CASE XXXIII.

N. B. He had been many years in the hospital as an incurable patient; his

mother was known to have been maniacal; his two brothers and his sister

have been insane. His eldest son, on taking a very small quantity of

fermented liquor, becomes frantic, and its effects continue much longer

than on persons in general. During this patient's confinement, he was, as

far as could be ascertained, completely in his senses; this induced the

medical persons of the hospital, on two or three occasions, to give him

leave of absence, that he might return on trial to his wife and family;

but, in a few hours after he came home, he felt uneasy, and found himself

bewitched at all points: the devil and his imps had pre-occupied the best

places in the house; he became very turbulent, and also jealous of his

wife, and was obliged to be returned to the hospital. As he found his home

so beset with difficulties he resolved that he would never enter it again.

During eight years that I was acquainted with him I never discovered the

least insanity in his actions or conversation. He was perfectly sensible

that his intellects were disordered whenever he returned to his family.

His wife and children frequently visited him in Bethlem, and he always

conducted himself affectionately towards them. About 14 months before his

death he laboured under a severe dysentery, which continued six weeks, and

left him in a very reduced state, with oedematous legs, and incipient

dropsy of the abdomen. On his recovery from these symptoms he became

troubled with fits; they appeared to be such as a medical person would

have termed apoplectic. After the attack, no symptoms of paralysis

remained, nor did he experience the fatigue and exhaustion, or fall into a

profound sleep, which usually accompanies Epilepsy. On October 10th, 1802,

being then in a pretty good state of health, he fell down, and expired in

a few minutes. He was about sixty-five years of age. On examination of the

head after death, there was a considerable determination of blood to the

brain; but there was no extravasation of that fluid, nor any collection of

water: the brain and its membranes had a healthy appearance, and its

consistence was natural. The heart was sound, and the abdominal viscera

were not conspicuously diseased.

Observations on madness and melancholy · 第 45 / 64 题