Amentia and dementia : a clinico-pathological study / by Joseph Shaw Bolton.

  • Bolton, Joseph Shaw, 1867-1946.
Date:
1905
Catalogue details

Licence: In copyright

Credit: Amentia and dementia : a clinico-pathological study / by Joseph Shaw Bolton. Source: Wellcome Collection.

Provider: This material has been provided by The Royal College of Surgeons of England. The original may be consulted at The Royal College of Surgeons of England.

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    In the ward she is most erratic and careless, though at times she talks sensibly. She is pleasant one moment and silly the next. She is very silly and mischievous in her behaviour and very lively and excitable. She often steals money or any article she can lay her hand on. She makes no attempt to read, but at times joins in singing. She will not work in the ward and neither makes her bed nor keeps herself tidy. She menstruates regularly, and is excited and silly and appears to hear voices at this time. She cannot be trusted at a dance. At the fancy dress ball she was most excited and indecent. She wore a bathing costume and tried to get the knickers down. She works daily in the laundry, and her behaviour here is different. She is a good worker, but varies much in this. If supervised she nearly always works well and talks very sensibly and rationally. At times, however, if no one is there, she will turn on the steam or start a machine for mischief, She is very untidy with regard to herself, and nearly always gets her clothes soaking wet. Group II. Class (c). Cases of Chronic Mania, with Incoherence and Delusions. This class contains 19 cases, of whom 6 are males and 13 are females. These cases form a half-way house between the previous class and class (d), and shade gradually into each of these. They differ from the former in being on the whole less troublesome and in showing an apparently complete incoher- ence in their association of ideas, and from the latter in the fact that their ideation is simply rapid and uncontrolled, rather than grotesque or symbolical, and resulting in erratic and eccentric conduct. In conversation they appear absolutely incoherent as a rule, although frequently the sequence of ideas by relative association is readily followed. Usually they are garrulous and exuberant, and are therefore grandiose. When ideas of grandeur arise, whether or not as a result of the suggestion contained in a question, they repeat the names of every person of eminence they happen to think of or perhaps of every place in the world they know by name, and hence the result is either an absurd exaggeration of their importance on the one hand, or a mere list of casual but related names on the other. The sequence of words may occur as a result of sound, or meaning, or both, and as a rule their ideation appears to be largely mechanical or automatic. The smart word-play, etc., which is a marked feature in the cases of class (d) is not as a rule obvious in these patients. They, however, equally with class (d), suggest gross madness to ordinary outside observers.