Skip to main content

Full text of "Medical Jurisprudence And Toxicology"

See other formats


In place of excitability and a general sense of exhilaration, gloom,
despondency, loss of energy and mental hypochondriasis may be the first
mental symptoms to announce the commencement of the disease.

The physical symptoms usually follow the mental symptoms but they
may precede or accompany them. Sometimes, the disease is ushered in by
apoplectic or epileptic convulsive seizures or a temporary attack of aphasia
lasting for a few hours or days.

The first physical symptoms that are generally observed are the tremors
of the tongue and lips causing an embarrassed speech as if the patient were
intoxicated. The tremors slowly involve the muscles of the face causing
loss of expression, and later the muscles of the hands, so that the hand-
writing becomes shaky and illegible, and the last letters of words are
omitted. The finer and rhythmical movements of the fingers are also not
properly executed. The pupils are frequently unequal, and sometimes small
and contracted. The deep reflexes are exaggerated. Headache and
neuralgic pains are often complained of. Insomnia is frequently a constant
symptom, though drowsiness may be present in a few cases. Owing to the
weakness and inco-ordination of the muscles of the legs the gait becomes
slow and tottering. The temperature rises generally in the evening upto
101° or 102°F.

By the time that these symptoms have become prominent, the mental
symptoms have become more pronounced. There is loss of memory with
marked impairment of the intellectual faculties. The patient is no more
restless or energetic, nor does he respond to external stimuli owing to the
. diminished activity of the general and special senses. Delusions of an
exalted kind may persist in a few cases, but they do not generally affect the
conduct of the patient, who is now quite manageable. He becomes listless,
apathetic and careless about his dress and appearances. The patient passes
into a state of complete dementia and, owing to the complete extinction of
the mental faculties, he is unmindful of his surroundings, and leads more or
less a vegetable existence without any interest in life. Complete paralysis
supervenes, so that the patient is bed-ridden and passes urine and faeces

At times, there are spasmodic attacks of violent mania leading to
destructive or homicidal tendencies. These are followed by remissions
lasting from a few months to two or three years. Death occurs from
exhaustion, some intercurrent disease or from blood poisoning. There is
difficulty in swallowing and the patient may die by being choked.

Epileptic Insanity*—Epilepsy usually occurs from early infancy, though
it may occur at any period of Hfe. Individuals, who have had epileptic fits
for years, do not necessarily show any mental aberration, but a great
majority of them suffer from mental deterioration. Religiosity is a marked
feature in the commencement, but the feeling is only emotional and per-
verted. Such patients are peevish, impulsive and suspicious, and are easily
provoked to anger on the slightest cause.

The disease is generally characterized by short transitory fits of
uncontrollable mania followed by complete recovery. The attacks, how-
ever, become more and more frequent. Lastly, there is general impairment
of the mental faculties with loss of memory and self-control. At the same
time hallucinations of sight and hearing occur, and are followed by delusions
of a persecuting nature.

Epileptic insane persons are deprived of all moral sensibility, are given
to the lowest forms of vice and sexual excesses, and are sometimes
dangerous to themselves as well as to others. In many long standing cases