Translations From French Journals
Complications in General Paralysis.
M. A. Fabre de Parrel, in his inaugural thesis, after affirming that general paralysis is, of all the neurosis, the least reducible to invariable description or definition, so multitudinous and fluc- tuating are the symptoms, has enumerated the following acces- sories or complications in support of his proposition. These are, it is to be understood, additions to the chronic diffuse inter- stitial encephalitis which constitutes the characteristic patho- logical condition of the disease.
Hemiplegia, or rather hemi-paresis.
Epileptiform Convulsions.
Monoplegia.
General Tremor.
(a) He adds that in the examination of these accessory and circumscribed lesions he has found in the persistent hemiplegia, atrophy of one hemisphere, central encephalitis, softening ?cerebral haemorrhage being very rare in consequence of the thickening of the walls of the vessels.
(b) In epileptiform convulsions there may be found active congestion of the membranes, accompanied with capillary hcemorrhage, upon the localities identified as motor centres. He concludes that great experience and exactitude are re- quired in forming a diagnosis between the phenomena presented in circumscribed lesions and those in actual general paralysis, and demands special attention to the defective articulation, the general weakening of the intelligence, the complete self- satisfaction. The incoherence and absurdity of the general paralytic is special and establishes a complete distinction from the preservation of a certain amount of judgment, a certain perception of his real position, and a special sensibility of the ordinary dement.?Annates Medico Psychologiques, November 1879. Claustrophobia.
It is well known that for some time, in the opinion of Dr. Bourdin, there has existed a cerebral state characterised by a horror of void or empty spaces, which he designates Agoraphobia. For some years he has observed, it is to be confessed in a few instances only, a somewhat analogous but opposite condition, consisting of a dislike to closed spaces, or Claustrophobia. His studies may cast a new light upon the general subject of mental disease. 1. A typical case of this kind was presented in a young man of good position subsequent to an attack of gonorrhoea, 154 COMPLICATIONS IN GENERAL PARALYSIS. and which was erroneously designated by my colleague, Legrand du Saulle, as aberration of the sense of touch. The patient, without any intellectual lesion, was depressed by the suspicion that he suffered from the infection of impurity. From the fear of further vicious contact, he would not touch the handle of a door, nor would he shake hands when uncovered, nor, sub- sequently, touch any part of the human body. Further, he would not place his unslippered feet upon the carpet, was inces- sant in his ablutions, adducing as a reason that the mere contact of his fingers with external objects gave the impression of an adhesive substance which was removed by water, even two drops of which was effective ; such imaginary cleansing proving the hallucination to be mental not tactile. Up to this point these were merely the peculiarities of a finical youth ; but, subsequently, he became affected by the terror of solitude, so that he imperatively demanded that the door and windows of his apartment should be kept open. In society this dread was so dissipated or controlled that he allowed the doors &c. to be shut. This morbid fancy was so intense that he caused all the windows of the house, and the door opening upon the street, to be open during the night, from which he issued to wander about till daylight. His description of his sensations was, that he was urged by an in- ternal impulse or agony, resembling what might occur if an individual rushed along a passage narrowing as he advanced, so that he could neither go forward nor recede. While thus oppressed he rushes to the country.
2. Madame X., hereditarily disposed to insanity, her father having been insane ; enjoyed good health in youth. She mar- ried early and had three children, the eldest of whom was an imbecile, without intelligence or affection. The second, a girl, became epileptic when two years old, with loss of memory. The youngest apparently enjoyed good health. The patient, after labouring under typhoid fever, became weak in mind, suf- fered from constant cephalalgia and complete loss of niemory. The deprivation related chiefly to very recent occurrences. Ana;mia was followed by hysteria, anger, and fury. There fol- lowed extreme melancholia pervigilium, suicidal tendencies, and intense sensations of cold. Sent into the country for change of air, she experiences various morbid conditions; is annoyed by the sound of her own voice, and flies from those whom she loves. In ascending a height she is seized with an involuntary terror, strikes her head against a wall, and staggers down to the bottom, and when calm and respiration were re- sorted, has the sensation as if she had emerged from a well into the open air. A similar sensation was experienced when shut into a bathroom, the windows of which she broke to seoure her liberation. Her fear is roused by the shutting of the door of her own room, the key of which she endeavours to secure, and having done so, rushes forth and loses all perception of where she is. She would not have remained with a shut door for an empire. Subsequently she complained of the dread of open spaces and the inability to find her way, although such ex- pressions were not used by her in a psychological sense. 3. The third case, cited by Dr Meschede to the Society of Naturalists, at Cassel, represents a youth experiencing dyspnoea and vertigo whenever he enters a small room or narrow place. Compelled to abandon his studies, he became a farmer, but in- variably slept in the open air, except during the depth of winter, when he occupied a vast apartment, having the doors and windows open. He was not hereditarily predisposed, but subject to nervous agitation.
4. M. Kaggie, of Boulogne, relates that a painter, while excited by the praises of his associates, and about to finish the picture on which he was engaged, perceives that the door of the saloon is locked, becomes alarmed, rushes to the window, makes his escape therefrom, and by means of the roof of an adjoining house reaches the ground, and then becomes perfectly tranquil. M. Ball refers to the work of Dr Beard, of New York, on Morbid Terrors, in which it is proposed to designate such states as those described above under the name of Topopliobia.?
Annates Medico-Psychologiques, November 1879, p. 378. [The cases described above do not appear to us to belong to the neurose named by Dr Verga, of Milan, as Claustrophobia. They may be more fairly classed under what the Germans formerly called airomania, in which, either from some affection of the cardiac or pulmonary organ, or from mental delusion, there was an intolerance of confinement to narrow places, a craving for the open and fresh air, &c. We have encountered many exam- ples of this symptom, for it is nothing more, both in the sane and insane, although generally combined with hallucinations of the muscular sense. The best known illustration is that of Saussure, who, conceiving that his proportions had waxed to so enormous a size that he could not inhabit small rooms, or pass through doors of the ordinary width, had the partitions between his rooms taken down, and so on. We had a patient who believing that he was a barley corn, or reduced to that magnitude, would not expose himself, and courted corners, in order to avoid the vigilance of the sparrows.?
Suicide in Germany.
Dr Dresde, of Saxony, writes in the Augsburg Gazette, that the number of suicides in that country has considerably in- creased. The statistics for 1878, which are more trustworthy v-^an those for the preceding years, show 1,126 suicides, of whom 215 are those of females. In 749 cases death was effected by hanging ; in 217 by drowning ; and in 88 by shooting. The causes indicated are?domestic or social events, 284; melancholia or disgust at position, 105 ; intemperance and its consequences, 94 ; aberration of intellect, 90; privations, 89; physical sufferings, 65; unfortunate amours, 39.
The age of the suicides varied between 14 and 90. It is suspected that, in the number quoted, 8 had not attained the age even of 14, while four had reached between 80 or 90. It is asserted that the proportion of suicides in England during the last weeks of 1878 is triple that of the corresponding period in the preceding year?an increase attributed to the con- tinuance of bad times, the inclement weather, inundations &c.? ” Le Progres Medical,” September 20, 1879, p. 754.
[The attention of the extreme advocates of abstinence in this country should be directed to the prevalence of intemperance in other countries, and at the same time to the declaration of Dr. Eraser, Professor of Materia Medica, Edinburgh University (Scotsman newspaper, February 27, 1880), that moderate quan- tities of alcohol contribute to the nourishment of the human body.?
Insanity as a Ground of Divorce. M. Van der Swalme comes to the following conclusion on this subject:?
The moral, religious, and practical considerations which appear to justify recognition of alienation as a ground of divorce ap- pear insufficient. In dealing with such a matter it would be necessary to plead, not simply mental derangement, but chronic, incurable derangement, with loss of memory. Cases coming under such a category will be all the more rare that patients so affected generally die early. It would be rash to fix for the small number of survivors the special terms of divorce, however carefully considered, as these might greatly aggravate the con- dition of the sufferer–. It hence follows that alienation does not seem to constitute a more clamant reason for divorce than many other infirmities and diseases which disturb conjugal happiness.?Medical International Congress of Amsterdam.
” Le Progres Medical,” October 4, 1879. Classification of Mental Maladies.
M. Van der Lith, answering the questions whether a classi- fication of mental diseases is necessary, and upon what basis it should be founded, writes : 1. Such a classification is necessary for instruction of students, the study and treatment of patients, as well as for medico-legal investigations. 2. The difficulties in all classification are greatly multiplied in the case of mental diseases by the complicated and little-known structures affected, by the diversity of their functions which dominate our life and being, by the varied degrees in character and amount of development, and by the great number and difference in the morbific causes which become factors of insanity. 3. In order to secure a clear and simple classification it would be expedient to select a different principle in that intended for the instruc- tion of students, from that intended for the classification of patients. 4. Such classification should have the same base as that of other diseases: (a) functional disturbances; (6) the causes which interfere with normal conditions ; (c) and lastly, the anatomical lesions on which the symptoms depend. 5. It is expedient to divide mental maladies into groups, but to keep in mind that the characters of these may not be stationary.? Medical International Congress of Amsterdam. ” Le Progres Medical,” October 4, 1879.
Hysteric Blindness.
Total blindness occurred in a girl, age 16, upon January 21, 1879. M. Abadie diagnosed the integrity of the membranes at the base of the eye, suspected hysteria, and discovered general cutaneous anaesthesia. Believing in the existence of an hysteric amblyopia, he, without informing the patient, affixed three pieces of gold upon the left temporal region, when, after the lapse of a quarter of an hour, vision was restored in the left eye, but no change took place in the right. There was no known cause of this affection.
January 23.?A magnet was applied to the left side of the head, followed, after ten minutes, by slight amelioration. When the magnet is applied to the right, vision returns in twenty minutes.
January 25.?Somnolency, almost lethargy, followed appli- cation of magnet.
Upon January 29 there is permanently applied a piece of gold to each temple, there having been given internally the muriate of gold and soda.
February 5.?Vision of different degrees of acuteness in both eyes. There were prescribed the cold water cure, muriate of gold internally, and the application of gold, as earrings, armlets, &c. Silver, copper, and zinc were successively tried without result. After an attack of fever the patient was subjected to electrical currents through the orbits. A quarter of an hour after this application complete vision returned, and by the continuance of local electricity the restoration became perma- nent, although somnolency remained.
The author concludes from these observations that the application of metals produced at once temporary restoration of vision, with somnolency and lethargy ; while local electricity effected complete cure.?Medical Society of Hospitals.?” Le Progres Medical” November 1, 1879, p. 838. Transmission of Hydrophobia from Man to a Rabbit.
M.* Raynaud received a patient into his ward in the Hospital of Lariboisiere labouring under all the symptoms of hydrophobia. Shortly before the death of the patient, M. Raynaud inoculated several rabbits with his blood, and several others with his saliva. The former experiment produced no effect; the latter was fol- lowed by indubitable signs of hydrophobia in a few days. He subsequently transferred the sub-maxillary glands of an infected to a healthy rabbit, when hydrophobia was again induced. No example has been recorded of the transmission of this disease from one human being to another ; but M. Raynaud has demon- strated the possibility of such an accident, by transmission from man to the lower animals.?Academie de Mededne. uLe Progres MedicalNovember 15, 1879, p. 904. Aphasia in General Paralysis.
M. Magnan has met with two cases of aphasia in general paralysis. 1. A cook, addicted to drinking, became affected with general paralysis, was seized with apoplexy, and sub- sequently became incoherently aphasic, pronouncing words and parts of words without signification. On death, there was found diffuse encephalitis of the membranes, especially on the left side and in the region connected with the function of language. 2. A man, subject for 18 months to general paralysis, complicated with apoplectiform attacks, was deprived of all language except the word merci. On dissection, grave lesions were found in the neighbourhood of the fissure of Sylvius which was obliterated. ? Societe de Biologie. ” Le Progres Medical” November 15, 1879, p. 903.
Paralysis Agitans.
M. Magnan has signalised an unusual form of this affection, in which the tremor is excited only when the patient makes particular efforts demanding special exertion, and consists in nodding the head forwards coincidently with the rigidity of certain other groups of muscles.?Societe de Biologie. ” Progres Medical” December 20, 1879.
Brains of Criminals.
It appears that M. Benedikt, of Vienna, and M. Hanot of Paris, have described a doubling of the second frontal circon- volution of the brain in assassins, thieves, and other jail birds. Sixteen examples are adduced, and the anomaly is said not to have been found in mere hospital patients.?Societe de Biologie. ” Le Progres Medical,” January 3, 1880.
Precocity.
M. M. Or. Dalaunay represents precocity as a mark of bio- logical inferiority. The lower species become rapidly mature. In man the development is so slow that the brain continues to increase until fifty. The lower races of mankind become mature more speedily than the higher. In illustration, it may be mentioned that the infants of the Esquimaux, Negroes, Japanese, Arabs, and of the natives of Cochin-China, are, up to a certain age, more vigorous and intelligent than those of Europeans. In proportion as a race advances its members become less precocious. The normal stature of the French is attained less quickly than that of other nations ; that of con- scripts, for example, has been twice lowered since the beginning of the century. It is affirmed that the heads of French nobles formerly exceeded in size those of their fellow citizens, but they are now smaller than those of the learned and mercantile classes. Again, females are more precocious than males. Among domes- tic animals the female becomes more quickly matured than the male. In man, the girl from eight to twelve gains one pound more per annum than the boy. In mixed schools, the girl up to twelve years attains the first places. The author concludes that the age at which children enter the naval and military schools is too early, as the cleverest or most precocious prove ultimately failures. The inferior tissues are most early perfected. The brain, and especially the anterior and the superior part of the left hemisphere, supposed to be connected with the manifesta- tions of intelligence, are of latest growth.?Societe de Biologie. ” Le Progres Medical,” January 3, 1880, p. 9.
Female Alienists. There is quoted, from the New York Herald, the announce- ment that Madame Cleave, Dr in Medicine, formerly assistant in the asylum at Davenport, and now a member of the adminis- trative council of that institution, argued in a conference on public charities, held in Chicago, strongly in favour of the appointment of female medical attendants on lunatics at least of their own sex. Certain of her propositions are worthy of attention. 1. She affirmed that, as many mental maladies depended remotely upon conditions of the utero-genital organs, educated females could alone examine, understand, and medi- cate these. 2. That female patients invariably endeavour to conceal from medical men such affections, but would willingly reveal them, or could not at least conceal them, from individuals of their own sex. 3. That, on the restoration of sanity, the recollection of the interference of physicians with such subjects is intolerable to feelings of delicacy and modesty.?Annates Physiologiques, January 1880, p. 173.
Morpiiiamania and Morphinism.
A lady, the wife of a merchant, who had been long subject to exquisite pain, had recourse to various medical advisers, but at length to one who recommended morphia, hypodermically injected. Having acquired dexterity in operating upon her- self, she made sometimes as many as twenty injections in a day. While thus treating herself she bore a healthy child, who survives. The drug having been experimentally withdrawn, the cephalalgia returned, with exhaustion and mental derange- ment. On resuming the use of morphia, and no limitation being imposed as to the quantity, her health was restored and the pain disappeared, and she was able to participate in all the pleasures and pursuits of general society. She succumbed under a second attack of mania. She used 1^ grammes or 150 or 200 francs’ worth of opium in a month.? Ibid., p. 174. Habitual Drunkards in Prussia.
After enumerating the steps taken in France, England, and America, to meet and to counteract intemperance and its consequences, and stating that 25 per cent, of the insane admitted to public hospitals in Prussia were habitual drunkards, the director of an important asylum proposed and carried in the Medical Synod, reports the Gazette of Madgebourg, the following resolutions:?1. That persons found drunk in the streets, in public-houses, or places where intoxicants are sold, shall be liable to punishment. 2. That the vendors of drink, who supply those in a state of intoxication, shall likewise be punishable. 3. That habitual drunkards should be compulsorily placed in institutions specially prepared for their reception. ?Ibid., p. 172.
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