Page:The American Cyclopædia (1879) Volume IX.djvu/313

 INSANITY 301 ual use of alcoholic beverages, which are pro- duced in such great quantities by civilized countries, lias had much to do in inducing a hereditary tendency to insanity, and causing the spread of mental maladies to a greater ex- tent among civilized than among other nations. The researches of Morel on the cause of the formation of degenerate varieties of the hu- man race are interesting as explaining the con- tinuance of morbid action through succeeding generations, and the final extinction of fami- lies. The evil influences which produce dis- ease, such as the poisonous air of a malarious district, or a badly drained and cleaned city, overcrowding and privation in large towns, per- sistent intemperance and sexual excess, and in- termarriage in families, unless counteracted, ap- pear to tend to increase through generations, until continuance of the species is impossible. He regards insanity in any form, whether ma- nia, melancholia, or dementia, as a stage in the descent toward sterile idiocy, as sometimes shown by the consequences of frequent inter- marriages in foolish families. He relates the history of one family in which the progress of degeneration may be briefly stated as follows : first generation immorality, alcoholic excess, brutal degradation ; second generation hered- itary drunkenness, maniacal attacks, general paralysis; third generation sobriety, hypo- chondriasis, lypemania, systematic mania, homicidal tendencies ; fourth generation fee- ble intelligence, stupidity, first attack of mania at 16, transition to complete idiocy, and prob- able extinction of the family. General Symp- tom* of Insanity. The earliest symptoms of coming insanity are depressed manner, unusual excitement, anger, and rashness; and even these may be preceded by an altered manner, if careful notice has been taken. An abnormal condition of brain exists, including a want of nervous energy which creates a consciousness that there is something wrong ; a want of co- ordination of the faculties produces false rea- sonings and conclusions as to the nature of the difficulty, and so as the disease progresses de- lusions and hallucinations make their appear- ance. An important symptom in all forms of insanity is impairment of the faculty of at- tention, as might be expected from the loss of will which directs the attention. The inconsis- tency of the beliefs of the insane is one of the earliest noticeable symptoms, and they are con- veniently classified as " delusions " and " hal- ception of the meaning of these terms should be had. A delusion is a false belief in regard to some fact which generally concerns the pa- tient, and which is so strongly rooted that all attempts to reason him out of it are futile. Thus, he may believe that a certain occurrence took place at a certain time, or that he is a certain person, as a saint, or a prince, or the Saviour, or that his head is made of metal. The delusions of the insane may be of a gloomy or of an exalted nature. A man who believes poverty to be the greatest evil may, in conse- quence of false reasoning as to the state of his affairs, imagine himself to be ruined, and that his family will be turned out of doors. When the patient has exalted delusions he is apt to imagine himself immensely wealthy, or that the asylum in which he is confined is a palace and himself a monarch. A hallucination is a false perception of one of the senses ; the patient may fancy that he sees a spirit, or a person who does not exist ; such hallucina- tions are common in the temporary insanity of delirium tremens, when the patient may imagine that he sees serpents, or frogs, or in- sects, or that people, generally those whom he dislikes, come into the room. Hallucinations affect the different senses ; thus the insane have hallucinations of sight, of hearing, of taste, of smell, and of touch. Hallucinations of sight are more liable to occur when the brain is in the greatest state of exhaustion, and to accompany the acute stages. They may bo simply flashes of light or colors, or they may be objects like those in the state of exhaustion called delirium tremens. The hallucinations are oftentimes visions of the supernatural. Epilepsy in the insane is constantly accom- panied by hallucinations of sight. Hallucina- tions of hearing occur in acute, but are more frequent in chronic cases, and are unfavorable symptoms ; and those who are subject to them are often the most dangerous patients. They are liable to hear voices commanding them to perform certain acts, which they are blindly impelled to attempt, however absurd or de- structive. Hallucinations of smell are gener- ally not persistent, and belong to the acute stages ; and those who have them are apt to imagine that their own persons have an intol- erable stench. Hallucinations of taste are rather uncommon, and are generally associated with disordered digestion. Those of feeling are not uncommon, and patients often declare that they feel themselves touched, or that they feel snakes or other animals in their bodies. The acts of the insane are prominent symp- toms. There is a proneness among them to strip off their clothes, arising from various causes. They often experience a feeling of uneasiness, often of heat from the pressure of their clothes, or they imagine that they are foul or poisoned. Sometimes in mania there is a desire to destroy them, and in other cases to expose the person. The desire to dress in a fantastic garb is common among the insane. In states of exaltation, whether of mania or of melancholia, the patient will often desire to assume a dress of authority, and the de- jected melancholic will assume the most care- less appearance. In some forms of insanity there is often a disposition to commit acts of violence and destruction. Sometimes these acts will be directed against inanimate objects, sometimes against other persons, and some- times against the patient's own person. In the two latter instances it has received the
 * lucinations." It is important that a clear con-