Page:Clinical psychiatry a text-book for students and physicians abstracted and adapted from the 7th German edition of Kraepelin's Lehrbuch der Psychiatrie by A. Ross Diefendorf.djvu/482

Rh insanity is a psychosis based upon epilepsy which is characterized by a variable degree of mental impairment and by the recurrence of certain transitory mental states, designated epileptic ill-humor and epileptic befogged states. The befogged states include pre- and post-epileptic excitement and stupor, anxious and conscious deliria, and possibly also dipsomania.

Etiology. — Defective heredity is the most frequent predisposing cause of epilepsy, appearing in eighty-seven per cent. of cases, while in over twenty-five per cent. epilepsy exists in the parents. Spratling found in 1070 cases hereditary taint in fifty-six per cent., sixteen per cent. of which displayed parental epilepsy. He also found nearly similar ratios in parental alcoholism and tuberculosis. Féré notes among progenitors and relatives of epileptics the extreme frequency of migraine, headaches, infantile convulsions, mental disturbances, and deterioration. All authorities agree that parental alcoholism is a prolific source of epilepsy in the offspring. Wildermuth considers its influence almost as powerful as that of mental disorders, including epilepsy. Other factors in the progenitors which predispose to epilepsy are insanity, syphilis, rheumatism, diabetes, and possibly chorea. Evidences of congenital defect are frequently found in malformation or asymmetry of skull, microcephaly, hydrocephalus, the so-called "epileptic physiognomy" (broad forehead, broad and 434