J. A. a man, forty-two years of age, was first admitted into the house on
June 27, 1795. His disease came on suddenly whilst he was working in a
garden, on a very hot day, without any covering to his head. He had some
years before travelled with a gentleman over a great part of Europe: his
ideas ran particularly on what he had seen abroad; sometimes he conceived
himself the king of Denmark, at other times the king of France. Although
naturally dull and wanting common education, he professed himself a master
of all the dead and living languages; but his most intimate acquaintance
was with the old French: and he was persuaded he had some faint
recollection of coming over to this country with William the Conqueror.
His temper was very irritable, and he was disposed to quarrel with every
body about him. After he had continued ten months in the hospital, he
became tranquil, relinquished his absurdities, and was discharged well in
June 1796. He went into the country with his wife to settle some domestic
affairs, and in about six weeks afterwards relapsed. He was re-admitted
into the hospital August 13th.
He now evidently had a paralytic affection; his speech was inarticulate,
and his mouth drawn aside. He shortly became stupid, his legs swelled, and
afterwards ulcerated: at length his appetite failed him; he became
emaciated, and died December 27th, of the same year. The head was opened
twenty hours after death. There was a greater quantity of water between
the different membranes of the brain than has ever occurred to me. The
tunica arachnoidea was generally opake and very much thickened: the pia
mater was loaded with blood, and the veins of that membrane were
particularly enlarged. On the forepart of the right hemisphere of the
brain, when stripped of its membranes, there was a blotch, of a brown
colour, several shades darker than the rest of the cortical substance: the
ventricles were much enlarged, and contained, by estimation, at least six
ounces of water. The veins in these cavities were particularly turgid.
The consistence of the brain was firmer than usual.