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Very often the appetite is voracious, but owing to impaired nutrition the

patient becomes lean and thin.

Types of Dementia.—The following four types of dementia have been

recognized :    Dementia praecox   (Primary dementia), secondary  dementia,

senile dementia and organic dementia.

Dementia  Praecox   (Primary  Dementia).—This  is  a  psychosis,  which

usually occurs between fifteen and thirty years of age, and is characterized

by a progressive mental
deterioration. It is a term
used by some authorities to
include the three conditions,
(1) Katatonia, (2) Hebe-
phrenia, and (3) Paranoia,
but this is not a scientifical-
ly correct term, as such
conditions may appear in
any age period and not only
in youth.

The onset of the disease
is slow and insidious. The
early physical symptoms are
loss of appetite, headache,
vertigo, insomnia and ema-
ciation. Epileptiform and
hysterical attacks sometimes
occur in the early stage of
the disease. The mental
symptoms are laziness,
moodiness, irritability of
temper, lack of normal in-
terest in the surroundings
and loss of moral control.
Perception and orientation
are preserved, but memory,
voluntary attention, and
power of reasoning and
judgment are absent. Hal-
lucinations and delusions

Fig. 157.—Case of Dementia. Is dull, apathetic
with childish delight, has impaired memory and
is disinclined to answer. (Dr. Benarsi Dos's cose.)

accompanied by suicidal and homicidal tendencies are often observed even
during the early period of the disease.

Secondary Dementia.—This is a state of mental enfeeblement, which is
the final result in all cases of acute insanity, which do not tend to recovery.

When a patient suffering from an attack of insanity passes into a state
of weak-mindedness, he gets good appetite, sleeps well and improves in
general health. However, general nutrition suffers in those cases wjaere
excitement and restlessness persist. Such patients suffer from insomnia
and, owing to perverted appetite, will eat mud, rubbish or anything that
comes to their hand. Owing to want of co-ordination their gait is unsteady
and other movements are slow and clumsy.

As dementia develops, the patient becomes listless and apathetic, easily
irritated and roused to passion, but by a little coaxing he can be appeased
very soon. He is devoid of feelings and emotions. He is quite impulsive
in his actions without any regard to consequences. He may be tpapeljed
a suicidal or 'homicidal act, especially when delusions and
the characteristic features of acute insanity, persist evei?,
has passed into a state of dementia.