Nervous diseases and their diagnosis : a treatise upon the phenomena produced by diseases of the nervous system, with especial reference to the recognition of their causes [Autographed].

  • Wood, Horatio C.
Date:
1887
Catalogue details

Licence: Public Domain Mark

Credit: Nervous diseases and their diagnosis : a treatise upon the phenomena produced by diseases of the nervous system, with especial reference to the recognition of their causes [Autographed]. Source: Wellcome Collection.

Provider: This material has been provided by UCL Library Services. The original may be consulted at UCL (University College London)

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    patient has no memory of occurrences which took place during the mania. In a certain proportion of the cases the attacks of epileptic mania are repeated in exact counterfeit one of the other. The maniacal outbreak, may, however, not recur for a great length of time. The difficulties of the expert are increased by the fact that the fii-st paroxysm of an epilepsy may take the form of a furious outbreak of epileptic mania. Under these circum- stances it may be essential that the patient be kept for a length of time under surveillance, since, although the circumstances of the paroxysm may satisfy the mind of the medical expert, they may fail to carry conviction to judge and jury. Esquirol states that the homicidal mania of epilepsy is never radically cured, and that its subject is always liable to a fresh outbreak. Whether this be absolutely true or not, it is certain that the recurrence is sufficiently habitual to demand the perpetual surveillance of the epileptic criminal.* Epilepsy frequently leads to mental degradation, which may end in complete dementia. More rarely a permanent insanity develops in the epileptic, although it is doubtful whether the convul- sions in these cases are not the direct outcome of the original neurotic vice, rather than the cause of the insanity. The type of such insanity is said to be usually melancholic, with delusions of persecution and suicidal impulses. The characteristic mental state of chronic epilepsy is progressively lowered mental power, with a peculiar irritability and brutal selfishness, and outbreaks of furious anger on the slightest provocation. Even while the men- tal powers are still active, epileptics very frequently are peculiarly irritable and revengeful. After a paroxysm these tendencies are increased. The tendency of epilepsy to cause dementia is usually in direct relation to the earliness of the age at which it first ap- pears, as is shown in the following analysis of fourteen hundred and fifty cases collected by Gowers : Age of First Mental Defect Appearance. developed. Under 10 years 55 per cent. Between 10 and 19 years 36 20 and 30 years 3 Over 30 years 6 * For further details upon this subject consult M. V. Magnan, L'^pilcpsie, Paris, 1882.