The cyclopaedia of practical medicine: comprising treatises on the nature and treatment of diseases, materia medica and therapeutics, medical jurisprudence, etc., etc (Volume 3).

Date:
1845
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Licence: Public Domain Mark

Credit: The cyclopaedia of practical medicine: comprising treatises on the nature and treatment of diseases, materia medica and therapeutics, medical jurisprudence, etc., etc (Volume 3). Source: Wellcome Collection.

Provider: This material has been provided by the National Library of Medicine (U.S.), through the Medical Heritage Library. The original may be consulted at the National Library of Medicine (U.S.)

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    in trifles, placing and replacing, and running from ! one room to another, that he was rarely dressed by dinner-time, and often apologised for dining in his dressing-gown, when it was well known thai h^ had done nothing the whole morning but dress. And he would often take a walk in a winter's evening with a lanthorn, because he had not been able to get ready earlier in the day. He would run up and down the garden a certain number of times, rinsing iiis mouth with water, and spitting alternately on one side and then on the other, in regular succession. He employed a good deal of time in rolling up little pieces of writing-paper, which he used for cleaning his nose. In short, his peculiarities were innumer- able, hut he concealed thern as much as possible from the observation of his wife, whom he knew to be vexed at his habits, and to whom he always behaved with the most respectful and affectionate attention, although she could not influence him in the slightest degree. He would, however, oc- casionally break through these habits ; as on Sun- days, though he rose early for the purpose, he was always ready to perform service at a chapel a mile and a half distant from his house. It was a mys- tery to his intimate friends when and how he prepared these services. It did not at all surprise those who were best acquainted with his pecu- liarities, to hear that in a short time he became notoriously insane. He fancied his wife's affec- tions were alienated from him, continually affirm- ing that it was quite impossible she could have any regard for a person who had rendered him- self so contemptible. He committed several acts of violence, argued vehemently in favour of sui- cide, and was shortly afterwards found drowned in a canal near his house. It must not be omitted that this individual derived a predisposition to madness by hereditary transmission : his father had been insane. Of Mania.—The phenomena of mania in its ordinary form are very distinguishable from those of monomania. The aspect, the voice, the ges- tures of the lunatic in the active state of maniacal derangement, form a contrast with the retired and morose habits of the sullen monomoniac. In cases, however, of mania, distinctly so termed, one im- pression often occupies the mind of the individual for the time being, and this is frequently some hallucination respecting his own person, some inagnific dream of self-importance and superiority. ]\I. Pinel says, I was frequently followed at the Bicetre by a general, who said that he had just been lighting an important battle, and had left fifty thousand men dead on the field. At my side was a monarch who talked of nothing but his subjects and his provinces. In another place was the prophet Mahomet in jierson, denouncing ven- geance in the name of the Almighty. A little further was a sovereign of the universe, who could with a breath annihilate the earth. Many of them seemed to be occupied by a multiplicity of objects, which were present to their imagina- tions. They gesticulated, declaimed, and vocife- rated incessantly, without appearing to see or hear anything that passed. Others, under illusive in- fluence, saw objects in forms and colours which they did not really possess. Under the influence of an illusion of that kind, was a maniac who mistook for a legion of devils every assemblage of people that he saw. Another maniac tore his clothes to tatters, and scattered the straw on which he lay, under the apprehension that they were heaps of twisted serpents. Ordinary mania, or madness affecting the mind with a general disturbance of the intellectual fa- culties, is sometimes precede*! by occasional fits of excitement and confusion, in which the under- standing is hurried and disordered. But it differs from monomania in making its attacks for the most part suddenly and without any premonitory symptoms. An individual, after having undergone an unusual degree of mental and bodily exertion and fatigue, after a fit of intoxication, which in this country is one of the most ordinary of ex- citing causes of madness, after the excitement of violent passions or anxieties, after exi)osure to cold and the inclemencies of weather, passes sometimes a day or two in a state of feverish disorder and general uneasiness, and two or three restless nights. His mind is then found to be confused ; he appears scarcely to know what he says, talks nonsense, repeats his words frequently, expresses his feelings with an absurd degree of warmth and enthusiasm, cries, laughs, utters rapid and confused sentences in a hurried and impetuous manner. In the course of a few days, or sometimes at first, he is seized with violent agitations, expresses vague and continual apprehensions, is subject to fits of terror; he is in a state of constant excitement and sleep- lessness ; he indicates the troubled state of his mind by unusual gestures, by singular appearances of the countenance, and by actions which cannot fail to strike in a forcible manner every observer. The various aspects which the symptoms of the disease assume at this period, have never been more graphically described than by M. Pinel. The patient sometimes keeps his head elevated and his looks fixed on high; he speaks in a low voice, or utters cries and vociferations without any apparent motive ; he walks to and fro, and some- times arrests his steps as if excited by the senti- ment of admiration, or wrapt up in profound re- verie. Some insane persons display wild excesses of merriment, with immoderate bursts of laughter. Sometimes, also, as if nature delighted in contrasts, gloom and taciturnity prevail, with involuntary showers of tears, or the anguish of deep sorrow, with all the external signs of acute mental suffer- ing. In certain cases a sudden reddening of the eyes and excessive loquacity give presage of a speedy explosion of violent madness, and the ur- gent necessity of a strict seclusion. One lunatic, after long intervals of calmness, spoke at first with volubility, he uttered frequent shouts of laughter, and then shed a torrent of tears; experience had taught the necessity of shutting him up immedi- ately, for his paroxysms were at such times of the greatest violence. It is often observed that extatic visions in the night are the preludes to fits of ma- niacal devotion ; and by enchanting dreams, or by the fancied apparition of a beloved object, it some- times happens that erotic madness breaks out with violence, when it may either assume the character of a calm reverie, or display nothing but extreme confusion in the ideas and the entire subversion of reason. When the disease has taken a Arm hold on its
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