General paralysis of the insane / by Wm. Julius Mickle.

  • Mickle, William Julius.
Date:
1880
Catalogue details

Licence: Public Domain Mark

Credit: General paralysis of the insane / by Wm. Julius Mickle. Source: Wellcome Collection.

Provider: This material has been provided by The University of Leeds Library. The original may be consulted at The University of Leeds Library.

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    occur among the prodromes, or, again, in the first period, that which is sometimes termed prodromic and is antecedent to mental alienation, but the pronounced hypochondria of general paralytics is more apt to occupy part of the second stage of the conjirmed disease (third period), and less often of the first stage (second period). Yet the mental symptoms may more or less partake of melanchohc or hypochondriacal characters throughout, and these may be intermingled. When marked depression occurs at the commencement, and thence is continued into the first stage of the conjirmed disease, the delusions assume by preference the melan- chohc form, and in the soldiers under my care are usually of a terrifying nature; the patients, stricken with anxiety and terror, assert that they are persecuted, hunted, insulted, or that they are to be shot, or they beg that they may not be killed. As I* have stated elsewhere, they are anxious, querulous, worried, and bewildered, distressed by trifles, suspicious of harm, sometimes have hallucinations of sight or hearing, or are either suicidal or hypochondriacal. These symptoms may continue even to the late stages. If occurring for the first time during the middle stages, the hypochondria co-exists with a shattered understanding, and the delusions are usually of the following nature:—The patients say of themselves that they are dead, have no head, II have no throat and cannot swallow, their intestines are gone their eyes have been extirpated, their testicles are wasted' or that they have been castrated, or that part of their body is dead. With this there is often a refusal of food and obstinate resistance to feeding, a wild howling when they are interfered with, an inabihty to walk or stand, a huddhng up in bed, and general spasmodic tremor when locomotion is attempted or when they shrink from contact. Having thus from my own practice, as just quoted, illustrated certain clinical phases of hypochondriacal dehrium in general paralysis, I may now add other cases, from the same, taking the loUowing forms. ° In one; after a period of exalted delusions with considerable mamacal agitation, hallucinations, insomnia, and restlessness, the patient for a time is usually silent and of apathetic appearance but now and then suddenly and paroxysmally breaks forth into the reiterated shout, Come here my cavalry-my cavalry come ftere; or as if in a paroxysm of terror, Oh God have mercy on my soul-oh God have mercy on my sou].-Later, the physical signs continue well-marked, and the face muddy, sallow, and * BritUh and ForeiynModico-Chimrffical lievieio, April, 1877, p. 457.