anomalies and curiosities of medicine-第221部分

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anity。　In　the　New　York　State　hospitals　there　is　a　regular　uniform　classification　of　mental　diseases　in　which　'circular　（alternating）　insanity'　occupies　a　place。　In　the　report　of　the　Buffalo　Hospital　for　1892；　in　statistical　table　No。　4；　'showing　forms　of　insanity　in　those　admitted；　etc。；　since　1888；'　out　of　1428　cases；　only　one　was　'alternating　（circular）　insanity。'　In　the　St。　Lawrence　Hospital　only　one　case　in　992　was　credited　to　this　special　class。　In　the　institution　in　Philadelphia；　of　which　Dr。　Chapin　is　the　superintendent；　10；379　patients　have　been　treated；　only　three　of　whom　were　diagnosed　cases　of　manie　circulaire。　Of　the　900　cases　of　insanity　in　the　State　Hospital　at　Danville；　Pa。；　less　than　four　per　cent　were　put　in　this　special　class。　There　are　in　the　Central　（Va。）　State　Hospital　（which　is　exclusively　for　the　colored　insane）　775　patients；　three　of　whom　are　genuine　cases　of　circular　insanity；　but　they　are　included　in　'periodic　insanity。'　This　same　custom　evidently　prevails　in　many　of　the　other　hospitals　for　the　insane。〃

Drewry　reports　three　cases　of　circular　insanity；　one　of　which　was　as　follows：

〃William　F。；　a　negro；　thirty…six　years　old；　of　fair　education；　steady；　sober　habits；　was　seized　with　gloomy　depression　a　few　weeks　prior　to　his　admission　to　this　hospital；　in　September；　1886。　This　condition　came　on　after　a　period　of　fever。　He　was　a　stranger　in　the　vicinity　and　scarcely　any　information　could　be　obtained　regarding　his　antecedents。　When　admitted　he　was　in　a　state　of　melancholic　hypochondriasis；　he　was　the　very　picture　of　abject　misery。　Many　imaginary　ills　troubled　his　peace　of　mind。　He　spoke　of　committing　suicide；　but　evidently　for　the　purpose　of　attracting　attention　and　sympathy。　On　one　occasion　he　said　he　intended　to　kill　himself；　but　when　the　means　to　do　so　were　placed　at　his　command；　he　said　he　would　do　the　deed　at　another　time。　The　most　trivial　physical　disturbances　were　exaggerated　into　very　serious　diseases。　From　this　state　of　morbid　depression　he　slowly　emerged；　grew　brighter；　more　energetic；　neater　in　personal　appearance；　etc。　During　this　period　of　slow　transition　or　partial　sanity　he　was　taken　out　on　the　farm　where　he　proved　to　be　a　careful　and　industrious　laborer。　He　escaped；　and　when　brought　back　to　the　hospital　a　few　weeks　subsequently　he　was　in　a　condition　of　great　excitement　and　hilarity。　His　expression　was　animated；　and　he　was；　as　it　were；　overflowing　with　superabundance　of　spirit；　very　loquacious；　and　incessantly　moving。　He　bore　an　air　of　great　importance　and　self…satisfaction；　said　he　felt　perfectly　well　and　happy；　but　abused　the　officers　for　keeping　him　'confined　unjustly　in　a　lunatic　asylum。'　It　was　his　habit　almost　daily；　if　not　interfered　with；　to　deliver　a　long　harangue　to　his　fellow…patients；　during　which　he　would　become　very　excited　and　noisy。　He　showed　evidences　of　having　a　remarkable　memory；　particularly　regarding　names　and　dates。　（Unusual　memory　is　frequently　observed　in　this　type　of　insanity；　says　Stearns。）　He　was　sometimes　disposed　to　be　somewhat　destructive　to　furniture；　etc。；　was　neat　in　person；　but　would　frequently　dress　rather　'gorgeously；'　wearing　feathers　and　the　like　in　his　hat；　etc。　He　was　not　often　noisy　and　sleepless　at　night；　and　then　only　for　a　short　time。　His　physical　health　was　good。　This　'mental　intoxication；'　as　it　were；　lasted　nearly　a　year。　After　this　long　exacerbation　of　excitement　there　was　a　short　remission　and　then　depression　again　set　in；　which　lasted　about　fifteen　months。　At　this　time　this　patient　is　in　the　depressed　stage　or　period　of　the　third　circle。　So；　thus　the　cycles　have　continuously　repeated　their　weary　rounds；　and　in　all　probability　they　will　keep　this　up　'until　the　final　capitation　in　the　battle　of　life　has　taken　place。'　〃

Katatonia；　according　to　Gray；　is　a　cerebral　disease　of　cyclic　symptoms；　ranging　in　succession　from　primary　melancholia　to　mania；　confusion；　and　dementia；　one　or　more　of　these　stages　being　occasionally　absent；　while　convulsive　and　epileptoid　symptoms　accompany　the　mental　changes。

It　is　manifestly　impossible　to　enter　into　the　manifold　forms　and　instances　of　insanity　in　this　volume；　but　there　is　one　case；　seldom　quoted；　which　may　be　of　interest。　It　appeared　under　the　title；　〃A　Modern　Pygmalion。〃　It　recorded　a　history　of　a　man　named　Justin；　who　died　in　the　Bicetre　Insane　Asylum。　He　had　been　an　exhibitor　of　wax　works　at　Montrouge；　and　became　deeply　impressed　with　the　beautiful　proportions　of　the　statue　of　a　girl　in　his　collection；　and　ultimately　became　intensely　enamored　with　her。　He　would　spend　hours　in　contemplation　of　the　inanimate　object　of　his　affections；　and　finally　had　the　illusion　that　the　figure；　by　movements　of　features；　actually　responded　to　his　devotions。　Nemesis　as　usual　at　last　arrived；　and　the　wife　of　Justin；　irritated　by　his　long　neglect；　in　a　fit　of　jealousy　destroyed　the　wax　figure；　and　this　resulted　in　a　murderous　attack　on　his　wife　by　Justin　who　resented　the　demolition　of　his　love。　He　was　finally　secured　and　lodged　in　Bicetre；　where　he　lived　for　five　years　under　the　influence　of　his　lost　love。

An　interesting　condition；　which　has　been　studied　more　in　France　than　elsewhere；　is　double　consciousness；　dual　personality；　or；　as　it　is　called　by　the　Germans；　Doppelwahrnehmungen。　In　these　peculiar　cases　an　individual　at　different　times　seems　to　lead　absolutely　different　existences。　The　idea　from　a　moralist's　view　is　inculcated　in　Stevenson's　〃Dr。　Jekyl　and　Mr。　Hyde。〃　In　an　article　on　this　subject　Weir　Mitchell　illustrated　his　paper　by　examples；　two　of　which　will　be　quoted。　The　first　was　the　case　of　Mary　Reynolds　who；　when　eighteen　years　of　age；　became　subject　to　hysteric　attacks；　and　on　one　occasion　she　continued　blind　and　deaf　for　a　period　of　five　or　six　weeks。　Her　hearing　returned　suddenly；　and　her　sight　gradually。　About　three　months　afterward　she　was　discovered　in　a　profound　sleep。　Her　memory　had　fled；　and　she　was　apparently　a　new…born　individual。　When　she　awoke　it　became　apparent　that　she　had　totally　forgotten　her　previous　existence；　her　parents；　her　country；　and　the　house　where　she　lived。　She　might　be　compared　to　an　immature　child。　It　was　necessary　to　recommence　her　education。　She　was　taught　to　write；　and　wrote　from　right　to　left；　as　in　the　Semitic　languages。　She　had　only　five　or　six　words　at　her　commandmere　reflexes　of　articulation　which　were　to　her　devoid　of　meaning。　The　labor　of　re…education；　conducted　methodically；　lasted　from　seven　to　eight　weeks。　Her　character　had　experienced　as　great　a　change　as　her　memory；　timid　to　excess　in　the　first　state；　she　became　gay；　unreserved；　boisterous；　daring；　even　to　rashness。　She　strolled　through　the　woods　and　the　mountains；　attracted　by　the　dangers　of　the　wild　country　in　which　she　lived。　Then　she　had　a　fresh　attack　of　sleep；　and　returned　to　her　first　condition；　she　recalled　all　the　memories　and　again　assumed　a　melancholy　character；　which　seemed　to　be　aggravated。　No　conscious　memory　of　the　second　state　existed。　A　new　attack　brought　back　the　second　state；　with　the　phenomenon　of　consciousness　which　accompanied　it　the　first　time。　The　patient　passed　successively　a　great　many　times　from　one　of　these　states　to　the　other。　These　repeated　changes　stretched　over　a　period　of　sixteen　years。　At　the　end　of　that　time　the　variations　ceased。　The　patient　was　then　thirty…six　years　of　age；　she　lived　in　a　mixed　state；　but　more　closely　resembling　the　second　than　the　first；　her　character　was　neither　sad　nor　boisterous；　but　more　reasonable。　She　died　at　the　age　of　sixty…five　years。

The　second　case　was　that　of　an　itinerant　Methodist　minister　named　Bourne；　living　in　Rhode　Island；　who　one　day　left　his　home　and　found　himself；　or　rather　his　second　self；　in　Norristown；　Pennsylvania。　Having　a　little　money；　he　bought　a　small　stock　in　trade；　and　instead　of　being　a　minister　of　the　gospel　under　the　Methodist　persuasion；　he　kept　a　candy　shop　under　the　name　of　A。　J。　Brown；　paid　his　rent　regularly；　and　acted　like　other　people。　At　last；　in　the　middle　of　the　night；　he　awoke　to　his　former　consciousness；　and　finding　himself　in　a　strange　place；　supposed　he　had　made　a　mistake　and　might　be　taken　for　a　burglar。　He　was　found　in　a　state　of　great　alarm　by　his　neighbors；　to　whom　he　stated　that　he　was　a　minister；　and　that　his　home　was　in　Rhode　Island。　His　friends　were　sent　for　and　recognized　him；　and　he　returned　to　his　home　after　an　absence　of　two　years　of　absolutely　foreign　existence。　A　most　careful　investigation　of　the　case　was　made　on　behalf　of　the　London　Society　for　Psychical　Research。

An　exhaustive　paper　on　this　subject；　written　by　Richard　Hodgson　in　the　proceedings　of　the　Society　for　Psychical　Research；　states　that　Mr。　Bourne　had　in　early　life　shown　a　tendency　to　abnormal　psychic　conditions；　but　he　had　never　before　engaged　in　trade；　and　nothing　could　be　remembered　which　would　explain　why　he　had　assumed　the　name　A。　J。　Brown；　under　which　he　did　business。　He　had；　however；　been　hypnotized　when　young　and　made　to　assume　various　characters　on　the　stage；　and　it　is　possible　that　the　name　A。　J。　Brown　was　then　suggested　to　him；　the　name　resting　in　his　memory；　to　be　revived　and　resumed　when　he　again　went　into　a　hypnotic　trance。

Alfred　Binet　describes　a　case　somewhat　similar　to　that　of　Mary　Reynolds：　〃Felida；　a　seamstress；　from　1858　up　to　the　present　time　（she　is　still　living）　has　been　under　the　care　of　a　physician　named　Azam　in　Bordeaux。　Her　normal；　or　at　least　her　usual；　disposition　when　he　first　met　her　was　one　of　melancholy　and　disinclination　to　talk；　conjoined　with　eagerness　for　work。　Nevertheless　her　actions　and　her　answers　to　all　questions　were　found　to　be　perfectly　rational。　Almost　every　day　she　passed　into　a　second　state。　Suddenly　and　without　the　slightest　premonition　save　a　violent　pain　in　the　temples　she　would　fall　into　a　profound　slumber…like　languor；　from　which　she　would　awake　in　a　few　moments　a　totally　different　being。　She　was　now　as　gay　and　cheery　as　she　had　formerly　been　morose。　Her　imagination　was　over…excited。　Instead　of　being　indifferent　to　everything；　she　had　become　alive　to　excess。　In　this　state　she　remembered　everything　that　had　happened　in　the　other　similar　states　that　had　preceded　it；　and　also　during　her　normal　life。　But　when　at　the　end　of　an　hour　or　two　the　languor　reappeared；　and　she　returned　to　her　normal