscious
To

themselves, that is,

relation to

manifest

of their effects.

of
we

which

in

some

ing.
remembrance, imagination,
or feelperception,
particular
We
have no generalconsciousness.
As consciousness
mental modification as its object,
supposes a special
it may

be

remembered

that

this modification

or

state

other state
supposes a change a transition from some
modification.
But as the modification must
be preor
sent
before we have a consciousness of the modification,
"

it is evident
rise

or

that

can

we

awakening,for
*

Lecture*

on

have

its rise and

no

consciousness

of its

awakeningis also

voL i.,
Mctaphytici,
p.

348.

the

438

PSYCHOLOGY

PATHOLOGY

AND

MEMORY.

OF

awakening of consciousness." Sir W. Hamilton

subtle mental
cites the followingillustration of such
tant
When
look/'he observes, at a diswe
phenomena.
Of
a certain
forest,we perceive
expanse of green.
and
this, as an affection of our
orgasm, we are clearly
conscious.
The expanse of which we
are
scious
condistinctly
made
is evidently
up of partsof which we are not
conscious.
No leaf,
perhapsno tree,may be separately

rise

or

"

"

But

visible.

the

of the greenness

up

impressionof
infinitude

an

hear

tve

Sir W.

Hamilton,

made

up

partsdid

not

sum

Latent

we

of which

the distant

of which

of the

which

we

of

of the

psychicalare

sea,

made

the

of

up

When

are,"says

what

of the total tion

percepThis
is a
murmur

conscious ?

parts,and

is made

conscious.

not

the constituents

are

count

conscious

are

murmur

"

forest is

leaves, that is, the total

are
we

the

of

greenness

would

sum

be

if the

zero

something."*

as

not
certainly

more

than
singularand inexplicable

latent

facts relative to light

physicalphenomena. The subjoinedinteresting
illustratethe matter in question.
with much diligence
M. Niepce de Saint- Victor has been pursuing
his investigation
into the influence of solar lighton organicand inorganic
bodies.
An
extensive series of experimentshas been communicated
by AI. Chevreul
des Sciences.
to the Academic
firmatory
Many of these experimentswere
merelyconof his former results,
tended to show that the propertyof absorbing
or
"

the solar rays

very largenumber

and

givingthem

out

of dissimilar bodies.

again in

darkness

was

to

common

It will be remembered

by

many

of

readers,that M. Niepce,in a former communication, stated that a tube

of paper or metal, white on the inside,being exposeddirectly
oppositethe
of light,
which could,by closing
for an hour, absorbed a largequantity
sun
the end of the tube, be preservedand employed at some
future time in producing

our

photographic
copy

of

chemicallypreparedpaper placedto

receive it.

tissue paper

upon

pieceof

tions
That, indeed,the solar radia-

could be bottled up for a future day. M. Niepce has since proved that
cylinderof white card-board, which has been been exposed to sunshine,

ifa
be

pictureon

'
it is active six
up in a tin case,
if there is placedat the end of the tube

montJis

carefullyclosed
and

lation,'
afterits insutransparentprint,and

pieceof photographic
paper, the radiations from the inside of the tube
will act precisely
if the arrangement had been exposedto the solar rays.
as
effected the decomposition
of any of
After these absorbed radiations have once
the salts of gold or silver they are
expended
powerless
; that is,they are
his investigations
in producing this change. M. Niepce has been carrying
beand
he has approachedthe confines of that 'territory
yet farther,
then

CHARACTER

INDESTRUCTIBLE

439

IDEAS.

OP

racter
and indestructible chatheoryof the persistent
of psychical
is countenanced,(I will not
impressions
normal
established,
phenomena observed duringvarious ab}\"y

The

say

mental,and disordered cerebral conditions.

refer,

tain
of the intellectas manifestedin cercaused
by drowningand
forms of asphyxia,

the state

1. To

hanging.
2.

of the

To the condition

mind

exhibited

as

previously

to death.

3. To

the morbid

mental

phenomena
the

from injuries
inflicted
upon

observed to result

brain,or

to

follow

disease.
particular
typesof encephalic

It has

(I

occurred,that persons

during the asphyxiacaused

presume
of venous
instead of artenal blood

in

the

agoniesof

of

the

most

their

past lives !
have

recalled to the

lation
circu-

the

in the

brain,

suspensionof the respiratory

presentedto their minds, whilst
tableaux
death, a series of striking
and

remarkable

Events

associated

minute

childhood

by

drowning

the

consequent upon
process),have had

of

in the act of

been, under

mind, and

of

occurrences

with

these

the

period

circumstances,
it like

presentedto

so

many

which has hitherto been but a bewildering

physicsand physiology,
considerable
soil has been taken
from
a
problem. Earth
agricultural
and
covered
with
in
spread upon a plate darkness,a pieceof paper
depth
chloride of silver has been placed
above it,and no effect has been produced.

tween

"

The

"

soil has been

same

exposed to

It has then

an
opaque screen.
similar photographic
paper

part of the
that

portionwhich

evidence of the
continuation

in

had

been

remarkable

The

manner

"

half of it being covered

one

taken into

dark

with

them, and

by
pieceof

experiment. All that

exposed icas darkened, but

had

been

effect.

producedno

Here

we

have

and of the
solar rays by the surface soil,
under
action which has been commenced

researches of M.
the views

Niepce de

entertained

pliore"
Niepce,who, in December, 1829, wrote thus
acts chemically
compositionand decomposition,
upon
it combines

room,

and

in the former

covered

of the
absorption
of
ob"curity that

th"- influence of sunshine.

in

been

placedas

the soil which

over

paper

sunshine

communicates

to them

shall

by
"

Saint-Victor

his uncle,M.

Light, in

bodies.
new

firm
con-

Nii'-

its state of

It is absorbed,

properties"

\V"

wait the extension of these researches upon vital organisms,

anxiously
in the direction indicated by M. Chevruul."
Athcnfum, January8, 1869.
"

440

PSYCHOLOGY

PATHOLOGY

AND

OF

MEMORY.

artistic photographicrepresentaexecuted
exquisitely
tions.
These phenomena have occurred
not exclusively
of death,
duringthe act of drowning,and at the moment
hut in analogous
conditions of morbidlyasphyxiated
and

affected brain.*
A

before he
to

attack

gentleman,during an
hung himself. A
for

me

cut down.

was

of acute

short

He

time

under

recovered.
supervision.He ultimately
the strangemental visions that
to me
his mind

duringthe

SECONDS,

he continued

few minutes

minutest

The

affection with
with

the
and

green,

scenes

which

he

his beloved

Incidents

He

taken

was

his childhood

Whispered the

thorn, that

with

connected

lated
re-

floated before

the

to

parents,gambolled once

"

the milk-white

often

born, interchangedtokens of

was

companions of
again,

Beneath

He

(in all probability)

or

revived.
particular,

cottage in

medical

my

prived
suspended,and temporarilydeThey were of the most pleasing
in their
of his earlylife were,

of consciousness.
character.

pression,
de-

period only elapsed

brought
subsequently

was

advice,and placedfor

mental

the

on

village

lover's tale,

scents the

school

the

more

eveninggale."

in which

he

ceived
re-

his

He

once

with

the

reproducedto his mind.

earlyinstruction were
and shook hands
againrenewed
acquaintance,
loved and dearlycherished companionsof his

boyhood !
that had

been

his memory,

remembrance

The

mind

restored to his recollection in

was

Miiller says, " we

know
in the brain, which
be

directed to

it
"

and

be

on
regardedas impressions
annul a part or

the brain may

'

moment

attention

'

During

manner.

idea is

at any

may

if the

the

vivid

that every

of the
impossibility
that causes
each
simultaneously

merely

child]

obliterated from
(as he supposed)
entirely

remarkably truthful
*

of faces (known when

most

that

permanent,immutable
presentitselfanew, if

be turned

to it
"

and

pression
imthe

that it is

attention
to be

being occupiedby many

objects
forgotten. All these latent ideas must

the brain which

cannot

all of these ideas."

be effaced.

Lesions

of

CTRIOU8

MENTAL

criticalsecond

CAUSED

circumstance

connected

his mind

sketches and

paintings.*

441

DROWNING.

of time

presentedto
"

BT

(when he might almost have been

and
strugglingwith death), every trifling

considered
minute

PHENOMENA

was

like

so

with

his

past life was

charmingpictorial

many

told," says De Quincey,author

once

"

of the

Confessions
of an EnglishOjnum Eater"
by a near
that having in her childhood fallen into a river,
relative,
and beingon the very verge of death, but for the critical
"

assistance which
whole
in

as

reached

her, she

life,in its minutest

a

How

in

saw

her

moment

reflected before her,

incidents,

mirror."
often the

mind, during the last strugglewith

is busily
life,
occupiedin the contemplationof pastoral

imagery

and

pleasantearlyremembrances,

with the innocent

country life!

recreations and

All

associated

unmatched

beauties of

the

and
unsophisticated
aspirations,
xfond reminiscences of the youthfulfancyappear, occathis awful crisis,
to gush back to the heart in
sionaityv-ai
all their original
beauty,freshness,and purity!
A young
man," says Dr. Symonds, who had been
"

"

but
*

little conversant

with

but

any

rural scenery,

dis-

hung, but cut down on the arrival of a reprieve,

person who was
upon
that
the
beingasked, what his sensations were whilst hanging?" replied,
for
his
execution
dreadful
horrible
all
and
were
pression,
expreparations
beyond
but that upon
found
himself
amid
being dropped,he instantly
Jieldt and rivert qf blood, which gradually acquireda greenishtinge.
Imagining that if he could reach a certain spot,he should be easy, he seemed
to himself to struggleforcibly
to attain it,and then consciousness and all
w
ere
feeling
completely
suspended."
I remember
needs
to have heard of a certain gentleman that would
make
in curiosity,
what men
did feel that were
trial,
hanged so he fastened
the cord about his neck, raising
himself upon a stool,and then letting
himself
"

"

"

-.

the stool at his pleasure,

fall,
thinkingit should be in his power to recover
which
he failed in, but was
helpedby a friend then present. He wan asked
afterwards

what

he

felt; he said he felt no

before his eyes a great fire,

and
and dark ; lastly,
it turned to a
is also often
a"iJ

seen

Death," by

by
Lord

them

burning;

which

liacon.

pain,but
then he

paleblue,or
fall into

sta-

firsthe

thoughthe

thought he
water

green

swooning*."
"

"

saw

saw

all black

which

colour

Hittory of Life

442

OF

PATHOLOGY

AND

PSYCHOLOGY

MEMORY.

short time before his death,

a
eloquently,
and bosky dell,purling
of sylvanglen,
streams, and happy
had been
as if his spirit
babblingof green fields,'
valleys,
always luxuriatingitself in the gardens of Elysium."
Shakspearealludes to this phenomenon in his account
of the death of Falstaff,in the play of Henry V.
into the water, and was
A gentlemanfell accidentally
in
After being rescued, he continued
nearlydrowned.
state of apparent death for nearlytwenty minutes.
a

coursed

most

'

After his restoration to consciousness,he thus described

his sensations

whilst

the

in

act of

drowning :

"

"

they

and
ecstatic I have ever
delightful
rienced.
expeI was
to a perfect
Paradise, and
transported
witnessed
that my
had, in
scenes
imaginationnever
mind.
I
its most
active condition, depictedto my
in company
with angelicspirits
wandered
through the
most lovelycitron and orange
groves,

the most

were

bowers,
flowers,'
ever-blooming
'

Celestial

palms,and

Roseate

baskingin an atmosphereredolent of the most delicious

music proceeding
perfumes. I heard the most exquisite
from

melodious

Whilst

and

voices

in this world

of

well-tuned

fancymy

mind

instruments.
had

recalled to

and associations of my

earlylife,
and the memory
of the companionsof my boyhood. All
the knowledgeI had acquired
duringa long liferecurred
to my
mind.
Favourite
Horace, Virgil,
passages from
and Cicero,were
of poetryI had been
revived, and pieces
fond of repeating
fresh to my recolwhen
lection."*
a boy, came
consciousness

when

The

the

scenes

late Professor Clarke,of

thus
Cambridge,

described his state of mind

in the water,"he
"After beingimmersed
being drowned:
and
I knew I could
would
the
but
mare
swim,
thought
says,
my danger,
that 1 had gone to the
ride when we were
overwhelmed.
It appearedto me
bottom with my eyes open.
and
At firstI thought I saw the bottom clearly,
then felt neither apprehensionnor pain; on the contrary,I felt as if I had been
iu the most
situation ; my mind was
tranquilana uncommonly
delightful
in the act of

"

saw

"

444

PSYCHOLOGY

patientin

relations of the

The

German.

MEMORY.

OF

PATHOLOGY

AND

lady assured

gentlemen in attendance, who were much

struck
by the singularphenomenon, that she had not
spokenthe foreignlanguage since she was ten years of
to her fatal illness she accompanied
age ! Five years previously
the

medical

friends to Frankfort, but whilst there

some

never

in the
although frequently
urged,to converse
attempted,
languageof the country. It was then supposedthat all
when
the knowledgeshe had acquired
of German
a child
had

been

Dr.

effaced from

Rush

alludes

her mind.
to

patientsubjectto

whose paroxysms
insanity,
by her conversingin a kind

recurrent

As

the

point,the lady
the

decline of her

illness she

during the stage of

about

her

in her

could

its culminating

only talk in French, at

spoke only German, and
she

convalescence

native

of

cated
always indiItalian patois.

reached

had

disease advanced, and

were

attacks of

tongue.

addressed

This

ladywhen
language,and

those

quite

if she
rarelyspoke any but her own
attemptedto do otherwise, always did so with extreme
diffidence and difficulty.
During her attack of insanity
she spoke with great fluency,
never
apparently
beingat

well

loss for words

convey her ideas.

the exception of the Italian,the

with

German

and

Lord

to

French,

gentlemanwell known
did me
world, who
political
with me
upon the subjectof
'

when
of the
son,

de

was

late

in

languages,

accurate.
singularly
relates the followingsingular
case

Monboddo

says,

other

that,

were

"

"

It is said

That

about

France, I had

Marechal

both
the

my

to

learned

the

honour

to

first volume

and

correspond
physics,
of Meta-

six-and-twenty
years
ago,
an
intimacyin the family

de Montmorenci

de

Laval.

His

Compte de Laval, was married to Mademoiselle

of
Maupeaux, the daughter of a lieutenant-general

that

the

name,

and

the

niece of the

late Chancellor.

This

"

The

'

years, but is since dead.

from her own
mouth.
fact comes
following

survived

widow

battle of Hastenbeck

killed at the

gentlemanwas

445

LANGUAGE.

OF

PHENOMENA

MORBID

him

his

some

She

of perfect
She was
a woman
repeatedly.
She
and very good sense.
appealedto her
veracity,
did she,indeed,
servants and familyfor the truth ; nor
so extraordinary
to be sensible that the matter was
seem
I wrote it down
at the time, and
to me.
as it appeared

has told it

the memorandum

I have
"

The

'

me

amongst
Laval

de

Comtesse

sate up with

servants,who

my papers.
had
been
observed

her

of

account

on

some

by

position,
indis-

of
sleepa language that none
them understood ; nor were
they sure, or, indeed,herself
the sounds
able to guess, upon
being repeatedto her,
not gibberish.
whether it was
was
or
of one of her children,she was
Upon her lying-in
who was
of Britanny,
of the province
attended by a nurse
and who
immediatelyknew the meaning of what she
said,it beingin the idiom of the natives of that country;
when
but she herself,
awake, did not understand a single
she had uttered in her sleepupon its
of what
syllable
beingretold to her.
and had been nursed
born in that province,
She was
in a familywhere nothingbut that languagewas
spoken;
it and no
known
in her first infancyshe had
so that
she had
she returned to her parents,
other ; but, when
of it ; and, as I
of keepingup the use
no
opportunity
to

"

"

'

not

understand

awake, though she spokeit

when

in her

word

of

sleep.

de Laval never
say that the Comtesse
imaginedthat she used any words of the Breton,

I need

'

or

idiom
that

said, she did

before

Breton

said

her

in

'

have

"

talk

than

more
are

not

within

"c.'
objects,

were

necessary

the compass

of

to
a

express those ideas

child's knowledgeof

'

"

"Ancient

Metaphysics."

446

OF

PATHOLOGY

AND

PSYCHOLOGY

Holland's

patientof Sir H.
plegiaat an advanced
A

MEMORY.

by hemidaysbefore

attacked

was

a few
passed,
He
death, into a state of low, rambling delirium.
spoke only in French, a language he had not
known
to
speak for thirtyyears before. "This

Holland,

H.

Sir

says

He

age.

"

then

been,
tinued,"
con-

ceased

until utterance

to be intelligible."1
altogether
in a Roman
occurred
The
following circumstance
before Mr.
in Germany, a year or two
Catholic town
at the time a
Coleridgearrived at Gottingen. It was
of
A young
woman,
frequentsubjectof conversation.
four or five and twenty, who could neither read or write,
seized with a nervous
fever,duringwhich, according
was
and monks
of the
to the asseverations of all the priests
and as it appeared,
she became
possessed,
neighbourhood,
by a very learned devil. She continued incessantly
talking Latin, Greek, and Hebrew, in very pompous
"

the most

with

terms, and

rendered

was

been

the

devil

to

men,

and

was

advises
medical

or

he

if

The

instance.

probableby

more

had

that she

distinct enunciation.

heretic.

decline

it would

had

taken
had

case

this

session
posfact

known

Voltaire

humorously
acquaintance with

all

have

the

This

been
advice

attracted the

to

more

in

the

his

putation
re-

present

attention
particular

physician,and by his statement

many
young
and
visited the town,
eminent physiologists psychologists

of

*
"

the

vain," says
change by which

It is in

however,

considers

doubt, he
or

in the

"

says,

disturbance

light

p. 358.

In

that

qualityof

the substance

of

that

brain.

of the

or

some

Mental

"

Pathology."

Dr.

to the nature
of
as
Carpenter, to speculate
thus
are
impressions
registered." He,
sensory
the nutrition
they are in some
dependent upon
way
cases

"

like those

previously
cited, there

can

the fluid,was

the

cause

of

of the sensorium, reproducedthe

visual

no

changes which, operatingin

former
sensations,just as a

of the circulation in the retina occasions the sensations

other

be

alterations either in the circulation of the blood

phenomena."

"

Principles of Human

of flashes

Physiology,
.

KNOWLEDGE

OP

and

cross-examined

her

ravingswere
found

\\ire

each

the

the

could

whole

Of

ever
woman
young
she evidently
was

in

town

years

the

as

of

Sheets

coherent

Hebrew,
the

no

small

full of

mouth, and

own

or

117

FEVER.

and

ligible
intel-

connexion

portionof

Bible,the remainder

dialect.

All

trick

or

spiracy
con-

question. Not only had the

been a harmless,simplecreature,but
fever.
In
labouringunder a nervous

the

which

servant

her

little

with

to

BY

spot.

of sentences

be traced

out

was

the

from

to be the rabbinical

seemed

the

on

down

for itself,
but

other.

REVIVED

case

taken

to consist

each
with

LANGUAGES

she

had

in different

itself. The

been

resident

no
families,

for many
solution presented

mined
physician,however, deterto trace her past life from step to step,for the
of returninga rational
patientherself was incapable
in discovering
He
at length succeeded
the
answer.
place where her parents had lived, travelled thither,
he learned
found them
dead, but an uncle surviving,
had been charitably
taken by
from him that the patient
old Protestant
an
pastor at nine years of age, and had
remained
death.
lu-

was

till the old man's

years, even
this pastorthe uncle knew nothing,
but that

with

Of
a

after much
a

very

him

young

some

good

man.

search,our
niece of the

With
young

and
great difficulty,

medical

who
pastor's,

had

discovered
philosopher
lived with

him

and had inherited his effects. She

housekeeper,
the girl,related that her venerable uncle
remembered
and could not bear to hear the
had been too indulgent,
girlscolded ; that she was willingto have kept her, but
death the girlherself refused to
that after her patron's
made
were
concerningthe
inquiries
stay. Anxious
habits,and the solution of the phenomenon was
pastor's
the old man's
It appearedthat it was
obtained.
soon
as

his

custom
se,

a
for years to walk up and down
passage of his
into which the kitchen door opened,and to read

448

to himself
A

with

OF

PATHOLOGY

AND

PSYCHOLOGY

MEMORY.

loud voice out of his favourite books.

of these

considerable number

were

stillin the

niece's

and a great
The pastorwas
a learned man,
possession.
found a collection
Hebraic scholar. Among the books were
of rabbinical writings,
togetherwith several of
succeeded
the Greek and Latin authors,and the physician
in identifying
so
passages with those taken down
many
the

at

remain

woman's

young

bedside, that

rational mind

in any

made
on
impressions
Analogousphenomena are

of the

of somnambulism

well

as

as

no

doubt

could

concerningthe true origin

her nervous
system."
observable
of

in

some

Sir
catalepsy.

forms

"W. Hamilton

illustration from a German

book by
quotesa singular
Collection of Remarkable
Phenomena
Abel, entitled,"A

from

Life."

Human

"

young

man

had

tack,
atcataleptic
singularchange was

in consequence
of which
a
effected in his mental constitution.

Some

six minutes

he began to speak distinctly,

and
fallingasleep,
almost always of the same
objectsand concatenated

after

events,so

that

he

carried

on

from

night to nightthe
playthe same
part.

or, rather continued to

history
On awakeninghe had no
reminiscence whatever of
a circumstance,by the way, which
dreamingthoughts,
same

this

rather

as

case

of somnambulism

his
tinguishes
dis-

than

of

dreaming. Be this,however, as it may, he

playeda double partin his existence. By day he was the
of a merchant ; by nighthe was
a married
poor apprentice
the father of a family,
a
senator, and in affluent
man,
said
circumstances.
If,duringhis vision,anythingwere
in regardto his waking state,he declared it unreal and
common

dream."

to the phenomena of
more
But, reverting
particularly
I would
ask, how are we to explainphysiologically
memory,

the modus

impressionson
m

celtan ical or

operandiof

the

mind?

psychleal law

attention in

certain
fixing

Is the fact referable to

?

LAWS

It is deemed

ASSOCIATION

THE

GOVERNING

of

OF

importancethat

419

IDEAS.

certain idea

or

phrases,
aggregationof ideas should, to use colloquial
be permanentlyimpressed,
fjccd,or stamped upon the
mind, in other words,be susceptible,
by an effortof the will,
unless
In ordinary
of beingremembered.
understandings,
directed and concentrated
the attention be continuously
to the subjectimmediatelyunder
consideration, the
made upon the brain,the material recipient
impression
of the mental image,is faint,transient,and evanescent.
If it be necessary to commit
pieceof prose or
any
we
repeatit without intermission,
poetry to memory,
until

we

are

conscious that

durable effect is made

upon
of the

continuityand concentration
of certain
attention satisfactorily
accounts for the tenacity
healthyas well as morbid, in which the
conceptions,
and explains
mind has taken a deep and abidinginterest,
the fixed character of a particular
sions
type of ideas (deluin their operations,
the emotions,
?} which implicate
and reflecting
as well as reasoning
imagination,
passions,

the

mind.

Such

faculties?

greatlyinterests and
A loved object
dies in a particular
involves the feelings.
is accidentally
or
deprivedof life in a certain
room,
The
attention of the unhappy survivor
is
locality.
alive and vividly
concentrated to all the physical
painfully
A

circumstance

well

as

with

the

made

as

moral

severe

occurs

and

which

emotional

associations connected

loss sustained,and

is thus
impression
if ever, effaced.
is rarely,

which
upon the memory,
and accuracy
Again, the activity

an

of the

are
memory
the laws regulating
the association

greatly
dependentupon
of ideas.*
This faculty
is noticed

in various

con-

The
Sir W.
Hamilton's
facultyof memory, reproduction,
or, to use
is considered by metaphysicians
to be regulated
phrase, resuscitation,"
by
the laws which govern the generalassociation of our
ideas. Aristotle,
who
flourishedmore
than 2000 yean ago, has left behind him a masterly
philosophical
of these laws.
which have once coanalysis
Thoughts,he maintains,
"

450

OF

PATHOLOGY

AND

PSYCHOLOGY

MEMORY.

states of

according
development,
and original
and conto educational training,
nate
In a few understandings
it is
vigour of mind.
observed to be altogether
absent, in others it operates
it is in a most painfully
morbid
and in some
sluggishly,
The most
and
and sensitive state of activity.
trifling
the faintest reference to a particular
allusion,
insignificant
in a certain type of healthyas well as of disordered
subject,
mind, recals immediatelyand vividlyto the
chain of pastconceptions.*
recollection a complicated
and thoughtlessly
A look
a word
carelessly
spoken;
trivial object,
the sight of some
perhaps,token of
affection ; the melancholy
wail of the wind among
the

ditions of manifestation

or

"

trees

of the

; murmur

ocean's dash

upon

the

beach

bells
of distant village

sound

floating
upon the evening
breeze ; the strains of a plaintive
melody associated with
the sad reminiscences of the past, strike the electric
encircles,and binds the
chain," which so mysteriously
mind, and suggests a long forgottensuccession, it
be, of agonising,
burning,and, alas ! maddening
may
thoughts!
"

existed in the mind

are

afterwards associated,
and

be disassociated. This is what

what

is termed

does the presence of one

way, asks Aristotle,
another ? All our thoughtsare said to have

other.

The

laws

governingthe

exceptby disease,
In
disintegration."
determine
and
thought
duce
pro-

never

can,

the law of the

"

well-defined relation to each

association of ideas Aristotle reduces to

four,

in time and space, Kesemblance, and Contrariety. It has

viz.,Contiguity
been established,"
says Sir W. Hamilton, "that thoughtsare associated ; that is,
able
excite
each other, 1, if co-existent,
to
are
or
immediatelysuccessive in
time ; 2, if their objectsare conterminous
or
adjoiningin space ; 3, if
and effect,
of mean
and
or
they hold the dependenceto each other as cause
end, or of whole or part; 4, if they stand in a relation either of contrast or
the operations
of the same
of similarity
ferent
; 5, if they are
powers, or of difif
the
about
their objects
conversant
the
same
are
object
; 6,
powers
"

sign and
the
*
"

the

same

Lord

bluntness

signified,
or, 7, even

sound."

Kames

"

Vide

if their

Aristotle's

denoted by
are
objects
accidentally
entitled,
Essay,
JIfp\MVTJMS KOI

refers to this fact,and

"

ascribes this mental

condition to

A person
who cannot
discerningfaculty." He says,
between a slight
connexion and one that is more
mate
intiaccurately
distinguish
is equallyaffected by each ; such a person must
have
a
necessarily
flow
because
of
introduced
relation
ideas,
great
they are
by any
indifferently
;
and the slighter
relations beingwithout number
furnish ideas without end."

of the

"

452

PSYCHOLOGY

PATHOLOGY

AND

OP

MEMORY.

to sense, throw
cognizable
any light
or
phenomena of memory ?
psychical
upon the physical
as a
If,on a cold polished
pieceof metal, any object,
material

substances

"

wafer, is laid,and the metal then be breathed

when

the moisture

be thrown

into

upon

upon

view, and

to

the

it,a

and,

the wafer
disappear,
surface the
polished

discover

can
inspection

breathe

form, if we
comes

time

off,though now

critical

most

has had

upon,

trace

no

of

any
of the wafer
spectral
figure

this may
be repeatedagain and
metal
be carefully
; if the polished

again. Nay, even more

put aside where nothingcan

deteriorate its surface,

for a year, on
kept for many months, even
breathingagain upon it,the shadowy form emerges ; or,
is laid,
if a sheet of paper on which
other object
a key or
and

be

so

be carried for

few

in the

viewed
instantaneously

removed,
paper

will be seen,
disturb

nothing can
the end

into the sunshine

moments

if the paper

it,and

so

be

the

put

key on
away

the

where

kept for

thereof,if it be carried into

hot metal, the

then

taneously
dark, the key being simul-

fading spectreof

and

and

months, at
many
dark placeand laid

spectreof

the

fall upon

key will come

of bodies more
In the cases
forth.
highlyphosphorescent
than
of many
different objects
paper, the spectres
have been in succession laid originally
which
upon,
theremay
in their proper
order.
will, on warming, emerge
pressions
imillustrations show how trivial are the physical
These
and
which
preserved.
may be thus registered
pieceof

on

shadow

is said

never

to

wall

without

leavingthereupon its permanent trace, a trace which

might be made visible by resortingto proper processes.
All kinds of photographic
drawing are, in their degree,
Of the moral consequences
of
examples of this kind.
here to speak. The
these phenomena, it is not my object
the worse
ifevery secret action might
world would be none
surfaces
thus be made
plain. But if on such inorganic

IMPEDIMENTS

PHYSICAL

INTERFERING

458

THOUGHT.

WITH

how much more

impressions
may in this way be preserved,
in the purposelyis it that the same
likely
thing occurs
constituted ganglion
! Not that there is any necessary
coincidence between an external form and its ganglionic
than there is between the letters of
impression,
any more
delivered in a telegraphic
officeand the signals
a message
which
the telegraphgives to the distant station,yet
these signalsare
easilyre-translated into the original
words

"

no

and

printedpage
describe
mind

than

more

there is between

the acts

but those

of the reader

or

scenes

the

letters of
chance

they may

to

letters call up with clearness in the

the events and scenes.
Indeed, the

such traces or
quicknesswith which the mind interprets
impressionsin its registering
gangliais illustrated by
the rapidity
with which we
gatherthe sense it contains,
his eye over
or
as a skilful accountant
a long column
runs
of figures,
and seems
to come
by intuition at once to the
correct
The
which we
thus possess of
sum.
capability
final perception
or
a
determining
judgment of results,
without dwellingon
is
the intermediate traces or steps,
also illustrated by our
of music without concentrating
appreciation
our
thoughts on the time and intensities of
vibration or
interferences of the notes, though these
mathematical

harmony ;

relations

are

at

the

and

very
the

bottom

of the

ligence,
does
Supreme Intelconspicuously
God, reach with unerringtruth to every final

result without

any

necessary

concern

in the intermediate

steps."
"

From

the

that there is

we
precedingconsiderations,

necessary

may

limitation of the amount

in
capableof being registered
in this regard,all human
and, therefore,

the

infer
pressions
of im-

organism,
knowledge is
finite. Yet its term is much
farther off than might at
firstsight
of a given size may only be
appear. A library
able to contain a givennumber
of books upon its shelves,

454

PSYCHOLOGY

but the amount

be

may

PATHOLOGY

AND

to vary

with

MEMORY.

it is capable
of

of information

made

OF

the

containing

condensation

and

spicuity
per-

of the books."
In

continuityof thought,

defective

channels,considered
of

of sequence

of want

cases

many

and

impressionsto
to their

to be the media
from

the

free passage,

efferent
conductingpower

in

in

the

the

ideas, or

cerebral

nerve

for the transmission

brain,
there

or

the

either

are

exists

central

and
in

loss of

fibres,

nerve

subtle
arising(most probably)from some
morbid
unexplained,mal-nutrition,
change

pervious
im-

yet

as

the molecular

portionof their tissue,abnormal condition of what

is termed
i\\Qpolarity
of the nerve
force,or change in the
chemical constitution of brain matter not yet discovered
in the laboratory,
and at presentinexplicable
to the physiologis
and pathologist.
the
of grey matter
on
Comparing the aggregations
surface of the brain to a galvanic
hemispherical
battery
placedat the extremityof, or in connection with, a
number
of electric wires (the white or medullarycerebral
understand, if any of these should
matter),we can easily
become
and not be in healthycondition,or the
deranged,
(thebrain)itself be out of order, that the ideas
battery
of a breach
cannot be freely
transmitted (inconsequence
of continuity
in the
channels
of communication, conducting,
or

tubes)in obedience

nerve
efferent

of volition,originating
in the
of the cineritious

centre

that

the

made
impressions

efforts of the

may
*

the

mind

upon

be faint,confused, or
An

attempthas

with
rapidity

Helmholtz

which

has, by

for
required

by

the

dates
man-

primary dynamical

the cerebral mass,

the

motor

feeble
and

or

(disordered?}

sensor

powers

unintelligible.*
altogether

executed experiments
to estimate
by carefully
the electric current passes along the nerve-tubes. M.
constructed galvanic
of an ingeniousand delicately
that in a nerve
of 50 to GO millipetres
length,the

been made

means

ascertained
apparatus,
time

portionof

to the

the transmission of

nerve

force

was

from

0'0014

to 0-0020

Can

455

IDEAS.

the singular
explainby any other hypothesis
to which I am
of the mind
in the operations

we

anomalies

to refer ?

about
A

LATENT

OF

RESUSCITATION

SUDDEN

loses all

man

knowledgeof

languageacquiredin

blow upon the

of a severe
consequence
the effect of a serious derangement of the

earlyyouth,in
head,

or

as

cerebral circulation

of the brain associated with

or

with
he

an

was

molecular

alteration of the

or

an

ture
struc-

attack of fever,paralysis,
but
from the illness,

apoplexy. He recovers
of a languagewith which
entire forgetfulness
He
is advised,when
familiar !
stored
repreviously
health, to re-learn it. He

to

with the

commences

ments
and makes
an
attempt to acquirethe rudigrammar,
of the lost tongue. Whilst so doing,he painfully
fact that all recollection of what
mortifying
and highlyvalued is
he had
formerlyso well known
! He endeavours
obliterated from his memory
entirely
classicalwork, and duringa
to translate some
elementary

realizes the

determined

effort to resuscitate

appearance,

lost ideas,and

his dormant,

revive former

and, to all

by
impressions

to construe
sentence, he
a difficultLatin
attempting
conscious of a physical
changetakingplacein the brain
"

all his critical

languagerushes
of

second!

Vitetse de
"

the
have

Quick as

F Agent dan*

action be electric,
the

quicknessof the transmission

been

torrent

(Tide Comptet Send**,

Propagation de

If mental

broughtto

an

been known

to be about

Wheafetone

have

shown

exact

"

Ith Uriel's spear,"

knowledge of
like

is

the

forgotten
apparently
to the mind

back

vol. xxx., 1850. Article " Sur

let Nerfs Rachidiens.")

quicknessof thought
proverbial
"

of sensation and
measurement.

The

will

The

"

may

be

la

that is,

presumed to

speed of lighthas long

192,000 miles per second,and the experimentsof

that the electric agent travels (ifI may
so
speak)

showinga likelihood that one law rules the movements

be presumed
bodies.' Mental action may accordingly
imponderable
miles
have
in
to
a
second,a rate far beyond
a rapidity
equal to 192,000
what is necessary to make
the design and execution of any of our
ordinary
identical in pointof time which theyare."
muscular
movements, apparently
(" The Vettiget
of the Natural Hittoryof Creation,"p. 342.)

at the

rate, thus

same

of all the

'

456

PSYCHOLOGY

PATHOLOGY

AND

OF

MEMORY.

The
one.
precedingillustration is not an hypothetical
is an analogouscase :
following
Rev. J. E
talent and energy,
a clergymanof rate
of sound education,while riding
throughhis mountainous
thrown
from his carriage,
and rewas
ceived
violently
parish,
"

"

days
when

he

concussion

violent

remained

of the

For

utterlyunconscious, and

restored,his intellect was

that of

brain.

observed

at

to be in

several

length
a

state

child, or like that of

naturally
intelligent
CasparHauser, after his long sequestration.The good
his English
commenced
man
again,but now in middle life,
and classical studies under tutors, and was
progressing
when, after several months' successful
very satisfactorily,
were
study,the rich storehouses of memory
gradually
like

unlocked,

as

that

so

its wonted
culture.

in

vigour,and

few weeks

his

its former

mind

wealth

For

resumed
and

several years he has continued

pastor,and has suffered no symptom

disturbance.

The

all

polishof
his labours

of cerebral

firstevidence of the restoration

of this

whilst attempting
was
gentleman'smemory
experienced
the mastery of an abstruse Greek author, an intellectual
of that veil
effort well adaptedto test the penetrability
that so long had excluded
from the mind the lightand
riches of its former hard-earned possessions.
A clergyman,about
of
thirtyyears of age, a man
and acquirements,
at the termination of a severe
learning

illness,
was

found

to have

lost the recollection of everything,

objects His
health beingrestored,he began to re-acquire
knowledge
the names
of objects,
he was
like a child. After learning
taughtto read, and after this,began to learn Latin. He
had made considerable progress, when, one day in reading
even

the

names

of the most

his lesson with his brother, who

asked

common

was

denly
his teacher,he sud-

stopped,and put his hand to his head. Being

senwhy he did so, he replied,I feel a peculiar
"

IDIOCY

CURED

BLOWS

BT

sation in my head ; and now

knew
all this before." From
his faculties.

THE

UPON

it appears
that time

state

of the

457

HEAD.

that

to

me

he

covered
rapidlyre-

mind

somewhat

in diseases arisingfrom
occurs
analogousoccasionally
simpleexhaustion.
Many years ago, Dr. Abercrombie
attended
and
a
neglected
lady who, from a severe
reduced
state of great weakness,
to a
diarrhoea,
was
followed

by a

remarkable

lost the recollection of

the

periodof about
formerlylived in another

over

She

had

of which
which

she had

she

had

they stood

health after
of

ten

twelve

city,and

lost the recollection

years.
the time

that

was

during

each

Edinburgh. Her ideas were

other, but they referred to things

before

her

removal.

She

considerable time, but

well-established

recovered

remained

imbecility
resemblingthe dotageof
It is

or

lived in

consistent with
as

She had
failure of memory.
tending
particular
epoch of her life ex-

in

her
state

old age.

fact that

idiocy,apparently
has been cured by a
irremediable,connate imbecility,
blow upon the head!
"Who
fathom the depths,uncan
ravel
the intricate labyrinths,
and penetrateinto the
Omhia exeunt in
of the nervous
secret arcana
system ?
exclaims an old schoolman.
MyiteriuM,"
A child up to the age of thirteen was
idiotic,giving
evidence either of a total deficiency
of intelligence,
or
of a stunted intellect of the lowest grade and order.
He fell from a heightupon
his head, and was
stunned.
a

"

He

rallied from

Credat

Judaus

this state of unconsciousness, and

? found

to be

in

full

was,

of
possession

his

intellectual faculties !
A

somewhat

similar

case

is recorded

by Louyer-Vilof memory,
paralysis

suffered from a
lermay. A man
blow upon the head.
He
tunate
forwas
followinga severe
to have a
enough (as the result established)
of the physicalinjury,
and, as the effect of
repetition

458

this accident, his memory

its original
strength!*
Petrarch

memory

MEMORY.

immediatelyrestored

was

to

Pope Clement VI. found his

wonderfullystrengthenedafter receivinga
records

been

I have

that

of the brain !

slightconcussion
"

OF

PATHOLOGY

AND

PSYCHOLOGY

informed," says Dr. Prichard, on good

there was,
time since, a family,
some
"

authority,that
consistingof three

boys, who

all considered

were

injuryof the
his faculties began to brighten,
head
from
that time
and he is now
of good talents,and practises
a man
as
a
barrister. His brothers are still idiotic or imbecile."!
One

idiots.

of

received

as

them

severe

Mabillon

Father

is said to

have

in his younger

been

days an idiot,continuingin this condition until the age

of twenty-six
his head
! He
then fell with
againsta
staircase and

stone

After

fractured

his

skull.

He

panned.
tre-

was

recoveringfrom

the effects of the tion

operahis
injury, intellect fullydevelopeditself! He

and

is said to have exhibited

*

"

to
subsequently

the accident and

Dictionnaire des Sciences Me*dicales,"

vol. xxxii. p. 321.

t "Treatise

Diseases

of the Nervous

System,"by J. C. Prichard,M.D.
these and other analogousand inexplicable
trative
facts,illusrelating
of the singularvagariesand wonderful eccentricities of the nervous
he emphaticallyexclaimed, I don't bewhen
lieve
system,to a medical sceptic,
that such thingscan
!"
P"
I
asked.
He
occur
Why
immediately
Are
replied, because I cannot understand the nature of the phenomena."
and put aside everything
that is not
we," I asked, to discredit,
disbelieve,
of mathematical
demonstration, and a satisfactory
susceptible
psychological
and physiological
?
If so, how
much
valuable knowledge must
explanation
That eminent Christian,John Newton, was
told
we
once
entirely
ignore?"
zealous
Unitarian
medical
the
a
on
by
(proceeding
principle
adopted by my
friend,that we are not requiredto believe what we cannot prove, understand,
that he had carefully
and explain)
read the New
Testament, but could find no
doctrine
there
of
the
of
the
Newton
he was
knew with whom
proof
Trinity.
and answered
talking,
by saying, do you know what happened to me last
Well," repliedhis opponent, what ?"
nightP"
Why," said Newton,
1822.

on

was

"

"

"

"

"

"

"

"

"

when

could

not

do

with

too

was

goingto my

bedroom, I wondered

"

what

ailed my

caudle,that I

lightit,and on examination I found that / had been attemptingto

the extinguisher
!"
Is it not better to believe too much
than
on
littleon the principle
that
to Dr. Johnson,)
a man
may breathe (according

so

in foul air,who

"

would

die in

an

exhausted receiver."

460

MEMORY.

OF

PATHOLOGY

AND

PSYCHOLOGY

of any

complete,and there has been no recurrence

symptom of mental aberration.*
illustrations establish
The previous
1, To
under
the dominion
the mental operations
are

and

of

the

some

the

is the

cases,

the

THOUGHT

OF

separatesthe

IDIOT
drivelling
babbling,

Well

GENIUS.

"

Great
And

from

wit to madness
THIN

control

with
interferes

3, how fine and fragile

the

from

SANE

and

the

INSANE

transcendent

of

man

man,

said,

it be

may

and

degree

in
trifling,

2, how

obstruction that

PHYSICAL

healtlyACTION

is tie line that

the brain

of

matter

nervous

what

PABTITIONS

nearlyis allied,
do their bounds

divide."

precedingphenomena?
the blows
the head
Have
a
suddenly removed
upon
cular
mechanical
entanglement,or derangement of the moleportionof the brain structure,thus dislodging
any
and
have existed in the afferent
obstructions that may
with
the free and unfettered
nerve-tubes interfering
efferent
current of psychical,
force,as
sensorial,and motor
and transmission
well as with the reception
of peripheral
?
of mental impressions
mena
psychicalphenoAnalogous singular inexplicable
What

is the

are

solution

of

the

in affections of the

observed

br^in associated

is seized with
mental
ment
derangeinsanity.A man
manual
whilst engaged in some
employment, or
of a particular
idea
when
occupiedin the contemplation
and contemporaneously
class of ideas.
He
or
recovers,
with

with

his restoration

to

mental

health, the

mind

recurs

immediatelyto the train of thought or business in

all
which
it was
engaged when seized with insanity,
tween
of duration being annihilated, the interval benotion
of seizure and

the first moment

reason

and
*

appearinglike
dream.
distressing

Dr. Elisha

Harris, in

"

New

the restoration of

blank, or analogousto

York

Journal

of Medicine

"

for

troubled

1864.
Sept.,

Bergmann
who

became

similar to the
I

relates the

attended

he

have

of
was

aged ninety,
eighteen,and was
man,

he

several

seen

justreferred
lady who was

461

IMPRESSIONS.

impressionthat

an

one

case

when

insane

always under
juvenileage.

MENTAL

OF

NATURE

DORMANT

continued

of

cases
interesting

to.

reduced

by pernicious
and
apparently
hopeless

habits to a sad state of

physical
She exhibited littleor no evidence
incurable imbecility.
of any degreeof rational
of intelligence,
was
incapable
other symptoms of imbecility.
conversation, and manifested
This patienthaving been placedunder
strict
for some
recovered her intelligence.
time, gradually
supervision
The first symptom which she manifested
of a
her going to her work-box
and
return of reason,
was
takingout a pieceof work in which she was
engaged
time it was
twelve months
at which
previously,
supposed
her mind had firstexhibited symptoms of derangement.
Phenomena
of a somewhat
analogouskind are observed
with
conditions of sleepand temporary
in connexion
unconsciousness
from injuries
states of morbid
resulting
of the head.
A

person

of the

name

of Samuel

Chilton,a labourer,

Timsbury, near Bath, in the year 1696, is said to

have sleptfor seventeen continuous
weeks, from the 9th
sustained by
of Aprilto the 7th of August. Life was
of wine.
When
the dailyexhibition of small quantities
of

he

awoke

he

dressed

himself

and

walked

observes,

about

the

scious
unconperfectly
than one night. Nothing
that he had sleptmore
could make him believe that he had been asleepfor so
until,upon going into the fields,
lengtheneda period,
he saw
crops of barleyand oats ready for the sickle,
when
which
he remembered
he last
were
only sown

room,

being,as

the narrator

visited them."*
"

"

Eraser's

Magazine."

"

462

PSYCHOLOGY

It is recorded

Nile, that he

was

of

givingan

his vessel,when

of

captainat

British

OF

PATHOLOGY

AND

order

struck

shot

from

MEMORY.

the battle of the

the

him

quarter-deck

on

the

head,

him
immediatelyof speech. As he survived
depriving
taken home, and remained
he was
the injury,
deprivedof
and
Hospital for fifteen
sense
speech,in Greenwich
! At the end of that period,
months
during which he
manifested
is said to have
no
an
sign of intelligence,
almost
performed on the head which
operationwas
He then
restored him to consciousness.
instantaneously
immediately rose from his bed, and not recognising
where he was, or what had occurred, expresseda desire
had been so abruptlyinterrupted
to completethe order which
when
he received
his injuryduring the battle
!
fifteenmonths previously

was

interior

in New

sale of his farm, he

was

sold it for less than

its value.

on

an

England, sold his farm, with an intention

His
mind
purchasinganother in a different town.
of a melancholycast.
Shortlyafter the
naturally

town

of

resided in

farmer, of fair character,who

to believe

induced

and
dissatisfaction,

This

eventuallya

that

he

had

persuasionbrought
considerable

degree
neighbours

melancholy. In this situation one of his

engaged him to enclose a pieceof land with a post and
rail fence,which he was
to commence
making the next
day. At the time appointedhe went into the field,and
began,with a beetle and wedges, to splitthe timber,
rails were
the posts and
to be prepared.
out of which
On
finishingthis day's work, he put his beetle and
Two
of his
wedges into a hollow tree, and went home.
had been at work
sons
through the day in a distant
of

part of the
to

get

making
became

up
the

same

field.

earlythe
fence.

On

next
In

the

his

return, he directed them

morning, to
course

delirious,and continued

assist him

of the

in this

evening

in

he

situationseveral

RECALLED

SUDDENLY

IDEAS

LATENT

years, when his mental

The
first questionhe
reason,

suddenlyrestored.

asked, after the

sons

had

of his

return

broughtin the beetle

whollyunconscious of

appearedto be
of his
the time that had elapsed
from the commencement
His sons, apprehensive
delirium.
that any explanation
that
might induce a return of his disease,simplyreplied
He
then immediately
they had been unable to find them.
and

wedges?

had

been

at work

the

wedges

left them,

During

his

from

arose

with

He

4G3

CONSCIOUSNESS.

were

powers

his

whether

was,

TO

and
the

he

of years before, and found

he had
the ringsof the beetle where
a

number

beetle

this delirium

those

into the field where

bed, went

itself

having

his mind

with
subjects

had

which

it

mouldered

away.

not

been

was

conversant

occupied
in

health.*
Mrs.

S
,

intelligent
lady, belonging to

an

respectable
familyin the State of New York, some years
She devoted
back undertook a pieceof fine needlework.
for a number
of
her time to it, almost unceasingly,
days. Before she had completedit she became suddenly
In this state,without experiencing
insane.
any material
of her disease,she continued

abatement

for about

seven

her reason
was
suddenlyrestored. One of
years, when
which she asked, after her sanitywas
the firstquestions

restored,related

to her needlework

It is

remarkable

the

long continuance of her mental

aberration,she said nothing,so far as was
recollected,
about her needlework, nor concerning
any of the subjects
in health.
that usuallyoccupiedher mind when
In the Transactions of the French Academy of Sciences
illustrative of
for 1719, there is publisheda statement
It is as follows :
the subject
under consideration.
A
nobleman, residingat Lausanne, whilst giving
orders to a servant, suddenlylost his speechand senses.

fact that,

during

"

"

Dr. I'richard

on

"

The

Diseases of the Nervous

System."

464

PSYCHOLOGY

Various modes
intellect to

PATHOLOGY

AND

of treatment

adopted to

were

state, but

sound

MEMORY.

OF

for

restore

his

considerable

very

appearedto be
of everything.
in a deep sleep,apparentlyunconscious
At
the end of that period a surgicaloperationwas
to restore
decided upon and performed. The effect was
When
him to the use
of his speech and consciousness.
he had been
he recovered, the servant to whom
giving
orders upon
enteringthe room, was asked by him if he
had
he was
done what
mencement
requestedto do at the comterval,
of his illness,
that any innot being aware
except perhaps a very short one, had elapsed
duringhis attack."*
A girl,
aged six years, while indulgingin a game with
her playmates,
tossingand catching playthingson the
pavement, failed to notice somethingthat was thrown to
about
her, and while hurriedly
seekingfor,and inquiring
time

effect.

without

it,made

false

was

watched

after the

hours

six months

fell upon

step and

cerebral concussion
she

For

appearedto
much

with

She

accident.

he

the

have

pavement. The
been violent,
and

anxiety for

about

ten

then, for the first time,

opened her eyes and manifested signsof consciousness.

She then immediately
jumped to the margin of her bed,
is it? where
did you
throw
it?"
exclaiming,"where
And
throwing littlearticlesfrom
immediatelycommenced
her dress, exclaiming, catch these !" By these acts,
she was
continuingthose physicaloperations
manifestly
and train of thoughtwhich had been so suddenlyarrested
by her fall. No marked vascular reaction occurred in
contracted duringthe
this case ; the pupilwas
very much
first six hours of the periodof concussion, the pulsesoft
"

and

hurried

she vomited

much, but

the moment
eyes at any time until
*

The

Academy

received

this

Professor at Lausanne, and author

statement

of

Treatise

did

not

of her sudden
from
on

open

her

restora-

Crousaz, Mathematical

Logic,"c.

ARREST

SUDDEN

OF

tion to consciousness.

Her

465

INTELLIGENCE.

recovery

was

perfectfrom

that moment.

clergyman was, one

wintry day, employed in
of their
with a friend; in the course
snipe-shooting
a
perambulations,
high hedge intervened between the
companions. The friend fired at a bird which sprang
unexpectedly
up, and lodged a partof the shot in the
forehead of the clergyman. He
and did
fell,
instantly
not recover
the shock for some
days,so as to be deemed
out of danger.When
he was
that he
perceived
so, it was
was
mentallyderanged. Pie was to have been married
two days subsequently
the accident
which
to that on
combination
of circumstances,
happened. From this peculiar
the phenomena of the case
for
appearedto arise,
all sanity
of mind seemed to make a fullstop,as it were, at
A

this spot

of

inoffensive

the current,and

lunacy.All

to the business

his mind

he

sank into

soon

his conversation

of the

deviated.

He

wedding.
dwelt

was

state of

fined
conliterally

Out of this circle

lating
everythingreto it with minuteness, never
or
retreating
advancing
stilla young,
one
ideally,
stepfurther foTjIffy
years, being,
and happybridegroom,
diness
active,expecting,
chidingthe tarof time, althoughit brought him, at the age of
known
to
eighty,gentlyto his grave ! He was never
complainof heat or cold,althoughhis windows were open
never

upon

all the year round.*

A

the

gentleman,on

the

bride for

short

stage coach

Gall
him

that of

in

saw,

to

an

state

the

to

took

journey he
*

one

at

of almost

hundred, but

the figureone

it

wad

was

the

last of his

whose
Vienna, a lunatic,

life.

had
insanity

duced
re-

completeidiocy. Ilia onlyoccupationwan

could count
hundred.
to one
At the figure

but he never
counting,
he invariably
stopped.

ninety-nine
say

her

from
asylum

tended
pointof marriage,left his inHe
travelled in
time.
usually
placeof her abode. The last

Gall tried

he
useless,

to induce him to
frequently
alwaysbegan againto count from

I
H

406

PSYCHOLOGY

AND

PATHOLOGY

Anxiouslyexpectingliis return, she

vehicle. An

old friend announced

lover.

uttered

She

exclamation,
for

"

ffty years,

went

is dead !"

has

this unfortunate
the distance

From

that

the

I will return

"

to
"

He

all

in
daily,

miles to the

of many

she

yet

piteous

fatal moment,

female

expectedher future husband

coach, utteringin a plaintive
tone,

where

and

involuntaryscream

an

the

meet

to

to her the death of her

He

traversed

seasons,

MEMORY.

OF

spot

alightfrom
is not

come

to-morrow."*

Garrick's

King Lear is said to have been this great

tragedian's
masterpiece. His delineation of the acute
of the unhappy monarch, consequent
mental
sufferings
of his daughter's
is recorded
ingratitude,
upon a recognition
of the most
terrible and natural pieces
of
as
one
actingever witnessed upon the stage. Garrick admitted
that he owed his success
in Lear to the following
fact
whilst playingwith his only child at
A worthy man,
let it fall upon
the pavean
open window, accidentally
ment
:"

The

beneath.

screamingwith
child into his

until the

agony,

arms

He

passedthe
going to the

remainder

at the

window,

neighboursdelivered the
became insane,
instantly

corpse ! He
that moment
recovered
never

from

and

father remained

poor

his understanding

of his

long and wretched

window
life in
and there playingin fancy
with his child,then
appearing to drop it,immediately
the
burstinginto a flood of tears, and for a while filling
house with his wild and unearthly
came
shrieks.
He then bein a state of profoundgloom,his
calm, sat down
and
his mind
one
object,
eyes fixed for a long time on
intenselyabsorbed in the contemplationof a fearful
image. Garrick was often presentat this heartrending
thus it was," he said, I learned
of misery,and
scene
!

"

to imitate
A
*

young
This

case

"

madness.".

gentleman having 10,000/. undisposedof

is related in the

"

Monthly Mirror,"for August, 1799"

4GS

MORBID

PHENOMENA

OF

CHAPTER

Morbid
THIS

XVIII.

Phenomena

function of the

MOTION.

of Motion.

Cerebro-Spinal
system may

be,

Impaired,

a.

/8. Lost,
7.

Exalted,

S.

Perverted.

impairment,I propose to consider

all those exceedingly
subtle and insidious cases
of paralysis
for
which
a
are
length of time by a
preceded
force and an enfeebled state of the
of motor
deficiency
muscular
This
condition
of motilityis often
power.
with generalphysicaldebility,
and attracts
confounded
notice until more
obvious cerebral symptoms
no
special
affection is quitelocalized.
appear, or the paralytic
In the second
division of the subjectare classified
Under

the head

of

of lesion

those

cases

ceases

to exercise any

of motion
influence
of

in well-developed
cases

as

In

states

spasm,

the

of motor

tonic

and

we
motility,

in
over

the

we

have

observe

as

the

volition

limbs,
paralysed
hemiplegia and paraplegia.

exaltation

clonic,and

which

condition

of

in

conditions
of
perverted
epilepsy,
typesof the affection,

tetanus, convulsions,and chorea.

It
either

affections
important,in consideringparalytic
advanced
in their incipient
or
stage,to recognise

is

DIAGNOSIS

BETWEEN

CEREBRAL

AND

the threefold division of which

These

affections of

motility
may
a.

0.
7.

In

SPINAL

4G9

PARALYSIS.

the

subjectis susceptible.
in their originbe,

Cerebral,

Spinalt
Peripheral.

other

in the brain,
words, paralysis
may commence
ramifications of the nerves.
spinalcord,or in the peripheral
It may

be

centric

eccentric affection. How

important
it is,when
this subject,
to
investigating
practically
this physiological
and pathological
classification
recognise
a

or

an

of the lesions of the motor

of

and
diagnosis,

success

Dr.

Hall

Marshall
the

power, with

view to accuracy

of treatment.

points out

with

his usual

criminatio
dis-

distinction between

of sponparalysis
taneous
motion
and voluntary
arisingfrom the removal
of the influence of the cerebrum,from parts in communication
with it,and the lesions of motility
which
result
from an arrest of the supplyof nervous
influence from
the spinalmarrow.
In cerebral paralysis,
there will be
and in spinalparaalwaysfound augmented irritability,
lysis
the irritability
is either diminished
or
altogether
lost.
"

We
"

muscular

logist,
physiomay conclude,"says this distinguished
the irritability
of the
that in cerebral paralysis,
fibre becomes

augmented

from

want

of the

of the stimulus
of volition; in paralysis
application
and its nerves
from disease of the spinal
marrow
arising
this irritability
is diminished,and at lengthbecomes extinct,
from its source
beingcut off. We may further deduce
that the spinal
have been detailed,
from the facts which
of
and not the cerebrum, is the special
source
marrow,
muscular contraction,
of exciting
the power in the nerves
of the muscular
and of the irritability
fibre;that the

470

MORBID

cerebrum

is,on

PHENOMENA

MOTION.

OF

the

the exhauster, throughits

contrary,
acts of volition,of the muscular irritability."
GENERAL
MUSCULAR
For
DEBILITY.
some
period
before any positive
lesion of motility
is perceptible,
the
patient
complainsof a generalfailure and loss of muscular
is easily
He
tired ; is obliged,
if engaged in a
power.
sit down, complainingof fatigue.
walk, to frequently
This condition of muscular
is observed to precede,
debility
for some
form
of
length of time, any local or specific
paralysis.
As
the affection of the brain, involving
disordered
a
state of the motor force advances, the patient's
feet slip
side. He
is observed
on
one
frequentlyto stumble
whilst walking,as if the ligamentsof the ankle-joint
weakened
or
were
elongated.He cannot put his foot or
conscious effort.Succeeding
leg forward without an obviously
this generaldeficiency
of muscular
power, there
is occasionally
noticed a want
of local specif
motor
c
strengthin one of the limbs.
"The
in
patient experiencesa greater difficulty
executingforced and limited movements, than those in
which he merelyfollows the impulseof his inclinations ;
he finds it much
with a
laborious to walk
more
slowty,
measured
than to let his feet
stepin a given direction,
take their own
the chair,or going
course
; risingfrom
difficult than sitting
is more
down
ing;
descendor
up stairs,
"

the

next

difficult matter

walking."*
In the earlystage of
made

of

side of the

weakness

is to

cerebral

in the arms,

Romberg.

Dr.

round

in

disease,
complaintsare
hands, legs,or
be

body.f Objectscannot
*

turn

in

one

or
firmly
grasped,

translation.
Sieveking's

side
loss of power
in the extremities of one
states a
f
while walking,so that the patientis compelledto sit down
fall,without
or
Dr. Fuch

sudden

Bufferingany loss of consciousness,to

of the brain. Among
symptom of softening

be
the

important and
earlysymptoms of

an

diagnostic
thin disease,

EARLY

SIGNS

OF

SOFTENING

OF

THE

DRAIN.

471

or
comfortably.There is often in these
steadily
in using one or both hands.
awkwardness
cases
an
before
In a case
related by Andral, for some
months
which
attack of paralysis
ended fatally,
there was
an
a
in the righthand, and to such an
loss of power
extent,
that the patient
could not hold his pen when in the act
of writing. There
was
no
impairment of sensibility,
in the rightarm,
affection of the motility
in any
or
of
other part of the body. Andral
In cases
says,
the patients
that one of the
incipient
paralysis,
perceive
than the other, one
of the
extremities has less strength
hands can hold objects
less strongly
than the other ; one
of the aims
appears insensible to them, or the patients'
legsdrag a little in walking." He continues, and the
observation is of great practical
this commencement
significance,
of paralysis
for a lony
stationary
may remain
else it
to increase,
time, then it is seen progressively
or

held

"

"

becomes

all at

once

more

considerable."1

had
previouslymanifested no
gentleman who
observed frequently
to
was
symptom of decided illness,
drop his stick,as well as his umbrella, in the street.
This was
for some
the first loss of motilityobserved
weeks priorto an apparently
sudden and acute attack of
followed by paralysis.
apoplexy,
A
patient,aged sixty,previouslyto an attack of
cerebral hemorrhageof which he died, exhibited in the
lection.
incipient
stage,indistinctness of speechand loss of recolof the
He appeared,
at times, to have a weakness
A

it affectsthe eyebrowand
paralysis.Occasionally
of the eyelids,
The patientappears to have lost power over
the mouth.
one
is
raised.
ifit
be
One
too
to
were
as
heavy
eyebrow more elevated
completely
side.
ia occasionally
than the other.
The mouth
on
to be drawn
one
seen

is a

slight
degreeof

facial

Durand- Fardel says, ir" may almost

dict
presymptoms are present,
t
hat
toflening
of the brain it 'hreatcningor has already
certainty
the same
attacks of paralysis,
commenced.
These apparently
slight
authority
ence,
with an astonished look,or one of stupor,indifferare
observe*,
accompanied
When

these

icith

or

idiocy.
"

Andnl's

"

Clinique."

472

MORBID

right arm,
from

the

muscular

stage of

OF

MOTION.

observed to drop things

being occasionally
righthand, but did not admit that he felt any
weakness.
He
made
no
complaintin this
that he
headache
but admitted
or
giddiness,

weak

was

PHENOMENA

and

in

able to bear

did

condition, and

exhausted

an

fatigue.Eighteen
days afterwards he exhibited confusion of thought,and
when
linquish
endeavouring to write a letter,was obligedto rethe attempt. He complainedthat he could not
of what he was
make
sense
engaged in writing. The
words as he wrote them
he said, to run
one
appeared,"
The
letter when
finished was
into the other."
scarcely
He died nine
and the lines were
legible,
very crooked.
days afterwards of apoplexy.
disease of the
loss of motor
in incipient
The
power
this
brain is occasionally
confined to one of the fingers,
being the onlyappreciable
symptom calculated to excite
A
alarm.
These
curious and inexplicable
are
cases.
of
affection of this kind has been recognised
as one
partial
and apoplexy.
the firstthreatening
symptoms of paralysis
A gentleman,
for some month* before he had an attack of
in the
cerebral hemorrhage,complainedof loss of motion
little finger,
and called the attention of his physician
to
feel himself

not

much

"

*'

the

fact.

but

about

symptom

There
week

of

considered
For

was

two

unable

his mouth
on

time,

after this

premonitory
patientsaid his

at the time

of any consequence.
before an attack of paralysis
a patient

months

into
or put any liquid
facility
himself, or spilling
a porslabbering
tion

to swallow

without

the table

or

with

on

his clothes.

irritation at the time, but

of any

days

at the

lump of lead." There was also a

hearing; but these symptoms were
"

in the

headache

observed, the

was
paralysis

slightdefect
not

ten

or

felt as if it were

head

marked

no

was

It
importance.

it

was

was,

not

This

caused

considered

however,

much

symptom
the -firstappre.

IN.

affection of the

APOPLEXY

AND

473

PARALYSIS.

fact,the commencement

in

sign,and,

ciable

OF

SYMPTOMS

I I'll NT

of

morbid

Three weeks
afterwards
power.
weak
that the patientcould
so

motor

righthand became
in it. Subsequently
he was
not hold anything steadily
for dinner,with an attack of paraseized,whilst dressing
lysis,

the

continued

and

of

his

powers

of

symptom
his

which

in

time

state of

consciousness,
un-

he

of disease of the brain.

known

I have

"

short

eventuallyrallied,but
much
enfeebled.
A
mind
paralysisof the
is often observed
as
an
deglutition
incipient
out

with

for

legs,then

talk

person

first lose the

fiddle
childishly,

with

strengthof

his knife and

fork

during dinner, to the confusion of his family,

attempt in vain to direct the morsel to his mouth, and
at lengthcarried to bed several hours before he became
apoplectic."*
to hold the pen when
to draw
on
Inability
writing,
the boots, (inconsequence
in the muscles

of morbid

of the arm)

loss of motor

to handle

the

razor

power

steadily

when

of defective muscular
shaving,(in consequence
to playthe pianowith the usual
strengthin the fingers,)
have been observed (in several cases)
vigourand facility,
to be the firstwarningsof approachingparalysis.
Dr. Ulric of Berlin has detailed an
resting
exceedinglyinteillustrative of this incipient
case
stage of paralysis.
It is also valuable as pointingout the gradual,
and progressive
of cerebral
march
insidious, stealthy,

disease,when
In

this

established within

once

instance, the
particular

disease of the brain

dying at

the age

of

was

observed

at

progress of the malady was

six years a condition
of muscular
On

Nerwnu

Cooke.M.D.,

1820.

first

symptom

of

the patient
eighteen,

twenty-xijc!

The

"

the cranium.

Diieatct, in 2 volfi.
; vol. 1, On

as

follows

"

For

existed.
sluggishness
Apoplexy,"c.

by

John

474

MORBID

This
and

PHENOMENA

OF

MOTION.

graduallyincreased. The limbs

the motor
began to fail. At
power

became

heavy,

the end

of six

patienthad
Then
followed great difficulty
and strabismus.
diplopia
of walking. The
became
gait subsequently
vacillating,
and the feet appearedf/lued
at every stepto the ground."
Importantand significant
incipient
symptom of paralysis!
The patient
then was
attacked with a general
numbness
and paraplegia.
He next was
to cramps
subject
affecting
the extensor muscles of the greattoes. A
year afterwards

years, the

the

obscured, and

sightbecame

"

he

had

the

was
paraplegia

tetanic

of the

spasms

muscles

converted

into

In

the

of the

back, and

of the upper
paralysis
and lower extremities. The paralysis
became
ultimately
and respiration
and
were
general,
deglutition
impossible,
the patientis said to have died with
his intellectual
faculties unimpaired!" The
examination
post mortem
revealed a state of softening
of the pyramidal and
olivarybodies,as well as of the left half of the pons
varolii. The
restiform bodies were
coloured
slightly
red.
MUSCULAR
disease of the

TREMOR.

"

brain, a tremulous

of

precursory

stage

state of the

muscular

fibre is

In one
observed.
remarkable case,
occasionally
for nearlya fortnight
to the manifestation of
previously
observed to
was
any acute head symptoms, the patient
have a tremulous
He
state of the hand.
appearedat
the time otherwise
in good health.
This condition
of
succeeded
the muscles was
by violent paroxysmalattacks
of headache, causingthe patientto scream
from the
died paralytic.
of the pain. He
intensity
subsequently
When
examined, after death, a malignanttumour
was
found
A

the

in the substance

tremulous
forerunner

gentleman,who

of the brain.

state of the
of

had

acute

tongue has

been

cerebral attacks.

for many

years

noticed
A

as

military
honourablyserved

476

MORDID

PHENOMENA

OP

MOTION.

elated with other characteristic evidences of cerebral mischief.

I have known

months
before
patientfor some
attack
of hemiplegiacomplain of acute
of
an
spasm
muscles of the calf. Occasionally
the spasm seizes hold of
the whole of the leg,which becomes
quitetetanic. This
symptom is observed in the earlystagesof acute cerebral
with
connected in some
irritation,
cases, but not always,
organicdisease of the nature of inflammatorysoftening
of the brain.
A sensation of slight
stiffness of the limbs,
combined
with pain,analogousto that of rheumatism,
companied
spasm, and convulsive twitchingof the muscles, if ac"c.,
by headache, mental confusion,vertigo,
should

never

escape

IRREGULAR

want

is

in

absence

an

ACTION.

observation.
In the

"

the patient
exhibits
motility,

unsteadiness

There

careful medical

MUSCULAR

of disordered
and

second

inequality
the action of the muscular
system.
in the motility,
of co-ordination
a

of consentaneousness

in the motor

an

movements,

to quote the languageof Eomberg,

disturbance,"

in

the

antagonism,or

balance."

This

stage

condition

in

the

either

symmetricalmuscular

of the motor

to that affection termed

"

"

by the

power

French

is analogous

pathologists,

croisee.
Paralysie
in walkingalways crosses
The patient
one
leg over
the other.
For
example, he places the rightfoot
before the left,and the latter again before
invariably
the right; in doing this, the front of the foot is
turned inwards, the individual generally
steppingupon
the external margin of
his toes, and but rarelyupon
the entire sole ; the largetoe of one foot strikes against

the Achilles tendon

Eomberg
affections of

has

of the other.

described

motility.When

with

great accuracy

to
alluding

the

these

incipient

the gait becomes

signs of brain disease, he says :
when
the patientis
and insecure,especially
tottering
"

WANT

MORBID

MUSCULAR

OF

477

CO-ORDINATION.

he wishes to walk from one

walking slowly. When
placeto another, he is obligedto givehimself an impulse
renders his mode of progression
which
the
repeatedly,
more
movements, such as
peculiar.When
complicated
the exertions made
climbingor jumping,are attempted,
to achieve them

When

the

no

relation to the result attained.

commenced
patienthas fairly

accelerate

can

bear

his

lyingin bed, so that the trunk

in moving his feet.
difficulty
articulation becomes
;

legsare
body.

is
As

even

the

run

disease

limited,and

still more

advance, he
;

he
supported,

it is almost

when

has

no

advances,

indisvery tinct
words ; the

necessary to guess the

almost deprivedof their power to support the
When
the insane person
rises from his chair

walks, he

and

and

movements,

to

rests

his

hands

the

upon

back

of his

and, like a child that

slowly,
bends to the right,
is measuringits first steps,
and bends
then makes
to the left,
an
attempt and drags himself
slowlyalongin a zigzagdirection. He stumbles over the
most
trifling
impediment,and is constantlytumbling
exist for a
down."*
These affections of the motility
may
decided and
long periodbefore symptoms of a more
alarmingcharacter awaken attention and excite apprehension.

chair; raises himself

up

Romberg candidlyadmits

that he

is unable

to

factorily
satis-

action
irregular
in hemiplegic
of the motor
power, he observes, occurs
of cerebral hemorrhage.
in cases
and especially
subjects,
with
when
in active locomotion, advances
The patient,
the healthyfoot,which forms the fulcrum of the body,
while the paralysed
extremity,with the toes pointed
downwards, performscircular or semicircular movements
and with a sort of slide. The other is met with
slowly,

explainthese phenomena.

"

M.D.

"

Manual

of the Nervous

Translated

from the German

Man," bjrM. II. Romberg,

II. Sievekiiig,
M.D.
London, 1853.

Disease*

by K.

of

The

478

MORBID

OF

PHENOMENA

MOTION.

of
before the supervention
patients,
hydrocephalic
described
and has been accurately
complete
immobility,
by Gb'lis.
When
engagedin walking the patientdrags one of
the
the one
heavier than
his legs,as if it were
on
exists to so
side. This symptom occasionally
opposite
time
that it may
be present for some
a
degree,
slight
and be unnoticed, unless the attention were
particularly
in

system and

directed to the state of the muscular

powers

of locomotion.
The

patientis

often

to roll himself

seen

about

like

lost his balancing

entirely
of approachinggeneralparalysis,
this
In cases
power.
symptom is often observed in a remarkable degree.The
and walk closely
resemble that of a man
gait,
gestures,
These
irregularactions of the
slightlyinebriated.
muscular
system are allied to the phenomena observable
advanced
in the earlier as well as in the more
stage of
a

drunken

as

man,

if he had

Chorea.

ACTION.

CONVULSIVE

irregularand

I have

"

morbid

states

to consider

now

of

the

motor

those

power

or

grouped under the head, congenerally

in
vulsion.
Among this class of affections,
epilepsy,
all its varied types and degreesof manifestation,
pies
occua prominent position.
muscular

fibre

of

This disease admits

a.

threefold

viz. :
division,

Epilepsy.

(With violent muscular

movements.)

ft.Epilepsy.

(Nocturnal in
with

its

and accompanied
character,

muscular
slight
7.

convulsion.)

EpilepticVertigo.

(AVithoutmuscular

convulsions.)

OBSCURE

This

TYPES

OP

NOCTURNAL

479

EPILEPSY.

affection is

divided by writers into

generally
two
without convulsive
classes,viz. epileptic
vertigo,
with convulsions,
action,or the Petit -mat, and epilepsy
:

or, the Grand-vial

but there exists

modified

type

of

at nightwith slight,
and
epilepsy
occurringgenerally

often

unobserved, convulsive

by the

late Dr. Marshall

Hall

muscular
"

Hidden

is distinct (not in its nature,but in its

(termed

action

which
Seizures,")
form of manifestation]

from the true

convulsive paroxysm.
epileptic
The important
phaseof epilepsy,
designated epileptic
will be fully
or
seizures,"
vertigo,"
epileptiform
considored in the succeedingchapteron
the
Morbid
"

"

"

Phenomena

of Sensation."

The attacks of

that
epilepsy

are generally
night,
by littleor no marked disturbance or irregular
accompanied
action of the muscular system. Occasionally
the convulsive
is analogous
to an
movement, when it takes place,
attack of simplespasm, and in many cases
the epileptic
resembles an apparently
fitclosely
ing"
unimportant"twitchof the muscular fibres generally
observed to occur
of insidious epilepsy
cases
during sleep. How
many
I have detected,particularly
children,
by these
among
symptoms !
This obscure typeof what Dr. Trousseau terms, nocturnal
exist for months, and in some
epilepsy,"
may
for years, without attracting
until the
observation,
cases
undermined, and the
bodilyhealth has been seriously
and irremediably
mental powers fatally
impaired.
from these hidden,and for a time
Patients suffering
unobserved, attacks,complainof great muscular,vital,
disturbed and unrefreshing
and nervous
debility,
sleep,
and headache,particularly
of spirits,
first
on
depression
waking in the morning.
seizures that occur
at night are unIf the epileptic
detected,
and allowed to proceedwithout any remedial
to arrest their fatal progress, the
treatment beingadopted
occur

at

"

480

MORBID

PHENOMENA

OF

becomes
physicalhealth generally
and the

mind

sinks into

soon

MOTION.

seriously
impaired,

condition

of senile imbecility.

psychicalmanifestations are,
incipient
weakened
lassitude,
impaired
powers of attention,
The

mental

and
enfeebled volition,

memory,
all the

and

importantconcerns

marked

indifference to

business of life.*

in the previous
referred,
pages, to the acute affectionsof the memory
of
various
types
epilepsy.Dr. Russell Reynolds,when speakaccompanying
*

I have

impairmentof

this

associated with what he terms

faculty
generally
observes :
By far the commonest
At firstit is noticed only with regard
and earliestchange is loss of memory.
to the trivial matters of the day, whilst those long since passedare readily
the patientforgetsthe earlier elements
recalled.
of his
Subsequently,
terioration
knowledge,and his mind then becomes an utter blank. The progress of dethat which is natural to the decayof
resembles,in many respects,
the work of time, and hurrying
human
life;often,as it were, anticipating
and more
a justopeninglifeinto a prematureold age, with all its feebleness,
Failure of memory
than all its gloom.
(exceptwhen occurringonly as the
is commonly attended with diminished
immediate
sequelof severe attacks)
and
this
is
firstmost marked with regardto new
of
at
apprehension
;
power
ideas,but subsequentlyappears to affect the mind in relation to previous
of applyingpast experience
the power
to the new
knowledge,diminishing
circumstances of dailylife. The patient
does not, concannot, or frequently
centrate
his thoughtsupon
another,it may
any subject. Ideas follow one
be in very rapidsuccession,
as
they are accidentally
suggestedby one another,
When
this power is onlyslightly
or
by surroundingevents.
deteriorated,
the mind may be recalled by a strongeffort,
or
a powerfulimpression
; but
this becomes impossible,
when the intellectualdisease has advanced further,
indicates but too plainly
and incoherence of expression
the incoherence of
thought,which may pass stillfurther into utter fatuity.
earlier mental changes resolve themselves mainly into defective
These

ing of

'

the

Phenomena,"
(Epileptic)
Interparoxysmal

"

"

firstfailureof memory
anythingelse. The individual

volition.
to

going

on

The

for

which

power

deep impressionsto
can

recollectthem.

of consciousness

by

an

same

not

of attention

ruther than

attend to what is
sufficiently
there is no
consequently
be
to
tion
simplythe direcappears

be made, and

Attention

effort of volition ; and in this firstfailure there

is the firstindication of diminished

has its originin the

is due to want

does

cause

attention.

will.

Probablythe

it is the consequence

loss of
of

apprehension
neglectedor not

becomes
simple disuse, the power
observed with regard to thought.
which in mental health form the basis of correct judgment
The associations,
from having their ground in the truest relations
and logical
appreciation,
discover between separate
which we
ideas,are lost altogether,
can
or
are
placed
reof
accidental
inessential
character
associations
and
or
a
merely
by
;
from the deficiency
of voluntary
thoughtbecomes incoherent,or wandering,'
exercised in its direction and control.
Thus, with deficient volition,
power
the epileptic
isreduced
and with increased readiness of emotional disturbance,
or
to a mere
machine, playedupon by every external impression,
suggested
to appreciate,
account
and without any power
for,or control his
feeling,
state." Lancet,Aug. 4 and 11, 1855.

properlyexercised
diminished.

The

same

By

thing is to be

'

"

SYMPTOMS

PREMONITORY

Tliis mischievous

of

form

OF

481

EPILEPSY.

Trousseau thinks,
epilepsy,

for

eightor ten years without any one, not

of its existence.
the patienthimself,beingaware
even
There are,"he says,
two principal
diagnostic
signsin
such a case, viz.,the biting
of the tongue,and the t"emission of urine, especially
in women.
If
voluntary
the person who
to consult you complainsof
comes
waking with headache, if the lateral partsof the tongue
continue

may
"

"

lacerated,and

are

if you

ascertain

can

been

do
passedunconsciously,

that

there

has

been

not

urine has

hesitate to declare
attack

nocturnal

that

of

epilepsy.

of cases, you may

observe on the forehead,and especially
below the eyes,
the size of a pin'shead, which are
myriadsof petechise,

Moreover,

never

in

very

producedunder

great number

other

circumstances.

In sion
possesof this form of the
the diagnosis
of these details,

disease becomes

certain,while

without

their aid it is

alwaysimpossible."*
The
premonitorysymptoms of ordinaryattacks of
of the
to the proximatecause
epilepsy
vary according
disease as well as constitutional temperament. Many
of the approaching
have clear intimations
patients
These warningsI have known
convulsive attack.
to
for several days priorto the accession of a
occur
Some
patientshave disturbed dreams for
paroxysm.
to the attack ; others are subject
nightspreviously
many
to spectral
illusions;occasionally
complainof
patients
almost

to fiveyears'
imprison*
aged twenty-twoyears, condemned
without
amices
for
of
one
ment
havingutruck,
provocation, of his
by a court
killed
to attacks of epilepsy
him, was subject
beat friends a blow which nearly
the
where this
been
able
this
fact
in
I
have
to
pritton
verify
duringsleep.
"

A young

man

confined,who was
was
unhappy man
insane
might be counted epileptics,
cerebral

hemorrhage.

had

He

no

descended

from a familyamong
whom
and
individuals
who
had
died
of
persona,
clear recollection of the criminal offence

neither did he show the least regretfor it.

incriminated,
of his disease,
did not contribute
the
This apparentinsensibility, consequence
for which

he

was

"
A
littleto his condemnation.
A. Morel.
Paris,1860, p. 695.

"

Trcatite

on

Mental

Diteatet,"by Dr.
I I

B.

482

MORBID

PHENOMENA

OF

MOTION.

singularand perplexingtrains of thoughta few hours

before the fit. I have known
to be precededby
epilepsy
remarkable

affections of the motor

power,

lesions of

sibility,
sen-

the
sounds within the head, resembling
peculiar
of bells,roar of the sea, bleating
and in
of sheep,
tinkling
the patientsaid that for two dayspreviously
to
case
one
his usual epileptic
he heard distinctly
sounds
paroxysm,
from a number
like those proceeding
of persons quarrelling.
In
the
mental
the
faculties,particularly
one
case,
exhibited great aftd unnatural
exaltation a few
memory,
hours anteriorly
of hearing
to the fit. The patient's
sense

and

A child who
acute.
is
seeingalso became painfully
becomes
subjectto epilepsy
extremelyagitatedin body

for several hours before the paroxysm.

the house in a state of greatterror and

and

excited in mind

He

rushes

about

alarm, and if

an

attempt be

made

to

control his

ments,
move-

with those who interfere

struggles
In some
with
him.
racterized
cases, the incipient
stage is chaby great depressionof spirits.This often
in the hysterical
occurs
types of epilepsy.A patient
I saw,
whom
always barked like a dog a few hours
In another
the fit was
before the attack.
case
preceded
by intense irritability,
occasionally
amounting to violent
is always
lady subjectto epilepsy,
passion. A young
able to indicate the approachof the convulsion by the
of a bright halo surroundingevery object
appearance
A
she gazes at.
youth,who has for five years been
he strikes and

afllicted with

the

disease,informs

me

that

for

an

hour

seizure he hears a sound

in his
priorto the epileptic
the tickingof a watch.
A patient,
for
head resembling
hours before his epileptic
attack,affirmed that he
a few
heard the voice of a deceased relative speaking
distinctly
riably
of affection. This symptom invato him in terms
precedesthe convulsive fit. A young boy subject
is always conscious of the
to acute and violent epilepsy

484

O?

PHENOMENA

MORBID

MOTION.

to be about one-fourth.
Herpin states the proportion
than four or five per
M. Georget affirms that not more
seizure have any
cent, of those attacked with an epileptic
of seventeen
M. Beau
givesthe proportion
premonition;
and Dr. Cheyne give no
M. Foville,Esquirol,
per cent.
the
numerical
ratio, but state that in much
greater
of epilepsythere are no
of cases
number
precursory
symptoms.
of invasion of his
at the moment
A young
epileptic
with the left eye, a toothed
fit perceived,
exclusively
wheel, the centre of which was
occupiedby a hideous
of epilepsy
there may
be a special
cases
figure.In some
the fit is invariably
premonition.In one of my patients,
of hunger. In another
precededby an intense feeling
since insane, a littleblue imp perchedupon
the
patient,
he lost his
at him
as
table, and moped and mocked
In a third, a guitar seemed
consciousness.
to have
the ear.*
been roughlygratednear
Remarkable
intellectual activity
has
sometimes
the commencement
of epilepsy
signalised,"
says Morel,
A wonderful
the young.
aptitudeto conceive
among
them under their most
to examine
liant
brilthings quickly,
and poetical
has been exhibited by many
of
aspects,
them.
to us
the names
of
History has transmitted
of great geniuswho
have been epileptics
several men
;

M.

"

"

"

but, as the late Dr. Gr. M.

have

been

Burrows

the victims

viduals
remarks, these indi-

of the

most

tyrannical

of the faculties
The full and entire preservation
passions.
of applyingthem in a conthe possibility
of epileptics,
tinuous
of designsremarkable
to the execution
manner
for their grandeur and continuity,
facts excessively
are

rare."

"

There

however," says M. Sandras, some

this rule, such
as
Caesar, Mahomet,
"

are,

exceptionsto
Petrarch, "c."
"

Dr. Radcliffeon

"

and
Epilepsy,

other Convulsive

1868.
Affections,"

p. 144.

PREMONITORY

'The

first

SYMPTOMS

OF

changes,"continues

48

EPILEPSY.

the

authority,
"that
remarked
in the
character
of epileptics
are
threatened with insanityis, a
very great irritability
which takes placewithout, and even
at the least contradiction,
under

the

most

compromising,forms.
it is natural
of

to

have
epileptics

constitute the

see

varied, and

same

sometimes

most

In the first periodof their affection

that the diseased

point d'appuiin

preoccupations
which

the elements

of temperament and
great diversity

racter.
cha-

niable
Hypochondriasisand hysteriahave an undeaction in the delirium which beginsto systematize
itself in the mind of the patients.
the
on
Preoccupations
tions
subjectof their health, unjust complaints,recriminawithout

foundation, decided venereal

facts which

tendencies,

justsolicitude of families."*
Dr. Sieveking,
has described
in his able treatise on epilepsy,
and with great accuracy,
at considerable length,
Of
the premonitorysymptoms of the disease. He says
have been under my
of epilepsy
which
cases
fifty-eight
I have
own
preservedcareful notes,
care, and of which
indication of the approachingpathirtyshowed some
roxysm.
are

awaken

the

"

"

It must

not, however, be concluded

that because

of the event about to

patientat one time is made aware
This
take place that therefore it will always be so.
a

Protean

disease varies in this

as

in many

other features

tually
commonly the case that a patienthabithat he
or
a premonitorysymptom,
experiences
is uniformlyseized without any indication whatever.
describe as
the patients
sensations which
The
ceding
preafter
But
even
the fit are
extremelyvarious.
hearingthe details of a small number, it cannot fail to
be ranged
suggest itselfthat theymay, without an effort,
still it is most

"

"

p. W3.

Trcatite

on

Mental

Duwuet"

by

Dr. B. A. Morel

Paro, 1860,

486

PHENOMENA

MORBID

classes ; those that

in two

referred to the trunk

are

extremities,and those that appear

head; in the former

at

is

towards

the

and

affect the

to

once

sensation

the

case

mounting

as

MOTION.

OF

scribed
always dein the

head, and

majorityof cases the paroxysm

appears to strike down
the patienton its reachingthat part: in the latter the
of some
sensation commonly takes the form
strange
illusion,which, however, the patientis able to recognise
such.

as

"

Tissot,whose

works

of close observation
Peiroux

the

of

case

yet be

may

and

clear

young

man

consulted

as

models

reasoning,quotes from
who, when

his fits came

thought he saw a carriagedrive up at a gallopand

in a red bonnet ;
with greatnoise,containing
a littleman
he fell down
stiff
fearingto be ecrase
by the carriage,
on,

consciousness.

without

and

In

Tissot's work

we

find

epilepsyfrequently
sleep,during which
dreams may indicate the approaching
supervenes, peculiar
who
dreamt
He givesthe case of a man
paroxysm.
that he was
pursued by a bull,and soon after waking

that

in

even

seized with

was
"

These

are,

however, rather

the sensations of
in

the sensorium

the fantastic kind

we

may

say that

rible to the

fit.

nerves

the curiositiesof

epilepsy,
the patientnot generally
actingupon
such a way as to produce illusions of
just described. With this exception,
there is scarcely
an
impressionreferof

common

or

muscular

sense,

or

of

which
does not occasionally
indicate
senses,
special
fit.
The
the approach of an
epileptic
premonitory
accompaniedby a sense of fear and
symptom is generally
One
of my
terror.
patientsdescribed the sensation,
which
in him
passedfrom the stomach to the head, as
show the
Children particularly
character.
of a pleasing
alarm they experience
by running to and clingingto
the

their

nurses

or

mothers.

The

aura

may

be

an.

undefined

FRXMONITORY

497

EPILEPSY.

OP

SYMPTOMS

be a definite
or discomfort ; it may
indisposition
the
or
feeling
pain,giddiness,
suffocating
; or it assumes
sense

of

more

classical form

by the
some
case

part

of the

of the last

commonly

we

described

passage

of

as
a

an

aura,

which

peculiarsensation

body to the throat or head.

would
observe that
specially

state that when

the

racterized
is cha-

aura,

or

from
In the

authors

sensation reaches

ensues
insensibility
; it has rather appeared
to us
to the
that the patientsrefer the termination
throat.
"With some
the premonitory
symptoms
patients
assume
a more
tangibleform, and one that makes itself
to bystanders.
perceptible
Dr. Cooke relates a case in which the approachof a
indicated by a peculiar
blue colour of the
was
paroxysm
lips. 'Frank/ as related by Dr. Copland, 'saw the
the whole
precededby an eruption over
paroxysm
alba.' The same
body except the face, of the vitiligo
author states
treated in
that in twenty-one epileptics
the clinical wards
of the hospital
at Wilna, vomiting
announced
the paroxysm
in seven.' Symptoms that may
be termed objective
have presented
themselves to me
in
the form
of tremors, cough, sickness,rigors,and
a
shakingof one hand.
Schenck relates a case of epilepsy
which came
under
his own
before the
observation,in which the patient,
turned round in a circle,
and then
seizure,was repeatedly
fell to the ground in an
'magna
ordinaryparoxysm,
astantium commiseratione.'
Peiroux (quoted
by Tissot)
mentions a man
who, before becoming unconscious, was
ness
compelledto run backwards ten steps; the unconsciouswas
rose
very brief,and he at once
up again as if
count
nothinghad occurred. In Schenck we also find the acof whom
of a man,
it is said in rather
aged thirty,
quaintLatin, Solebat, quura duos vel tres passus proinflecterequasi in circulum, idque
esset, sese
gressus

the head,the

"

'

"

"

488

sequently
compulsus erat." This patientsubmovements
and the peculiar
became
epileptic,
those related by Schenck
Such
ceased.
as
cases
of
Peiroux have received the name
curepilepsia

continenter

then

facere

"

and

siva," under
marked

which

Dr.

term

instances,which

instructive

before
which

and

ensues,

with

meets

by venesection,
antispasmodics.They are
to justify
as
our
inserting
cured

"

of faintness

sense

fit being over,

and

dizzy;and
become

AFFECTIONS

she then

resistance,then

some

The

MOUTH.

well-

"

after which
first,

almost

details two

Eebecca Cole, aetatis 1 6,

brieflyhere :
her seizures first perceives
a weightin her head,
all over
her hang it down
makes
; then a tremor

of them

one

and

well told,so

and

Andree*
both

were

remedies,
antiphlogistic

at

MOTION.

OF

PHENOMENA

MORBID

falls

and
she lies still,
she

recovers.
gradually

trembles, is faint,sick at stomach,

now,

THE

till she

down, struggles

by frequentreturns
stupid/'f

OF

runs

TONGUE,

AND

of them, is

MUSCLES

or

THB

the
premonitorystage of paralysis,
of muscular
tongue often givesevidence of a deficiency
strength. The patientis observed to have lost,to a
degree,the power of protrudingit rapidlyand freely
do so at
from the mouth, and, occasionally,
he cannot
all. I have frequently
noticed this symptom in connexion
with
other signs of flaggingmotility,
as
cursory
preattacks of cerebral disease,particularly
of severe
of softening.Occasionally
the tongue is observed to
side. How
be tremulous, and turned
on
one
slightly
the avant
often this symptom has been observed
as
courier of fatal attacks of apoplexy,softening,and
?
paralysis
the tongue
In the earlystageof generalparalysis,
*

"

In

the

Cases of Epilepsy,
HystericFits,and St. Yitus's Dance," by John
Andree,M.D.
London, 1746.
On Epilepsy
and Epileptiform
M.D. 1858.
f
Seizures,"
by E. H. Sieveking,
"

"

489

PARALYSIS.

OP

SYMPTOMS

SIDIOU8

It
appearance.
occasionally
presentsan hypertrophied
looks large and
flabby. I have often noticed this
and other organic
symptom associated with softening,
racteristi
chalesions of the brain, but it is more
particularly
of cerebral paralysis.
are
sionally
occaHow
apparentlyslightand insignificant
the
most
important of the early signs of
to forcibly
organicdisease of the brain ? An inability
ejectsaliva from the mouth, in consequence of a slight
obicularis oris and

of the
paralysis
preceding more
cerebral

marked

alterations in the structure

Dr.

details at

Watson

decided

and

known

disorder,has been

buccinator

to

muscles

symptoms
indicate

of

serious

of the brain !

length a deeply interesting

of the brain, in
connected with cancer
paralysis
the incipient
which
the
symptoms :
followingwere
stairs on
the
down
The patient
found, when he came
morning after he was taken ill,that he could not spitas
case

of

"

usual,and his friends observed

features.

He

had

no

fit,
nor

an

unusual

state

of his

loss of consciousness,but

was
failing.At the time when
thoughthis memory
numbness
first noticed, he had some
the paralysis
was
in the right arm,
and tingling
extendingto the last
deaf in the rightear."1
two fingers.He was
who died of softening
A celebrated playeron the flute,
festation
fifteen months
of the brain,exhibited,
priorto the maniof more
alarming signsof cerebral disease,
with his accusthe instrument
tomed
to use
an
inability
owing (as was supposed)to incipient
facility,
and cheek. f
of the muscles of the mouth
paralysis

he

"

Practice of

Softeningof the

alteration in motion

1857.
WaUon, M.D.
induces
to
Andrei,
hemispheres,
according
than in iiUclltgenrx.
However,
constantly
without iU exceptions. He cites some
cases

by
Physic,"

Thomas

cerebral

much

more

thin rule is not, he says,

even
not observed,in reference to
in which there was

modification.

In four instances,of this kind

motility,
any appreciable

the
which Andral has recorded,

490

MOTION.

OF

PHENOMENA

MORBID

gular
in,and sinpeculiarity
writing
variation from, the ordinarycharacter of the handobserved as the first signs of apbeen
have
proaching
softeningof the brain, and
generalparalysis,
apoplexy. The patienthas not been able to write in a
sionally
straightline or to form his letters correctly.Occahe singularly
misplaceshis words, and appears
to have lost all power of correct spelling.When
writing
HANDWRITING.

remarkable

"

patientsubstitutes one word for another, his letters

I
blunders, and erasures
are
nighty,full of eccentricities,
for
observed
often
these symptoms been
How
have
has existed as to the healthy
before a suspicion
months
the

state of the brain.

softening
occupiedthe

most

different seats.

In

one

case

it

was

limited

to

portionof the convexity; another time it occupiedat the base of the anterior
lobe of one
of the hemispheresa space largeenough to contain a pullet's
egg.
In two other cases
it occupiedseveral pointsof the two hemispheres. Several
of the brain existed without
record in which softening
on
cases, however, are
observed.1
When
this does happen,"
having been
any disturbance of motion
that the softeningtakes place very slowly.
says Andral, "it is probable
the brain, subjectedto a gradual
remind us
of those in which
Such cases
developed around it or in its substance,does not
compressionby tumours
other disturbance in locomotion.
its suffering
or
announce
by any paralysis
this
be regardedas nearlyconis
affected
When
motion
case
stant),
(and
may
It
it is very far from being always affected in the same
hag
way.
of the brain produced,
been laid down
much
too generally,
that softening
in
tion
Observaof cases
of the limbs.
the greater number
a flexion (contracture)
be as often absent as it is present;
has satisfied us that this flexion may
"

"

it does occur, it becomes

excellent sign to
an
of the brain from
other affection of this organ.
a softening
any
distinguish
but

that when

it is very true

sign as pathognomonic
; for it has been
where there was
found in other cases
no
softening. It has been often noticed,
of congenital
for instance,in the cases
atrophyof the brain publishedby MM.
modifications which
motion
and Casauvielh.2 The
Bouchet
undergoes in
far from
of softeningof the brain, are
cases
being always of the same
either in simpleparalysis,
modifications
consist
most
These
nature.
usually
Let

us

not, however, regard such

in convulsions.

flexion of the limbs,or

motion

Tom.

"

is modified

in

quitea

d'Anatomie
Repertoire

Also,

i.,p. 116.
8

"

"

"

different

et de

There

are

other

cases

then, in whiclr

way."3

PhysiologiePathologique,"
par Breschet,.

Journal

Archives
8

Hebdomadaire," torn. iv. p. 270.

Ge*ne*ralesde Me"decine,"torn. ix.

M^dicale,"by
Clinique

M.

Andral.

492

PHENOMENA

MORBJD

increase in
gradually
but
uncertain period,
or

MOTION.

part first affected;and

seldom

in less than

influence is felt in

the morbid

more,

the

OF

Thus, assuming one

of the

hands

and

at

months

twelve

other

some
arms

an

to

part.

be

the

firstattacked, the other at this

periodbecomes similarly
is found
affected. After a few more
the patient
months
to be less strict than usual
in preservingan
upright
posture this beingmost observable whilst walking,but
whilst sitting
sometimes
or
standing. Sometimes, after
the appearance
of this symptom, and during its slow
to tremble,
increase,one of the legsis discovered slightly
and is also found to suffer fatiguesooner
than the leg
:

of

the

becomes

other

side

and, in

agitatedby

similar

few

months,

and
tremblings,

this limb
suffers

similar loss of power.

"

will have experienced

but little
Hitherto,the patient

by the strong influence

of habitual endurance, would, perhaps,seldom think of
reminded
his being the subject
of disease,except when
of it by the unsteadiness of his hand, whilst writing or
employing himself in any nicer kind of manipulation.
But
the disease proceeds,
similar employments are
as
the hand
accomplishedwith considerable difficulty,
to the dictates of the
with exactness
to answer
failing
be perwill. Walking becomes
task which
cannot
a
formed
The
considerable attention.
without
legs are
with that promptitude
not raised to that height,or
inconvenience

to

The

and, befriended

the will directs,scr that the utmost

which

"

At

care

is

sary
neces-

preventfrequentfalls.
much
venience,
inconthe patient
experiences
period,
which
unhappilyis found dailyto increase.

this

submission

of the

limbs

to the

directions of

the

hardlyever be obtained in the performanceof

cannot be
officesof life. The fingers
the most ordinary
and applied
with
disposedof in the proposeddirections,

will

can

PREMONITORY

SYMPTOMS

OP

PARALYSIS

AGITANS.

to any
certainty
proposedpoint. As time and the
disease proceed,
difficultiesincrease : writingcan now
be
and reading,from the
hardlyat all accomplished;
with some
tremulous motion, is accomplished
difficulty.
Whilst at meals the fork,not being duly directed,frequently
failsto raise the morsel from the plate
: which,
when
seized,is with much difficulty
conveyed to the
mouth.
At this stage the patient
seldom experiences
a
of the agitation
of his limbs. Commencing,
suspension
for instance,in one
the wearisome
arm,
agitationis
borne
until beyond sufferance,when, by suddenly
changingthe posture,it is for a time stoppedin that
in less than a minute
in
limb, to commence,
generally,
of the legs,
of the other side. Harassed
one
or in the arm
by this tormenting round, the patient has
to walking,a mode of exercise to which
the
recourse
sufferers from this malady are in generalpartial
; owing
to their attention beingtherebysomewhat
diverted from
their unpleasant
quired
feelings,
by the care and exertion reits safe performance.
to ensure
this temporary
But, as the maladyproceeds,
even
of suffering
from the agitation
of the limbs
mitigation
is denied.
The
propensityto lean forward becomes
and the patientis therebyforced to step on
invincible,
the toes and fore partof the feet,whilst the upper part
of the body is thrown
far forward as to render it
so
difficult to avoid falling
the face. In some
on
cases,
when
this state of the malady is attained,the patient
can
no
longerexercise himself by walkingin his usual
"

manner,

but is thrown

feet; being,at the

take

much

same

on

the toes and

fore

part of the

time, irresistibly
impelledto

quickerand shorter steps,and therebyto

In some
it is
a runningpace.
cases
adoptunwillingly
found necessary entirely
to substitute running for walking
the patient,
on
; since otherwise
proceeding
onlya
fall.
very few paces, would inevitably

494

MORBID

The

"

PHENOMENA

becomes

sleepnow

motions

of the limbs

OF

MOTION.

disturbed. The

much

lous
tremu-

and augduringsleep,
ment
and frequently
until theyawaken
the patient,
with
much
The power of conveyingthe
and alarm.
agitation
food to the mouth
is at lengthso much
impededthat he
is obliged
to consent to be fed by others.
The bowels,
which
had been all along torpid,
in most
now
cases
demand
stimulatingmedicines of very considerable
of matter from the rectum
times
somepower : the expulsion
requiringmechanical aid. As the disease proceeds
towards its last stage,
the trunk is almost
manently
perbowed, the muscular power is more
decidedly
becomes violent.
diminished, and tremulous agitation
The patientwalks
with great difficulty,
and
now
unable any longerto support himself with his stick,he
dares not venture
this exercise unless assisted by an
on
attendant,who, walkingbackwards before him, prevents
forwards by the pressure of his hands against
him falling
the fore part of his shoulders.
His words
are
now
and he is not onlyno longerable to
intelligible,
scarcely
the food is conveyed to the
feed himself,but when
occur

"

mouth,

much

so

are

the

actions

of the muscles

of the

tongue, pharynx,"c., impeded by impairedaction and

that
perpetualagitation,

retained

in the

mouth

the

food

is with

difficulty

until masticated, and

then

as

swallowed.
Now
also,from the same
difficultly
cause,
another very unpleasant
circumstance occurs
; the saliva
failsof beingdirected to the back part of the fauces,
from the mouth
and hence is continually
mixed
draining
of food which he is no longerable to
with the particles
the inside of the mouth.

clear from
As

"

will

over

becomes
for
a

the

the influence of the

the muscles

fades away, the tremulous agitation

vehement.
It now
suddenlyleaves him

more

moment

small

increases,and
debility

but

even

when

the
portionof sleep,

exhausted, nature
motion

becomes

so

seizes
violent

MORBID

not

as

AFFECTIONS

shake

only to

floor and sashes of the

'

The chin is

the sternum.
be

now

The

fed, with the

OF

the

THE

SPINAL

495

COUD.

but
bed-hangings,

the

even

room.

almost

immovablybent down upon

fluids with which he is attemptedto
from
are
saliva,
trickling
continually

the mouth.
"

The

power

of articulation is lost.

The

evacuations

and at the last,constant

passed involuntarily;
with slightdelirium, and other marks
of
sleepiness,
are

extreme

the fatal result."

exhaustion,announce

AFFECTIONS

SPINAL

CORD.

As

generalrule,
the motor power is affected in allcases of softening
of the
record.
cases
spinalmarrow, but there are exceptional
on
Dr. Janson, of Lyons,has published
the particulars
of
in which
the spinalmarrow
a
case
was, for the most
pediment
part,in a state of bouillie,
yet the patienthad no imin the power of motion.
M. Velpeaucites a
in which the cervical portion
of the spinal
cord was
case
the motor
morbidlysoftened without impairing
power.
In animals the spinalcord has been damaged without
with the movements.
dressing
adAndral, when
interfering
himself to this subject,
observes :
do all not
has free power
know that the foetus,duringuterine life,
of motion, althoughits spinal
cord at that periodis far
from having that consistence which
it acquires
subsequently."
OF

THE

"

"

M.
considerable
was

Rullier relates

of
softening
maintained

case

where

spinalcord, but

between

the

upper

there

was

cation
communiand

lower

merelyby a slight
though firm slip;
the part of the cord
relation between
there was
no
affected and the parts of the body capableof being
the patientcould walk, but his arms
moved;
were
and contracted.
paralysed
of acute softening
of the spinal
There is a form
itselfvery suddenly,
which developes
marrow
progresses
and speedily
terminates in death.
with greatrapidity,
of
portions

the cord

the

496

These

resemble,in

of the

ramollissement

of acute

cases

MOTION.

OF

PHENOMENA

MORBID

spinalcord

morrhage.
of their features,those of cerebral he-

many
The

in the firstinstance,
patient,
appears to
have an attack of lumbago, this is succeeded by great
in the spinal
muscular
column, as well as in the
debility
then speedily
Coma
the
lower extremities.
supervenes,
limbs become
contracted,and the patientdies
forcibly

in

In

state of tetanic spasm.

in

even

of
softening

acute

often continues

unclouded

PERIPHERAL

PARALYSIS.

those lesions of the motor

the

cases,

many

spinalcord, the

until the moment

I have

"

and

however,

not

mind

of death.

yet spoken of

sensorial power

which

mence
com-

in the

extremities of the nerves,

and
peripheral
which are occasionally
to progress upwards from the
seen
involve the great nervous
lower limbs, and ultimately
and eventually
the brain itself.
ganglia,
I have

several remarkable

seen

cases

of this kind.

The

earlysymptoms of this affection are occasionally

of their great
altogetheroverlooked in consequence
obscurity.A patientcomplainsof a generalfailure in
the muscular tone of his feet and legs. He
tomed
(ifaccusis conscious of his inability
to active walking)
to
take his usual amount
time

no

other

of muscular
This state
before the
feels under
In
was

alteration in the

informed

been

arms,

case

that

in the

and

it

was

is confined to the
course

notices for

The
power.
to the foot and

motor

came

not

under

some

loss

six years.

extended

notice, I

my

this failure of muscular

foot,it then

that the brain became

in the

that

for
gradually
progressing

observed

He

strengthis confined
leg.
of local partial
paralysis
may exist for years
of danger,or
patienthas any apprehension
the necessity
of obtainingmedical
advice.

remarkable

one

of exercise.

power
It was

to the

had

first

legs and

of seven
expiration
years
! Occasionally
the paralysis

until the

involved

and
legs,

of its progress

appears

to be arrested

upwardstowards

there,

the brain.

CEREBRAL

LOCALIZATION

CHAPTER

Morbid
THIS

1. Cerebral

of Speech.

will
subject

be

considered

in the

"

Localization

2.

IrregularAction

3.

Impairment

4. Morbid

497

SPEECH.

XIX.

Phenomena

division of the

order
following

OP

of Speech.

of Articulation.
Loss of Speech.

and

Imitative

Movements

tion.
of Articula-

InvoluntaryArticulation.
Various
of

attempts
and
speech,

have

been

made

to

localize the

executed
by carefully
served
obexaminations,as well as by accurately
post mortem
physiological
experimentsmade upon animals
the precise
duringlife,
portionof the brain influencing
this faculty.
and regulating
The following
Gall,Serres,
distinguished
physiologists,
Pinel,Grandchamp, Belhomme, and Bouillard,maintain
the organ
that the anterior lobes of the brain preside
over
of cases
and a number
loss
of speech,
of total and partial
of this function have been cited,in which this portion
after death, to be
of the encephalonhas been discovered,
in a state of organicdisease.
In 1845, at 1'Academic
homme
Royalede Medecine, M. BelOn the Localization of Speechin
read a memoir,
the anterior lobes of the Brain,"in which, by a reference
organs

to

ascertain

"

498
to ten

he narrates,he endeavoured

which

cases

SPEECH.

OF

PHENOMENA

MORBID

to prove

that the cerehral organ which regulates

speechwas seated
arrived
in the anterior lobes of the brain. M. Belhomme

followingconclusions

at the
"

Affection of the

on

between
"

2.

other

rhagic or

of speechdependseither
faculty
a

on

loss of

sudden

The

"

lesion of the organs of communication

the brain and the organs of speech.

cerebral affection,
or

lesion

speechdepends on a hemorof one, or more

frequentlyof

both, anterior lobes of the brain.

8. "It

is necessary to guard against

vulsive
confoundingconand paralytic
disorders which affect the power
of

of words, and
with that sudden loss of memory
speech,
of speechdependingon affection
consequently
difficulty

of the anterior lobes of the brain.

"

4.

In disorder

partialdestruction of the anterior

brain, the speechis suddenlyarrested,and

lobes of the
it is

only after

the organ
Out of

or

cicatrix has formed

recovers

more

in

cerebral lesions,in which

affection resided in

both, speechwas

function."

observed and analysed

carefully
tive
relaby other pathologists,

by Andral, as well as
to hemorrhageand other
or

brain that

the

less of its former

or

cases
thirty-seven

the morbid

in

of the anterior

one

abolished

and
twenty-one,

lobes,

retained

sixteen times.

On
were

the

other hand, the

collected
without

these fourteen
of the

of fourteen
particulars
by Andral, where the speechwas

any
cases,

middle, and

alteration in the
seven

seven

were

with

anterior

connected
diseases

cases

lished
abo-

lobes.

Of

with diseases

of the

posterior

lobes.
The

loss of

speechis

not

then,

as

Andral

concludes,

the necessary result of the lesion of the anterior lobes.

It may
take placein cases
where examination
does not
reveal any

alteration at all in the

structure

of

these

500

structural changes in the

SPEECH.

OF

PHENOMENA

MORBID

anterior lobes

of the

brain

and pathological
anything like a physiological
the phenomena it will be
between
relationship
and
of
necessary to establish a greateruniformity cause
effectthan the researches of morbid anatomists at present
appear to justify.
instance of generalparalysis
I recollect one remarkable
of mind, which
associated with considerable imbecility
(likemany other cases of this disease)was
accompanied,
in the incipientstage,by considerable loss of power of
speech,and defective articulation,in which after death
lesion of the brain detected was
the only morbid
a
piece of circumscribed softened brain of the size of a
of the anterior lobes.
The
careful
most
one
on
shilling
but

to prove

examination
any

of the

other

softeningof

brain

was

made

organic change !

the

without
In

ing
discover-

another

case

of

cerebellum, the

time
impairedfor some
lesion of
any perceptible

ably
speech was remarkto death without
previously
the

anterior lobes of the

brain.
A
upon

the

gentleman had

attack of

an

extravasation, the
cerebral

attack, and

vessels.

again

He

effect of

apoplexy,
consequent
a
rupture of one of

rallied.

recovered.

At

He
the

had

second

expirationof

he experienceda third attack, and

eighteenmonths
this eventually
proved fatal. He became hemiplegic,
and entirely
lost his speech. He
in this
continued
state for two
months, never
utteringa vocal sound !
After death,a small patch of softened brain was
found
in the pons varolii,
surroundinga clot which had been
that ganglion. The other portionsof the
on
deposited
cerebral mass
were
apparentlyin a healthycondition,
with the exception
of some
of the vessels being closed
of bony matter.
by depositions
In a work
an
recently
published,
attempt is made to

OF

DISEASE

establish

CORPORA

501

OLIVAR1A.

close

between the

and pathological
connexion
physiological
functions of articulation and speechand the

olivaria.

corpora

THE

Professor Schroeder Van

der Kolk

was

led to this conclusion

in consequence
of the anatomical
between the two previously
mentioned
existing

connexion
cerebral

gangliaand the nuclei of the hypoglossus.*

he observes, and the articulation of words
Speech,"
requiresuch a multitude of peculiarmotions of the
nations
tongue,and such an infinite number of varying combiof its muscular
movements, that two auxiliary
gangliashould be requiredfor the performanceof these
"

"

functions."

Professor

Van

der

Kolk

cites

numerous

in illustration of his

hypothesis.His friend,Dr.
allowed him to examine
the medulla ollongata
of a
lioell,
had been for twenty-five
who
aged fifty,
woman,
years
insane and completely
tinctly
demented, and could only indisword
snuif
utter the single
(snuff).There was
of the rightside of the face. In the medulla
paralysis
there was
; the right
very decided fattydegeneration
cases

"

"

corpus olivare

than

the

was

slender and

more

left,
althoughboth

slender and

were

In the corpora pyramidaliawere

numerous
in the raphe =0'305.
of 0'276 mm.
There
dilatation in the other
Dr.

total loss of

wide
was

vessels
no

cular
vas-

parts.

On

of

all but

was

utter
scarcely

met
Silesia,

Olivier relates

and dementia
the voice

in

speech connected

corpora olivaria.

"

atrophied.

Martini,physician
to, and director of, the Leubus

Institution for the insane

smaller

somewhat

with
a

with

induration

remarkable

case

of

of the

case

of paralysis

where eventually
long standing,
whollylost. The patientcould

few articulate sounds.

the Minute Structure and Functions of the

After

SpinalCord

death,the
and Medulla

of Epilepsy,"
and on the Proximate Cause and Rational Treatment
Oblongata,
D.
Professor
Van
W.
Schroxler
der
Kolk.
Translated
Moore, A.B.,
by
by
1859.
M.H.,
(New Sydenham Society.)

602

SPEECH.

OF

PHENOMENA

MORBID

found
were
pyramidalia
changed into a grey semi-fluid pulpy state.
relates the following
case
olivaria and

corpora

that

carried

laid

or

on

fallen into

could

limbs, but

could

he could

bed
not

Cruveilhier

state

guide

his

he exercise any

of such

stand,and had

not

could,however,

he

and

"

child,of four years, had

generalweakness

softened

to be

all his

move

with

movements

cision,
pre-

force.

was
Deglutition
of fluids,
especially
only a small quantity
very difficult,
reached
his stomach, while the rest was
of which
rejected
The
by the mouth and sometimes
through the nose.
articulation of sounds was
exceedinglyslow ; the voice
low and stammering; the little patientstill articulated
was
but only syllable
distinctly,
by syllable
ration
; the respiwas
slow, often oppressedand sighing,and in a
recumbent
the head
when
even
positionwas
impossible,
was
supported by several pillows. The intellectual
of the child were
powers
developedvery much beyond
his time of life; nutrition was
well performed,
perfectly
the patientbeing even
illness was
stout and fat. The
nor

the result of
attacked

convulsions,with which

three

the child had

been

had
and which
since
previously,
returned repeatedly
at irregular
intervals,causinghim to
be considered
later, he
epileptic.Five or six months
died asphyxiated,
of his
although in the full possession
but no longerable to utter a sound.
intellect,
On examining the body, Cruveilhier found the corpora
olivaria as hard as cartilage
hibited
respectsthey ex; in other
there any
no
was
abnormity of
change, nor

colour
had

or

years

extent;

of the

one

which)
forgotten

and

in the induration
cerebral
so

much

mass

was

of the

sound.
medulla

crura

(the author

cerebetti

the tuber cula mammillaria

;

ticipated
par-

the entire of the

He

was

oUongataas

able to
could

remaining
examine
only
be taken

out

MORBID

IMPAIRMENT

by t}\eforatnen
magnum
below, and
Dr.

the medulla

the

case

of

who
hospital,

was

olivaria*

in the

Dutch

Indies,relates

native gunner
under treatment
bitten by a serpent called

natives Oeloer.

Severe

by

and

syncope,

perfectly
healthy

was

at the sides of the corpora

Maudt, officer of health

503

SPEECH.

OF

in the

by

the

lowed
vertigoimmediatelyensued, folin about

ten minutes

he lost the

of

associated
swallowing.These symptoms were
with total loss of speech,
but unimpaired consciousness.
Whenever
he was
spoken to, he appliedhis hand to his
that the part was
constricted. He
throat,as if to signify
died from the effects of the bite. The
principalsymptoms

power

observed

at

the

great congestionof

post

the

medulla

between
arachnoid, especially
corpus

tension

restiforme.There

accessory and

corpus

also
which

nerves.
hypoglossal

were,

ollongataunder

the

was

of the cervical muscles

examination

mortem

a
are

and

hyperamia and
suppliedby the

Professor

this case, says,

that he
that the corpora olivaria were
inferring

olivare

the

Kolk,

menting
com-

avoid
scarcely
affected,
whereby
the nuclei of the two nerves
and hypoglossal)
(accessory
in their bilateral relations,
were
injured,particularly
the powers of speechand deglutition
were
consequently
completelylost."
of Professor Kolk, aged
under
the care
A woman,
and quitesilly.She was
became epileptic
twenty-eight,
able to speak,but there was
in the tone and accent of
her voice somethingstrangewhich she could not control.
The
vocal sound
varied, without
nearlyan
any reason,
octave up and down, and often ended
in a sharp,high,
discordant tone.
Latterlyboth speech and deglutition
of the rightside
were
difficult,
apparentlyfrom paralysis
of the tongue. After death, there was
found atrophyof
"

on

1.c., livr.zxzv.
Cruveilhier,

"

can

Maladies de la Protuberance

Annulaire,"p. 2.

504

OF

PHENOMENA

MORBID

SPEECH.

cells were
ganglionic
scattered in and around the nuclei of the /typoylossi,
cially
espeThe entire medulla
that of the righthypoglossus.
had fallen into a state of decided fattydegeneration.
ollongata
often bit her tongue. It
the patient
In the fits,
generatio
dark deis not probable,
says Professor Kolk, that the
of very recent
of the ganglioniccells was
correspond
closely
though this would certainly
occurrence,

the

dark

rightcorpus olivare,and

with
Pinel

olivaria

the

symptoms

above

detailed.

teristic
characsays, that as alterations in speech are
and changes in the corpora
of generalparalysis,
are

connected

latter organs must

the articulation of the sounds formed

equallyconstant, the
with

with
and consequently
speech,
ACTION

IRREGULAR

OF

the

THE

developmentof

ARTICULATION.

in

voice.*
In

"

be

the

observe a
earlystageof cerebral disease we occasionally
of articulation. There is a want
of the faculty
perversion
of the
of co-ordination in the action of those portions
of articulate
centres necessary for the production
nervous
sounds, or, more
as suggested
correctly
speaking,
by Kom(caused by various
berg, there exists an interruption
morbid
states of the brain) in the pre-established
mony
hartelligenc
inwhich
should obtain between
the subjective
and the organs of speech,givingrise to those
anomalies
in the co-ordinating
lation,
of articusingular
faculty
witnessed in connexion
with organic
occasionally
"

cerebral conditions."
The

expressingour thoughts in
languagedepends,as Dr. Todd observes,upon
relation between
action.

frame
a

the centre
The

of volition and

latter centre

may
the thoughts,
but, unless it can

certain mode

cannot

be

suitable

of

power

of sustained

the due
lectual
of intel-

full power to
prompt the will to

have

action,the organs of speech

brought into play."

*

that

"

Vide Professor Kolk's Work, p. 164.

MORBID

"

IRREGULARITY

A loss of the power

of

extensive

more

In

motion.

some

cases,

OF

505

SPEECH.

a prespeechis frequently
cursor
of
sensation
and
derangement

of

the

intellect

seems

the

unable
patientis utterly

to express

and

in others there is

less of mental

The

of consent

want

more

or

between

the centre

his

clear,but

thoughts;
confusion.

of intellectual

action and of volition is

equallyapparentin cases of this

from the inability
of the patients
to commit
description,
their thoughtsto writing."*
In the incipient
stage of disease of the brain, the
if he has not lost all power of articulation,
will be
patient,
to stammer, and his words
observed, occasionally,
are
sometimes
half formed, and clipped.He also shows signs
of greatembarrassment
when speaking.He commences
a
sentence without finishing
what he
it, either forgetting
intended to say or having a difficulty
in usingthe right
word to express the conceptions
in his mind.
originating
How
does this paralysis
of ideas precedefor
frequently
a lengthof time all the other evidences of vocal muscular
loss of power ?
This cerebral affection is considered by
"

to arise from

some

is not the fact.

failure of memory,
but such,I think,
It is a paralysis
I have
of ideas which
a

seen

to exist for

and

noticeable loss of muscular

patienthas, however,
what

he wishes and

any actual
sensorial power.
The

to
long periodantecedently

means

in many

or

cases,

to say, but

clear notion

of

is either unable

to

has extreme

in pronouncingthe words characteristic

difficulty
of his thoughts.
of co-ordination
This
between
the
singularwant
and the act of articulation is distinct
mental conceptions
in its character from those partiallosses of memory,
of
which I have spoken in the chapteron chronic affections
of this faculty
consequentupon organiccerebral lesions
to the head.
mechanical
or
injuries
or

"

"

by Todd
Phyiiology,"

and

Bowman,

vol. i.,1845.

506

OP

PHENOMENA

MORBID

SPEECH.

of an interesting
case,
particulars
of certain words was
which
this forgetfulness
a prominent
condition
symptom associated with an apoplectic
the 3rd of September,a note, written
I received,on
a
remarkably clear and neat hand, desiringthat I

Dr. Watson
in

relates the

"

"

in

would

call upon

the

writer,as he had had

severe

attack

apoplexya day or two before. I concluded that the

member
of the patient's
note had been penned by some
and I expectedto see him
in his bed paralytic
family,
ill. But I found a stout active
or manifestly
probably,
gentleman walking about in his drawing-room apparently
in perfect
He
that he felt so.
health,and declaring
showed
however, a paper written by a surgeon, who
me,
the previous
on
day had brought him to town from a
diately.
distance,and who had been obligedto return immeof

The
sudden

paper

had suffered

stated that Mr.

apoplexy on the 30th of

bled ; that perfect
consciousness
August ; that he was then freely
the force of the pulse
not restored,nor
was
of blood had issued from his
subdued, till twenty ounces
the evening of the same
arm
; and that on
day sixteen
drawn.
ounces
more
were
My patientspoke of going
down
to his country-house,
where
he had, he said, a
good deal of shootingto do/ I dissuaded him from this,
and enjoinedperfectquiet for at least a fortnight
to
The next day,after a long and imprudent concome.
versation
with
a friend,he
suddenlylost the thread of
and

decided

fit of

'

his

and could
discourse,

not

it.

recover

Then

he became

I asked him
how
words.
confused, and misapplied
felt. He answered,
Not quiteright/and this he
'

very

many

times, abbreviatingit

he
peated
re-

at first into

right/ and at length into n'ight/ Wishing to

mention
I mention
he called it 'pamphlet.'
'camphor,'
these as specimens. On the 5th, it was
evident that his
and leg were
rightarm
weak, in comparisonwith the
'

not

508
If he wanted
vice

call for

tumbler, he would

He

versa.

SPEECH.

OF

PHENOMENA

MORBID

decanter,and

that he

evidentlyconscious

was

nounced
pro-

proper expressions
asked if it were
used by another person, and he was
were
of
not such a thing he wanted, he alwaysappearedaware
the

words, for when

wrong

himself

corrected

his mistake, and

by adoptingthe

propriate
apof his

cured

expression.This gentlemanwas
complaintby largedoses of valerian and

other

nervine

medicines.
Professor

Gruner, of Jena, relates the historyof

affected in

articulation

learned friend of his, whose

After

manner.
singular

was

from
recovering

acute

an

fever,

coffee
things he desired to have was
he substituted
the letters//,
but instead of pronouncing
(kaffee),
in their placea t and z, and therefore asked for a
cat (katze).In every word which had an /he committed
a z for it.
a similar mistake
substituting
of the

one

fessor
says that the wife of Mr. Hennert, proof mathematics
at Utrecht, who, like her husband,

Van

Goens

also

was

first

with

wished

mathematician

remarkable
to ask for

she wanted

of her

astronomer,

of

articulation.

chair she asked

book she demanded

her

in
singular

defect

and

case

was,

thoughtwas

that when
mentioned

for

affected

was

When

she

table,and when

glass. But

what

was

the proper expression

could
not
she
to her

peoplebrought her the

instead of the thing she desired.
thingshe had named
Sometimes
she herself discovered that she had givena
to her thoughts. This complaintcontinued
name
wrong
recovered the
several months, after which she gradually
of speech. It was
only in this
rightuse of her faculty
seemed defective,for
particular
point that her memory
pronounce

.Van

Goens

matters

it.

with

man,

She

was

angry

if

conducted
says, that she
as she
as much
regularity

aged seventy,was

seized with

her
ever
a

household
had

done.

kind of cramp

in the muscles

of the

509

ARTICULATION.

MORBID

with
mouth, accompanied

sense

of

all over
the surface of the body,as if ants were
tickling
attack of
an
creepingover it. After havingexperienced
and mental confusion, a remarkable
alteration
giddiness
in his speechwas
observed.
He articulated easily
and
but made
of strange words which
use
fluently,
nobody
could understand.
he spoke quickly,he proWhen
nounced
and
then
he employed
numbers, and now
words
in an
He
common
was
improper signification.
What
conscious that he spokenonsense.
he wrote was
equallywrong with what he spoke. He could not write
his name.
The words he wrote were
those he spoke,and
of
they were
alwayswritten conformablyto his manner
He could not read, and yet many
pronouncingthem.
external objects
appearedto awaken in him the idea of
their presence.
The articulating
movements
disease of the

brain

in these

cases

of

incipient

produced,Romberg remarks,
like movements
of locomotion, in single
sounds, or in a
certain series,as
words, without
or
syllables
any
will
mental
the
of
the
act, or even
against
patient.
He
has observed
the phenomenon accompanying cerebral
hemorrhage, in which the patientintends to
utter

certain

are

sound, but

emits

different

one.

by rank and education,once

gentleman,distinguished
assured Eomberg that of the various inconveniences
and
troubles followingan
seizure,none
were
so
apoplectic
painfulto himself as the fact of his applyingwrong
for wood and the like)to express
terms (suchas water
of insanity
his meaning, and the suspicion
which
he
thus excited among
his friends.
Dr. Bright describes the case

of

girlof eighteen
of depressing
mental
years of age, who, in consequence
and very
emotions, was
obligedto sigh involuntarily
This passedinto a spasm, during the confrequently.
a

510

tinuance of which
like

She

three seconds

she every

which
keigk-Jio,
was
only able to

she

by
being interrupted
A

of certain words

that

while

If any

reasoningpowers.
in

two

an

obligedto employ

or

sound

for

short time,

short sentence, but

three sentences

out
with-

exclamation.*

observed

been

patienthas

he seized them

to say

to combine

unable

was

sound

control the

uttered

changed into lirigh.

sometimes

if,for instance, she wanted

she

SPEECH.

OF

PHENOMENA

MORBID

lose the memory

entirely
the integrity
of his
preserving
were
pronounced before him,
to

instant,but in conversation

he

was

the objects,
paraphraseto designate
of which had escapedhim.
An epileptic
the names
could
not pronounce
a
peated
singleword, but he respontaneously
and wrote them without difficulty
them
when they
were
pronouncedto him.
A patientattacked with
of the uterus, which
cancer
completelyprostratedher, was suddenlyseized in the
middle
of the night,and without
cause, with
any known
almost completedumbness, which
an
only enabled her
to say,
Yes ! yes !" to all questions,
whether they were
She, however, retained possession
or not.
contradictory,
of her intelligence,
for she was
neither paralysedor
insane.
If she were
requestedto write what she had to
communicate, she traced an assemblageof letters on the
paper, to which no meaning could be attached.
a

"

Patients

at

the

commencement

of

attack

an

of

lose the use

of
apoplexy,congestion,and softening,
almost all the vocabulary,
and only retain a knowledge
of few

words, which, in their

estimation, have

all sible
posnot understood

kinds of

When
signification.
they are
the patients
and repeatwith
are
moody, impatient,
the words theyhave coined. Such
or less vehemence
more
of their reason.
This
persons have apparent possession
is easily
manifest by the expression
of their eyes, and
*

"

Keports of

Medical

Cases,"vol. ii.p.

458:

M18-U8E

MORBID

511

WORDS.

OF

and by the air of satisfaction

especially
by their gestures,
has guessedtheir meanwhich they show when
one
ing. This state often exists for a long time, even to the
periodof death itself*
Dr. Beddoes knew a gentlemanwho, previously
to an
attack of epilepsy,
misplacedhis words in a singular
He
manner.
was
constantlycommitting blunders of
the kind in his letters,
and when
talkinghe was in the
habit of substituting
word
for another, bearing,
one

however,
For

resemblance

some

example,he

this

weather

WET

who

mil

would
"

sit down

in
"

say

weather

HOT

? here is

to supper

pudding / mean pie"

A
gentleman connected

well

as

in sound.

as

feeh
Everybody

this

mean

sense

very

"

languid
Come,

"

or,

onlycold

and

meat

"

mind

had

of

in his business

meeting of
were

his

anxious

He

matters

discussion

and

whose

the

strain,

matters,

was

counting-house,
larly
singuwas

for several

the firm,when
under

on
severely

urgent and

some

day, when in
misplacehis words.

continue

commerce,

been for several weeks

in consequence
observed one
to

with

and

able,however, to

days,and attended a
of a complicated
character

consideration.

Three

and
daysafterwards he complained of great giddiness,
seized with a fit of
one
morning whilst shaving was
he was
his back
on
vomiting. Two hours subsequently
in a state of profound coma.
He, however, recovered
from a very unpromisingstate of cerebral disorder.
the same
whilst
A clergyman experienced
difficulty
but he was
able,by a strongeffort of the will,
preaching,
the
to
He, however, eventually
difficulty.
conquer
few hours before an
became
a
paralysed.A patient,
called his children by their wrong
attack of apoplexy,
reversingthe sexes, addressing Sarah" by the
names,
"

"

feMft

Traitl des

Maladies

Mentales,"par le

Docteur

B. A. Morel.

Paris,

512

of

name

"

John," and

Emma"

"

SPEECH.

OP

PHENOMENA

MORBID

"

as

Thomas," and

has been
misplacementof names
the incipient
cases
symptoms
among

This

versa.

in many
brain disease.

vice

observed
of

acute

morbid
insanitythe same
nomenon
pheA
is observed.
with
lady deeply imbued
the subject
became
of a severe
nervous
feelings,
religious
tion.
and mind
affection,not, however, amounting to alienawhilst in the act of repeating
the
Occasionally,
Lord's Prayer,instead of saying, Our Father which
she was
pulse
art in Heaven"
obligedby an irresistible imIn

types

some

of

"

to say,

the
the
a

cause

of

"

Our

Father

greatmental

until
difficulty

art in Hell."

which
agony.

restored

by

She

did

This

was

not

conquer
remedies to
appropriate

state of cerebral health.

of

speech sometimes presentvery curious

phenomena most difficult of explanation.A woman
from chronic softening
of the brain, could not
suffering
speakwithout, at the end of three or four words, saying:
Alterations

"par le commandement"

This

....

phenomenon for several

exhibited the

woman

The

onlysymptoms
which revealed the existence of an organiclesion of the
the doltishness of the physiognomy,and the
brain were
A woman
torpid state of her intelligence.
aged sixtyeightyears, could only make incoherent sounds, always
same

the
She

same,

heard

and which
and

formed

years.

the word

sinona

or

cJtinona.

understood

perfectlywell, and she

answered
everybodyby this singleword, only varying
the inflexion of her voice, accordingto the idea she
The rightarm
wished to express.
was
rigidand flexed,
in its articulations.
The
deprivedof motion and painful
had quitevanished in that part.
sensibility
of the Salpetriere
at the infirmary
There
a woman
was
and who could
of fortyyears of age, quitehemiplegic,
"MonDieitf"
ete !"
only say: "Madame
....

....

IMPAIRMENT

"

?"
Eat-il possible

Her

OF

Bonjour,Madame!"

"
....

was
intelligence

513

SPEECH.

....

she laughedat
preserved,
perfectly

jokes which she heard, and cried when she wished to

taken of her.
her thankfulness for the care that was
testify
the few words which she could
She pronouncedperfectly
incessantly
; but,however,
say, and these she repeated
it was
for her to utter anythingelse.*
impossible
IRREGULARITY
SPEECH.

AND

Associated

IMPAIRMENT
with

SPEECH.

OF

Loss

OF

the

loss of power over

slight
the muscles of the tongue and mouth
referred
previously
to,there is in the earlystageof brain disease an inability
with his usual clearthe partof the patient
ness,
to give,
on
and facility,
to the ideas. He
expression
perspicuity,
speaksin a slow and measured intonation,as if he were cauand critically
his phrases,
and carefully
selecting
.tiously
what he is saying.He drawls out his words.
"considering
The voice is often thick and husky,
pression
givingrise to the imis suffering
that the patient
from the effects of a
ing
extraneous
cold,or has some
body in the mouth, interferwith his freedom
of speech.He talks with what may
"

be termed

muffled

under
slightly

man

emotional

veiled,or
(voilee),

voice,like

influence of stimulants, strong

the

excitement,

clouded

or

as

if he

were

partially

even

intoxicated.

speech,feebleness of voice, mistakes in

and disorder
accentuation, hesitation in pronunciation,
in the succession of words, are
phenomena of great
value.
diagnostic
They pointout, says Dr. Guislain,
of cerebral disturbance.
The
correctly
very grave cases
the most
of the tongue, hesitation of speech,
tremor
are
It is almost
characteristic signsof generalparalysis.
the embarrassed
impossible,
says Morel, to mistake
of general
symptomaticof the commencement
speech,
Slowness

"

"

of

Trait^ da Ramollissement

du

Cerveau,"par

Max.

Durand-

Fardel,M.D.

Paris,1843.
L

514

with the
paralysis,
the impressionof
with very

persons

OF

PHENOMENA

MORBID

of the

tremor

quick

decided

when
Occasionally,
disease,the patientis

emotion

nervous

this

in

observed

SPEECH.

tongue, which

under

sometimes

attacks

dispositions.
state of brain
incipient
to make
repeatedbut

ineffectual efforts to utter articulate sounds.

He

is

seen

if tryingto speak,but
as
lips,
The
do
cannot
so.
attempt thus made
produces a
of the lips,
similar to that seen
in
singularmovement
the action of smoking a pipe,conveyingto those who
notice the phenomenon the idea of the patienthaving,
in a slightdegree,a symptom hitherto described and
considered as pathognomonicof a serious and fatal state
of cerebral coma,
designatedby French pathologists,
"Le malade fume la pipe"
vocal power
exist for
These symptoms of failing
may

to

and

open

close his

before the attention

several months
Such
among

morbid

affections

the most

is directed

of articulation

insidious

are

to them.

to be found

centric
signsof incipient

brain

disease.
The

speech,says

M.

altered in acute

developethemselves

Durand-Fardel, is almost

softening. When

the

stantly
con-

symptoms

gradually,
derangementof the pronunciation
usual
of
is a
accompaniment the disease. There
is a kind of heaviness of the tongue,which
is observed to
increase dailyas the malady progresses. In general,
when
and
doltishness
hemiplegiahave become complete,the
articulation of sounds is quiteimpossible.
This happens
of softening,
the malady is
when
at the commencement
announced
by a sudden loss of knowledge, accompanied
with
paralysis.At a later periodpatientsusuallyrecover
the power of articulating
selves
a few words, making themThis obtuseness
of the faculty
a little understood.
remains
of speechoccasionally
a permanent condition.
is
Delirium, or agitation,
joinedor not to paralysis,

516

SPEECH.

OF

PHENOMENA

MORBID

in a state of
gentleman,previously
excellent health, had conveyedto him abruptly
a painful
He at first exhibited in his physiognomy
pieceof intelligence.
he
of great terror and alarm
an
expression
"When
spoken
subsequentlyappeared to be stunned.
to, he tried to replyto the questionsaddressed to him ;
of
fruitless. His power
but his efforts to speak were
articulation
was
perfectlyparalysed. He died that
evening of apoplexy!
loss of

speech. A

I have

several

seen

instances

of

cases

similar kind,

as

well

as

aphonia,from mental shocks, and

great and prolongedanxiety. A lady,pending the prosecution
of a protracted
and expensive
suit in Chancery,
which
caused
lost her
distress,entirely
great mental
In another case, a lady was
voice for eighteenmonths.
numerous

of

informed

of the

accidental

death

of

rise to

intense

degree of

mental

agony, reducingher
for several
continued

to

an

state of

hours.
that

which
insensibility,

When

consciousness

was

son,

which

restored,it

was

gave

found

she could

onlyspeakin the faintest whisper: this

state of aphoniacontinued for six months.
A gentleman,subject
attacks of epilepsy,
to periodical
tonation
of speakingin his usual inloses all power
invariably
for

some

hours

before

the

convulsive

attack

supervenes.

denly
sudbecame
clergyman,whilst readingthe litany,
He
without
speechless,
losinghis consciousness.
in this
He
continued
was
obligedto leave the church.
state for an hour, being perfectly
sensible of everything
that was
going on about him, and being able to write on
certain physicianto be
a pieceof paper
a requestfor a
for.
Two
hours after the loss
immediately
telegraphed
of speechhe was
in which
in a state of apoplectic
coma,
he

died.

mortem

Alas ! for the

examination

was

interests of

permitted!

science, no
"

post

SIGNS

PREMONITORY

It is
of

most

speechto

acute

unusual

circumstance

517

PARALYSIS.

for this sudden

loss

followed by
beingimmediately

exist without

cerebral

OF

symptoms.

patienthavingexhibited these premonitorysignsof

for a short periodantecedently
to the development
paralysis
informed
of more
decided signsof cerebral disease,
conscious
of something
that he
me
was
distinctly
"snapping" in his brain before he was sensible of his
to speak. He had been overworkinghis mind
inability
duringthe previousweek, and had been ridingsome
distance on horseback.
the day previously
He felt,
to
on
the attack,a sensation of "throbbing"
and "metallic tinkling"
A

(as he described it)in his head, and

these

were

the

attack of hemiplegia.
onlywarningshe had of an approaching
A literary
gentleman,whose vocation in life was that
of a publiclecturer,noticed for nearlyeight
weeks before
he was
seized with paralysis,
whilst
that occasionally
he lost for a second or two all power of articulation.
speaking,
This occurred on five or six occasions previously
to
attack of decided hemiplegia. This patient
had taxed
an
his powers of mind to their utmost, by lecturing
twice,
and often thrice,a day ; but independently
of this amount
of literary
labours,he had been exposedto much anxiety
respecting
familymatters, and this had producedrestless,
and, in some
instances,sleepless
nights.
A gentleman,
while standingin the
aged thirty-five,
with a friend,suddenlylost his speech;
street conversing

he recovered it after

few

minutes, walked home, and made

In the evening
particular
complaintof indisposition.
of the same
day he suddenlyfell from his chair, speechless,
and paralytic
the rightside,but without coma;
on
beingsensible of what was said to him, and answering
by signs.He was then confined to bed for several weeks
without
any change in the symptoms. At the end of

no

three

months, he had recovered

so

far the motion

of his

518

legas to
legby a

be able to walk

the

little,dragging forward

rightside of his body. He

in bodilystrength,
so
improvedconsiderably
of tbe whole

motion

afterwards

SPEECH.

OF

PHENOMENA

MORBID

walk

that he could

for several miles

but

thighand

his

kind of
draggedforward by the same
covered
reeffort,without any farther improvement. He never
hand ; he
of the arm
of motion
or
any degree
the fingers
could not even
move
; his speech was
very
expressiveof great
inarticulate,and his countenance
imbecility.In this state he continued without relapse,
he
for fifteen years, when
or
any farther improvement,
him about
Dr. Abercrombie
died at the age of fifty.
saw
four days before he died, and found him in a state resembling
typhus; his pulse frequentand weak, his
tongue very foul and dry in the middle ; he had no other
complaint. He was not then in bed, but was confined to
of rapidsinking
it next day,and died in three days more,
to be

leg continued

without
A

young

aged sixteen, bathed

man,

second

time, he

lay

down

twice, in the

After

of June, in the river Tweed.

month

the

coma*

the

on

coming out
fell

bank, and

exposed to the
! On awaking, he was
direct beams
of a hot sun
less
speechhome, and seemed to be otherwise in good
; but walked
bled and purged,and the next day rehealth !
He was
covered
but lost it againat intervals several
his speech,
times duringthe three or four followingdays. He was
dull and
and his look was
heavy he made
forgetful,
said he
little complaint,but, when
questioned,
closely
his

asleepwithout

hat, with

his

head

had

dull uneasiness

days more,

very obstinate
After further

of his head.

double

squintingand

had

he

at the back

state

of bowels, and

his

bleeding,the pulse rose

into coma,

sank
gradually
*

"

On

and

Diseases of the

died

on

Brain,"p.

In

vision,and

pulsewas
to 86

the 30th.
261.

few

but

60.

he

LOSS

SUDDEN

The

substance

OF

of the brain in

510

SPEECH.

found

generalwas

highly

very considerable extent of it was

of softening
mixed
with suppuration.The

ular,and
e

distended

were

in

with

and
fluid,

tricles
ven-

the membranes

in

thickened.
One very curious
much
placeswere
many
riivumstance
explanationof
(affording,
perhaps,some
tlu" readiness with

the inflammation

which

that the cranium

produced)

was

unequal thickness at
its upper part. In one
it was
spot,as big as a sixpence,
as thin as
writingpaper, and transparent.*
Loss of speechhas been known
without
to occur
any
previouslyexistingpremonitorysymptom of brain or
was,

disorder

nervous

of very

was

no

headache,vertigo,noise

in the

ears,

of spirits,
affection
depression
as
symptom to excite suspicion

abnormal

been

has

in other words, there

state of the structure

loss of

of vision,

sensibility,

or

other

any

presence of any
of the brain or condition
to the

of cerebral circulation.
illustrative
followinginteresting
A barrister was
walkingup and down the hall of
ting
Courts,waitingfor a case to come
on, and chat-

Dr. Graves
case

"

"

the Four
with

crowded

cites the

friend and another

one

and hot, he went

for the sake of the

than

ten minutes

out

as

the hall

into the

area

air,and had not remained

when

an

old friend from

was

rather

of the courts

there
the

more

country

He was
pleasedto see
up and spoke to him.
when
friend,and wished to inquireabout his family,
came

that he could
found, to his great surprise,

but

his

the

utter

he
a

completelylost his voice !

recovered the use of his tongue in about three weeks,
slowness of speech renot completely,
for some
mained.
first perceived,
When
the loss of speechwas
in a carriage
friend brought him home
;. and during
and afterwards
day he had several attacks of vertigo,

singleaudible
He

not

his

"

Dr.

sound

he had

Abercrombie,"

On

Ditiate*

qf the

Brain."

520

tion
several hours, however, before distor-

hemiplegia.For
of the

had
loss of

face,or any of the usual symptoms of paralysis

commenced, the only existing
symptom was

speech.This gentlemandied

of

apoplexyin

about

months."1

two

lady,after an
but was
speaking,
A

wish

This

able

you

to

I
patient,

defect alluded

lost
paralysis,
communicate

to

yes, and

she meant

when

"I

attack of

in

all power

of

writingher

wrote
however, doing so, she invariably

When,

wishes.
no

SPEECH.

OF

PHENOMENA

MORBID

am

do

so,"

it

vice
was

informed, is

versa.

When

she wrote,

conversely.
still living,
the singular
construed

remainingunaltered.
A gentleman,
after many
which
premonitory
warnings,
fell down
in a fit. It was
tion
were
a combinadisregarded,
of epilepsy
and apoplexy. For two days his life
in imminent
was
covered,
redanger. He, however, partially
but with an
to give anything like a
inability
clear expressionof his wishes.
He
could speak,but
what
he said,without
its interpretation,
was
a key to
words
able to pronounce
He was
quite unintelligible.
with greatclearness,but they were
sadlymisplacedand
he said was
written down, and the
transposed. What
words
placedin their proper order. By adoptingthis
able clearly
to comprehend his
course, his familywere
This state of brain and impairment of speech
wishes.
continued
night,
with slightintermissions for nearlya fortregion.
accompaniedby acute pain in the occipital
In consequence
of this and other symptoms of local congestion,
the gentleman,at my request,
was
cupped. The
abstraction of blood was
followed by a decided mitigation
bited,
exhiof the symptoms.
Mercurial purgatives
were
the head was
shaved, and counter-irritation applied
behind the ears.
In the course
of five days from the
*

"

p. 688.

Systemof

to

Clinical Medicine," by R. J. Graves, M.D.,

Dublin,1843.

MORBID

timo

FOLLOWING

SPEECH

521

APOPLEXY.

the

he was
able to
were
cupping-glasses
applied,
for a few minutes, but if he conconverse
tinued
coherently
in conversation beyondthat time, he againbegan
to jumble and misplacehis words.
Minute
doses of the
bichloride of mercury were
administered in
subsequently
combination

with

greatestbenefit.

the

tincture

cinchona, with

of

gentleman,in

This

the

recovered, and has been

months, entirely
free from
A

all

had
somewhat

symptoms, superveningupon

two

to which

was

feature in the
and
coherently,
to communicate

case

with
to

two

attacks

of

apoplexy.

singularintermixture
be attached

was,

that

he

others, but when

of words

but the remarkable

was

able to write

whatever
lucidity,
perfect

he wished

he tried to talk,his

was

treatment, but in consequence

where

years

for many
similar cerebral

I saw
quiteunintelligible.
occasions, and suggesteda course

conversation
on

meaning could

no

four

few

resided

years in Canada, suffered from

conversation

for

of brain disease.

symptoms

militarygentleman,who

His

of

course

the

of his removal

this

patient

of remedial
to

America,

obligedto go on urgent family

business,I have lost all knowledge of the progress of
the case.
I was
not, however, sanguineof his recovery,
associated
as there were
symptoms of generalparalysis
with the case, dependent,
subtle
as I conceived,upon
some
organicchangesin the vesicular neurine of the brain.
The wife of an
eminent
dissentingminister lost,in
all knowledge of the
of a cerebral affection,
consequence
distinction of sex.
addressed men
This ladyinvariably
as

the

women,

familywere

and

vice

versa.

NapoleonJoubert, aged twenty-three

years, sailor of
admitted
into the principal
the third class,was
marine
the 31st October, 1855, under
at Toulon
on
hospital
the care of M. Reynaud.
Joubert,on the 28th April,1855, had been wounded

522

in the trenches

the forehead, a littleto the

after

line, and

median

aperture.

small

fragment of

In
months

patientin

In

phorus.

Toulon, and
which

the

month

the

with

31st

he

was

by
compelledto

this time the wounds

covered
they were
probeencountered
a

towards
to

on

very

the

Bos-

sent

to

sick leave,

suddenlyseized

was

the

the forehead

in

again.
hospital
were

osseous

tumefaction

of

consequence

not

surfaces.
was

At

cicatrised,

beneath
fungosities,

denuded

bone,

which
ever,
How-

remarked

the left eye, due apparently

bone.
Fistulous tracts opening

angleof

lesion of the malar

beneath

enter

with

of.

syncope,

considerable

the external

received

he

October, 1855, he

vertigo,followed

which

the

on
hospitals
September he was

of

it

for four

was

of the

his arrival there

on

left of the

to the

wound, Joubert

he did not avail himself

On

and

one

bullet.

to the

of this

consequence

for

skin

the external table of the frontal

adherent

remained

left of the

carried along with

projectile

The

first

the

passing beneath

distance of three centimetres, issued

which

piercedthe

hall

Sebastopol.A

hefore

portionof

upper

SPEECH.

OF

PHENOMENA

MORBID

had been
pointindicated that the locality
the seat of previousabscess.
In the night of the 31st October, or 1st November,
the wounded
sequent
seized with
man
was
vertigo and subsyncope. On the eveningof the 1st of November
he was
This ended
again attacked in a similar manner.
in a true epileptiform
On
the 2nd, in the
seizure.
had
morning,he had heaviness of the head, was torpid,
in articulating
a
words, no appetite,
difficulty
regular
pulse,and the bowels had not acted for twenty-four
this

hours.
In the

attacks recurred five times

nightthe epileptic
the bowels
the effects of
acted abundantly from
purgative.

;
a

524

ball.

The

and

of entrance

of exit of the

the wound

having

ferule

osseous

SPEECH.

line,in the interval which separated

to the left of the median

the wound

OP

PHENOMENA

MORBID

been

raised

by

the

of the internal table of

splinter
than a
This splinter
rather more
the frontal bone.
was
bited
centimetre in diameter, it was
detached, exhientirely
the commencement
of necrosis,with thinning,
and
compressedthe dura-mater on a level with the anterior
lobe of the brain. This splinter
beingremoved, a jutting
ther
pointof the frontal bone, which might have induced fur-

elevator,there

was

mischief,was

seen

re-sected

were
splinters

under

after which

neither
discovered,

any

other

no

tached
de-

suppuration

the dura-mater.

Soon
became

after the

operationthe aspect of the patient

better; the physiognomy appearedmore
open,

the eye showed more

of
movements
attention,and some
the lipswere
About
two hours after noon
distinguished.
the

who
patientrespondedYes to the surgeon in charge,
questionedhim; and about five,P.M., he uttered some
connected

On

words.

the 7th, the wounds

there had been

gave neither

painnor

trouble

seizure since five,A.M.

No
epileptic
dreams,
sleepin the night,a little agitation,
disturbing
incoherent
stools. At eight,
some
words, involuntary
heat
natural,pulsefull and regular,
A.M., the tongue was
of the skin normal
words
respondedby some
; the patient
to questionsaddressed
in part
to him ; he
executed
certain movements

On
were

no

at command.

the 8th tactile sensibility

returned, the movements
more

but
regular,

the

was
intelligence

still sluggish,

the responses were

slow and confused, but there was
a
gradual and marked
improvement. On the 13th, the
well as on the 1 5th,
as
eighthday after the operation,
the tenth day, he exhibited manifest signsof marked
intelligence.

CASE

SINGULAR

On

the

525

MUTISM.

21st,the sixteenth day,he raised himself

On

moments.

all the

OF

functions

the

27th, the twenty-secondday,of

the vision alone

is still changed,the

left eye cannot

but at a littledistance
distinguish
objects
and in a confused manner
; the speech is precise.On
the 29th, a splinter
removed
from the zygomatic
was
arch. On the 16th December, several small-pox
pustules
and visage(the patienthad been
appearedon the arm
well.
was
vaccinated). The wound
cicatrizing
On the 28th December, 1855, fifty-three
days after the
Joubert left the hospital
cured, enjoyingthe
operation,
whole of his faculties,speakingsanely,
and having no
disturbance

more

This

man,

obtained
about

of the vision.

after

sick-leave

for

six

rest

in

months.

the

On

barracks,

his

return,

after the

he presented
self
himoperation,
before the conseil de sante ; his intelligence
anew
was
free. He declared
clear,and the speechentirely
perfectly
that all his functions were
executed as regularly
before
as
the operation
well as before ; and
as
; he read and wrote
a
depressedcicatrix was alone visible at the pointwhere
the trepanhad been applied.*
wounded
in the head with
was
Fagan, a pipe-maker,
sword.
The
skull was
fractured,the mema dragoon's
branes
wounded, and the brain protruded.On the eighth
day he was attacked with convulsions,followed by stupor.
A portion
removed
of the bone was
The
by Key'ssaw.
convulsions graduallypassedaway, but fungus cerebri
days this had
appearedon the tenth day. In twenty-four
and in eleven days after this the wound
was
disappeared,
and
healed. In a fortnight
more,
Fagan was discharged,
unable to remember
his employment. He was
resumed
the names
of things. At this pointthe last reportended.
*

p.

ten months

weeks'

some

Reportedby

667.)

M.

Lallujeaux.(Gazette

MidicaU

de

Parit, 1867,

520

SPEECH.

OF

PHENOMENA

MORBID

led

irregular
from severe
after each debauch
pain in the
life,suffering
of August (he was
the 22nd
dischargedon
On
head.
the 15th May) he nearlylost all power in the rightarm
paralysed.
and hand, and the right side of the face was
this

After

he

24th

the

On

was

man

was

dischargedhe

very

re-admitted.

pital
abridged from the hosJohn
Fagan, re-admitted August 24th,
journal
pain in the seat of the original
complainingof severe
and although his head pain is not constant, the
wound
;
The

is

followingstatement
"

"

several

recur

paroxysms

times

in

last for

hour, and

an

distinct
inoccasionally
; vision
pupilsdilated, and very sluggish; strength
;
diminished
and legmuch
of the rightarm
and sensibility
;
; tongue clean ;
pulse 1 00, soft and easilycompressible
with
free ; memory
bowels
defective, particularly
very
two

or

minutes

three

respectto

and

names

vomits

events

recent

the

but

defect is not

few
as, with
facultyof memory,
tions,
excepbut miscalls almost
he cannot repeatproper names,
describe the use
everything; although he can perfectly
to the

confined

it,he calls,for instance, a watch,

of

pipe,"c.

pipe is

the word

that

gate ;

he

pronounces

book,

most

that the moment

frequently
; it is remarkable, however,
of his mistake,
word
he is conscious
he employs a wrong

and

is most

wound,
is

which

anxious

to

correct

is six inches

it.

long,and

The
half

at its centre, above

raised,particularly

cicatrix of the
an

the

inch

broad,

level of the

scalp; it is of a purplishred colour, tense, and shining,

which
is
very painfulto the touch ; and at the centre,
the softest and
most
prominent part,there is a strong
obviouslysynchronous with the radial pulse.
pulsation,
several severe
of pain,accom26th. Had
panied
paroxysms
of the
with grindingof the teeth and contortions
which
features,and succeeded by complete insensibility,
"

PERVERSION

lasted for five

six minutes,

or

in
pulsefell to fifty
round

neck, and
"27th.
"

28th.

the

minute.

527

SPKKCII.

during which
Twenty leeches

cicatrix,a blister

cold lotion to the head

to

the

time
were

nape

the
plied
ap-

of the

purgativepills.
No return of paroxysms
; pain relieved.
Several paroxysms
of convulsion,followed by

stupor;

cicatrix

it

disappearson

covers

OP

tense

more

is removed

and

red, but the fluid which

pressure, and

returns

when

the

pulse seventy-two, and regular;

to improve ; patongue foul ; bowels open. Continued
roxysms
until
less
the
4th of Sepbecoming
frequent
tember,
when
he had violent vomiting followed by convulsion,
pressure

after which

hours

he

remained

insensible

for several

tural
napupilsdilated ; pulsefifty-four
; respiration
small opening was
made into the prominent part
; a
and two drachms
of healthypus were
of the cicatrix,
charged
disto sixty-eight
; the pulseimmediatelyrose
; he
sat up in the bed, answered
and
questionsrationally,
said he was
quitefree from pain.
7th. Continued
free from painor convulsion ; the little
is as largeas before ;
opening is healed, and the tumour
a larger
opening was made into it,and a small quantity
was
(about half a drachm) of bloody serum
discharged.
Oct. 9th.
Has
had no
pain or convulsion since the
4th of September, when
the abscess was
opened; he
appears in perfectbodilyhealth, with the exceptionof
and hand,
some
remainingweakness in the right arm
and some
slightconfusion of vision j the cicatrix is
there is no
level with the head, and
on
a
perfectly
in the seat of the former
s" nsible pulsation
abscess; the
mental phenomena are as before described, and are most
and even
describes
remarkable; he speakscorrectly,
fluently;
;

his sensations

proper

names

he

with

great clearness,but avoids all

(forexample)

"

says,

I have

great

528

"

to his shoulder,)
here," (pointing

and numbness

weakness

along here," (drawinghis fingeralong the

and

palm of the hand ;) but

;
suddenlyI don't see rightly
"

the

He

ever."
the word
He

so.
"

SPEECH.

OF

PHENOMENA

MORBID

"

counted five

but

soon

see

was

though he
finger,"

friend." When

"

of ideas could
to the

misnomer
in

country;

be

mind

the
but

in

the

as
surprise,

traced

and

of every

the

error,

but

idea of

the

the association

he

led

was

nected
being con-

would, naturally
enough, be
thing,
of
association."*
the faculty

of instances

this should
which

disturbingcause,

force to dissociate

"

of his class in this

greater number
;

said, I

and

buttermilk

man

be traced

;"

buttermilk

through which

stirabout

as

desired to say
"

of it." Sometimes

name

such association could

no

of his

immediatelyconscious

that's not the

know

well

as

fingers
; but could not say
made
attemptsto do
many

he said,and invariably
stirabout,"
says,

but

I sit up

When

his

on

called his thumb,

pain.

no

to

arm

the

was

name

no

excite

cient
of suffifrom

the

sufficient to disorder

"

Osborn

Dr.

has

illustration of the

detailed

the

followingremarkable
phenomena of speech,which

morbid

to be

quotedin extenso.^
A
gentleman,of about twenty-sixyears of age, of
considerable
literaryattainments, a scholar of
very
and a proficient
in the French, Italian,
TrinityCollege,
and German
languages,about a year ago was
residing
in the country,and indulgedthe habit of bathingin a
neighbouringlake.
One morning,after bathing,
he was
at breakfast,
sitting
fit. A physician
when he suddenlyfell in an
apoplectic
was
immediatelysent for; the patientwas bled, and
after
being subjectedto appropriatetreatment, he

deserves

under

"

Dublin
the

care

QuarterlyJournal
of the late Sir P.

of

Medical

Science,"for

Crampton, AI.D.

f Ibid., vol.

iv. p. 157.

1833.

"

case

PERVERSION

EXTRAORDINARY

became
to the

sensible in about
of his

use

OP

529

SPEECH.

Although restored
fortnight.

he had
intellects,

mortification of

the

findinghimself deprivedof speech. He spoke,but

what he uttered was
althoughhe
quiteunintelligible,
laboured under no
and uttered a
affection,
paralytic
with the greatestapparent ease.
varietyof syllables
When
he came
to Dublin, his extraordinary
jargon
led to his being treated as a foreigner
in the hotel
where he stopped
he went to the college
to
; and when
see

friend,he

and
gate-porter,
apartmentswhich

was

unable

to express

his wish

to the

only by pointingto the

his friend had occupied.
of observing
Dr. Osborn had ample opportunities
the
under
which
the
peculiarnature of the deprivation
patientlaboured ; and the circumstance of his having
received

succeeded

liberal education, enabled

him

to

ascertain

in this affection,which
would
not
peculiarities
otherwise have come
follows :
to light. They were
as
1. He
perfectly
comprehended every word said to
him ; this was
of ways unnecessary
provedin a variety
some

"

to describe.

2. He

perfectly
comprehendedwritten language. He
continued to read a newspaper
every day, and, when
examined, proved that he had a very clear recollection
of all that he read. Having procureda copy of AndraTs
Pathologyin French, he read it with great diligence,
intended to embrace the medical profession.
having lately
his ideas in writingwith considerable
3. He expressed
it appearedto arise merely
he failed,
fluency
; and when
the words being
from confusion,and not from inability,
not in their
correct, but sometimes
ortho"jraphically
proper places.Latin sentences he translated accurately.
He also wrote correct answers
to historical questions.
4. His knowledgeof arithmetic was
unimpaired. He
added and subtracted numbers

of different denominations
M

530

with

of

game

numbers

playedwell at the
calculations relating
to
also

He

readiness.

uncommon

involves
which
draughts,
and position.
recollection of musical

5. His

SPEECH.

OF

PHENOMENA

MORBID

sounds

ascertained,not knowing the extent

be

not

knowledge of

seizure ; but he remembered

apoplectic
the King ;" and when
God
Rule
save
he pointed
to the shippingin the
played,

before the

music
the

of his

could

of

tune

Britannia"

"

"

was

river.
words
after another person
power of repeating
almost
confined to certain monosyllables;
and in

6. His
was

repeatingthe

letters of the

k, q, ^ti v, w,
pronounce
uttered
in
those sounds
other letters.

The

alphabet,he could
x, and
z, although he
attemptingto pronounce

letter i also he

very seldom

was

never

often
the
able

to pronounce.
7. In

order

to

ascertain

and

place on record the

of language which
he exhibited,
peculiarimperfection
Dr. Osborn
selected and laid before the patientthe
the bye-lawsof the Collegeof
sentence from
following
viz. :
It shall be in the power
Physicians,
of the College
to examine
not examine
or
any Licentiate previousto his
admission to a Fellowship,
as
theyshall think ft."
Having set him to read, he read as follows : An the
be what in the temother of the trothoiodoo to majorum or
"

"

that emidrate
to

ein einkrastrai

that kekriiest."

fromtreidoas

ra

presentedto him

was

then read it
the

follows

as

in

to his

a
"

cowpcstret to samtreis

mestreitcrso

mestreit to ketra

few

Be

The

days

totombreidei

same

passage
afterwards, and he

inather be in the kondreit

amtreit

eftrcidoturn

emtreido

and

dried rederiso

of

temtreido

of deid daf

drit des frest."

Dr.

Osborn

in the above
which

observes

that there

several

syllaM^s

in the German

of

frequentoccurrence
probablyhad made

are

guage,
lan-

strongimpression011

532

SPEECH.

OF

PHENOMENA

MORBID

as
questions,

the brain, invariably

repeatedmy
me

your

without

tongue," or,
doing as she

you lift up your arm?"

I am
bid.
acquaintedwith

was

idiot of eleven years, who

in

occurred

to

in

in this way
The

manner.

me

two

whose

exhibited
examined
"

echo"

addressed

mind

was

young

never

mimics

music

phenomenon has
girlslabouringunder
at its height."

same

typhus fever,when the disease was

had suffered
A gentleman,who
and

show

"will

an

remarkable

"

acute

remarkable

mental

distress,

for its

vigour,

I
softeningof the brain.
He
him.
had, to a singulardegree,the
symptom, repeatingalmost every questionI
His friends, who
to him.
accompanied the

of

symptoms

themselves
patientto my house, were
symptom, although they had never
This
patient subsequentlyhad an

struck

before

with

this

observed

attack

of

it.

decided

found
extensive
and, after death, there was
paralysis,
softeningin the whole of the right hemisphereof the
brain.
I

the

presume

extent, arise from

"

echo"

that

phenomenon may,
sluggishand abstracted

to

some

of

state

thoughtamounting to reverie,which is so often seen in

and undetected, because obscure,
of long-existing,
cases
mind
affection of the brain.
The
appears incapable,
under
these circumstances, of apprehendingthe most
I have
and, parrot-like,
simplequestions,
repeatsthem.
noticed this symptom in other conditions
of depressed
vital and nervous
but it more
companies
acparticularly
power,
of some
softening
portionof the brain.
INVOLUNTARY
Whilst

ARTICULATION,

to
referring

it will not

be

out

the
of

morbid

OR

THINKING

phenomena

ALOUD.
of

"

speech,

placeto direct attention to a

precursory symptom, not only of approachingparalysis,
I allude to the practice
but of insanity.
of many
patients,
from
disease, of
suffering
incipientbrain and mind

EFFECT

OF

INSANITY

talkingaloud,when

UPON

alone.

THE

533

VOICE.

observed this symptom to

distinguished
physician
precedean attack of paralysis,

in the

who

of

case

nobleman

for many

years ruled the

destinies of this country.

In
the

conditions

many

patientis

observed

of

of brain

irritation and

to talk to

himself, and

the

mencement
com-

by this symptom.
I am
that tliis eccentric habit is quite conaware
sistent
fully
with a perfect
state of health of body and mind ;
it is a symptom that should be carebut, nevertheless,
fully
regardedin all cases of suspecteddisease of the
brain coming on at a criticalperiodof life,
if
particularly
conjoinedwith other signsof cerebral disorder.
MORBID
In

is often
insanity

disease,

VOCAL

PHENOMENA

detected

INSANITY.

ACCOMPANYING

of

all power of speechappears,

insanity,
for a considerable period,
Insane patients
to be lost.
have been known
to continue
for years without uttering
! This does not generally
arise from any
a vocal sound
of the organs of speech,
paralysis
althoughthis affection
sometimes
exists,but it is owing to the mind
being
absorbed
or
intensely
preoccupiedin the contemplation
of predominantinsane ideas.
"

some

cases

Dr. Brierre
who

de

Boismont

relates the

case

of

man

for

was

had not
fifty-two
years insane, but who
gated
interroWhen
thirty
years !
perse veringly

spoken for

he gave a kind of grunt and ran

About
away.
fifteen days before his death, this patientrecovered the
use

of his

put
There
voice and

speech,and

to him
are

answered

well
perfectly

all questions

I.

certain

characteristic
peculiarities

of the

ally
speech of the insane, and these are occasionin the incipient
recognised
stageof the malady. I
am
acquaintedwith a gentleman subjectto attacks of
whose paroxysms
recurrent insanity,
are
alwayspreceded
alteration and eccentricity
For a
of voice.
by singular

53 I

PHENOMENA

MORBID

OF

SPEECH.

for a fortnight,
before
days,and occasionally
exhibits symptoms of aberration,
the mind
the voice becomes
remarkablysharpand shrill. This warning of the
approachingrelapseis immediatelyappreciatedby the
taken to prevent any misand steps are
at once
chief
family,
from
the violence of a sudden
that might ensue
maniacal
In another case, a lady who has had
outbreak.
repeatedattacks of insanity,
begins to clipher words
and leave her sentences half-finished in the earlyperiod
of the attack.
in the incipientstage,
Some
patients,
and quickly. In other forms
speak snappishly,
sharply,
of insanitythe voice
solemn
and
a
assumes
grave

week

ten

or

character.

These

attacks
voice

latter alterations

of acute

are

melancholia.

observed
have

to precede

known

the

modifications
and
undergo very remarkable
sometimes
a
completemetamorphosisin the incipient
stageof insanity.
A lady,some
her
respecting
years ago, consulted me
husband, who had, accordingto the observation of her
unsoundness.
friends,exhibited symptoms of mental
She

to

had

not, however, herself noticed any

remarkable

her
change in his mental condition such as to justify
a
entertaining
suspicionof approachingaberration of

mind.

She, however,

singularalteration
attributed

was

to

from.
suffering
voice to
it

came

cold

which

could

It sounded

not

confinement

this

had

of

remarked

his voice,which

she

presumed he
describe
accurately

was

his

(sheobserved,)hollow, as if

througha largeempty
to

she

in the character

She
"

me.

admitted

tub."

consultation, the

Two

sequently
sub-

months

gentleman was

in

dangerouslunatic.
in which
M. Morel
of insanity
refers to a case
the
attacks of
patientwas subjectto dangerous periodical
violent homicidal delirium.
His relations alwaysknew
when

as

the maniacal

crisis was

about

to occur, from

sin-

ALTERATIONS

OP

VOICE

alteration that took

SYMPTOMATIC

OP

placein

535

INSANITY.

his voice.

It had

at

these

He
periodsa hell-like sound.
spoke in what is
"Foiis Je Polichinelle"
designated
by French pathologists,

Punch's

or,

voice.

Quislain, when

the

alluding to

vocal

subjectof morbid
observes :
insanity,

phenomena as associated with

"The
speech is altered from the natural tone and
It is not
style; the articulation becomes embarrassed.
distinct as usual,or it is clipped,
so
hurried, or weak,
or
too emphatic,or prosy, or drawling. Some
words are
or
cut short like a drunken
man's, or singlewords are repeated
a
or
or
hastily,
syllableof a word is repeated,
there is a difficulty
in utteringcertain letters,
such as
T's and R's, or words
requiringan emphasis,or when
several consonants
come
together. At times the patient
to be at fault in findingthe proper
stammers, and seems
word, expletive,
or
epithet,
phrase,which in health he
both apt and fluent in using; or, it may be, that instead
was
of being cautious and studied in his speech,
he is all
of a sudden voluble, redundant, and profusely
garrulous.
But at other times the speechis perfectly
natural in utterance
and rational in what
is said,and yet the patientis
deeplyattainted with insanityall the time. There shall
unreasonable
word uttered.
not be a single
or
ill-spoken
But
a

"

at the

time

same

of

slinkingout

friend,or

answer

there is a

reserved
retired,

sight,a refusal to speak

the queriesof the medical

or
ill-temper

sulkiness, that

articulation.

At

is

worse

than

manner,

to
man

old

an
;

an

imperfect

length he speakswith irritation : I

their designs he is not my friend ; he has been
know
of everything. I am
informed
surrounded
with freemasons,
tories,or dissenters. I know there
or
or
papists,
'

"

is

God,' "c.

spiteof

his

"c.

good

Such

person

articulation."

is still insane

in

536

SENSATION.

OF

PHENOMENA

MORBID

XX.

CHAPTER

Phenomena

Morbid

of Sensation.

is very frequently
affected in organic
sensibility
disease of the brain, and exalted,depressed,
or perverted
states of this important function are to be found among
the earlyand premonitory symptoms of all cerebral

THE

affections.

The

EXALTATION
many

OF

acuteness

and

this state

throw

of the
the

may

be,

a.

Exalted.

P.

Impaired

7.

Vitiated.

SENSATION

affections of the

organicdisease

touch

sensation

of the

nervous

lost.

or

(HYPER^STHESIA).

"

system unconnected

In
with

exhibits great
brain,the sensibility

to such

of morbid

degreedo

ness
witoccasionally
exaltation,that the slightest
we

skin,or puff of cold air,has been

known

to

of convulsive agony.
patientinto a paroxysm
In hydrophobiathis condition of acute
is
sensibility
in its highestdegreeof development,
observed, perhaps,
and it is frequently
time
to exhibit itselffor some
seen
after death has apparently
taken place.
In these cases, such is the morbid peripheral
acuteness
of sensibility,
that the minimum
portionof cold wind, or
the mouth, coming in contact
a faint puffof air from
even
with the cutaneous
has
surface of the hydrophobic
patient,
of spasmodicsuffering.
often induced a fearful paroxysm
In cases of acute visceral inflammation
of
some
involving

OF

SOFTENING

the

gangliaof
has
sensibility
t- rieal

the

THE

537

SPINAL-CORD.

nerve,
greatsympathetic

become

affections of

keenlyacute.
women

the

In

the

general
certain hysis

sensation

often

manifested.
such
To
intensely
a
degree has
been observed, that patientshave
hypera'sthesia

known

to

touched.

scream

The

ruffle of

this
been

when the skin has been only

violently
faintest whisper,
sudden openingof a door,

has been known, in such cases,

newspaper
to induce severe
conditions of violent convulsive spasm.
It is difficultsatisfactorily
to explainthis phenomenon,

or

but

as

described

here, it is frequentlyobserved

in

practice.
in the incipient
Occasionally,
stage of inflammation
of the encephalon,
exalted condition of sensation is
an
noticed. The same
phenomenon is apparentin cases of
tumours
with the corpora rextiformia,
pont
interfering
Vdrolii,
and corpora quadragemina.An
cerebelli,
processm
exaltation of sensibility,
has been
and general,
both special
observed in diffused neuralgic
conditions,and
frequently
when connected with cephalalgia
of longcontinuance, and
associated with morbid
phenomena,it should
psychical
of supposeddisease
attention in cases
alwayscommand
of the brain and spinalcord.*
Hypenusthesiaof the
referred
will be more
sensorial ganglia
special
particularly
9

the
in often connected with a profoundpain occupying
Spinalsoftening
alted
Extrunks.
the
of the great nervous
depthof the limb or following
for neuralgia.
is,as Andral observes,liable to be mistaken
sensibility
In other caae*
these pains do not exist. The limb is merelybenumbed, the
course

The patient,
parts are cold and less sensible than they should be.
but
the disease
with
treats
these
neglect,
says Andral,
symptoms
incipient
marches
graduallyincrease,and
insensibility
on, the engourdissementand

extreme

then

ensues.
paralysis

the chief symptom

sensation of cold

Andral
for two

refers to the

consecutive

of a
particulars

months

was

nothing

case

more

in which
than

occupyingthe extremities of the fingers

and toes.
It
This symptom continued without any change for eightweeks.
After
of
kind
in
the
was
same
feeling
part.
suddenlychanged to a pricking
seized with a brusqueconvulsive movement.
a short time the extremities were
des mouvements
saccade*."
These latter symptoms continued to progress
"

of intense cold

"

"

until followed

by characteristicsignsof spinalsoftening.

538

MORBID

to when

of

SENSATION.

OF

PHENOMENA

of the exaltations

proceed to a consideration
viz.
special
sensibility,
:

"

Vision.

a.

(3. Hearing,
Taste.

y.

3. Touch.
have
Epileptic
Vertigo.Physiologists
the body
types of vertigo. 1. When

described various

"

backwards

and

to be

seems

2. In

forwards.

on

which

3. When

side.

one

the

to

appears

movement

the

sensation
illusory

is

rotatory. It is not my intention to consider

these various phases of vertiginous
sensation.
In all affections of the

forward

among

In

symptoms.

form

of.illusory

brain, the sensation

some

of
diagnostic
than
functional,

in detail

stand prominently
vertigo,or giddiness,
cipient
the significant
and importantin-

termed

movements,

move

respectsit

of manifestation.

headache,
If the

istically
character-

more

disease,organicand

serious cerebral

that of

is

in its

even

more

acute

an
vertigobe clearly

idio-

pathicencephalicaffection,and not, as is often the case,

form
of stomach, heart, hepatic,
symptomatic of some
visceral,renal,or
of

state

the

blood,disease,we

brain

is

may

infer that

entitled to careful

the

pathological

and earnest therapeutic

consideration.
analysis,
This phase of disordered sensibility,
when
not obviously
from the above causes,
connected with states
or
arising
of poisonedblood, resulting
from retained excretions,or
of a toxic agent in the vital fluid,generally
presence

indicates serious disturbance

and

is

of the

frequentlydependent upon

balance in the amount

of blood

sinuses

the

as

well

as

to

cranial circulation,
a

want

of normal

distributed to the various

venous

and

arterial cerebral

vessels.
The

cerebral

typeof vertigois easilydiagnosedby

540

MORBID

PHENOMENA

OF

SENSATION.

by the French
the Petit-mal, and, by English writers,
pathologists,
epileptic
vertigo. It is observed, at all periodsof life,
affection
in various degreesof severity.It is a common
of childhood, and often,before its existence is suspected,
the
damages the bodilyhealth and undermines
fatally
Much
of the defective and enfeebled intellect
intelligence.
observed among
children,associated with great
disorder of the generalhealth and impairedvital and
force arises from this subtle and mischievous
nerve
phase
of epilepsy.
In the majorityof cases, particularly
in adults,these
attacks of pseudo epilepsyare
with
unassociated
any
form
of convulsive
falls
action.
The
patient never
down
in a characteristic fit,neither is he deprived
for
The
length of time of consciousness.
malady
any
exhibits itself at all periodsof the day, and in all
in the
possiblepositionsof the body. The fit occurs
middle of the night,duringthe transition state between
sleepingand waking, early in the morning on first
during meals, whilst engaged in conversation,
rising,
for a
and when
walking in the streets. The patient,
is
second or two, and occasionally
for a longerperiod,
seized with
severe
vertigo,and momentarily loses his
This disorder of sensation often developes
consciousness.
the patientis activelyengaged in his
itself whilst
I have known
vocation.
accustomed
clergymenattacked
whilst preaching
merchants
when
in the pulpit,
engaged
at the desk, or on the Stock Exchange, barristers whilst
traced the
courts of law. I have in many
cases
addressing
itself
malady back for a periodof some years, manifesting
conditions.
under
all conceivable physicaland mental
of an
This
affection is rarelyconsidered
important
character,until the bodilyhealth and mental condition
of the patientbegin to be affected. It is then disThis

has
type of epilepsy

been

termed

OBSCURE

CASES

OF

541

EPILEPSY.

for a lengthened
subject
time to undetected
and unobserved
attacks of epileptic
vert iiro,
which have been considered either as symptomatic
of a disordered state of the stomach
liver,or as simple
or
fits of ordinarysyncope.
It is scarcely
possible,"
says Trousseau, to describe
these epileptic
attacks exceptby examples. In childhood,
when
it is especially
it may
manifest itself
common,
thus : The child stops short in the middle of its play,
remains
fixed eye
and
motionless, with
suspended
or
returning to itself after seven
respiration,
eight
We
observe
seconds, and sometimes
hardly two.
may
A
while
analogous examples in the adult.
person
of his hand
denly
sudplayingat cards finds the movement
about to play,the card remaining
arrested when
in his hand as if affixed to it. A deepinspiration
occurs,
is completed,
and the vertigo
the suspendedmovement
At
lias passed away.
other times the patientrises,
walks he knows
not where, striking
and
againstobjects,
stops short at the instant he returns to himself. At
others he mumbles
words, or repeats
some
unintelligible
the same
word, as his own
name,
obstinately,
during
or
seven
eightseconds. In all these cases the individual
without the external world.
is completely
Sensation is
abolished,and we may shake or pinch him without his
anything. In certain cases, as in a patientnow
feeling
in the wards, the vertigois announced
by a peculiar
authors have
of
sensation, to which
given the name
and which, in the greatmajorityof cases, consists
aura,
of a current, that mounts
of
in the feeling
up from one
other point of the surface,towards
tin- limbs, or some
At other times there is a sensation of pain,
the head.
of little imperceptible
convulsive
of formication, or
of cases
these phenomena
In a great number
shocks.
covered

that the invalid has been

"

constitute

"

the entire

affection,and deserve the

name

of

542

SENSATION.

OF

PHENOMENA

MORBID

until
At others,they go on increasing
epileptic
vertigo.
the fititselfoccurs, and then it is usually
by the thumb
But the fit is onlypreceded
that the aura
commences.
by the aura quiteexceptionally."
seau's
A child,five years of age, was
broughtfor M. Trous-

day, the

once

times

Several

advice.

week, and

the

child became

which, accompaniedby remarkable

than
several seconds,and never
more

subjectof hiccough,
lasted for
paleness,
minute, headache

succeeding. M. Trousseau,

hebetude

and

than

more

alone in his

and a year after the

pronouncedthis epilepsy,
opinion,
At other times,"says
fits.
child had regular
epileptic
the same
"epilepsymanifests itself by a
authority,
sensation of cardiac suffocation. The
marked
patient,
becomes
seized with most violent palpitations,
extremely
and loses all consciousness. In ordinary
palpitation,
pale,
it is well to be
consciousness is alwayspreserved
; and
in the epileptic,
since the
of these palpitations
aware
idea
onlyof his heart,an erroneous
patientcomplaining
formed.
of the nature of the disease may be easily
of the intellect are very frequent
after
Disturbances
the epileptic
fit,and they are also met with subsequent
head
is heavy and
to the vertigo.The
aching,the
and taciturn,and as if stupified
for
being morose
patient
"

"

while

"

for

half

or

of
the purpose
importance to observe these

whole

it is of extreme
diagnosis,
changes; for we find them
nervous

may

spasm,

however

be exhaustion

after

intellect always remains

of the mental

hour.

as

For

of

consequence
violent it may have
a

violent fit of

very

powers

clear.

no

been.

other

There

but
hysteria,

This

relative

the
fusion
con-

may escape the physician's

for it to escape that of the

attention,but it is very rare

his relatives,
that they should
so
or
patient

be

always

interrogated
upon this point.
in the vertiginous
form, as it
There is nothingspecial
dependsupon the same causes as the fit;ancl very often
"

HTPER.BSTIIE8IA

ol'M-rvi-alternations

we

subject.It

same

after from
the

is

to ten

one

OF

of the

THE

BRAIN.

and
vertigo

543

the fitsin the

rare, however, to find,

by no means
time,the fitsentirely
displace
years'

vertigo."

and fatally
so
epilepsy
fearfully
that previously
scribed.
dedestructive to the intelligence
as
associated with obscure and not
It is generally
detected or defined changesin the cerebral tissue.
easily
alterations are
These
more
particularly
pathological
diagnosedin the advanced stageof the affection. Hence
the grave
importanceof an earlyrecognitionof this
and the necessity
subtle and insidious form of vertigo,
administration of remedies for its cure.
for a speedy
This type of hypersesthesia
of the brain
HEADACHE.
in detail when, in the concluding
will be considered more
section of the work, I address myselfparticularly
to an
of diagnosis.It may
of the general
principles
analysis
that all organicdiseases of the
be affirmed,as a. postulate,
brain are accompanied
headache,acute and
by vertigo,
abnormal
sensation within
chronic,or by some
physical
the cranium. Cephalalgia,
however, may be considered as
tions.
almost invariable accompanimentof all cerebral affecan
in the
This symptom is rarely
absent,particularly
disease. In some
earlyor acute stageof the encephalic
There

is

type

no

of

"

forms of tumour, and in those obscure alterations of tissue

the patient
often posigeneralparalysis,
tively
denies that he has headache,or ever was
subject
I have, however,
to any cerebral pain or uneasiness.
ascertained that cephaafter minute inquiry,
generally
by the patient,
lalgiahas existed,but been forgotten
ligence
instances from an impairmentof intelin many
arising
In cases of advanced general
and loss of memory.
of the brain,the patient
and chronic softening
paralysis
maintains that he is quitefree from all headache,
stoutly
and will not admit that he suffers from vertigo,
or
any
of uneasiness within the cranium, but his
description

connected

with

544

OF

PHENOMENA

MORBID

that

demonstrate
clearly

actions

SENSATION.

there exists

hyper-

an

sesthesia of the brain.

exceptionof atrophy,"says Romberg,

of the diseases of the brain occur
unaccompanied
none
by headache." Nasse affirms that pain of the head is
of the most constant symptoms associated with cerebral
one
It always exists,particularly
in central
tumours.
softeningof the brain involvingthe corpus callosum,
septum lucidum, fornix, and the ventricular parietes.
the

"With

"

and
says, that disease of the corpus striatum
with
is attended
little or no
localized
opticthalamus
Todd

Dr.

pain pointingout

of the

abscess

In

character, is

the exact
brain

rarelyabsent.

seat of the lesion.

headache, paroxysmalin
In

all the

its

affections of the

encephalonconsequent upon chronic otorrhrea,the same

riably
present. Apoplexy is almost invasymptom is generally
noises in the head,
precededby either severe vertigo,
of cephalalgia.
confusion of intellect,
or
severe
paroxysms
In cerebral hemorrhage,the patientis often heard to
complain,immediatelypriorto the attack,of a sensation
in the head giving rise to the impression
that an actual
laceration of the cerebral substance has taken place.
Pain of the head does not alwaysdenote the character
cerebral

of the

lesion.

remarks, the most

of
their

varied

of concretions

on

as

Andral

of the

tents
con-

of
injection

the

free

face
sur-

arachnoid, purulent infiltration of the pia

of the
or

morbid

accompany,
condition

cranium, bones, membranes,

the

tissue,formation

mater,

It may

effusion of pus

or

serum

into the ventricles.

this
authorities,
According to the opinionsof some
what
symptom of organicdisease of the brain has been someexaggerated.*It has been asserted that headache
*

have

"

is a symptom
Cephalalgia

anticipateda

additional

"

care

in

fact

which

of less

frequentoccurrence

demonstrates
negatively

attending to

other

than
the

we

might

necessityof

signs indicatingdisturbance

of

545

HEADACHE.

CEREBRAL

affections. Cases
invariably
presentin encephalic
makes no complaint
where the patient
occur
undoubtedly
N not

of

headache,but

of
repudiation

it would

the

be unsafe to infer from

this

that it has not, at any stage

examined
I have never
carefully

symptom

of the disease,existed.

clearly
developeddisease of the brain, without
headache, or some
havingassured myselfthat vertigo,
a

of

case

the

that there is

cerebellum,between
With

pain.

recorded

oases

the

view

to

in Dr.

Andral's fifthvolume
ti'in,

the

The

centres.

nervous

also shows

analysisof

no

authentic

of this

cases

definite relation,
except in the

site of the lesion and

the site of

the

these points,I
determining
Abercrombie's

of that monument

work

have gone
diseases of the

on

description

instance of the

previous
through the
brain, and

indueof talent,
and logical
industry,
results of the experience
of the British

CliniqueMedicale.' The
should have
wider apart than we
physicianare numerically
coincide
undoubted
mischief
in
that
cerebral
expected,
though they
proving
is
unassociated
with
frequently
cephalalgia.
We
take first by the laws of courtesy the foreignauthor.
He gives
hundred and eight cases
in which death was
one
manifestlydue to intracranial disease,
as confirmed \"y
post-mortem examination ; or in which, though
'

and the French

"

"

the fatal issue

"

due
immediately

was

the cadaveric

to other causes,

section

demonstrated coincident cerebral disorganization.

In

conformitywith the observations of Andral, the ratio in which headto sixty-one,

or
nearly
accompaniesintra-cranial mischief is as forty-five
subtract the apoplectic
as
two to three : if we
cases, in which this symptom
is comparatively
of less import,we obtain a ratio of thirty-nine
in
to forty,
other words, the frequencyand absence of headache are
almost equal,or, to
use
a sporting
phrase,it is an even chance whether the intra-cranial disease
is or is not accompaniedby cephalalgia.
hundred and thirtyof Dr. Abercrombie's
one
Accordingto the analysis
"

ache

"

histories of intra-cranial diseases,the ratio in which headache

is a
of organic
disease of the brain is as ninety-two
to thirtyeight,

nine

concomitant
or

the apoplectic
cases,
nearlythree to one ; while,by eliminating
to fifteen,
or
higherratio of seventy-four
nearlyfive to one.
that determine
We cannot
stop to inquireinto the causes

obtain

we

thV Mill
"

want

of accordance

bias

any

on

observer*,and
affections;

side

one

neither

nor

can

we

between
or

the two

authors

both

the other, because

upholds any

it

so

is not
certainly

to

eminentlyimpartial

are

peculiartheory

great
due

in

regard to

cerebral

that the national constitution of the French

suppose

to afford

an
adequateexplanation
givendemonstrate that headache is an
important
symptom in the localaffectionsof the cerebral system,while theyalso
evidence of the
show that its absence must
not be regardedas trustworthy

and

Englishhabit of body is
of the discrepancy.Stillthe

immunity of
of headache

numbers

When

in the individual varieties of

considerably
; it
disorder*
apoplectic
; here

involved.

different as

the cranial contents.

ratio varies
in

so

The

cases

is

we

examine

we
disease,
cephalic

comparatively
rare,

as

we

the cerebral tissue itselfis

of cerebral

into the

softeningin

which

see

have

occurrence

that the

already
seen,

commonly primarily

headache

is absent also
N

540

cerebral sensation,pain,or

of abnormal

form

referred to

has not been

by

the

uneasiness,

patient.

(loss of sensation)is

ANAESTHESIA

nected
closelycon-

more

cerebral states than

certain morbid

with

SENSATION.

OP

PHENOMENA

MORBID

the

dition
con-

referred to.
previously
few
lesions of sensibility
These
occur
a
occasionally
days and hours before acute attacks of brain disease ;
of

has

sensation

been

priorto anything like active

pairment
This imsymptoms manifestingthemselves.
of sensation is often most obscure in its origin,

cerebral

insidious

in

its progress.
For
time
some
the patientcomplainsof any diminution
sensiof bility,

well

before

loss

for years

to exist

noticed

as

the

however,

sometimes,

as

of the

is conscious

he

largelyover
predominate

surface of

cutaneous

those in which

it

occurs

while

the

some

is the

reverse

to its absence is,

meningeal disease,where the frequencyof cephalalgia
Andral's
four
three.
This
is
in
to
to
observations,
as
according
harmony with

case

what

in

observe in all the organs of the body ; for,it is a rule almost without
disease
the
that
is
affecting
envelopes
accompaniedby pain in
exception,
we

and

frequentratio then when it seizes upon the actual

able
parenchymaof the viscera. This pointis also one that may be made availthe probablelocality
in estimating
affected in the chronic or periodical
The relation of the envelopesof the brain,in a physioforms of cephalalgia.
logical
pointof view, to their contents, is even of more
importance,if such a
is justifiable,
than in the case of most
other viscera,
since they serve
remark
and for the facilitationof change of form and place,
not only for protection
of nutrition.
but are, at least in part,eminentlythe medium
The liver,the
kidneys,the spleen,the heart,the lungs,and the muscles, receive their supplies
of the nutrient fluid by conduits that enter directly
into their structure,
The great
by immediate vascular connexion with the nearest arterial trunk.
bulk of the blood conveyed to the brain is, as it were, filtered through the
ramifications contained in the pia mater, while it quits the organ in a less
circuitous manner
indirect course, though stillin a much
than commonly
more
elsewhere.
Both the pia mater, therefore,
the arterial membrane,
as
prevails
a

form

severer

and

the dura

attention in
serous,

or

more

matter, sit venia

pointof view

verbo, as

distinct from

fibro-serous membranes

which

are

may

enter

which

we

are

teaches

us

that

all the items

Medical

case

that

presentedby

of headache
necessary

into the determination

comparatively
ignorant;

to

of the
and

membrane, claim

venous

occurringelsewhere.

able to localize every

we
cranial tissues ; but it is the more

that

the

the

am

the

far from

our

epithelial,

asserting

in any one
of the intraestablish all the elements

question,as it is
whole historyof

one

upon

medicine

results by minute
we
can
attention to
only arrive at positive
Dr.
a complex of morbid
constituting
phenomena."
Sieveking,

Times

"

and

Gazette,August,1854.

548

SENSATION.

OF

PHENOMENA

MORBID

fingermay be
passed over the entire surface of the globeof the eye
without causing any irritation in the part sufficient to
an
approximationof the eyelids. The
produce even
of the
patientsmanifest no sign of pain or sensibility
these circumstances, the end of the

under

eyes
other
In

of the

halves
some

body.
the
cases,
apoplectic
decided impairmentof

some

membrane

mucous

priorto

cases,

side of the mouth.

attack

an

This

are
patients
takingtheir

relates

in this

was

in isolated

five

case

or

in

of acute
loss of

one

of the
In

fossae.

disease of the

on
one
sensibility
apparentwhen the

is

food.

apoplexyin

observed

some

parts of

six

sensation

symptom

of

case

loss of sensation
the attack

in

has
physiologist

same

of the nasal

brain, there has been noticed

Andral

of sensation

diminution

no

the

partsof

observed

is

there

when

even

which

time

the thorax.

complete
to
previously
a

There

portionsof skin, about

existed

the size of

piece each, where it showed no signs of

when
even
sensibility
pinched or prickedwith a sharp
instrument.
In other partsof the thorax, the sensibility
a

five-franc

of the skin continued

intact.

These

circumscribed

states

of cutaneous

continuous
not
in their
were
insensibility
and insensibility
manifestation, sensibility
appearingto

be alternate conditions.
Decided
some

which
cases,
cases

loss of sensation

is

in
frequently
preceded,
for many
of numbness,
cases
years, by states
considered
are
unimportant,and, in fact,in many
several
are
altogether
neglected.I have known
of apoplexyand paralysis
where
slightdegreesof
anaesthesia

cutaneous

to

have

existed

fatal attacks.

In

has
sensibility

been

the

diminution

of

of
feeling

intense

cold in

one

for many
years
instances
some
associated

viously
pre-

this

with

of the extremities.

have noticed
Andral, Eomberg, and other pathologists,

SYMPTOMS

INCIPIENT

OF

.")
10

APOPLEXY.

this

and softening.
incipient
paralysis,
symptom of apoplexy,
Among the premonitorysymptoms of cerebral
has observed odd senthe former authority
sations
hemorrhage,
confined to the tipsof the fingers,
resembling
of intense cold in those parts.
The tipsof
a
feeling
the fingers,"
he says, "appear as if they had
been
plunged into iced water." Dr. Cooke refers to a case of
weeks
apoplexy where the patientcomplained,some
before the attack,of a painfulsensation of cold in one
of his feet. There was
bility
no
apparentdiminution of sensiin the legor any other part of the body. In other
"

cases, the

anaesthesia has

face,one

of the

markable

cases

been restricted

fingers.This
a

nobleman
These

been

to
fingers,
on

was

the

record, the

to
altogether
a

confined to

and
scalp,
feelingof

in

symptom

re

some

has

numbness

lateral half of

remarkable

side of the

one

in the

of the
case

of

died several years ago of paralysis.

circumscribed
states of impairedsensation are
who

often valuable

of
diagnostic
signsof the commencement
when
of
the feeling
softeningof the brain, particularly
side of the body,
is limited to one
defective sensibility
and there exists vertigo,headache, impairment of the
confusion of mind.
or
intelligence,
I attended
died of this
of a gentlemanwho
a
case
disease,who, for five years before he was
suspected
to be
sufferingfrom ramollissement, felt a partial
and leg. This
in his left arm
of sensibility
paralysis
considered to be
symptom was observed,but was never
viewed as of a
cerebral in its origin. The affection was
local character,and treated accordingly.
the incipient
I have remarked, among
In other cases
symptoms of acute diseases of the brain, an impaired
state of the function of taste consequentupon a loss of
In one
in the tongue as well as fauces.
sensibility

remarkable

instance

the

defect

of sensation

was

con-

550

fined to

one

OF

PHENOMENA

MORBID

SENSATION.

tongue. This symptom

lateral half of the

was

manifested, and at one periodappeared

only occasionally
altogetherto subside. After the lapseof two years it
The
recurred.
patientat this time suffered also from
occasional headaches,
debility,
great generalmuscular
of spirits.He
attacks of vertigoand depression
severe
symptoms of
eventuallydied at Berlin of well-marked
softeningof the brain.
This
morbid
state of the nervous
sionally
system is occaor
diagnosedby a sensation, not of numbness
ness
heaviactual anaesthesia, but a feelingof weight and
in the affected part. The
patientwill be heard to
complain of one leg,arm, or the side of the body being
I have
this premoniheavier than the other.
observed
tory

symptom
disease

of

associated

in several

brain.

the
with

of acute

cases

This

sensation

as

symptom

well
is

as

chronic

occasionally

of stiffness in the limbs

and

well as with
contraction,
as
joints,
spasmodic muscular
deep-seatedpain, and coldness in the part. DurandFardel refers to these symptoms when
speakingof the
incipient
stage of cerebral softening.He remarks, that
the deep-seated
they are, particularly
painsin the limbs,
of chronic
diagnosticof the commencement
significantly
softeningof the brain.
There
has been much
written
the subjectof the
on
of the
insane, and
an
insensibility
attempt made
by several authorities to establish, that a state of
of mental
anesthesia
exists in the majorityof cases
disease.
Such
pressed
an
opinion could only have been exby writers practically
unacquaintedwith the
as
a
ordinaryphenomena of insanity. Insane patients,
generalrule,are not reduced to a condition of anaesthesia.
In many cases, the sensibility,
as well as physical,
psychical
is most
manifested.
acutelyand painfully

DEFICIENT

Impairment

SENSIBILITY

OF

THE

INSANE.

551

of

of the
is, however, one
sensibility
characteristics of certain types and stages of insanity.
This state of anaesthesia admits
of a psychicaland a
physicalexplanation.In many cases, the disease of the
brain causingthe insanity
induces a paralysis,
out
throughthe whole of the body of the nerves
of sensation,consequently
their special
function is weakened, benumbed,
or
entirely
paralysed. This condition of anaesthesia is
observed in various degreesof manifestation, in proportion
to the nature and degree of the mental alienation,
cerebral organicchange.
or
In the earlystage of generalparalysis,
this impairment
of sensibility
is well marked.
The
phenomenon
is observed in
of this disease long before it
cases
many
is suspectedto have commenced.
Deficient sensibility
is occasionally
in many
manifested
types of disease of
the brain previously
loss
decided and perceptible
to any
of motor
Such
ceptible
suspatientsare not ordinarily
power.
to the

influence of marked

They
duringthe
without

been

known

to

wander

about

cold nightsin a state of nudity,

severely
comfort,
exhibitingthe slightestphysical pain, dis-

or

They

have

alternations of temperature.

most

uneasiness.

often

resist,when

in

of
bed, the application

it is necessary
Occasionally
any extent of bed-clothes.
fix the blankets to
for their protection
to mechanically
in very
is often resisted,even
bed-posts
; but this
cold weather.
This
state of insensibility
severely
vails
preas
throughout the whole of the body,internally
of the
membrane
well
as
externally.The mucous
in the ana3S"
and
stomach
intestinal canal participate
thesia.
The
action of the intestines either
peristaltic
is considerably
or
altogether
impaired. All the
ceases,
organicfunctions of animal life are altered in tone and

the

552

SENSATION.

OF

PHENOMENA

MORBID

cine
vigour. Hence largeand active doses of cathartic mediproduce no salutarystimulating effect upon the
of the bowels, and opium,in heroic proliningmembrane
portions,
in the slightest
is administered without
degree
the brain or nervous
influencing
system. In these cases
there appears to be a general sluggishstate of mind
and physicalstimuli making no
pression
imand body, mental
the

upon
of

one

arise from

insensibility
may

mind

in

an

the

or

other.

delusions

condition

the

of the
pre-occupation
contemplationof fixed,

intenselymorbid

engrossing insane

This

hallucinations.

or

Pinel,

of the insane, says

speakingof the insensibility
Their
is so great,that instances occur
insensibility
with
comminuted
of patients
fractures of the lower extremities
and
tearingoff their bandages and splints,
tryingto walk with their broken limbs, without betraying
the slightest
feelingof pain; and of others who,
with broken ribs, sing and dance without
showing the
slightest
sign of suffering.Patients, in short,who have
been
operatedon for hernia, have introduced their
fingersinto the wounds, and in the coolest manner
amused
themselves by pullingout their intestines,as if
theywere manoeuvringon a dead body."
A
tempted
patientin Bethlem Hospitalsome
years ago at:

"

"

suicide
watched

of the

his

in

the

most

determined

whilst
opportunity,

ward, and

back of his head

then
upon

went
the

the attendants

and

and
fire,

He

manner.
were

laid
deliberately
held it

out

the

there,without

until a largeportionof
or
flinching
apparent suffering,
the scalp
burnt away. Very extensive sloughing
and
was
exfoliation of the bone ensued.
The patientrecovered
from the effects of the injury
without appearing
to suffer
pain,and lived twelve or thirteen years
any particular

afterwards.

His

skull,in the

shows
Hospital,

the whole

museum,

of the

St. Bartholomew's

bones
parietal

DE1K

SENSIBILITY

I! NT

exfoliated.

The

brain

OF

THE

553

INSANE.

protectedby a tough dense

membrane
stretched across
the opening.*
from
An insane gentleman,aged thirty-two,
suffering
sence
suicidal melancholia, succeeded,duringthe temporaryabof the servant who was
employed to watch him, in
his foot into a bright,
thrusting
blazingfire.He voluntarily
held it in this position
until the flesh was
nearlyburnt
to the bone.
He
heard to complain of a
was
never
sensation of pain until he recovered from his mental
disorder.
He then allegedhe felt great uneasiness in
the injured
limb.
A French
dragoon became insane from the effects of
In a paa
war.
coup de soleil during the Peninsular
roxysm
of delirium

was

he

obtained

access

to the

kitchen

the fire,
seized hold of a vessel that was
on
hospital,
and drank at a draught about a pint of boiling
water.
He then quietlyreturned to bed without
complaining
of the slightest
pain or discomfort.
have been known
Insane patients
to expose themselves
to the severest degreesof cold in the depth of winter
without
apparent suffering.Lunatics, influenced by
delusions, have scooped out the eyes, cut
religious

of the

the
tongue, and
away
without
exhibitingany
An

pain.
the

insane

emasculated

even

evidence

of

deliberately
put her hand
until it nearly
droppedfrom

in

consciousness

woman

and held it there

fire,

themselves

or

the

feeling(as she said)any sensation. She

made
to her that
laughedat the idea of the suggestion
she must have undergonegreattorture whilst voluntarily
holdingher hand in the burningflame.
became
A mistress of Robespierre
insane, and was
She would not lie down in bed
sent to the Salpetriere.
wrist, without

till she

Pinel

had

drenched

mentions
*

"

the

Lecture*

on

it with
case

of

Insanity,"
by

bucketful

a
a

man

Sir A.

of

confined
Moriaon,M.D.

water.

in

the

554

MORBID

OF

PHENOMENA

SENSATION.

meter
depth of winter, when the thermoand even
stood at twenty, twenty-five,
thirty
degreesbelow freezingpoint,had such a sensation of
heat in his systemthat he could not bear a single
blanket,
but remained
seated all nighton the frozen pavement of
the door open in the morning,
his cell,and scarcely
was
of
when he ran
out in his shirt,and applied
quantities
to his chest,and allowed it to melt with a delight
snow
like that experienced
by persons when breathingcool air
in the dog-days.
M. Verga has published
in one
of the Italian journals
of the insane
to illustratethe extreme
a case
insensibility
to suffering.
A derangedperson ate and drank heartily
to the last day of his life; he died during a violent
of asthma.
after death,
Upon examination
paroxysm

Bicetre,who,

it

was

found

in the

there

was

most

extensive

ulceration

of

had advanced
to a
disorganization
had the
its having apparently
extent without
striking
of the patient.
effect upon the sensibility
slightest
In speakingof the ana3sthesia of the insane, Dr.
of the nervous
Browne
This torpidity
system is
says :
Suicide and
in melancholic females.
manifested
chiefly
of the most
cruel and appalling
kinds,
self-mutilation,
have been practised;
the religious
fanatics,called the
Convulsionaires of St. Medard, bore with pleasureand
relief to the hystericecstasyinto which
they were
of torture. Cases
thrown, the infliction of every species
in every asylum of complete anaesthesia,in which
occur
and pain induced therahave been performed,
operations
fession
by blisters,cupping,"c., and no cry or conpeutically,

the

stomach.

The

"

of

uneasiness

been

elicited; where

diseases

by excruciating
agony, have
advanced
to
to a fatal issue unnoticed, perhapsunknown
the victim, showing that even
the ganglionic
feeling,
which is exalted in many
other examplesof melancholia,
attended

even
by suffering,

556

SENSATION.

OF

PHENOMENA

MORBID

owing to this condition of vital

The
and
lungs,stomach, liver,
organicinsensibility.
kidneys,heart,bladder, and intestines have occasionally
unobserved,

gress

exhibited
which

after

of

lesions,the existence

serious

death

suspected
duringthe lifeof the patient.
portant
Organic structures appear in insanityto undergo imnever

was

and

hence

often

unobserved

material

modifications;

necessityof watching closelythe

thological
pa-

state

of the

tecting,
de-

the

earliest

the grave

insane, with

the

view

of

the presence of
possible
period,
certain physical
often seriously
complications
interfering
with the mental
and proving
recovery of the patient,
to his life.
perilous
I have known
mation
from active inflampatientssuffering
of the pleuraas well as lungs,repudiate
all idea
of indisposition.
A gentleman,who
had a largecalculus
at

in

his

bladder, declared

uneasiness.

Had

that

he been

it gave

sane,

him

an
exhibiting

I am
degreeof sensibility,

satisfied his

have

witnessed

been

intense.

have

painful character
very
without givingrise to
any

kind

no

of

abnormal

agony

would

of
operations

the
performed upon
apparentdisturbance

insane
of their

sensibility.
I have not yet referred to the anesthesia of the insane
from
intense absorption
the pre-occupation
or
resulting
of the imagination,
in some
fearful hallucination of the
illusion of the
monomaniacal
miad, or all-engrossing
I have no
doubt that much
of the apparent
senses.
of the insane arises from this cause.
physical
insensibility
often effectually
masks and obscures all evidence
Insanity
of organic
the greatermaladyeffectually
sensibility,
lysing
parathe functions of the
When

sensor

nerves.

standingalone on
the wild heath, exposedto the raging of the pitiless
and feelingly
storm, Kent
affectionately
imploresthe
Lear, Kent,

and

the Fool

are

INSENSIBILITY

king
"

tyranny of the open

Lear

exclaims

an

Invade*

to the skin

us

But where

so

'tisto thee

Doth

from

Save

what

in

with

and
religious
and

uncivilized

havingexcited
enthusiastic ecstasy,

their bodies in the severest

sible
pos-

the slightest
exhibiting
symptom

without

sensibility.*

of
*

Mr.

Catlin,in his

"

Notes

the North

on

American

he records afford
p. 170, refers (and the facts
effects of intense mental

for the honoured

alreadyemaciated with
days and nighU, advanced

fellows
four
on

One

inch

fingerand
the

knife, which

and

notched

had

the

man

forced

followed

by

best

shoulder

ground sharp

been

at

to make

throughthe flesh below the

splintor

hand, and

was

skewer

of

purpose
time
a

qualifying

ready to
down

ut

and placedhimself
lodge,
the

was

from

manner.
following

taken

knife in his

up

between

the

right hand,

and

both

edges and then hacked

it produce as much
pain as
and
beingwithdrawn,
fingers,

from the other,who

force them

performanceof

held

through

bundle of such

the wound.

the top of the

There

lodge,which were
were
and
fastened to these splints
or skewers,
they instantly
began to haul him up :
he was
thus raised until his body was
where
justsuspendedfrom the ground*"
the
flesh
he rested,until the knife and a splintwere
teguments
inthrough
or
passed
below
each
the
below
the
arm
in a similar manner
on
shoulder,
In some
instances they remained
elbow,on the thighs,and below the knee*.
the ground, until this painfuloperation was
in a recliningposture on
the same
which was
on
finished,
performedin all instances exactly
parts of
then

two

cords

lowered

One

adapted for

held the

who

with the blade of another

was
possible,

in his led

by

thumb

"

to the cruelties in the

of the flesh of each

more

or

for the

from the Hide of the

submitted

he

where
the operation,

of the young
and
and
fasting, thirsting, waking, for nearly

otherwise,as

and feet,or

his hands

Indians

of warriors.

rank

Indian*," vol. iL

good illustration of the

to the
bluntingthe sensibility),

in
preoccupation

of the Mandan

tortures
self-imported

themselves

was

the

of

after

been known,

burn, cut, and maim

are

exaltation

of barbarous

highestpitch of

to the

manner,

of morbid

connexion

have

Persons

physicalphenomena

conditions

observances
superstitious

to

mind

elte
take all feeling
my tenses
beats there"

exhibited in certain
conscience

in my

tempctt

Analogous psychicaland

themselves

greatermalady itjired,
tcarcefelt;
The

nations.

storm

the

Ike letter it

the

557

MIND.

think'st 'tis much, that this contention*

Thou

"

OP

adjoininghovel from the

to this appeal,
night."In answer

shelter in

seek

to

PREOCCUPATION

FROM

558

OF

PHENOMENA

MORBID

SENSATION.

incipientstage of
is not
various forms of cerebral disease,the sensibility
and paralysed,
but it shows
impaired,
only heightened,
The patientcomevidence of being vitiated.
plains
marked
sensations in various
of the existence of pricking
partsof the body,as well as of the existence of formication,
and toes. For
at the extremities of the fingers
particularly
to the developmentof well-marked
time previously
some
that
symptoms of cerebral disease,a patientremarked
everythinghe touched was extremelycold. In some
a gritty
cases
body like that of sand, and a pieceof cloth,
between
the patient's
fingers
appearedto be interposed
in contact with.
Other invalids
and whatever
they came
have
affirmed,that whatever
they touched felt like a
pieceof velvet. Andral notices this phenomenon.* Six
weeks before a paralytic
attack,a patientcomplainedof
In
like a pieceof leather.
one-half of the scalpfeeling
died of apoplexy,there
of a gentleman who
the case
time previously
for some
to his illness a feeling
in
was
SENSATION.

VITIATED

both

hands

if the

as

"

In

skin

the

were

covered

with

minute

of dust or sand.
He repeatedly
particles
irritating
observed
complainedof this symptom, and was frequently
with
the view
of removing the
his hands
to wash
in tHe
Impairment of sensibility
imaginaryannoyance.

and

the

bodies

and

limbs, and

which, in its progress, occupied

some

five

or

six

minutes.

instantlyraised with the cords,until the weight of

his body was
suspendedby them, and then, while the blood was
streaming
their limbs, the bystanders
each man's approdown
hung upon the splints
priate
instances the skull of a buffalo,
shield,bow, quiver,Sic.,and in many
attached to each lower arm
and each lower leg,for
with the horns on it,was
of preventing,
the purpose, probably,
by their great weight,the struggling
whilst they were
which might otherwise take placeto their disadvantage
hung
all
each
raised
these
the
When
were
one
was
things
adjusted
higher
by
up.
from
all
clear
the
until
these
The
ground
cords,
weights
swung
of them bore this part of the
unflinchingfortitude with which every one
torture surpassedcredibility,"
"

Each

He

sensation

one

terms

was

then

it the

"

velvet-like sensation"

precedingattacks

of

and
paralysis

accompanyingthe
softening.

alterations of

first

preceded

arm,

and

part,

by

the

of

of
of

confusion

prior

that

he

his

boots,

to

had

or

with

interfering
of

locomotion.

observed
cerebral

for

his

his
This

two

disorder.

of

months

stockings,

personal

perverted

another

dirt

and

of

the

his

siderable
con-

some

feet,

and

freedom

as

sensation
attack

in

stones

his

well

as

to

slight

imagined

patient

comfort,

previously

also

verted
per-

case,

irritating

state

the

occasionally,

the

seizure,

particles

extraneous

inside

In

thought.

in
this

had

patient
and,

headache,

cold

followed

The

paralytic

intense

numbness,

sensation.

attacks

paroxysmal

of

559

DISEASE.

CEREBRAL

feeling

of

subsequently

state

time

OF

SYMPTOMATIC

SENSATIONS

of

was

acute

500

OF

PHENOMENA

MORBID

XXI.

CHAPTER

section

THIS

Senses.
of the Special

Phenomena

Morbid

subjectwill

of the

followingorder

SENSES.

SPECIAL

THE

be

in the

considered

"

a.

p.

Sight.
Hearing.
Taste.

7.

8. Touch,
e.

estimatingthe

In

Smell.

value of all morbid

evidences

of the

supposedto be symptomatic of brain

consider
their normal
must
state,
disease,we
carefully
existing
making proper allowances for any previously
of action.
The
of
in their mode
sense
idiosyncrasies
narily
extraordiseen
vision, of hearing,"c., is occasionally

specialsenses

acute.
of smell

known

I have
and

individuals

in whom

the

exquisitely
developed,
and
odours
that certain substances
produced a severe
degreeof mental torture, when brought in contact with
The
the gustatoryand nasal organs.
slightest
particle
violent vomiting in certain
has caused
of ipecacuanha
nervous
temperaments. In other instances, the smell
action upon the bowels,
of rhubarb has produceda severe
sense

and

taste

true that

the lower
a

portionof

person
"

Die

so

affected,in

of aloes has

the faintest odour

manner,

was

the

bowels.

may,
of

rose

in aromatic

pain,"

marked

It is literally

NORMAL

ACUTEXESS

OF

THE

50 1

SENSES.

for there exists among

the North
American
Indians a
tril"e whose mode
of punishment consists in subjecting
their

to the influence of the odours of certain

prisoners
This produces
the most exquisite
mental distress
plants.
and
if the prisoner
be
bodilypain; and occasionally,
death has been known
to
exposedlong to its influence,
ensue.

It is said that in
South

of China,
portions

some

Sea Islands,the natives

their victims

are

and

in the

in the habit of exposing

punishmentto what Falstaff terms,

the
rankest compound of villanous smells."
We
observe unnatural manifestations and
occasionally
of seeing,hearing,
exquisiteconditions of the sense
touch, and taste,quiteapartfrom disease of the brain.
of hearingis in an
In some
exalted
persons the sense
sound
state of manifestation,the slightest
coming from
distances beingat once
Celebrated
remote
perceptible.
musicians, owing in the first place to the natural
of the sense
of hearing,and
vigour and acuteness
to the careful education and long-continued
secondly,
in a
have had this special
exercise of this faculty,
sense
high state of activity.It is said of Mozart that, during
of a most complicated
the performance
pieceof concerted
as

"

music, he

able,among

was

to detect with

wonderful

deviation
slightest

from

able also to

the

Any

name

aberration of

sensations

in

the

several hundred

musicians,

and quicknessthe
precision
the

correct

instrument

He

score.

that

was

at fault.

was

harmony producedthe most painful

nervous
system of this wonderful

musical

genius.
Among blind persons we often notice an extraordinary
of touch.
objectsby the sense
capacityof recognising
A person who became blind at an early
was
periodof life,
of the touch,
able to distinguish
by means
individually,
and to singlethem
of botanical plants,
number
out,
a
o

562

SENSES.

SPECIAL

TUB

OF

PHENOMENA

MORBID

We
witness,
occasionally
accuracy.
of the nervous
the effects of certain diseases,particularly

wonderful

with

capacityof the special

positiveperversionin their modes
in the

system,a great acuteness

well

as

senses,

as

as

of action.

attacks of fever,conditions

from

in power,
Dr. Heberden
"

case
a

"

that

so

nervous

functions

specialsenses

either diminished

of
particulars
fortyyears old had

about

he took

the returns

being removed.

of it

the

small

following
the spring
a quantity

weakened

without

too

were

hearing

after recovery
and
debility

records the

fever,for which

tertian

of bark,

man

of

of

sense

the various

cases

or their
perverted,
lost.
or
entirely

been

have

other

In

exhaustion.

the

sensitive
painfully

become

have

smell

and

in which

instances

known

I have

in

days after his last fit,

beingthen
employed on board a ship in the river,he observed at
sun-settingthat all objectsbegan to look blue, which
thickened into a cloud ; and not long
blueness gradually
the light
after,he became so blind as hardlyto perceive
The
next morning, about sun-rising,
of a candle.
his
When
the next
as
ever.
sightwas restored as perfectly
he lost his sight again in the same
on,
night came
for twelve days and nights.
and this continued
manner,
then

He

Three

ashore, where

came

graduallyabated,
A

after three
as

he

after

month

and

in three

went

days'stay in

before, and

lasted

upon

land.

another
which
never

Some

ship,in
time

of his eyes

days was
board

entirely
gone.
another
ship,and

it the

did

little time

which

not

return

afterwards

he continued

the blindness

afterwards."

on

disorder

night blindness returned

all the time
of his remaining in
nine
nights. He then left the

ship,which was
ship, and his blindness
the

the

returned

while

he

he went

for ten

only two

was

into

days,during
nights,and

It appears, however, that this indi-

564

distinguished

sufficiently
could

not

black.

could

perceive

by

leaves

appeared
a

of

that

light

and

black

could

more.

dark.

On

distinguish

that

or

Nicholl

Dr.

same

His

them

with

maternal

imperfection.

red

at

ing
surround-

still

whole,

they

did

the
and
;

grandfather

of

case

resolved

called
and

light
one

all

and

purple,
of

one

but

them

nothing

boy

who

red

and

uncle

the

colour,

straw

or

stripes,
of

than

power

rainbow,

consisted

brothers

the

crimson,
a

tinguished
dis-

only

but

dove,

green,

or

colours,

they

that

so

looking

relates

of

the

which

and

it

the

distinguishing

into

"

white

green
blue.

to

few

upon

other

any

as

regarded

was

and

shade,

presented

colours

as

possess

from

white

but

One

of

them

tree

shape.

sense

notion

to

seem

faint

imperfect

very

not

have

to

on

and

stockings,

calling

red-ripe,

and

size

their

of

of

cherries

when

even

SENSES.

name

necessity

the

them,

the

by

conceive

He

SPECIAL

THE

OF

PHENOMENA

MORBID

had

founded
con-

pink,
the

IMPAIRED

AND

PARALYSED

CHAPTER

Morbid

XXII.

Phenomena

of Vision.

IN diseases of the brain the visual

power
a.

565

SIGHT.

be,

may

Impaired,

". Lost,

IMPAIRMENT
and
The
occur

y-

Exalted,

S.

Perverted.

Loss

AND

VISION.

OF

These

"

are

common

importantsymptoms of organicdisease of the brain.

impairment of vision may come
on
graduallyor
lost in one
suddenly. The sight is occasionally
before the defect is observed,but, as a generalrule,

eye
the disordered

function of the eye is of slow and progressive

growth,proceeding,
pari passu,
of subtle structural changes in
of the

brain, its membranes

connected

with the

and

the

with

ment
develop-

the delicate tissue

vessels, more

origin,
course,

diately
imme-

and distribution

of the

opticnerves.
Impairmentof vision is often symptomaticof gastric,
and intestinal derangement. It is of importance
hepatic,
not to overlook
this fact,when
diagnosinga suspected
condition

of brain

disease,associated with what

may

be

considered,symptoms of cerebral amaurosis.

This affection of

from general
sightarises,occasionally,
debility,
hemorrhage,morbid states of the blood, and
exhaustingand debilitating
discharges.Sudden loss of
vision has been

known

to succeed

severe

mental

shock.

5CO

of the consequences of typhusfever,

the head, after the
succeeds blows
upon
frequently

It is observed
and

VISION.

OF

PHENOMENA

MORBID

cerebral

acute

one

as

symptoms

This

subsided.

effect of lead

poison,
be

dorsalis,arthritis,or

upon

distress of

those

causingatrophyof

with

connected
F.

have

anxietyand
greatand long-continued
with
the nutrition, and
mind, interfering

consequent

Dr.

tabes

of

effect

the
syphilis,

induced

also be the

of vision may

condition

so

when

Hawkins,

mediately
importionsof the brain more
the opticnerve.
speakingof the inflammatory

brain, says

affections of the

is well

It

"

that

known

of the digestive
sympathy with the nerves
organs will
giverise to various affections of vision,from the slightest
dimness
up to temporary amaurosis, from the occasional
of a luminous
spot,up to that of forms and
appearance
into distinct
spectrawhich are shapedby the imagination
therefore,to arrive at any
apparitions.It is difficult,
of
certain
conclusion
with
respect to the existence
cerebral
disease from
the indications afforded by the
of vision

organ

and

numerous

of affection of the

cases

onlysympathetic,
which, in fact,were
symptoms of disease actingat once
A gentlethe originof those nerves
of the brain.
on
man
to town
about two years ago on discovering
came
with surprise
and alarm, that the sightof one
suddenly,
consulted
all the
He
utterly failed him.
eye had
oculists and surgeons
celebrated for the treatment
chiefly
of such cases, and most
of them were
of opinion
that this partial
defect of vision was
purelysympathetic,
and blue pill,
and would be removed
by the use of senna
opticnerves

and
but

in
as

have

fact

he

symptoms,

it

died
I

as

brain, and

tendencyto

as

considered

been

to

was,

certain

soon

afterwards

have

been

he

extent,
in

so

removed:

Ireland, with

informed, of disease

inherited,and

cerebral

as

himself

disorder,which

the

of the

evinced,

appearedto

be

1 UlLY

OF

SIGNS

(his mother
hereditary

567

CEREBRAL

AMAURO8I8.

being at

this moment

afflicted

with

I think there can

be littledoubt that
hemiplegia),
his temporary loss of sightwas
a symptom, not
merely,
it was
but of a morbid state
as
supposed,of dyspepsia,
then existing
in the brain.
In a recent case of paralysis

the

and

occurrence

fatal termination

the friends

of which

of science

it appearedfrom the result

everywheredeplore,
that a singular
which had
affection of the optic
nerves
been attributed to derangementof the stomach,
previously
indicated with

too much

truth the existence of irritation

the organ of one

pressure, affecting
In the earlystages of cerebral

or

of those nerves."1

amaurosis, termed

amaurosis, the patient

arablyopia,or
incomplete
complains
of his vision becoming gradually
indistinct,objectsappearing
either lightedup by a bright flame, or
rounded
surby a fogor mist. These symptoms are somewhat
analogous to those described by Romberg as symptomatic
ofyuflasercna.
The outlines of objects,"
says Romberg, appear not
but also broken, and thus disfigured.
only indistinct,
The lightof the candle appears rent ; while reading,
the
words, and lines,and he
patientmisses singlesyllables,
is forced to follow them
by moving his eye, head, or
entire body. At times, the upper or lower, the rightor
left half,the circumference
centre of the object
or
only
is seen ; at others the loss of vision is stillmore
partial,
and is confined to different spots of small extent, and
with differently
shapedoutlines. Instances also occur in
which
when
it bears a definite
the objectis only seen
the slightest
relation to the eye, and
it vanishes on
"

"

movement

Let

me

of the eye or head."

consider briefly
some

symptoms
*

F.

"

of the

of centric cerebral amaurosis

Croomian

Hawkins, M.D.

Lectures

on

the

characteristic

more

connected

InflammatoryAffections

with

of the Brain,"bj

5G8

organicdiseases
associated

of morbid

In all

vision

complainsof vertigoand
sometimes

in

acute

follow

as

of the

escape

may

be

sympathetic
*

"

amaurosis,the patient

headache.

character,but

type as altogetherto

are

we

cerebral from

of centric cerebral

cases

disturbances

of which

means

of
diagnosis

our

VISION.

ordinarypremonitory or

The

symptoms, by

facilitated in
conditions

brain, and

of the

circulation.

cerebral

OF

PHENOMENA

MORBID

The

is
cephalalgia
of so mild
occasionally

observation.

ache
head-

The

is associated

of

the

with sympatheticaffections
occasionally
of sense,
such
the hearing,
as
organs

other

The

smelling,"c.
symptoms

mind

of disorder.

in

many

cases

also exhibits

The

patientcomplainsat times
of great depression
is occasionally
of spirits,
suicidal,
and frequently
troubled with hallucinations.
The cephalalgia
of centric cerebral amaurosis
is, according
to the experience
of all authorities,
not generally
of a permanent and stationary
kind ; it occasionally
tirely
enbut is extremely
in violent
liable to recur
disappears,
The remissions,"says Dr. Copland, from
paroxysms.
often so remarkable
iis
severe
are
as to lead
suffering
observer to the belief,that it is merely
a
superficial
with dyspepsia.
periodicalheadache connected
"f The
character of the headache
differs remarkablyin various
Sometimes
it is acute and lancinating;
in other
cases.
instances it is oppressiveand obtuse.
The painis frequently
referred to a particular
spot. During the severe
the headache is aggravatedto perfect
torture
paroxysms,
increased by mental
motion, is greatly
by the slightest
"

Mr.

Jabez

"

Hogg

has called

attention to an extremely
professional
nious
ingeinstrument, termed the
of which
the
Ophthalmoscope" by means
obscure diseases of the eye are
more
and
This
detected,
easily
diagnosed.
aid the physicianin distinguishing
cerebral from
discoverywill effectually
those amaurotic affections,
the effect of organicchanges in the delicate structure
of the eye itself. (Vide Mr. Hogg"O" the Use of the Ophthalmoscope
in the Explorationof Internal Diseases of the Eye"
London, 1859.)
t Med. Diet.
"

"

DOUBLE

VISION

SYMPTOM

OF

DISEASE

application,
aggravatedwhen
becomes

THE

569

BRAIN.

patientstoops,and

the influence of stimulants.

under

acute

the

OF

Dyspepticsymptoms, often accompanying a pain and

sickness of the stomach, occur
during the
occasionally
When
to these
of cephalalgia.
severer
alluding
paroxysms
symptoms,

Dr. Abercrombie

observes, after
"

tinuance
con-

some

become
organs of sense
the sight,
the taste, and smell,
the hearing,

of fixed headache, the

affected,
as
and

some

the intellect." The loss of sightgeneoccasionally

rally
takes placegradually,
beingfirstobscured,and,after
lost.
time, entirely

Double

vision

either be

permanent

is on

case

This condition may

supervenes.
at intervals. A remarkable
occur

soon
or

blindness took

record in which

and, after it had

restored

by

continued

emetic.

an

hour, and then, alas !

The

vision

some

denly,
placerather sudtime, sightwas
distinct for

was

The

permanentlylost.
is frequently
impairedin these cases, and
the speechis lost. The morbid appearances
presentno uniformity.
"

In

two

was

there

cases

tumours

were

lect
intel-

sometimes

after death

situated

so

an

as

to compress the opticnerve

; in another,a large
directly
in a
tumour
;
pressedupon the corpora quadrigemina

third,the disease
anterior lobe

and

it
affected,

was

was

the

near

tius,the disease

part of

situated at the lower

was

in
in

another,in which
the

substance

the

the

righteye

sphere,
of the left hemi-

posterior
part. In a case by Drelincuran
was
enlargementof the pinealgland;

case, in which

and

in another

and

deafness,a largetumour

there
was

were

both

blindness

found,situated between

the brain and the cerebellum."1

the effect of local pressure
occasionally
portionof the brain in its
opticnerve, or on some

Amaurosis
on

the

is

neighbourhood.

immediate

This

affection arises from

"

Aborcfombie

on

Diseases of the

Brain,"p.

318.

570

PHENOMENA

MORBID

lesions in

from

originof

the

nerves

consequence

atrophyof

the brain

of white
and

other

disordered

with

the cerebrum,

as

partsof the brain remote from the

of sight. The impairmentof vision

is often the

connected

well

of the cerebellum,
as

organicdisease
and

VISION.

OF

abscess,and
softening,
conditions
of

states

of the tissue
This

nutrition.

disorder, however, is not

the effect of congestion,

necessarily
or
or
organicalterations in the optic nerve
Andral
thalamus.
relates the particulars
of several instances
of disease of the cerebellum,
plete
accompaniedby a comloss of vision. This distinguished
when
pathologist,
referringto these cases, says, I am unable to account
for the phenomenon. In two out of twelve cases
of softening
"

of the cerebellar
of the

lobes,blindness existed

body oppositethe lesion."*

sionally
organicdiseases within the cranium, which occaflammatio
produceamaurosis, are such as result from ineffusion,
(acute and chronic)serous
softening

The

induration,abscesses

of various

culous
kinds, tumours, tuber-

formations, adiposetumours,
tumours

of

flesh-like tumours,

fibro-cartilaginous
nature,

careous
bony and calconcretions, hygromatous tumours, cysts containing
albuminous
a
or
serous
fluid,
hydatids,
fungus
a

haematodes, melanosis, ha3matomatous

of the

aneurismal
blood-vessels,

the

membranes,
laminae; dense

of
depositions
tumours

of

albumen,
coagulated
to the dura

In

mater

which

are

tumours, disease

tumours, thickeningof
between

matter

uniform

the appearance
colour,and exhibiting

coma,

the side

on

most

whitish

or

ash

and

of
properties
attached
frequently

diseases of the cranial

their

bones, osteosa

exostosis,"c.
an

amaurotic

short time

boy, who

before his

"

was

death, Beer

M"licale."
Clinique

attacked

by

found

considerable

Andral.

mania

572
sometimes

or

VISION.

OF

PHENOMENA

MORBID

to lightwith
sensibility
contracted pupil. Not unfre-

there is increased

spectra and
quentlyobjectsappear

luminous

distorted and

confused

with

vulsive
con-

globe or eyelids.As the

becomes
amaurosis
more
complete, the vacant stare of
the amaurotic
patientis evidenced ; the pupil becomes
widelydilated and motionless,and the muscles convulsed.
all
examination
free from
The
eye usuallyappears on
tained,
organicchange, and the retina,as far as can be ascerthe
But
sound
in its structure.
to be perfectly
is not
of the eye, and particularly
of the pupil,
appearance
dilated
to be depended upon, for,althoughit is usually
and immovable, the exceptions
to
too numerous
are
admit of its being considered as of uniform
occurrence.*
loss of sight is occasionally
Sudden
premonitoryof
considerable vertigo
apoplexy. A locksmith experienced
for eightdays. He
then
suddenlybecame blind. He
he
remained
in this state of vision for fifteen days,when
lowed
seized with sudden
of consciousness,folwas
deprivation
by paralysis.His sight was graduallyrestored,
but the hemiplegia
continued.!
The
impairment of vision which so often precedes
time without beingrecogapoplexy,may exist for some
nised
of the
by the patientor his friends in consequence
defect of sightbeinglimited to one
pensating,
eye, the other comas
suggestedby Dr. F. Devay (of Lyons),for
of

movements

the weakness

of its fellow.

Total loss of
of brain
to the

became

"

sight,unassociated

disease,
may

exist for

blind

weeks

with other

symptoms

longperiodantecedently
order.
manifestation of other symptoms of cerebral disis cited by Wepfer,
Baron Hornestein, whose
case

fatal attack of
*

the

three

J
apoplexy.

before

Dr.

he

seized with

was

Young

lost the

vol. i. p. 56.
Copland'sMedical Dictionary,"
Aoiatomica
Apoplecticorum."
J
"

sightof
f

Andral.

OX

THE

EAULY

eye from

one

TION

DKTIA

CEREBRAL

of the brain

tumour

of the

OF

fact.

It

573

DISEASE.

time

some

before he

not until he

appliedhis
and found that the sightof one was
eyes to a telescope,
with the morbid
lost,that he became acquainted
entirely
was

aware

was

state of his visual powers.

The
states

amaurosis,
of

the

brain

symptoms

associated

connected

after the

continues
acute

often

so

with

with

morbid

sionally
apoplexy,occa-

patientrecovers

from

the

of the cerebral attack.

gentleman,after
and continued
in
sight,

seizure, lost his

apoplectic
of perfectblindness for
a state
about seven
After that period,while one
day
years.
in his carriage,
out
he suddenly recovered his sense
of vision.
It was
found that he had entirely
subsequently
retained his skill in drawing,for which
he was
much
previously
distinguished.
The
late Dr. Gregory,of Edinburgh, was
in the
habit of mentioningin his lectures the case of Dr. Adam
of
one
Ferguson,the celebrated historian,as affording
the

an

strongestillustrations he
be

derived from

ever

met

with of the benefit

earlyattention to the incipient

and apoplexy. Dr. Ferguson
symptoms of cerebral plethora
several attacks of temporary blindness
experienced
time before he had an attack of palsy; and he did
some
he should have done.
not take these hints so readily
as
He observed that while he was
his
lecture,
a
delivering
class and the papers before him would disappear,
vanish
and reappear againin a few seconds.
from his sight,
He
of full habit ; at one time corpulent
and very
teas
a man
he lived
ruddy,and, though by no means
intemperate,
freely.I say he did not attend to these admonitions,
in the sixtieth year of his age, he suffered
and at length,
He recovered,however, and
shock of paralysis.
a decided
under
the advice of his friend,Dr.
from
that period,
Black, became a strict Pythagoreanin his diet,eating

to

an

574

OF

PHENOMENA

MORBID

VISION.

and drinkingonlywater or
nothingbut vegetables,
symptom, became
He
got rid of every paralytic
muscular

robust and

for

of his time

man

of his
died in full possession

mental

milk.
even

life,and

of

faculties at the advanced

; upwards of thirty
ninety-three
years after
Scott describes him as having
his first attack. Sir Walter
of the most
been, long after his eightiethyear, one
it was
to look at.
His firm
possible
striking old men
pectedly
agreeablyand unexstep and ruddy cheek contrasted

age of

"

with his silver locks

and the dress which

he

ally
usu-

resemblingthat of the Flemish peasant,

of peculiarity
to his whole figure. In his
gave an air
conversation,the mixture of original
thinkingwith high
his love of country,
and extensive learning,
moral feeling
the strongsubjection
contempt of luxury,and especially
and feelings
of his reason,
of his passions
to the dominion
the most
made
him, perhaps,
strikingexample of the
which
could be seen
in modern
stoic philosopher
days."*
"Amaurosis
dependentupon vascular congestionis
all of the followingsymptoms :
marked
or
by some
bismus,
dilated, sluggishor immovable
pupil, ptosis or straand obliqueor double vision of the affected
eye ;
action of the carotids,flushed face,sense
a preternatural
of weight,pain or stricture of the scalp,
occasional
lethargy,
tinnitus aurium, with
table
greatlydisordered and irriThe
stomach.
patientfrequently
complains,
particularly
in straining,
first
stooping,or on
lyingdown,
of seeing luminous
sparks and flashes,and a reflection
of the choroidal vessels,
of one
the visible pulsaor more
tion
wore,

much

"

is

of which

The

of much

cause

followingcase

"

Lectures

London,
f
"

1857.

on

the

him."f

is recorded

illustrative of the benefit

distress to

by Dr. Wigan, and is

derived from suboccasionally

and
Principles

Practice of

Physic,"by Dr.

T. Watson.

Vol. i.,p. 527.

Diseases of the

Eye,"by

B.

Travers,F.R.S.

1825.

P. 162.

brain

of

jectingcases

states of the vision

had
for

MORBID

OF

CASE

SINGULAR

attack

severe

treatment

of

OF

connected

disease

to medical

under

been

DERANGEMENT

with
A

:
supervision
"

about

six months

and
phrenitis,

had

575

SIGHT.

morbid

man
gentlebefore

only

been

by the aid of very active remedies administered

I afterwards saw
him
by a very judiciouspractitioner.
called perfectrecovery.
in a state which
He
had
was
restored

for

some

resumed

time

his active habits of business

but

himself perfectly
well,complained
althoughconsidering
time he had been conthat for some
to me
stantly
confidentially
arguing with himself on an increasingapathy
towards his wife
not physical
apathy,quitethe contrary
it was
to be in her society
a strange disinclination
;
he found himself frequenting
the haunts of his former
bachelor state against
his intention,and almost against
his will,yet received no
from any indulgences
gratification
harassed by a
they afforded,and was
constantly
for neglecting
the society
of remorse
of his wife,
feeling
whom
he had married from choice,whom
he respected
and thoroughlyloved, and who was
tolerant
exceedingly
from
of his indifference,
belief that it was
caused by
a
to convince
him
pecuniaryanxiety. I endeavoured
that it was
moral
a
produced by a physicalchange,
"

"

and

that

it would

his health.

He

pass away
remained
some

with

the consolidation of

time in this state,when

he

afterwards
graduallybegan to see faces in the dark
in the daylight;groups of faces constantly
changing
of one
their shape; sometimes
face would join
a portion
itself to a portionof another
face ; sometimes
parts of
"

eyes, noses, mouths, cheeks, and foreheads,would

float about in vast numbers
before him, and from time

faces

"

to time

unite themselves
The

him

whole

in the

most

fantastic combinations.

occupiedhis mind,

attention to
of continuous
incapable
deep consideration.
importancerequiring

and

rendered

of
any subject
A large
bleed-

570

ing and

him

restored

the nape

blister to

neck

of the

vigorous health, and

of his amiable and
society

all

to

the

in
delights

VISION.

OF

PHENOMENA

MORBID

HYPEILESTHKSIA,

EXALTATION

OR

immediately
his original

affectionate wife.*

VISION.

OF

"

morbid

observed
sightis occasionally
the premonitory
symptoms of cerebral disease,
among
either of an acute and sensitive
the patientcomplaining
condition of the retina,or of his abnormal expandedvisual
A young
gentleman,a few days before an
capabilities.
of the brain,had a painful
condition
attack of inflammation
for a minute,
of sight. If his eyes were
exposed,even
he shrieked with pain. In another case the
to the light,
symptom was precursory of apoplexyfor at least ten days!
attacks of vertigo.
It was, however, associated with severe
Andral
alludingto this symptom of brain
says, when
disease, cases have been observed in which, for a longer
shorter period before the attack, the sight has acquired
or
unusual degreeof fineness."
an
The existence of importantmorbid
visual phenomena,
like those
previouslydetailed, manifestingthemselves
of hemorrhage,incontestably
prior to the occurrence
BEFORE
observes,that
THE
sagaciously
proves, as Andral
of the

exaltation

of

sense

"

"

BLOOD

CONTINUOUS

EITHER
WHICH

THERE

EFFUSED,

IS

IT WOULD

NATURE."

OR
BE

How

IS

ALREADY

SOME

MORBID
IN

INTERMITTENT,

IMPORTANT

TO

THE

DETERMINE

does
significantly

ACTION,
BRAIN,

THE

OF

PRECISE

this

sagaciouspathologist
of carefully
necessity

pointout, in this passage, the

obsta of cerebral diseases !
studyingthe principiis
disease of the brain was
In the followingcase
first
indicated by an
acute condition of vision.
A painter,
admitted, in 1849, into the Hotel
two, was
aged thirtywho
Dieu, at Lyons. This young
was
man,
possessed
of some
distalent, had been graduallyreduced
to
"

"

On

the Duality of the Mind,"

hy

R.

Wigan, M.D.

torn.
Al^dicale,"
f Andral, Clinique
"

v.

MORBID

EXALTATION

OF

VISION.

tress

disturbances and other causes.

A
by political
his sight,
which was
the hospital,
year before entering
previously
good,acquiredgreater development. From
his window, which
opened into a very long street,
he could distinguish
he
objects and persons whom
could before neither distinguish
This
even
see.
nor
circumstance
troubled him, and surprised
those about
him.

The

1848, when
in the

exaltation of vision continued

he

was

violent

seized with

in

the

left

The

arm.

till March, 1849, when

there

was

August,

continued

at this time

rightparietal
region;

slightweakness

until

pains

there

was

symptoms

creased
in-

and
paralysis

rightarm, and blindness of the left

he entered the hospital
in July,the followWhen
ing
eye.
his condition.
There
almost profound
was
was
covered
stupor.The paralyzed
eye was almost completely
and there was
with contraction,
by the upper eyelid,
paralysis,
of all the left side of the body. There was
plete
comloss of power over
the sphincters.He continued
in this state until the beginning of September,when
death ensued, preceded
by symptoms of low fever. The
of the
autopsyrevealed partialcircumscribed softening
for the
middle and upper part of the righthemisphere,
contraction

extent

of the

of about

two

pale and pufiy;

grey colour.
Dr. Brachet
in

1811, the

astonished him

the

The

centimetres.

pulp

when
relates,
of
infinnier

and
diffluent,

was

he

convolutions

was

the

of

interne at the

surgicalward

were

dirty

Bicetre,

day
his vision had acquired
could distinguish
the
one

by the extent which

since the previous
day. The man
distance. Five hours
at an enormous
most minute objects
he felt a slight
headache, and in a few hours
r wards
seized with apoplexy (" tine apoplexie
more
was
fou/"uite") and died the next night! A recent coagulum
found in the right
opticthalamus. The inflammation
P

573
which

effusion had

irritated

the brain concerned

in vision.

precededthis

had

proximitya part of

of

disease.

obscure

observes, that, in

He

its

on

certain

with

connected

as

by

makes
Illusions,
Spectral
morbidlyacute sensorial symptoms

Dr. Hibbert, in his work

mention
particular

VISION.

OF

PHENOMENA

MORBID

conditions

of brain

forms
particular

inflammation,the first symptoms

evinced

of

bral
cere-

ing
increas-

an

of visual sensation. In the case

of a lady,a
intensity
patientof Dr. Good, there was an intolerable acuteness
of hearingand vision,insomuch
that the slightest
light

and

sound,

the

even

inflammation

the

external

rendered

Ideas, also,were
as

of

humming
increased

the

became
fly,
vivid.

more

images of the mind

In an examplewhich
reality.
the illusions of vision

were

assumed

my

intense that

so

he could not, even

patientclosed his eyelids,
the lively
images of demons that haunted

sleepwas,

disturbed

moreover,

with

the

whilst

the

frightful

most

under

came

But

to
sensibility

acute

impressions graduallydiminished,

recollected

portable.
insup-

notice,

own

althoughthe
then, dispel
his bed.
most

The

horrible

dreams.*
A

of delicate

singlewoman,

had

been

months.

much

afflicted with

The

paroxysms

The

vision

cause

that the

so

the

He

sometimes

says

image

this flower

and
itself,

"

of

did not

developedfrom
green

leaves.

When

were

more

than

often

rare

I closed my

three

violent,

with
constantly,
disease appearedto be
not

possessedthe

illustrious Goethe

at will.

could

for
hysteria

of the disease

but
accompanied frequently,
delirium

frame, aged twenty-two,

porary
tem-

well

facultyof producing phantasms

and
I
head,
depressed
eyes
"y

in the middle of the field of

flower to appear
retain it* first form, but unfolded
for a moment

its interior,
new
These

were

not

flowers,formed of coloured or
flowers,but of fantastic

natural

forms, althoughsymmetricalas the rosettes of sculptors. I was unable to

flowers continued as long as I
fix any one
form, but the development of new
of the changes. The same
desired it,without any variation in the rapidity

thing occurred when I figuredto myself a variegateddisk. The coloured

constant
changes,which extended progressively
figuresupon it underwent
towards
from the centre
the periphery,exactlylike the changes in the
modern
kaleidoscope."

580

MORBID

PHENOMENA

OF

VISION.

At this time she

lightfrom darkness.
distinguish
of worms,
first began to complainof seeinglong rows
stantly
stripsof coloured linen, or threads of worsted connow
passingupwards. An artificial pupilwas
The
made
in the right eye.
phantasms ceased for
returned after eight weeks ; first assuming
a time, but
the old shapes,and subsequently
new
ones.
High walls
carts surrounded
rose
her,
up before her, heavily-laden
human
threatening
or
figureshovered about her, generally
and alarming,
rarelywith a friendly
aspect. These
occurred
phenomena generally
only during the waking
became
state ; they soon
vivid,that the patientfelt
so
convinced of their real existence,and, though continuing
in the full possession
of her intellectual faculties,made
with her hands
whilst conversing.
defensive movements
Her forehead was
hot, the face much
flushed, the pulse
full and
of anxietyand
hard, and there was
a
sense
oppression which, with the other symptoms, became
aggravated towards night. The phantasms continued
with occasional remissions and exacerbations
during six
Fits of vertigo and
sciousness
unconyears, until death ensued.
supervened,associated with weakness, and
these
subsequentlywith paralysisof the left arm;
recurred several times duringthe year without
exerting
In
influence upon
the visual phenomena.
the
any
month
of January,1837, the patient
seized with a
was
violent apoplectic
attack,the symptoms of which were
torous
hours, sterdeep coma, continuingfor four-and-twenty
of the left
slow, full pulse,paralysis
breathing,
and leg, and
arm
vered
involuntarydischarges. She recoto

also from
threB months
"

On

well and

this

without

the 16th

attack, and

lived for

year

and

further inconvenience.

March,

1838, after feeling

particularly

seized
happy during the previousday,she was
attack,accomduringthe nightwith another apoplectic

OP

ABERRATION

AND

PERVERSION

581

SIGHT.

paniedby completehemiplegiaof the rightside. She

died in the eveningof the following
day."
In the righthemisphere of the cerebrum, not far
lobe and the surface,
from the external edge of the posterior
discovered a cavityof the size of a plum,
there was
invested with a reddish membrane, containinga small
quantityof ochra fluid. There was fresh extravasation
lobe of the left
and posterior
of blood in the middle
the optic
and
striatum
the corpus
hemisphere,near
converted into a greyish
ihalamu*.
The latter was
pulp.
The

and

opticnerves
An

examination

DERANGEMENT,
These

the chiasma

morbid

of the retina

PERVERSION,

phenomena

symptomatic of

OR

in

were

was

normal

permitted.

not

ABERRATION

will be found

disease of the brain

more

than

dition.
con-

OF

SIGHT.

frequently
impairment,

loss,or exaltation of the function of vision.

Such

morbid
and

turbances
of the eyes vary from
slightdisof sightto actual illusions,
irregularities
states

spectra,and phantasms. The

ocula

physiognomy of

the

peculiarin these cases of brain disease. This

observed. The eyes present
symptom should be accurately
and the vision an
unnatural
an
brightness,
occasionally
attention is conthe patient's
centrated
of power, when
intensity
if engaged in exciting
or
upon
any object,
topicsof conversation.
conditions of cerebral disorder, the
Again, in some
to fix his eyes for
patientis conscious of an inability
upon any one pointor object.
many minutes, continuously,
the
the sight,
There is an evident want of control over
sionally,
of volition. Occavision ceasing
to obey the mandates
to stare at
the patientexhibits a propensity
of the eyes assofixed expression
ciated
objects
; there is a
of the pupil.
with an apparentimmobility
eye

is

There
termed

is often observed

by Romberg, a

in these

cases

what

destruction of the motor

has been

paralldivm

582

MORBID

of the

opticnerve

deviation, in fact,from

VISION.

OP

PHENOMENA

the

optic

axis.

have

been

Birkett, of

Dr.

case", with

attending a

gular
disease,in which there exists a sincerebro-spinal
it is presumed,of
of vision,the effect,
irregularity
of
atrophyand impairednutrition of the brain, possibly
obscure

the

opticthalamus.
marked

any

There

headache.

of mental
and

have

of

He

in two
sensibility

for

of the

of the

The

left eye

with

the

In

in

seen

forms

some

cases

The eyes

Dr. Merier

has

are

which

that

more
:

this

rare.

1. That

down, which

has short, and

the accurate

affection

observer

is in these cases,

not in the axis

attention to

kind of

globesamong
of permanent
a kind
practitioner,

The

small

they work
observations

and

up

and

of Dr.

greatnumber

an

Dr. F.
the

Devay
organ of

r*

trembling,oscillation,

threatened

lateral movements

the exhibition of convulsive

he has observed in

as

of reason

the insane

the

influence of

in
ofparallelism

want

The

depends.

the

under

were

called
lately

in consequence
of which
ocular globes. Sometimes
much

socket, and

the eyes, similar to that

the musof strabismus, but without
cular

vacillation of the ocular

It is,says

has

of
peculiarexpression

"

and

right

vision is also

The

left he

of brain disease

patientstares as if he
illusion. There
optical
remarks, a
pertinently
*

in its

oppositeone.
the

the

and
atrophied,

flat,sunk

were

With

eye.

affection upon

vision.

dilatation

righteye long sight.

some

notices

peculiarly

eyes are
difference in the

to be

His

left hand.

his

The

appears

the appearance
as if it
much
smaller than the

lefective in each

impairment of

an

left pupilis contracted,and

pupils.The

dilated.

time

fingersof

appears to
lower extremities.

the

over

some

intellect appears unclouded.

affected. There is a marked

plained
com-

in himself,

of confidence

controlling
power
had

case

vertigo. He

of

paroxysms

has

in this

been

patienthas, however,

The

confusion, want

severe

lost the

has

never

with dementia.

continual
are

convulsion,

confined

to

the

is
down, but the last movement
sions
MeVier have led to these conclu-

movements,

and
laterally

has
of patients,

up

and

alwayscoincided

INCIPIENT

SYMPTOMS

OP

683

APOPLEXY.

Portal

attack of apoplexyin a gentlean

predicated
man
(apparentlyin perfecthealth) from observing a
weakness
slightfixedness of his left eye and a trifling
the same
side of the body.
on
(incipient
paralysis)
to an
Previously
apoplecticseizure, patientshave
been known
to complain of objectsappearingto be
coloured red.
Others
fancythat a line of a like tint
borders all bodies,or complainof a sensation similar to
tlmt experienced
by the eyes when they have been extime to a strong light. Objectsappear
posed for some
if they were
dotted with black or red spots,or the
as
tween
patientimaginesthat a mist or thin veil intervenes bethe eyes and the objects
at which they are directed.
Meningitis,congestion,or cerebral hypenemia, and
other acute diseases of the brain are
occasionally
ceded
preby double vision,strabismus, and other derangements
of sight. These
also the well-recognised
are
of the
premonitorysymptoms of acute inflammation
substance

of the brain.

Andral

had

an

opportunityof observinga person who

tormented
was
constantly
nary
by the imagi-

for several years

sightof small bodies of different forms

and

colours

dancing before his eyes. If he looked steadilyat an

it dotted with red or black points. These
he saw
object,
oct'la spectra,which
were
permanent, prevented his
readingor writing. He did not complain of vertigo,
with that period of the disorder
chronic state

marked

by

the

for example,in the transition from

change
mania

to

from

an

dementia

acute
;

to

2. That

the existence and

of these ocular movements

patientsgive
persistence
among
to the prognosisa very great gravity,
the
notion
the insane
that
justifying
who were
condition
in a supposed favourable
about to
were
or
were
already,
become, incurable.
M. Morel (who refers to the previousfacts),
adds,that in these same
the
patients
this last

eye throws

phenomenon

transition.

and undefinable brilliancy

extraordinary
; but
remarked
the
of
ever
during
period
scarcely
except

out

is

an

is confirmed,the eye is as it were

and the
extinct,
quitein hanuouy with the weak*
gaze has that stupidand doltish expression
of the intellectual faculties.
nens
When

dementia

594

VISION.

OF

PHENOMENA

MORBID

habitually
congested,
considerable suffering,
and he could not endure, without
than ordinary
strong light.
a more
Among the aberrations of the sense of sightprecursory
the following: Seeing objects
of cerebral disease are
cut in half, double
vision, inversion of objects.*A
lady who had complained of being out of health, of
headache
and partialdeafness,found, in the early
slight
disordered.
In
part of one morning,that her sightwas
to read a book, she remarked
that the printed
attempting
letters and sentences were
running one into the other.
the page appeared as if a pieceof finely
Subsequently
glazedpaper had been placedover it,through which she
was
justable to discern the letters. In the afternoon of that
!
day she had an attack of apoplexywhich ended fatally
Vitiated perception
is one
of the common
precursory
vated
symptoms of apoplexy. A lady of vigorous and cultiwhom
Dr. Cheyne attended,was
understanding,
menaced
with apoplexy. Previously
to the attack, she
unusual
complainedof beingannoyed by numerous
pearances
apheadache.

or

The

VCD
conjunct!

were

"

in luminous
*

but
was

bodies

the flame of

Dr. "VVollaston relates that it twice occurred

on

one

side of the axis of vision.

affected ; he

at; and in
SON,

....

view

saw

read the

the commencement

the

not

candle

was

to be able to see

The

but the half of

attemptingto

to him

firsttime the left side of each eye

man's face or of any objecthe looked
JOHNSON

name

of the

name

over

door, he

obliterated
being totally

saw

from

only
hia

nineteen years afterwards

complaint
the visual phenomenon recurred
the right side of the eye, about
; this time
three degreesfrom the centre of the retina,
and its duration was
was
affected,
ten

was

minutes.

of short duration.

About

Two

analogouscases are also mentioned by Dr. Wollaston. Desmonlins states that J\l.Arago has experiencedthis affection of vision three
times : on
the first two occasions objectssituated to the rightof the axis of
vision were
invisible ; the third time he saw
objectson the rightonly of this
axis.

The
of

became
centre

same
a

author notices also the

remarkable
following

case.

In

sequence
con-

cerebral fever,
the external side of the left retina of M. de M

insensible

with his eye he

of vision,
and, as at the same
:

saw

objectsonlysituate

time

there

to the left of the

outward

deviation of
the axis of this eye througha paralysis
of the norve
of the third pair,when
he employed both eyes, he saw
still more
objectsdouble ; but, what was
the right eye being closed,he saw
with the left eye the objects
singular,
removed
from twenty to twenty-five
of their real position.
to the right
degrees
was

an

MORBID

LUMINOUS

585

PHENOMENA.

and with a red centre ;

enlargedto the shapeof a tulip,
the moon
appearedoval with a central portionof a bright
scarlet. All distant objects
were
hazy,yet she read and
wrote without any difficulty.
A gentleman complaineda few hours before he was
attacked
with paralysis
of his being able to recognise
If he looked at a person,
onlyhalf of everythinghe saw.
there appearedto be but one
eye, half of a nose, and
mouth.
In another case, every part of the body was
the premoenvelopedin a thick mist. This was among
nitory
attack of phrenitis,
and existed
signsof a severe
some
days before severe headache excited alarm as to the
state of the brain.

When

speakingof the affections of vision connected

with cerebral haemorrhage,
Andral
remarks,
Sight is
duals
indiviWe
sometimes, but not always,disturbed.
see
struck
down
with apoplexy and
affected with
and loss of sensation,where, nevertheless,consciousness
paralysis
"

"

and

vision remain.

from disturbance

Different

sensations,resulting

of this function,are

experienced

who
describe them in different ways ; some
by patients,
say that they have motes before their eyes ; others,they
the lightas through a cloud, justas on the onset of
see
lens is clear ; others see
cataract
yet here the crystalline
various colours. Sometimes, those who at a later period
attacked with apoplexy,
have the sightmodified for a
are
longeror shorter time before the 'attack in such a manner
that all objects
times
appear double, a symptom which is sometransient,beingpresentone day and not another.
but
In other cases
the loss of sight is nearlycomplete,
When
the sight is lost,this
such cases
are
very rare.
ness
side or on both ; and this blindmay take placeon one
"

coincides with the loss of

or
Photopsia,

the appearance

numerous

other senses."1

of luminous

""Clinique."

phenomena,

586

MORBID

PHENOMENA

OF

objectsilla

state of

or
ignition,

surrounded

halo,
acute

phorescen
phosof

case
interesting

of the kind.

phenomena
assumingthe

swords, whose
varied.

The

continued

light. The

mental

of

vision

added,

were

Nevertheless

night

and

the

sionally
day, occa-

angelswith flaming
were
apparentlyaccompanied
forms, however, frequently

appearance

movements

electric

an

"

blindness.

terminatingin complete
luminous

of
particulars
A distinguished
artist
wards
afterto which
photopsia,
relates the

Johnson

late Dr. James

for several years suffered from

headache
and diminution

by

disease of the brain.

The
an

by

incipientsymptoms

common

are

VISION.

powers

of

of the

individual

remained

he went
out he was
unimpaired,and whenever
very
attentive to everythingthat did not requireeyesight.
In the springof 1835 he had an apoplectic
seizure which
deprivedhim of movement, consciousness, and speech.
There was
and the
of the sphincters,
completeparalysis
pupilswere dilated. He recovered from this condition,
and after a few weeks was
again able to go about the
town

and

attend

to

his

But

business.

the

visual

as
phenomena returned, and the sight was
painfully
and more
than before.
In the
so
dazzling,
continuously
month
of August an
attack
occurred, and
apoplectic
death ensued in three days. The rightlateral ventricle
of the brain was
found after death to contain
nearly

three

ounces

of clear fluid. The

left was

full of bladders

resemblinghydatids of various sizes,and containing

fluids varying in consistency.
This accumulation
sprung
from the floor of the ventricle by a kind of pedicle,
and
of the cavity,
penetratedinto all the recesses
pushing
its branches
one

side

thalami

forwards
into

the

so

as

to

extend

opposite half

of

the
the

thalamus

of

stroying
brain, de-

everythingthat opposed its passage.

converted into a pulp,as well
were
optici

Both
as

the

588

VISION.

OF

PHENOMENA

MORBID

tion

was

performed. Subsequentlya

over

the

ninth

the continued

under

recovered

soon

with

combined
aperients,
"

He

had

of

use

applied
He

tive
gentlealtera-

counter-irritation.

of the attack

recurrence

was

great benefit.

with

dorsal vertebra

blister

some

months

after

plained
drinking; but though he comof it,
of the head, especially
at the back
more
material fulness or frequencyof the pulse,
there was
no
and
febrile irritation.
He was
relieved by purgatives
or
and was
afterwards treated with camphor and
blistering,

in consequence

of hard

other nervine

medicines."

nobleman,

for

previouslyto an at-,
tack of apoplexy,was
subjectto a carious phantasmal
phenomenon. He, on several occasions during the day
when
clearlya
sufferingfrom acute headache, saw
nation
spectral
image resemblinghimself. This form of halluciis termed
deuteroscopia.The
phenomenon is
considered

of

rare

or

type

id et Remimscen/id"

lengthin

even

occurrence,

Aristotle refers to this

Mem

weeks

some

among

the insane.

of illusion in his essay,

but

it is

"

explainedmore

De
at

his

Meteorology.
A
certain Antipheron,Aristotle says, when
he was
walking,saw a phantasmalreflexion of himself advancing
towards
him.
A traveller who
had
passed a long time
without
image,
sleeping,
perceivedone night his own
which
rode by his side. It imitated all his actions.
The
horseman
a
river,the phantom passed
having to cross
it with
him.
over
Having arrived at a placewhere the
mist was
less thick, this curious
apparitionvanished.
Goethe relates having had a similar hallucination.
This
form of hallucination
is frequently
observed
duringthe
delirium of typhoidfevers.*
restored
Morel
relates the case
of a lady who
was
*

"

Anatomic

Gratiolet.

Compare

Paris,1857.

du

SystfcmeNerveux,"

P. 639.

par

Fr. Leuret

and

P.

MORBID

nealth

from

PHANTASMAL

incipientphase of

PHENOMENA.

of

state

generalparalysis.In

disease

the

affirmed

that

she

without
garden a man
AVhen
she directed her stepsboldlytowards the
a head.
placewhere the apparition
appearedto be, it immediately
vanished.
She said nothingabout this phantom to her
family,
fearingthat she would be thought insane. This
patientobserved, after her allegedrestoration to reason,
saw
constantly

at the

that the firsttrial she

end

she

the

of the

made

of her

intellectual powers
herself,consisted in her occupying

communing with
the placewhere the apparition
formerlyappeared.
The absence or presence of the phantom ought to prove,
of her cure.
she said,the validity
illusions of visions and
In many
the ocula spectra,
cases
phantasms are supposedto be referable to spinaldisease
irritation. I, however, suspect that when
morbid
or
tion
psychical
phenomena of this kind are present,the affecof a cerebro-spinal
is to be viewed
as
more
one
localized in the
character than as a disorder exclusively
spinalcolumn.
whilst

An

instance

occurred

some

years

since of

young

tion,
girlbeing haunted, whilst labouringunder spinalirritafigurewhich she described as standing
by a spectral
seized with fits of
by her bedside. She was frequently
screamingas she fancied the phantom approachedher.
She kept her relatives in the greatest
state of alarm and
A few active purgatives
astonishment.
gave immediate
of
and effectual relief. Dr. Griffin cites the particulars
two cases
singular
phenomena.
presenting
of a good constitution,but
A man,
aged thirty-six,
days of
very intemperatehabits, complainedfor some
occasional painsin the stomach and arch of the colon,
and
with
costiveness,loss of appetite,
generalnervous
had constant
He
excitement.
slightpain in the brow
of vision and extreme
disturbance
with
to
sensibility

590

MORBID

PHENOMENA

with
noise,conjoined
His

senses.

eyes

a
were

about

morbid

OF

VISION.

state of exaltation of the

suffused, tongue white, pulse

pain in his chest, accompanied

ninety. He had a
with
great anxiety. His chief distress,however, arose
he
from
was
opticalvisions, with which
continually
troubled.
were
Figuresof persons, almost all of whom
to him, were
before him,
wholly unknown
frequently
that althoughhis reason
sometimes
distinct,
so plainand
assured him they were
he could scarcely
illusions,
mere
avoid believingthat they had
absolute existence.
an
not alwaysthe same
nor
They were
alwayspresent,but
and came,
went
renewing his anxietyand irritation of
often
mind
as
as
they appeared. On examining the
found
at the three upper cervical
spinetenderness was
vertebrae,pressure on any of them
pain.
excitingmuch
The
cessively
exeighth,ninth, and tenth dorsal vertebrae were
tender, the slightest
on
pressure
any of them
sensation
occasioningan exceedinglydistressing
along
the spineto the sacrum.
J. H., aged fifteen years, complainedthat, at night,
he
became
blind : he could not see the furniture or
invariably
visible
peopleabout the room, when they were perfectly
else. The candle or fire-light
to every one
appearedlike
from darkness,but
red haze, justdistinguishable
a broad
He could perceiveany dark
making nothing perceptible.
him
and the light,
and
He
no
more.
objectbetween
and had a
affected in this way for about a fortnight,
was
similar complainta year ago, which
continued
a
long
is greattenderness on
There
time.
pressingthe second
He
recovered
in less than
cervical vertebra.
perfectly
active calomel
hours, by a small bleeding,
an
forty-eight
and a blister to the nape of the neck, and has
purgative,
since continued

the

well.

followingcase
manner.
extraordinary
In

the

vision

was

afiected in

an

PHENOMENA

MORBID

OF

SIGHT.

591

gentleman,aged seventeen, is frequently

young
attacked with violent headache and sickness of stomach,
A

alwaysushered in by indistinctness
of vision. His first warning of the fit is a sudden
appearance of somethingmisty and tremulous before his
afterwards
he perceives
onlythe vertical half
eyes ; soon
of any objecthe looks at, and eventually
the outlines
fade away altogether
This almost
into thick darkness.
total blindness
continues
generallyfor a very short
period; the thick dark mist graduallyclears off,and the
him
forms of everythingaround
are
again distinctly
seized with
He
intense
observed.
is then instantly
headache, chieflyaffectingthe forehead, usuallyso
ing
dreadful in its nature, and accompaniedby sucli distresssickness,that he says he could scarcely
or
nausea
live if it lasted a second day. He commonly finds relief
endured,
easily
by lyingdown : the pain is thus more
in four or five
is shorter,terminating
and the paroxysm
it might otherwise
for twenty.
continue
hours, when
Instead of pain,a deep lethargysometimes
supervenes
he lies as in
the affection of vision, during which
on
conscious of time passing,
heavy slumber, but frightfully
sounds
and of terrific sightsand
crowding upon his
imagination.He awakes out of this state of mind in a
for some
not know
state of temporary delirium ; does
coherentl
time where he is,or what has happened,and speaksinwhich

symptoms

Even

althoughthere is
the
the lethargy,
some

He

hours.

to make

at the moment.

much

less confusion of mind

memory
cannot

of the

is

headache,
than after

always very imperfectfor

recollect the words

he wishes

employs others whollyinapplicable

and of this mistake he is alwaysconscious
To these attacks he has been subject

times
years, but in their intervals he has someHe awakes
affected in a very different way.

two

been

alter the subsidence

of, but

use

in their stead

for about

are

592

MORBID

for which

dreadful

sleepat night in

of his

suddeDly out

VISION.

OF

PHENOMENA

he

There

account.

cannot

is

through his

ideas

crowding and rushing of

hension,
appretinued
con-

mind.

everythinghe did, and all that was done

with a frightful
and hurried
about him, passed over
even
rapidity.This at last wears
away, and is generally,
He

feels

from
will

first,
more

the

less

or

effort to check

; an

divert

if

as

it into

the

under

influence of his

of his ideas, and

the current

direction,frequentlyproving

another

successful.
On

examination, there

the second

found

was

great tenderness

of

eighth dorsal
vertebrae.
When
this last was
pressedupon,
slightly
he felt a horrible sensation
shoot through his whole
frame. It was
quiteindescribable,and nearlymade him
faint.
He
expressedthe greatestapprehensionat the
agreeable
thought of the pressure being repeated,and had a disin his back for the entire day afterwards.*
feeling
This is occasionally
STRABISMUS.
observed
the
among
in the
earlysigns of disease of the brain, particularly
should be
cerebral affections of children ; and, if present,
noted.
A slightsquintin the eye has occasionally
carefully
been found precursory of an attack of apoplexy,
and is often diagnostic
of the commencement
of effusion
cervical and

of the

seventh

or

"

the brain.

on

gentleman,who

headache

complainedfor a few days of

of spirits,
was
observed,whilst
depression

and

strabismus.

dinner, to have

at

droppeddown

he
of
forms

had

in

similar character

of acute

brain

few

fitof

minutes

apoplexy.

quently,
subsetions
Illustra-

could be cited,in which

disease have

been

ushered

I have

yet spoken of

in

other

by

this

symptom.
VISION.

DOUBLE
*

Tide

"

Griffin,M.D.

On

"

Functional

Disorders

not

of the

SpinalCord," by

this perW.

L. D.

MORBID

PHENOMENA

version of

sight. It
symptoms of

cerebral disease is of
and
significance,

593

HEARING.

of the

importantprecursory
disease of the brain.
This signof
value and diagnostic
greatpractical
one

most

should

tion.
escape attentive observafirst indication of acute mischief

never

It is often
in
originating

is

OF

the

the brain, and

cerebral diseases of children

in
occasionally

the obscure

it constitutes

important
occasionally

an

diagnostic
sign. This aberration of vision is
symptomatic of gastricand hepaticdisorder,but when
associated with persistent
ache,
or
paroxysmalattacks of headlowness of spirits,
morbid conditions of the seasonal
motorial powers, we
be too closely
cannot
observant of
or
the state of the patient's
brain.
Attacks of apoplexy,
and meningitis
cerebritis,
paralysis,
have often been precededby double vision.
Dr.
in point: "Dr.
Watson
relates the
followingcase
Gregorywas acquaintedwith a sportsman who, one day
when
out shooting,
disputedwith his gamekeeper as to
of dogs they had in the field. He asked how
the number
him.
he came
The
to bringso many
as eightdogs with
"

assured

servant

him

gentlemanbecame
his

there

at

once

house

when

MORBID

he

was

He

attacked

PHENOMENA

OF

four, and

of his

aware

horse, and rode home.

but

were

had

affected in different morbid

not been

"

This

there is

died."
is

sense

states of the brain

observed,in connexion

with

the

longin

disordered conditions of the cerebral circulation.

cases

the

situation,mounted

by apoplexy,and
HEARING.

then

subtle

In

riously
va-

and
some

changes
hearing.

completeloss of
obtuse. In
becomes
In other instances,this special
sense
forms of
and in particular
it is perverted,
some
patients
disease of the brain an exalted condition,or hypcresthesia
is developed.
of the faculty,
the incipient
symptoms of cerebral
Occasionally,
among
of the auditory
there is a sudden paralysis
disease,
nerve,
of structure

within the cranium,

594

allsense
destroying

however, of

HEARING,

OF

PHENOMENA

MORBID

These extreme

of sound.

The

occurrence.

common

cases

symptoms

affections of the

noticed
generally

in the insidious

in relation to the

of hearing,
are
faculty

either

not,

are

most

brain,

gradual,

obtuseness
of the sense, or an
or
impairment,
progressive
exaltation and aberration of the faculty.
morbid
intensely
of the most frequent
A disordered state of hearingis one
gerous
symptoms attendant upon those extremelydanaffections of the internal structure of the
the
which
a

for a lengthof time, by

preceded,
frequently
purulentdischargefrom the external meatus,
so

chronic

chronic

inginvolv-

the brain itself,

bones,membranes, and ultimately
are

known

ear

of otorrhoea,and often connected with

by the name
cerebral suppurative
inflammation.
or
meningitis,

stage of certain affections of the brain

incipient
The faintest
the hearingoften becomes
acute.
painfully
whisper reverberates through the ear like the noise of
thunder, and conversations that are takingplacein remote
and distinctly
heard by the
partsof the house are clearly
patientwhilst in this state of auricular hyperaesthesia.
It is extraordinary
how
of hearing
acute the sense
in certain forms of delirium.
I
becomes
occasionally
informed
that
was
livingphysician
by a distinguished
In the

he

able,when

was

occupyinga

this

state of cerebral

at the

room

top of

the

witnessed

I have

phenomenon

in the

some

earlyas

whilst
exaltation,

house, to hear with

clearness the conversation

remarkable
kitchen.

in

takingplacein the

remarkable

well

as

instances

advanced

of

stages

of brain disease.
Dr. Elliotson attended

of age, who

had

whilst in bed
the house

about forty
gentleman,
years
attack
of
and
suddenlyan
hemiplegia,
a

he heard the least sound

with

at the

bottom

of

him ; and
surprised
could tell the hour by a watch placedon a table at such
from his bed as to have rendered it impossible
a distance
in health.
for him to distinguish
the hands when he was
an

acuteness

which

OF

PHENOMENA

MORBID

HEARING.

considered to
before her mind was
lady,a fortnight
in the habit of waking her husband
be deranged,was
several times during the night,imagining that she heard
in some
the voices of persons in the room
or
part of the
A

On

house.

occasions

two

or

one

recognisedthe
distinctly

declared

of her

voice

her by
Zealand) calling

in New

then

she

mother
name,

that she

(who

and

was

begging

to her.
deepestdistress,to come
The patientinsisted upon
gettingup and examining the
be persuadedher
whole of the house before she would
mother
At this time no
not there.
was
one
suspected
that these were
incipient
symptoms of insanity.
illusions of hearing often lead to a sad sacrifice
These
of life,occasionally
impellingits unhappy victim to the

her, in accents

of the

of both

commission

influence
is driven

of

the

the

the

one

of two

him
inciting

to

yieldto

bad

his

distinct
fice
to sacriand

ploring
im-

insane
dangerously
good voices restrain

voices urge, iny

remark
of a patientwho

impulses. My

character,that is,

influence

patient
Occasionally,
a

voice,begging
restraining

patientnot
"

homicide.
double

the

bad voice

life,the other

of

the irresistible

Under

imaginary voice, many

hearingare
subjectto

patientis
voices,a good and

was

an

suicide.

to acts of violence and

the illusions of

me,"

and

murder

believed

himself

demoniacally
possessed. I should have destro}red
myselflong ago,"said an insane person to Dr. Morel, or
I should have killed somebody else,if the voice of my good
angelhad not begged and encouragedme to suffer."
Patients are often seen
contendingwith these antagonistic
double voice,"as Morel
illusions,
or
designates
obscene
the phenomenon. In one ear the most frightfully
ideas are suggested; whilst at the same
moment, in the
oppositeone, sentiments of the greatestpuritywill be
whisperedto the disordered imaginationof the sufferer.
These antagonistic
and opposingillusions lead to fearful
to be

"

"

"

597

SMELL.

AND

TOUCH,

TASTE,

MORBID

of mental agony.
produce a sad amount
Which
voice ought I to obey?" said a delicate and sensitive-minded
to me one day after a fitof hystericopatient
maniacal excitement.
"I am urgedby persons that address
me
on
my rightside to utter blasphemousand indecent
and to commit
acts the most repugnant and
expressions,
repulsiveto my nature ; whilst in the oppositeear I
?) beseeching
clearly
recognisea tender voice (conscience
of Satan, but
to the fearful temptations
not to yield
me
to battle with his vile and wicked suggestions."
Another
patientwas urged by a voice to destroyhimself. He was

contests,and
"

"

commanded
"

to

cut

throat.

his

blood," blood," were

repeatedwith

"

and

in

rapidsuccession

occasion he

was

to him

discovered

with

an
seriously
contemplating
gentleman was subjectto

voice,for at times when

awfullyin

The

"blood,"

terrible emphasis,
than

more

on

a razor

in his

the

"

an

of the

influence
"

blood"

air-drawn

one

possession,
This

act of self-destruction.

the word

his ear, and

and

words,

double

ringing
dagger"stained
was

before his eyes there stood, as he

glittered
imagined,on the oppositeside of his body a good spirit
of
repeatingverses
whisperingto him texts of Scripture,
ploring
to his then state of mind, and imhymns applicable
him in most affectionate and touchinglanguage,
his own
life.
damn his soul by destroying
not to eternally
with

gore,

MORBID
These

PHKNOMENA

senses

OF

TASTE, TOUCH,

SMELL.

AND

"

at the commencement
exhibit,occasionally,

exaltation,and
impairment,
racteristic
chaperversion.Prior to the developmentof the more
symptoms of disease of the brain, the patient
complainsof a morbid condition of taste,of abnormal
and of perversionof
states of the tactile sensibility,
of cerebral disease,evidence of

the

sense

mind
organs,

of smell.

associated
the

In

with

latter

sense

all affections of the brain

derangement
is observed

of

the
to

and

digestive
be
greatly

598

MORBID

affected ; but there is no

in connexion

TOUCH,

TASTE,

with

AND

SMELL.

characteristic tom
sympeither of them
pathognomonicof
and
special

organicdisease of the brain.

The insane, in the incipient
stage of their malady,are
often heard to complainof being exposedto the influence
The predominant
smells.
of most offensive and noxious
odours noticed
by patientsin the earlyperiodof their
mental alienation are those of sulphurand putridbodies.
in a state of putreA ladydeclared that her inside was
faction,
exhalation
she recognised
a fact
by a particular
months
before her intellect was
from her body for some
heard to complain
frequently
palpablyderanged. She was
of the offensive odour, but no
one
suspectedher
mind
to be in the slightest
degree affected,until one
morning she left home before breakfast,and going to a
accused herself of having
neighbouringpolice-station,
of

the commencement

committed
The

serious criminal

in

will be heard

the

is frequently
observed
to be
sensibility
the earlystage of paralysis.The patient
of numbness
to complainof a feeling
or

tactile

disordered

of sensation

want

in the

ramifications

tipsof the fingers. This

and
fingers,

extends

to the

hand.

I have known

to exist for many

more

offence.

decided

the

nerves

at

condition of anaesthesia often

sometimes

to the whole

of the

this local

months

impairmentof sensibility
to the recognition
of
previously

manifestation

lesion of sensation

of

of disease of the brain.

This

often

precedesattacks of generalparalysis.
Professor Simpson,of Edinburgh,has alluded to
from incipithe morbid phenomenon. Patients suffering
ent
he says, often complain of their
generalparalysis,
"*
A tailor who
died of
fingers feelinglike sausages.
this disease,lost all sensation at the tipsof his fingers
for
twelve months
to any suspicion
to
as
existing
previously
"

During a

paper read

of Edinburgh,"ona
"Medico-Chirurgical
Society
"General
of
the
on
Insane,"Feb. 1,I860.
Paralysis

discussion at the

by Dr. David Skae

EXALTED

the

healthystate

his

needle,as he

when

he had

599

SENSIBILITY.

TACTILE

of his brain.

He

unable to work with

was

knew, owing to the anaesthesia,

never

it between

his

fingers.
I have referred in a previouspart of this volume
to
the loss of sensation that occasionally
at the perioccurs
pheral
terminations of the nerves
in the incipient
stage
of paralysis.
Dr. Todd
cites a case
of hemiplegiathat
six months
commenced
priorto admission into King's
and pricking
with a sensation of tingling
College
hospital,
in both
about

hands, and

both

jarred,or
was

elbows,just

small

as

of numbness

amount

if the ulnar

had

nerve

been

words, as if he had
own
patient's
funny-bone. Accompanying these symptoms
a

became

soon

considerable

in the

struck his
there

sensation

unable

objectwith

to button

his

the
Occasionally,
will be observed

in

of heat in the

irritation in this

his clothes

or

pickup

he
any

righthand.

sensation
a

fore-arms, and

state of

at

the

tipsof

the

great exaltation.

fingers
A

bid
mor-

part of the hand often co-exists with

well as with other types of nervous

disorder.
as
insanity,
The habit of bitingthe nails to the quick,and gnawing
the tipsof the fingers
is very common
the insane.
among
In many
of mental
cases
irritation,
exaltation,
hysteria,
and anxiety,
with
unassociated
there is often
insanity,
manifested a morbid degreeof exalted tactile sensibility.
This local hyperajsthesia
is occasionally
observed among
the incipient
symptoms of mental derangement. A lady
is annoyed by
who
has had several attacks of insanity,
for some
intense irritation at the ends of the fingers,
an
ing
weeks previously
alienation of mind exhibitto positive
the approach
itself. Her familyare able to predicate
of insanity
of the paroxysms
by this symptom. It is
the
difficult to explainphysiologically
or
pathologically
relation

ami

this

between

type of

certain cerebral and

exalted local

mental

sensibility.

disorders

600

PHENOMENA

MORBID

CHAPTER

Phenomena

Morbid

OP

SLEEP.

XXIII.

of Sleepand

Dreaming.
identified with,
phenomena of sleepare so closely
so intimately
dependentupon, the state of the brain,

THE
and

that the varied

affections of the sensorium

(functionalas

tion
deviaare usually
organic),
accompaniedby some
from a normal
state of this important function.
The morbid
affections of sleep
will be considered in the
followingorder :

well

as

"

a.

P.

7.

Insomnia.
or
of Sleeplessness,
Abnormal
An
Disposition to Excess
Sleep.
Morbid
Phenomena
of Dreaming.

State

of

subjectembraces the many

of insomnia, ranging from
a
simplestate of
gradations
cerebral
to a disturbed,eccentric,irregular,
restlessness,
and unrefreshingcondition of
repose (pavores,jactatio],
insomnia, or sleeplessness.
slumber, to a state of positive
The
second section of the subjectwill embody a brief
of sleep,
of certain morbid
to excess
analysis
dispositions
designated,according to the extent of the symptoms,
by the nosological
phrasessopor, coina, carm, Icthargm.
There is no
symptom, when viewed in relation to the
careful
health of the brain and mind, that requires
more
The

first division

of the

OF

SLEEPLESSNESS

and

unremittingattention

wakefulness.
of

many

some

cases

It is

It is

an

of the

one

that
most

of

insomnia,

axiom

or

tants
concomi-

constant

brain disease,and
types of incipient
certain forerunnerof insanity
!

admitted

be in

than

601

INSANITY.

INCIPIENT

in

medicine, that the brain

in

state of

sleeplessness
exists. Sound, continuous, unbroken, regular,
and uninterrupted
sleepare essential to the preservation
of the mental and bodily
health.
Any interference with
this importantfunction or state of cerebral rest,seriously
damages the health of both body and mind.
We
cannot
too
zealouslyguard against,or too
teristic
anxiouslywatch for,the firstapproachesof this characbrain and mental disorder.
symptom of incipient
Persons predisposed
to attacks
of cerebral disease and
morbid
affections of the mind, ought never
to permita
condition of sleeplessness,
of disturbed
even
or
a state
and broken rest,to continue for many
consecutive nights,
without
seriouslyconsideringtheir state of bodily,
cannot

healthycondition

and mental
cerebral,
In

whilst

health.

the

forms of acute
premonitory stage of some
and
of delirium
tremens, the
insanity,
particularly
by night
patientis in a constant state of sleeplessness
is broken
and restlessness by day. His repose, at first,
He
slumbers
.and disturbed.
lightly,and has only
noise or ruffle
snatches of sleep. If asleep,
the slightest
of the bed-clothes,awakens
him; and when suddenly

aroused he looks like

person

whose

eyes had

never

been

characteristic and

significant
insanity.
symptom of the insomnia of incipient
In conditions of healthy
sleepthe vital energy or nerre
force is supposed to be reproduced,
evolved, or regenerated
closed in

sleepI

This

is

in the vesicular neurine,and

his
muscular

morning'swork,

with
character,

whether

renewed

the individual
it be of

supplyof the

mences
com-

mental
powers

or

of

602

MORBID

OF

PHENOMENA

SLEEP.

energy, sufficient to carry him successfully

throughthe day'sregularand appointedduties ; but the

life or

nervous

unhealthysnatches

partialand

certain states

disorder

of brain

of

repose

obtained

do not appear

in

to refresh

the system. In this condition of cerebral

invigorate
of the
disease,the grey matter
or
activity,
irritability,
conditions of
brain is incapableof eliminating
normal
or

nerve

or

vital force.

state of wakefulness

is

consequent upon
frequently
is often
and agitated brain, and
an
unduly worked
exhibited by persons of a nervous
and excitable temperament,
whose
who have been subject
to great anxiety,
or
intellects have
been overwroughtand unduly strained.
When
himself to the importanceof anticipating
addressing
the firstdawningsof the cerebral diseases of children,
as

well

will

those

as

find

in

symptoms

of adult

age, Dr.

patientswho

degree of

are

restless

observes, "You

Graves
about

cerebral

to have

anxiety,and

higher

degree of energy, than accords with their condition.

They either do not sleepat all,or their sleepis broken
and incoherent
by startings
expressions.AVhen a person
is spoken to in this state,he answers
in a perfectly
rational
headache

manner

he will declare

that he has littleor

no

by a
be very likely
to
hastyreview of his
If a close inquirybe
overlook the state of the brain.
made, it will be found, that the patientscarcelyever
is irritable,excitable,
dozes
that he
sleeps,or even
incoherent, and muttering to himself. Under
frequently
such circumstances,
althoughthere is no remarkable heat
of scalp,
suffusion of the eye, or headache, the medical
attendant
must
suspect the superventionof cerebral
about the ninth or tenth day of
symptoms, particularly
the fever (forit is generally
about this periodthat cerebral
and whensymptoms beginto manifest themselves),
;

and

were

the

physicianto
symptoms, would

"

be

led away

604

SLEEP.

OP

PHENOMENA

MORBID

and whose
pursuits,
engagedin literary
actively
occupationsabsorb a largeamount of nervous
energy and
to conditions of insomnia.
thought,are subject
energetic
It is said that Paganini rarelyslept,
so
was
entirely
his mind occupied,
night and day,in his intense passion

Persons

for music.

Boerhaave

sleepfor

to have

not

closed his

periodof six weeks, in consequence of

his brain being overwroughtby intense thought on
a
of study.*
profoundsubject
The insane are
with apparent
capableof sustaining,
conditions
of
impunityand indifference,
long-continued
The case is published
of a derangedperson
sleeplessness.
who was
not known
to close his eyes in sleepfor the
periodof three months ! He was in the habit of walking
long distances,greatlyexcited during the day, and at
ceased
night he never
talkingto imaginarypersons.
form
No
dose of opium had
him.
or
any effect upon
Dr. Wigan had
a
patientunder his care who did not
in the habit of getting
sleepfor fifteen days. He was
galloping,
up in the night,and tiringthree horses with
in the vain hope that excessive muscular
fatiguemight
induce a disposition
!
to sleep
The
for
account
state of the brain may
pathological
the condition
often seen
associated
of sleeplessness
so
eyes

in

is recorded

The

how
question,

asked than

longa

person

can

exist without

answered, and the difficultiesof answeringthe

would
been

to

seem

convicted

leave it for

ever

unsolved.

of

murdering his wife,and

deprivedof sleep. This painfulmode of
under

the

circumstances
following

under

the

care

of three

"

The

was

death

sleep,is one oftener

questionby ment
experi-

Chinese

sentenced
was

condemned

to

carried
was

merchant
die

had

by being

into execution

placed in prison

policeguard,who relieved each other every

asleep nightof
preventedthe prisonerfrom falling
lived
He
thus
nineteen
without
day.
days
enjoyingany sleep. At the
intense that he imof the eighthday his sufferings
plored
commencement
were
so
the authorities to grant him the blessed opportunity
of being strangulated,
burned to death,drowned, garotted,
blown up
shot, quartered,
guillotined,
with gunpowder, or put to death in any conceivable way which their humanity
could invent.
This will give a slightidea of the horrors of death
or
ferocity
from want
of sleep. Semi- Monthly Medical
Newt.
1859.
Louisville,
alternate hour, and who

"

of the

\\ith

but
insanity,
with

in

605

SLEEPLESSNESS.

OF

PATHOLOGY

the

cases

many

derangementarises

mental

insomnia
from

nected
con-

complete
thoughts

of the
abstraction, concentration
absorption,
terrible and
of the mind, in some
and pre-occupation
tion,
fearful form of illusion,or frightful
type of hallucinathe morbid
that has firmlyseized upon
nation.
imagi-

The

of transient repose which

afflicted are able to obtain,

snatches

continuance

of

so

happily
un-

not sleep,
enduring thought."
"

But

those

Are

insane
Sleep is one of the functions which, among
undergoesthe greatestchanges. It is espepatients,
cially
of insanity
in the period of incubation
that the
itself as an importantsymptom.
absence of sleeppresents
I interrogate
'When
phenomena
parentson the incipient
fail to inform
of the disease of their relations,they never
of sleepas one
of the greatest
of the deprivation
me
One can with
that they have had to endure.
sufferings
of sleeplessness
in
form an idea of the tenacity
difficulty
the incipient
periodsof insanity.The absence of a
increases the conditions
fiftictionso eminentlyreparative
in which
the insane are generally
found ;
of irritability
and it ordinarily
happens that in the confirmed stage of
disturbed.
and more
Complete
insanitysleepis more
observed
the insane is seldom
except in
sleepamong
confirmed dementia, and in the condition of melancholy
often
with stupor. Even in their convalescence,patients
complainof not being able to sleep. In all cases it is
interrupted.
frequently
Incompletesleepis the repose of one of these two
orders of sense, and waking of the other ; it refreshes
"

"

much

it satisfies nature

less,but

sleep,and
when

know
one

many
says that

men

the

than

more

who
insane

have
do

no

not

entire

other.

sleep,

COG

OF

PHENOMENA

MORBID

SLEEP.

ing,
perhapsit is better to say that theyare alwaysdreamexceptin their lucid intervals."1
who
closed her
attended a patient
I formerly
rarely
for nearly
a
eyes in sleepfor ten consecutive minutes
year! Her existence under these circumstances was
mind
The
tortured by the
miraculous.
was
perfectly
racked a poor maniac's
most horrible phantasythat ever
She
brain.
imagined she was the original
serpent
that tempted Eve
to eat the forbidden
fruit,and
to be punishedfor this great sin by beingcompelled
was
to have scorpions,
snakes,and reptiles
venomous
about her person night and day.
of every description
she retired to rest, she, in an
Whenever
agonising
tone of voice,begged,in most piteous
terms, that the
I sleep
snakes might be taken from her bed.
upon
adders are
scorpions,
my bed is full of horrible reptiles,
and clinging
in my pillow
round my neck ; for heaven's
to have compassion
sake, I beseech, I imploreyou,
"

"

me,

upon

"

rid

and

of this terrible affliction

!"

me

In

would
this poor
languagethus touchingand affecting
and affectionately
creature earnestly
appealto every one
who approached
her.
No preparation
dose of opium,however strong,
had
or

sedative effect upon her brain. She at one time had

administered to her largeand repeated
of the
quantities
any

of
potentand concentrated preparation

most

without

or
causingsleep,

even

condition

this

drug
analogous

to it :

"

"

Not

poppy,

nor

mandragora,

Nor allthe drowsysyrups of the world,"

could,alas !
"Medicine

to

sweet

"

sleep

that

it
unhappy and perturbedmind, so fearfully
was
shattered and shipwrecked
! Her wailings
of profound
*

Morel,p, 458.

SLEEPLESSNESS

OP

THE

C07

INSANE.

and frantic shrieks of wild and hopelessdespair

grief,
heard in the dead of the night,towering
\\vre
occasionally
loudly above the noisy tempest often raging
without.
In

the patient's
mind
types of insanity

some

absorbed
illusion.

in the

Under

of
contemplation

these

sufferer is afraid to close his

fear and

dread

horrible

phantasm

frightful
tral
speccircumstances
the unhappy
from an intense
eyes in sleep,

he will then

that

which

is altogether

fall an

his morbid

called into existence,and which

easy prey to the

imaginationhas

he

imaginesfollows him
The patient
in all his movements.
afflicted declares
so
he will not sleep,
and resolutely
repudiatesand perseOn many
to slumber.
veringlyignoresall disposition
refuses to go to bed, or to place
occasions he obstinately
himself in a recumbent
position.He will battle with
his attendant if he attempts to confine him to bed.
He
insists on remainingin the chair,or standingin an erect
all night,and often determinately
walks
about
position
when
him are wrapt in profound
those near
the room
rejx"se. In these

cases

the hallucinations

appear to be
the patientis

vivid when
and acutely
exquisitely
position,on account,
placedin a recumbent
most

of the
blood
A

mechanical

it is

ceived,
con-

facilitiesthus afforded for the

to the head.
freely
gravitating
gentlemanwho appeared free duringthe day from
could

any acute hallucinations,never

harassed
without
being distressingly

lie

on

his back

of
by a number
he imaginedto be dancing fantastically
frightful
imps,whom
him
around
these
during the night. Under
circumstances, undisturbed
sleepwhilst in bed could
in the habit of sleeping
He was
be obtained.
in
never
an

arm-chair

symptoms.
been

for many

for

some

time

in

consequence

of these

He, however, eventually

recovered,and has
years

free
entirely

from

all hallucinations.

608
In

MORBID

similar to those

cases

found
occasionally

is

OF

PHENOMENA

in

SLEEP.

narrated,the heart
previously
an
unhealthystate. Valvular

disease of this organ is a common

concomitant
of disease
of the brain associated with illusions or hallucinations.
the

speakingof

When

Southey

afflicted

was

of

with which
insanity
previouslyto his death, Dr.

directs

Mackay

Charles

attack

attention

fact that

the

to

the

poet laureate's mental illness arose from

that he experienced
during the time he

was

in close and

affectionate attendance

bed

of his

Mackay observes, alludingto

Dr.
to

the sick

upon

Wordsworth,

"

found

calm

from

scene

philosophyand

him

to make

such

happy

choice

and

love

true

of such

such

view

had

yet seen

and

from

Bydal water
forming,with

was

wife.

paid

Excursion'

the

beauty of

window,

of nature

that

and

the

had

led

place,and

longseclusion

at another

of

the

'

sleep

the Mount

at

admire

before

of Windermere

The

view

lawn

the

of the

I arrived
I

had

visit he

the bard

walking in his garden when

and long and
ferventlydid
the

the loss of

from

his door

part

combined

of

with

kept him in
the busy world.

was

his

the

finest I

grounds,the

that of Winder-

circling
Loughrigg in front, amid the enhills on every side,a landscape
of extreme beauty.
In speaking of Southey,whose
is so intimately
name
associated with his own,
and whose
friendship
he enjoyedfor so many
and society
years, he dwelt with
and
much
emphasis on the long-continued
systematic
of his time, by which
he was
enabled to vary his
economy
to politics,
from politics
to poetry,
studies from history

mere,

and

clo

more

work

in

each

than

would

have

sufficed to

of inferior
reputationof half a dozen, even
At
the periodof his death, and
indeed
attainments.
the generalopinion that he had
long before, it was
tasked his brain too severely
by study; that his intellect

make

had

the

become

overclouded

from

excess

of mental

toil,and

.NITT

that he had

CAUSED

laboured

BY

WANT

OP

009

SLEEP.

wiselybut too well.' Mr.

Wordsworth, however, upon my puttingthe questionto
him, denied that such was the case.
Though Southey's
labours were
almost superhuman,and varied in a wonderful
they seemed, he said, rather to refresh
manner,
and strengthen,
than to weary and weaken
his mind.
He fell a victim,not to literary
toil,but to his strong
affection for his firstwife, which led him nightafter night,
when
his labours of the day were
ended, to watch
with sleepless
anxietyover her sick bed. The strongest
mind, as he observed, will ultimately
give way under
the long-continued
of the natural refreshment
deprivation
of the body. No brain can
remain in permanent
health that has been overtasked
still
by nightlyvigils,
such
than
When
more
by daily labour.
vigilsare
holding
accompaniedby the perpetually-recurring
pain of bethe sufferings
of a beloved object,
and the as
recurringfear of losingit, they become
perpetually
the labour that must
doublyand treblyinjurious
; and
be done, becomes
no
longerthe joy and solace that it
into a pain,
usgd to be. It is transformed from a pleasure
from a companion into a
from a friend into an enemy,
leech,
fearful monster, crying,like the daughterof the horsegive! give!' It is then that the fine and delicate
machineryof the mind is deranged. It is then that the
sweet bells are jangledand out of tune,'that the light
and
the glory under
is extinguished,
cloud, that
a
but not Time.
Such, it appears, was
Eternitymay lift,
the case with the amiable Southey; the grand,if not the
greatpoet,the accomplishedscholar,and the estimable
'

not

'

in every relation of life."1

EXCESS
MORBID
DISPOSITION
TO

man

symptom
"

"

The

is

frequently
precursory

Scenery and

OP

SLEEP.

of attacks of

Poetry of the Engluh

"

This

apoplexy,

Lake*," by

Mackay,LL.D.
RB

Charlee

610

of disease of the brain

forms

exists in other

often

and

TO

DISPOSITION

MORBID

by the presence of toxic agents in the blood. A

state of lethargic
sleepis one of the peculiarand welltional
marked
signsof cerebral disorder consequent upon funcderangement or chronic organic disease of the
the free elimination
with
of urea.
kidneys interfering
When
this poisonis retained in the blood in consequence
of the kidneysnot being in a condition to separateand
ously
seriejectit from the system,the brain often becomes
caused

I have

involved.

in good
gentleman,apparently

A
*

Dr. Todd

delirium

health

given the followinginstructions for the

well as for its discoveryin the

has

in the brain after death, as

"

Take

the

of

solvent
and

plunged into
If

it.

the

This

urea.

urea

good sized

residue

The

midable
for-

blister and

is to be extracted

alcoholic extract

time,

detection of
blood

urea

duringlife:

evaporateit to drynessover a
alcohol,which is a ready

with

is then to be

make

at the

evaporatedto dryness,

which should be
syrupy
nitric
of
acid added to
a
drops pure
of nitrate of urea
be present the characteristic crystals
are
soon

little water

found

from

serum

water-bath.

of

this cause.*

arise from

character

renal

seen

added, so

to

as

freezingmixture, and

and
in the solution,

be

may

mass

few

recognisedeither by

the naked

eye

or

by

microscope.
"

Take

Then

about three-fourths

treat

it with

of

whole

four successive

of
portion,
consisting

about

hours

is added.

before the next

stirred and
frequently

mashed

ten

cut it up

into small

pieces.

portionsof

ounces,

The

about

brain and

boilingdistilled water, each

allowed
to stand six or eight
being

brain
with

while thus

glassrod.

maceratingshould
The

be

after
washings,

togetherand filtered. The filtered aqueous

evaporatedto drynessover a water-bath,and the
dry residue, after being powdered,is to be again treated with four successive
portionsof boilingdistilled water, observingthe same
precautionsas before.
The washings,after being mixed together,
and the
as
before,are to be filtered,
clear solution evaporated to dryness over
and
after
a
water-bath,
being
thoroughlydried in a hot-water oven, the residue obtained in this manner
should be finely
of
powdered,and the powder boiled in five successive portions
ether. The ethereal extract so obtained should be evaporated
to drynessat a low
and then treated with a littletepidwater, and allowed to get quite
temperature,
cold.
It is then to be filtered through paper
moistened
with
previously
and
clear
solution
the
water,
againevaporatedto drynessat a low temperature,
when
a small quantityof the extract
procuredin this way (which would contain
in
the
brain
is
all the urea
be
to
operated upon),
present
placed on a
glassslide,treated with a drop of strong nitric acid,covered with a bit of
thin glass,and allowed to stand a little time, and then examined
under the
A
all
will
then
be
few
the
characters
of
crystals
having
seen,
microscope.
Clinical
Dr.
Todd."
those of nitrate of urea."
1859.
Lectures,by
being poured off,are
extract

so

to be mixed
be

obtained must

"

612

OF

PHENOMENA

MORBID

DREAMING.

and of being torn to piecesby wild beasts.

precipices,
in flames, and
that his house
was
A gentleman dreamt
to a cinder. This
that he was
graduallybeing consumed
mation
few
occurred
dream
a
days before an attack of inflamattack of
A person, prior to an
of the brain.
lacerated by a tiger.
that he was
dreamt
severely
epilepsy,
Another
epilepticpatient,shortly before a seizure,
attacked by murderers, and
fancied, during sleep,he was
that they were
knocking his brains out with a hammer.
of
weeks
For
some
previouslyto the manifestation
cerebral symptoms, patients have complained of
acute
hallucinations,
being the subject of troubled and distressing
A
occurring between
waking.
sleeping and

barrister, for

some

before

years

an

attack

of cerebral

his wife informed

in the habit of
as
was,
me,
paralysis,
frequentlyawaking from sleepin a state of great alarm
and
to explain
terror, without
being able satisfactorily
for his state of apprehension. This condition
the reasons
not apparently
of mind
was
consequent upon a troubled
ject
dream, for he had no recollection of having been the subof
have

Cases

one.

are

on

record

in which

persons

who

attacked

and
by epilepsy,paralysis,
plexy,
apohave had
for some
period previouslyto their
fections
seizures, distinct recollection of dreaming of these afin fact, they appear
had
morbid
to have
a
;
disease as well as
presentimentof their particular
psychial
mode
of death.
Insanityis often preceded by disturbed
visions.
This
abnormal
sleep and frightfulnocturnal
condition of the mind
during sleepcannot be too closely

been

in all the

watched
well

as

cerebral diseases

acute

of adults, particularly
in
scrofulous

occurringin
Dr. Beddoes
succeeded

attended

severe

of

children, as

attacks

of fever

constitutions.
an

dream, in which

epileptic
patientwhose
there

had

occurred

firstfit
the idea

MORBID

DRFAMIM;

PRECEDING

613

INSANITY.

of his

beingcrushed by an avalanche,which he had seen

the day before.*
before becoming completely
Many patients,
insane,
have frightful
dreams, and appear as if they were
conBcious of being on the eve
of losingtheir reason.
They
often express this sad prognosis,
and their anxietyis very
great. They start up out of their sleep,
pass the greater
fering
part of the night in walking about, complainingof suf"

intolerable headaches.
so
sleep,

much
In

Some

their dreams

are

book

attributed

almost

dread

to

to go

filledwith horrible

tions.
appari-

Hippocrates,there are,
with regardto the symptomatology of dreaming, indications
which are not without interest. Perhaps it is correct
to say that, in our
science,this element
days of modern
of diagnosis
and prognosishas been too much
neglected.
*

"

In certain

dreams
respects,

to

to be

natural instinct
studied
attentively
the imagination
to certain ideas,
can, in certain cases, while inciting
induce useful dreams, containingsalutary
warnings. Aspasia thus learnt the

ought

simple remedy which restored her to health,and it

physicianAbin-Zoar had the revelation of a
which he freed himself from severe
ophthalmia. If one,

is likewise in

tl:;itthe

with
facility

which

associate themselves
thousand
"

One

dreamers
the

germ

thu ideas,free from

during sleep,one

strangecombinations, luminous
explainin

can

who, under
until

the

form

one

then

same

had

way

latent.

night that a black cat bit him

appeared on the part bitten. A
his limbs was
changed into stone.
one

Such

was

the

case

patientof
Some
of

the

de

The

Galen's

Villeneuve

day

next

dreamt

certain

of

dreamt
anthrax

an

that

days after, this leg

woman

foresee diseases of which

to

Arnauld

the side.

of

arise."

was

Gunther

whom

of

one

paralysed.
has

ing
whip. In the mornof
the
of
Roger d'Oxteyn,knight
company
of
middle
the
he
Towards
the
Douglas, went to sleepin good health.
night
in his dream
infected with the plague,quitenaked, who attacked
aaw
a
man
him with fury,threw him
and
the ground after a desperate struggle,
on
holdinghim between his open thighs,vomited the plagueinto his mouth.
Three days after he was
seized with the plague,and died.
marks
Hippocrates re-

spoken ;

she dreamt

also

on

treme
ex-

impressions,

of
perspicuity

marvellous

other, seem

or

been

by

how, in the midst

sometimes
perceptions
the

dream

the aid of

in fact,notices the

the chain of exterior

conceive

can

medicine

that she

she bore lesions like

that dreams
Anatomic
tioUt.

in

Compares

which
du

Paris,1839"1857.

was

beingbeaten

with

scant.

black

spectres are
Systeme Nerveux, Ac., par Drs.
one

sees

bad
Leuret

omen.""
et

Gra-

614

DREAMING.

OF

PHENOMENA

MORBID

noisy and animated

prognostications,
dication
dreams, accordingto the father of medicine, are the inof the nervous
of a state of excitement
system.
other

Among

Quiet,

soft

dreams

favourable

announce

crisis in

nation
Frightfuldreams indicate a determiof blood to the head causingdelirium.
If a person
in dreams
sees
figuresmaking grimaces,the
frightful
with an intestinal malady,or an affection
person is menaced
fevers.

nervous

of the liver.

Diseases

of

the

internal

cause

organs

in

dreaming painfulsensations, which relate to the

in
Apoplexy is preceded by dreams
parts affected.
which
the
believes that he is in danger of
person
The
the
perishing
nightmare announces
of blood
in the
concentration
great cavities of the
chest. I mention
these principal
because the
prognostics
ordinarysubjectof complaintsin individuals destined
become

to

insane

associated with

are

sensations

of this

kind."*
A

gentleman who
symptoms

and

anxious

state

had

manifested
previously

of mental

disorder,or

thought,retired

of mind.

senses

He

exhibited

his

ciable
appre-

of disturbed

to bed

Upon risingin

intense horror of his wife, he

even

no

was

apparentlyin a
the
morning, to

found

to have

sane

the

lost his

insanity
by assertingthat

he

going to be tried for an offence which he could

not clearly
define,and of the nature of which he had no
rightconception.He declared that the officers of justice
in hot pursuitof him ; in fact,he maintained
were
that
in the house.
He
plored
they were
actually
begged and imwas

his wife to
bedroom

in

protect him.

state of

He

walked

about

and
great agitation,
apprehension,

alarm, stampinghis feet and wringinghis hands

wildest
*

"

1860.

agony

Trait^

des

of
Maladies

the

in the

despair. Upon inquiringinto

Mentales," pur

le Docteur

B. A. Morel.

the
Paris,

INSANITY

of
history

the

COMMENCING

IN

case, his wife

C15

DREAM.

said, that she had

served
not ob-

any symptom that excited her

state of her husband's mind; but upon

as to the
suspicion
beingquestioned
duringthe previousnight

she admitted that

very closely,
he appearedto have been under
she considered
AVhilst

to be the

or
nightmare,
apparently
asleephe cried out

dream.
frightful

dently
several times, evi-

me."
Don't come
near
great distress of mind,
them away." Oh, save me, theyare pursuingme !"
in

"Take

the influence of what

"

"

It is

which was
insanity
in the morning appeared like a continuation
character and train ofperturbedthought
of tliesame
that existed duringhis troubled sleep,
when, accordingto
the wife's account, he was
evidently
dreaming.
Pinel observes,"ecstatic
visions
during the night
tion.
of maniacal devooften form the preludeto paroxysms
It is also sometimes
by enchantingdreams, and a
from
of a beloved object
that insanity
supposedapparition
love breaks out with furyafter longeror shorter intervals
and tranquillity."
of reason
I am
indebted to a medical friend for the particulars
of the following
case
:
During the winter of 1849, he
that
singular
manifested
clearly

in

this

the

case,

"

was

called to

morning.
mother

H.

see

The

B. about

emaciated

and

the

patientwas

of three children.

five

At

or

six o'clock in the

wife

this

time

of

tailor,and

she

was

rather

bodilyhealth, and ana?mic

of religious
She was
turn of mind, and
Wesleyan persuasion. On the morning

debilitated in

in appearance.
belongedto the

of the narrator's visit,he found

greatmental excitement, and

She

had

the

under
to bed

woman

the

in

state of

influence of hallucination

well, but
apparently
the subjectof a vivid dream,
during the night was
imaginingthat she saw her sister,long since dead, and
to whom
she was
the
attached, suffering
very much
painsof hell. AY hen quiteawake, no one could persuade
gone

C1G

MORBID

PHENOMENA

OP

her that she had

been

the

fifth year

DREAMING.

the influence of

agitated
dream.
She stoutly
in maintaining
the reality
persisted
of her vision.
During the whole of that day she was
insane ; but on the following
clearly
morning the mind
She continued
appearedto have recovered its balance.
ception
tolerablywelj mentallyfor four years, with the exof her
of despondency
occasionally
having moments
At
arisingfrom real or fancied troubles.
end

Seven

of

months

the

under

she

birth

gave

afterwards, she went

an

to

child.

bed

apparently
well as usual.
In the middle
of the night she got
as
apparentlyknowing what she was
doing,
up, without
and

cut

her

however, was

child's throat

with

to

The

razor.

wound,

fatal. When

to explain
why
requested
she had attemptedthe life of her child,she replied,
that
she had been ordered duringthe nightto murder
all her
taken
into custody,
children,as well as herself. When
she expressedno regretfor what
she had done, but appeared
to entertain a greatfear of punishment. During
the night of the murder, her husband
states that she was
tion
unusuallydisturbed. It is conceived that the hallucinawhich

not

led to the commission

duringa dream. This woman

the ground of insanity,
and
County Lunatic Asylum.
Suicide has been
A

of the murder
was

is

tried and

confined

now

under

committed

occurred

acquittedon
in Stafford

stances.
analogouscircum-

apparentlywell, has gone to bed

without
manifestingthe slightest
tendency to selfand beingsuddenlyaroused from a frightful
destruction,
dream, has destroyedhimself.
An
old lady,residing
in London, awoke in the middle
of the night,
went down
stairs,and threw herself into a
person,

cistern of water, where

suicide

she

was

found

drowned.

The

supposedto be the result of certain mental

in the mind duringa dream.
impressions
originating
was

MURDER

Dr.

refers

Pagan

prove

that

murder

under

the

effects

"Bernard
the

at

DURING

COMMITTED

the

to

of

he

called

saw

and

answer,

he

and

him,

upon

raised

the

that

and

spectre,

it

the

was

his

spectre

He

receiving

no

advancing

was

his

beside

what

or

and,

lost

midnight;

at

phantom

was

when

"

fearful

that?'

to

case,

person

awoke

"

altogether

which

hatchet

such

as

is

having

frightful phantom,

imagining

suddenly

'Who

out,

by

frightful vision

imagination represented
twice

committed

Schedmaizig

moment

interesting

following

be

may

617

SLEEP.

self-possession,
attacked

and

him,

found

that

he

had

murdered

the

habit

of

walking

his

wife.""
A

who

pedler,

with

armed

country,

while

evening

in

was

lying asleep
and

suddenly seizing him,

The

who

man,

hjid done

of

out

sword,

and

He

was

died.

that

he

the

half

waking

competent

guilty, and,
*

"

Medical

joke.

tried

The

Jurisprudence
"

most

of

by

the

man

shoulders.

companions,

some

who

man,

his

by
been

This

He

wards
after-

soon

His

manslaughter.

urged
have

by

one

pedlar suddenly awoke,

the
for

road

high
him

the

awakened

was

with

by

witnesses.

think,

not
state.

medical
I

shaking

stabbed

could

ground
in

strongly

was

the

on

walking

was

this

his

drew

sword-stick,

about

counsel,

conscious

of

sponsibili
irrethe

on

his

strengthened

was

was,

however,

by

Medico-Chirurgical

Dr.

Pagan.

Review."

London,

by

found

unjustly punished, f
Insanity,"

act

1840.

CIS

MORBID

OF

PHENOMENA

Morbid

the

LIFE.

XXIV.

Phenomena

of Organicand

division of the

order
following
a.

NUTRITIVE

CHAPTER

Nutritive
THIS

AND

ORGANIC

Life.

will
subject

be

considered
briefly

in

"

Digestionand

Assimilation,

p. Circulation.
7.

Respiration.

"$. Generation.
DIGESTION

AND

ASSIMILATION.

"

Owing

to the close and

intimate

between
the brain, organs ot
sympathy existing
of the chylopoietic
cera,
visand in fact the whole
digestion,
we
are
usuallyable to detect, in association with
of the digestion
cerebral diseases,functional disturbances
and nutrition,often giving rise to serious complications.
These
looked,
symptoms, however, are often altogetheroverin consequence
of their being masked
by the
more
prominentlydevelopedsignsof local head affection
disorder.*
or
psychical
In the earlystage of insanity,
exhibits
the stomach
evidences of greatfunctional derangement. The appetite
*

relates
Willis,as quoted by Morel, says Dr. Griesinger,

lady whose

health had

after

ot

having eaten

been

remarkable

injuredby profound grief. One day,

seized with a feelingof
a very
cake, she was
indigestible
burning heat in the precordial
region. There followed an instantaneous
sensorial delirium.
She imagined that the upper part of her body was
on
fire. She took a spring,
and precipitated
herself into the street, cryingout
that she was
cursed by God, damned, and that she alreadywas
experiencing
the punishments of hell.
The same
delirium was
reproducedas soon as
this lady experienced
the same
sensation.
physical
case

G20

arise from
treated

several times, I
There

was

diagnoseddisease
the

associated with

LIFE.

of the brain

nausea

severe

cerebral abscess

was

considered

was
case

(tumour).

and
vertigo,
headache.

paroxysmalattacks (somewhat localized)of

The

he

examining the

After

affection.

this

NUTRITIVE

stomach, and

state of the

disordered

for

AND

ORGANIC

OF

PHENOMENA

MORBID

to be the effect of

injuryinflicted upon the head by a fall

horse, whilst hunting,ten years previously.
severe

from

a
a

amounting to actual
symptomatic of acute and
vomiting,is occasionally
chronic
softeningof the brain. It often indicates the
of inflammatoryand congested encecommencement
phalic
sensation

The

of

conditions.

nausea,

In

the

not

cerebral

obscure

diseases

of

of the stomach,
irritability
intestinal derangewith gastric
not connected
or
ment,
clearly
is an importantdiagnostic
symptom.
Chronic disorders of the digestive
frequently
organs
precede,are associated with, if they do not operateas the
direct cause
of, various types of mental derangement. A

children, the presence

morbid

state of the

of

liver,stomach, and bowels is seen

minently
pro-

degreesof insanity.
These gastric
disturbances and visceral complications
are
often observed in an
advanced
positionthroughout the
whole course
of the malady.They givecharacter and persistence
In consequence of these
to the mental impressions.
often led to believe
are
derangements,patients
physical
and under such
that theyhave been or are beingpoisoned,
In
hallucinations obstinately
refuse all nourishment.
such cases, there is generally
found clear and unmistakemanifested

in all forms

and

able evidence of serious disorder of the stomach, disease of

the

chronic
liver,
or

of the bowels.

the

secretions

The

irritation of the
breath

is

vitiated,bowels

mucous

membrane

foetid,the tongue furred,

inactive, and

appetite

lost or extremelyvitiated. Under

altogether
there is a positive
circumstances,
loathingof food.

either

these

"often

dependsupon
certain

G21

INSANE.

THE

of the

condition

disordered

The

organs.

BY

nourishment," says M. Morel,

refusal to take

"The

which

FOOD

OP

REFUSAL

gestive
di-

obstinacywith

truly wonderful

persons refuse food

caused
by their delirious

insane

is, however,

ideas,such as
commonly
a desire to die of hunger in obedience
a fear of poisonand
to an order given them by a superior
power." M. Morel
he had to feed for several
relates the case of a ladywhom
of the stomach-pump,who
refused to
weeks by means
illusion that
under the influence of an
eat voluntarily,
the food placedbefore her was
composed of the flesh of
most

her murdered

insane

Some

"

children !

patientscomplainof
of

fire that devours

icycoldness which paralyses

the peristaltic
action.
They are subjectto borborygmus
and flatulence. All the phenomena that men
enjoying
their reason
bring easilyto a right interpretation,
of the
become
hypochondriacsthe starting-point
among
most
strange illusions. They have in their intestines
them ; some
unclean animals who gnaw
even
pretendto
thenf, and sometimes

have

neither stomach

an

intestines.

nor

It

to them

seems

bottomless
a
gulf. One
they eat falls down
patientimagines that she ought no longer to eat or
speak. Her body no longerexists,it is one composed
of shapeless
fragments,which have no cohesion between

that

all

Also

them.
she

and
for

woman

The
often

presence
creates

Chronic
the

she

"

exposednaked

be

not

are

attached

to her

person,

painfulsensation
that she is going to

a most
constantly
experiences

modest

her clothes

to

of

an

publicview."*
in the stomach

worms

uncontrollable

inflammation,

bowels, have

believes

and

symptoms.
"

Morel.

intestines

for
indisposition

sometimes

known

been

and

to

food.

ulceration

of

produce analogous

622

AND

ORGANIC

OF

PHENOMENA

MORBID

NUTRITIVE

LIFE.

appetiteis frequentlyseriouslyvitiated and

the
patient has a morbid
depraved. In these cases
His hunger
satisfied desire for food.
craving,and never
meal he
cannot be appeased. After eatingan enormous
declare that he has been starved, or
will emphatically
amount
of
had
suppliedto him either the minimum
nutriment, or no food at all ! A vitiation of the appetite
is shown
by the patienteatingwith an apparent relish
the most repulsive
and disgusting
or at least indifference,
of taste in these cases
The sense
matters.
occasionally
appears to be paralysed.
In the incipient
stage of insanitythe assimilative
often
disordered.
Hence
the
functions are
seriously
not onlythe
emaciation so often observed to accompany,
of insanity,but of various
eases
commencement
organic diswith aberration of mind.*
of the brain uncomplicated
The

As

the

disorder

mental

advances, the

of

function

restored to a state of healthy

occasionally
not onlygains flesh,but becomes
the patient

assimilation is

action,and

embonpoint.

condition

This

and
types of insanity,
is less sensitive

He

delusions.

in

is often observed

other

where

cases

the destructive

to
ceases

to

in chronic

the

effect of his

be worried

and

vexed

patient
insane

by

his

an
consequently
improvement in the
digestionand nutrition takes place. If the mental does
restoration
not proceedpari passu with the physical
to
tained.
health, an unfavourable
prognosis is generallyenterunder
these discouraging
But even
conditions
I have frequently
seen
patientsrecover.

morbid

ideas,and

All disorders

of the

nervous

those implicating
the
system,particularly

In
damaging influence upon the functions of nutrition.
observe the generalhealth
of simpleanxietyof mind, how often do we
cases
to become
seriouslyimpaired,and the assimilative powers to be completely
paralysed. In the incipientstage of insanitythe nutritive functions appear
altogether
suspended. The patient,
occasionally
long before attention is
have
intelligence,

called to the state of the mind, loses flesh,and

dangerousstate

of emaciation and

inanition.

is

reduced
occasionally

to

APOPLEXY

MORBID

COXXECTKD

PHENOMENA

GF.XERATION.

AND

Consideringthe

"

the

in all affections of

would

functions

cardiac

deviations from

marked

DISEASE.

G23

CIRCULATION, RESPIRATION,

OF

l"rt\veen the heart and

infer that

CARDIAC

WITH

close

organic sympathy
brain,we should, a priori,
the great nervous
centre,
almost

invariablyexhibit
state. In the writings

normal

Morgagui, Baglivi,Lieutaud, and Corvisart,this

referred to.
subjectis but cursorily
Although the latter
affirms that he has never
instance of
seen
an
authority
traced to cardiac disease,
he
apoplexythat can be clearly
recorded by
is, nevertheless,of opinionthat the cases
Testa, Laurent, and the other writers previously
mentioned,
du cccur peut
sujflsen!
pour etablir qu line affection
devenir la cause
determinante de Vapoplexie" Ilicherand
is said to be the first writer who pointedout pathologically
between
connexion
the intimate
encephalicand
of

"

cardiac disorders."
the dissection
physiologist
distinguished
says,
who have died of apoplexyhas proved to me
patients

This

of

"

that the

of force in the left ventricle of the heart

excess

of the disease
cause
predisposing
powerfully
than a largehead and short neck
a state of body which
to indicate the apoplecis supposedby most
physicians

is

more

"

tiform conformation."1
In

read

Mdmoire

by

Mcdecinc, he refers to the

who

Richerand
case

before the Ecole

of the illustrious

dc

Cabauis,

apoplexycaused by,or associated with, disease

The autopsy of this distinguished
heart.
sopher
philo-

died of

of the

revealed extensive
was

ounces

brain, and
thalauu

The

left ventricle

Eight
enormouslyenlargedand hypertrophied.

of blood

septum

cardiac disease.

were

effusion had

this

lucidum
and

was

corpora
"

effused into

"

been

the

ventricles of the

so

violent,that the

through,and the surface of the

striata found rough and jagged.

torn

vol.UL
NosographieChirurgicale,"

624

NUTRITIVE

AND

ORGANIC

OF

PHENOMENA

MORBID

LIFE.

attacks connected
Malpighi and Ramazzini died of apoplectic
of the heart.
with hypertrophy
Lallemand, Broussais,Andral,Bouillaud,
More
recently
and

Bertin

directed

have

Rochoux

attention

this

to

suhject.MM. Bertin and Bouillaud remark that, the

in whom
hypertrophyof the left
majorityof the patients
will be found to exhibit
ventricle of the heart is present,
and that many of them
symptoms of cerebral congestion,
"

of disease of the brain."11

will fall victims

In

our

own

country Drs. Hope, Copland,Watson, Wardrop, Bright,

Burrows,

and

considered

Bennett, have

f
length.
Important as

this

subjectat

some

this

subjectis to the practical

physician
it is not my
intention
well as physiologist,
as
to go minutelyinto its analysis.It is sufficient for my
the fact,reservingfor the
purpose to call attention to
succeedingvolume any detailed remarks I may have to
make in reference to the influence exercised by certain
affections of the heart upon various functional and organic
diseases of the brain.
There

can

be

doubt

no

among

investigatethe disorders
numerous
phases,that cardiac

to

those whose
mind

of the

duty it

in

disease exercises

is

all their
material

functions of the cerebrum.

psychical
whilst performing
it is for the physician
How
common
of
chronic
in acute and particularly
his autopsies
cases
to discover
apparentlylong-existingorganic
insanity,
in its valvular
structure.
disease of the heart, especially
of insanity
have called attention
All writers on the subject
influence

over

the

to this fact.

by

"

Dr.

On

Medical

by

Trait^ des Maladies

Diseases of the Heart," by Dr.

Copland. Communication

1835, by
"

"

Dr. Watson.

Reports,"by

Dr. Burrows.

"

Dr.

On

read at
Disease

Bright.

"

du Coeur."

Dictionaryof Medicine,"
Hope.
March
the Collegeof Physicians,
30,
Dr.
of the Heart," by
Wardrop.

Disorders

"

of the Cerebral

Circulation,"

AND

CEREBRAL

M.

HEART

G25

DISEASE.

Falret,of the Hospicede la Salpctru

re, has published
the results of his dissections in

of chronic mania.

In

twenty of

dirrrses du cceur, coincidant

/M

niqursdu
More

these there

"

were

cerebrates"

to the connexion
Morel, when referring
recently,
the central circulatory
system and cerebral

between

diseases,
observes, that the affections of the heart
"

into
largely
under
that

des

des alterations cfiro-

avec

des membranes

ou

ccrveau,

cases
ninety-two

his
he

the

of mental
etiology
to maniacal
subject

care,

had

devouringhis

affections." A

patient
imagined

paroxysms,
in his chest an animal

confined
heart.

enter

that

was

of this
death, hypertrophy

After

with the
discovered,with disease interfering
organ was
free passage of the blood throughthe auriculo-ventricular
orifice. These

heart,as well

organicchanges in
in its

as

the substance

valves,associated with

of the

insanity,

of respiration,
headache,
give rise to great difficulty

insomnia, and
These
of the

symptoms

are

lessness,
rest-

of irritability.
paroxysms
often associated with greato?dema

extremities.

severe

Morel

adds,

"

have

observed

*such

of strange
return
patientsthe periodical
lucination
halideas,hypochondriacal
sensations,and often special
among

which

arise with

to the circulation and

wliich

is the

consequence

the

increase

the cerebral

of it.

These

of the

pediment
im-

congestion

hallucinations

It is known," says
terrify
ingnature."
M. Saucerotte, what a powerfulshock the beatingof
the arteries occasions to the encephalic
and one
mass,
what
disorder might be caused to
conceives, a priori,
if they were
the intelligence
repeatedwith abnormal
destined to elaborate the ideas.
the organ
on
frequency,
"VVe are bound
also to consider the effect thus produced
stimulation
and nutrition of the
in the physiological
arc

usuallyof

"

"

brain.
or

The

blood, altered in its character,and hurried

impeded in

its

course

through the

cerebral
8

vessels,
8

G2G

GENERATION.

AND

RESPIRATION

produce profound modifications in the nervous

tissue of the organ of thought."
the pulseoccasionally
dicates
inIn the earlystage of insanity
but more
of the centre of circulation,
greatactivity
the action of the heart is feeble,and the state of
generally
the pulseestablishes the presence of greatvascular,vital,
and nervous
depression.This condition of the radial
with a considerable amount
of
arteryis quitecompatible
and muscular
violence.
acute mental
agitation
must

difference in the action of the

is considerable

There

carotid,and temporalvessels,
as well

dial,
ra-

in the

intensity
of the ascendingand descending
aorta.
of the pulsation
attention to this phenomenon,
Jacobi has called particular
but the consideration
of this important and
interesting
and pathological
physiological
subjectmust be deferred
for another

occasion.

EESPIRATION
morbid

be considered
indicative of
The
with
the

GENERATION.

AND

conditions

brain.

There

"

are

special

no

function which can

respiratory
as
or
symptomatic of incipient
insanity,
the commencement
of organicdisease of the
lungs are, no doubt, in close organicsympathy

the

of the

brain,and

two

organs

influence each

other.

The

as

of
autopsies

in

in many
marked

of mental

cases

manner

tion,
aliena-

reciprocally

often reveal extensive

the insane

of the substance

well

organizati
dis-

membrane
investing
of the lungs,
which
have seriously
the
complicated
psychicaldisorder, and interfered with the satisfactory

progress
The

are

as

case.

generativefunctions

disorder
nervous

of the

as

exalted.

system,they

In
are

in

forms

of cerebral

other states of the brain

impaired,or
perverted,
of a
known
insanity,

paralysed.I have
type,developeitself by a sudden
of virile inclination

some

and

and

unnatural

at
capacity,

and
gether
alto-

senile

tation
manifes-

period of

623

GENERAL

CEREBRAL

OF

PRINCIPLES

PATHOLOGY.

XXV.

CHAPTER

Principles
of Cerebral Pathology
r,
Treatment, and Prophylaxis.
Diagnosis,

General

PATHOLOGY.
this

"

It

was

and

importantfield of
treatise is

mental

consideration

pathology.

scientific research

concerned, be but

must,

of the subject

This
as

vast
far

examined,
cursorily

altogetherunexplored. This

is

as

and
this

if not

dering
unavoidable, consi-

complex and disputed questions

involved in its investigation.
The
obscuritythat envelopesthe pathologyof the
is admitted
brain
by every writer whose attention has
vain and illusory
been directed to its analysis.How
I to attempt to embody in a few pages
would it be were
to an accurate conception
of the
anythingapproximating
numerous
changes,functional and organic,which the
brain, appendages, and vessels are susceptible
of, and
which
known
of types of
to give rise to a variety
are
the

number

to enter, in

intention

my

work, at any length into

of cerebral

left

never

cerebral disease and

and
to

mental

disorder?

illustrate the difficulties of the subject.

briefly
in good health,
gentleman,aged fifty-six,
apparently

Let
A

of

me

constitutional predisposition
with, it is alleged,
no
the subjectof a violent
disease of the brain, was
I

into detail.
purposelyavoid going more
in its most
itself. The
acute form, developed
Insanity,
and alarming
mental
of a most frightful
excitement
was

mental

shock.

INSANITY

character.

There

FROM

MENTAL

029

SHOCK.

nothing in the state of the pulse,

condition of the carotids or temporalarteries,
in the
or
action of the heart itself,
to justify
the conclusion that
there was
any great disturbance of the vascular system.
The head was
cool,the conjunctiva}
presenteda normal
but slightly
furred.
appearance, and the tongue was
A

most

of

the
discovering

but

was

careful examination

none

existence

detected.

were

belief that he

made

was

of

His

with

the

view

physicalcomplications,

delusions

consisted

in

and that
by evil spirits,
of them were
some
engaged in tearinghim to pieces.He
treated by means
of prolongedhot-baths,cathartics,
was
and sedatives,
but no persistent
made upon
was
impression
the malady. The evident vital depression
terized
that characthe attack clearly
contra-indicated antiphlogistic
the debility,
that wine and
so greatwas
Remedies
; in fact,
ammonia

to

with

view

the

surrounded

was

considerable
of

the
distinguished
few

hours

one

who

brain.

no

was

To

cerebral

the

membranes

careful

the
disease

present,no

which

disorder.
most

made.

The

structural

excitement

mental

afterwards
was

administered,

were

life during
sustaining

of maniacal

paroxysms

extent

substance

the

fearful

remarkably

so

died, and

He

post

mortem

astonishment

of

was

discovered

was

envelopingthe

change,and

the

numerous

of

normal

mination
exa-

every
in the
sistence,
con-

brain exhibited
vessels

ing
ramify-

free from disease as well as

throughthe organ were
congestion.In generalterms, the brain appearedto be
in a healthycondition.
The heart was
unusuallysmall
and flabby
stomach, and bowels presented
no
; the liver,
symptom of disease. In one of the kidneysthere was
of granular
disease.
We
evidence of the commencement
in the
had no reason
to suspectthe presence of urea
blood

or

in the substance

was
analysis

made

with

of the brain, and therefore

a

view to its detection.

no

C30

GENERAL

PRINCIPLES

OF

gentleman holdingan

CEREBRAL

PATHOLOGY.

officialposition
in

one

of

our

colonial

sick leave.
to England on
came
dependencies,
Whilst
in this country he formed
ment
an
unhappy attachhe afterwards
found to be a married
to a ladywhom
from her husband.
This discovery
woman
livingseparately
caused at the time considerable agitation,
eventually
in great mental
This state of mind
resulting
depression.
continued
for four or five weeks, during which
periodit
was
necessary to have him watched with greatcare, with
the view of preventinghim
from
committing suicide.
At the expiration
of three months
from the commencement
of his

altered.

the character
illness,

He

of the afflictionentirely

became

and acutely
excited ; he
violently
requiredthree attendants to be constantly
with him, and
these he frequently
attacked with great furor,threatening
to

murder

mental

exaltation
The

the usual
was

case

was

This

condition

associated with

remedies

period of
was

death.

paleand

At

the

anemic

free from

condition.
blood.

touch
the

post

examined.
carefully

bloodless,
or

of cerebral

No

None

of

the

malady. There
symptoms up to the

mortem

It

and

great vital depression.

bid defiance to all treatment.

appearedto
variation in
particular

no

brain

them.

examination

was

in

never

saw

disease of

the

perfectly

brain

so

importancewas
discovered in any other part of the body.
A
gentleman, allegedto have been previouslyfree
from all symptoms of mental derangement,
became much
Great mental
impressedon hearingan exciting
sermon.
excitement soon
followed, endingin a furious attack of
mania.
There was
no
symptom in connexion with the
to justify
the conclusion that there was
case
activity
of the circulation.
The pulsewas
weak, and the action
of the heart feeble. The case
appearedin its principal
features to resemble
those previously
detailed. After
death I examined
the brain in conjunction
with
Dr.

W.

0.

brain

substance

as

C31

EPILEPSY.

I firstsaw

whom

with
Priestley,

The

OP

CASE

SINGULAR

well

as

the

in

case

membranes

sultation.
con-

of the

venous

gorged with blood. The passivestate of

that existed gave a dark, and in fuct,
congestion

almost

black

were

calvarium

was

the cerebral vessels,no

of the brain

the

brain

as

this

Beyond

disease in the

the

as

soon

engorgement

structure

or

of

branes
mem-

discovered.

was

insane
of age, became acutely
She
died.
The post
confinement.

lady,thirty-five
years

month

to

appearance
removed.

after her
examination

revealed

specialorganicchange
within the cranium, with this exception,
that on
the
surface of the two hemispheresthere appearedto be the
smallest possible
similar in chaof turgescence,
racter
amount
to a transient blush upon the cheek consequent
mental
emotion.
fugitive
upon some
A
died labouringunder sympman,
aged sixty-four
toms
characteristic of generalparalysis.
Neither
the
brain or membranes
exhibited
evidences
of organic
change. The surface of the two hemispheresappeared
mortem

if some

as

water

had

no

been dashed

over

them.*

This

was

the

cerebral disturbance
for the severe
cause
only appreciable
which precededfor so many
years the death of
this patient.
A young
from an early
gentleman had been subject,
of varying degrees of
period of his life,to epilepsy
and severity.Many years back the fits apfrequency
peared
to

less often,and

occur

in violence.

At

were

somewhat

diminished

from his bowels

discharged
medical gentleman attending
The

this time

he

tapeworm.

an

enormous

cause

exclaimed, Here is the

patientat once
inferred that
of the epilepsy
!" and very reasonably
disease would immediatelysubside or be disarmed of
"

the

the
"
was

This could

what

Dr.

not be considered

Seymour terms, a

"

at

the effect of subarachnoid effusion.

watery brain."

It

C32

its

GENERAL

formidable

more

expectationof
the

the

case,

Contrary,however, to the
acquaintedwith the facts of

features.
person

every

epilepticfits

Reasoning,a priori,it was

would
manifest
unquestionably
of organicchange either
an

unusual

But

firmness

of the whole
there

of the

recurred

with

such

and

that

concluded

in its substance
the

not

consistence

Beyond

case.

in the

ing
invest-

or

tissue

nervous

ration,
brain, not reallyamounting to indu-

nothing within the cranium that

for the great severity
and
account
satisfactorily
duration
I

was

of the cerebral

have

brain

the

unequivocalsymptoms

some

was

increased

of death.

until the moment

violence,and continued

membranes.

PATHOLOGY.

CEREBRAL

OF

PRINCIPLES

could

long

disorder.

designedlyselected

the

illustrations of the difficulties that

preceding cases
beset

the

as

efforts of

the medical

philosopherin his vain, and often illusory

attemptsto unravel the obscurity
envelopingthe subject
of cerebral pathology.
I have
made
of chronic organic
reference to cases
no
encephalicdisease of long duration, the existence of
which
not suspectedduring life. I allude partiwas
cularly
to
have

tumours

and

abscesses

of

the

brain

of structure
produced serious disorganizations

which
out
with-

apparentlydisturbingthe specialfunctions of the

sensorium
during life.
Let me
glance at the pathologyof the brain
cursorily
the phenomena of incipient
as
elucidating
insanity. Is
there any one
condition of the encephalonor its membranes
pathognomonic of mental derangement? It
will be well to consider, before attempting to reply to
this question,the varietyof theories propounded by
and experiencedpathologists
eminent
with
the view
of
the cerebral or somatic
elucidating
originof insanity.
A short historical rasumc
of the kind proposedwill enable

PATHOLOGY

reader to

OF

appreciatethe

033

INSANITY.

difficultiessurroundingthis

branch of pathological
science.
Important
Morgagni considered insanityto be more
connected

immediately

hardening and softeningof the brain.

of the cranial
to thickening
Greding refers principally
of the brain, and atrophyof the thalami.
bones, softening
Broussais asserts that insanity
is the result of irritation
of the brain.
Gall and Spurzheim attribute insanityto
Pinel considered mania
acute and chronic.
encephalitis,
to

be

with

the

energy.
effect of

result of excessive
He

affirms that

the

insanity,and

exaltation of the

cerebral

lesions

nervous

but

are

the

frequentlyaltogether
unobserved.
quently
freis also of opinion that insanity
He
arises from visceral complications.Delaye and
are

Foville attribute alienation to inflammation

of the superficies

of the grey matter

of the brain.
Fodcre imputes
to an alteration of the vital principle.Defour
insanity
endeavours
connexion

establish

to

with

and

Boismont

not

arise from

or

its

of

some

is

consequent

gangliaof

nervous

has

brain

to be of

appear
any

to

some

upon

the abdomen.

directlyno
his theory,
affection

of

Leuret, Baillarger,

opinion that insanitydoes

of
specific
disorganization

membranes, but that,in

kind

the

insanity. According

alienation of mind
the

that

all cases,

the brain

cerebral

exists.

disease

Grandchamp, Bayle,and Calmeil

of opinion that the brain is always diseased in
are
insanity.Rodriguez recognisesthree kinds of disease
of the brain which give rise to insanity,
viz. : 1 Hypertrophichardening. 2. Inflammatory hardening. 3.
A trophic,
or
serous
hardening. The first and third class
he believes generallyaffect the whole
cerebral mass.
The second is only partialin its operation,
and is characterized
by change of colour. Rush, the distinguished
American
traces insanity
to a disordered state
authority,
.

634

GENERAL

PATHOLOGY.

CEREBRAL

OF

PRINCIPLES

in his
principally,
glands,
post mortem data, to adhesions of the Pacchionian
of the brain, and softening
alterations in the membranes
mination
ascribes insanityto deterof the cerebral pulp. Cox
Arnold
and Parry trace
of blood to the head.
creased
of blood to the brain, or into determination
insanity
sidered
activityof the cerebral vessels. Cullen conin
that insanityarose
from some
irregularity
the action of the brain or nervous
system, and that, in
caused
the majorityof cases,
by
derangement was

of the

cerebral

blood-vessels.

excitement.

Sir

of the

vessels

which

Crichton

Alexander
caused

opinion that insanitywas

action

refers

Haslam

by

secrete

was

of

morbid
specific

the

nervous

fluid,

but quantity.
not only its quality
affecting
It would
be useless,and foreign
to the designof this
work, to proceedany further into the historical analysis
of this subject.This matter will be considered at great
treatise.
lengthin a succeeding
The questionmore
immediatelyin review is,whether
there are any specific
definable characteristic
and clearly
organic alterations in the tissue of the encephalic
mass,

its

membranes,

osseous

investment, blood-vessels,"c.,

that
invariably
present in insanity,
to stand

of the

in relation of

cause

and

can

effect.

be

considered

If the substance

implicatedin all cases of

universally
alienation of mind, is there
uniformityin the
any
be, as many
organicchanges? If insanity
suppose, an
and
what
is the precisenature
affection,
inflammatory
seat of the phlegmasia
?
entertained
There
be no
doubt
can
by those who
and treating
of observing
have had practical
opportunities
the varied phenomena of mental
derangement,that in
state
instances the disease clearly
arises from
a
many
of active capillary
congestionon the surface of the
the
over
or in the vessels ramifying
hemispherical
ganglia,
brain

be

030

GENERAL

PATHOLOGY.

CEREBRAL

OF

PRINCIPLES

encephalonis
irritation,innervation, hypernervous
somia
(active and passive). In instances of intense
of their
exaltation
of
mind
(resembling,in many
features, violent and
ungovernablepassion),with or
without
aberration of the ideas, apparently
untraceable
alterations in the structure of
to physicalmolecular
the brain, its membranes,
to derangement in other
or
organicportionsof the body in intimate sympathy with
in many
cases
in a state of

the
one

of

mental

disorder, the

sensorium, the condition

of cerebral

of the

irritation,
or,

mind

if I may

may
coin

be either
a

phrase,

psychical
hyperasthesia.
I designedly
avoid enteringinto a consideration of
those subtle changes in the grey matter of the brain,
the
effect of irritation,congestion,or
inflammatory
action,recognisedby slightvariations in the colour or
tint of the cineritious matter of the hemispheres,
to
or
those organic alterations in the structure
of the dura
mater, tunica arachnoidea,orjyia
mater, as well as formation
of adventitious
in

cases

of

membranes

insanity.I

certain morbid

so

often observed

after death

also defer

for

conditions

of the blood,diseases

sideration
subsequentcon-

of the cerebral arteries

affections of
degeneration)
(fatty
the heart,liver,lungs,and kidneys,as well as visceral
in association with various
often seen
complications,
so
types of mental alienation.
I have
to the
previouslyaddressed myself briefly
well as to those conditions
as
pathologyof general paralysis,
of the brain which
usuallyaccompany
ordinary
attacks of apoplexy,
and hemiplegia. In the
softening,
former affection the following
phenomena
pathological
after death
less appreciable
are
or
generallymore
Albuminous
effusion in the cavityof the
jelly-like
spheres
arachnoid ; false membranes
of hemithe convexity
on
the folds
; suppurative
meningitis
; pus between
:

"

PATHOLOGT

of the arachnoid

OP

and

GENERAL

the

PARALYSIS.

C37

pia mater, different from the

(white,and composedof irregularly

character of pus
ordinary
smaller than those in pus detected
formed globules,
of the brain ;
in other parts of the body); hyperamiia
and slightly
tumid, and when sliced
pulp red, injected
of brain,
small pointsof blood appearing;softening
diminution in the
or deeplyseated,or
superficial
partial
of the grey matter of the hemispheres,
consistency
ciable
appre; alterations in the colour
by aid of the microscope
of the brain,varyingfrom red, deep brown, palegreen,
alterations
and yellow; induration of the brain ; organic

brain, of the character

in the

membranes

chronic

meningitis
; subarachnoid

of

the

of

effusion ;

as
injected
well as indurated condition of the medullary
portionof
of
delicate layers
the brain ; effusion into the ventricles,
coagulable
lymph over the cineritious substance of the
state of the cineritious neurine;
brain; highlycongested
and engorgement of the meninges ;
thickening,
opacity,

marble-like appearance of the white substance of the brain;

of the
atrophyof the convolutions ; fattydegeneration

organicchanges in the pons varolii

and medulla oblongata
state of the brain.
; cedematous
I do not propose to go at any lengthinto a consideration
of the pathologyof apoplexy,
what
or
hemiplegia,
of the brain. All these
is termed red and white softening
and intimately
allied,
organicaffections are so closely
that it would
be impossible
without
to analyseone
reviewingthe morbid phenomena characteristicof the
conditions.
other encephalic
followed by apoof the brain is frequently
Softening
plexy,
The
latter
and its sister affection,
hemiplegia.
disorder,when consequentupon the ruptureof one of the

cerebral vessels ;

cerebral vessels (theeffect of extravasation of

blood),often

to a pulpydisorganimechanically)
zation
givesrise (operating
of the brain
immediatelyconnected with and
the clot.
surrounding

838

what

In

in that type
occasionally

brain, and

of the

result of

the
pulpydisorganization
vessels

numerous

often

are

in

of

inflammation, acute

of the

substance

chronic, of the

and

nutrition,termed

of cerebral

effect of disordered states

gangrene

the

ramollissement
idiopathic

be termed

may

PATHOLOGY.

CEREBRAL

OP

PRINCIPLES

GENERAL

encephalon,the

diseased

condition,

of osseous
ternal
their inmatter
on
deposition
to
coats, thus causing a mechanical
interruption
the free admission and circulation of blood through the
brain, and cuttingoff a proper supplyof nutrient fluid
mass.*
to the encephalic

caused

by

If the cerebral vessels

*

arteries

the

depositsiu

The

"

are

themselves

not

produce a

circulation by roughening the inner surface

create

certain

ventricle

the

influence

the

upon

arterial channels
flow

of blood

they

from

the

the elasticity
of the
nearly destroying,
of the most important forces by which
the
arterial system. Thus the arteries,
from being

or
by diminishing,

and

of direct obstacle to

amount

twofold

of the

"

diseased in

arterial walls,they

impair

circulation is carried

one

in the

on

elastic yieldingchannels,with

smooth
perfectly

inert tubes,with
into resisting

rough

inner

inner surfaces.

surfaces,are
It is

changed

plain,then, that

the heart has to encounter

under these circumstances,
and to do
great obstacles,
the
when
in
than
arteries
work
their
deal
normal
more
are
state.
a great
obstacle
the
caused
to
the
free
flow
of the blood
the dilatation
Hence
and
by
;

greaterexercise and effort of the muscle of the heart.

The increase offeree is merely remedial,to meet the increase of obstacle,
and
of
to change of circumof those beautiful instances
is one
stances
self-adaptation
the animal organism,especially
the muscular system,so
with which
by
hypertrophy,

the

abounds.

much
"

the

the

less able
blood

deposits
go on they impairthe materials
walls of these vessels possess
degenerated

of the arteries of the

these

As

brain

support their contents.

to

the brain,but

to

posture,to

in the erect

the
be

therefore any obstacle in the

There

is

no

less

undue

determination

are

of

for the blood that goes to the head has,

againstthe force of gravity
up
; and

reverse,

pumped

of the arteries would

course

strength,and

be

more

It is a common
in any other
notion that the
blood with an
rise
the
to
apoplexyby sending
gives

felt in thin

direction than

of
hypertrophy

the heart

undue

to the head ; but for the correction of this

the additional force is

and such
circulation,
as

to
possible

as

which

lews than
probably,

the

blood

in health.

which
arteries,

arteries."
"

need

we

impulse

onlyremember

that

is necessary for the exigencies

of the
the force of the blood's current as near

spiteof

the

obstruction.
existing

circulates in the morbid

The

arteries is,most

The

renders

contents, and to the diseased state

"

as

shall preserve
the normal
point,in

actual force with

state of the

merely such

error

apoplexyis,in fact,due to the diseased

their walls an inadequatesupport to their
of brain, which

imperfectly
supports the

Clinical Lectures,"by Dr. Todd, p. 115.

SOFTENING

THE

OP

BRAIN

CAUSING

the firstinstance,they often

time embedded

some

in

become

so

after

ment

of

being for

of softened brain.

mass

of this organ often in cases

of severe
is pulpy and diffluent in character,
and

ue

039

APOPLEXY.

The

rumollisseof the

sistence
con-

cream.

of hemiplegiaoccurring
in the
cases
describing
manner
previouslynarrated, Dr. Todd remarks, "that
the diseased blood-vessels lie in the midst of this pulpy
without undergoingany further change; but sooner
mass
mental
emotion, or during some
or
later,under some
increased heart's action, depending either upon
mental
emotion, upon
derangement of the digestiveorgans,
some
bodilyexertion, or increased mental effort of any
When

kind, the blood

is sent

with

undue

force

or

in unusual

in consequence
the vascular
canals in the pulpy portionof the cerebral tissue,

quantityinto

the vessels,and

being deprivedof

their usual

blood is effused into the softened

it breaks

up, and

the

support,give way, and

partof the brain,which

readilyin

of its
consequence
This is the rationale of

more

alreadydiminished consistence.
attack of apoplexy,
the development of many
from
an
which the patient
accordingto
may or may not recover,
and according
the extent of the brain previously
softened,
to the amount

of
the subject
considering

In

conclusions would

erroneous

to

were

of blood effused."*

confine
exclusively

of the contents
would
and

Close

"

indeed lead him

is the

p.

129.

Such

an

course

examination
of investigation

of an ignis
pursuit
fatuus.
sympathy, indissoluble and
in

between
vital and

the material

ment
instru-

organicstructures.

Disease of the Brain, and other AffecParalysis,

tions
System,"by R. B. Todd, M.D., F.ll.S. London,1854.

Clinical Lectures

of the Nervous

pathologyvery
at if the inquirer

his attention to

the connexion,
inseparable
of thought and other
"

be arrived

of the cranium.

intimate

cerebral

on

G40

OF

PRINCIPLES

GENERAL

Hypertrophy, atrophy,and
irritation

heart; chronic

of

DIAGNOSIS.

CEREBRAL

the

valvular

disease

membrane

mucous

(oftenthe

of the
of

effect of

protracted
conditions of the blood ; impaired
; morbid
dyspepsia)
of assimilation ; pulmonary affections ; hepatic
powers
disease (acute and chronic); nephritis,
granulardegeneration,
with the
or
any other renal disorder interfering
from
the blood, play an
elimination of urea
important
part in the pathologyof cerebral and mental affections.
No
analysisof the anatomical characteristics of the
cerebral diseases previously
referred to could be viewed
or
as
satisfactory
complete,that did not embrace a full
stomach

and

the bowels

of

consideration
in close

the

morbid

conditions

organicsympathy

with

of other

the

tures
struc-

greatnervous

centre.
DIAGNOSIS.
to

"

be

is the phyBy what generalprinciples

sician
guided when
attempting accuratelyto

diagnosebstween mental aberration and those abnormal

states of thought,and erratic flights
of fancy,which
so
of their modes
of manifestation,
resemble, in many
closely
?
Is mental
alienation of reason
pathology a
certain and
exact
science, and are its data so clearly
established,and

the

defined, as
accurately
to speak with
actual presence

conclusions
to enable

deduced
the

authorityand

of aberration

in

therefrom

so

psychological,
sician
phyconfidence

every case
healthystandard

of

of the

suspected

of intellect ?
allegeddeviation from a
Is it possible
to discriminate eccentricity,
vice,
clearly
and crime from insanity,
the preto fullyappreciate
or
cise
that
marks
of
the
frontier
the boundary
position
between
extraordinary
departuresfrom ordinarymodes
conduct
of thought and
(consistentwith sanity and
of mind), and those deviations from states
responsibility
of thinking and action utterlyirreconcilable with
the
hypothesisof mental soundness ?
or

DIAGNOSIS

When

OP

641

INSANITY.

does violent and

ungovernablepassionbecome
symptomatic of psychicaldisorder,and what extent of
brutality,
prodigality,
cruelty,
parsimony,revenge, and
with intellectual sanity
?
When
jealousyis compatible
does an
has acquired
idea which
influence over
the
an
with its value,
imagination,
obviouslyincommensurate
in its character,
to be healthy
and become a monocease
maniacal conception?
Admittingthe difficultiesthat undoubtedlysurround
I am, nevertheless,
subtle questions,
a solution of these
of opinion,
and cautiously
that the carefully
observant,
will encounter
and practically
educated physician
bond,
no
fide impediment in his attempt to diagnose between
actual disorder of the mind
and other states of
(insanity)
intellect,
emotion, and conduct, generally
supposedto be
allied to, or confounded with it. The boundaryline separating
from analogousstates of thought,is no
morbid
doubt occasionally
obscure, faint,and shadowy,and cases
and
which puzzleand confound the most sagacious
occur
experienced
psychologists.
I have elsewhere spokenof the impossibility
of defining
and pointedout briefly
not only the rules that
insanity,
called upon to inveswhen
tigate
should guide the physician
a subtle and
complex case of morbid thought,but
that would

the serious

error

making

of
analysis

an

soundness, were

such

be committed

typesof allegedmental

to restrict himself

the then manifested

state of

if he, whilst

to

un-

consideration of

intellect,
utterly
disregarding

psychical
developmentand ordinarymodes of
characteristic of the person
thinkingand action generally
whose
sideration.
.sanityof mind and conduct is under his con-

the normal

As

generalrule,derangementof mind,

consist in

vitiation of the

element,
psychical

or

whether

mental, emotional, or

exhibit

itself in actions
T

it

moral

different
T

642

DIAGNOSIS.

CEREBRAL

OP

PRINCIPLES

GENERAL

considered to be the effect of a

generally
-balanced understanding,
and rightly
well-governed,
sane,
deviation from
manifests itself by a marked
ordinarily
those

from

natural states of
entered

I have
in
there

I refer the reader.

made

There

with

former

thought,and normal modes of conduct.

ject
at length into an
analysisof this subpart of this work, and to the remarks

three

are

affections of the

insanityis

which

1. A

state of

acted

upon,

liable to

cerebro-spinal
system
be

confounded

viz.,

of the nervous
or hyperasthesia
depression,
disorder ; 2.
functions, generallydesignated nervous
Delirium
tremens
of congestionof
; 3. Ordinary attacks
acute and chronic encephalitis.
the brain, meningitis,
It has been propounded as an axiom
by a well-known
that all disorders of the
Englishpsychological
authority,
nervous
system are but degreesof insanity. If such a
and
dictum were
admitted
to be universally
generally
how

mischievous

There

are

other

is

and

sad would
of

vast amount

be the

sequences
con-

derangement,
of a very formidable
and
character,
distressing
which
connexion
has no pathological
with, or psychical
relation to, mental
derangement.
I have detailed in the chapteron the Morbid
mena
Phenoseveral illustrations of this
of Conscious Insanity,
alienation of thought.But this state of
type of incipient
of the approachof insanity
unhealthyapprehension
very
often exists as a nervous
disorder without
being complicated
with, or passinginto a phase of, mental
ment.
derangeI have seen
remarkable
examples of the
many
kind in connexion
with various forms of acute hysteria.
There
resemble

In such

in
cases

many
there

affections

of the

nervous

nervous

of their

features

is often

great emotional

mental

system that
alienation.

exaltation,

of the instincts,confusion
of thought,
perversion
geration
exagclosely
borderingon aberration of jdeas,as well

C44

DIAGNOSIS.

CEREBRAL

OF

PRINCIPLES

GENERAL

of venous
the latter condition from one
distinguish
The ordinarysymptoms of active determination
plethora.
of tension,
of an
acute type, a feeling
are
cephalalgia
vertigo,
aggravated
weight,or heaviness in the head, severe
the patient
whenever
stoops,suffusion of the face,
noises in the ears, sendistressing
conjunctiva),
injected
of the arterial circulation,
sorial hypersesthesia,
activity
recognisedby undue action of the temporaland radial
arteries,depressionof spirits,
apprehensionsof an approaching
increased temperacalamity,opticalillusions,
ture
of the scalp,
wakefulness, or disturbed sleep,
accompanied
with frightful
twitchdreams, sudden muscular
ings and spasmodicstartings.
It is difficult to define when
cerebral state
the preceding
to

of active determination
In

the

passes

former

into

affection

condition

there

of

gestion.
con-

marked

exists

of the ordinaryfunctions of the cerebrum,

hypersesthesia
the symptoms indicate
whereas in the state ofhyperaemia
of the
an
oppositecondition of the brain. This depression
cerebral functions
is marked
by a sensation of dull,
heavy weight in the head, seldom amounting to acute
cephalalgia.The patient complains of vertigoand
obtuseness
of hearing. In many
there is partial
cases
amaurosis.

The

intellectual faculties

state.

The

all the

great functions

vital

memory

is

are

in

an

inactive

impaired,
thoughtsconfused, and
of life

are

in

state

of

severe

depression.

The

advance of insanity,
insidious,slow,and progressive
in the majorityof cases, by great singuexhibitingitself,
larity
of
normal

modes

absence
of

conduct, delusive ideas,and clear deviations from

of

of the

mania)

thinkingand acting,as well as by an

acute cerebral symptoms (exceptin cases

that mark

and

arrivingat

the

condition

hypersemia,will
an

accurate

of active

assist the

tion
determina-

practitionerin

diagnosis.Again, insanityis

DISTINCTION

BETWEEN

INSANITY

from
ilydistinguished
and

cerebritis.

its

character,

the acute

645

CEREDR1TI8.

symptoms

gitis
of menin-

These

accompanied by severe
in

AND

sense

head, Hushing of the

affections are
inflammatory
fugitive
cephalalgia,
occasionally
of weight and fulness in the
face,heat of the scalp,
lethargy,

attacks of

of hearing,
vertigo,exaltation of the sense
and smelling,
tinnitus aurium,
seeing,
opticalillusions,
full and laborious pulse,sudden
injected
conjunctiva),
startingsduring heavy sleep,as if the patientwere
alarmed
stipated,
condream, bowels obstinately
by a frightful
pupil contracted, skin dry and parched,and
the mental
between
condition alternating
delirious excitement
and depression.
With
the preceding
symptoms
there will occasionally
of the
be
great irritability
flammation
stomach, sometimes
amounting to actual vomiting. Inof the

membranes

and

substance

of

the

brain

from each
(affections
very difficult to distinguish
in
other) is often complicatedwith delirium (different

its character

from

the

delusions

and

hallucinations

of

with convulsions.
as well as
insanity)
Lallemand
to be able to diagnosebetween
professed
of the substance
of the
meningitisand inflammation
brain by means
of lesions of the functions of the muscular
he affirms, almost exclusively,
accompany,
the former cerebral condition; but, according

system
to his

own

which

admission, the

two

types

disease very frequently

blend with, and
be distinguished
from, the other.

of
are

inflammatory
not easily
to

The

of

affections
premonitory
symptoms of inflammatory
the brain are essentially
dissimilar from those that precede
attacks of mental
For
some
derangement.
period

before

the

invasion

of the

acute

cerebral

disease, the

patient
complainsof rarely
beingfree from some degreeof
headache, either continued, fugitive,
fixed,or deep-seated
in its character. These degreesof cephalalgia,
Dr. Craw-

646

OF

PRINCIPLES

GENERAL

DIAGNOSIS.

CEREBRAL

numbness, weakness,
ford says, are accompaniedby pain,
of the
and a sensation of creepingand tinglingin one
sensations

extremities,or in one-half of the body. These

be confined

may

portionof

one

is often

loss of power

and

numbness

to

set of muscles.*

body, and

the

restricted to
In

the
one

the

earlystage
of the brain the speechis occasionally
of inflammation
is a degree of hesitation,stuttering,
There
affected.
or
indistinctness of pronunciation. The patientcomplains
and depression
of spirits.
of drowsiness, languor,
will encounter
The practitioner
but few difficultiesin
nary
ordidiagnosingbetween progressivegeneralparalysis,
attacks of encephalic
softening(white and red),
paraplegia,
hemiplegia,cerebral abscesses, and various
to

finger,or

kinds

one

of the brain.

of tumour

the
on
have, in the precedingpages, in the chapters
Morbid
Phenomena
of Intelligence,
Motion, Sensation,
I

and

Speech, described
that
generalparalysis,

subtle

fullythe

it will be unnecessary

advance
for

me

of
here

the description
there givenof the incipient
recapitulate
well as diagnostic
symptoms of this obscure and generally
fatal type of cerebral disease.

to
as

Dr.

Skae

has, in

of the learned

the
*

th.it

The

communication

societies,
so

treacherous

to

one

admirablydelineated
of this

advance

affection,

isolated attacks of anaesthesia,

in the
occurringparticularly

often

so

recent

medical

steadyand

fingers,

precedeattacks of

observation of Galen.
"

so

"

did not escape the acute

disease,
cerebro-spinal
Pausanias the sophist,"
says this illustrious authority,

whilst

in
a loss of feeling
making a voyage from Syriato Rome
experienced
his
left
and
side
of
the
middle
of
hand.
on
one
fingers
finger
Under
of the affected part became
injudicious
treatment, the insensibility
other
permanent. I made inquiriesinto his condition,and learned,among
that
from
struck
the
had
he
fallen
his
and
with
things,
chair,
during
voyage
the two

last

force the upper part of his back.

The contusion was
soon
cured, but a numb*
of the fingers
I
advised
that
the same
remedies
ness
supervened. immediately
which

had been

appliedto the fingersshould be directed to the part that had

been firstinjured,
recovered the
viz.,the spinalcord,and my patientspeedily
entire use
of his left hand."
From
fu
cated
a paper
L'Experience,"communiM.
Dubois
by
d'Amiens, On the Writingsof Galen."
"

"

"

OF

SYMPTOMS

INCIPIENT

GENERAL

647

PARALT8IS.

in detail,
apologyfor quoting,somewhat
his account of its premonitory
and diagnostic
signs.
but not always,
and generally,
The
most
significant,
tho first symptom of generalparalysis
is,accordingto
Dr. Skae, a peculiar
tion.
impairmentof the power of articulacertain words,
The patient
speaksthick,mumbles
like a person who is slightly
intoxicated.
Accompanying this affection of the speechthere is
of the countenance,
(I think always)a peculiar
expression
and so easy to
but so peculiar
very difficultto describe,
racteristi
frequentlyseen, and so very charecognise,when
that I offer no

"

of the

that any
disease,

who

one

has

had

few

the insane could pronounce

years'experience
among
from the aspect
upon the existence of generalparalysis
of the face alone.
The face is characterized by a general
hebetude
of expression a heaviness of the
want
or
features ;
the eyes have a vacant and absent expression,
the pupils
being often unequallydilated ; the anglesof
the risor
the mouth
are
sluggishin their movements,
and
levator anguli oris muscles not appearingto act
and
the mouth
shuts in a piece,as it
at all ;
opens
without
were,
any play of the lipsindicative of the
and passions. Not
sentiments
unfrequentlythe face
about to
trembles before speaking,
were
as if the person
"

"

"

cry.
"

any

the

When
marked

rarely
; but
control

tongue

deviation
it often

without

protruded,it

to

palsy,at least
from side to side,as if beyond
advanced
stages,the patient
the will,to protrudeit at all,

wavers

and, in the

is done

is

more

one

side,as

in

by an effort of
his
asked to show
his mouth, when
but simply opens
is more
tongue. The pulse of the generalparalytic
compressed; the extremities
commonly feeble and easily

is unable,

cold
and

and

livid,and

every
languidcirculation.

indication

exists of

weak

C48

GENERAL

PRINCIPLES

OF

CEREBRAL

DIAGNOSIS.

speechwhich I have described,

graduallyincreases during the progress of the disease,
almost
until, in its latter stages,the speech becomes
inarticulate and unintelligible.
entirely
At some
tion
periodof the disease the powers of locomoand the gait is unsteady.
to be impaired,
appear
This
affection sometimes
but more
precedes,
generally
I
succeeds, the impaired articulation. In some
cases
have known
the unsteadywalkingprecedefor some
years
the affection of the speechor the symptoms of insanity,
and the disease appeared to
creep slowlyupwards from
the lower part of the spinalcord, as it were,
to the
central organ of the nervous
ever,
howsystem. Generally,
the impairedlocomotion
succeeds the impaired
speech.
This affection of the lower limbs, which
certainly
precedesany affection of the upper extremities,
generally
The

"

affection of the

"

"

is

very

different from

the

affection

of the

limbs

in

ordinarypalsy. And this is one of the features of the

tinguished
dismalady which has not, I think, been sufficiently
is no
There
dragging of the limbs, as in
there is no
loss of muscular
hemiplegia
;
power ; no
palsy,in the ordinarysense of the term, in the limbs at
all. There is an impairment in the
of directing
power
the movements
of the limbs, an inability
to control their
co-ordinate action.
walks

from

The result of this is,that the person

widens
his base of support,and sways
unsteadily,

side to side like

drunken

man.

In

nounced
well-pro-

in those where
the so-called
especially
has longprecededthe mental
he rises
affection,
paralysis
slowlyfrom his seat,balances himself,and beginsto walk,
the
on
very wide in the gyves, fixinghis eye sometimes
and making for it as
objecttowards which he is tending,
he can.
In such cases, if the individual is
as
steadily
made to close his eyes, it often happens that he cannot
cases,

I N"

I I'll NT

SYMPTOMS

OP

GENERAL

G49

PARALYSIS.

himself from
saves
difficulty
fallinghe walks up a stair with comparativeease and
comfort, because he has some
objectbefore his eyes to
ficulty,
guidehim ; but he goes down stairs with fear and difbecause there is nothingbefore him on which he
fix his eye.
This is the most exaggerated
can
or
fullydevelopedform of the paralyticcondition ; but it is
seldom seen, in the earlystages at least,of the disease
which I am
marked.
so
describing,
strongly
Very often
it is hardly observable, consisting
merely of a slight
or
wideningof the limbs, and a rolling
shambling,and
somewhat
unsteadygait; in fact,the affection of the
speech is not more
trulylike that of drunkenness than
that of the locomotive powers ; they are both the result
of the loss or impairment of that power
of
by means
which we regulate
and control the co-ordinate action of
our
voluntarymuscles ; and may exist,in every varying
thickness of speech
degree,from the slightest
appreciable
of walking,up to total loss of articulate
or unsteadiness
speechor the power of walking.
balance

himself,and

with

"

In

ordinary
palsy,the

muscles

nervous

connexion

between

the

of the

palsied
part and the organ of volition is,
it were, cut off entirely,
and the individual can
no
as
muscles
longer,by an effort of the will,make the palsied
act

he

cannot

lift his

arm,

or

close his hand,

or

draw

perfect
Or, it may be, he conveys a feeble and imup his limb.
volition to the part (ifthe palsyis incomplete
or

the limb
or
passingoff),and the hand is graspedfeebly,
In the so called
is slowlyand with difficulty
drawn up.
the other hand,
of the generalparalytic,
on
paralysis
connexion
there appears to be no stoppageof the nervous
between the organ of volition and the
or electriccurrent
affected
and

parts;

but

distrifiutrd.

his movements

the

The

volition is

person

and
perfectly

cannot

conveyed
irregularly
control and

direct

consentaneously,
just as

650

drunken

man

upon
eyes converge
because he cannot

and

direct

of his

movements

;
given object

or drunken
generalparalytic

of the term

ordinarysense

regulatethe

In these

limbs.

the

harmonious
of the

movements

there is

man,

unsteadily,

walks

or

no

palsy,in

affected will

person

his

make

he cannot

double, because

sees

DIAGNOSIS.

CEREBRAL

OF

PRINCIPLES

GENERAL

the

run,

and violently
as
ever, but
actively
and not alwaysthose desired
his movements
are
irregular,
willed.
In fact, they resemble
in kind, although
or
of c/torea,
modified in degree,
the movements
very much
in which the patientin vain attemptsto steadyhis hand

dance, or

or

kick, as

I
carry it to his mouth.
because I think
distinctions,
or

and
recognised,
to mislead

as

because

the

am

anxious

theyhave

to enforce these
not

hitherto been

of this affection is

name

apt

to their nature.

"Dr.

Reynoldscorroborates my statements,by pointing

out as a means
of diagnosis,
between
general paralysis
and wastingpalsy,
the muscles
that in generalparalysis
contract readily
while
under the stimulus of galvanism,
in wastingpalsythey do not.
in fact,
In wasting palsy,
the contractility
of the muscular fibre is impairedor lost,
while in generalparalysis
it stillremains
unimpaired.*
This impairmentof the muscular
movement
ally
graduincreases and extends,the speechbecomes
and
more
"

inarticulate,the

more

until at last
and

the

locomotion

a word
scarcely

patientcannot

rise

or

and

more
can

cross

be
the

more

steady,
un-

distinguished,
room

without

beingassisted.
"

The

much

in

speechis
a

changes,however, varies very

different cases;
sometimes, for example,the
so, until
hardlyappreciably
very littleaffected,

progress

very advanced

of these

stage of

varies,being at times
others.

In

the

the disease.

much

way, the

same
"

On

In

other

cases

it

than
at
perceptible
impairmentof the loco-

more

Wasting Palsy.

C52

only to

DIAGNOSIS.

subdivisions,but it is my

and

other divisions

CEREBRAL

OF

PRINCIPLES

GENERAL

intention

ing
the symptoms of the two leadcursorily
will be
softening. This important subject

describe

forms

of

fullyconsidered

in

all its details in

the

succeeding

volume.

is not well
premonitorystage of acute softening
marked.
or distinctly
Many of the symptoms manifested
of the disease closely
resemble
the incipient
at this period
such as headache,
signsof cerebral hemorrhageand paralysis,
loss of sensibility
in
vertigo,muscular
debility,
some
a
part of the body,tinnitus aurium, formications,
sensation of weight,or slightsymptoms of hemiplegia
on
side of the body,muscular
one
tremors, tetanic spasm,
of one
of
occasionally
resemblinga stiffness or rigidity
the limbs, slight
strabismus,
palsyof one of the eyelids,
defective
articulation,misplacement of words, with
marked
changes in the physiognomy, the expression
becility."
imor
being that of astonishment, stupor,indifference,
The eyes are sometimes
brilliant and staring,
and at other times dull and without
expression. The
face is occasionally
suffused,indicating
a state of cerebral
sanguineouscongestion.
Durand-Fardel
and striking
says, that a remarkable
is
symptom, frequentlyobserved in acute softening,
The

"

an

increased

is

remarked
especially

secretion

from

viscid secretion dries,and

the
old

with
forms

and

eye.

in
people,

whom

mouth

hard

masses

on

the

'

This

this

edge
O

of the

which irritate the eyes, whilst an abundant

eyelids,
viscid,
glairyfluid dropsfrom the mouth, or, when more
adheres to the tongue and
palate,forming a thick
removed.
as
crust, which is reproducedas soon
yellowish
A

remarkable

fact connected

with

these increased

tions,
secre-

cerebral amendment
partial
takes place,
the discharge
of itselfceases, but reappears
the acute softening
as soon
as
progresses.

says Fardel, is that, if

CEREBRAL

In

ABSCESSES

AND

TUMOURS.

G53

softeningthe patientoften complains of

and of impairedpowers of deglutition.
illusions,
optical
But the principal
symptoms are undoubtedly
diagnostic
and acute in its character,
less persistent
more
or
cephulalgia,
marked symptoms
affections of the speech,
vertigo,
of paralysis
of the palpebra),
face,or one side of the body,
associated with muscular
bility
irritaloss of memory,
debility,
of temper, occasional attacks of epilepsy,
and a
and confused state of the intellect. The spirits
muddled
excited.
sometimes
and occasionally
The
are
depressed,
dilated.
pupilsare often contracted,but as frequently
conditions
In chronic,white, or non-inflammatory
of
the premonitorysymptoms very closely
resemble
softening,
those previously
described as characteristic of acute
types of this disease,but materially
varyingin severity.
I have described in the chapterson
Impairment of the
of Attenthe Morbid Phenomena
tion,
Intelligence,
including
Volition,Emotion, and Memory, the principal
chical
psyof this
symptoms indicative of the commencement
form of cerebral degeneration
or
disorganization.
for me
than briefly
It will be unnecessary
to remore
capitulate
described as the psychiwhat I have previously
cal
evidences
of white
softening. I refer principally,
to a confusion and then to a gradualimpairment
first,
of the intelligence,
showing itself in defective powers of
of purpose, vacillation
attention,enfeebled memory,
infirmity
sequently
of will,and a generalsluggishness,
apathy,and subof intellect. Associated with these
imbecility
mental
obscure, but'
symptoms, there are cephalalgia,
and motor
often obvious changes in the sensor
powers,
I have described
and often partial
paralysis).
(hyperaesthesia
these insidious and subtle lesions when
analyzing
the morbid phenomena of motion, sensation,and speech.
In
are

acute

cerebral tumours
not

and

detected
generally

abscesses of the brain there

in the

earlystage any

well-

654

In these

symptoms.
diagnostic

marked

DIAGNOSIS.

CEREBRAL

OP

PRINCIPLES

GENERAL

types of organic

is generally
brain,headache, often localized,

disease of the

racter.
paroxysmalin its chashould not be presentthe patient
If cephalalgia
tinnitus aurium,
will complainof sensations of vertigo,
lect
of confusion of inteland occasionally
defective memory,

present,but

but

often intermittent

I have

even

uneasiness

in

organicdisease of
minutelyinto the
of these

in several

observed

local

pain,or
of suspected
In all cases
the head.
this kind, it is important to inquire
antecedents of the patient. In many

the cranium

appearance of cerebral
is often associated with

Abscess

symptoms.

been

to
previously

years

many

have

that blows

affections it will be found

inflicted upon

and

of tumour

cases

of acute

absence

brain, an

abscess of the

or

the

of the brain

from
purulentdischarge
these circumstances
Under
the internal ear.
persistent
noises in the ear and head,
headache, vertigo,
distressing
the mastoid
and pain upon
process, are
pressure over
signs.
important diagnostic
I have, in a former partof this work, addressed myself
to a consideration of two
important generalsymptoms
usuallyindicative of organic disease of the brain, viz.,
Cerebral cephaand sickness of the stomach.
headache
lalgia
be

may

the

pain

rheumatic

may

hemicrania,

with

confounded

and
neuralgic,
gastric,

headache

chronic

be

headache.

nervous,

In

cerebral

acute, lancinating,

either

of
of the suffering
The intensity
obtuse.
or
throbbing,
so
great that the
inflammatoryheadache is occasionally
patientis obliged to remain for a considerable time in
the slightest
motion
aggravatingthe pain
one
position,
The patient,
torture.
to perfect
says Dr. Abercrombie,
the noise of combear a warm
pany,
cannot generally
room,
or

even

the exertion

of cheerful

feelinggreatlydistressed
increased.

There

and

is also connected

out
conversation,with-

the

headache

with

this

being
type

of

DIAGNOSIS

OF

CEREBRAL

of

intolerance
cephalalgia,

great sensorial

cases

035

IIEADACIIE.

and,
light,
In this

acute-ness.

in

fact,in many

type of headache,

characterized by the
Romberg, the pain "is generally
it is permanentlyconfined to a
:
following
peculiarities
is a
There
largeror smaller portionof the cranium.
the pain
sensation of pressure, tension, or pulsation,
or
has a shooting,
or
tearing,
rollingcharacter. It varies
in intensity,
and is excited and exalted by bodilyor
mental fatigue,
of the head, elevated tempemovement
rature,
highlyspicedfood, and long and sound sleep.
The pain is relieved by raising
the head or by assuming
the erect position,
or
restingthe head firmlyagainst
something; it possesses a remittent character. There
but during the intermissions the health is
intervals,
are
confined
impaired. Spasmodicaction or paralysis,
generally
says

to

side of the face

one

the organ of sense

delirium follows.
as

the

becomes
The

and
paralysis

"It
features

is

matter

with

trunk, supervenes,

or

afflictedwith

pain abates

and

and
anaesthesia,
ceases

altogether

sopor advance.
of much
to define
difficulty

sufficient for the

accuracy
from
the organ is withdrawn

as
diagnosis,
by a rigidosseous

or

purposes

of

examination

approachhas
been overlooked, which we
to avail ourselves
ought certainly
of. It is a fact that duringevery vigorousand
the brain is elevated,
act of expiration
long-continued
the cerebellum beingpassedagainstthe tentorium, the
cerebrum
againstthe cranial bones. We may easily
ourselves of the latter by placingthe hand
convince
upon the fontanelli of a child while it is crying. The
stance,
old surgeons, actingupon
a
knowledge of this circumwho
suffered from
their patients
recommended
wounds
of the cranium, to cough violently,
penetrating
of blood
to sneeze, in order to promote the discharge
or
or

pus.

case

stillone

means

of

these

G56

DIAGNOSIS.

CEREBRAL

OF

PRINCIPLES

GENERAL

therefore,employ continued

or
expiration,
in cerebral
holding the breathing during expiration,
if it affects the surface,as a sort of
diseases,especially
"

"VVe may,

have

The

headache
the

For

to in the

recourse

which

pressure

we

of
exploration

quently
fre-

so

the abdomen

thorax.

or
"

external

the

for

substitute

complain of the
patientsalluded to generally
being brought on by strainingin defecation.
of diagnosis,
the patient
we
may cause
purposes

by holding the breath for some

while the abdominal
muscles are
time during expiration,
This at once
contracted.
brings on the pain,or if it
The
same
were
present,increases it to the utmost.
in screaming,coughing, and vomiting. Similar
occurs
during
experimentsmay be instituted duringinspiration,
the brain falls and
which
approaches the basis of the
this effort

imitate

to

We

skull.*
the

thus

may

obtain

the
affecting

diseases

information

some

base

of

the

on

cerebrum

and

cerebellum.
"

We

are

more

in the habit of

using the

influence

of

of the head
the means
of
as
positionand movement
ing
diagnosis.Swinging the head from side to side,stoopdown, risingrapidlyfrom the horizontal to an erect
are
position,
apt to produceand augment the pain.
and
The
modifications
relations of cephalalgiato
definite diseases of the brain,are importantin a diagnostic
them, it is necespointof view. Before investigating
"

Bavina

found

that

he
duringinspiration

able to introduce

quill
placinga cork cylinder
divided into degrees upon
the brain, it sank during ordinary inspiration
three lines.
If a cylindrical
one
line,during strong inspiration
glasstube
filled with water
was
placed upon the brain, the fluid disappearedduring
returned
discoloured with blood on expiration.See Lund :
and
inspiration
between

the skull and the brain of

was

pointer.

On

"

"

Eesultate
Physiologische

stillmore
iiber die
and

der Vivisectionen

neuerer

Zeit,"p. 149:

and

the

experimentsof Dr. Ecker, in Physiologische

Untersuchungen
des
Gehirns
und
102
Riickenmarks," 1843, pp. 27
Bewegungen
recent

pp. 112"122.

"

"

OF

DIAGNOSIS

sary to
of the
than

CEREBRAL

"'"~"7

I1EADACHK.

pointout that,in order to determine the existence

it is even
more
pain in these diseases,
necessary

in ailcctions of other

organs, to have an accurate

series of observations of the

historyand a continued
patient.This is necessary, not only on account of the
but also on account of the recurrence
longerintermissions,
of pain when
other symptoms, and especially
and on
account
of the loss of
paralysis,
supervene,
which

memory
The

ensues

absence

of

cases."1
in many
well-marked
symptoms

of

gastric
such as furred tongue, loss of appetite,
disorder,
acidity
of the stomach, flatulence,
painor uneasiness after eating,
vitiated secretions,
sluggishaction of the liver as well as
intestinal canal,will assist the physician
in his diagnostic
examination of a case of headache suspected
to proceed
from organicdisease of the brain.
and rheumatic cephalalgia,
of neuralgic
In cases
the
pain will not be confined to the head, but will be felt in
in certain conditions
other partsof the body,particularly
of the atmosphereand alternations of temperature.
In types of nervous
headache, the pain is generally
and when
frontal,and often relieved by cheerful society,
food and

stimulants

are

administered.

Attacks

of this

long duration, whereas in cerebral

from softening,
headache, arising
tumour, and abscess of
absent.
is,in acute cases, rarely
the brain,the cephalalgia
in many
instances intermits,
but
The pain,undoubtedly,
followed by, or associated with vertigo
it is generally
noises in the head, often compared to
and distressing
the roaringof the sea.
The headache symptomaticof the presence of tumours
is considerably
of the brain,Romberg affirms,
diminished,
tion
if not in some
removed, by the accumulacases
altogether
kind

are

of

seldom

serum

of

in the cavities and bitwcm

"

Romberg, p.

the membrane's

159.
u

658

PROPHYLAXIS.

AND

TREATMENT

OF

PRINCIPLES

mation
aggravatedwhen inflamof
in the immediate
and softeningoccur
vicinity
that accompanies cancerous
The headache
the tumour.
acute and lancinating
affections of the brain is generally
In abscess of the brain it is generally
in its character.
of the brain, but

the

pain

is

paroxysmal.
referred
I have previously

the

to

the

intimate

sympathy

stomach, and to the

existingbetween

the brain

and

frequentpresence
vomiting,in many
brain.
Romberg

of

and actual
gastric
irritability,

nausea,

organicdisease of the
and
has, with his usual perspicuity
described
the characteristic diagnosticsymptoms,
accuracy,
of which we
enabled to distinguish
are
by means
sickness of the stomach.
cerebral from idiopathic
They
are

follows

as

1.

"

The

vomiting is

cases

of obscure

"

influence

of the

positionof

the

arrested in the horizontal,and

head; the

recurs,

and

is

frequentlyrepeatedin the erect position.It is also

of the head, by swinging,
easilyinduced by movements
shaking,or stooping,or suddenlyrising. 2. The prevailing
absence
of premonitory nausea.
3. The
peculiar
character of the act of vomiting; the contents of the
stomach
without fatigue or retching,
the
are
as
ejected
milk is ejectedby babies at the breast.
4. The complication
with other phenomena,the more
frequentof which
and
the irregularity
are
pain in the head, constipation,
of the cardiac and radial pulse,
which is increased during,
and subsequentto the act of vomiting. The duration
of the vomiting is limited in the inflammatoryaffections
of the brain, meningitis,
and
acute
encephalitis,
to the first stagesof the disease ; and the
hydrocephalus
rule is,that as the paralytic
and
comatose
prevailing
symptoms increase the vomiting remits and ceases."
TREATMENT
of the brain

AND

and

PROPHYLAXIS.

"

In all acute

disorders of the mind

the

cure

affections
and

life

000

PRINCIPLES

health.

TREATMENT

OF

will almost

He

PROPHYLAXIS.

AND

detect
invariably

either

hepatic,

cardiac,renal, or intestinal disorder which

gastric,
and sympathetically
the
be irritating
disordering

may
brain.

tions
remedies, these affectimelyuse of appropriate
be removed.
speedily
may
be necessary to relieve the overIt may
loaded
occasionally
condition of the vessels of the brain. The patient
often complains of severe
headache, attended with an
for the relief of which the appliincrease of temperature,
cation
of a few leeches,cold evaporatinglotions,
and ice
the

By

to the head

be recommended.

may

in the

necessary
Alas

measures.

! how

use

of

often

Great

caution

ever,
is,how-

and antiphlogistic
depleting
have patients,
who have been

treated by such means,

sunk into incurable
injudiciously
chronic
melancholy. In recent attacks, occurringin
and plethoric
when
the symptoms are
subjects,
young
allied to inflammation
of the brain, local bloodletting
closely
is often attended
with the happiest
results.
In considering
the physical
of insanity,
treatment
it
is essentially
should
stand
clearlyundernecessary that we
what
condition
of brain
the
pathological
upon
mind
morbid
state
of the
depends. I think it
be
safely laid down, as a general principle,
may

that

the

exalted

brain, in

cases

kind, is not

of mania,

in
necessarily

congestionor inflammation.
usher
the symptoms which

it

all

that

establish
unequivocally
arises from

with

vascular

cerebral

state

character of

of

most
active

insanity,

in, and mark

its progress,
alienation of mind
quently
fre-

disorder,unaccompanied

doubtful

cases

tartrate of

excellent substitute for

an

the

or
activity
turgescence.

In obscure and

be found

The

of

even

antimonywill
bleeding. Violent

dication
maniacal excitement, accompanied by every apparent in-

of

high degreeof cerebral congestionand

will often yieldto the administration of

flammation
inthis

II

INCIPIENT

IN

II'ING

C01

INSANITY.

should beginwith small doses,and

drug. The physician
is able to take
increase them, until the patient
gradually
actual vomiting.
t\\." or three grainswithout
exciting
in insanity,
Dr. Seymour
On the subject
of depletion
observes
In the greatmajorityof cases, the functions
of the brain in mental
derangement are increased in
force,while the circulation is depressed,
extremelyquick
and feeble,
and the action of the heart -gives
way to the
often
smallest abstraction of blood ; and yet these are
attended by ravingdelirium, great increase of muscular
The
force,and are, in fact,what are termed highcases.
is,either the more
frequent
consequence of such practice
return of the high stage,or the patientsinks into one
approachingidiotcy."
to
cold applied
When
inadmissible,
bleedingis clearly
the head will be found not only to diminish vascular excitement,
ness
but to lessen powerfully
the morbid sensitive"

"

of the cerebral organs. Should there,however, exist

tendencyto active plethoraand apoplexy,cold lotions

and ice should be used with

hot

The

greatcaution.

prolonged

with the cold douche,will often be

bath,in conjunction

subduingmaniacal excitement.
of incipient
I have witnessed
the mental
perturbation
insanityfrequently
yieldto this potent remedy. The
douche is to be used when the patient
is in the hot bath.
In the incipient,
well as in advanced
as
stages of
the generally
overloaded and inactive state of
insanity,
of purgatives.
the bowels should be relieved by means
found

most

Much

caution, however, must

efficacious in

medicine.
aperient
the

state of

the
Very frequently

membrane

mucous

sub-acute

and

aggravates the

morbid

state

of the

the

brain

mental

whole

This
and

intestines is

is in

condition

acts

system,

nervous

irritation.

of

use

surface of

intestinal canal

of the

inflammation.

sympathetically
upon

in the

be observed

this

"When

present,the

use

of

602

INSANITY.

IN

HELLEBORE

of a few
should be preceded
by the application
aperients
if there be pain upon
leeches (particularly
or
pressure),
to the neighbourhood of the abdominal
counter-irritants,
it will be necessary
of insanity,
affection. In other cases
has been known
to
to exhibit drastic purgatives.
Insanity
yieldto the steadyand perseveringuse of cathartics.
of beinga
Hellebore had in ancient times the reputation
of insanity.This drug was
considered
in cases
specific
in cleansingand invigorating
the
to operatepowerfully
intellectual faculties.

It is said

Academic, when

that

Carneades,

the

refute the

dogmas of the
of purgationby means
of
Stoics,went
So celebrated was
white hellebore.
this medicinal agent
mental
have
a
as
remedy that the poets of antiquity
its virtues.
Horace, in allusion to the "happy
sung
madman," says (I have quoted a portionof the original
in a former part of this work)
preparingto
througha course

"

Had

'

to himself

Is this to

Than
The

Persius

save

Ah

cruel friends !' he cried,

Better far had died,

pleasureso refined,
rapturedmind.'

of

"

which

this medicine

of disordered mind.

In his fourth

also refers to the

cases

"
"

that, instead of takingupon

Anticyrasmelior

Melampus,the
The

islands of

from
quotation
"

Thou
Drink

fame

of

son

sound

famous

Anticyrawere

Persius

standing.
to clear his under-

sorbere meracas."*

for

to have

hellebore.
producing
Dryden
by

has been thus translated

hast not

The

"

strengthsuch labours to sustain,

brain."
hellebore,
my boy drink deep,and purge thy0
"

quired
re-

judgment,he ought

Amythaon, is said

of

himself

government, which

powerfulmedicine

most

pains,

great and weighty task

much
experienceand

to take the

me

thus be robbed

satire he tells Nero

the

'
"

dear delusion of

acquiredin

and

expense

purgedwith hellebore his brains,

amply

Came

had

his friends,
at much

He, when

"

cured
above

Till

\l\ir.\T

OF

INSANITY

BY

003

OPIUM.

of Pro?tus, king of Argos,of melancholy,

daughters
ditionary
by purgingthem with hellebore. Accordingto the tratable,
Melampus had observed that the goats who
f.(1 on this plantwere
purged; and havingadministered
it to the king's
who
were
wandering in the
daughters,
woods under the delusion that they were
he cured
cows,
them, and received the hand of one of them in marriage,
and a part of the kingdom of Argos as his reward.
In the treatment
of incipient
nected
unconclearly
insanity,
with active head symptoms, there is no
remedy
which so effectually
the disease as that of opium
masters
tin*

in

satisfied that a vast

of its many
formula;.
I am
of mental
derangement may be successfully

one

amount

treated

in

its

earlystage by

administration

of

the

continuous

sedatives.

When

and

severing
per-

insanity

depressedcondition of the
vital powers, evidenced
by a weak pulse,feeble action
of the heart, and generalanaemic
state of the system,
the exhibition of the hydrochlorate,
acetate, or muriate
of morphia,combined
with
iron and quinine,will,in a
greatmajorityof cases, be found to act like a charm in
the progress of the mental malady.
arresting
In some
forms of insanity,
belladonna, conium, hydrocyanic
nium,
acid,chloroform, Indian
hemp, henbane, stramoand hops,may be administered with advantage. It
is obvious that no particular
instructions can be givenfor
must
the administration of these remedial agents. Much
be left to the judgment of the practitioner,
necessarily
who should be directed in the application
of sedatives by
the peculiar
circumstances
of each individual case
sented
prefound
for his consideration. It will be occasionally
opium by what is termed the
necessary to administer
endermic
In some
method, as well as by enemata.
is

associated
clearly

cases

of acute

benefit from

with

maniacal

the careful

excitement, I have found

use

of chloroform

by

gn-at

inhalation.

604

AND

TREATMENT

OF

PRINCIPLES

PROPHYLAXIS.

and other forms of delirium this anaesthetic

epileptic
much
used with
advantage.
agent may be occasionally
In

It will often be found

excitement
I have

to

yield to

remedies

have

the

this

mode

of

treatment

and
after

mental
other

failed.

dismissingthis part of
few

of acute mental

of active cerebral

instances

known

Before

cases

and opium.
give,in combination, digitalis

disorder

make

beneficial in

observations

patientfrom

on

the

his friends and

I would
subject,
of separating
necessity
familyin the incipient

the

stage of insanity.
There

be

experienced
opinionsamong
medical men
to the propriety
of occasionally
as
mending
recomthat a patient
from
order
acute mental dissuffering
be
should, immediatelythe malady manifests itself,
removed
from all his former associations.
As " principle
cannot

of treatment,
to such

course

no

two

sensible person will refuse his assent

of procedure. The object
of separation

is to break

throughthe morbid train of thought,and to

placethe patientat once within the range of efficient
curative treatment.
As long as he is surrounded
cumstances
by cirto his
likelyto encourage and giveactivity
morbid
and delusive ideas,all remedial efforts
suspicions
will be of little or

No

avail.

no

physicianwould

be

in undertakingthe
justified
of a case
treatment
of acute insanity
without
receiving
from
the friends and
family of the invalid absolute
and unconditional
to isolate the patient
pletely
compermission

from

home

and

every

circumstance

with

he had been

which

connected. The lunatic may fancy

previously
features of the disease)
(and this is one of the peculiar
that his familyare conspiring
againsthis life he may
imaginethat his house is dailyvisited by persons engaged
in devising
him of his lifeand proschemes for depriving
perty.
The physician
would exhibit greatwant of judg"

SELF-CREATED

il'h

mi-lit

"

605

I \s\Mn

to lose valual"le tiino

\\vre

by attemptingto

vourable
derangement under such unfacircumstances.
In the majority
of cases, it will
from the sphereof his
the patient
necessary to remove
to
before any permanent advantageis likely
circle,

combat

be
own

the mental

with

from

ensue

medical

moral

or

occasionally
occur, in which
in suggesting
this
justified
is favourable

and

the

any

made

to

home

is advised

member

of recent

dently
character, evi-

patientunconnected

the

be
family,
every effort should
from
malady before separation

carried into effect.

or

have, in the chapteron

referred

doubt

temporary bodilyconditions of

of the

grapplewith

no

would not be
practitioner
AVhen the prognosis
course.

the delusions of the

with

Cases

the

attack

dependent upon
and
ill-health,

treatment.

the

stageof consciousness,

the

distressing,
blasphemous,and often
obscene thoughtsthat occasionally
in certain forms
occur
sanity.
inof nervous
disorder and particular
types of incipient
It is possible
in many
cases, whilst such morbid
ideas are transient impressions,
to overpower,
conquer,
and dismiss them
table
indomifrom the imaginationby an
and persevering
effort of the will.
Alas! the unhappy sufferer is occasionally
so
fearfully
under the dominion
of morbid
thoughtsthat he makes
from their
effort to interfere with or dislodgethem
no
fortress. Instead
of attempting to do so, he often
appears

to

into,as well

their admission

to encourage

promote their unhealthyascendancyover

with
"

the

my

claiming
ex-

"

Vapours,and cloud*,and

storms, be these my
kindred
Welcome

theme

glooms,

hail !"

Spurgeon,when

connected
of

his mind,

to

poet

Congenialhorrors
Mr.

as

with his

Christian

recountingan episodeof his life

In the earlydays
conversion, says

career

"

was

much

troubled

with wicked

OG6

and

PRINCIPLES

PROPHYLAXIS.

AND

TREATMENT

OF

would

blasphemousthoughts,which

selves
force them-

myselfmost ardently
To such a degreewas
strugglingwith God in prayer.
that
I under the influence of these terrible suggestions,
when
they made an effort to rush to my lipsI was
obligedto put my hand to my mouth to prevent myself
I
So greatlyafflicted was
to them.
giving utterance
that

in this manner,

I fancied

when

mind

into my

consulted

venerable

Christian

these wicked
thoughts. He asked me
respecting
in any consecutive form,
whether
into my mind
theycame
I replied
that they came
or onlyby fits and starts.
quite
and had nothingconsecutive about them.
Oh,
suddenly,
then,'said my Christian friend, care nothingfor these
from ; treat them as
thoughts,I know where they come
in Old England we
used to treat vagrants,flogthem
and send them home to their parish.
well at the cart's tail,
These thoughts are
suggestedto your mind by Satan,
who
and
to lose this man,
likely
says to himself, I am
I will make
a
desperateeffort to keep him within my
well,and send them home.'
power." Flog them, I repeat,
I did,"continues Mr. Spurgeon,"what my dear Christian
counsellor advised,and conquered the enemy."
friend

'

'

"

The

of

power

self-control is, in

instances,

many

lost,by a voluntaryand criminal

altogether
in a train of thought which
the duty
it was
indulgence
of the individual,
battle
in i\\Qfirstinstance,
to resolutely

weakened,

or

with, control,and subdue.

insane

delusive

Tt may

not

obtain

be

Nervous

thoughts are
an

easy

thus

disorders
often

task to subdue

as

well

as

self-created.

morbid

tions,
sugges-

crush
feelings,

natural
ununhappy
inclinations,
destroyin their infancythe tyranny
of unhealthy impulses,keep in subjectionwicked,
The difficulty
of obtaining
vicious,and criminal tendencies.
mind may bo
such a dominion
the perturbed
over
and
insurmountable, nevertheless,
a .resolute
apparently

mastery over

668

PRINCIPLES

Our remedie*

"

Which
Gives
Our

us

PROPHYLAXIS.

oil in ourselves do lie,

ascribe to Heaven

we

"low

AND

TREATMENT

OF

the fated
backward

; only doth
designs,when we ourselves

free scope

are

sky
pull
dulL"

quasimorbid states of thought,or

rived
much
benefit is often deearlyscintillations of insanity,
of remedial medical
from the adoptionof a course
of invigotreatment.
rating
Happily we possess the means
the functions of the brain and nervous
system,and
and enfeebled efforts
therebygiving tone to the flagging
It would be most unwise, while struggling
of the will.
to keep in check unhealthythoughts,
to neglect
a careful
consideration
of the state of the bodilyhealth.
It will be impossible
for me
to enter,exceptin general
of incipient
terms, into a consideration of the treatment
paralysis,
apoplexy,softeningof the brain, and other
I
what
organiccerebral diseases,without anticipating
shall have
in reference to this important
to advance
work.
subjectin the succeeding
I am
convinced from the number
of cases
of incipient
under my
organicdisease of the brain which have come
of
be effected by means
observation,that much
may
treatment
in arresting
the progress of these encephalic
affections,
providedthey are brought at an earlyperiod
of their development within
the range
of remedial
In

of these

many

treatment.

The

abstraction of

small

quantityof

head, the administration of mercurial

attention

to the

state of the

functions,combined

with

blood from

the

alteratives,
a careful

secretions,skin, and renal

counter-irritation and

an

nence
absti-

from all mental

be

found

of

apoplexyand
with

will often
agitationand anxiety,
essential benefit in the incipient
stagesof
nected
paralysis.In a certain type of case con-

organicor functional disease of the heart, I

the local head symptoms by means
have,after relieving
Of

TREATMENT

OF

INCIPI1

NT

SOFTENING,

PARALYSIS,

ETC.

COO

dry),leeches and blisters,found great

and iodide
of opium,digitalis,
benefit from a combined
use
there is laborious action of the
of potassium. Where
valvular disease,
heart consequentupon hypertrophy
or
alleviates the
almost invariably
tin- precedingformula
cardiac as well as the head symptoms.
other types of incipient
There are
apoplexyand patreated by means
of tonics
ralvsis only to be successfully
I have observed well-marked
and stimulants.
symptoms
acute attacks of cerebral hemorrhage and
of apparently
to the administration of iron,
yieldspeedily
paraplegia
of zinc and copper. In
and various preparations
quinine,
wine and good nourishment
this ana?mic class of case
The pulseis generally
weak,
will also be indispensable.
and

cupping (wet

action of the heart feeble,and

the blood

deficient in red

nance
globules.This is indicated by the pallorof the counteThe patientcomand general
state of amumia.
plains
and nervous
of great muscular
sion.
depresdebility
Associated with the preceding
symptoms, I have
considered at the time
often observed signsof what was
indications of apoplexyand paralysis.
to be threatening
I am
of opinion that
In incipient
generalparalysis,
and
benefit is to be derived from a persevering
much

continuous

of tonic treatment.

course

In

this affection

necessary, whilst buildingup

conservinghis powers of life by means

the

it will often be found

and
patient,
zinc,cod-liver oil,"c., to applya
iron, quinine,

of

seton

or

nape of the neck.

observe toms
of this disease we
In cases
occasionally
sympFor the
of temporary congestionof the brain.

issue to the

arm

relief of this
or

two

marked

or

I
complication

leeches

to

benefit.

In

the
some

have

appliedone
generally

schneiderian

membrane

instances I have

of arsenic and copper

preparations
conditions of the
advantage.In depressed

various

with

exhibited the
with

apparent

cerebral force,

670

strychnine

be administered.

oil,may

cod-liver

and

of

doses

minute

with

combined
phosphorus,

PROPHYLAXIS.

AND

TREATMENT

OF

PRINCIPLES

of the brain, it
softening
incipient
will be necessary, in the majorityof cases, to give tonics
of
I am
satisfied of the possibility
and
stimulants.
the progress of
in the earlystagesof softening,
arresting,
of the treatment
the cerebral disorganization
by means
suggested.Much, however, will depend upon
previously
of

In the treatment

characteristics of

the

patientsit
onset
to

see

will

be

case

in this

individual

case.

In

some

at the first
necessary to apply,even
of the disease,if the physician
be fortunate enough
the

neck,

the

each

well

as

of the

formations

to

as

earlystage,counter-irritation to
use
dry-cupping. In particular

cranium, states of the heart and cerebral

the powers
vessels,it will be necessary, whilst sustaining
of life by the

to cautiously
agents specified,
therapeutic
of leeches.
relieve local head
But
symptoms by means
will rarely
be found
treatment
antiphlogistic
necessary.
I need
of tonic treatment,
not, whilst advisinga course

associated with

wine, "c., in

generous

diet,and

liberal use

of

of

incipientsofteningof the brain,

the patient
protecting
suggestthe importanceof carefully
from mental
labour, irritation,and anxiety. It will be
useless to grappleby means
of medicine
with this serious
cerebral disease,unless the mind is most scrupulously
served
prefrom

cases

undue

an

It will often

abroad,
view

of

be found
remote

removing him

to advise

and

to

or

sea

cerebral

exercise

or

strain of its powers.

desirable to send

patient

the

country,with the
all temptation to work, or
his state of general,
mental,

part
from

of

the

voyage after
health has been

well

analysedand

reme-

diallytreated.
I have

record the

of a number
of cases
particulars
of incipient
softeningof the brain which have been
cured by an
successfully
adoption of these remedial
on

INJURIOUS

It

iiu-ans.

vting

KFFKCTS

BLOWS

UPON

here
impossible

is

the

OF

treatment

of cerebral disease.

to

THF.

enter

of this most

071

HEAD.

into

details

importanttype

only,in this work, deal with

it presentsitself
as
general principles.Every case
and characteristic
to the physician
will exhibit peculiar
cation
morbid phenomena,requiring
a modifior
idiosyncrasies,
of treatment, medical, moral, and hygienic.
Do

estimate

we

in

can

commensurate

manner

with

its

of watching,
importancethe necessity
with the most
scrupulouscare, the cerebral symptoms
I am
that follow all mechanical
injuriesto the head?
of organic,
satisfied that a vast amount
chronic, and
grave

and

vital

incurable disease of the brain and

disorder of the

mind

traced to this cause.

directly
evidences of
and undoubted
In many
cases, positive
disease of the brain are
present without excitinga
to the cerebral originof the affection,
or
as
su"picion
A
receives a blow
character of the symptoms.
man
concussion
He may suffer from
partial
upon the head.
He
of the brain, or be merely stunned.
recovers
the injury,
from
without
any apparent inconveniences
head symptoms exhibit themselves,
but subsequently
the brain
of the injurywhich
clearlythe consequence
!
lias sustained many
years previously
satisfied that the importance of this subject
I am
cannot be exaggerated.
Repeatedlyhave I had cases of
epilepsybidding defiance to all treatment, tumours,
softeningof the brain, as well as
abscesses, cancer,
formidable types,under
in its more
care,
my
insanity
be traced back, for
\\liose origincould unquestionably
varyingperiodsof one, two, five,eight,ten, fifteen,and
even
twenty years, to damage done to the delicate
inflicted upon the head !
structure of the brain by injuries

can

be

In

some

followed

kind may not be

serious results; but in certain temperaments,

instances, accidents

by

of the

072

PRINCIPLES

OF

TREATMENT

AND

PROPHXLAXIS.

tions,
predisposibodilyhealth, and in particular
the developmentof chronic
we
predicate
may safely
blows on
disease of the brain as the result of neglected
to persons
of this character occurring
the head. Injuries
from
habit, or to those suffering
of a strumous
longdiseases,impairedand perverted
continued
debilitating
nutrition,overwrought and anxious minds, or inheriting
to mental or cerebral disease,are
a constitutional liability
followed by serious and often fatal results.
frequently
and
It is therefore highlynecessary to keep a vigilant
have
been
those who
watchful
exposed to
eye upon
of anticipating
if
accidents of this kind, with a view
of important
cerebral symptoms.
the development
possible
have
it in our
satisfied that we
I am
power, by timely
to arrest the progress of many
and judicious
measures,
from
of the organicaffections of the brain originating
if the patient's
condition immediately
mechanical
causes,
after the injurybe attended
to, the state of his cerebral
time
for a
health
regarded,the incipient
carefully
selves,
they present themsymptoms of brain disorder,when
and the patient
recognised,
immediatelysubjected
treatment.
to prompt and appropriate
Softeningof the brain, the formation of cerebral
abscesses,the slow growth of encephalic
tumours, subtle
tissue in the form of canof the nervous
cerous
degeneration
to the
growths (allthe remote effects of injuries
head) are, in my opinion,preventablediseases of the
jority
brain,if the unmistakeable warningsafforded in the maof their existence are not neglected,
of cases
cognised,
unreconditions of

and

untreated.

activelyengaged, apparentlyin
excellent health, in playingcricket.
He suddenlycomplained
of faintness ; he then began to vomit, and in
A post-mortem exafew seconds droppeddown
dead!
a
mination
being made, the brain revealed 4he existence
A

gentleman was

FROM

ABSCESSES

of

BLOWS

UPON

THE

073

HEAD.

chronic

encystedabscess that had emptieditselfinto

of the ventricles.
It appearedthat this gentleman
one
had been thrown
from his horse six years previously
concussion
whilst hunting,and had suffered from partial
of the brain. He quiterecovered from all the acute head
plained
symptoms, but two years after the accident he comof repeated
headaches, not, however, of a violent
a

These
of occasional loss of memory.
a character that he
symptoms, however, were of so trifling

character,
as well

as

did not consider it necessary to applyfor medical advice.

In this case how much
good might have been effected if
the cerebral

had

symptoms

been

recognised,

at this time

of the head he had

injury
sustained
tiro years previously? Judicious
treatment,
adopted at this earlyperiod,would, in all probability,
and

viewed

have

with the

in connexion

valuable life.

saved

man,

fell
aged fifty-two,

shipupon

He

the deck.

became

In

;me

work.
of any

his

in about

and
sensible,

habits, as

For
head

the
a

four years
symptoms.

well

as

the

mainyardof
of the

course

he
fortnight
this
He

to the cabin in

removed

was

state of unconsciousness.

from

day

he

able to

was

plained
com-

never

seaman

continued active in

in
intelligent

conversation.

his

aches
to headFive years after the accident he became
subject
of a severe, but paroxysmal
type. These attacks

coming
accompaniedby occasional acts of vomiting,
on
immediately after meals. At times he exhibited
treated for what
much
depressionof spirits.He was
and appeared
considered
to be a gastricaffection,
was
in
greatlyto improve; the headache was less severe
were

character,and became
;r

from

down

more

the accident the

the left side,and

increased violence.

It

was

In

intermittent.

the sixth

patientcomplainedof
the headache

ness
numb-

returned

still considered

with

that all his

x

074

PROPHYLAXIS.

AND

TREATMENT

OF

PRINCIPLES

disorder,
symptoms proceededfrom hepaticand gastric
for the relief of the cerebral
done
and
nothing was
symptoms beyond giving him occasional doses of blue
in
pill

In

and bitter infusions.

of the
this state

after death

received

boy

cricket

numbness

eightweeks

found

was

did

He

bat.

extract of

with

combination

rhubarb, mineral acids,

few months

he became

from

the ance
appearand died in
parayltic,

subsequently.An encystedabscess
in the left hemisphereof the brain.
violent blow
not

appear

to

head

from

veniences
suffer any inconeleven years afterwards,

injuryuntil ten or
when
he became
subjectto paroxysmalattacks
of headache, associated with extreme
of
vertigo,clearly
character.
He eventually
had a succession
an
epileptic
of severe
attacks of epilepsy,
which
continued
for a
died in a violent
period of five years. He ultimately
An
epileptic
encystedabscess,of the size of
paroxysm.
from

an

egg,

What

was

the

the

on

found

course

circumstances?

in the cerebellum.

of treatment
In

severe

would

blows

I advise under
upon

the

head

these
it is

important to keep in check all tendency to cerebral

congestionand inflammation in the portionof the brain
immediatelyunder the part of the scalpand skull that
has

been

injured.By closely
watchingfor local cerebral
disorder,we may preventthose states of chronic irritation,
induce
congestion,and inflammation that so frequently
"^r
in the form
of structure
disorganization
tumours,
In the "daysof Pott, venesecand
abscesses.
tion
softening,
almost universally
after the head had
was
practised
received a mechanical
injury. This mode of treatment
has, in modern
times, been altogetherexploded. In
the local abstraction
of blood by means
these cases
of
leeches appliedover, or in the immediate
neighbourhood
of the injuryis decidedly
advantageousin preventing
the developmentof organicalterations in the brain. It

G7G

PRINCIPLES

natc

of zinc, quinine,
iron, and
in

remedies

valuable

PROPHYLAXIS.

AND

TREATMENT

OP

these

blood

other

paired
instances of im-

In

cases.

tonics,are

associated with active head symptoms,

intelligence,
the belief that
headache, "c., such as to justify
vertigo,
local depletion
and
congestionexists,judicious
capillary

counter-irritation

much

of

often

are

The

service.

in
blood, however, is rarelynecessary
and yet I have known
these cerebro-psychical
affections,
of

abstraction

of
patientsto be greatlyrelieved by a modified course
doses
of strychnine
Minute
treatment.
antiphlogistic
indicated,and the various preparations
are
occasionally
of

arsenic,with

and

without

iron, and

of copper, I have found

to the brain and
mind, if

ammoniated

tion
solu-

afford considerable

to

tone

I
administered.
judiciously
value of arsenic and
of opinionthat the therapeutic
am
in the affections
not sufficiently
are
appreciated
copper
if associated
of the brain and nervous
system,particularly
with states of vital depression.
is susThe faculty
of attention, like that of memory,
ceptible
of being greatly
cultivated and strengthenedby
exercise of its powers.
Habits
and continuous
a regular
careless attention
of slovenlythought and
are
easily
contracted
combated.
not easily
once
formed, and when
effort to subjectthe attention
The
to the controlling

of

influences

will

the

all obstacles will vanish

determination
the

given

have

bringinto a
we
faculty. When

restive
"

"

for the

a hundred
object,

of
arduous

and

to conquer

Hamilton,

Sir W.

but
at first be difficult,
may
before a steadyand unrelaxed

our

thoughts.

first time,

other
Even

exertion,to break

force themselves

on

our

determination,or

turn," says
view

our

on

any

things still retain possession

when

loose from

previously
engrossedus,

jugation
state of sub-

we

are

able,by

the matters

an

which

which

every moment
when
consideration, even
a resolute
or

the attraction of

t^ienew

object,

ON

THE

CULTIVATION

lias smoothed
mind

OF

the way

THE

on

FACULTY

which

OF

we

are

C77

ATTENTION.

to

travel,stillthe

is

trusive
continually
perplexedby the glimmer of inand distracting
thoughts,which prevent it from
its view
placingthat which should exclusively
occupy
in the full clearness of an undivided
light. How
great
be the interests which
take in the
we
may
object,it will,however, only be fullyestablished
soever

when
favourite,

it has

been

fused into

new
as

integral
part
of the system of our
previousknowledge,and of our
established associations of thoughts,
and desires.
feelings,
But this can only be accomplished
by time and custom.
Our imaginationand our
to which
must
we
memory,
resort for materials

with

which

an

to illustrate and

enliven

and indeed
study,accord us their aid unwillingly,
onlyby compulsion. But if we are vigorousenough to
in spiteof obstacles,every step as we
pursue our course
our

new

advance

will be
and

animated

found

its

freedom
what

object,the

and

the mind

energetic,the

diminish, the attention

upon

easier

is

more

kindred

becomes

distractions

more

gradually

concentrated
exclusively
ideas flow with
greater

abundance, and afford

is suitable for illustration.

an

easier selection of

At

lengthour system
of thought harmonizes
with our
pursuit. The whole
historian,or
becomes, as it may
be, philosopher,
man
to
poet ; he lives only in the trains of thoughtrelating
this character.
and conseHe
quently
now
energisesfreely,
with pleasure,
for pleasureis the reflex of unforced
All that is produced in
and unimpeded energy.
bears the stamp of excellence and
this state of mind
perfection."*
I have yet to address myselfto the treatment, medical
In
and
moral, of impairment and loss of memory.
disease or irrisuch cases, clearly
the effect of physical
"

"Lecture*

p. 2o5.

on

Metaphysics,"by

Sir

W.

Hamilton,

Bart.

Vol. i.

673

PRINCIPLES

OP

tation established

in the

PROPHYLAXIS.

AND

TREATMENT

brain,

in

or

part of

some

the

body closelysympathisingwith this organ, no good will

result from an
attempt to strengthen or revivifythis
investigati
mental
apart from a careful pathological
power,
of the cerebral state of the patient,and the
adoptionof a mode of physicaland psychicaltreatment
In all acute affections
suggestedby such examination.
of the brain damaging the memory,
it is useless to battle
with
without
a
effect,
carefully
symptom^ to treat an
Great benefit occasionally
results
consideringthe came.
from

the exhibition

consequent upon

memory
of the
In

and

nerve

of stimulants

in certain
exhausted

an

paired
of im-

cases

condition

vital force.

less acute

of

conditions

defective memory,

vantage
ad-

from judiciousattempts on
undoubtedlyaccrues
the part of the patient to revivify
if
but
the faculty,
these efforts should be succeeded
the
(as is occasionally
headache, or other corporealsymptoms
case) by vertigo,

of distress,the mind
until the cerebral

should

be

condition

left in

is such

passivestate,

a repejustify
tition
of the experiment. It occasionally
that a
occurs
has been suddenlyrevived
language,
apparently
forgotten,
duringthe effort made to seize hold of and resuscitate
past impressions.When
making these efforts we should
be careful not to strain the faculty
beyond justifiable
limits. How
often the attempt to recall ideas to the

mind
brain

is abortive?
is

permittedto be

recur
frequently

permitted
to

remember

to

in

on

suggest, that

quiescentstate,the

to the mind

theorise

circumstances, if the

these

Under

to

as

spontaneously.If
I should
the subject,

the

movement,
psychicaloscillating
of the brain

conscious effort to resuscitate

thus

endeavour

past impressionsestablishes

vesicular neurine

ideas will

which

after

we

be inclined

made

cerebral

continues
cease

to

were

make

obliterated
apparently

to
and

in the
any
ideas.

STATE

OF

TIIK

AFTER

MINI)

AN

ATTACK

OF

079

INSANITY.

Is not this
How

fact ?
supported
by the following
hypothesis
does it happen that all attemptsto exercise
late at night to rest,
to retiring
previously

often

the memory
found to be
are

nugatory ;

but

vivid

how

and

life-like

state of brain
a
morning following
of cereamount
bral
activity,
consequentupon a satisfactory
and psychical
Impressionswhich we were
repose ?
not
conscious of effecting
to sleephave
doubtedly
unpreviously

the ideas in the

are

been
actions thus

or

made

induced

the oscillations

the mind, and

upon
in

the

vesicle have

nerve

tinued
con-

during the night,the mind being clearlyand

forcibly
impingedwith the ideas which we tried to stamp
evening.
upon it on the previous
During the stage of convalescence, and occasionally
I have
after recovery from attacks of insanity,
known
of thought,
patientscomplain of a distressing
rapidity
and of an acute sensitiveness to impressions,
physicalas
well

moral, which

as

anxietyof

mind.

have

There

caused
has

them

been

at times

of cerebral

want

great

quietude,of which the patienthas

repose and mental
been painfully
conscious.
The
tempest of the mind"
"

havingsubsided, has
of the

which

waves

only can
Dr.

care, and

to

his dreams,
the

had

restoration

and

time

refers to

maniac

who

had

been

recovered.
entirely

health,he

by the

same

slightruffle on
and an immunity

the

surface

from

ment
excite-

subdue.

Abercrombie

Gregory,of

left

same

was

related

case

time

some

For

week

by

Dr.

under

his

after his

harassed,particularly
during

rapidand

violent emotions

tumultuous

which

had

thoughts,
him
agitated

whilst insane.
A
to

who
patient,

be

months

an

exalted

imagined himself
duringhis insanity
personage,

told

after his recovery he never

his mind
of the idea of his

me,

that

could

for

some

possess
disentirely
having acquireda

6SO

AND

TREATMENT

OF

PRINCIPLES

PROPHYLAXIS.

degreeof social elevation. He had no belief in

his having obtained
regal distinction,for this delusion
I believed,"to use
no
longerexisted in his mind ; but
I was
than the
his own
a littlehigherin rank
words,
class I legitimately
belongedto."
there undoubtedly exists a cerebral
In these cases
certain

"

"

action

which
oscillation,

or

has

mind

of the

continues

restored.

been

after the

balance

It is

phenomena like
the stage of convalescence,perhaps,
these that render
of insanity.
the most critical one
to treat in cases
of the mind
There
is no faculty
of being
so
susceptible
and
improved by moderate
regularexercise as that of
It is said that Sir Isaac Newton, at one
period
memory.
of his life,entirely
forgotthe contents of his celebrated
in consequence
of his neglecting
to exercise
Principia,"
the memory.
Mr. Hude
The famous
spentseveral years
in close application
to conic sections.
Leibnitz,in returning
from his travels,called to see him, and expected
to have been highlyentertained by conversingwith him
the subjectof his studies.
on
Here," said Mr. Hude,
sighing, "look at this manuscript;I have forgotten
everything in it since I became
burgomaster of
"

"

Amsterdam."

opinion that the memory

strengthenedby repeatedefforts to fix certain
Lord

the mind;
wish
be

is of

Bacon

words, that

in other

to recollect is

an

if it

effort be made

reading.

"

Qua

disces,quam
rccitare et ubi

to

were

passage

read

more

et

ideas
which

on
we

to
likely

twentytimes, provided

recite the words

expectantur

attentionem

after each

excitant,

pratervolant. Hague si scnjjtinu

tarn facile illud memoriter
non
perlegeris,

melius ha rent quam

aliquodvicies

read ten, it is
carefully

than

remembered

if

is not

qua

legasdecies, tentando interim

librum"*
memoria, inspiciendo
dejicit

si illud

"

Nov.

Org." lib.ii.aph.26.

illud

HUSH'S

DR.

Dr. Rush

RULES

FOR

IMPKOMMJ

081

MEMORY.

THE

valuable rules for the

suggestssome

ment
treat-

The mental
impairmentand loss of memory.
should be, says
for loss or decay of memory
remedies
of what we wish to
this authority,
a
repetition
frequent
The benefits of this practice
remember.
are
strikingly
who
illustrated in the historyof a London
after
printer,
working seven years in composing the Bible, was able to
in it by
The
repeatevery chapterand verse
memory.
the memory
is
advantageof this mode of strengthening
whole sentences
in persons who
or
seen
repeatquestions
them.
that are proposedto them before they can answer
in such
The
door of the mind
people requirestwo
be opened,one
knocks
before it can
by the person who
the quesasks,and the other by the person who answers
tions
the mind
a double
simply,
requires
; or to speakmore
impressionfrom words before it is able to convert them
in the aid of two or more
into thoughts.Again, calling
of knowledge,is
of the senses
to assist in the retention
It is
of impaired memory.
found beneficial in cases
seldom
said that we
forgetwhat we have handled, or
of

"

tasted, seen
the

ears

or

the

memories

are

their

eyes

and

when

alone, with

an

audible
even

renderingthem audible
talkingto themselves.
same

it

hence

ears;

unable to remember

the low and

The

Where

assist the

and

ears,

vulgar,whose
to retain what
they
time
at the same
through
of reading,
their practice
In some
voice.
cases
they
their own
thoughtswithout

hence

chronic state of

cause.

eyes

and
Children
eyes.
alike weak, are unable

they receive

read unless

are

The

heard.

we

the

so

often

hear

them

thing is observed
from
partially
insanity,

the

both

be

same

the eyes and

ears

cannot

in

acquiringknowledge,the use of the ears

should be preferred.
Julius Cicsar says the reason
why the ancient Druids
their instructions to writingwas, that
did not commit
employed
"

in

G82

OF

PRINCIPLES

PROPHYLAXIS.

AND

TREATMENT

pupilsmight,by receivingthem through their

and more
durablyretain them
easily
acquire,
ears, more
The
is less apt to be distracted
in their memories.
ear
of surroundingobjects,
than the eye by the obtrusion
The mind,
constant than the other.
the one beingmore
in
concentrated in hearingthan
is more
moreover,
seeing. The truth of these remarks is confirmed by
few of the sayings
or songs learned by the ear
only,and
is
in the nursery, being ever
forgotten.The memory
improvedby exercise. Its low state among
savages is
of objects
occasioned by the small number
upon which
theyexercise it. The memory is aided in hearing and
In this way
after reading by shutting the eyes.
Mr. Woodfall
received and retained the speeches
of the
until he committed
members
of the British parliament
he publishedand forgot
them
to paper, after which
is restored and strengthened
The
them.
by
memory
circumstances which
of association.
The principal
means
of the mind
influence this operation
are
time, place,
habit,and interest.
pleasure,
pain,sounds, words, letters,
words
that have been forgotten,
Ideas, and even
are
often recalled by conversation
that are
subjects
upon
related to them.
This is effected by some
incidental
word
idea awakening,by association,
the word or
or
their

idea

we

Danish

wish

to revive in

Dr. Van

minds.

our

Rohr,

the year
1793, informed me that he could at any time excite the
remembrance
of words by committing
two or three lines
of

who
physician,

poetry to

visited

in
Philadelphia

Singingaids

memory.

the

memory

in

of words, and of the ideas connected

a knowledge
acquiring
with them.
A
song is alwayslearned sooner
than
*

and

the

number

same

I remember

havingseen,

insane
an
Mitivie*,

she
alwaysspeaking,

woman,

of

words

while six months

whose

ideas

did not associate two

not

set to

music.*

in the service of MM.

Pariset

incoherent that,though
capableof composinga
syllables

were

so

684

PROPHYLAXIS.

AND

TREATMENT

OF

PRINCIPLES

had his
his writings,to have
from
evidently,
wonderfullystored with an infinite varietyof
memory
had
apophthegms, and of historical passages which
and
to have been familiarly
impressedhis imagination,
but with the absurd
not only with the names,
acquainted,
and explodedopinionsof the ancient philosophers.
seems

several

In

that

cases

have

under

come

tion,
observa-

my

impairedin consequence
undue
an
strainingof the facultyin earlylife. I
into a condition
sank
a
saw
youth who eventually
dants
caused
(as was
allegedby medical attenimbecility,
of the patient's
and prolonged
family)by severe
the memory

of
once

of

exercise

become

has

of the

It is with

memory.
the memory

the amount
faculties,

should

with

as

of strain

the other

to which

intellectual

it is

subjected

equitablerelation to its condition of

normal
be manifestly
connate
or
vigour. It would
to the same
to subjectall memories
unphilosophical
degree of pressure, or to imagine that because a few
minds
and
are
capable of committing expeditiously
within
a
accuratelyto memory,
prescribedperiod,a
certain degreeof knowledge,that every intellect is competent,
with
similar task.
There
to execute
a
facility,
are
as
great differences in the mental as in the physical
absurd to deal
of children.
It is consequently
capacities
with

have

them

en

an

masse,

as

if the

machine, capable,without
the

same

amount

of

mind

human

scientific

sustained

were

discrimination, of

intellectual labour

rapid

It
progress.
element
in education

is

intellectual culture and

educational

mere

and

important
undoubtedly an
to carefully,
steadilyinvigorate,
and discipline
the memory
in earlylife,but in effecting
this most desirable object,
taking
it is our
duty to avoid misfor culpable
natural mental dulness
idleness,and
for criminal indifference to
organiccerebral incapacity
advancement.

I IFECTS

OP

UNDULY

STRAINING

THE

085

MEMORY.

When

effects of overstrainspeakingof the injurious

in earlylife it has been observed, the
ing the memory
is much
too hardly pressedby the
facultyof memory
schools.
It is a great temptation to a
practiceof some
clined,
inschoolmaster,who may be overworked
or
indolently
to have recourse
to long repetition
tasks,because
It keeps a whole
it economises
his own
time.
class
actively
employed,and costs him a very little time to
hear what
it has cost them a very long time, comparatively,
to learn. This is a very different thingfrom labouring
with boys,and patiently
solvingtheir difficulties.*
I am
that this exercise,
in its degree,
is
quiteaware
"

"

useful

very

that

to commit

in

to memory

passages

language conduces to a thorough acquaintancewith it,

and a power
of composing in it.
But this is carried
In that in which I
schools.
beyond all bounds in some
was
educated, it was the custom, once a year, that boys
in the middle
and lower classes should repeat all the
Latin and Greek
poetry they had learned in the year,
with such addition to it of fresh matter
each boy
as
did our
could accomplish. So much
placein the school
in this,and so severe
the rivalry,
was
depend on success
then only about fourteen years of
that althoughwe were
from
age, the usual quantityfor the boys to repeat was
did in eight difsix to eightthousand
ferent
lines, which
we
lessons,and

it took

about

week

to hear

One

us.

boy, in my year, construed and repeatedthe enormous

quantityof fourteen thousand lines of Homer, Horace,
and Virgil
dodged him
; I heard him
say it ; the master
missed a single
about very much, but he scarcely
ever
One

word.

have
possibly

could

"

Mental

the Rev.

in what
been

I do not think

Now

"

wonders

Vigour ;

iU

II. Fearon, B.D.

chamber

of the

brain it

stowed

away !
that this excessive strain

attainment

London,

impededby
1859.

on

the

Error* in Education,"by

6S6

PRINCIPLES

AND

TREATMENT

OF

PROPHYLAXIS.

strengthenit ; nor do I
other facultyought to be so
believe
that this or any
severelypressed. I have a livelyrecollection of the
after
exertion it required
how, week
;
long-sustained
and late took rest, in our
week, we rose early,
anxietyto
outstripothers, upon which our station in the school,
of us depended. This
and, I may say, the bread of many
custom
is,I hope,now,
thouglinot given up, modified.
Boys ought to be rather repressedthan encouraged in
facultyis calculated

mnemonic

such

trial.

minds

send

not

them
with

overweighted,and
in

are,

Do

such

an

excess,

rule, ought to be

to

not

directed

out

into the world

things which,

needed.

after all,

Education,

to what

more

with

as

elicits thought

what

than

Feats of repemerely encourages

tition
memory.
but poor offerings
to the goddess of wisdom
are
"*
renderingunto Minerva, as it were, only a lipservice.
I should
regret if, in the preceding observations, I
"

"

Children

made

are

to filltheir heads

with words,

or

are

severelypunished,

vating
stupid,because, instead of cultitheir masters
their reason,
to aim at fatiguingand
seem
weakening
of
their
Instead
children
over-exertions.
to contheir memory
sider
by
teaching
and examine
a
it,these masters
oblige
thing,in order to understand
it fifteen or twenty times with a view
them
to imprint it on
to pronounce
Boerhaave
their memory.
styledthis a piteousmode of instruction. Baron
Haller observes,that the truth of this is but too palpable,
because, instead of
enabling them to analyze a compound idea, and making them feel the
of the simple ideas it includes, they teach
them
value
due
only the
and words that express them, and thus add obstacle after obstacle
syllables
to the improvement of the understanding.
ledge
all the knowThis absurd method, which is so generallyadopted,makes
it ought to do, but
of children consist not in the understanding,as
This seems
in memory.
to be the reason
why so many young peoplewho have
diminutive
at school,make
shone
so
a
figurewhen they launch into the
with
As the chief objectof their studies was
world.
to load their memories
soon
understood, were
forgotten,so they find
things which, as they never
of
and
in
themselves
incapable
observingor judging,
generalof thinking,
for
been taught to think
in their younger
because
days they had never
and

by

these

become

means

dull,heavy,and

"

themselves.
"

Baron

Van

Swieten

rendered
dispositions
of their masters."

"

tells us

stupid,and
Zimmerman's

he has

of the most
promising
the
through
mismanagement
epileptic,
Experience in Physic.

even

seen

children

DUE

EXERCISE

the

to convoy

tin- benefit

OF

fcl

Til

impression that

to be derived

from

I.AUI.Y

IN

C87

1 IFE.

I estimated

lightly
persevering

steadyand
cultivation of the memory
in earlylife. It is,in every
pointof view, most essential that this facultyshould be
and invigorated
carefully
developed,disciplined,
during
the scholastic trainingwhich
most
boys intended for
the universities,and
for political
and prosubsequently
fessional
life,have to undergo. The knowledge then
acquiredis seldom if ever obliterated,except by disease,
from the mind.
mental

How

much

enjoyment in

of the pure,

which

we

vated
refined,and ele-

revel in
luxuriously
periodwhen we were

after years is to be traced to that

often
compelledto commit to memory,

as

task, but

more

curriculum of the school,

as a partof the regular
frequently
from
illustrious classical
long and brilliant passages
authors ?
Do we ever
bark is beiug
our
regret,when
tossed upon
of life,
the noisyand tempestuous ocean
having had to go through such an intellectual ordeal ? Is
thus stored with an imperishable
not the mind
knowledge
of passages

from

the

poets,orators, and historians

of

tiquity
an-

site
thoughts,profoundwisdom, exquiand magnanimous sentiments?

fullof elevated

imagery,noble
It would

be absurd

to undervalue

discipline
productiveof
are
My animadversions
well

exclusive cultivation, as
memory,
there are

I think

as
forgetting,

higher and

as

more

so

system

obvioun

many

directed
undue
we

exalted

tional
of educatages.
advan-

against the too

of the
strainitiff

sometimes
mental

do, that

faculties that

requireto
mind

be

before
expanded and fortified,
carefully

is fitted to enter

into the

great

arena

the

of life,and

in its many
battles,
to contend
successfully
qualified
and trials.
struggles,
I would
add reBefore concludingthis chapter,
briefly
myselfto the consideration of two important qiu"t
"

088

DOES

WHEN

connected
intimately

BEGIN

INTELLECT

THE

"

DECLINE

facts preinteresting
viously

with the very

discussed in this volume

TO

viz.:

period of lifedoes the intellect

particular
beginto decline,and when, as a generalrule,isfirstobserved
the commencement
of an insenescence of the intellectual
1. At

what

?
principle
often associated intU
of memory
2. Is great strength
with
and conjoined
limited powers ofjudgmentand reasoning,
?
a low order of intelligence
In old persons,"
says Cabanis, the feebleness of the
therein,
originate
brain, and of those functions which
the same
mobility,
givesto their determination the same
characteristic uncertaintywhich
they possess during
resemble
childhood ; in fact the two conditions
closely
versity
The Professor of Physiologyat the Unieach other."
Dr. Lordat, denies the truth of
of Montpelier,
and terms it a
this aphorism,
populardelusion." This
maintains
and philosopher
that it is
able physiologist
that is seen
to
the vital,not the intellectual principle
its autumnal
old age throws
wane
as
tinge over the
It is not true,"he says,
that
green foliageof life.
"

"

"

"

the

weaker

intellect becomes

"

after

the

vital

force has

quires
passed its culminatingpoint. The understandingacmore
strengthduring the first half of that period
It is impossible,"
is designated
old age.
which
he
as
at which
the
to assignany period of existence
says,
trations
illusreasoningpower suffers deterioration." Numerous
adduced for the purpose of establishing
that
are
is not isochronous
of the intelligence
with
senescence
"

that of the vital force.

of the celebrated composer, Cherubini,

is said to have been as brilliant as
at the age of eight}7,
Gosse composed
during the meridian of his existence.
The

conversation

Te Deum

at the age

seventy years

of age,

of

when
Corneille,
seventy-eight.
exhibited no
decay of intellect,

ILLUSTRATIONS

OF

VIGOUR

OP

MIND

IN

OLD

089

AGE.

judging from his poeticaddress to the king. M. des

Quensounniire's, the accomplished
poet,at the advanced
hundred
and sixteen, was
full of vivacity,
age of one
and fully
a
livelyand intelligent
capableof sustaining
M. Leroy,of Ilambouillet,at the age of
conversation.
one
hundred, composed a remarkably beautiful and
Abbe
Taublet, when
spiritedpoem.
speakingof the
intellect of Fontenelle
His

when

far advanced

intellectual faculties,
with

in

life,says,

the

of a slight
exception
their integrity
had preserved
defect of memory,
in spite
of corporeal
elevated,his
debility.His thoughtswere
finished,his answers
quick and to the point,
expressions
his reasoningpowers
accurate and profound." Cardinal
from
de Fleurywas
Prime
Minister of France
the age
of seventy to ninety. At the age of eightyFontenelle
the ground of physicalinfirmity,
asked permission,
on
the post of perpetualsecretaryof the
to retire from
Academy of Sciences. The prime minister refused the
Fontenelle
again
request. Three years subsequently,
You are an indolent,
expresseda wish to resignoffice.
but I suppose
we
lazyfellow," writes the Cardinal ;
must
Voltaire,
indulge such characters."
occasionally
to Paris,agreeably
when
at the age of eighty-four,
came
to his own
language, to seek a triumph and to fnd a
full
tomb."
Richelieu died at the age of ninety-three,
before his death, his
of mental vigour. A few minutes
wishingto encourage him, said, You
daughter-in-law,
"

"

"

"

"

would

wish

charming."
and full of
vivacity,

"What

not

are

so

ill

face been
Mr.
"

by

Dr.

converted

Waller

Vide

"

Lectures

Speen

you

is

countenance
utmost

as

into

for the

Mental

to

believe

!" said he, with

and

humour,

"

your
the

has

my

mirror?"*

wrote, when
on

wit

us

he

was

a poem,
past eighty,

Dynamics,"by Professor

Lordat

Translated

Journal.
Psychological
T

G90

entitled

"

Presage of

his old age

he refreshed

AGE.

Empire,
II. on his birthday."
delightof his youth,

presentedto his MajestyKing James

..."
Poetry had been the supreme
and

OLD

of the Turkish

Ruin

the

IN

MIND

OF

VIGOUR

OF

ILLUSTRATIONS

with

the

whatever

cordial

same

and

traces of

decay may
observation
in his later compositions,
yet Longinus's
appear
the
is justlyappliedto our
of Homer
poet,it was
Could
it be supposed that the
old age of Mr. Waller.
it cannot

be

he wrote

verses

that

denied

the

on

of Roscommon's

Earl

translation

Poetry were the compositionof a man

twelve
years beyond his grand climacteric ? for he was
then seventy-five.
Even
at this advanced
tinued
age, he conwith
to write
beauty and spirit.Not many
of Horace's

of

heaven, for which

towards

been

preparing.

written

And

though

fire,though with
as

crown

all his labours

in the

book,' which

natural

and

earlier

Divine

with

the poem,
be too

never

'

age,

evidently

Poems

were

elevation

same

little fainter

productions.

his

had

soul

after,yet the
a

can

his

became

as

in

flame, glows
He

intended

of the
much

last

to

verses

admired,

so

of
livelythe representation
does the author speakof its infirmities,
so
feelingly
all is so poetical
!"*
learned physicianand pious
a
Maplesoft was

divine.
of the

his

the

are

old age,

John

in

muse,

flighthis

and

at fourscore

them

was

his

after this, he turned

years

and

Art

He

born

was

Directors

chosen

benefactor
to

(where he

images, so

June

of Greenwich

President
both

eightyyears

of

to that

preach in
was

16, 1631.

also
of age

"

his

Sion

was

one

Hospital. In 1707,
College,having been

buildingand
church

He
.

library. He

of St. Laurence

he
a

tinued
con-

Jewry
Thursday lecturer)till he was past
and when
he thought of retiring,
j
BiographiaBritannica."

G92
of

ILLUSTRATIONS

VIGOUR

OF

seventy-five.After

declined
Of
meet

this
his

it

and

he
end

that
evident

was

MIND

OF

periodhis
had

he

himself

was

with

fully aware,
resignationand
doctrines

IN

OLD

AGE.

faculties
not

and

long to live.
prepared to

composure
of

rapidly

based

Christianity.
he signified
As the close of his life approached,
a fervent
Good
wish that he might expireon
Friday, and it is
singularthat he breathed his last on that day.
Jonson
died in 1637, aged sixty-three.He
Ben
his
death-bed, that exquisite
on
composed, literally
Sad Shepherd,"which
drama, the
fragmentof a pastoral
is
in beauty and freshness
of conceptionand
treatment
Sir Isaac Newton
the most
youthfulof all his works.
month
died in 1727, aged eighty-four.About
a
viously
preand
with
to his death he presided,
great ability
died
at the Royal Society. Locke
unimpaired intellect,
of his last comin 1704, aged seventy-three.Some
positions,
written
which
were
shortlybefore his death,
and
A
published with his posthumous papers, were,
with
Discourse
of
Notes
Miracles, and Paraphrases,
on
the Epistles
of St. Paul.
works
These
evidence no decadence
in his powerful intellect. Dr. Johnson
died in
He
1784, aged seventy-five.
publishedhis last work,
The Lives of the EnglishPoets," onlythree years before
his death.
His last hours were
employed in adjusting
his worldlyconcerns,
and exactness, as
with composure
who was
one
fullyconscious that he was soon to render
his last account
intellect was
His
to God.
powerful
and clear to the last.
Whilst
dying, he repeatedthe
Lord's Prayer in the Latin
language. Bacon died in
and retained to the last his love
1625, aged sixty-seven,
for science.
driving
Shortly before his death, he was
in the neighbourhood of High gate ; the day was
cold,
and the snow
lay on the ground. It had previously
upon

sincere

belief in the

"

"

NATIONS

1 1.1.tM

occurred

OF

that

to him

VIGOUR

OP

MIND

might

snow

of

IN

OLD

C93

AGE.

be used for the purpose

from putrefaction,
and

preservinganimal substances
determined to try the experiment,he descended
from
his carriage,
entered a cottage,and purchased a fowl,
which

with

doing

this

terminated

his
he

stuffed with

he
with

in

at

the

of

age

sudden
a

treatise

on

in

cold, which

seventy-two. During

1391, and

learned

snow

week.

up to the time
intellect in full vigour,he was

writinghis
of his

seized

was

died

his retirement
an

hands

after suffering
for
fatally

Chaucer

witli

own

the

of his death

employed

"Astrolabe"

in

for the

boy ten years old. Sir E. Coke died at

the advanced
He spent his last days
-two.
age of eighty
in full intellectual vigour in revisinghis numerous
works.
He
died repeatingwith his last breath, Thy
kingdom come.
Thy will be done."
Lord Eldon
died at the age of eighty-six.He
mained
rein the full enjoyment of his mental
powers until
shortlybefore his death, when althoughhis mind on the
whole
clear and
was
some
on
correct, yet he formed
subjectserroneous
impressions; and his pleasantry,
though it very visiblywaned, yet sparkledforth from
time to time so as to recal its former brilliancy.
Lord Kenyon died at the age of seventy.He retained
to the last his mental
Gratefullyexpressing,
powers.
with his last breath, his sense
he
of the many
blessings
had
enjoyed,and his resignationto the will of God.
Lord Hardwicke
died at the age of seventy-three.He
resignedthe Great Seal in 1754 ; but he stillcontinued
to serve
the public in a more
privatestation with an
unimpairedvigourof mind, which he enjoyedeven under
Lord Stowell died
until his death.
a long indisposition
at the advanced
was
vigorous
age of ninety. His mind
until within two years of his death.
Bolingbrokedied
We

son,

"

C94

ILLUSTRATIONS

at the

age of

to the

last.

OF

VIGOUR

OP

His

seventy-three.

MIND

IN

OLD

intellect

AGE.

powerful

was

publishedthe third edition of his

greatwork, the "Prindjria"in February or March, 1726,
with
a
new
prefaceby the author, dated January 12,
Sir Isaac Newton

1725-G, at the age of 83-4.*

illustrious Lord

The

Mansfield

eighty-ninein full and

intellect.
So completely,"
says

at the

advanced

vigour of
his noble biographer,
had he retained
his mental
faculties,that only a few
days before his last illness his niece,Lady Anne Laving,
in his hearingasked a gentleman what was
the meaning
of the word
psephismata,'in Mr. Burke's book on the
French
Revolution
? and the answer
being that it must
the old Westminster
be a misprint for
sophisinata,'
scholar said, No ; psephismata is right;'and he not
only explainedthe meaning of the word with critical
but
from
a
quoted ofi-hand
long passage
accuracy,
Demosthenes
to illustrate it. On the day of his death,
age

of

died

unclouded

"

"

'

'

'

in the year

1793, he desired to be taken up and carried to

his chair, but
he soon
wished
again to be in bed, and
said, Let
'

sleep!

me

"

expected that
followed

in

he

most

might
excitingscenes

have

addressed

the action

the

for

some

sleep!' It might have been

wandering of his thoughts which
let

have

me

conceived

of his
taunt

damages to

himself

past life,and
to

Lord

in

that

Chatham

be

some

he

of the

might

respecting

brought againstthe House of

Commons
Teuterden, he might have desired
; or, like Lord
the jury to consider
whether
the publication
and
the
inuendos were
proved on a trial for libel,cautioningthem
to leave the questionof libel or no-libel for the court. But
he never
On his return to bed he breathed
spoke more.
*

"

Brewster'a

Life of Sir I. Newton."

ILLUSTRATIONS

freelyand
serene

UP

OP

child, and

softlylike

MIND

IN

OLD

with

as

AGE.

695

calm

and

in his best health, though rently

appaHe
had
after void of consciousness

countenance

VIGOUR

ever

as

he had a visit
eighty-ninthyear. When
oft' a
broke
fr"nu Dr. Turton, his physician,he thus
discussion
of
-'Instead
respecting his symptoms:
dwelling on an old man's pulse,let me ask you, dear

entered

his

"

doctor, what
?'
know

Turton

Dr.

what

of this wonderful

think

you

'It

"

is

lordshipthinks

your
dear

men

"

for

more

than

the

figurein
politearts
and

twelve

annals

the

of

first flourished

found

incursions

centuries

of it.'

and

Vandals

of science

men

and graftedon
civilization,

of

nation, whose
and

system

improved

learned

centuries, have

retainingwhat

worth

so

sightof

lost

laws fit for

farragoof

fill the

mind

constitution
an

"

MAN,

protect and
broke

out

with
!

OLD

first

preserving,

once

sunk

into

or

stead
in-

getic
ener-

barity,
bar-

and brought forward

principles,
Botany Bay ! It is enough to
and

astonishment

abhorrence

constitution

survive

that

but

miracle

can

transmit

and

at

many

valuable, sound, and

was

constitution,have

in their

of

something

that

have

not

of

of

course

various

little code of laws,

hit upon
some
! Idiots ! who
sufficient to form one
principles

should
few

not, in the

best of

the

the descents and

respecting
territorial property : to think

should

like this

nation

sphere,
hemi-

barbarous

the

all systems,their laws

modifications

where

northern

cherished

the feudal

cuous
conspi-

nation

asylum against

an

of the Goths

and
philosophers

made

the

in

reasonable

nation, which

Europe ;

to

field
Mans-

Lord

two

has

lution
Revo-

material

more

Turton, how
can
My
?
think differently
the subject
on
'

French

like this may

nothing less than a
it down

succeeded

each

posterity.'Horrors
other even
more
rapidly
to

696

than

that, every
extinguishedin France, the

hear

the

news

the

now

whether

proceedto
there

of

lived to

XVI., the

Louis

scaffold

the

on

as

"*

great vigour of
powers

he

was

vestige of libertybeing
dating
inunEeign of Terror was

executed

king, was

he

as

blood, and

with

country

constitutional
malefactor.

old

anticipated
; and

lie had

JUDGMENT.

AND

MEMORY

BETWEEN

CONNEXION

is any

brief consideration

is often

memory

judgment,

in

truth

defective

reflective faculties

in

the

of the

question,

popular notion
with

associated

reasoning,and
other

that

limited
scribed
circum-

words, conjoined

intelligence.Do facts establish

beati memoria,
the axiom,
such an hypothesisor justify
expcctantcsjudicium?"
conclusions upon
If we
based our
a
priorireasoning,
examination
of the question,
we
might,upon a superficial
in the affirmative.
be disposedto answer
the interrogatory
The
is in its fundamental
facultyof memory
features an
The
automatic
or
involuntarypower.
mental
involved in the receptionof ideas is in.
process
itself a simpleand
ing
callelementaryone, not necessarily
into action
complex intellectual operations.
any
whilst it is in
The majorityof our
ideas enter the mind
mental effort is required
Little or no
a passivestate.
in order to
receive the myriads of impressions
grasp or
into the
that are
momentarily forcing an admission
with

low

of

order

"

mind.
of

It is true

that many

active state of the

an

those which

of

our

ideas

are

intelligence.Among

the result
such

are

designatesas ideas of reflection,as

Whilst
contradistinguishedfrom those of sensation.
endeavouring to comprehend a subtle and profoundly
is in the
the mind
philosophical
process of reasoning,
*

Locke

''Lives
Campbell's

of the Lord

Chief

Justices,"vol.

ii.p. 558.

CHARACTER

AUTOMATIC

highest state

of

OF

with
activity,

G97

MEMORY.

of

the view

seizinghold

and

in the argument imtlu" idi-as emhodied

mediately
retaining
suggestedto consciousness. In order to effect
this objecta great and
sustained
effort of thought is
and the more
standing
required,
importantfaculties of the underare
unavoidablycalled into active exercise. But
to reproducethe ideas so imbibed, a voluntary
act of the
mind, termed recollection or reminiscence, is only necessary,
to the
that is,supposingthe ideas do not occur
mind as a spontaneousact of suggestion.
It requiresno
obvious exercise of thought or severe
of reasoningto enable us
to recal to the mind,
course
when
once
thoroughly comprehended, the leading
in Paley's Evidences," Butler's
embodied
principles
Kant's
"Pure
or
"Analogy," Newton's
Priucipia,"
Heason."
a healthy
They are indelibly(presupposing
the
state of the brain and
intellect)impressed upon
"

"

mind

of

branches

every
of

consciousness

educated

literature,and

by an
the

conversant

man

are

easilymade

effort of the will.

these

with

objectsof

Considered

physically,
meta-

although a most important

is not one
of a high intellectual character.
How
faculty,
in this respect from
different is the memory
the more
and judgment !
exalted faculties of reason
understand
If my argument be tenable, we can
easily
that great vigour of memory
is not
the proposition,
associated with superior
necessarily
powers of judgment
active
an
or
strength of reasoningcapacity. Hence
co-exist with an intellect genestate of this faculty
may
rally
defective in its organization
; in other words, with
and imperfectly
but partially
a mind
developedin its
higher manifestations.
ordinary
Many facts have been cited to establish,that extrapowers

memory,

of memory

are

often

allied to

an

en-

COS

IDIOTS.

OF

MEMORY

THE

of

retention

limited

to

circumscribed

and

defective

most

their

for

of this

accuracy
?
the

Let

have

had
I

tenacity.
statement

consider

for

me

but

of very

men

of

guished
distin-

question the

not

what

strate
it demon-

does
the

moment

faculty

memories

do

most

reasoning and

of

powers

judgment

the

extent, and

remarkable

exhibited

have

Idiots

memories.

with

favoured

been

have

intellectual endowments

limited

but
possessing

Men
to imbecility.*
occasionally

retentive

faculties,
amounting

of the other mental

feebled condition

of

converse

precedingproposition.
Do

often

not

we

witness

order, great manifestations

reasoningand

mental

of intellectual

reflective

of

powers

ordinary
vigour,extra-

combined
faculties,

great strengthof memory?

Dr.

Johnson, the

character

no

one

of

remarkable
He

whose

intellect

for the

wonderful

read.

He

often

his

gave

he

intimate

with

gigantic
question,was

can

of

accuracy

forgotanything that

never

high

had

his

seen,

friends

memory.

heard,

or

of

evidence

his wonderful

Burke, of

great
his

capacityof retainingknowledge. Edmund

transcendent
genius,was also noted for having

History of

"

author

Clarendon, celebrated

of retention.

powers

of the

"

Rebellion," Gibbon,

the

Decline

and

Fall," Locke,

the

immortal

the

celebrated

tinguishe
all dis-

metaphysician,and Archbishop Tillotson, were

for having great strengthof memory.

alludingto
"

For

subject,Sir

this

intellectual power

Hamilton

highest order

When

observes,
none

were

in my
father's
Henry Fearon, a man
who
could
remember
when
had
buried
the
been
in
parish
day
every
person
the parish for thirty-five
unvarying accuracy the
years, and could repeat with
name

"

There

of the

W.

for

and

age

was," says

of the

the

Rev.

deceased, and

"

the

mourners

Out
a complete fool.
give an intelligible
replyto a singlequestion,nor
himself."
Mental
Vigour," "c.)
(On

at

of the line of burials he had

was

"

"

the funeral.
not

one

be trusted

But

idea,could
even

to

he
not

feed

700

KIND

with.

memory

shaken

It

with

and

now,

age

to be

wont

was

referred to
previously
of two
important conclusions
vigorous condition of the mental
:

with

old age.

2. That

exercise of the
of

mental

mind

mental
In
am

what
the

subjectI

the

moral

well

as

entrusted

with

and

compatible

often

and

laborious

subjectwill be still
myself to the effects

this

to be

under

had

of the mind

precedingpages,

the

detailed reference

to

importantsection

of

I allude

to

an

the

upon

consideration.

as
incipient
types of insanity,
duties devolvingupon those legally
special

of

treatment

to the

least

active

an

faculties is

I address

conceive

have

cannot

exercise
or
straining
and bodilyhealth.
over
glancingretrospectively
of having omitted
conscious
may

but

only consistent with a state

is apparentlyproductive of

but

health,

many

That

undue

an

the

is not

further considered, when

"

but

me,

at
susceptible

are

continuous

longevity.
In the succeedingvolume
of

faithful to

(which weakens

slofh

facts

chargemy

to

performsomewhat

it may
strongestabilities),
promise much."

The

liked

I have

selected friends which

some

INSANE.

THE

OF

TREATMENT

the

medical, mental, and

social management

of the insane.
I

for

designedlydefer

expositionof

my

views

on

another
the

work

first

any

part

detailed

of this

ject.
sub-

the
latter important topic
on
My sentiments
are
fullyexpressed in a Presidential address I had the
honour
of the
of deliveringto a
section
profession
connected
with
of
the management
officially
public
and
sane,
of the inprivateinstitutions for the treatment
and
I quote the
from
that discourse
subjoined

passage
How

:"

noble

is the

studyin

which

the

psychological

DUTIKS

OF

Til)

is engaged !
physician

I-"1"

HOLOOICAL

How

devolve

him ! How
upon
!
Is it possible
to
position
his

701

PHYSICIAN

important the duties that

is his
solemnlyresponsible
exaggerate or

over-estimate

character, influence, importance, usefulness, and

knowledge of
is* required before the
the mind
in its normal
state
to investigate,
unravel,
physicianis fitted successfully
and
treat
remediallyits deviations from a healthy
be his acquaintance
intimate must
with
standard ! How
and
with
the nature
the phenomena of thought,and
! How
should be his
exact
operationsof the passions
faculties before
notions of the instinctive and perceptive
to appreciate
he is fully
subtle,morbid, psychical
qualified
dignity!

What

conditions

profound and

accurate

physicianshould entertain right notions of his

should encourage
elevated,lofty
duty and position
; he
of his honourable
tion
vocathoughtsand grand conceptions
and emphatically
earnestly,
impressrepeatedly,
; he should
The

upon

his

own

as

well

as

upon

the minds

of all

fact,that
holy work the significant
engaged in the same
they are occupiedin the studyand treatment of a class of
the very source,
diseases affecting
spring,and fountain
in its healthyoperationsalone
which
of that principle
that the
can
bring them into remote proximityto DEITY
part of man's
physicianhas to deal with the spiritual
complex nature, with that which elevates him in the
scale of created excellences,and
placeshim high on
wise of this
the great,good,and
the pedestalamong
his solemn
functions expand in interest,
But
world.
he reflects that it
as
grandeur,and importance,
gravity,
MIND
i" HUMAN
perverted,and often crushed
prostrated,
physicianhas to
by disease with which the practical
class of the
deal ; that he has placed under
care
our
a
aillicted human
family,reduced by the inscrutable de"

702

TREATMENT

KIND

to which
position
duty to witness
and to sigh over
Like

over

humiliatingand helpless
being can fall; that it is his

sad wreck

the
the

INSANE.

most

rational

the historian

sad heart
the

to the

of Providence

crees

THE

OF

of

great and

noble

minds,

decay of exalted genius.

and antiquarianwandering with

ground made

story of great men,

and

classical

and

in the annals

surveying with painfulinterest

ancient
temples, viewing with

the

memorable
of heroic

emotion

in

deeds,

crumbling ruins

subdued

of
the

extinguishedremains of proud imperialcities,

consecrated
renowned
in the world's
by the geniusof men
and
historyas statesmen, scholars,artists,philosophers,
poets, so it is the duty of the mental
physicianto
wander
through the sad ruins of still greater temples
than any that were
in ancient days raised to the honour
DEITY.
It is his distressing
of an unseen
province to
witness
standings,
great and good intellects,proud elevated underlevelled to the earth, crumbling like dust in
almost

the balance, under

Survey
room,

with

that

old

the

dire influence of disease.

man

his face buried

crouched

in the

in his hands.

He

of the

corner

is indifferent

to all that is

passingaround him ; he heeds not the voice

he delightsnot
in the carolling
of man
of
or
woman
;
birds or in the sweet music of the rippling
brooks.
The
gentlewind of heaven, playingits sweetest melody as it
rushes through the greenwood,awakens
to his mind
no
consciousness of nature's charms.
Speak to him in terms
of endearment
and affection ; bring before him the glowing
and
impassionedimages of the past. He elevates
and mechanically
at you,
makes
himself, gazes listlessly
and, dropping his poor head, buries it in his
no
sign,'
choly
bosom, and sinks into his former state of moody melanman's
This
abstraction.
the
oratory charmed
in a
senate ; the magic of his eloquenceheld thousands
'

OK

DUTIK8

state

PfQPDl

Mil

of breathless

\I

admiration

I'll Vs|"

his influence

70S

I \ \.

was

manding,
com-

and judgment eminentlyacute and

sagacity
profound. View him as he is fallen from his high and
honourable
estate ! Listen to the sweet and gentlevoice
whose
head
of yonder woman,
scarcelyeighteen
upon
and influence.
shed their genialwarmth
have
suns
summer
How
merrilyshe dances over the greensward !
in her delirium,
How
touchinglyshe warbles,like Ophelia,
of a sweet
snatches of song ! What
a pitiful
spectacle
mind
lying in beautiful fragments before us ! Look !
she
she has decked herself with a springgarland. Now
with
holds herself perfectly
erect, and walks
queenly
majesty. Approach and accost her ; she exclaims, Yes,
he will come
promised to be here ; where are the
; he
guests?where's the ring? where's my wedding dress
is overblossoms?"
shadowed,
Suddenly her mind
orange
my
and her face assumes
an
expressionof deep,
sobs and
choking and bitter anguish she alternately
laughs is gay and sad, cheerful and melancholy
his

"

"

"

"

"

"

Thought
She

and

affliction,
passion,hell itself,
and

to favour

turns

to

prettineaa."

Speak again to her, and another change takes placein

Like her sad prototype,the
of her dream.
the spirit
immortal
sweetest creation of Shakspeare's
genius,she
sings
plaintively
"

"

He

is dead
He

"

At

and

is dead

his head
At

gone,

and
a

gone

green

hit heels

lady,
;

gnuw

turf,

stone."

historyis soon told. Deep and absorbingpassion,

elevated hopes,bright,sunny, and fanciful dreams of the
sad and
with all its fictitious trappings,
DEATH
future
seared affections,
broken
a
solemn
mockery of woe
Her

"

"

heart, and

disordered brain !

704
The

cited

illustrations I have

two

truthful outlines of

type

of

INSANE.

THE

OF

TREATMENT

KIND

case

that

faithful and

are

have

must

come

of
engaged in the treatment
like these tear
the
How
the insane.
keenly cases
heartstringsasunder and call into active operationall
nature.
the kindly sympathiesof our
allow his mind
too frequently
The physiciancannot
sanity
the peculiar
state of those reduced by into dwell upon
of ntter and
childish helplessness,
to a condition
the psychical
functions
In other classes of disease,in which
under

the

notice of those

of the brain
most

those

around

him

"

the exhibition

of tender

sympathy

and

attention

bestowed

the

care

and

the
recognises

Alas

! how

many

and

acute

his actual relations with

estimates

while

tress,
agonizingpain,bodilydisis in a state to appreciate
physicalprostration,

the
suffering
and

intact,the invalid,even

remain

he
upon

skill of his faithful medical

different

of the insane

"

he feels

are

the

feelingsand

sitively
sen-

properly
his case,

adviser.

thoughts

of

! In this class of affections the kindness,

and attention
sympathy, skill,unremittingassiduity,
festly
often not outwardlyor maniof the physicianare
appreciated.He has, in many cases, to pursue his
holy work without the exhibition of the slightest
apparent
of his
consciousness, on the part of the patient,
his anguish and mitigatehis condition
efforts to assuage
of mental disease and bodilysuffering.
Nevertheless, it is
the case,
his sacred duty,even
where, as is occasionally
and
his actions
are
pervertedby
greatlymisconstrued
to unflaggingly
those to whose relief he is administering,

persevere in his

This
most

curative

process

unhappy invalid may believe

his physicianis acting the part of a bitter foe.
ought not to excite any feelingbut that of the
profoundlove and sympathy. If the patient's

of treatment.
that

efforts to carry out

The

poor,

DUTIES

OF

languagebe
any

acts

of

THE

PSYCHOLOGICAL

offensive and
violence

should
him, the physician

of the tart, that

repulsiveif
"

towards

those

never

705

PHYSICIAN.

for

be

he

guiltyof

in attendance
a

upon

lose

sight
degree,

moment

the

unhappy affliction has, to a

1 -troyedthe patient's
free will, and that he, for a
time, has ceased to be a responsible
being. It would
"

be cruel,whilst such

him

as

condition

of mind

exists,to treat

deprivedby disease of
the power of completeself-government
and moral control.
Let me
and affectionately
earnestly
urge upon all
engaged in the treatment of the insane, the importance
of never
losingsightof the fact,that even in the worst
salient and bright
types of mental disease there are some
spots upon which the physicianmay act, and against
which may
be directed his most potentcurative agents.
otherwise

How

true it is
"

than

person

that,

There

is some

Would

The

men

soul of

goodnessin thing*evil,

distil it out."
observingly

curable
formidable, apparentlyhopelessand intypes of mental derangement admit, if not of

more

cure,

at least of considerable

alleviation and

It is

alwaysin

add
materially

and

our

to

power

social comforts

of

even

the worst

mitigation.
to

the

sical
phy-

class of insane

of materially
undoubtedlypossess the means
re-establish the
modifying(ifwe cannot entirely
unfavourable and distressing
the more
mental
equilibrium)
lent
forms of insanity,
renderingthe violent and turbuthe dangerous
to discipline,
tractable and amenable
in their habits,
the dirty
harmless, the noisyquiet,
cleanly
and the melancholyto an extent, cheerful and happy.
It is possible,
by a careful studyof the bodilyand mental
of each individual case, and by an
mitting
unreidiosyncrasies
attention to dietetic and hygienicregimen,as
and assiduous admiwell as by a persevering,
unflagging,

patients. We

700

KIND

nistration

INSANE.

THE

moral

and

physical

of

OF

TREATMENT

for

remedies

their

relief,

to
Pluck

"

The

spirit

the

from

the

in
is

responsible

special

the

What
that

in

ache

he

Angelic

spirits

exalted

pleasures
love,

and

with

and

has

air,

might

the

well

incidental

charity.

Christian

in

of

action
of

silken

and

and

the

envy
to

him
his

those

gaged
en-

[insane.

It

physician

to

words."

sacred

privilege

should

thread,
with

agony

volence,
bene-

affection

psychological

honourable,

holy,

which

madness

strong

Charm

the

"c.

warm

treatment

of

province

Fetter

"

and

look,

thought,

every

sorrow,"

sympathy,

kindness,

unwearying
influence

rooted

tender

love,

of

memory

of

is

occupation
being

the
mission

engaged

ennobling
of

and

lence,
benevo-

708

INDEX.

the

Aphorisms of Hippocrates,1
Apoplexy,

amneaia

often

371

of,by Sir Walter Scott, 263

anticipation
case
of,preceded by sensation of cold,

cultivation of the facultyof, in

334
of women,

the education

the prelude to,

Aspasia, dream of, 613

Aura-epileptica,483, 486, 541
Autobiography of the insane, 47

549
connexion

B.

between, and cardiac disease,

BACON, Lord,

623
and
corpora striata found rough
in a person who died of, 623

effect of, on

the memory,

Life and

jagged

405

on

memory,

on

the

extract

from

"

History of

Death," by, 441

680

mists,
perseveringefforts of the alche436

illusions premonitory of, 307

of impaired
Baillie,Dr., curious case
incipientsymptoms
lated
583
produced by paralysis,rememory
by the late, 412
of, related by Dr.
interestiugcase
Baillie,Joanna, invocation of madness
Watson, 506
panying
accomby, 233
Itard, Dr., on loss of memory
of sudden
attacks of, 362
Banks, Sir Joseph, case
lysis
pararelated
of
related
of
by, 401
loss
by
speech after,case
memory
Dr. Cooke, 412
Bathing,Juvenal on the danger of,after a
full meal, 384
morbid speech following,521
preceded by great depressionof spirits, Bean, M., on premonitory symptoms of
302
epilepsy,484
293
Beddoes,
Dr., case of morbid misuse of
signsof,
premonitory
words
related by, 511
softeningof the brain,causing,639
the localization of
state of mental
Belhomme, M., on
excitement,precursory
497
293
speech,
of,
vertigo frequently the forerunner of, Bell,Sir Charles,on phenomena resulting
from injurydone to the brain, 16
539
of insanity,
in the treatment
Belladonna
vitiated perception,
precursory
tom
symp-

of,326, 473, 547,

of, 584

663

incipient,668, 669
impaired
Arago, singular temporary
vision of, 584
of Autipheron, related by,
case
Aristotle,
treatment

of

588
on

association of ideas,450

on

memory

in

youth

Articulation,imitative

and

age,

movements

427

of,531

Bennett, Dr., on the connexion between

apoplexy and cardiac disease, 624
between
Bertin, Dr., on the connexion
624
and
cardiac
disease,
apoplexy
Birkett,Dr., case of singularirregularity
of vision related by, 582
Blood, clot of, found in the corpora
striata

of

person

who

died

of

apoplexy, 294
Paget, Mr., on the assimilative power
of the, 432
in the treatment
Arsenic
of affections of
Boerhaave, insomnia of, 604
the brain,676
fected
of, temporarilyafBonaparte, memory
the retreat from Moscow, 4 00
at
on
Atkinson, an idiot tried for murder
the York Assizes in 1858, 217
Borgia,Caesar,descriptionof the madness
pairment
Attention,Abercrombie, Dr., on the imof,by Nathaniel Lee, 275
of the facultyof, 347
Bouillard,Dr., on the connexion between
Chalmers, Dr., on, 334
apoplexy and cardiac disease,624
of morbid
exaltation
genius nothing hut continued,333
Brachet, Dr., case
of vision related by, 577
Hamilton, Sir W., on, 676
from disease of the, 571
Brain, amaurosis
heightened and concentrated,340
amnesia indicatingprecedingdisorders
impairment of, 335
of the, 872
importance of the facultyof, 333
morbid concentration of, 34 1
anaemic condition of the, 21
morbid effect of concentrated, 345
Andral, on the lesions of intelligence
morbid phenomena of, 332, 336
which precede or accompany
diseases
in impairment of, 676
of the, 329
treatment
anterior lobes of, supposed to preside
opinion of Buffon, Cuvier, and Lord
the organ of speech, 497
stituted
over
Chesterfield,that genius is conby continued applicationof,
Bell,Sir C., on phenomena resulting
333
from injury done to the, 16
sufficient importance not attached
of obscure disease of the, 355
to
case
involuntary,532
irregularaction of the, 504
morbid, 509

709

IMHA.

Bruin, diagnosisof softeningof the,651

disease,insidious case of, 383
diMMe

of

thf, indicated

by

IOM

Butler,Bishop,his strugglesagainsthorrible
morbid suggestions,
230

of

377

memory,

duubl"

vision
the,569

"

C.
of disease of

symptom

of the, 471
earlysignsof softening
effect*of diseased,
on
character,193
bypencmia of the, 370
of the, 543
hjpenettbesia
illusions

premonitory of

disease

of

CALVAKIUM, induration of the, 328

Carpenter,
Dr., on disordered nutrition of
the brain, 446
Catlin,Mr., on the self-imposed
tortures
of the Mandan
Indians,557
Cephalalgia,
apoplexy preceded by, 544
cerebral,confounded

the, 311

impaired nutrition of the, 331

of
impairment of memory,
a
symptom
disease of the, 889
of softening of
incipientsymptoms
the, 326
is the mind situated in the, 435
latent disease of the, 1 1
VI. strength
of Po;" Clement
memory
-"' ened after he had
received a slight
concussion of the, 457
muscular
tremors
ease
symptomatic of dis-

of

the, 475

in connexion
memory
of the, 393

with

disease

photopsi* an

of
incipient symptom
disease of the, 585
of the, 15
physiology
softeningof the, 323
softeningof the,causingapoplexy,639
acute

softeningof the,frequentlyfollowed by
637
apoplexyand beiniplegia,
subtle case
of softeningof the, 327
Tudd, Dr., his instructions for the
detection of urea
in
the, after
death, 610

watery"

case

of,related by Dr. Seymour,

631
Bricrrode

Boismont, Dr., case of aphonia

related by, 533
of softeningof the brain related
case
by, 323
eases

of aberration

of

mind

related

by, 320
remarks

upon

in earlylifeby,
insanity

162

Bright, Dr., case

on

other

types

diagnosisof,655, 656, 657, 658

from cerebral lesion,
544
in connexion
544

of morbid

described by, 600

the connexion between

articulation

apoplexyand

with abscess in the brain,

,,

cerebral affections,
544
chronic otorrtuea,
544

,,

560
dyspepsia,

,,

softeningof the brain,544

meningitisand cerebritis accompanied
by, 645
neuralgicand rheumatic,657
,,

of

neglecteddisease of the, 13
Oaborn, Dr., on loss of speech and

"

with

of headache, 654

central cerebral amauronis, 568

of
paralysis

after

memory

ail

attack

of, 880
ratio of, accompanying inter-cranial
disease, according to Dr. Abercrombie, 555
symptomatic of cerebral tumours, 544,
657
Cerebral

abscess,loss
by, 499

of speech caused

abscesses and tumours,

653

amaurosis, earlysignsof,567
and heart disease, 625

of,640
diagnosis,general principles
disease, importanceof early detection
of, 573
disease,sensations symptomaticof,559

headache, 545
headache,diagnosisof,655
localisation of

speech,497

ment,
of, treatgeneralprinciples
pathology,
and prophylaxis,628
of speech,505
physiology
nausea
symptomaticof,539
tumours,
611
of
rertigo,
type
insanity
Cerebritis, distinction between
and, 645
psychicalexaltation,premonitoryof,
293

835
Chalmers, the Rer. Dr., on attention,
of
of disordered Chambers, Dr. T. K., singular ease
case
413
related
of
395
defect
by,
reported
by,
memory
memory
Brown, Rev. 8., insanityof,260
Chesterfield,
Lord, on genius,333
Browue, Dr., on the anasthesia of the
Cbeyne, Dr., case of apoplexy preceded
insane,554
by unusual appearances in luminous
Brutality,inotireless acU of,209
bodies,related by, 584
thought
Huflon on genius,333
insidious adrances of morbid
in a patientof, 233
484
Burrows, Dr., on epilepsy,
tin-connexion
between apoplexyand
on
on
premonitory symptoms of epilepsy,
cardiac disease,624
484
cardiac disease,624
Brodie, Sir B., remarkable

710

INDEX.

161
Children,insanity
Corpora quadrigemina, effect of pressure
among,
165
statisticsof insanityamong,
upon the, 16
tumour
pressingupon the, 569
Chilton,Samuel, case of,461
with the, 537
tumours
interfering
Chloroform,effect of,on the mind, 195
effect
of tumours
to
Corpora restiformia,
great temporary prominence given
with the, 537
insane illusions by, 279
interfering
treatment
Corpora striata, clot of blood found in
by, 663
the, after death, 294
Chorea, psychical,37
of
disease
of
conditions
motility,
of, attended with little or no
perverted
type
468
pain, 544
found rough and jagged in a person
morbid phenomena of, 623
Circulation,
who died of apoplexy, 623
his
mind
of
while
Clarke, Dr., state
Corpus callosum, softeningof the, 544
drowning, described by, 442
Cowper, hypochondriasisof, 210
by,
Claudius,Emperor, loss of memory
645
from intemperance,373
Crawford, Dr , on cephalalgia,
of diseases
Cod-liver oil in the treatment
Crichton, Dr., curious case of misplacement
of words related by 507
of the brain,375, 378, 669
piled
Cruden, Alexander, Concordance of,comColeridge,curious case of knowledge of
whilst insane,275
languages caused by fever,related
Cunning of the insane, 271, 283
by, 447
view of madness by, 234
Cuvier on genius,333
Combe, Mr., case of perverted memory
D.
related by, 418
DARWIN, Dr., shower bath recommended
Condillac,Abbe de, on reverie,338
376
Confessions of a physician,
of
by, in cases of loss of memory,
account
an
his own
Death, curious phenomena manifested at,
case, 144
443
of patients,after recoveringfrom insanity,
47
Debility,generalmuscular, 470
Delirium tremens, 642
of the Rev. Mr. Walford, 146, 155
643
Conium
distinction between, and insanity,
in the treatment
of insanity,
663
Delusion of the mind
of the, 547
incipientsymptom
Conjunctiva,insensibility
of acute affection of the eucephalou,
flicted
inConscience, Juvenal
on
vengeance
307
by, 289
of
painful case
impelledto suicide by latent,
insanity caused by
person
300
guilty,289
Dementia, Juvenal on, 367
unceasing tortures of a wicked and
sia
anaestheDemoniacal possession,
cutaneous
perturbed,288
of
considered
of,547
a
formerly
sign
case
420
Consciousness,
divided,
latent idea suddenly recalled to, 463
heart,
Depravity,natural,of the human
256
of insanity,
Horace on the,228
Depression,mental, difficult to diagnose
Shakspeareon the, 228
,,
existence of, 299
stage of,225
morbid imaginative,339
mental, necessityof vigilancein stage
Contemplation,
Cooke, Dr., case of apoplexy related by,
of,300
473
stage of general,299
of apoplexy,preceded by sensation
case
Deuteroscopiasign of brain disease,588
of cold,related by, 549
Diagnosis between cerebral and spinal
469
of loss of speech after apoplexy
case
paralysis,
related by, 412
generalprinciplesof cerebral,640
of cerebral headache, 655
of epilepsy related
premonitory symptom
difficult,
of existence of mental depression
by, 487
299
of the
Coombe, Dr., on the investigation
641
of insanity,
nature of insanity,
observations by,
170
of insanity,Dr. Coombe
on, 170
morbid
of softeningof the brain,651
of muscular,
Co-ordination,
want
psychicaldefect of,477
Digestionand assimilation,618
in treatment
of insanity,663
Copland, Dr., case of aphonia related
Digitalis,
by, 515
Diplopia,symptomatic of obscure disease
of the brain,474
on
cephalalgiaof centric cerebral
568
amaurosis,
Disease,case of obscure brain, 355
on
the connexion between apoplexy and
importanceof earlydetection of cerebral,
cardiac disease,624
573
insidious case of brain,JJ83
disease in the, 500
Corporaoltvaria,

711

INDEX.

Disease,mental. p"cnlUrtype of, 277

of brain,indicated by Ion of memory,

Rlliotson,
Dr.,case of auricular bypenMthesia by, 594
877
Sir W., on earlytreatment
of inEllis,
with
of the corpora striata,attended
sanity,19
littleor no |"ain,
644
Encephalon,affections of the, consequent
sensations symptomatic of cerebral,
544
upon chronic otorrhoea,

incipient
symptoms

"59

864
Disorder*,acute, of the memory,
of the brain,amnesia preceding,
372
""f the perceptivefaculties,
805
Disraeli on
morbid
tion,
imaginativemedita88V

Distraction,
morbid, 837
morbid, case of,349
Divided consciousness,
case
of, 420
Double personality,
remarkable
case

of,

419

Draper,Dr., on

impressions made

upon

material substances,451

Dream, insanitycommencing

in a, 615
of Abin Zoar, the physician,613
of Aspasia, 613
of Count Lavalette,41

of

weakness

of memory
of the, 869

Ennui, analysisof,27
ported
Ephemerides Curium, singularcase rein,404
Epilepsynfter a dream, 486
483
aura
epileptic*,
case
of,by Dr. Schenck, 487
case
of,by Professor Kolk, 503
cases
of,by Dr. Audree, 488
convulsive action connected with, 478
the
caused
head,
by blows
upon
671

epilepsiacursiva,488

of a patientof Galen's,613
de Villeueuve,
613
of Roger d'Oxteyn, 613
of the woman
spokenof by Gunther,

613,
after

616
frightful,

Dreaming,morbid phenomena of,611

morbid, precedinginsanity,613
Dreams, difficult mathematical
problems
solved in, 89

Hippocrates on, 613

Morel, Dr., on morbid phenomena of, 614
of mental action occurringin, 11
rapidity
of enlargement of the
Drelincour, case
pinealgland,569
phenomena
Drowning, curious mental
caused by, 441
state of mind of Dr. Clarke while, 442
divided into three
Dubois,hypochondrias!*
stages by, 840
of
CMS
Dupuytren, Baron, remarkable
disordered memory,
395
Dura
mater, alterations of structure

mental

faculties

ceding,
pre-

482
Foville on premonitorysignsof,483
grand mal, 479
manifestations, 480
incipientpsychical
Marshall Hall, Dr., on, 479
nected
conmorbid
phenomena of motion
with, 488
on, 484
obscure types of nocturnal,479
petitmal, 479

Morel

premonitorysymptoms

of, 481, 482,

483, 485, 486, 487

pseudo, 540
Russell Reynolds, Dr., on

loss of

mory
me-

accompanying,480
of,631

singularcase

Erotic monomania,

Etskine, Lord,
insane, 280
Dr.
Esquirol,

on

of,203
of the

the acuteness

of

earlycommencement

on

cases

insanity,161
in

on

premonitorysymptoms

of

epilepsy,

484
attached

to

the, 270

great thickening and adhesions of the,

in
Evidence, Author misrepresented
of Atkinson, 217
in

819

organicchange in the,202, 636

thickeningof the, 328
B.
EDCCATIOW

of

exaltation

the, 14
dense tumours

affections

of the, 537
in organicdiseases

inflammation

of Arnauld

suicide committed

of acute

the, 307

of women,
not attached

sufficient importance
the cultivation

to

of attention in the, 334

Egomania, 181
of,tothe head,375
application
Electricity,
the velocity
on
Professor WheaUtone

of, 455

Ellenborongh, Lord, incorrect judgment

of, iiicase of an insane person, 282

cases

case

of allegedlunacy, 217

Exaltation, description
by Horace, 202

emotional,'269
morbid, of vision,577
of hearing,594
of memory,
of memory,

416
a

fatal diagnosticsign,

423

of sensation, 536
of vision, 576
patient""fDr. Willis in stage
1'iiul.Dr., on stage of, 292
2"6
psychical,

somatic,286

of,292

712

INDEX.

Exaltation,spasm

tonic and

clonic in

of

motor, 468
stage of,266
states

Excitement,mental, premonitory
of

of

of the

589

tacks
at-

Guislain, Dr.,

meningitis,293

Expert, duties

of a
case
Griesinger,Dr., remarkable
lady, 618
of spectralillusions,
Griffin,Dr., cases
morbid

on

vocal phenomena,

535

212
psychological,

Gunther, dream

Juvenal's advice to, 212

of

spoken of by,

woman

613

Gutta

F.

serena,

symptoms

Dr., results of his dissections in

of chronic mania,
ninety-two cases

of, 567

FALKET,

Hall, Dr. M.,

625

tion
incipientaberraFaculties,intellectual,
of the, 303
disorder of the, 305
perceptive,
ease
Dr.
Adam, case of obscure disFerguson,
of brain,573
Feuchtersleben,on amnesia, 372
Fever, knowledge of languagescaused by,

H.
"Hidden

Foville, Dr.,

on

premonitorysigns

469
paralysis,
perversionsof temper, 181
Haller,vis nervosa
of,33
Halford,Sir Henry, incorrect judgment
of an
of Lord Ellenborough,in case
on
on

insane person,

of

epilepsy,483
in
Fuch, Dr., on sudden loss of power
ing
the extremities symptomaticof softenof the brain,470
G.
G/VIKTV
exuberant, ominous
symptom,
when
pected,
tendency to suicide is sus-

Galen, case
of

270
of local anaesthesia,
646

patientof, 613

Seizures,"

479

282

case
of,by
Hallucinations,

447

dream

on

Dr. Alderson,

311

of,by Morgagni, 311

sight,59
singularcase of,239
Hamilton, Sir W., 332
mind
of Newton
dinary
compared with an ormind not situated solelyin the
brain,435
case

of

on
on
on
on

450
association of thoughts,
676
attention,
latent mental impressions,436
state of mind
between sleepingand

waking, 38
Gall, Dr., anterior lobes of the brain
singularcase of catalepsy,448
presideover the organ of speech,497
of idiotcyrelated by, 465
case
Handwriting,morbid, 491
Harris,Dr. Elisha,case reportedby, 460
Ganglia,hemispherical,15, 20
15
555
Haslam, Dr.,case of anaesthesia,
sensorial,
of moral idiotcy
under care
case
of,190
Gairick, imitation of madness by, 466
the examination
of the insane,280
on
Generation,morbid phenomena of, 623
Genius, nothing but continued attention, Hawkins, Dr. F., on the necessityof
333
earlytreatment of insanity,21
various affections of vision, 566
on
Georget, M., on premonitory symptoms
of epilepsy,
484
to the,375
of electricity
Head, application
of injuryof,by Dr. Abernetby, 389
case
Gillio,Dr. Pietro,interestingcase of,by
Dr. Shapter, 408
effect of injuries
of the,on the memory,
391
Goethe, deuteroscopiaof,588
the indestructibility
of mental
pressions,effects of blows on the, 671
imon
430
idiotcycured by blows upon the, 457
loss of languagecaused by a blow upon
rare
facultyof producing phantoms at
will,578
the,389
restored by a blow upon
Good, Dr., case of intense acuteness of
the,
memory
457
hearing and vision,578
to rememDr., case of inability
ber
Gratiolet,
Headache, cerebral,545
361
diagnosisof cerebral,655
names,
of in delirium,594
ideas of things,359
on
Hearing, acuteness
the effects of temporary physical
of hypenesthesiaof,by Dr. Ellioton
case
200
irritation,
son, 594
mory,
of,593, 594, 595
Graves, Dr., case of impairment of mehypersesthesia
414
illusions of the sense
of,595, 596
of sudden loss of speech,519
case
loss of, 593
morbid phenomena of,594
on
insomnia,602
of obscure cerebral disease,
treatment
perversionof, 593
675
625
Heart, and cerebral disease,

713

INDEX.

Heart, connexion between apoplexy,and

diaeaM of the, 6:24
innate corruptionof the human, 256
Heberden, Dr., case of temporary blindness,

HypenMtbasia of

the brain,543
of hearing in scrofulous diseases,595
of bearing prior to inflammation
of
the brain,595
of the nervous
642
functions,
of the senses
precedinginsanity,695
of vision,576

662
in
Hellebore,

662
of insanity,
treatment
Huliiiholtz,
M., on the transmission of
nerve
force,454
Helvetius,geniusnothing but a continued

psychical,636
sanity,
somatic, in the incipient
stage of in-

attention,333

286

3U8, 390, 392, 895, 397,

Hemij.legiii,
41-',445, 468, 476, 514, 517, 547,
566, 594, 636, 689

Hemp, Indian, in

treatment

of insanity,

663
in treatment
of insanity,663
Henliane,
Herpin, M., on premonitory symptoms
of epilepsy,
484

Hertz, Dr., case of paralysis,

393
Hibbert, Dr., on increasingintensityof
visual sensation,
378
312
singularcase of spectral
illusions,
Hippocrates,
aphorisms of, 1
on

Hypochondriacs, divided into three stages

by Dubois, 340
of Cow

|KT, 210

485
premonitory symptom of epilepsy,
485
symptomatic of epilepsy,
Hysteria,
I.

IDEA, morbid fixedness of,467

Ideas, effect of mental emotion

on

the,

387

indestructibility
of, Goethe

on, 430

Horace

on, 429
,,
,,
indestructible character of,439
ness,
latent,suddenly recalled to conscious-

dreams, 613

of the
the use
Hogg, Mr. Jabez, on
568
ophthalmoscope,
Holland, Sir II.,case of hemiplegia,
445

463

loss of memory

laws governing the association of,449

laws regulating
the admission of,363
Locke on, 363

on

natural

by, from fatigue,374

in earlylife,401
strainingmemory
Homicidal
insanity,subtle, case of, 281
Hops, in treatment of insanity,663
of a
Horace, description
by, of the feelings
292
lunatic,
on
on

on

on

the

of mental
indestructibility
429

on
on

self,

of
of case
Haslam, his account
moral, 190
illustrations of moral, 189
639
pressions,of Dean Swift,preceded by vertigo,
imof
delineation
his
moral,
Shakspeare,

lI'Tiiestcin,
Baron, case of, 372
brutal conHoward, the philanthropist,
duct
of, 183
of perversionof
Hunter, John, case

190

Ignorance,honest

of the
of the
sanity,
in-

663

Hydrophobia, singularcase of, 197

Hypeneuiiaof the brain,370
auricular,694
Hyperasthesia,
auricular
and
by Dr.
vibual, case
EllioUon, 594
attack of apoauricular prior to an
plexy,
595
cutaneous, 536
in connexion with hydrophobia, 536
537
affections of women,
in hysterical
nervous

affections,536

of the encephalon,537
in inflammation
537
mistaken for neuralgia,

of,by

Sir

related by
of
Illusions,canes
spectral,
589
Dr. Griffin,

417
IOHS of memory

of

confession

I. Newton, 34
popular,of insanity,215

memory,

in

insane, 259
controlling

resuscitation of latent,455
Idiotcy,case of,related by Dr. Gall,4C5
cured by blows upon the head, 457
Dr.

the infirmities of old age, 364

the generallyreceived opinion,213

by, 373
Hydrocyanic acid, in treatment

of

power

sudden

consciousness of insanity,228
impossibilityof flying from
287

keeping within bounds, 180

666
self-control,

on

classificationof, 359
of things,Gratiolet on, 359
paralysisof, 505

sense

of hearing, 595

senses,

incipientsymptoms

of

affectionsof the encephalon,307

premonitory of apoplexy, 307
of disease of the brain,311
acute

"

of insanity,
237
of spectral,related by
singular case
Dr. Hibbert, 212
Imagination,Dr. Johnson's opinionthat
disease of, is so difficultof cure
no
"

that which is complicatedwith

as
dread of guilt,290
the control of the, 343
on
Imbecility,insidious advances of mental,
326

exhibited
Immorality,insanity

in acts of.

714

INDEX.

Incubation

of insanity,249
Insane, Concordance compiled by Cruden
whilst,275

delusions,great temporary prominence

given to, by chloroform,279
deficient sensibility
of the, 551
general paialynisof the, 295
gentleman, will of an, 273
habit of biting the nails, common
the, 599
among
of
Haalain, Dr., on the examination
subtle cases
of the, 280
259
ideas,power of controlling,
oscillation
of the
Merier, Dr., on
ocular globe among
the, 582
and concealing,
317
pilfering
refusal of food by the, 621
of the, to
Shakspeare, on the inability
revive past impressions,425
of the, 606
sleeplessness
subtlety of the, metaphysically
explained,
285

wit, ingenuity,and cunning of, 271

often the prelude to,
Insanity,amnesia

Insanity,morbid anticipation
of,265
morbid
53
suggestionsin incipient,
morbid dreaming preceding,613
morbid apprehensionsof,231
painful case of,brought on by guilty
conscience,289
pathologyof,633
Finel, Dr., revolution effected by, in
moral treatment
of,49
case

,,

years,

of,unnoticed

for fifteen

161

of, by a lunatic,
31
poeticaldescription
premonitory symptoms of, 31, 167
physicalagitationof incipient,
287
Shakspeare on consciousness of, 228
singularcase of concealed,205
self-created,665

singularcase

of recovery

Shnkspeare'sdelineation

from, 153
of Hamlet's,

299
subtle

of homicidal, 281
case
subtle types of (suicidal),
301
state of mind
when
recoveringfrom
attack of, 150

an

transformations

371

children,161
among
and dreaming, 39
Brierre de Boismonton, of earlylife,
162
of undetected,207

case

of character in early
periodof, 168
of incipient,
treatment
659
from pre-occupation
of mind,
Insensibility,
557

55
Insomnia,case of,related by Dr. Wigan,
incipient,
604
commencing in a dream, 615
of Boerhaave
and Faganini,604
connexion between wit and, 459
decision of juriesin cases
pathologyof, 605
of,221
of
symptomatic of the commencement
diagnosisof, 171
distinction between, and delirium,643
insanity,603
Dr. Johnson's delineation of incipient, Intelligence,
morbid phenomena of, 24
252
sudden arrest of,465
Dr. F. Hawkins, his opinion as to the
loss of memory
Intemperance,
from, 373
Iodide
of
of
of
treatment
potassium in treatment
necessity early
of, 21
insanity,668
early treatment
of, 19
effect of,on the voice,533
of insanity,
Iron, in the treatment
675,
669
eighty per cent, of cases cured by early
of insanity,675
Issues,in the treatment
treatment
of, 18
Itard,Dr., on loss of memory
Esquirol,
Dr., on earlycommencement
ing
accompanyattacks of apoplexy, 362
of, 161
exaggerationof natural states of mind
J.
in, 169
exhibited in acts of immorality,321
JANSOH, Dr., case of softening of the
spinalmarrow,
published by, 495
of,2'29
foreshadowings
from a mental shock, 629
sanity
Johnson, Dr., delineation of incipientinin "Rasselas," 252
happy type of,291
insidious advances of deranged thought
Horace on consciousness of,228
traced by, 305
Howard, brutal conduct of,to his own
183
the indestructibility
of mental impressions,
on
family,
429
of Ophelia, 255
ignoranceof the nature of,31
opinionof,as to duty of an advocate, 220
illusions premonitoryof, 237
of insanity,
Juries, decisions of,in cases
221
of defining,
5l5
impossibility
ful
incubation of,304, 249
Juvenal,advice of,to a witness in a doubtlatent and unrecognised,173
matter, 212
lucid intermissions duringattacksof,
on
45
dementia, 367
moral treatment
the danger of bathingafter a full
of incipient,
700
on
Morbid presentimentsof, 261
meal, 384
cases

of

716

INDKX.

MiiiJury,failure of,resultingfrum bodily

374
fatigue,
undue strainingof, 700
Itard, Dr., on loss of, accompanying
attacks of apoplexy,362
John Hunter, loss of, by, 373
recorded by
loss of, as to names,
case
Dr. Qratiolet,
361
loss of,by Sir Isaac Newton, 680
loss of,caused by blows upon tbe bead,
381
loss of, in advanced

life,367

psychologyand pathologyof, 427

perversion and

exaltation, 416
VI. strengthened after
be had received a slightconcussion of

the brain,457
remarkable case of disordered,
395, 409

by a blow upon the head, 457

Rush, Dr., on, 681
Russel Reynolds, Dr., on
loss of, acing epilepsy,480
companj
singular case of perversionof, related
by John Hunter, 417
sudden and transient loss of, 371
Stewart, Dugald, on the various effects
produced on the, by disease and old

restored

360

singular loss of, caused by a moonstroke,382

singularcase of defect of,413
of impairment of,57
treatment
too earlystraining
of,684
Mental action, rapidityof, occurring in
dreams, 41
caused by,
anxiety,enfeebled memory
379
difficult to diagnoseexistence
depression,

of,299
depression,stage of,399
necessity of vigilancein
,,
stage of, 300
emotion, effect of, on the ideas,387
excitement, frequentlyprecursory

of

apoplexy, 393
insidious advances of,325
imbecility,
l
oss
faculties,
of, after putrid fever,
case
reportedby Dr. Willis,406
impressions,indestructibility
of, 430,
429

,,

151
and

aberration

of

cases

masked

affections of

of, mentioned

phenomena
dormant

of

nature

latent,437
of ,461

by

Dr. Brierre de Boismont, 320

condition of, when in a state of aberration,
47
delusions of,tbe incipient
symptoms of
acute

affections of the

encephalon,

307
difference between
that of

an

ordinary,and

Newton, 332

effect of chloroform

on

the, 195
the

the, 194
effect of organicchanges on the, 431
exaggerationof natural states of the,
state

Pope Clement

"

phenomena caused by drowning, 441

407
shock,effectsof,on the memory,
Merier, Dr., on oscillation of the ocular
globe among the insane, 582
358
Mill,James, on memory,
Milton, of what pansed in Adam's mind
on
awakening into life,
description,

effect of meteorological
changes on

391)

of

latent,451

Mind, anomalous
the, 159

Martial,on, 365
Mill,James, on, 358
Montaigne's remarks on, 683
of Bonapartetemporarilyaffected,
400
of the insane,416
of early impressions,tenacity of, in
Niebuhr, 346
paralysisof the, 383
impairment of, 365
premature
paralysisof the,caused by intense cold,

age,

impressions,physicalnature

Mental

of

175

general weakness of, 324

Hamilton, Sir W., on state of,between
sleepingand waking, 38
impairment of,324
from pre-occupation of,
insensibility
557

indivisibility
of,47
is the, situated in the brain ? 435
Lucian
the danger of an
on
of the, to
concentration

excessive
any

one

subjectof contemplation,343
of a patientcompared by himself to a
kaleidoscope,386
state of,premonitory of insanity,267
Tasso on
tbe exaltation and depression
of the, 27
Monbuddo, Lord, singularcase related by,
444

of erotic,203
Monomania, cases
concealed,185
latent case
of, 1 91
Moon
stroke, singular loss of memory
caused
by, 382
of early,257
Moral deterioration,
sources
Moral idiotcy,illustrations of, 189
Haslam, Dr., case of, 190
Shakspeare'sdelineation of, 190
Moral sense, paralysisof the, 187
perversionof the, 315
Morbid

affections of the

spinalcord,495

of insanity,265
anticipation
apprehensionsof insanity,231
509
articulation,
341
concentration of attention,
derangement of sight,singularcase

575

of,

717

INDIA.

Xi.-holl,Dr., ease

Morbid distraction,
of, 349
case
ciiatractiun of reverie,S87
613
dreaming precedinginsanity,
of sleep,611
drowsiness and excess
345
"feet of concentrated
attention,
exaltation of vision,577
fixedness of idea, 567
hand writ! ng, 491

imaginativecontemplation,369
imaginativemeditation,Disraeli on, 831)
luminous phenomena, 585
of,411
proximate cause
memory,
misuse of words, 511
179
of passion,
phantasmalphenomena, 589
phenomena of attention,332

paroxysms

circulation,generation,

,,

623
respiration,

and

hearing,593
language, 445
memory,

Nnx

of colour

error

lated
re-

in the treatment

vomica

nutritive

insanity.

0.
OCULA

symptomatic of disease uf

SPECTRA

brain, 581, 583, 589

Ohio, lines by a lunatic lady,confined in

an
asylum at, 271
Old age, Horace on the infirmities of,3"J4
M., case of loss of speech recorded
Olivier,
by, 499
Ophelia,insanityof, 255
use

motion, 468

of

380

Ophthalmoscope,Mr.

357

organic and

of

by, 564
with which his miud
Nicbuhr, u-nai-iiy
retained early impressions,364
ence
Niepce de St. Victor,M., on the influof solar light on
organic and
inorganicbodies,488
Nutrition,impaired, of the brain,31 1

Jabei

Hogg

on

the

of the, 668

Opium in treatment of insanity,

668,608
Organic changes,effect of on the mi in I.
431

life, It

changesin

sensation,536

aud

specialsense*, 560
speech, 497
sight,591

sleep

and

the dura

tunica

OriginalSin, criticalessay

runt

r,

on,

by a lunatic,

mtf

dreaming,

Osborn, Dr.,
in

600

loss of speech and memory

with disease uf

on

connexion

the brain,393

vision, 577

,,

mater, pia

636
arachnoidea,

remarkable

presentimentsof insanity,261
speech followingapoplexy,521
struggleof Bishop Butler
suggestions,
against,230
taste, touch, and smell, 597
thought, conquered by effort of will,

case

the morbid
illustrating

phenomena of speechdetailed by, 52M

Oscar, King of Sweden, case of, 350
Otorrhoea,chronic,generallyaccompanied
544
by cephalalgia,
Oxteyn, Roger de, dream of, 613

665

thought, insidious advances of, 233

201
views of religion,
vocal phenomena of, Dr. Guulain

P.

on,

535

477
co-ordination,
phenomena of, 468
Mouth, affections of the muscles of the,
of muscular

want

Motion, morbid
488

Morrison, Sir A., case of anaesthesia in

Bethlem
Hospital,related by, 551
of hearing
of the sense
acuteueas
Mozart,
of, 561
committed
Murder
duringsleep,617
c
ase
of, 523
Mntism, singular
Muscae

volitantea,571

PIOAK, Dr., case of murder committed

during sleep,related by, 617
Pa^aniui, insomnia of,604
Paget, Mr., on the assimilative power of
the blood,432
Panophobia, case of, 459
Paralysisagitans,491
teristic
alterations in speech characParalysis,
of general,504
amnesia, often the prelude to, 371
412
of impaired memory,
caae
related by Dr. Rush, 403
case
case
preceded by aphonia, reportedby
Dr. Abercrombie, 518
diagnosisbetween cerebral and spinal,
469

V.
NERVE

FORCR,

M. Flelmholti

on

the trans-

misaion of, 454

Newton, Sir Isaac, difference between the
mind of,and an ordinary mil
honest confession of ignoranceby, 346

by, 680
"f cerebral abjoesaea
Hvinptomrttir

lost of memory
and

tumours,

619

393
of,on the memory,
general,of the insane,295
of. 473
incipientsymptoms
of genera],647
incipientsymptoms
effect*

obncure
of

-aie

of

297
general,

ideas, 505

of speech,515
of the mural sense, 187

713

INDEX.

383
memory,
of sudden, related
case

Physiology,cerebral,505

Paralysisof the

of memory,
Dr. Wauon,

by

pathology of general,637
496
peripheral,

premonitory signsof,517
singularcase of, 329
of incipient,
treatment
668,
Paroxysms

attacks

669

474

468,
Paraplegia,
of

years,

insanityresemble prolonged

on

passion, opinion of Dr.

on

of

Pinel, 180

on

speech,497

ecstatic vision,515
of insanity,
opinionof,
paroxysms

on

on

characteristic of generalparalysis,
504

insanity, 635

or
insomnia, 605
sleeplessness,
628
of cerebral,
principles
6
37
of
subtle,
insanity,
case
double, remarkable
Personality,

revolution effected in the moral

of

ment
treat-

of the

of,

insane,by, 49
Presentiments,morbid, of insanity,261
Prichard, Dr., cases
reported by, 391,
458, 463

419
of the moral

Perversion
of memory,

sense,

315

416

disorder of the, 305

Perceptivefaculties,
of Pope Clement VI., recorded
Petrarch, case
by, 458
Petechiae on the forehead symptomatic of
epilepsy,481
facultyof producing at
Phantasms, rare
will,by Goethe, 578
Phenomena, Andral on morbid visual,576
curious mental, caused by drowuiug,

of error
of
Priestley,Dr., curious case
colour,publishedby, 563
Processus
cerebelli,effect ot tumours
with the, 537
interfering
Pseudo forms of mental disorder,175
427
Psychologyof memory,
266
Psychicalexaltation,
636
hyperaesthesia,

Q.
QUININE

in the treatment

mental

441

curious,manifested

at

R.
the

luminous, 585
of attention, 332, 354

RADCUFFE, Dr. , on premonitorysymptoms

of epilepsy,483
Ranc6, Abbe
de, insanity of the, from
effects of remorse,

morbid,

memory,

motion, 468

of

sensation, 536

Reid, Dr., on difficulties attending the

investigationof psychical phenomena,
36

and mind, 34
Religion,morbid views of, 201
Respiration,morbid phenomena of,623
and generation,625
Resuscitation,sudden, of latent ideas,
on

of sight,591

of sleep and dreaming, 600

morbid, of the specialsenses, 560
morbid, of speech,497
morbid, of vision, 565
morbid phantasmal, 589
of latent mental impressions,437
resultingfrom injury done to the brain,
16

455

Ecole de Medecine, 623

iron in insanity, 375

Phosphorus ditto,878
of acute
Photopsia, incipientsymptom

Phosphateof

disease of the brain,585

of his
account

own

case,

insanityby a, 144
recovery
cerebral,of speech,505
Physiology,
from

matter

Reverie,Abbe de Condillac on, 338

Reynolds, Dr. Russell,on loss of memory
accompanying epilepsy,480
read by, before the
Richeraud, memoire

singularphantasmal,587

Physician, an

restoration

to, 46

357

of

290

Reason, singular temporary

morbid, of hearing,593
24
moriiid, of intelligence,
445
of
language,
morbid,

morbid, of

of cerebral and

affections,
375, 663, 675

death, 443

Dr. Guislain on morbid vocal, 535

Dr. Reid on difficultiesattendingon
of psychical,36
investigation

morbid,
morbid,
morbid,
morbid,

161

cerebral localization of

292
stage of exaltation,
the insensibility
of the insane,49
opinion of, alterations of speech as

of,179

427
Pathology of memory,
637
of generalparalysis,

morbid

ot

180

of passion,morbid, 179
Passion, morbid paroxysms

of

Pia-inater,alterations in the structure

the, 14
organicchange in the, 202, 636
Pineal gland, case
of enlargement of, 569
of anaesthesia in the
Pinel, Dr., case
related by, 553
Bicfitre,
case
by, of insanityunnoticed for fifteen

489

in advanced
Rogers, state of his memory
life,367
of hyperaesthesiaof
Rom berg, Dr., case
vision,related by, 579
affections of mobility,476
on
cerebral headache, 654
on
on

symptoms

of gutta serena,

567

710

INDKX.

Rullii-r,M.,

ease

of

softeningof

the

spinalcord, related by, 495

Rush, Dr., case related by, 444
of paralysis related by, 403
case
on
on

memory,
the wit,

the

ingenuity,and

cunning of

487
of apoplexy
Scott,Sir Walter,anticipation

de, on the effect of the

campaign on Napoleon, 400
the impossibility
of flying
on

from, 287
Self-inspection,
neglectof habits of,225
curative effect of, 667
Self-control,
Horace

on, 666

Sensation,exaltation of, 536

morbid phenomena of,536
558
vitiated,
Sensations

"

tactile

sibility,
insen-

symptomaticof

Skae, Dr., on generalparalysis,

646
Sleep, Chinese puuuhment of death
deprivationof, 604
morbid

8.

Self,Horace

"(,575
598

SACCEBOTTK, M., ou cerebral and heart

disease,625
naizig,Bernard, case of, 617
related by,
Schenck, Dr.,case of epilepsy,

Russian

"

Simpson, Professor,on

681

insane,271

by, 263
Segur, Count

Sight,perversionand aberration of, 581

kiugular case
of morbid
derangement

,,

to excess
disposition
excess

by

of,600

of, 611

phenomena of,600
committed
during, 617
of the insane,
Sleeplessness
606
pathologyof,605
Smell, morbid, 597
Softeningof the brain, apoplexy caused
by, 639
to walk caused by,
blindness,
inability
,,

murder

323

by injurieson the head, 671

cases
of, successfully
treated,670
diagnosisof, 651
earlysignsof, 471
followed by apoplexyand hemiplegia,
637

cerebral disease,

of arresting,
in
possibility
stages, 670, 675

its early

subtle case
559
of,327
treatment
Sense, paralysisof the moral,187
of,669
Somatic exaltation,
286
perversionof the, 315
Senses,morbid phenomena of the special, Sources of early moral deterioration,
257
560
South, Rev. Dr., observations on the
normal
of the, 561
acuteness
mysteriesof inner mental life,
by,227
of the insane,551
Speech, alterations in, characteristic of
Sensibility,
deficient,
exalted tactile,
599
generalparalysis,504
cerebral
localization of, 497
of
544
Septum lucidum, softening the,
cerebral physiology
of,505
rough and jagged, 623
impairment of,513
loss of,after apoplexy, 412
Seymour, Dr., case of "watery brain"
caused
related by, 631
by cerebral absces*.
,,
499
of insanity,660
in cases
on
depletion
caused
Shak spear?, delineation of moral idiotcy
by organic disease of
,,
the pons varolii,
499
190
by,
morbid, followingapoplexy,
521
descriptionof King Lear's insensibility
phenomena of, 497
to cold by, 557
,,
paralysisof,515
insanityof Ophelia depictedby, 255
perversionof. 527
consciousness of insanity,228
on
remarkable case illustrating
the mor!"M
87
on mental exaltation and depression,
the inability
of the insane to revive
phenomena
on
of, detailed by Dr.
Usborn, 528
past impressions,425
of soften ing of the, 495
cord, cases
Spinal
Hamlet's
truth
of
sanity
inpsychological
morbid affections of the, 495
delineated by, 299
BpMgpua, Mr., episodein the lifeof,665
Shapter,Dr., of Exeter, case of loss of
Statistics of insanity
related
children,165
after apoplexy,
by,
among
memory
St. Austin on mysterious union of mind
406
and matter, 34
interestingcase of Dr. Pictro Gillio,
Sterne, physical agitation of incipient
published l.\,408
insanityportrayed in his character
Shower-bath, 375
of Smel fungus, 287
Stroking. Dr., on premonitory symptoms
Stewart, Dugald, on the various eftoU
of epilepsy,485
hallucinations of, .19
565
impairedand paralysed,
morbid phenomena of, 591
;

which

are

producedon

by disease and old

547
StigmataDiaboli,

the memory

age, 360

720

INDEX.

ing
Thought, physicalimpediments interfer679
with,
memory,
ease,
Thoughts, morbid, conqueredby effort of
Strabismus
symptomaticof cerebral diswill,665
474, 683, 692
the power of expressingour, 504
on
of incipient
in the treatment
Stramonium
loss of memory
Thucydides,
by many who
663
insanity,
recovered
from
the effects of the
Strychnine in ditto, 375, 676
plague at Athens, recorded by, 398
metaphysically
Subtlety of the insane
on
Tissot,Dr.,
premonitory symptoms of
explained,285
486
Butler
of
epilepsy,
Bishop
struggles
Suggestions,
Tongue, affections of the, 486
againstmorbid,230
sociated
Touch, morbid, 597
Suicide, attacks of mental depressionasof incipient
Treatment
with a disposition
insanity,658
to, 300
and
668
latent
some
antiphlogistic
remedies,660,
impelled
by
to,
person

Stimulant*, effect of, in

restoring the

375

arsenic,676

concealed delusion, 300

by

committed

suddenly

person
from
aroused

being
frightful

after
a

Belladonna,coniuin,hydrocyanicacid,
662

chloroform,Indian hemp, stramonium,

dream, 616

Sulphate of copper in insanity,375, 380

Sulphate of zinc, ditto,380
Swift, Dean, singularpresentimentof his
264
imbecility,
idiotcyof,preceded by vertigo,539
demic
Sydenham, Dr., on the effects of the epiin 1673,
fever on the memory
398

Symptoms, dyspeptic,accompanying

ce-

phalalgia,569
early,of mental disorders,29
affections of the
incipient,of acute
encephalon,307
of apoplexy,326, 473, 547,
incipient,

662

cold applications
to the head, 661
ease,
Graves, Dr., on obscure cerebral dis675

hellebore,used by the ancients,662

henbane and hops, 662
importance of isolatingpatient from
excitement, 679
isolation of patient,664
leeches in injuriesof the head, 674
medical
and
moral, of impairment of

677, 681
memory,
moral, of incipientinsanity,700
iodide of
morphia with digitalis,

tassium,
po-

662

683, 584
647
of generalparalysis,
incipient,
of insanity,167
incipient,
473
of paralysis,
incipient,
of softeningof the brain,326
incipient,
insidious,of general
paralysis,
295, 489
3
neglectof incipient,
obscure cerebral,9
of cerebral abscesses and tumours, 61 9,
653

of cerebral amaurosis, 328

of gutta serena, 567

676
of impaired attention,
incipientinsanity, 658

by enemata, 662
incipient softening of

the

brain,

669

injurieson

the head, 674

the insane, by the physician,701

opium by endermic methods, 662
cerebral disease,
of arresting
possibility
675

purgatives,661

of insanity,30
premonitory,
o
ne
pbotopsia, of the,of acute

and issues in injuries of the

head, 675
Seymour, Dr., on depletion,660
state of generalhealth to be observed,
setons

disease

of the brain,586
of epilepsy,481
premonitory,
of paralysisagitans,493
premonitory,

659

in injuries
of the head, 675
strychnine,676
of antimony, 660
tartrate
sanity,Tremors, muscular, symptomaticof brain
incipient in-

stimulants

T.

TASTK, morbid, 697

Tartrate of antimony in

disease, 475

660

lepsy,
Trousseau, Dr., on obscure types of epi-

nervi optici,309, 544

effect of disease of, 16, 328, 623

Thalumus

541

Thought, curious case of morbid, 234

distressingrapidityof, 679
Dr. Johnson

on

insidious advances

deranged, 305
insane, impurity of,253
of morbid, 233
insidious advances
laws governing the operationof,37

on

nocturnal

Tumours,
of

attacks of epilepsy,479
by blows on

cerebral,caused

head, 671
672,
cerebral,growth of preventable,
675

cerebral,nausea
,,

symptomatic of,61
of, 653

symptoms

IM'I

Tumour*, effect of,interfering

with

the

6S7
raitiformia,
headache symptomatic of cerebral,
057
in proximity to the optictbalami,828
corpora

721

Voice,general,of mankind, opinion of

Horace on, 213
Voix de PnBchinelle symptomatic of incipient
insanity,535

U.
W.
I'LKic, Dr., interesting
WATEKT
cue, illustrative
of,related by Dr.
BRAIN, case
of incipient
tailed
stag* of paralysi"sdeSeymour,631

by,478
Urea, detection of,
death,610

Watson, Dr.,caseof double vision related

the brain

iu

after

nutrition of brain,610
affecting
in the blood, poisoningthe brain
causingdelirium,610

by, 593
case
interesting

and

caso
interesting

on

VBLPEAU'S,M.,

of softeningof the
case
spinalcord,495
cerebral,
Vertigo,
type of,539
589

540
epileptic,
889
frequentforerunner of apoplexy,
of Dean Swift preceded by, 539
idiotcy
treatment
of,connected with impaired
678
memory,
various types of,538

necessity
Vigilance,
of,in stage of
800
depression,
Vis nervosa,
admitted
case
Vision,

mental

of Haller,33

582
of disease of the

Hawkins, Dr. P.,on

various affections

of,566
exaltation of,577
phenomena of,565

defects of,563
singular

Visions,Pinel,Dr., on
Vitiated sensation

the connexion between

cardiac disease,624

apoplexyand

Walford, Rev. Mr., confessions of, after

recovery, 147, 155
Weakness, general,of mind, 324
Weather, effectof changesin,on nervous
disordeis, 194
on
Wheatstone, Professor,

the velocityof
the electricagent, 455
Who well Dr., his opinionof the general
voice of mankind, 213
Wigan, Dr. , case ofinsomnia related by,604
of phrenitis
related by, 575
case
curious case of perversion
of thought in
,.

clergyman,a patientof,234
insane gentleman, 273
an
Willis,Dr.,case of lossof mental faculties
after putridfever,related by, 406
patientof,in stageof mental exaltation,
Will of

292

and,459
271
Dr. Rush
on,
Women, sufficientimportancenot attached
to the cultivation of the facultyof
attention in the education of,334
Words, morbid misuse of,511
misplacement of,507
singular

615
ecstatic,

symptomaticof

Y.

bral
cere-

disease,558

YocRO,Dr.,aneodoteofDeanSwiftlby,264

sanity,York
Voice,alterations of, symptomaticof in-

assixes,misrepresentationas
author's evidence taken, in
Atkinson, 217

535
effectof insanityon

detailed
paralysis

Wit, connexion between madness

exaltation of, 576

or
hypenesthesia,

,,

of

of the, 435
ignorance
of singularirregularity
of,

double,592
double, a symptom
brain,569

morbid

apoplexyrelated by,

by, 489

V.

Dr.Clutterbuck,
on,

of

Mfl

the, 533

THE

END.

SA

case

to

of

-i*t".,t.
London, Neu" 2iurlin"jt"ii

May,

1800.

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CLASSIFIED

CHERCHIIL'S

INDEX

CATALOGUE.

-"'"

INDEX.

CLASSIFIED

MEDICINE

PULMONARY

OPHTHALMOLOGY.

continued.

"

HOT

l'i Gregory's
Do.

Celsus

Thomas'

Practice

Tliuilichnra

of

Physic
.

What

to Observe

Hogg

29

1 loli house

29

Impaired Vision
Jacob
on
Eye-ball
Jogo on Ocular Spectres
Jones' Ophthalmic Medicine
Do.
Defects of Sight

on

........

19

......

Whitehead

Transmission

on

Williams'

Principles

Wright

30
..

30
......

Headaches

on

Near

..31

Do.

10
.

Do.

and

Eye

1ft

Beale

Microscope in Medicine

on

Bird's Natural
.

16
.

17
.

Burnett's

Craig

Electric

17

on

Entherapeia
Hardwich's
Photography

Hinds'
Jones

29

Tension

Garner's

..

17

6
Philosophy
Philosophy of Spirits 8

16

sion
Organs of Vi-

Ophthalmic

on

15

Do.
Walton

98
29

SCIENCE.

21

MICROSCOPE.

Auscultation

on

..

15

Ear

the

on

Consumption

on

Weber

11

on

Nunneley

Turnbull

..

..

CHEST

continued.
MM

9
.

Strabismus

on

"

Ophthalmoscope

on

......

Gout

on

28

on

Do.

Lectures

Wegg's Observations
Wells

28

Cooper

Injuries of Eye
Sight
Diilrymple on Eye
Dixon
the Eye
on

26
2"!
27

Urine

on

Clinical

Todil's

Conspectus

........

and
"C

DISEASES,

14
..

..

Harmonies

15

on

Vision

17

on

Body, Sense, and Mind

17

Mayne's Lexicon
Nourse's

20

Students'

Tables

21
.

Do.

How

Carpenter

Work

to

Microscope

on

PHYSIOLOGY.

6
.

Price's

do.

on

24

....

Do.
Manual
Cottle's Human
Heale
Hilton

MISCELLANEOUS.
Acton

Prostitution

on

3
.

Atkinson's

Bibliography
Bascome
on
Epidemics
Bryce on Sebastopol
Cooley's Cyclopaedia
Forbes'

Nature

and

Art

Massy

Part's

Case

7
9

in Disease
..

..

..

..

Coagulation

on

PSYCHOLOGY.
Arlidge

12

Austin

13

Bucknill

on

and

18

Burnett
on
Insanity
Conolly on Asylums
Davey on Nature of Insanity
Dunn's
Physiological Psychology

20
21

Madness

Bellingham on Aneurism
Bigg on Artificial Limbs
Bishop on Bones
Bryant on Joints

Chapman

9
10

Criminal

on

Lunatics

16
..

sane
of In-

Treatment

on

Monro

INDIGESTION.

Downing

Hysteria
Indigestion
on
Neuralgia

Hunt

Heartburn

Child

on

on

Leared
Lobb

Radcliffe

on

Reynolds
Rowe

8
9
.

11
.

10

Nervous

on

on

18

Affections

Epilepsy
the

19
.

Diseases

Turnbull

Epilepsy

on
on

on

Mind

Williams

24

(J.) on Insanity
(J. H) Unsounduess

Williams

Winslow
Do.

Lettsomian

Davis
Lee's

Praevla

..18

..

Pretty's Aids
Priestley on

Gravid

Ramsbotham's

Obstetrics
.

Midwifery..
Johnston's
Midwifery

PULMONARY

and
Healthy

on

Obstetric
Manual

Plates.

Swayne's Aphorisms
Midwifery

Waller's

9
.

9
10

12

Throat

13

Stricture

on

..14
..

Lawrence

Ruptures

on

Maclise

17
.

18
.

Lungs and

Pemberton

Heart
.

on

on

Consumption
Stethoscope
Lungs and Heart

on

the Chest

Do.

on

Davies

23

Markham
Suiter
Skoda

Asthma

on

Auscultation

Smith

on

Stricture

on

Haemorrhoids

22

10
11

11
.

..11
.

Da

Snow
Teale

25
25
.

Chloroform

on

25

Steggall'sSurgical Manual
Amputation

on

Thompson

26
.

27

Stricture

on

27
.

Do.

on

Prostate

27

Toynbee

on

Ear

28

17

Wade

19

Watson

Stricture

on
on

23

\\i]liams"m

24

Wilson
Da

the

on

Port

Larynx

the
un

..19

22

10

Consumption

on

Surgery

on

on

Heart

on

Pirrie

Auscultation

on

Richardson

Consumption

on

19

Melanosis

on

C
.

19
..21

..

the Chest

on

Erysipelas

on

18
18

of the Crimea
Fractures

on

15
1 ft

17
.

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Macleod's
Surgery

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Dis-

Cotton

23

25

11

11

Chest

on

Nunneley

and

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Fen wick
Lacnnec

10

Surgery
Fergusson's Surgery

3 1

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on

23

25
.

of Obstetrics
.

Testis

on

31

CHEST

Bright

Dobell

25

Do.

James
Hernia
on
Jordan's
Clinical Surgery
Laurence
Cancer
on

Lectures

DISEASES,

22

..

Smith's

Uterus
.

Do.
Sinclair "
Smellie's

11

Midwifery
during Labour

Clinical

Cooper (Sir A.) on Testis

Da
(S.) Surg. Dictionary
Curling on Rectum

Listen's

Addison

Parturition

on

Higginbottom on Nitrate of Silver

Hodgson on Prostate

Blakiston

Harrison

of

Billing on

Placenta

Veins

20

the Brain

on

OBSTETRICS.
on

Varicose

20

Structure

Barnes

Fraser

28
.

Gibbon

30

Stomach
.

20

30
.

Mind

25
.

Ulcers

on

Do.

5
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20

23
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Noble
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Private

23
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Nervous

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on

Insanity
Asylums
Psychology

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5
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20

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3
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11

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18

19

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Causes
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Richardson

Book

Pettigrew

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..

23
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Reymond's Animal
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Taylor's Medical Jurisprudence 27
28
Vestiges of Creation
28
Sequel to ditto
29
Unger's Botanical Letters

Food

on

the Cranium

on

Photographic Manipulation

Guy's Hospital Reports

Haycock's Veterinary
Lane's
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Lee on Homceop. and Hydrop.
Marcet

Vital

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22

Carpenter's Human
Do.
Comparative
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Schacht

10

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Gunshot

29
29
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30

Diseases

31

Skin

raits

of Skin

30

..

26

Thompson

29

Timms

on

on
Consumption
Consumption

27
.

28
.

Yearsley
Do.

on

Deafness

on

Throat

..31
..

31

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