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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
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
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
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
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
"
"
"
Attention
"
brain
the
of
disease
of
disease
of
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
"
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
of mind
Indivisibility
of
condition
their previous
instructive
recovery,
"
CONTENTS.
disordered mind?"
of the insane
treatment
"
"
"
"
"
"
"
"
"
"
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
THE
MIND.
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
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
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
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.
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
"
"
"
"
"
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
"
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
"
"
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
"
more
investigated Phenomena
"
light
"
"
at death
by
fever
"
"
"
Mental
by hanging
manifested
revived
"
of the blood"
"
Morbid
Curious
"
"
"
with thought
impedimentsinterfering
The
"
brain
"
Morbid
mental
of
impressions Physical
compared to a galvanicbattery
"
"
"
"
"
"
"
"
"
"
"
CHAPTER
MORBID
XVIII.
OF
PHENOMENA
MOTION.
"
"
"
"
"
"
"
"
"
"
"
"
"
"
"
"
"
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
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.
"
"
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
"
"
"
sight
HEARING,
TASTE,
TOUCH,
SMELL.
Defect
of vision
amaurosis
cerebral amaurosis
Value of the
Double
vision a symptom
the eye
of
XXII.
"
-Loss of
"
Case of sudden
tion
restora-
"
"
"
"
"
"
"
"
"
"
"
"
"
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
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
"
between
Derangement
sea-sickness
renal disorder
by
in the
urea
sleep
"
disease
want
the
of
causing
blood
Morbid
brain
and
phenomena of
brain
Hallucinations
"
"
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
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
often is the
physiciancalled
to witness
upon
the
The
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
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
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
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
whose
tion
attenprofessional
men,
directed to a studyof this
specially
whose opportunities
of watching the
ILLUSTRATIVE
CASES.
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,
or
in
state of
unconsciousness,
bows his head on his
or
quietly
plateat the dinner table and dies,surrounded by his
coma
becomes
soon
person in
exercise in the
A
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
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
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
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.
his seat
was
septum.
All
the
found in this
had
extensive extravasation
case
of blood
arteries
"
ABEECEOMBIE.
f All the
the substance
of the
with
ABEBCROMBIE.
ventricles
of the
cerebral
the
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
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
and
evanescent
but of
not
to awaken
In many
and confusion,
depression
trivialand unimportanta character, ai
so
excite attention.
or
apprehension,
attacks
of mental
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
no
or
victim, givingno
its
signof
advent,
no
indication of its
advance, no
the
breach
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
time
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
"
"
with
the
littleor
;
no
convulsive
the headache
bilious,
rheumatic,or
movement,
for
optici,
sciousness
cona
loss of
considered to be of
has been
nervous
or
the
instead
optician,
all
even
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
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
is termed
heart.
It is often
head
to decide,in
difficulty
cases
of sudden
with
death, conjoined
and
and
the
drawn
alteration
slightest
brain may
be discovered
is detected
cause
in
in
of death, even
a
such
have
no
the combined
12
INTRODUCTION.
structures ?
The
affections
a
of the
upon
have,
maintain, undoubtedly
and
premonitory,
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
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,
in the
brain*
"
Vide
chapteron
the
"
case
interesting
The
of the late
.Morbid 1'honomena
King
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
"
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
some
the
and
his friends.
The
alterations of structure
after death
pia mater,
on
araclmoidea,and in
tunica
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
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
not
of
to
modation,
accom-
considerable
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
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
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
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
the painful
acutely
perceive
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
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
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
tend
to confirm
the conclusions
which
the
experimentsmade
I should
be
tance,
impor-
; we
may
of
that such
higherpowers.
brain diseased,without
the surface of
correct in this view of the
necting
con-
yet occupy
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.
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
"
Lehrbuch
Valentin.
der
des
Physiologie
Menachen."
Band
11.
Von
P. 743.
C
Dr. G.
18
INTRODUCTION.
value which
at the earliest
detection,
of the
if
power,
structure
to
motor
action ?
with certainty
the
predicate
of the periphery
of the
lose
sightof
action
can
the
fact,that
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
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
cases
of
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
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
IMPORTANCE
the
OF
EARLY
judiciousexhibition
has
into
been
of
opium
relieved,and
21
TREATMENT.
after the
the
local
secretions
gestion
con-
brought
cure
mischief.
In
of
certain
type of
is in
insanity,
an
case,
an
sheet-anchor
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
cases,
whether
But
of
chance
brief indeed
periodis
of art is available.
any
the
success.
in which
case
the
be acute
or
nature
admits
of
with
being distinguished
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
presentalike
soon
in disorders of the
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
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
advance
mischief.
Having
dwelt
at
some
lengthon
the
the
existence of
brain,and
on
the
threateningsof
in
to investigate,
premonitorysymptoms
first
DIVISION
of the
OF
THE
SUBJECT.
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.
manifests
of the intelligence,
physicalmedm
its varied
instrument
powers,
membranes
qualityof
calibre
the
of the
can
take
no
place,
alteration
anatomical
vital fluid,or
in the
character
or
numerous
record, in which
on
are
serious
every
is strictly
confined
to the
fibrous,or
instance,the alteration of
or
stricted
rehemisphere,
conducting
part of the nervous
to
one
vessels
maining
re-
intact,and
EFFECT
DISEASE
OF
THE
BRAIN
ON
THE
MINI).
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
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
too much
to
disposed
normal
and
cerebral
xistence
nal
of
latent,and
concealed mental
aberration.
Tl
26
MORBID
conditions
OF
PHENOMENA
of the
brain, and
INTELLIGENCE.
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
there
has
from
dependentupon
are
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
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
matter,
or
of the
ence-
pressure be
in the membranes
stage,on
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
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
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
"
"
"
"
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.
"
freedom
"
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
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
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
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
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
appropriateimage)
an
the
to
"
rays of
light
the pen of
man
It is
state
unquestionable
an
"
maniac
as
interesting
proceeding
derangement.
of mental
!
Know
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.
scorch'd
red
On
by fire,
quench'd.
doth
Should
distracted soul,will, by
Then
side
every
tempest toss'd.
man
distracted soul,
it,what
might'stthou
'Pon
Are
the inner
envelopehis
doth
That
draw
scan
ye
seem
to
him),
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,
must
or
feel,
become, like him,
Asvluin,Ftica, N.Y.
maniac
!"
*
J. M.
B.
IGNORANCE
OF
THE
MENTAL
AND
NERVE
FORCE.
33
cause,
disturbance
upon
in
the
normal
relations
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-
mass
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
how
dependentupon, organized
34
SYMPTOMS
PREMONITORY
INSANITY.
OF
relations between
and psychical
greatproblemsof organic,
arrived
sub judice?* Have
we
physiologists,
Are
with
life,
still,
says
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
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
substances.
metal," says
but have
but
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
firm
if
SYMPTOMS
PREMONITORY
to the
to
referring
care
INSANITY.
being placedon
the
of others."1
the limited
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
it no
farther,and
is
harm
no
done
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.
"
Essay
Beattie,LL.D.
on
be my
the Nature
and
of Truth,"
Immutability
p.
LAWS
GOVERNING
of the
guage
THE
OPERATION
schools)the relation
stands to the
the
OF
in
37
THOI'UIT.
which
the
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
of
powers
state of the
its
healthyco-ordination.*
laws
co-ordination
or
governingthe operationsof thought,
of the
of mind,
which
essential to
so
are
understanding,
supposed by
producethat
healthyequilibrium
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
psychicalas
patientis not
these
the
cases,
well
under
as
phraseologyof
physicalchorea,
William
St.
body.
There
insanity
appears
Sir
or
fixed,or
psychicalco-ordinating
power
of what
and paralysis,
may
of the
movements
to
Hamilton,
regulative and
"
"
"
"
legislative
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.
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,
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
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
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!
This
of divines,
proceedfrom
phase of mental
languageonly expectedto
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
not
dreaming
problems,
person
were,
the
enter
as
mind
the
into operation
practically
neee"*ary, before
of motion.
Majorca
"
going to sleep,mechanicallyto
enim
'
quain
If,"says Pascal,
affect us
if an
was
artisan
a
as
we
pursued by
were
as
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
69.)
(" De Divinatione,"
"
"
ideas that
be
dreaming,it would
should stand in
we
are
real
cause
hend
appreincondifferent and sistent,
have dreamt,
as
to
William
for life
"
"
Hamilton, in hi*
40
PREMONITORY
Sir Isaac
SYMPTOMS
OF
INSANITY.
mathematical
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
of many
characteristic,
There
ideas, one
is
conditions
gruous
incon-
of
images,
of disordered
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-
"
its authority.If it
can
be shown
suppositionis
INSANITY
AND
41
DREAMING.
an
idea that he
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
continued
not
of
events
long
in their minutest
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
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,
from
in that situation. Wd
call out for innitnni
or
rather i* a
whi"
neoe*
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
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
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
vancing
street,and ad-
troop of cavalry;
St.
All of
arose.
of the
tins
windows
filled the
with
alone, petrified
in
dismal
air,and I
mained
re-
horror, and
of blood
and
bitumen
almost
choked
me.
At
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
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
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
dream
influence
of
person,
whilst
"
condition
makes
of
the
emotions, and
instincts,and
the predominant
repeatedeffort to crush, or dissipate
INTERMISSIONS
LUCID
insane
character
ments,
and
DURING
of
ATTACKS
OF
45
INSANITY.
their
however, of
character,appearinglike
evanescent
an
flash of
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
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
employedas
lengthsunk
who
was
woman,
young
servant, became insane, and at
apparently
perfectdementia.
continued
of
the flashes
But
be found
of
starts,
than
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.
fadinginto
accurate
account
condition of alienation,
well
as
of the condition
of the
mind
as
an
after its
the human
mind.
? Can
theyhave
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.
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
that
themselves
with
insane.
of events
We
are
as
have
well
confused
and
in
transpired,
with
as
correct
innexion
con-
others, whilst
extreme
as
in
advanced
stages,of
its disorders.
have
not been
with
great minuteness,
In
cases,
many
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
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
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
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
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
"
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.
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
'
'
'
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-
healthy state.
that I was
recovering."
for nine
A gentleman,who
an
'
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
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.
in
fit
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-
continued, without
any
CASES
OF
INCIPIENT
INSANITY.
55
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
it was
found
of the
by means
lady informed
commenced
insanity
chaste
number
and
feelings,
out
me
by
This
and
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-
physically
impure notions. So acute
to
that she endeavoured
sufferings,
horrible thoughts,
by an act of suicide.
she threw
more.
patientultimately
she saw,
no
the idea of
Eventually,
complete possessionof
stomach-pump.
himself
eat
her mind,
of soup.
but
basin
herself into
were
her
mental
her
escape from
For this purpose,
was
fortunately
extinguished.This
state of mind
inexplicable
appeared
56
OF
STATE
her, because
to
ideas
and
books, she
could
have
MIND
DURING
INSANITY.
of the animal
she had
never
instincts.
ifhe
or,
as
were
if he
under
had, to
use
his
the words
phrase,
"
own
consciousness,"
"
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
to the wishes
upon
from
whilst under
of
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
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
the words
they uttered
consolation; then
verses
from
pieces of
I
texts
of
were
Scripturewere
to
repeated;
favourite
were
internal"
58
STATE
that
OF
MIND
INSANITY.
DURING
is, originating
within, and
did
proceedfrom
not
persons
to
"
well
as
as
street,in which
appeared to
he resided.
be better, and
mind
my
and
Now
quitefree
was
then
from
such
At
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
that I heard
enter
relative.
fancyingthat
the voices
(" crucified,"
on
a near
in
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.
ture
under
consideration.
"
am
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
alive,and
My brother,
everybodyon
the
after
of it ; but
idea
these, togetherwith
the
anguish
to
under
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
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
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.
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
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
"
as
taken
was
long affliction,
attendingmy
to state them
endeavour
now
in which
manner
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
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
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
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
on
and
the
very,
reco-
amazed."
State of
born," writes another patient,in the
"
"
began
various
I was,
often, where
induced
gave
word
to the
as
of it.
made
use
until I
spring,and
was
of
mention, I entertained
to
which
answers
many
States,
were
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
back
four
I continued
out of my
head
distress and
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
There's
but
talkingso,
thoughtswould
dreadful
'
come
mind
as
troubled
husband
this time
get drunk.
for he
was
kind
again
born, and
children,
poor
Frequentlyit
beaten
I
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
I cried and
me.
I sometimes
my
escape,
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
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
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,
the
up
to the wild
to the house
all returned
we
off on
ran
ing,
morn-
about
and
INSANITY.
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
borrowed
from
the
one
fatal lick
across
his
neck
He
kind
63
OF
STATE
do
willingto
the flash of
The
he
:
to Dr. Hood
far back
periodso
to take
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
the
strong drinks
the
As
for
was
as
before."1
as
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
go
and all
moment,
INSANITY.
DURING
somethingto
writer
period
MIND
an
account
arrival to
pecuniary
who
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
three
hours
I lived in the
months
every time.
college,
attending
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
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
more
of my
about
conduct
Deny
word, I
as
honour
before
saw
me
strangersto
teacher
to
the
most
the steadiness
caused
we
and
me,
were
with
their
esteem.
In
encouragingprospects,but
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
of God.
all notion
men
alone
almost
The
name.
or
our
Creator
is
irreproachable.
to chapel
during
years.
to
France,
as
came
"
in
70
STATE
diction.
OF
When
INSANITY.
DURING
MIND
back, I found
came
on
arrival,a
my
new
who
woman
to wait
used
ever
table,and to do what-
at
me
on
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
all my
girl,
though
to which
attention
for my
but
preferable.
young
I
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
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
le
to you, Monsieur
that
expectedas
unpleasantnews,
threw
my
unavoidable, whatever
mind.
saw
that
not
Docteur, the
make
Instead
better sentiments,and
to
returning
If I do
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
the
71
RECOVERY.
of
averting
town, with
be able to atone
for
fault in the
have
none.
mind.
my
"An
girlto
incident
be removed
presence
little
which
the
led
hope
house, and
the
from
caused
anticipated
me
to
her
town, where
She, either
on
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
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
72
OF
STATE
MIND
INSANITY.
DURING
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
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
town, and
mother
and
to
came
a
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
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
"
"
Mr.
Henderson
sent for
I used
I
me.
The
to attend.
not
was
home.
at
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
to
shake off my
some
torpor
resume
business.
"
what
Notwithstanding
received
could
me
number
increase
was
pupils
if this
But
upwards of fiftyof them.
calls
repeated
to me, there were
gratifying
well.
New
74
STATE
MIND
OP
DURING
INSANITY.
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
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
Had
entitle
would
his establishment, he
me
to
answered
employ me
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,
bread
sorry
am
able
respect-
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,
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
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
may
on
between
three
or
and then, I
Now
cup of tea.
shall,from
hope that
sit up
mere
take
OF
they are
herself.
drowned
then
money
I sent
the
and
son
of the two
brother
women
for
some
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
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
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
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
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
about
presentsme
woman
broken
crying out :
poisonme.'
see
my
'
wish you
it. I then
want
two
resume
mind.
am
awakened
'
mistaken.
Well,' said I,
'come
with
mo
up.
me
to
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.
Fear
OF
from
preventsme
"
time
and
I hear
sister ;
increases
they are
my
which
pursuit,
and
continue
close behind
terrors.
me
I ascribe to bad
my
less than
run
at random.
half
hour
idea
that
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
answers
who
man
perhapswould
better
to
on
not
let him
in.
Such
went
move
caudles.
from
The
given since
along with her
to the house
on
pretencethat they
that he has
and
is the account
of his senses,
out
by the girlwho
me
was
me
stand
until I
out
not
perceive
been
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
80
STATE
dumb).
was
I feel
me.
The
to the
return
make
MIND
DURING
former
INSANITY.
imperiouslyinvites
house, where
harm
no
the
come
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
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
helpthinkingthat
soda
is not black.
make
"They
sit down
me
and
change
clothes,
my
are
feel weary
not
at
all.
look
at my
feet and
hands,
sharp
"
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
CONFESSIONS
OF
visions
Strange
PATIENT
throw
ray
AFTER
81
RECOVERY.
mind
into
ment
great excite-
ing
at
Their
me.
whichever
me
laugh'
shudder.
On
my ears,
If I look towards
laughtermakes
moves
imagineI
the door, it is
and
opening noiselessly,
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.
"
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
As if their number
made
on
the 27th
I don't
that
repeatedly
o
STATE
OF
MIND
DURING
INSANITY.
want
notice
of my
remonstrations.
"
the infant
undeceived
even
so
are
below
by
foolish
the
as
words
believe
of the
that
she
I cannot
be
landlady. I am
has given them
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.'
This
"
of
All
times.
lyingbeside
'
me
I hear
sudden
a
:
Does
girl
ask the
the mother
sleep?'
he
Girl. 'Yes.'
"
Mother.
"
him.
It
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
I feel twice
into
penetrating
my
is silent.
mother
The
something like
I utter
back.
again
all
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
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
'
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
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
arm,
and
the
CONFESSIONS
door.
oppositethe
but
the
in
missed
the well.
so
PATIENT
AFTER
her
The
killed Mr.
are
hat)
servant
not
forgotten,
wide
open) the
to
out
littlegirlis also
theyhave
well awakened
tongue
have
eyes
infant,and,
his
tears
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
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
'
"
"
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
86
STATE
but
I must
OF
be
DURING
MIND
INSANITY.
trulyrepentant.
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
and white
rest of her
body
is closer to
me
is nearlybald
few hours.
peoplewho
from
is concealed
she is dressed
There
is
candle
They
look but
assumed
for
as
The
me.
a
the
daughter
fete,but
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
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.
very
the
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
is
fifth
with curling
tragictableau the young girl,
hair, neatlyclothed, leaningsometimes
her grandon
mother,
"
sometimes
'
heraunt,and repeating
at intervals:
on
the
only
away,
This
'
whole
those
given is
answer
he is
is Mr.
'
D. ?' to which
Hold
question
tongue ; he is
your
spectacle
keepsmy
mind
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
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
wards
few
hours
ago.
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
"
attendants
to
make
swallow
me
medicine.
some
The
idea
on
resumed
press,
his natural
They
me.
are
form, and
lyingin
brother, who
readyto springon
seems
has
there
seems
to
me
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
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-
92
OP
STATE
taken
into consideration.
Roman
time
Catholic, I
in
and
struck
"
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
on
obtain the
"
an
invincible
in
with-
courage
myself.
time
when
Now
theatres.
attended
and
then,
if I
that
perceive
I remark
that
the attacks
no
one
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.
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
(man).
It
was
not,
even
with
fortunate that
The
doctor
comes
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
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
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
Christian.
live
as
the
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
was
resumed
was
from
without
any strong
enabled to maintain
been
"
reasons
any
means
from
I
those
then
going
saw
the
her
had
family,
friends,who
For
Deny.
little
my
badly advised by
to my
come
man
I abstained
been
likely
not
my
wife
she visited.
out
they,withexplainto myself,
in
livelihood,had taken up lodgings
I cannot
of
her
found
visits,in
that
wrong
the
way.
drank
she returned
state
bordering on
intoxication.
fruit
of
my
lalxmrs
was
again
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
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
some
cakes and
little bottle of
whisky.
For
after
peopleof
walk
the house
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
substantial nourishment.
any more
stomach
It
seems
if my
as
could not
throughwhich
ears
in
;
a
round, and
I turn
small
who
stall,
few
find that
sells
words
French
at
one
bed-room
can
man,
night,
mation
infor-
some
ask
my
each.
penny
for the
give me
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.
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
greatmany
France very
that
I perceive
ice.
Some
although he
has
appear to be
just told
me
with
acquainted
that he
H
com-
98
STATE
OF
MIND
menced
DURING
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
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-
whose
woman
for
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.
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
into conversation
a
of the
man
me.
and
size.
woman,
This
not
one
to be
of them
They enter
but theyuse
fact increases
my
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
when
part,will
from
nate.
alter-
outside
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.
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
in the street
men
"
and
women
"
de
most
Fualdcs
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
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.
contain
placesaround
are
well
often address
haste
reluctantly
givethe
At
go.
but
every
riable
inva-
same
intervals,too, the
concert,which, in my
cries
no
of what
aware
voices
make
to
no
soning.
rea-
any
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-
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
observe
that
its
prised
sur-
to the
whenever
the
have
died
as
soon
as
the
sounds
of the
said
steps
foot-
away.
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
this house.
and
them
take my
Let them
and
unsuccessful,
I
as
beg of
a
favour.
fall on
in
There
them
now
longer fear
men
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-
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
I find
strike
them
stillin bed
as
open.
not
seven
are
time
staircase.
and
Let
gone.
reflection does
This
INSANITY.
DURING
time
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
that
exhaustion, and
walk
is
guidethat London-bridge
the
at
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
not to abandon
I go
me.
at random
on
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
see
thousands
of
eatingcakes.
beer, because
people,
drinkingbeer
but I would
no
good.
pump.
There
buy
sit many,
am
am
very
sure
littlewater
many
thirsty,
it dots
out of
106
OF
STATE
I then
"
resume
MIND
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
accommodation
for the
"
"
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
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.
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
takinga
cumbrance,
entrust
her
with
she
which
the
readily
of
intention
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
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
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
policemanwho
took
best
can
me
chief
do
of my
to
ties
abili-
speak.
officer tells
nothing unless
me
the
I
I
lodging-house.
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.
can
PATIENT
been
me
all my
to try if
that I
found, and
that he will
spare
restored to me.
I leave the
assures
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
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
on
my
110
STATE
OP
MIND
remember,) where
DURING
INSANITY.
desired to
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
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
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
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
'
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
me
in
over
invisible adviser
an
who
commands
to bear
me
silence
however,
lien la, M.
Diavolo
mais
vous
je ne
encore
crains pas
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
every
one
has been
away
roused
112
STATE
againstme.
loaf
penny
OF
on
closing
now
food
it
seems
need
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.
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
"
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
am
faith have
been
probably
shape of a large
the
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
"
me
Some
others among
the crowd
are
not
so
to
accept,
henceforth
posed
kindlydis-
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
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
with
is to be done
accueil
but
the
me.
poor-house
; I
to send
to the
good
himself
take upon
the
me
must
from
The
above.
sound
was
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,
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
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
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
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
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.
CONFESSIONS
OF
THE
INSANE
AFTER
117
RECOVERY.
ham, which
leave
to taste it.
appetite
the night. It is not
it has
abated.
untouched,
The
over
Then
because
yet.
I wait
resume
my
have
no
a part
falling
in the
random
room
of
until
strolls. I
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
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
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.
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
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
found
there shall be
in which
no
rest for
me
until I have
CONFESSIONS
OF
THE
INSANE
AFTER
119
RECOVERY.
harassing
cry of
sound by my ears.
beside
me;
'
againsee
and
now
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
are
of the
nightat
kind
requestof
to
me
my
is
liquidfrom
dreaded
is
who
shower
burns
accompaniedwith
few
On the
to send
consents
words
to that purpose,
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,
guide,he, however,
the
behind
allow that
which
me
I follow
police-station.
the
officer cannot
find any
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
others
four
see
are
infernal
brother-in-law.
my
hear
He
of delusions.
occupiedby
God
organs
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
sinner's death.
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
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
life. He
of his
is
show
to
to myself,
Evil One.
obtain
life of sins,I
the
arc
shall
Satan
and
great sufferings,
instance
that God
that
121
RECOVERY.
therefore
well-known
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
red
says, he
have
must
scenes
frightful
assume
spirits,
the
horrid
my
soul.
whom
men,
shapes;
at
me
into
the
got
lead is
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
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
voice
tells
I therefore
(in words)
defence
styleshimself
who
pray
to silence.
that
for
prayer alone
interruption,
exceptwhen
exhaustion.
is loathsome
it would
I become
and
cannot
whenever
"
INSANITY.
DURING
believer.
true
MIND
to me,
I wont
and
take
any
me.
thing
Everyis
poison for
food.
and
Now
of the devils
then
I drink
;
a
"
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
this must
the
enter
can
mind,
my
voice
Encore
Jesuits.
forgotten.
night
every
is
that there
am
There
none.
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
latter end
the
informed
am
heaven.
doubt
or
Towards
heart.
any
celestial palacesin God's
cannot
Infant
for the
take
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
'
forgiveus
"Such
the
were
such
!' "c.
my
mind
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
because
sine
it was
my
attendants
as
and
new
to resist.
Thus
and
the
down
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
make
one
his way
on
same
"
It seemed
to
me
that I
was
ordered to do
so
some
hundred
126
STATE
OF
MIND
DURING
INSANITY.
times before
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
made
appearance
"
Annales
d'Hygifene."
CONFESSIONS
paper on her
and means,
OP
THE
INSANE
business,to which
AFTER
J 27
RECOVERY.
to
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,
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
was
"
Jews.
When
was
informed
of that
circumstance, I
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.
one
my
attacked
DURING
by
diarrhoea, and
severe
had
no
rest.
more
"
hostess
"
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
in the same
myself,occurring
fullyout. My daughtertold me, that she had witnessed
me
throwingmyselfinto the street from the third flat of
a
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
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
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.
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
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
it
was
sacred
would
precision
peoplewould
money
as
manner,
fear.
Rotterdam, whence
see
this
without
boat
to
family
the
to
Munster
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.
at
DURING
in
to
MIND
have
different
at
,
Delft,I
fancied
myself
of madness
means
very
hotel,where
idea
floating
people,and that I
a
different
rest
"
was
as
The
night
dream.
condition,however, in which
spent
the
first
seems
been
buried
alive,and
was
had
now
awakened
in
the
with
eternity,
the
fate,and
as
was
unconscious
of any
crime
done
with
CONFESSIONS
OF
PATIENT
AFTER
133
RRCOVF.RT.
as
affected with
person
tetanus.
I recovered
fallen into
not
('Query,Armi').
this
prosecuted
a
smile in the
into the
The
search
house
the house
person, and
demolished.
was
of souls
merchant
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.
have
burst
I
luckily
Most
brain.
in my
left in the
was
were
the
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,
which
and
ear
cannonade, ceaseless,reverberated
we
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
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
"
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
the
men
he
in
French,
me
and
princeroyal,
all of a sudden
I felt myself
my eyes.
before the princem i
for appearing
that
he
so
was
unsuited
for the
still alive,and
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
there
were
which
be
still
not
was
cruel trials in
more
until I had
to escape
gone
days'illness.
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,
ascended
again
saw
servation
ob-
it deserved
thrown
that
caused
stairs I counted
into
the door
distress
on
could not
was
rence
diffe-
I felt much
on
had
attemptedto
smile
keeper
route, without
When
away.
did
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
been
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.
thought that
and
insisted
"
the meat
the idea
me
had
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
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
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
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
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
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
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.
to
was
and
lest he
them, and
double
was
for the
no
gone
lock to it.
to
room,
bed-
husband
my
bed, I noticed
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.
which
that,
so
spirit,
had
from
recovered, impartedto
that
me
new
had
life.
entered
for
on
new
incident which
an
the
much
has
of the
appearance
marvellous.
"Arriving
at
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
of the
corn
had
corn
had
been
spreadon
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
across
body had
was
tenantless.
I called
I made
word, to
To
the
soldier,who
young
coffin.
procession
; but
their escort
the
was
hillock covered
with
verdure
and thorns
CONFESSIONS
OP
he there made
cane.
He
him
whether
banks
PATIENT
still declined
of the Rhine
was
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
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
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
were
treme
this
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
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
He
fancied himself
"
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
was
him
of
horn
transported
in
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
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
"
"
those
most
flowers
on
common
my
curtains
in
every
and
form
of delirium.
in
men
there
tin
in.
tinual
con-
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
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,
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
the
He
existed
him
to
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
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
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.
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
go
it
high-prince,of our
the morning, I felt a
alarmed
frequently
afraid I should
as
believed that
now
My
radiance
that it
I had
me.
was
the
to perform.
ore
than
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
"
he
and
towards
progressed
bewildered
ing.
understand-
ILLUSTRATIVE
151
CASES.
perceptionsbecame
relate to the
"
after
awakening into
Whilst
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
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
alas !
brightobject,
looked
so
to my
mind.
I found that
degree,dazzle
"
time
me.
of my
darkness
this mysterious
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
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
form.
his
"
"
SINGULAR
of my
wife ?
Could
againsther, in
divorce
CASE
the
I establish
of law ?
court
OF
ground
153
RECOVERY.
an
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."
She
to suppose.
home,
gave
detailed and
gradualreturn of
been carrying
on
For
with
struggling
her
account
deeplyinteresting
battle
and of the steady
reason,
for two
more
the
months
with
of the
she had
the insane
lusions.
de-
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
and
satisfaction to the
was
could
sermon."
much
occasionally
But
listen
even
distressed
informed
me
after her
was
pelled
im-
156
STATE
OF
MIND
WHEN
RECOVERING
FROM
INSANITY.
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
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
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
years,
verdure of
and
sorrows
vanished
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
had
before travelled
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.
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
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
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
Walford."
Edited
from
by
the Rev.
IMPOSSIBILITY
OF
DEFINING
CHAPTER
Anomalous
and
159
INSANITY.
VI.
Masked
Affections
of the
Mind.
BEFORE
masked
however, premise,that
it is
insanity,
firstinroads and
healthyand
of brain
in the
dawnings of
demonstrate
to
conditions
when
disordered
preciseperiod certain
morbid
mind.
majorityof cases
to its origin,
the
and
insane tion,
percepbetween
boundary-line
the
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,
When
deviation
remarked,
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
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-
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.
child's tendencies.
the
appearinglike
other
and
until
it
not
was
manifested
placehim
the age
of
fifteen,
he,
and then it
itself,
under
At
considered necessary to
was
restraint.
When
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
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
been
thing.
With
these
had
Pinel
been
*
"
was
a mere
dispositions,
the
is sufficient to make
M.
insanitybreak out.'
with
acquainted
going
on
Dictionnaire
accidental cause
unnoticed
case
for
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-
but
acutely,
adult
life; not
their sensations
that
are
of
children
a
do
not
feel
nature, and
fleeting
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
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."
men
young
and
four
me
mad
American
or
kill me;
engage
of business
men
this kind
but
asylums,which
in
of
I must
contained
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
nineteen,20
in the
one
Drs. Aubanel
per cent.
Bicetre,in the
and
children,
to
and
Thorpeobserved
"
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
made
the
and
to a
disposition
great susceptibility
of the mental
return
has
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
inherited
number
sixteen
from
of cases,
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-
to
inability
remarkable
assume
afforded insecure
The
number
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,
duties to occupy
their attention.
antecedents
Upon analysingthe patient'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
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
man
excess,
manifests
an
excess
of
these
mental
He
will
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
excess
recovery)the
time
efforts made
to
induce
them
to
eat, at
"
"
of
More
devils than
vast hell
In
investigating,"
says an
the first caution
insanity,
confound
disorders
of
mental
acute
can
hold."
to be
observed
is not
with
functions
to
natural
very unlikeness
actingand of
common
from
sometimes
of their manifestations
to the modes
of
in
health,that is the
true
feature
172
MASKED
AFFECTIONS
OF
THE
MIND.
the variations of
pare
third,would, in
index
In
different
constitution,be
as
sure
an
disease."*
of stomachic
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
intellect which
sanction
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
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
infancy. It
field is
and
here
to
presented
the
truth-seeking
174
MASKED
OF
AFFECTIONS
THE
MIND.
so
often witnessed
concealed
do
from
and
such
the canker
alienation ! How
often
and death
ruin, beggary,disgrace,
result
mental
the
happinessof
be
done
to
many
the
arrest
hurlingso
This
extent
morbid
in real life.
and
mental
It is
hearth.
progress
of the
course
to ruin
many
type of
domestic
fearful
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
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.
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,
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.
or
These
health.
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
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
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
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.
and
manners
nor
sionally
Occa-
disoverbearing
N
178
AFFECTIONS
MASKED
.OF
THE
MIND.
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
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
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
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."
"
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
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.
meanour,
de-
unworthineii,
own
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
"
"
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
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
great benefit,
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
do
of
most
equanimity of
of a lady,who,
he
coma.
not
continues
painfulebullitions
exhibited
been the
headaches.
generally
precededby severe
faculties
but
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
once
separate himself
happy
from
her,
and
abandon
his
fireside.
somewhat
similar
case
INSANITY
SHOWN
Dr. "Webster.
IN
ACTS
OF
BRUTALITY.
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
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
ordinaryactions
affected,in many
so
of domestic
with
compatible
of those
of this latent
life,
larities
greatirregu-
fearful amount
benevolence.
exist
in existence,producing,
domestic
attainments, and
is much
There
tality.
bru-
cases,
or
would
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
184
MASKED
AFFECTIONS
OF
THE
MIND.
relations could
not
enter
his house
without
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
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
systematicbrutality.To
and
unnatural
such
that
feeling,
remove
extent
an
the
her
house,
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
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
Pepper,fourteen
years of age,
a
pot-boy,
186
MASKED
OF
AFFECTIONS
of sullen
and
MIND.
THE
mitted
comdisposition,
morose
"
"
kick."
throw
He
them
had
often
been
into the
known
that
fire,
he
to
catch
might
flies and
observe them
"
locked
himself
up
in
room,
and, when
discovered,life
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
his letter
room,
contain
the details of
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
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
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
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,
such
birth
there
an
becile
im-
to make
as
the individual
"
"
"
was
That
And
servingman,
proud in
heart and
mind,
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
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
disorder.
It
was
not
until
I had
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
conditioned
man,
with
whom
no
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
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.
condition
of
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
Psychology."
hung
Then
he
one
forwards,his
was
heavilyupon
we
sky
soul.
poor
Could
walked
in his
affected
by
been made."
MASKED
AFFECTIONS
OF
MIND.
THE
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
not
advanced
nistration
followed the admi-
to be in existence
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.
she
she
had
in
was
herself
agitation,I
"
out
have
been
prison.
accused
Under
up
to make
of
the
done
no
of
the
some
crime, for
influence
of this
tried
It
was.
then
to
great
deemed
SINGULAR
confine
to
necessary
CASE
OF
her
by
197
HYDROPHOBIA.
of
means
strait waistcoat.
About
the
curtains
her back,
lying on
was
The
undrawn.
were
young
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
"
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
cried
sunk
into
me
up ! break
state of calmness
minute, but
looks, and
frightened
renewed
soon
her
a
expressed
became
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
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
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
of the
waistcoat
requestedto swallow
hand, beginningto be
100
HYDROPHOBIA.
The
cords of the
slackened,and
were
she
waa
the
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-
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.
was
serious
of
THE
OF
mischief
to herself
excitement, may, to
of
preventing
duringher
violent
extent, have
some
gested
sug-
and
her
moral
duellists,what
assassins
crueltyto similar
to physiologywill
who
have
remarks
emotions,
been
causes
be
"
"
What
ferocious
How
attentive
executed, and
their
who
have
been
urged
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-
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
MIND.
St. Bartholomew's
Can
moral
OF
replied
He
/"
me
of
confession
his
insanity,and
assassinated
Henry
he suffered
the
longed
pro-
beingtorn
directions ?
A
made.
The
from
brain
health, but
evidences of
found
itself showed
the
marked
no
deviation
dura,
and
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
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
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
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
wench
cured
one
mad
the
"
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
was
health.
to
MIND.
"c., decided
manner,
She
THE
an
so
sort of
stuff,for
I do you or
any
effectual in the removal
of
more
fact was,
or
three active
the
his warehouse
absent from
and
business
than
usual
but
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
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
P. 34.
206
MASKED
tion.
closelyobserved, but
personalrestraint should
MIND.
should
that
no
actual
of
measures
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
to his
assigna
THE
gentleman'sconduct
that the
advised
be
of the
OF
AFFECTIONS
for
motive
sane
so
for
doing)disposed,
an
amount
matters
relative to the
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
condition
of mind
insane
yet sufficiently
to manage
his
own
but not
affairs,
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
or
him, ordered
associated with
to be cut down
on
number
of valuable
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,
Nevertheless, he did
symptom
which
entailed),and
not
for many
years
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
from
in
court
friends for
of law
one
libel,without
of his
any
oldest
and
most
valued
for such
of justification
kind
common
was
and
necessaries
in the habit of
of life.
When
flyinginto
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!)
were
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
moment,
screen
be conceived,that I have
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
related to the
dearest
ties.
morbid
desire to
shed
human
of the
affections
(caused by particular
blood,
brain,) from
that
"
"
*Jiattbe done
"
and
must
"
dear
my
must
has
"
my
and
was
the most
loving
fathers.
destroyhuman life,
by a fearful
obtained a completeascendancy
over
lunatic,driven
delusion,which
wife
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
solemn
functions that
can
gated
dele-
responsible
being.
"
rei ;
Incertseque
Et
dictet
perjuria
tauro,
prseferre
pndori,
vivendi perderecausas."
nefas animam
erode
Suinmum
testis
Falsus,et admoto
proptervitam
"Juven."Sat.
The
be
positionof
Which
must
psychologicalexpert"is one
"
be false,
or
heaven
would
pass
In
Or your
I dreamt
own
tears would
fleck the
ground !
"
*****
"
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
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
parts of
her
hair, and
tied round
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
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
and
judges have
216
of
MASKED
AFFECTIONS
OF
THE
MIND.
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
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
had
"
should be
than
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
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
pleaof insanitywere
strong, and
rise to
the
had
of the
of the
state
prisoner's
imputedcrime, and
conclusions
of intellect,
some
on
the examination 1
to his trial.
immediatelypreviously
perpetration
218
MASKED
AFFECTIONS
OF
THE
MIND.
sufficient to
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
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
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
as
command,
of
amount
him, by
and
under
221
INSANITY.
an
man
propertyis, upon
clear and
undoubted
neous
erro-
ing
hav-
large
dence,
evi-
alienation,
are
decision
the
unable
to
come
to
an
unanimous
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.
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
who
person
to mask, from
cleverly,
jury, all evidence of his
the
THE
and
undetected insanity,
legally
towards
those who, influenced by
of
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
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
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.
many
upon
portant, and
often
thankless
duty
in
support
an
im-
of
the
evidence
of
the
medical
agoniesof
much
painfuldeath
strongerthan was
a
mentioned
abuse.
court, the
Instead
is
proving insanity
man
treated
rescue
adduced
expert is
profound
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
not, in many
by
to
cases,
tenanced
degreecounpress, in the slightest
the judge who triesthe criminal,or deferred
portionof
by
the
the
by
jury,whose
duty it is to
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
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
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
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
certain
a
periodof life,few
high degree of
moral
have
th"" hardihood
is
courage
requiredto
have
awaits
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
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
"
"
"
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
me
Insanire
est genus
unum),
putas?"
adds,
"
"
in temper, I would
me
conversation
"
and
agonizingconsciousness
lib. ii.),
the
madness
not
me
Quid
?"
Ego
uam
videor mihi
sanus"
respondsthe Stoic,
"
Caput
abscissum
demens
Gnati
infelicis,"
cum
portatAgave
It would
thus
that
of
conception
FORE8HADOWING8
bid
and
insane
OP
INSANITY.
229
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
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
from
language,conceptions,
of which
his
delicate and
the
sensitive
templation
con-
nature
unclouded
230
STAGE
suicide, and
OF
did
which
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
"
"
"
"
"
BISHOP
BUTLER
records
that
he
reason
him
if he
for
had
relaxed
singlemoment
the
was,
all his
life,
(he
suggestions
have
says, would
stern wakefulness
MORBID
APPREHENSIONS
OF
231
INSANITY.
If I went
severance.
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
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
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
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
temporary
;
familiariieyour
gradually
disease.
to
homble.
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
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
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
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
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
obscene
words
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-
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
of the Mind
Cheyne,M.D.
in
supposed connexion
236
STAGE
CONSCIOUSNESS.
OF
moments
brain
A
not
was
The
persons
who
nothing of
his
he
into
entered
and
more
more
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
and
decorum.
*
Wijjau's Dualityof
"
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
lifeunder
that
might
to commit
his
veloped
en-
own
some
act
harrowing
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,
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-
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
was,
therefore,competent to
reason
with
himself
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
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
paying court
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
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
Ireland.
party, and
afternoon
my
not
apparitionwas,
an
attend
Appearing somewhat
prescription.
was
visions,as fancies.
my
on
He
"
"
He
"
"
what
he
he
I
prescribes."
had
deavoured
en-
of treatment
Whatever
the
for the
suggested
health,these imaginarypersons
clergyman's
to oppose !
uncourteously,
of this
most
mind
patient's
lishment
re-estab-
240
CONSCIOUSNESS.
OF
STAGE
'
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
in
India, he
regularly,
saying
it agreed with him
never
morning, either
with
appointment
an
there he wrote
two
or
three
days
after what
we
"
the
strange as
more
The
arouse.
could
inches
not
being about
had
opened
bending over
withdraw
my
so
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
seen
lady whom
young
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
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
"
'
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
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
.
bore
the
no
resemblance
time, but
do
for
to any
now
one
think
it
knew.
was
I did
warning
not at
of my
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
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
'
for I had
nervous,
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.
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
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
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
one
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
robed
better,for nothingcould be
I knew
to my
lonely.It
I ascended
at
I told
me
distinct than
afterwards,I went
she
us
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
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
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
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,
in my
that
room.
then
who
asked
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
was
SINGULAR
snatchingup
I reached
the
CASE
OP
the
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
some
night,
He
had
months
I had
seen.
after this,a
gentlemanfriend
been
not
told
how
them
had
been
alarmed,
some
one
went
into
passage, but
saw
horrible vision I
ever
the
nothing.
"
The
had, was
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
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
deceived
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
I did not
mention
or
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
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
weeks
been found
again at
should
my
After I woke
'
awake
and
daylight,
but
from
'
Afterwards
aroused
was
"
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.
'
child ?V-
was
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
see,
249
'8 school
INSANITY.
after
we
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
parent to
secret
his children
of
recesses
twining
en-
thought;
"
motiveless,unaccountable, and
"
unreasonable
"
shadow, and
mist, dark
morbidlydisturbed and
is imagined to
*
There
whilst
no
delusions
so
commenced
have
across
the
its
ravages.*
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-
eight or
about
week
nine
or
months
ten
he
daysafterwards,he
murdered
252
OF
STAGE
will,for
time
CONSCIOUSNESS.
playwell
to
his
part,and
thus
disarm
all suspicion
to his actual condition of inebriation.
as
Such
person in the
incipient
stage
of
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
portrayedthe
"
"
"
"
Do
escape
could
believe,"said he, with impatience,that such objections
"
not
me
againsttruth
reasoned
with
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
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,
know
the
to influence
another,who
conviction
of its """*
cannot, like roe, be conscious
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
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
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."
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
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."
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
sleep.
are
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
"
when
Oh, now ! do
fate,
you know,
My
"
fowls
not
u
WM
naughty man
; was
be
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
by
healthy
and
the
when
women
Jeremiah, chap.xvii. v.
t
our
in sane.
"
need
Why
nature,
reason,
no
were
we
9.
talk of
withdrawn
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
There
the results of
are, of course,
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
vigilant
parentsare
of moral contamination
which
operation,
the most
are
bound
not
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
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
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
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
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,
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
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
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
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,
Brown
as
recorded
his
in
The
pointreferred to.
greatintellectual
was
that he had
fallen under
common
with brutes,an
animal
unhappy state
own
"
minister of
dissenting
delusion
of God, who
left him
Simon
suffered from
Gentleman's
He
powers.
and
graduallyto perish,
life; that it
was
therefore
tokens
him
to pray,
and
and after
of distress,
some
incongruousto
be
"
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,
there may
rise up
man
MORBID
PRESENTIMENT
of
generalfeeling
after
head, and
two
few
or
OP
This
malaixc.
vered
reco-
taken from
were
his
tered.
purges adminisfrom the time he placed
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
threatened
remarks
with
sometimes
attacks
perfectand
appear
ment,
astonish-
without
"
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
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
consciousness
before
memory,
paused and
half-wakingfrom
his
chords
uncertain
an
one
'
203
BRAIN-DISEASE.
eclipse.
'
Ever
OF
Under
these
circumstances, it
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
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
"
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,
'
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
"
first."
TOP
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
of his
"
by
havingpassed
several
weeks
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
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
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
These
of headache.
as well as
sleep,
only observable symptoms that precededthis
want
of
were
the
unnatunil
270
OF
STAGE
EXALTATION.
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
as
several
seen
in
of
(aftera violent
exaltation
referred
previously
to, the
speaking of
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
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,
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
state is extreme
to
constitutes
depression,
suicide
is
suspected.The
"
an
achieved
"
Furor
to commit
est,agnoscere solis
"
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
"
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.
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
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
the
stomach
was
overloaded
and
distended
with
food.
"
On
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,
in the Three
of God.
name
"
.
about
Amen
bequeath all
"
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
."
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.
Journal."
Ptychological
T
274
the
STAGE
OF
EXALTATION.
and
incorrigible
garrulity,
and
words
incoherent
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
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
276
acute
symptoms
OF
of his
maniacal
his mind
employ
to
STAGE
found
that
This
talent
in
EXALTATION.
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
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,
attendance
the
upon
she
phenomenon, that
patient,
had
scribed,
tran-
before
of
verses
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
has
many
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
"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
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
gust of
as
which
278
STAGE
OF
EXALTATION.
me
to consider
an
portant
im-
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.
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
He
The*
SUBTLE
His
eyes
their wildnew
kit the
came
that
hurt*
lone.
abuse
SOIIHO
hit
brain,
foams, he ihates hit chain,
it mad
again."
It
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.
unmasked
been found
280
STAGE
OF
EXALTATION.
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
of
observes, in
one
"
to deal
unaccustomed
them, and
phenomena
persons
not
cases
which
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
acts and
remarkable
been
have, in general,
acuteness.
These
are
the
of their lives,
circumstances
cases
which
and
subtlety
mock
frequently
for
the wisdom
It will be
of the wisest
importantnot
to
in
confound
the
hallucinations
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."
murder
my
care
than
a
one
young
man
gentle-
occasion, to
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
282
STAGE
EXALTATION.
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
"
"
that
an
insane
person
him
had
to
pletely
com-
sustain
284
STAGE
In attacks of
and
OF
EXALTATION.
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
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
seat
of
dormant
reason,
and
and
undisputed,
*
"
arrogate and
often unbridled
sleepof
"
the
with
spirit,
not
exercise
the
right of
sovereignty.*
simply a bodilydisease.
It is the
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
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,
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
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
conduct, and
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
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
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
"
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
every
so
Smttfu*g**
on
trayelled
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
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
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
an
account
of them, but
'twas
'
than
St.
Bartholomew,
at every
You
stagehe
had
had
come
to.
'
fungus,
I'll tell it,'
cried Smel-
PHYSICIAN."
TORTURES
ment
OP
WICKED
CONSCIENCE.
and unrepentedcrimes,unforagainstinexpiated
givenby Heaven,
"
and
"
unwhiptof justice"
upon
Judioe
nemo
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
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
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
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
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
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,
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.
great
centre, not
nervous
affections
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
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-
"
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
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-
top of
the
he
a
opened
faint tone
happened?"
able to
resume
his
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,
had, duringthe
of
altered condition
was
epilepsy,
six months,
succeeding
of his
remarkable.
eleven simila
INSIDIOUS
SYMPTOMS
OF
GENERAL
295
PARALYSIS.
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
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
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.
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
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
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
some
mind
latent and
not
concealed delusion,that
has
for
weeks,
SUBTLE
and
the
TYPES
OF
SUICIDAL
301
INSANITY.
under
influence
the
hallucinations
for
of monomaniacal
ideas and
upon
been
terrible
"
"
"
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
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
one
of
the
most
304
STAGE
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
This
first
the
of the
estimation
person
whose
mind
is
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:
"
all other
mind, in
favourite
whenever
it is offended
with
the
bitterness
of
truth.
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.
before
months
he
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
"
306
STAGE
mind.
The
was
ABERRATION.
OF
first indication
of actual
the
of
appearance
delusion
sanity,
in-
around
halo
transient
and
whatever
which
one
floor,over
of
she
;
had, that
that
deep
which
it
height of
the
was
one
smooth
chasms
was
was
the stair
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.
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
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 !
cerebral
to
walk
But
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
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
remained
lobes
were
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
some
insensible.
When
the surgeon
came,
he bled
him
but still he
under
considerable
stupor; he
was
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
OF
state of
DISEASE
OF
THE
311
BRAIN.
greatterror by
apparition
an
fancied
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.
"
"
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
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
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
that
sent
was
quicklyperceivedthat
deranged,when, turning towards
time
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
more
up
cause
his
and
mind
composed.
importunate,
more
to
retire to rest,
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
it,which
I have
hag, like
one
enters
with
straightup
sometimes
haunt
frowningand
incensed countenance,
which
indignation
the
heath
of
Abudah
in the
oriental tale
old
; an
of those who
to me,
the merchant
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
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
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
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
"
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
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
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
husband
of al"erration of mind.
exhibited
pilfereverythingshe
so
the
mental
Il.r
nine months
became
patnitlysingular,that, for
317
CONCEALIXO.
itself in
to
disposition
The
lay her hands upon.
concealed in various
cleverly
in
-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,
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
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.
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
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.
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.
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
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
"
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
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
ACTS
the
OF
vessel he
mental
Indies
had
821
IMMORALITY.
had
shown
derangement.
""
never
in this
case
no
His
pected
sus-
the
conduct
time
of the
commission
of the
assault,his
was
strict surveillance.
On
in
pronounced to be clearly
his
an
322
STAGE
OF
ABERRATION.
the immoral
did the mind
offence the
of the civilauthorities,
and
and
treatment
frst OVERT
act
restraint.
of i/ixn/iily,
become
of the indecent
been
of
singularin
offence,he
his manner,
the age
of acute
health.
to her
with
been
and
was
disturbed
observed
heard
to
to
have
complain
nights.
young
herself
tears.
had
own
She
room,
where
exhibited
she
a
was
often
found
bathed
in
to associate
great indisposition
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
of
want
deviation from
his
normal
and
acuteness,activity,
condition
vigour.
He
of intellectual
is
painfully
recognises
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
room,
condition
these
or
about
saunter
the
of
dreamy reverie.
symptoms consequent
house
have
upon
an
or
streets
often
nessed
wit-
overtaxed
and
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,
the mind
of
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
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
"
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
the
patient
may
well be anxious
as
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,
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
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
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
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
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
faculties ; sometimes
manifest
th.-re
are
what
MMicab.
theywy.""A*dral'i Cliitiyuf
330
IMPAIRMENT
observed
never
vigour;
in this
OF
MIND.
diminution
patientany
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
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
was
habit of
the pages
over
children
of favourite
ing
books, and look-
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
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
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
"
Newton,
capableof
to
fatigue,
long
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
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
appears
in the
to be
"
"
"
"
"
the
exact
334
MORBID
to
sipatedly
genius."
How
PHENOMENA
OF
singleobjectis the
desirable then
it
ATTENTION.
sure
of
mark
superior
should
is,that this faculty
be
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
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
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
cultivation and
IMPAIRMENT
It is
"
heart
by
the
OF
attention
335
ATTENTION.
that
shiftingits objects,
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,
"
"
"
of whose
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.
(when
it is too
late to
he reads and
re-reads with
determined
resolution,and
"
"
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
but
perfectly
plain,
into each
run
that
in
such
the
inscription,
in
that the
manner
characters
are
little time
they seem to
and
undistinguishable,
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
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
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
is also
mind.
the
is often precursory
softeningof
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,
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
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-
romance
will be
the
only idea
that
can
340
MORBID
be convinced
PHENOMENA
these times
there
in my
was
an
ATTENTION.
OF
dreamingof myself.At
incredible acuteness
or
intense-
sensations.
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
from
physicalsensibility,
slightbodilyailments, which
tually
even-
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,
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
have
the
alterations of tissue
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
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.
is
agencies
organism,
psychical
influence of moral
results
tangible
tissues.
of mental influences on the various physical
How
much
of self-created bodily
voluntarily
suffering,
attests
anatomy painfully
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
"
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
THE
an
unhealthyand
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
fearful mischief
resolute mental
of
that
ensues
the
mental
from
emotions.
neglecting,
by
"
Whenever
effort is
there exists
requiredin
consciousness
that
decided
and
rivet
venous
that
the
assured
cerebral circulation.
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
In
his
attempt
to
do
so, he
still further
"
The
OF
EFPECT
MORBID
existence of
3 1 ~)
ATTENTION.
CONCENTRATED
detailed,
previously
brain is quiteunfit for
like those
symptoms
essential to
are
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
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
tumultuous
disorder of my
senses, in which
was
inca-
346
MORBID
PHENOMENA
OF
ATTENTION.
one
mind.
my
The
of,and
several efforts to
by
better
of
nature
trifling
aware
perfectly
into
involuntarily
these thoughtsI was
also conscious
was
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
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
an
strange and
less
which
ones
to
come
little
me
longer,to
rightpronunciationof
the
few
with
part,preserved
slow
anxious
348
MORBID
others
PHENOMENA
the false
corrected
;
by
any
and
in
OF
ATTENTION.
is made
third modification
condition,he mixes
up
to
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
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
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
was
one
air and
scene,
as
well
anxieties of business.
manifested
symptoms
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
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,
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
business, involvingcomplicatedcalculations
and
and
afterwards
mineral
hesitation in the
of
thought,were
the
disease
reason
and
of
tonics.
The
mental
distraction,
life.
precedingcase
very
CASE
It appears
account
from
OF
that
OSCAR,
the
Dr. W.
KINO
OF
851
SWEDEN.
D. Moore's
reportof
the
"
"
The
lower
extremities,the muscles
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.
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
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
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
itself
the late
occurred with
more
symptoms.
last
we
long since,
six or eight
have
seen,
it
No
one
who
had the
good fortune
to
of a sudden
appear
to
his thoughts
tranxfrr
really
to be abstracted and
t
some
other
on
subject
A
354
MORBID
PHENOMENA
OF
ATTENTION.
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
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
is effected." *
of movements
I
consulted
was
in the
gentleman,connected
suspectedto
at the
with
of
Exchange, who
was
brain.
His
of my
muscular
weakness,
in the
case
1857
occasional
symptoms,
were
as
follow
paroxysms
of
of the superior
headache, slight
paralysis
palpebrae
severe
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
to
of numbness
not,
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
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
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,
as
dent,
decay,acci-
disease,be,
a.
Disordered.
/8. Weakened.
"y.
Lost.
J. Perverted.
".
I propose
Exalted.
to consider
in this
in
section,somewhat
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
and
its
358
MORBID
membranes,
PHENOMENA
mechanical
OF
violence
MEMORY.
to
the
head,
by
or
atheromatous
cerebral
vessels
the
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 this
situation of the
the
"
thesaurus
vesicular
"
omnium
mental
rerum
repository
protectfrom
into the
entrance
an
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
memory,
obscure
CLASSIFICATION
NATURAL
TI1K
to
the
mind, it will be
and
natural
order
sary
neces-
as
priorityof
their admission
of
various
which
in
of
only
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
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
aspect and
a
two
When
latter.
that
less
or
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
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
ness
with
termed
properly
"
Memory,"
is made
mental
the revival
memory,
"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
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
of
I cannot
"
others,that the
The
power
of
ment
derange-
the former
of these
of
capacity
attention is weakened
causes.
It is
which
circumstantial
youth.
In
some
common
occurrences
of life.
stroke of
old
men
"
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
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
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
admitted
Vives,
memory
words, the
as
"
relation in which
The
translated
to the
senses
by Sir W.
and
imagination,
Such
from
the
the
simpleto
universal.
This
order
from
is from
"
the
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
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-
events, becomes
says, when
destroyed. Horace
sad infirmities that sometimes
"
Multa
Quaeritet
quod
Vel
old age,
the
"
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
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
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
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
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,
memory.
Strange infirmities
"
with
of the
there
memory
cerebral disease, and justlyto be
are
ciated
asso-
regarded
among
letters of
mental
symptoms
our
Jean
"
"
The
all round
F. Richter.
youn"j,"
says
in memory."
Aristotle,
"
"
"
stand
we
The
by
of age
iiiibcx-ility
is not
so
priorefrvi." Martial.
lose the
conttionsnea*
of
our
happy, and
to
painful
the
the old
as
of
our
return
it is to those who
second childhood,
prime.
"
With
live backwards,
e"t
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
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
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
than
undergoeschangesmore
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
life! When
of his friend
"
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
near
body.'
and bodily,which
blessingor a curse
raises
He
then
feelingof
lifelesseyes
relate
knew
well,
so
him."
"
strikingexceptionto
as
now
once
lengthdeserted
him
could
been
ever
without
over
what
known,
once
now
Another
"
vacant
now
seen,
the
of
complimentary
expressions.
the
rule
'
of the
gradually
droppedinto
reasonable
doubt
whether
longed
pro-
"
'Omni
Membrorum
Nomina
damno
servorum,
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.
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
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
"
or
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
aged
principle.It
integrity.
should
is not
manifest
of the vital
offspring
therefore surprising,
that
while
itself,
IMPAIRMENT
memory
without
the
"
MEMORY,
OK
SYMPTOM
be carried
cannot
OF
DRAIN
DISEASE.
309
beyond a particular
point
to avoid them."*
and intellect,
as well
as
disturbances
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-
to
the
moment
his
centre.
to
Previously
patientis heard
"
the
apoplexyand paralysis
complainof a stunned, inactive,
attacks of
to
Edinburgh Review,
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
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,
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.
hemispheres of
in
fifty
years
time
MEMORY.
THE
fifteen
an
OF
longer recognisedhis
continued
attack
DISORDERS
had
and political
advancement, strugglingat
position
time
with
the same
great pecuniaryembarrassments,
whilst addressingone
of the judges,suddenlylost all
in his brief.
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
"
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
Partial amnesia
but not
instantaneous
an
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,
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
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
to
in
of the
if he could
see
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.
By
an
old
Spanishlaw
no
person
was
admitted
to
destroythe
memory.
374
ACUTE
DISORDERS
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
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
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
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
of what
he had
of
temporary
loss ol
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
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
DISEASE
of
He
OF
few
BRAIN
INDICATED
BY
LOSS
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
378
ACUTE
face
DISORDERS
MEMORY.
THE
OF
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
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
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
"
and
case,
few
the
months
treatment
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
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
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
advice, removed
into the
country,
LOSS
and
OP
MEMORY
BT
BLOWS
UPON
THE
381
HEAD.
saw
remained
CAUSED
him
in
in consequence
of unusual
manifestations
of
active head
disturbance.
I ordered
him
to be
After
all evidence
cerebral mischief
througha course
took quininewith
subsequently
able to return
He. eventually,
was
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
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
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
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
affected.
was
sick leave.
father
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
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
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
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
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
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
"
CONPUSED
STATE
OF
THS
885
MEMORY.
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
*'
considered
at the
time, as
state of
and gastric
simple"nervousness" dependentupon hepatic
c
380
OP
DISORDERS
ACUTE
MEMORY.
THE
was
In
much
many
forms
the
memory,
what
the
or
wishes
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
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
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
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
of his address.
He
was
in the. habit
of
LOSS
OF
LANGUAGE
CAUSED
BT
BLOW
and saying,
stoppingstrangers,
"
He
state of
am
head
was
THE
389
HEAD.
what
so-and-so,
by
his
fall from
is
do I reside ?"
in
recovery, it
that all recollection,
not only of the accident,
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
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
and
country
OF
of which
course
this time
At
delirious.
She
England.
in
she
was
had
severe
she became
pletely
com-
heard
frequently
talk
to
cry
in
out
to be in the
house
domestic, who
Welsh
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
The
Welsh.
language of
Lower
Britannyis
or
well
known
to
be
dialect of
EFFECT
OF
OF
INJURIES
THE
HEAD
ON
ties
the
began
were
of his
prayers
church, and
891
MEMORY.
THE
know
to
words, to repeat
read
few
of
words
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
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
the Disease*
of the
Nervotu
transcribed from
Syttcm."
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
than
wedding-day,
her
husband
were
and
entertain
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
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
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
of his
wife,but
uniformlythe
same."t
Dr.
"
Osborn, who
Vide Art.
"
has
publishedan
interesting
paper
394
(MODIFIED) AFFECTIONS
CHRONIC
MEMORY.
THE
in connexion
memory,
disease of the brain, considers that there are
of speechand
faculty
on
OF
with
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,
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
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
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
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
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
to
su, he
si,so,
se,
he answered,
salutation,when
return
tongue
latter, and
two
head
your
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
"
rightside,to
precision.The
enough, and it
or
He
"
"
Oui.
"
your
Vitrier,
"
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
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
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
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
the
endow
organ
of motion.''*
the power
A French
soldier
by
on
bullet at the
with the
sets of
two
of taste
sense
was
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
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.
Larrey,who
M.
skull with
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
whom
she
establish
oath.
oath what
that
the
was
had
serious
dispute.
few
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
plague of typhus
war,) the
from
the
their memories.
they not
famine
at
effects of this
So
completely
onlyforgotthe names
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.
3 for 1.
This
aberration
long duration.
In an account published
many
of a ship in the Pacific Ocean,
not
happily,
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
painfulevents
he could give no
recent
but
born, whether
The
was
memory
and
accurate
singularly
information
as
to where
to
as
vivid,
he
was
he had
tabula
"
rasa.
In the
retreat
of the
Russian
Buonaparte's
French
from
campaign, many
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
an
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
"
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
genius was,
the tripleload
manner,
of
chained
down
of fever, and
fatigue,
by
his
; which
of
"
EFFECT
OF
THE
RUSSIAN
CAMPAIGN
ON
His
memory
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
of them.
Numerous
cases
recorded
are
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
genius.
tor
This
the
it
duringthe battle,and
up
Borodino, and
it
bound
allowed
was
him
which
time
to
"
"
import,applyingto
the condition
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
name,
connected
was
with
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
sician
phy-
Johnson,
He
resided in America.
abilities,
master
was
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
are
we
one
we
efforts in
its work,
or
Pathology.
it
are
bound
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-
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
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
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
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
the
attack.
years previousto
reflective,moral, and animal
organs
His
is good,his
appear unaltered ; his appetite
improved,and he enjoysbodilyexercise.
generalhealth
In
tion
conversa-
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
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
the various
after
of
names
to have
was
observed
"
'
that
she
had
She
of
lost all
collected
earlyrecaHing her
OF
EFFECTS
by
name
MENTAL
at the end
SHOCK
of
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
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
recovered
eventually
with
communicate
his
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
of the
tained.
sus-
death of her
for the
found
was
brain
was
dead in her
bed.
discovered
of the
heart
and
after death.
French
Disease
(MODIFIED)
CHRONIC
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.
confusion,after which
"
On
the
with
"
We
these
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
of
memory
attracted
readily
was
said
were
any
but
the-
very
right
K!
MARK
ABLE
CASE
OF
DISORDERED
409
MEMORY.
the
amounting to paralysis,
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.
was
recollect
still tumultuous
portionsof
trials,could
without
write
some
in
the
of the
extreme.
He
right
could
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-
After
membrane
this he
of the
had
nose
an
and
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
in which
he took
comparative view
of his
symptoms,
"
"
"
"
"
"
"
"
"
"
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.
"
'
"
'
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
'
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-
in
typhus fever
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
word, and
and
bread
butter
called
was
sin-im-sinner/
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
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
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
and
cow,' and kept his finger
until he had
the word
in its proper
looked
eye fixed
cow
"
He
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
An
of
case
"
La
in the
was
Yon, named
battle of Austerlitz.
the
singular
very
in the
patient
He
has, as
he
speaksof
ME
or
it
are
vocabulary.
in
one
"*
Leuret
mfane"
or
afflicted the
so
person
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
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
PERVERSION
of odd words
use
appearedto
of others
OF
in his
conversation,and
appearedto
memory
of action.
have
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,
between
/?re#e;//,that
althoughhis
be done
mind
in consequence
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
was
subjectto
violent
"
418
upon
OF
PERVERSION
MEMORY.
THE
the lamentable
would
insist
state
to which
all too
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
"
the 2nd
of March
to the
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
been
in any
such
in Mrs.
and
but
that
and
next
she
tions
ques-
denied
nighton
had
been
at
Dyce's
of the tragical
tive
narrawhich
her feelings
had
this occasion,though
at the
sermon,
place;
mencement.
com-
quite amazed
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.
CASE
which
On
of
"
DOUBLE
OF
several hours
continued
term.
beyondthe ordinary
and
It
gone.
found
was
421
CONSCIOUSNESS.
DIVIDED
OR
every trait
tabula rasa
obliterated
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
but
was
paroxysm
that
occurrence
double
On
her.
found
rousingfrom it,she
in before
was
the first
whollyignorantof
befallen
had
her
former condition
of
few
fit of
months, another
But,
proficiency.
somnolencyinvaded
'
considerable
state
new
character
as
and
she
was
as
unconscious
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
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
arrival
talkative.
home,
his
observed
was
to be
He
during the
then
he
unusually
occupiedin
fatigue. He
abilityto
minute
boasted
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
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
of
an
"
"
In
the
connected
state
incipient
with acute
of brain
disease of
earlylife
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
fever.
bilious
As
the State of
as
"
I have
of the
I will
particular,
of this disease.
circumstances
more
recorded
than
have
had
day ;
infantile
was
And
relate
some
it is in my
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
state
every
prostratedto
was
that
had
of mind.
it
experienced.
third
That
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.
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
is able,vividly,
to recal to the
earlylife.
conversations
"
mind
the
It is,undoubtedly,
fact,that the
a
old,
lunatic
incurable
patientsrelate
but
transactions,
am
bound
to
admit,
as
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
"
not
other
and
What
organisms,but
types and
nature
and
new
are,
assume
in their
original
annihilated.
elements, never
with
tonic, permanent
and
indestructible
of the
character
abnormal
and
conditions
use
there
mind
are
the
many
"
ideas that
"
which
and
in matured
in
registered
not
like shadows
old
their character,and
which
"
the memorial
cannot
over
therefore obtain
archives.
Such
so
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
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.
"
'
the
reach
either
by
of accident
our
or
violence,nor
it be
can
lost,
own
Non
"
irritum
tamen
truth,"remarks
seeds of immortal
The
"
physicalnutrition
modifications in the
chemical
or
that vital,organic,and
with
interfering
I may
being either
defective
originally
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
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
the
During
quantityor
to what
examination
He
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
was
been remarkable
had
of
and
elasticity
no
impressions.
last year,
opportunity,
an
periodhe
mental
would
pathologist
expect
to
detect in
In
another
become
person
case, I
prematurely
in
and
complexity,
the
atrophiedappearance.
I wit limit
a want
softening)
"
"
encephalicmans
The
brain
was
of coherence
The
Rambler."
also
430
PSYCHOLOGY
PATHOLOGY
AND
OF
MEMORY.
writer,
"
are
not
to
sown
Kein
"
Wesen
kann
zu
nichts zerfallen,
Das
How, it may
be
asked, can
reconcile with
this
and pathologist
physiologist
of
latencyand indestructibility
the
conceptions,
psychical
tear,destruction
and
the
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 ?
"
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
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
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.
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
character,which continues
in
protective
influence
againstsmall-pox,
the
to exercise
great mass
the
time
blood
have
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
upon
words, he would
continue
early
tainly
cerprotected,
of the small-pox
poison.
How
can
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
assimilative
"
"
than
and in many
alone, but
they,in
cases
which
it would
the
blood
as
much
or
much
that,whatever
materials
OP
POWER
ASSIMILATIVE
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
"
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
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,
In all these
seems
to be
hardlydoubt
made
truth of widest
its
And
successors.
application
; and
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
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
answer
of assimilation
"
in the formative
by
an
the
because
impressionupon
in intellectual
or
process
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
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.
who
way
of which
we
kinds
of latent
nected
body is,that the former is conare
wholly ignorant; and that
different both in
it holds relations,
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-
in
possessing
revealed
of the
recesses
certain
or
are
in the
in
certain
extraordinary
w
we
manifest
conscious.
are
This
how
can
know
we
which
existence
we
by
are
effects of
for,as
ambiguousproposition,
"
ordinarymental
lies
beyond the
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
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
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
no
consciousness
of its
awakeningis also
voL i.,
Mctaphytici,
p.
348.
the
438
PSYCHOLOGY
PATHOLOGY
AND
MEMORY.
OF
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
conscious ?
parts,and
is made
conscious.
not
the constituents
are
count
conscious
are
murmur
"
forest is
are
we
the
of
greenness
would
sum
be
if the
zero
something."*
as
not
certainly
more
than
singularand inexplicable
latent
and
givingthem
out
of dissimilar bodies.
again in
darkness
was
to
common
It will be remembered
by
many
of
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
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
in
the
agoniesof
of
the
most
their
past lives !
have
recalled to the
lation
circu-
the
in the
brain,
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
tween
"
The
"
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
"
one
taken into
dark
with
them, and
by
pieceof
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
in
been
placedas
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"
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
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-
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
boyhood !
that had
been
his memory,
remembrance
The
mind
was
directed to
it
"
and
be
on
regardedas impressions
annul a part or
'
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
*
most
that
permanent,immutable
presentitselfanew, if
be turned
to it
"
and
pression
imthe
that it is
attention
to be
cannot
be effaced.
Lesions
of
CTRIOU8
MENTAL
criticalsecond
CAUSED
circumstance
connected
his mind
sketches and
paintings.*
441
DROWNING.
of time
presentedto
"
BT
considered
minute
PHENOMENA
was
like
so
with
his
charmingpictorial
many
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
How
in
saw
her
moment
mirror."
often the
is busily
life,
occupiedin the contemplationof pastoral
imagery
and
pleasantearlyremembrances,
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-
"
"
-.
what
he
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.
coursed
most
'
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
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
thus
Cambridge,
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
medical
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
her
in her
could
its culminating
convalescence
native
of
cated
always indiItalian patois.
reached
had
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
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
that
the
name,
and
the
niece of the
late Chancellor.
This
"
The
'
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
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
before
Breton
said
her
in
'
have
"
talk
than
more
are
not
within
"c.'
objects,
were
necessary
the compass
of
to
a
'
"
"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
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
no
be
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-
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
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
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.
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
in
some
Sir
catalepsy.
forms
"W. Hamilton
from
Life."
Human
"
young
man
had
tack,
atcataleptic
singularchange was
in consequence
of which
a
effected in his mental constitution.
Some
six minutes
after
events,so
that
he
carried
on
from
night to nightthe
playthe same
part.
this
rather
as
case
of somnambulism
his
tinguishes
dis-
than
of
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
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
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!
"
are
afterwards associated,
and
what
is termed
other.
The
laws
governingthe
exceptby disease,
In
disintegration."
determine
and
thought
duce
pro-
never
can,
"
four,
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
"
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
"
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
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
moments
if the paper
it,and
so
be
the
put
key on
away
the
where
kept for
then
taneously
dark, the key being simul-
fading spectreof
and
and
months, at
many
dark placeand laid
spectreof
the
fall upon
on
shadow
is said
never
to
wall
without
IMPEDIMENTS
PHYSICAL
INTERFERING
458
THOUGHT.
WITH
"
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
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
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
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
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
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
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
earlyyouth,in
head,
or
as
cerebral circulation
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
"
languagerushes
of
second!
Vitetse de
"
the
have
Quick as
F Agent dan*
action be electric,
the
torrent
Propagation de
If mental
broughtto
an
been known
to be about
Wheafetone
have
shown
exact
"
knowledge of
like
is
the
forgotten
apparently
to the mind
back
quicknessof thought
proverbial
"
of sensation and
measurement.
The
will
The
"
may
be
la
that is,
presumed to
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
brain.
observed
at
to be in
several
length
a
state
unlocked,
as
that
so
its wonted
culture.
in
vigour,and
few weeks
his
its former
mind
wealth
For
resumed
and
disturbance.
The
all
polishof
his labours
of cerebral
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
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
asked
common
was
denly
his teacher,he sud-
IDIOCY
CURED
BLOWS
BT
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
periodof about
formerlylived in another
over
She
had
of which
which
she had
she
had
they stood
health after
of
ten
twelve
city,and
years.
the time
that
was
during
each
before
her
removal.
She
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
? 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
memory
MEMORY.
immediatelyrestored
was
to
been
I have
that
of the brain !
slightconcussion
"
OF
PATHOLOGY
AND
PSYCHOLOGY
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
stone
After
fractured
his
skull.
He
panned.
tre-
was
recoveringfrom
and
"
to
subsequently
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
so
in foul air,who
"
would
die in
an
exhausted receiver."
460
MEMORY.
OF
PATHOLOGY
AND
PSYCHOLOGY
of any
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
from
SANE
and
the
INSANE
transcendent
of
man
man,
said,
it be
may
and
degree
in
trifling,
2, how
obstruction that
PHYSICAL
healtlyACTION
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
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
person
of the
name
of Samuel
Chilton,a labourer,
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
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
was
its value.
on
an
town
of
resided in
to believe
induced
and
dissatisfaction,
This
eventuallya
that
he
had
persuasionbrought
considerable
degree
neighbours
part of the
to
get
making
became
up
the
same
field.
earlythe
fence.
On
next
In
the
his
morning, to
course
delirious,and continued
assist him
of the
in this
evening
in
he
situationseveral
RECALLED
SUDDENLY
IDEAS
LATENT
suddenlyrestored.
had
of his
return
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
number
beetle
this delirium
those
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
fact that,
during
"
"
Dr. I'richard
on
"
The
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
and
hurried
she vomited
much, but
the moment
eyes at any time until
*
The
Academy
received
this
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.
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
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
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-
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
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
where
and
involuntaryscream
an
the
meet
to
He
traversed
seasons,
MEMORY.
OF
spot
alightfrom
is not
come
to-morrow."*
Garrick's
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
"
to imitate
A
*
young
This
case
"
madness.".
"
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.
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,
affections
important,in consideringparalytic
advanced
in their incipient
or
stage,to recognise
is
DIAGNOSIS
BETWEEN
CEREBRAL
AND
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
important
it is,when
this subject,
to
investigating
practically
this physiological
and pathological
classification
recognise
a
or
an
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
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
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
these
icith
or
idiocy.
"
Andnl's
"
Clinique."
472
MORBID
right arm,
from
the
muscular
stage of
OF
MOTION.
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.
days
at the
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
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
fiddle
childishly,
with
strengthof
fork
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
dying at
the age
of
was
observed
at
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.
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.
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,
in
the
antagonism,or
balance."
This
stage
condition
in
the
either
symmetricalmuscular
of the motor
"
"
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
Eomberg
affections of
has
of the other.
described
motility.When
with
great accuracy
to
alluding
the
these
incipient
WANT
MORBID
MUSCULAR
OF
477
CO-ORDINATION.
When
the
no
commenced
patienthas fairly
accelerate
can
bear
his
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
walks, he
and
and
movements,
to
rests
his
hands
the
upon
back
of his
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
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
powers
of locomotion.
The
patientis
often
to roll himself
seen
about
like
drunken
as
man,
if he had
Chorea.
ACTION.
CONVULSIVE
irregularand
I have
"
morbid
states
to consider
now
of
the
motor
those
power
or
fibre
of
threefold
viz. :
division,
Epilepsy.
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
modified
type
of
at nightwith slight,
and
epilepsy
occurringgenerally
often
unobserved, convulsive
by the
Hall
muscular
"
Hidden
(termed
action
which
Seizures,")
form of manifestation]
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
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
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
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.
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
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.
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
and
excited in mind
He
rushes
about
alarm, and if
an
attempt be
made
to
control his
ments,
move-
afllicted with
the
disease,informs
me
that
for
an
hour
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.
"
"
"
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
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
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
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
that because
Protean
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
in two
are
at
is
towards
the
and
affect the
to
once
sensation
the
case
mounting
as
MOTION.
OF
scribed
always dein the
head, and
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
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
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
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
and
dizzy;and
become
AFFECTIONS
she then
resistance,then
some
The
MOUTH.
well-
"
after which
first,
almost
details two
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
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
details at
Watson
decided
and
known
disorder,has been
buccinator
to
muscles
symptoms
indicate
of
serious
of the brain !
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
"
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
modification.
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
"
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
"
"
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
in convulsions.
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
M^dicale,"by
Clinique
M.
Andral.
492
PHENOMENA
MORBJD
increase in
gradually
but
uncertain period,
or
MOTION.
seldom
in less than
influence is felt in
the morbid
more,
the
OF
of the
hands
and
at
months
twelve
other
some
arms
an
to
part.
be
the
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
to
The
and, befriended
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
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
much
same
on
fore
part of the
time, irresistibly
impelledto
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
retained
in the
mouth
the
food
is with
difficulty
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 muscles
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
The chin is
the sternum.
be
now
The
OF
the
THE
SPINAL
495
COUD.
but
bed-hangings,
the
even
room.
almost
the mouth.
"
The
power
of articulation is lost.
The
evacuations
extreme
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
in
even
of
softening
acute
often continues
unclouded
PERIPHERAL
PARALYSIS.
the
cases,
many
spinalcord, the
"
and
however,
not
mind
of death.
yet spoken of
sensorial power
which
mence
com-
in the
several remarkable
seen
cases
of this kind.
The
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
foot,it then
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
followingconclusions
at the
"
Affection of the
on
between
"
2.
other
rhagic or
of speechdependseither
faculty
a
on
loss of
sudden
The
"
cerebral affection,
or
lesion
of words, and
with that sudden loss of memory
speech,
of speechdependingon affection
consequently
difficulty
4.
In disorder
lobes of the
it is
only after
the organ
Out of
or
recovers
more
in
affection resided in
both, speechwas
function."
by Andral, as well as
to hemorrhageand other
or
brain that
the
or
cases
thirty-seven
the morbid
in
of the anterior
one
abolished
and
twenty-one,
lobes,
retained
sixteen times.
On
were
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,
structure
of
these
500
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
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
OF
DISEASE
establish
CORPORA
501
OLIVAR1A.
close
between the
and pathological
connexion
physiological
functions of articulation and speechand the
olivaria.
corpora
THE
der Kolk
was
in consequence
of the anatomical
between the two previously
mentioned
existing
connexion
cerebral
"
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
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
smaller
somewhat
with
a
with
induration
remarkable
case
of
of the
case
of paralysis
where eventually
long standing,
whollylost. The patientcould
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
"
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
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
ticipated
par-
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
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
examination
mortem
a
are
and
hyperamia and
suppliedby the
Professor
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
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
that
"
MORBID
"
IRREGULARITY
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
to arise from
some
failure of memory,
but such,I think,
It is a paralysis
I have
of ideas which
a
seen
to exist for
and
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
"
"
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
severe
attack
The
sudden
paper
had suffered
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
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
wrong
himself
corrected
by adoptingthe
propriate
apof his
cured
expression.This gentlemanwas
complaintby largedoses of valerian and
other
nervine
medicines.
Professor
affected in
articulation
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.
her
in
singular
defect
and
case
was,
thoughtwas
that when
mentioned
for
affected
was
When
she
table,and when
glass. But
what
was
.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.
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,
three sentences
out
with-
exclamation.*
observed
been
patienthas
he seized them
to say
to combine
unable
was
sound
control the
uttered
sometimes
SPEECH.
OF
PHENOMENA
MORBID
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
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
however,
For
resemblance
some
example,he
this
weather
WET
who
mil
would
"
sit down
in
"
say
weather
HOT
? here is
to supper
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,
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
"par le commandement"
This
....
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
....
IMPAIRMENT
"
?"
Eat-il possible
Her
OF
Bonjour,Madame!"
"
....
was
intelligence
513
SPEECH.
....
she laughedat
preserved,
perfectly
AND
Associated
IMPAIRMENT
with
SPEECH.
OF
Loss
OF
the
be termed
muffled
under
slightly
man
emotional
veiled,or
(voilee),
voice,like
the
excitement,
clouded
or
as
if he
were
partially
even
intoxicated.
"
"
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
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
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
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
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
examination
was
interests of
permitted!
science, no
"
post
SIGNS
PREMONITORY
It is
of
most
speechto
acute
unusual
circumstance
517
PARALYSIS.
loss
followed by
beingimmediately
exist without
cerebral
OF
symptoms.
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
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
so
of his
518
legas to
legby a
be able to walk
the
little,dragging forward
motion
afterwards
SPEECH.
OF
PHENOMENA
MORBID
walk
that he could
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
man,
second
time, he
lay
down
twice, in the
After
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
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
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
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
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
one
ten minutes
out
as
the hall
into the
area
an
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
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
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
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
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
of words
was
able to write
whatever
lucidity,
perfect
he wished
he tried to talk,his
was
years
for many
similar cerebral
I saw
quiteunintelligible.
occasions, and suggesteda course
conversation
on
meaning could
no
four
few
resided
conversation
for
of brain disease.
symptoms
militarygentleman,who
His
of
course
the
of his removal
this
patient
of remedial
to
America,
the
women,
familywere
and
vice
versa.
522
in the trenches
line, and
median
aperture.
small
fragment of
In
months
patientin
In
phorus.
Toulon, and
which
the
month
the
with
31st
he
was
by
compelledto
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
angleof
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
on
left of the
to the
wound, Joubert
On
and
one
bullet.
to the
of this
consequence
for
skin
adherent
remained
left of the
The
first
the
passing beneath
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
;
a
524
ball.
The
and
of entrance
of exit of the
the wound
having
ferule
osseous
SPEECH.
the wound
OP
PHENOMENA
MORBID
been
raised
by
the
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
who
patientrespondedYes to the surgeon in charge,
questionedhim; and about five,P.M., he uttered some
connected
On
words.
gave neither
painnor
trouble
On
were
no
at command.
but
regular,
the
was
intelligence
still sluggish,
CASE
SINGULAR
On
the
525
MUTISM.
moments.
all the
OF
functions
the
is still changed,the
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
of
pipe,"c.
pipe is
the word
that
gate ;
he
pronounces
book,
most
and
is most
wound,
is
which
anxious
to
correct
is six inches
it.
long,and
The
half
cicatrix of the
an
the
inch
broad,
level of the
PERVERSION
six minutes,
or
in
pulsefell to fifty
round
neck, and
"27th.
"
28th.
the
minute.
527
SPKKCII.
during which
Twenty leeches
cicatrix,a blister
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
pressure, and
returns
when
the
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
(forexample)
"
says,
I have
great
528
"
to his shoulder,)
here," (pointing
and numbness
weakness
and
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
"
greater number
;
said, I
and
buttermilk
man
be traced
;"
buttermilk
through which
stirabout
as
desired to say
"
of it." Sometimes
name
of his
immediatelyconscious
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
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
friend,he
and
gate-porter,
apartmentswhich
was
unable
to express
his wish
to the
succeeded
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
be
not
knowledge of
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
"
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
amtreit
eftrcidoturn
emtreido
and
dried rederiso
of
temtreido
of deid daf
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,
your
without
tongue," or,
doing as she
was
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
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
"
echo"
that
phenomenon may,
sluggishand abstracted
to
some
of
state
ARTICULATION,
to
referring
it will not
be
out
the
of
morbid
OR
THINKING
phenomena
ALOUD.
of
"
speech,
EFFECT
OF
INSANITY
talkingaloud,when
UPON
alone.
THE
533
VOICE.
distinguished
physician
precedean attack of paralysis,
in the
who
of
case
nobleman
for many
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
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
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
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
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,
"
at the
time
same
of
slinkingout
friend,or
answer
there is a
reserved
retired,
or
ill-temper
sulkiness, that
articulation.
At
is
worse
than
manner,
to
man
old
an
;
an
imperfect
"
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
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
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
Andral
for two
refers to the
consecutive
of a
particulars
months
was
nothing
case
more
in which
than
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
forward
among
In
symptoms.
form
of.illusory
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-
state
the
blood,disease,we
brain
is
may
infer that
entitled to careful
the
pathological
is
of the
frequentlydependent upon
of blood
sinuses
the
as
well
as
to
cranial circulation,
a
want
of normal
venous
and
arterial cerebral
vessels.
The
cerebral
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
"
constitute
"
the entire
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
subjectof hiccough,
lasted for
paleness,
minute, headache
succeeding. M. Trousseau,
hebetude
and
than
more
alone in his
"
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
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-
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
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
"
connected
with
544
OF
PHENOMENA
MORBID
that
demonstrate
clearly
actions
SENSATION.
there exists
hyper-
an
"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.
headache, paroxysmalin
In
all the
its
affections of the
of the
lesion.
varied
of concretions
on
as
Andral
of the
tents
con-
of
injection
the
free
face
sur-
of the
or
morbid
accompany,
condition
the
tissue,formation
mater,
It may
effusion of pus
or
serum
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
this
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
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
'
"
"
"
due
immediately
was
the cadaveric
to other causes,
section
ache
"
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
upholds any
it
so
is not
certainly
to
eminentlyimpartial
are
peculiartheory
great
due
in
regard to
cerebral
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
considerably
; it
disorder*
apoplectic
; here
involved.
different as
ratio varies
in
so
The
cases
is
we
examine
we
disease,
cephalic
comparatively
rare,
as
we
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
by
the
uneasiness,
patient.
(loss of sensation)is
ANAESTHESIA
nected
closelycon-
more
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
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
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
form
severer
and
the dura
attention in
serous,
or
more
pointof view
verbo, as
distinct from
fibro-serous membranes
which
are
may
enter
which
we
are
teaches
us
that
case
that
presentedby
of headache
necessary
comparatively
ignorant;
to
of the
and
membrane, claim
venous
occurringelsewhere.
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,
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
Andral
of sensation
diminution
no
the
partsof
observed
is
there
when
even
which
time
the thorax.
complete
to
previously
a
There
existed
the size of
five-franc
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
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.
was
symptom
disease
of
associated
in several
brain.
the
with
of acute
cases
This
sensation
as
symptom
well
is
as
chronic
occasionally
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
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,
"
"
suicide
watched
of the
his
in
the
most
determined
whilst
opportunity,
ward, and
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.
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
themselves
or
the
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
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;
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
"
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,
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
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
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
performanceof
held
through
bundle of such
the wound.
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
was
possible,
in his led
by
thumb
"
more
or
for 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
in
preoccupation
of the Mandan
tortures
self-imported
themselves
was
the
of
after
been known,
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.
Thou
"
OP
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
five
or
six
minutes.
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.
evidences
of the
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
manner,
was
the
bowels.
may,
of
rose
in aromatic
pain,"
marked
It is literally
NORMAL
ACUTEXESS
OF
THE
50 1
SENSES.
It is said that in
South
of China,
portions
some
their victims
are
and
in the
"
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
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
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
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
ship,which was
ship, and his blindness
the
the
returned
while
he
he went
for ten
only two
was
into
days,during
nights,and
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.
565
SIGHT.
be,
may
Impaired,
". Lost,
IMPAIRMENT
and
The
occur
y-
Exalted,
S.
Perverted.
Loss
AND
VISION.
OF
These
"
are
common
eye
the disordered
growth,proceeding,
pari passu,
of subtle structural changes in
of the
with the
and
the
with
ment
develop-
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
may
be
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
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
the
and
occurrence
fatal termination
the friends
of which
of science
too much
or
of those nerves."1
amaurosis, termed
"
movement
Let
me
symptoms
*
F.
"
of the
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
under
acute
the
OF
Dr. Abercrombie
observes, after
"
tinuance
con-
some
become
organs of sense
the sight,
the taste, and smell,
the hearing,
affected,
as
and
some
Double
vision
either be
permanent
is on
case
soon
or
blindness took
record in which
by
continued
emetic.
an
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
third,the disease
anterior lobe
and
it
affected,
was
was
the
near
tius,the disease
part of
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
Amaurosis
on
the
is
neighbourhood.
immediate
This
"
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
is often the
connected
well
of the cerebellum,
as
organicdisease
and
VISION.
OF
abscess,and
softening,
conditions
of
states
of the tissue
This
nutrition.
of the cerebellar
of the
lobes,blindness existed
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
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
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-
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
The
states
amaurosis,
of
the
brain
symptoms
associated
connected
after the
continues
acute
often
so
with
with
morbid
sionally
apoplexy,occa-
patientrecovers
from
the
gentleman,after
and continued
in
sight,
an
strongestillustrations he
be
derived from
ever
met
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
; 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
"
he
ally
usu-
much
"
is
of which
The
of much
cause
followingcase
"
Lectures
London,
f
"
1857.
on
the
him."f
is recorded
distress to
and
Principles
Practice of
Physic,"by Dr.
T. Watson.
Diseases of the
Eye,"by
B.
Travers,F.R.S.
1825.
P. 162.
brain
of
jectingcases
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
for
some
resumed
time
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
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
"
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
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
"
On
hy
R.
Wigan, M.D.
torn.
Al^dicale,"
f Andral, Clinique
"
v.
MORBID
EXALTATION
OF
VISION.
tress
The
1848, when
in the
was
violent
seized with
in
the
left
The
arm.
there
was
August,
continued
at this time
rightparietal
region;
slightweakness
until
pains
there
was
symptoms
creased
in-
and
paralysis
extent
of the
of about
two
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
573
which
effusion had
irritated
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
VISION.
OF
PHENOMENA
MORBID
conditions
of brain
forms
particular
evinced
of
bral
cere-
ing
increas-
an
and
sound,
the
even
inflammation
the
external
rendered
Ideas, also,were
as
of
humming
increased
the
became
fly,
vivid.
more
were
assumed
my
intense that
so
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
porary
tem-
well
its interior,
new
These
were
not
flowers,formed of coloured or
flowers,but of fantastic
natural
580
MORBID
PHENOMENA
OF
VISION.
also from
threB months
"
On
well and
this
without
the 16th
attack, and
lived for
year
and
further inconvenience.
March,
seized
happy during the previousday,she was
attack,accomduringthe nightwith another apoplectic
OP
ABERRATION
AND
PERVERSION
581
SIGHT.
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
more
than
dition.
con-
OF
SIGHT.
frequently
impairment,
morbid
and
turbances
of the eyes vary from
slightdisof sightto actual illusions,
irregularities
states
ocula
physiognomy of
the
is
There
termed
is often observed
by Romberg, a
in these
cases
what
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
the accurate
affection
observer
is in these cases,
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
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
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
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
pupils.The
dilated.
time
fingersof
appears to
lower extremities.
the
over
some
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
of the brain.
Andral
had
an
and
colours
marked
by
the
change
mania
to
from
an
dementia
acute
;
to
2. That
eye throws
phenomenon
transition.
out
is
an
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
one
affected ; he
at; and in
SON,
....
view
saw
read the
the commencement
the
not
candle
was
to be able to see
The
attemptingto
to him
name
of the
name
over
door, he
obliterated
being totally
saw
from
only
hia
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
remarkable
following
case.
In
sequence
con-
cerebral fever,
the external side of the left retina of M. de M
insensible
saw
objectsonlysituate
time
there
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.
When
"
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
"
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
by
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
left was
full of bladders
side
thalami
forwards
into
the
so
as
to
extend
opposite half
of
the
the
thalamus
of
stroying
brain, de-
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,
weeks
some
among
the insane.
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
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.
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
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
memory
cannot
of the
is
headache,
than after
he wishes
times
years, but in their intervals he has someHe awakes
affected in a very different way.
two
been
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
hension,
appretinued
con-
mind.
feels
from
will
first,
more
the
less
or
effort to check
; an
divert
if
as
it into
the
under
influence of his
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
and
strabismus.
dinner, to have
at
droppeddown
he
of
forms
had
in
similar character
of acute
brain
few
fitof
minutes
apoplexy.
quently,
subsetions
Illustra-
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
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
but
were
had
not been
"
This
there is
died."
is
sense
observed,in connexion
with
the
longin
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
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
chronic
chronic
inginvolv-
known
ear
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,
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
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
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
hearingare
subjectto
patientis
voices,a good and
was
an
suicide.
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
repeatedwith
"
and
in
rapidsuccession
occasion he
was
to him
discovered
with
an
seriously
contemplating
gentleman was subjectto
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
and
words,
double
ringing
dagger"stained
was
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
derangement
is observed
of
the
to
and
digestive
be
greatly
598
MORBID
TOUCH,
TASTE,
with
AND
SMELL.
characteristic tom
sympeither of them
pathognomonicof
and
special
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
extends
to the
hand.
I have known
offence.
decided
the
nerves
at
sometimes
to the whole
of the
this local
months
impairmentof sensibility
to the recognition
of
previously
manifestation
lesion of sensation
of
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
EXALTED
the
healthystate
his
needle,as he
when
he had
599
SENSIBILITY.
TACTILE
of his brain.
He
was
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-
ami
this
between
type of
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
(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
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
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
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
morning'swork,
with
character,
whether
renewed
the individual
it be of
supplyof the
mences
com-
mental
powers
or
of
602
MORBID
OF
PHENOMENA
SLEEP.
life or
nervous
unhealthysnatches
partialand
certain states
disorder
of brain
of
repose
obtained
do not appear
in
to refresh
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
manner
he will declare
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
in
is recorded
The
how
question,
asked than
longa
person
can
exist without
would
been
to
seem
convicted
leave it for
ever
unsolved.
of
the
circumstances
following
under
the
care
of three
"
The
was
death
Chinese
sentenced
was
condemned
to
carried
was
merchant
die
had
by being
into execution
placed in prison
"
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
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
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
of
potentand concentrated preparation
most
without
or
causingsleep,
even
condition
this
drug
analogous
to it :
"
"
Not
poppy,
nor
mandragora,
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.
the patient's
mind
types of insanity
some
absorbed
illusion.
in the
Under
of
contemplation
these
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
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-
to the head.
freely
gravitating
gentlemanwho appeared free duringthe day from
could
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
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
speakingof
When
Southey
afflicted
was
of
with which
insanity
previouslyto his death, Dr.
directs
Mackay
Charles
attack
attention
fact that
the
to
the
was
in close and
affectionate attendance
bed
of his
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
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.
not
'
man
symptom
"
"
The
is
frequently
precursory
Scenery and
OP
SLEEP.
of attacks of
"
This
apoplexy,
Lake*," by
Mackay,LL.D.
RB
Charlee
610
forms
exists in other
often
and
TO
DISPOSITION
MORBID
I have
involved.
in good
gentleman,apparently
A
*
Dr. Todd
delirium
health
has
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.
stirred and
frequently
mashed
ten
cut it up
into small
pieces.
portionsof
ounces,
The
about
brain and
brain
with
while thus
glassrod.
maceratingshould
The
be
after
washings,
so
to be mixed
be
obtained must
"
612
OF
PHENOMENA
MORBID
DREAMING.
barrister, for
some
before
years
an
attack
of cerebral
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
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
is likewise in
tl:;itthe
with
facility
which
associate themselves
thousand
"
One
dreamers
the
germ
during sleep,one
strangecombinations, luminous
explainin
can
who, under
until
the
form
one
then
same
had
way
latent.
Such
was
the
case
patientof
Some
of
the
de
The
Galen's
Villeneuve
day
next
dreamt
certain
of
dreamt
anthrax
an
that
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
sometimes
perceptions
the
dream
the aid of
in fact,notices the
can
medicine
that she
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
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
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
even
no
was
apparentlyin a
the
morning, to
found
to have
sane
the
lost his
insanity
by assertingthat
he
his wife to
bedroom
in
protect him.
state of
He
walked
about
and
great agitation,
apprehension,
"
1860.
agony
Trait^
des
of
Maladies
the
in the
le Docteur
B. A. Morel.
the
Paris,
INSANITY
of
history
the
COMMENCING
IN
C15
DREAM.
served
not ob-
as to the
suspicion
beingquestioned
duringthe previousnight
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
"
"
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
wife
this
time
of
tailor,and
she
was
rather
debilitated in
in appearance.
belongedto the
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
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
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
of the murder
was
is
tried and
confined
now
under
committed
occurred
acquittedon
in Stafford
stances.
analogouscircum-
she
was
found
drowned.
The
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
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
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
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
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.
he
examining the
After
affection.
this
NUTRITIVE
stomach, and
state of the
disordered
for
AND
ORGANIC
OF
PHENOMENA
MORBID
to be the effect of
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
morbid
state of the
of
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
chronic
liver,
or
of the bowels.
the
secretions
The
irritation of the
breath
is
vitiated,bowels
mucous
membrane
appetite
either
these
"often
dependsupon
certain
G21
INSANE.
THE
of the
condition
disordered
The
organs.
BY
refusal to take
"The
which
FOOD
OP
REFUSAL
gestive
di-
obstinacywith
truly wonderful
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
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.
As
the
disorder
mental
advances, the
of
function
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,
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
CARDIAC
WITH
close
organic sympathy
brain,we should, a priori,
the great nervous
centre,
almost
invariablyexhibit
state. In the writings
normal
"
cardiac disorders."
the dissection
physiologist
distinguished
says,
who have died of apoplexyhas proved to me
patients
This
of
"
that the
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
Richerand
case
of the illustrious
dc
Cabauis,
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
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
In
our
own
and
considered
Bennett, have
f
length.
Important as
this
subjectat
some
this
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
over
the
to this fact.
by
"
Dr.
On
Medical
by
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.
of chronic mania.
In
twenty of
/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
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
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
impeded in
its
course
through the
cerebral
8
vessels,
8
G2G
GENERATION.
AND
RESPIRATION
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
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
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
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-
number
to enter, in
intention
my
left
never
and
to
mental
disorder?
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.
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-
or
in the substance
was
analysis
made
with
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
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
almost
black
were
calvarium
was
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
this time
he
tapeworm.
an
enormous
cause
the
the
"
was
This could
what
Dr.
not be considered
Seymour terms, a
"
at
watery brain."
It
C32
its
GENERAL
formidable
more
expectationof
the
the
case,
Contrary,however, to the
acquaintedwith the facts of
features.
person
every
epilepticfits
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-
was
of the cerebral
have
brain
the
unequivocalsymptoms
some
was
increased
of death.
violence,and continued
membranes.
PATHOLOGY.
CEREBRAL
OF
PRINCIPLES
could
long
disorder.
designedlyselected
the
preceding cases
beset
the
as
efforts of
the medical
tumours
and
abscesses
of
the
brain
of structure
produced serious disorganizations
which
out
with-
PATHOLOGY
reader to
OF
appreciatethe
033
INSANITY.
difficultiessurroundingthis
branch of pathological
science.
Important
Morgagni considered insanityto be more
connected
immediately
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
of the superficies
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,
of
specific
disorganization
the
insanity. According
alienation of mind
the
that
all cases,
the brain
cerebral
exists.
disease
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
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
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
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-
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
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
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,
cerebral vessels ;
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
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
arteries
the
depositsiu
The
"
are
themselves
not
produce a
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
abounds.
much
"
the
the
less able
blood
deposits
go on they impairthe materials
walls of these vessels possess
degenerated
these
As
brain
to
the brain,but
to
posture,to
in the erect
the
be
There
is
no
less
undue
determination
are
of
reverse,
pumped
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
possible
as
which
lews than
probably,
the
blood
in health.
which
arteries,
arteries."
"
need
we
impulse
onlyremember
that
spiteof
the
obstruction.
existing
The
arteries is,most
The
renders
as
shall preserve
the normal
point,in
state of the
merely such
error
imperfectly
supports the
SOFTENING
THE
OP
BRAIN
CAUSING
some
in
become
so
after
ment
of
being for
of softened brain.
mass
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
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
up, and
the
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
"
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.
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
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.
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
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
from
natural states of
entered
I have
in
there
made
There
with
former
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
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
of the
mania)
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
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
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
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,
often
so
recent
medical
steadyand
fingers,
precedeattacks of
observation of Galen.
"
so
"
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
had been
"
"
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
"
"
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.
"
affection of the
"
"
is
very
different from
the
affection
of the
limbs
in
from
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
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.
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
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
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
the
old
with
forms
and
eye.
in
people,
whom
mouth
hard
masses
on
the
'
This
this
edge
O
of the
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.
CEREBRAL
In
ABSCESSES
AND
TUMOURS.
G53
acute
cerebral tumours
not
and
detected
generally
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
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
one
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
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
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
was
pointer.
On
"
"
Eesultate
Physiologische
stillmore
iiber die
and
der Vivisectionen
neuerer
Zeit,"p. 149:
and
the
pp. 112"122.
"
"
OF
DIAGNOSIS
sary to
of the
than
CEREBRAL
"'"~"7
I1EADACHK.
in ailcctions of other
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
are
of
seldom
serum
of
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
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
head; the
recurs,
and
is
AND
and
PROPHYLAXIS.
"
In all acute
the
cure
affections
and
life
000
PRINCIPLES
health.
TREATMENT
OF
will almost
He
PROPHYLAXIS.
AND
detect
invariably
either
hepatic,
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
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,
its progress,
alienation of mind
quently
fre-
disorder,unaccompanied
doubtful
cases
tartrate of
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
flammation
inthis
II
INCIPIENT
IN
II'ING
C01
INSANITY.
"
The
greatcaution.
prolonged
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
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
pleasureso refined,
rapturedmind.'
of
"
which
this medicine
of disordered mind.
In his fourth
"
"
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
hast not
The
"
quired
re-
judgment,he ought
Amythaon, is said
of
himself
government, which
powerfulmedicine
most
pains,
to take the
me
thus be robbed
'
"
dear delusion of
acquiredin
and
expense
amply
Came
had
his friends,
at much
He, when
"
cured
above
Till
\l\ir.\T
OF
INSANITY
BY
003
OPIUM.
in
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
of chloroform
by
gn-at
inhalation.
604
AND
TREATMENT
OF
PRINCIPLES
PROPHYLAXIS.
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
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
is to break
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
SELF-CREATED
il'h
mi-lit
"
605
I \s\Mn
\\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
or
referred
doubt
temporary bodilyconditions of
of the
grapplewith
no
would not be
practitioner
AVhen the prognosis
course.
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
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
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
weakened,
or
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.
ascribe to Heaven
we
"low
AND
TREATMENT
OF
the fated
backward
; only doth
designs,when we ourselves
free scope
are
sky
pull
dulL"
of these
many
treatment.
The
abstraction of
small
quantityof
to the
state of the
functions,combined
with
blood from
the
alteratives,
a careful
counter-irritation and
an
nence
absti-
found
of
apoplexyand
with
will often
agitationand anxiety,
essential benefit in the incipient
stagesof
nected
paralysis.In a certain type of case con-
TREATMENT
OF
INCIPI1
NT
SOFTENING,
PARALYSIS,
ETC.
COO
cupping (wet
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
the
and
patient,
zinc,cod-liver oil,"c., to applya
iron, quinine,
of
seton
or
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
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
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
cases
undue
an
It will often
abroad,
view
of
be found
remote
removing him
to advise
and
to
or
sea
cerebral
exercise
or
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
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
disorder of the
mind
can
be
In
some
followed
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
These
of occasional loss of memory.
a character that he
symptoms, however, were of so trifling
character,
as well
as
had
symptoms
been
recognised,
at this time
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
increased violence.
It
was
In
intermittent.
the sixth
patientcomplainedof
the headache
ness
numb-
returned
still considered
with
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
after death
received
boy
cricket
numbness
eightweeks
found
was
did
He
bat.
extract of
with
combination
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
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
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
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
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
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
easier
is
more
kindred
becomes
distractions
more
gradually
concentrated
exclusively
ideas flow with
greater
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
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
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
are
been
actions thus
or
made
induced
the oscillations
upon
in
the
vesicle have
nerve
tinued
con-
moral, which
as
anxietyof
mind.
have
There
caused
has
them
been
at times
of cerebral
want
great
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
me,
that
could
for
some
possess
disentirely
having acquireda
6SO
AND
TREATMENT
OF
PRINCIPLES
PROPHYLAXIS.
"
"
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."
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
expectantur
attentionem
after each
excitant,
aliquodvicies
read ten, it is
carefully
than
remembered
if
is not
qua
si illud
"
Nov.
Org." lib.ii.aph.26.
illud
HUSH'S
DR.
Dr. Rush
RULES
FOR
IMPKOMMJ
081
MEMORY.
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
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
ears
cannot
in
in
G82
OF
PRINCIPLES
PROPHYLAXIS.
AND
TREATMENT
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
and
the
number
same
I remember
havingseen,
insane
an
Mitivie*,
she
alwaysspeaking,
woman,
of
words
ideas
not
set to
music.*
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
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
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
"
useful
very
that
to commit
in
to memory
passages
it took
about
week
to hear
One
us.
word.
have
possibly
could
"
Mental
the Rev.
in what
been
I do not think
Now
"
wonders
Vigour ;
iU
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
things which,
needed.
after all,
Education,
to what
more
with
as
elicits thought
what
than
"
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
as
task, but
more
from
the
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-
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
TO
viz.:
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
"
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.
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
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
he refreshed
AGE.
Empire,
II. on his birthday."
delightof his youth,
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
of
towards
been
preparing.
written
And
though
fire,though with
as
crown
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
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.
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
son,
"
C94
ILLUSTRATIONS
at the
age of
to the
last.
OF
VIGOUR
OP
His
seventy-three.
MIND
IN
OLD
intellect
AGE.
powerful
was
The
Mansfield
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
sleep!
me
"
expected that
followed
in
he
most
might
excitingscenes
have
addressed
the action
the
for
some
have
me
conceived
of his
taunt
damages to
himself
past life,and
to
Lord
in
that
Chatham
be
some
he
of the
might
respecting
"
Brewster'a
ILLUSTRATIONS
freelyand
serene
UP
OP
child, and
softlylike
MIND
IN
OLD
with
as
AGE.
695
calm
and
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
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-
astonishment
abhorrence
constitution
survive
that
but
miracle
can
transmit
and
at
many
was
constitution,have
in their
of
something
that
have
not
of
of
course
various
should
few
not, in the
best of
the
should
like this
nation
sphere,
hemi-
barbarous
the
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
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
low
of
order
"
mind.
of
It is true
that many
an
those which
of
our
ideas
are
intelligence.Among
the result
such
are
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
"
mind
of
branches
every
of
consciousness
educated
literature,and
by an
the
conversant
man
are
easilymade
these
with
objectsof
Considered
physically,
meta-
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
feebled condition
of
converse
precedingproposition.
Do
often
not
we
witness
reasoningand
mental
of intellectual
reflective
of
powers
ordinary
vigour,extra-
combined
faculties,
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
History of
"
author
Clarendon, celebrated
of retention.
powers
of the
"
Rebellion," Gibbon,
the
Decline
and
Fall," Locke,
the
immortal
the
celebrated
tinguishe
all dis-
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
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
but
health,
many
That
undue
an
the
is not
"
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
some
INSANE.
THE
OF
TREATMENT
the
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
over-estimate
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
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,
ground made
and
classical
and
in the annals
the
memorable
of heroic
emotion
in
deeds,
crumbling ruins
subdued
of
the
Survey
room,
with
that
old
the
man
crouched
in the
in his hands.
He
of the
corner
is indifferent
to all that is
OK
DUTIK8
state
PfQPDl
Mil
of breathless
\I
admiration
I'll Vs|"
his influence
70S
I \ \.
was
manding,
com-
"
"
"
"
"
"
Thought
She
and
affliction,
passion,hell itself,
and
to favour
turns
to
prettineaa."
"
He
is dead
He
"
At
and
is dead
his head
At
gone,
and
a
gone
green
hit heels
lady,
;
gnuw
turf,
stone."
"
"
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
estimates
while
tress,
agonizingpain,bodilydisis in a state to appreciate
physicalprostration,
the
suffering
and
intact,the invalid,even
remain
he
upon
different
of the insane
"
he feels
are
the
feelingsand
sitively
sen-
properly
his case,
adviser.
thoughts
of
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
of treatment.
that
The
poor,
DUTIES
OF
languagebe
any
acts
of
THE
PSYCHOLOGICAL
offensive and
violence
should
him, the physician
repulsiveif
"
towards
those
never
705
PHYSICIAN.
for
be
he
guiltyof
in attendance
a
upon
lose
sight
degree,
moment
the
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
the education
549
connexion
B.
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
mists,
perseveringefforts of the alche436
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, 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
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.
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
the, 311
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
631
Bricrrode
of aberration
of
mind
related
by, 320
remarks
upon
in earlylifeby,
insanity
162
other
types
of morbid
articulation
apoplexyand
,,
cerebral affections,
544
chronic otorrtuea,
544
,,
560
dyspepsia,
,,
of
neglecteddisease of the, 13
Oaborn, Dr., on loss of speech and
"
with
of headache, 654
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
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.
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,
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
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
in
Evidence, Author misrepresented
of Atkinson, 217
in
819
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, 455
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
of
spoken of by,
woman
613
Gutta
F.
serena,
symptoms
of, 567
FALKET,
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
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.
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
Hemp, Indian, in
treatment
of insanity,
663
in treatment
of insanity,663
Henliane,
Herpin, M., on premonitory symptoms
of epilepsy,
484
|KT, 210
485
premonitory symptom of epilepsy,
485
symptomatic of epilepsy,
Hysteria,
I.
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
on
natural
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
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.
by, 373
Hydrocyanic acid, in treatment
of
power
sudden
consciousness of insanity,228
impossibilityof flying from
287
on
classificationof, 359
of things,Gratiolet on, 359
paralysisof, 505
sense
of hearing, 595
senses,
incipientsymptoms
of
"
of insanity,
237
of spectral,related by
singular case
Dr. Hibbert, 212
Imagination,Dr. Johnson's opinionthat
disease of, is so difficultof cure
no
"
exhibited
Immorality,insanity
in acts of.
714
INDEX.
Incubation
of insanity,249
Insane, Concordance compiled by Cruden
whilst,275
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.
life,367
exaltation, 416
VI. strengthened after
be had received a slightconcussion of
the brain,457
remarkable case of disordered,
395, 409
restored
360
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
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
"
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
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
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
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
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
665
P.
on,
535
477
co-ordination,
phenomena of, 468
Mouth, affections of the muscles of the,
of muscular
want
Motion, morbid
488
volitantea,571
V.
NERVE
FORCR,
M. Flelmholti
on
the trans-
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
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,
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
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
morbid,
memory,
motion, 468
of
sensation, 536
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
455
Phosphateof
own
case,
insanityby a, 144
recovery
cerebral,of speech,505
Physiology,
from
matter
singularphantasmal,587
Physician, an
restoration
to, 46
357
of
290
morbid, of hearing,593
24
moriiid, of intelligence,
445
of
language,
morbid,
morbid, of
of cerebral and
affections,
375, 663, 675
death, 443
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
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
memory,
the wit,
the
ingenuity,and
cunning of
487
of apoplexy
Scott,Sir Walter,anticipation
from, 287
Self-inspection,
neglectof habits of,225
curative effect of, 667
Self-control,
Horace
on, 666
"
tactile
sibility,
insen-
symptomaticof
8.
Self,Horace
"(,575
598
Russian
"
Simpson, Professor,on
681
insane,271
by, 263
Segur, Count
,,
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
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
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
restoring the
375
arsenic,676
by
committed
suddenly
person
from
aroused
being
frightful
after
a
Belladonna,coniuin,hydrocyanicacid,
662
dream, 616
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
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
676
of impaired attention,
incipientinsanity, 658
by enemata, 662
incipient softening of
the
brain,
669
injurieson
purgatives,661
of insanity,30
premonitory,
o
ne
pbotopsia, of the,of acute
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.
disease, 475
660
lepsy,
Trousseau, Dr., on obscure types of epi-
Thalumus
541
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
the
6S7
raitiformia,
headache symptomatic of cerebral,
057
in proximity to the optictbalami,828
corpora
721
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
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
various affections
of,566
exaltation of,577
phenomena of,565
defects of,563
singular
Visions,Pinel,Dr., on
Vitiated sensation
apoplexyand
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
,,
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
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Mfi.
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
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
.
Surgery
Macleod's
Surgery
eased
Dis-
Cotton
23
25
11
11
Chest
on
Nunneley
and
the Chest
Fen wick
Lacnnec
10
Surgery
Fergusson's Surgery
3 1
"c.
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
Listen's
Addison
Parturition
on
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
.
20
23
.
Sieveking
Noble
Do.
Private
23
.
Brain
Nervous
on
on
Insanity
Asylums
Psychology
on
Do.
Imperfect Digestion
on
5
.
Druitt's
20
AND
DISEASES
on
3
.
Millingen
Carter
Rectum
on
11
22
.
Ashton
Burgess
on
gical
Psycholo-
Tuke's
Medicine
14
Hood
NERVOUS
SURGERY.
Lunacy
Paralysis
on
18
19
Superstitions
on
Causes
.
Richardson
Book
Pettigrew
..
4
.
Recruits
on
..
23
Rainey on Shells
Reymond's Animal
Electricity 23
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
Vital
on
22
Carpenter's Human
Do.
Comparative
.
Schacht
10
..13
..
Gunshot
29
29
.
Injuries
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
MR.
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