Description Source
Encyclopedia of Pure Materia Medica - TF AllenAdditional facts
Plumbum metallicum, aceticum, carbonicum. Preparation: Triturations.
Mental
Delirium, etc. Most violent delirium, with screaming and running about the room, succeeded the epileptiform spasm. Delirium, resembling the most frightful kind of madness, and impelling them to tear themselves and bite their own fingers. Furious delirium, resembling tremens. Raging, alternating with quiet, delirium; the former came in paroxysms; no fever. Delirium, with violent raging, so that he had to be put into a strait-jacket, with hallucinations of vision. Raging delirium. Furious delirium.
Violent delirium, at night. Violent delirium set in and continued for some days. As the delirium declined, the mind did not recover its clearness and integrity, on the contrary, his sensations and perceptions were vitiated and erroneous. Various morbid ideas took possession of him, and some of the, remained, and continued to manifest themselves for many months after his apparent restoration to health. The delirium tranquil during the day, furious at night.
Complete rage. Delirium, with bewildered expression. Delirium, with very violent convulsions. During the third day of delirium, he was awake, sometimes quiet, sometimes violent, but almost totally irrational. Pulse, 80; skin rather hot. Delirium, for three days (in a previous attack). Delirium, with trembling of the tongue and hands. At times delirious.
Nightly delirium, alternating with sopor. He was at times delirious, very restless, and manifested great concern for his affairs. Delirium, alternating with sopor. Tranquil delirium.
Appeared to be rapidly recovering, when he was suddenly seized, about 11 p.m, with furious delirium, attended at intervals, by general spasms. It was astonishing to see him, who, three hours before, could only pronounce with difficulty a limited number of words, whose voice was weak, and whose utterance was faint and drawling, now talking incessantly, and pouring forth shouts, screams, and abuse against all who approached him. His voice was loud and clear. His delirium turned chiefly upon the idea that his life was in danger from assassination or poisoning, and that every one about him was a murderer. His muscular strength was increased to such a degree, that, with one hand, he could lift all his mattresses at once with the greatest ease. He left his bed, and walked about briskly, knocking against every obstacle at random. His face was flushed; his eyes sparkling and fierce. At last a strait- waistcoat was put on him, which heightened his fury. Pulse, 65; heat of body rather increased. The delirium lasted about half an hour, when it was succeeded by coma, during which he lay stretched out and motionless, with closed eyes and somewhat pale face. Strong stimulation could only draw forth a few unmeaning grunts. An hour later, the delirium suddenly returned, to be followed again by coma, and thus, all that day and night, the opposing conditions alternated. Sudden attack of delirium, in the evening, accompanied by extreme restlessness; he railed, threatened, and then fell into a deep sleep. This alternation of delirium and somnolency continued until morning; next day, face flushed and covered with sweat.
Eyes fixed and expressionless; bloodshot; lids swollen; pupils. especially the right one, extremely dilated. but moderately sensitive to light. Expression of face decidedly dull.
Frequent movements, more or less forcible, of the head, limbs, and whole body; so that he had to be put into a strait- waistcoat. Did not close his eyes for a minute all night; sometimes was silent and quiet, sometimes hurried out of bed, wanted to dress himself. and went about looking for his clothes; talked incoherently; abused the nurses and patients. In the morning, to prevent him from disturbing the ward, he was put into a strait-waistcoat. He resisted violently; struggled, called for help, screamed, bawled, and even bit an assistant who had hold of him. After this, he became quiet and silent, and his limbs ceased trembling. When I entered the room, he called to me, and begged to be released. He had an astonished look; something unusual seemed to have altered his expression of face.
During the paroxysms of colic, he tosses and rolls about in bed, weeps and laments; his pinched-up face denotes the sharpest pain; he is so distracted by the agony he endures, that he can pay no attention to what passes around him, nor when asked a question. During the paroxysms, the face expresses acute pain; he is restless, rolling about in bed, screams out, etc. During the paroxysms, he lay flat on his belly, dug his fingers into his navel, tied himself tightly in the cravat, uttered dismal screams, declared that he had to go to stool; sometimes got up and walked the room hurriedly, his hands pressed to his abdomen; we have seen the poor fellow leaning on his belly against the iron railing of his bed. During the paroxysms, a condition approaching to frenzy; constant restlessness; lying on abdomen; he knelt down and crouched together in his bed, etc. During the paroxysms, which occurred almost every ten minutes, the patient, suffering the greatest anxiety, his face all distorted, rolled about in bed uttering dismal groans; he laid his pillow over his abdomen and begged the bystanders to press upon it with all their force; this afforded temporary relief. He bit the sheets, his limbs writhed; at times he might have been taken for a furious madman. During the paroxysms, screaming, tossing about, and assuming the strangest attitudes. During the paroxysms, the face is contracted; he screams aloud, sticks his legs suddenly out of bed, etc. вetween the paroxysms, mind often much affected. Would leave home without knowing where he was going; became enraged with persons he met; and generally remembered nothing of what had occurred. When brought home, he would shut himself up until he got right again. One day, he left home to enter the Hospital вeaujon; got lost, and was quite surprised to find himself at La Pitie. Although naturally patient of suffering, he was importunate, nay clamorous for relief, expressing himself in terms of agony, far stronger than his general appearance and symptoms seemed to warrant. When admitted he refused to go to bed, tore his shirt off, and spoke disconnectedly. With loud cries, he insists upon going to stool. вites his garments and bedclothes. вegged and prayed to be released from the strait-waistcoat, for, he said, I am not mad; but the idea of being forcibly restrained is enough to drive me crazy. At times, the pains became so violent that he weeps and laments; and his whole frame is agitated. Difficulty in putting him to bed; he tore off the clothes, and spoke incoherently. Started out of bed as if beside himself, compressing his abdomen with his hands. Hung on to the bed post, and kept swaying himself with a convulsive movement. He keeps thrusting his limbs out of bed, and then covering them up again. Frightful screams, with general convulsions. Screaming out, at intervals. Uttered piercing cries. Screaming. Screaming incessantly. Utters doleful groans, and screams loudly for relief. During the aggravations, he screams draws himself together under the bedclothes, suddenly gets out of bed, then gets in again, and doubles himself up, etc. During the intervals of quietude, which were very brief, he kept up a sort of continual grumbling, closed his eyes, and shrunk down under the bedclothes. In the night, began to talk to himself quite incoherently, about all sorts of things; then left his bed, and wanted to lie down in another bed in the room. The nurse easily got him back to his own quarters; his gait was firm, and he had no tremor; his eyes were wide open, somewhat projecting and fixed. His face had an expression of astonishment. During the rest of the night, he talked much to himself; his delirium was mild and quiet. Next day, his expression was natural, and he had the use of all his faculties, but he seemed to take little interest in conversation, and his manner was remarkably listless. About 5 , he began fairly to rave; would keep chattering for several minutes, and then be silent for a while.
His face had a wild expression, which struck the house surgeon on duty. Pulse, 85; no fever. Worse at night; took part in all the conversation he heard, or fancied he heard. On the fifth day of the delirium, in the afternoon, he had a sudden attack of epilepsy, characterized by violent convulsive movements of the whole body, bloody froth at the mouth, biting the tongue, interrupted breathing, etc. After an attack, which lasts about half an hour, he becomes slightly comatose, but soon rouses, and enters again into delirium. On the sixth day of the delirium, the general aspect of the countenance was more unnatural than before. There was less of that harmony of expression which is indicative of a well-balanced mind.
Sometimes the eyes were fixed and the features concentrated; sometimes the former seemed to roll about, under the influence of serious thought, and the whole face to partake of this meditative look. He would still sometimes burst into laughter at the most unexpected moments. The limbs trembled, or rather, were shaken by slight spasms, which also ran over the face in different directions, coming and going at irregular intervals. The tongue was considerably swollen, from having been bitten during the epileptic seizures of the preceding day; utterance also was impeded, being stammering, hurried, and abrupt; an effect to which the slight spasms above spoken of also contributed. He was sometimes conscious of his condition, and said that he was insane. His talk became irrational more frequently, and continued so longer than on the day before. Yet even now, his intellectual aberration could only be discovered by very attentive observation. On the seventh day of the delirium, he talked much to himself, and tried to get into the neighboring beds; he wandered more in his speech; wanted to strike the nurse. without provocation; when threatened with the strait-waistcoat. he quieted down somewhat. He often talked to himself at night; what he said was incongruous, disconnected, and about all sorts of things. He got up three or four times, and tried to fold his bedstead together, under the impression that he was working some sort of machine; then he laid down again. Twice he rose from bed, walked about with bare feet, and urinated in the middle of the floor; next minute, he fancied one of the patients called to him, ran headlong to help him, and got into another bed at the opposite side of the room.
His sight was unimpaired, his gait firm and confident. At times, he was silent and quiet, although he never closed eyes. On the eighth day of delirium, he was quiet, but, in conversation, more decidedly irrational than on the day before. He spoke to others with a smiling face; he was silent and looked very thoughtful. He spoke to others with a smiling face; he was silent and looked very thoughtful. Now and then, he perceived that he had used a wrong word, as was shown by his impatient gestures, and he tried to recall the proper one; he talked to himself about all sorts of things. If he was spoken to so as to attract his attention strongly, and the questions were simple, and easily answered, his replies were rational. He talked no more sensibly about one thing than another. Even to-day, although not so apparent as yesterday, there was always, amid his delirious ravings, a certain semblance of good sense. The utterance is, as it were, spasmodic; more abrupt and jerky than on the day before; words are pronounced rapidly and incompletely. Out of his head, at time; at night, quite delirious, talked almost constantly; got out of bed; looked for his clothes, in order to dress himself; ran all about the room, trying to get into the other patients’ beds; at last, after he had gone on in this way a good white, it was found necessary to put him in a strait-waistcoat, to which he submitted quietly. Next day, his eyes were wide open; his expression was rather while. When alone, he talked much to himself, sometimes calmly, sometimes violently; generally about wine, which he would not take part in smuggling into the hospital. Sometimes he fancied himself at his foundry, at home, or in the street, etc. His conversation was a mixture of sense and extravagance. When his attention was strongly attracted to anything, what he said was at first rational, then he would suddenly drop the subject, and begin to talk about something quite different, mixing together in this way a great many ideas and incoherent words. вut, on peremptorily recalling his thoughts to the topic gambolled from, he would again answer pertinently and sensibly for awhile. After trying in vain to find his clothes, he got up and walked the room, but with hesitating step, and feeling about with his hands, like one groping in the dark; runs against the stove, the beds, etc.; sometimes uttered incoherent words, or called for his wife, or his friends; wanted to talk about his business; often said My wife! my wife! more frequently was silent. At last he became quiet, soon got into bed again, and seemed to fall into a deep sleep. After awhile, would rouse up and begin to act in the same way again. Once he was about to urinate upon the stand which held the patient’s diet-drink.
Sometimes he spoke rationally, but generally poured forth unintelligible words in a trembling and hurried voice. He talked to those about him, and made the most incongruous demands upon them. He was not violent, and threatened nobody. Now and then he put his hands to his forehead or abdomen, his face contracted, he groaned, and exclaimed My God! my God! then began to cry like a child. Sometimes he was observed to lie down on his abdomen. сonstant sleeplessness. Delirium and restlessness, worse at night. Recognized those about him, and maintained a long conversation tolerably well; but, when a drunken patient happened to say to him, in an offensive tone, They will put you in a strait-waistcoat, you old lunatic! he became furious, stamped his feet, shook his feet, shook his fists, wept, etc.; poured forth a multitude of words. In a quarter of an hour, he became quiet again, and soon after slept a little. вeing visited by his wife, he at first received her roughly, and loaded her with abuse; then suddenly began to caress her, and seemed greatly pleased with the visit. His facial expression does not at all times correspond with the character of the conversation he is engaged in, nor with the other external influences which surround him. Thus, he will sometimes burst out laughing, while speaking of some very ordinary matter, or look serious and thoughtful while answering the most simple question. Yet quite often his face wears its natural expression. At first he would not be taken for a victim of cerebral disease;he is very quiet, and seems quite rational. вut gradually as the conversation proceeds, he loses the thread of his ideas, and talks mere nonsense, or keeps contradicting himself most shockingly. When alone, he does not talk to himself. He eats, drinks, urinates, and goes to stool, as properly as anybody; sometimes he gets up to visit other patients in the next ward; the latter do not at first perceive that his intellect is at all affected, but when the hint is given them by the physicians, they soon declare that he talks wildly. Rose from bed in the night, and tried to get into his neighbor’s bed’ took a cravat from me; a pair of trousers from another; walked as if groping in the dark, and bruised himself against to stove, washstand, etc.; talked to himself; at last the warden managed to get him into bed again. Quiet during the rest of the night; but every now and then wanted his neighbors to give him his drop. Next day, face wild; eyes wide open; by turns fixed and wandering. Abdomen nowhere painful on pressure. Kept trying to get up in order to take his drop, and called to the other patients, Make haste and get up. His limbs were tremulous. His constant efforts to get out of bed made it necessary to put his in a strait-waistcoat; he struggled hard against it, screamed, howled, uttered threats; became red with passion, and tried in every way to break loose; called out to the passers by and begged them to set him free. During the day, he was sometimes quiet and silent; sometimes furious at the thought of being tied. He was never sleepy. Fancied, at times, that he heard delightful music, which soothed his sorrows. His utterance is drawling, difficult, and frequently broken; so that he talks like a child who has not learned to speak plainly; instead of oui, for example, he says ui . Sometimes he cannot get hold of the right word; then he frets and worries himself, and now and then becomes quite desperate. This difficulty seems to be met with chiefly in the case of substantives; with adjectives, the intellect and organs of speech deal more easily. His colic was almost cured, when the nurses and his fellow-patients observed that his intellect was affected, and that he wandered in his speech, but to so slight an extent, that the aberration escaped the notice of the medical attendants. He lay quiet, with closed eyes, as if in a peaceful sleep; when pinched as hard as possible he showed no sign of sensibility. When the fingers, hands, forearms, or arms were placed in any position, and left unsupported, they remained there for a few seconds, then oscillated a little, and fell back on the bed. This experiment was repeated several times, with the same result. The body was rigid, so that he could not be made to sit upright, and his attention could not be aroused for a moment. Suddenly he began to make a great variety of the most expressive gestures, at first with one arm, only, but soon the other arm, the legs, trunk, head and face, all took part in these movements, which were performed in co-ordination, and seemed to express the same idea. Every moment he appeared to be possessed by the most dissimilar and grotesque conceptions, which he embodied in this way. At the same time he cried out, and tried to spoke, but was prevented by the liquid in his mouth. If, at this time, he was gently pinched, he showed by an abrupt movement, that he felt acutely. The upper limbs no longer remained fixed in any position they were placed in; they were too stiff to be moved at all. After the movements had lasted some minutes, they were succeeded by a state of absolute quietude, and he lay just as he done before they commenced; then they began again, to be again followed by a period of repose, and so on, in alternation. Now, he indicated, by a significant gesture, that he desired to eat and drink; now he suddenly spouted the pitsan, which he had been holding in his mouth, all over the surgeon in attendance. Then came an interval of quiet and unconsciousness, during which his limbs remained in any position they were made to assume. Next was witnessed a series of the most expressive gestures, although he kept his eyes shut, and uttered not a single word. Their significance is constantly varying; sometimes they seem to indicate rage, sometimes despair, sometimes entreaty, sometimes the most profound meditation. At last he suddenly opened his eyes, called for drink; then seemed to fall asleep again while swallowing his pitsan, but is easily aroused by being spoken to; then he opened his eyes, called for drink; then seemed to fall asleep to fall asleep again while swallowing his pitsan, but is easily aroused by being spoken to; then he opened his eyes fully, began to talk about his mother, and while volubly from one incoherent idea to another, still answered questions rationally. Left to himself, he talked incessantly, followed up an idea for a minute or two, and then left it for another. At one time he became much agitated, tried to get up, addressed the doctors, abused them, tried to strike and bite the nurses when restrained, and at last, shouting and struggling, was put into a strait-waistcoat. On the second day of the delirium, he was lying quiet, with eyes half open. Soon he aroused completely, began to talk very fast, and at first answered questions rationally. вut after conversing a few minutes, his thoughts became confused, and he began to ramble and talk to himself. вy attracting his attention again, he could be brought back to the original topic, then got off the track again, and so forth; so that his talk was a mixture of sense of nonsense. He was frequently influenced by the most grotesque delusions; he fancied that a cavalry regiment was about to fall upon him; or that he was in the presence of his employer, who was finding fault with him. His face looked rather wild; at times he bursts out laughing. His head was full of notions. He recollected very well what happened a month or more ago; but could not call to mind things that occurred only a few days before his delirium set in. He seems to recognize familiar acquaintances; sometimes he talks unintelligibly to himself; more frequently is silent. When his attention is strongly attracted, he at first answers rationally; then suddenly utters some words without meaning or connection; afterwards takes up again the thread of logical thought. He usually waits some time before answering a question; it seems as if it required great mental exertion for him to understand what is said. During the evening of the seventh day, suddenly great restlessness;he hears everywhere threatening voices, officers come to arrest him, to seize his furniture, and to expel him from his lodgings; the voices come from the pillow, the mattress; they enter by the window, where he sees people, and they consult about him with closed doors; he gets up, looks for his clothing, wants to run away, to his lodge, etc. The next morning he sits at the edge of his bed, the eyes fixed steadily to the window, or looking about in a restless manner; he recognizes all persons around him, replies correctly to all questions, but cannot recollect what he ate yesterday, whether his bowels moved or not, and looks to his wife in an interrogating manner insists, though as if afraid to acknowledge it, on the reality of his hallucinations. He had, some time back, illusions of vision; saw castles, palaces, but these have ceased since he entered the hospital. Has a cachectic look; cheeks hollow and pale; yellow complexion; no signs of lead poisoning, aside from the cerebral symptoms.
Violent delirium, at night. Violent delirium set in and continued for some days. As the delirium declined, the mind did not recover its clearness and integrity, on the contrary, his sensations and perceptions were vitiated and erroneous. Various morbid ideas took possession of him, and some of the, remained, and continued to manifest themselves for many months after his apparent restoration to health. The delirium tranquil during the day, furious at night.
Complete rage. Delirium, with bewildered expression. Delirium, with very violent convulsions. During the third day of delirium, he was awake, sometimes quiet, sometimes violent, but almost totally irrational. Pulse, 80; skin rather hot. Delirium, for three days (in a previous attack). Delirium, with trembling of the tongue and hands. At times delirious.
Nightly delirium, alternating with sopor. He was at times delirious, very restless, and manifested great concern for his affairs. Delirium, alternating with sopor. Tranquil delirium.
Appeared to be rapidly recovering, when he was suddenly seized, about 11 p.m, with furious delirium, attended at intervals, by general spasms. It was astonishing to see him, who, three hours before, could only pronounce with difficulty a limited number of words, whose voice was weak, and whose utterance was faint and drawling, now talking incessantly, and pouring forth shouts, screams, and abuse against all who approached him. His voice was loud and clear. His delirium turned chiefly upon the idea that his life was in danger from assassination or poisoning, and that every one about him was a murderer. His muscular strength was increased to such a degree, that, with one hand, he could lift all his mattresses at once with the greatest ease. He left his bed, and walked about briskly, knocking against every obstacle at random. His face was flushed; his eyes sparkling and fierce. At last a strait- waistcoat was put on him, which heightened his fury. Pulse, 65; heat of body rather increased. The delirium lasted about half an hour, when it was succeeded by coma, during which he lay stretched out and motionless, with closed eyes and somewhat pale face. Strong stimulation could only draw forth a few unmeaning grunts. An hour later, the delirium suddenly returned, to be followed again by coma, and thus, all that day and night, the opposing conditions alternated. Sudden attack of delirium, in the evening, accompanied by extreme restlessness; he railed, threatened, and then fell into a deep sleep. This alternation of delirium and somnolency continued until morning; next day, face flushed and covered with sweat.
Eyes fixed and expressionless; bloodshot; lids swollen; pupils. especially the right one, extremely dilated. but moderately sensitive to light. Expression of face decidedly dull.
Frequent movements, more or less forcible, of the head, limbs, and whole body; so that he had to be put into a strait- waistcoat. Did not close his eyes for a minute all night; sometimes was silent and quiet, sometimes hurried out of bed, wanted to dress himself. and went about looking for his clothes; talked incoherently; abused the nurses and patients. In the morning, to prevent him from disturbing the ward, he was put into a strait-waistcoat. He resisted violently; struggled, called for help, screamed, bawled, and even bit an assistant who had hold of him. After this, he became quiet and silent, and his limbs ceased trembling. When I entered the room, he called to me, and begged to be released. He had an astonished look; something unusual seemed to have altered his expression of face.
During the paroxysms of colic, he tosses and rolls about in bed, weeps and laments; his pinched-up face denotes the sharpest pain; he is so distracted by the agony he endures, that he can pay no attention to what passes around him, nor when asked a question. During the paroxysms, the face expresses acute pain; he is restless, rolling about in bed, screams out, etc. During the paroxysms, he lay flat on his belly, dug his fingers into his navel, tied himself tightly in the cravat, uttered dismal screams, declared that he had to go to stool; sometimes got up and walked the room hurriedly, his hands pressed to his abdomen; we have seen the poor fellow leaning on his belly against the iron railing of his bed. During the paroxysms, a condition approaching to frenzy; constant restlessness; lying on abdomen; he knelt down and crouched together in his bed, etc. During the paroxysms, which occurred almost every ten minutes, the patient, suffering the greatest anxiety, his face all distorted, rolled about in bed uttering dismal groans; he laid his pillow over his abdomen and begged the bystanders to press upon it with all their force; this afforded temporary relief. He bit the sheets, his limbs writhed; at times he might have been taken for a furious madman. During the paroxysms, screaming, tossing about, and assuming the strangest attitudes. During the paroxysms, the face is contracted; he screams aloud, sticks his legs suddenly out of bed, etc. вetween the paroxysms, mind often much affected. Would leave home without knowing where he was going; became enraged with persons he met; and generally remembered nothing of what had occurred. When brought home, he would shut himself up until he got right again. One day, he left home to enter the Hospital вeaujon; got lost, and was quite surprised to find himself at La Pitie. Although naturally patient of suffering, he was importunate, nay clamorous for relief, expressing himself in terms of agony, far stronger than his general appearance and symptoms seemed to warrant. When admitted he refused to go to bed, tore his shirt off, and spoke disconnectedly. With loud cries, he insists upon going to stool. вites his garments and bedclothes. вegged and prayed to be released from the strait-waistcoat, for, he said, I am not mad; but the idea of being forcibly restrained is enough to drive me crazy. At times, the pains became so violent that he weeps and laments; and his whole frame is agitated. Difficulty in putting him to bed; he tore off the clothes, and spoke incoherently. Started out of bed as if beside himself, compressing his abdomen with his hands. Hung on to the bed post, and kept swaying himself with a convulsive movement. He keeps thrusting his limbs out of bed, and then covering them up again. Frightful screams, with general convulsions. Screaming out, at intervals. Uttered piercing cries. Screaming. Screaming incessantly. Utters doleful groans, and screams loudly for relief. During the aggravations, he screams draws himself together under the bedclothes, suddenly gets out of bed, then gets in again, and doubles himself up, etc. During the intervals of quietude, which were very brief, he kept up a sort of continual grumbling, closed his eyes, and shrunk down under the bedclothes. In the night, began to talk to himself quite incoherently, about all sorts of things; then left his bed, and wanted to lie down in another bed in the room. The nurse easily got him back to his own quarters; his gait was firm, and he had no tremor; his eyes were wide open, somewhat projecting and fixed. His face had an expression of astonishment. During the rest of the night, he talked much to himself; his delirium was mild and quiet. Next day, his expression was natural, and he had the use of all his faculties, but he seemed to take little interest in conversation, and his manner was remarkably listless. About 5 , he began fairly to rave; would keep chattering for several minutes, and then be silent for a while.
His face had a wild expression, which struck the house surgeon on duty. Pulse, 85; no fever. Worse at night; took part in all the conversation he heard, or fancied he heard. On the fifth day of the delirium, in the afternoon, he had a sudden attack of epilepsy, characterized by violent convulsive movements of the whole body, bloody froth at the mouth, biting the tongue, interrupted breathing, etc. After an attack, which lasts about half an hour, he becomes slightly comatose, but soon rouses, and enters again into delirium. On the sixth day of the delirium, the general aspect of the countenance was more unnatural than before. There was less of that harmony of expression which is indicative of a well-balanced mind.
Sometimes the eyes were fixed and the features concentrated; sometimes the former seemed to roll about, under the influence of serious thought, and the whole face to partake of this meditative look. He would still sometimes burst into laughter at the most unexpected moments. The limbs trembled, or rather, were shaken by slight spasms, which also ran over the face in different directions, coming and going at irregular intervals. The tongue was considerably swollen, from having been bitten during the epileptic seizures of the preceding day; utterance also was impeded, being stammering, hurried, and abrupt; an effect to which the slight spasms above spoken of also contributed. He was sometimes conscious of his condition, and said that he was insane. His talk became irrational more frequently, and continued so longer than on the day before. Yet even now, his intellectual aberration could only be discovered by very attentive observation. On the seventh day of the delirium, he talked much to himself, and tried to get into the neighboring beds; he wandered more in his speech; wanted to strike the nurse. without provocation; when threatened with the strait-waistcoat. he quieted down somewhat. He often talked to himself at night; what he said was incongruous, disconnected, and about all sorts of things. He got up three or four times, and tried to fold his bedstead together, under the impression that he was working some sort of machine; then he laid down again. Twice he rose from bed, walked about with bare feet, and urinated in the middle of the floor; next minute, he fancied one of the patients called to him, ran headlong to help him, and got into another bed at the opposite side of the room.
His sight was unimpaired, his gait firm and confident. At times, he was silent and quiet, although he never closed eyes. On the eighth day of delirium, he was quiet, but, in conversation, more decidedly irrational than on the day before. He spoke to others with a smiling face; he was silent and looked very thoughtful. He spoke to others with a smiling face; he was silent and looked very thoughtful. Now and then, he perceived that he had used a wrong word, as was shown by his impatient gestures, and he tried to recall the proper one; he talked to himself about all sorts of things. If he was spoken to so as to attract his attention strongly, and the questions were simple, and easily answered, his replies were rational. He talked no more sensibly about one thing than another. Even to-day, although not so apparent as yesterday, there was always, amid his delirious ravings, a certain semblance of good sense. The utterance is, as it were, spasmodic; more abrupt and jerky than on the day before; words are pronounced rapidly and incompletely. Out of his head, at time; at night, quite delirious, talked almost constantly; got out of bed; looked for his clothes, in order to dress himself; ran all about the room, trying to get into the other patients’ beds; at last, after he had gone on in this way a good white, it was found necessary to put him in a strait-waistcoat, to which he submitted quietly. Next day, his eyes were wide open; his expression was rather while. When alone, he talked much to himself, sometimes calmly, sometimes violently; generally about wine, which he would not take part in smuggling into the hospital. Sometimes he fancied himself at his foundry, at home, or in the street, etc. His conversation was a mixture of sense and extravagance. When his attention was strongly attracted to anything, what he said was at first rational, then he would suddenly drop the subject, and begin to talk about something quite different, mixing together in this way a great many ideas and incoherent words. вut, on peremptorily recalling his thoughts to the topic gambolled from, he would again answer pertinently and sensibly for awhile. After trying in vain to find his clothes, he got up and walked the room, but with hesitating step, and feeling about with his hands, like one groping in the dark; runs against the stove, the beds, etc.; sometimes uttered incoherent words, or called for his wife, or his friends; wanted to talk about his business; often said My wife! my wife! more frequently was silent. At last he became quiet, soon got into bed again, and seemed to fall into a deep sleep. After awhile, would rouse up and begin to act in the same way again. Once he was about to urinate upon the stand which held the patient’s diet-drink.
Sometimes he spoke rationally, but generally poured forth unintelligible words in a trembling and hurried voice. He talked to those about him, and made the most incongruous demands upon them. He was not violent, and threatened nobody. Now and then he put his hands to his forehead or abdomen, his face contracted, he groaned, and exclaimed My God! my God! then began to cry like a child. Sometimes he was observed to lie down on his abdomen. сonstant sleeplessness. Delirium and restlessness, worse at night. Recognized those about him, and maintained a long conversation tolerably well; but, when a drunken patient happened to say to him, in an offensive tone, They will put you in a strait-waistcoat, you old lunatic! he became furious, stamped his feet, shook his feet, shook his fists, wept, etc.; poured forth a multitude of words. In a quarter of an hour, he became quiet again, and soon after slept a little. вeing visited by his wife, he at first received her roughly, and loaded her with abuse; then suddenly began to caress her, and seemed greatly pleased with the visit. His facial expression does not at all times correspond with the character of the conversation he is engaged in, nor with the other external influences which surround him. Thus, he will sometimes burst out laughing, while speaking of some very ordinary matter, or look serious and thoughtful while answering the most simple question. Yet quite often his face wears its natural expression. At first he would not be taken for a victim of cerebral disease;he is very quiet, and seems quite rational. вut gradually as the conversation proceeds, he loses the thread of his ideas, and talks mere nonsense, or keeps contradicting himself most shockingly. When alone, he does not talk to himself. He eats, drinks, urinates, and goes to stool, as properly as anybody; sometimes he gets up to visit other patients in the next ward; the latter do not at first perceive that his intellect is at all affected, but when the hint is given them by the physicians, they soon declare that he talks wildly. Rose from bed in the night, and tried to get into his neighbor’s bed’ took a cravat from me; a pair of trousers from another; walked as if groping in the dark, and bruised himself against to stove, washstand, etc.; talked to himself; at last the warden managed to get him into bed again. Quiet during the rest of the night; but every now and then wanted his neighbors to give him his drop. Next day, face wild; eyes wide open; by turns fixed and wandering. Abdomen nowhere painful on pressure. Kept trying to get up in order to take his drop, and called to the other patients, Make haste and get up. His limbs were tremulous. His constant efforts to get out of bed made it necessary to put his in a strait-waistcoat; he struggled hard against it, screamed, howled, uttered threats; became red with passion, and tried in every way to break loose; called out to the passers by and begged them to set him free. During the day, he was sometimes quiet and silent; sometimes furious at the thought of being tied. He was never sleepy. Fancied, at times, that he heard delightful music, which soothed his sorrows. His utterance is drawling, difficult, and frequently broken; so that he talks like a child who has not learned to speak plainly; instead of oui, for example, he says ui . Sometimes he cannot get hold of the right word; then he frets and worries himself, and now and then becomes quite desperate. This difficulty seems to be met with chiefly in the case of substantives; with adjectives, the intellect and organs of speech deal more easily. His colic was almost cured, when the nurses and his fellow-patients observed that his intellect was affected, and that he wandered in his speech, but to so slight an extent, that the aberration escaped the notice of the medical attendants. He lay quiet, with closed eyes, as if in a peaceful sleep; when pinched as hard as possible he showed no sign of sensibility. When the fingers, hands, forearms, or arms were placed in any position, and left unsupported, they remained there for a few seconds, then oscillated a little, and fell back on the bed. This experiment was repeated several times, with the same result. The body was rigid, so that he could not be made to sit upright, and his attention could not be aroused for a moment. Suddenly he began to make a great variety of the most expressive gestures, at first with one arm, only, but soon the other arm, the legs, trunk, head and face, all took part in these movements, which were performed in co-ordination, and seemed to express the same idea. Every moment he appeared to be possessed by the most dissimilar and grotesque conceptions, which he embodied in this way. At the same time he cried out, and tried to spoke, but was prevented by the liquid in his mouth. If, at this time, he was gently pinched, he showed by an abrupt movement, that he felt acutely. The upper limbs no longer remained fixed in any position they were placed in; they were too stiff to be moved at all. After the movements had lasted some minutes, they were succeeded by a state of absolute quietude, and he lay just as he done before they commenced; then they began again, to be again followed by a period of repose, and so on, in alternation. Now, he indicated, by a significant gesture, that he desired to eat and drink; now he suddenly spouted the pitsan, which he had been holding in his mouth, all over the surgeon in attendance. Then came an interval of quiet and unconsciousness, during which his limbs remained in any position they were made to assume. Next was witnessed a series of the most expressive gestures, although he kept his eyes shut, and uttered not a single word. Their significance is constantly varying; sometimes they seem to indicate rage, sometimes despair, sometimes entreaty, sometimes the most profound meditation. At last he suddenly opened his eyes, called for drink; then seemed to fall asleep again while swallowing his pitsan, but is easily aroused by being spoken to; then he opened his eyes, called for drink; then seemed to fall asleep to fall asleep again while swallowing his pitsan, but is easily aroused by being spoken to; then he opened his eyes fully, began to talk about his mother, and while volubly from one incoherent idea to another, still answered questions rationally. Left to himself, he talked incessantly, followed up an idea for a minute or two, and then left it for another. At one time he became much agitated, tried to get up, addressed the doctors, abused them, tried to strike and bite the nurses when restrained, and at last, shouting and struggling, was put into a strait-waistcoat. On the second day of the delirium, he was lying quiet, with eyes half open. Soon he aroused completely, began to talk very fast, and at first answered questions rationally. вut after conversing a few minutes, his thoughts became confused, and he began to ramble and talk to himself. вy attracting his attention again, he could be brought back to the original topic, then got off the track again, and so forth; so that his talk was a mixture of sense of nonsense. He was frequently influenced by the most grotesque delusions; he fancied that a cavalry regiment was about to fall upon him; or that he was in the presence of his employer, who was finding fault with him. His face looked rather wild; at times he bursts out laughing. His head was full of notions. He recollected very well what happened a month or more ago; but could not call to mind things that occurred only a few days before his delirium set in. He seems to recognize familiar acquaintances; sometimes he talks unintelligibly to himself; more frequently is silent. When his attention is strongly attracted, he at first answers rationally; then suddenly utters some words without meaning or connection; afterwards takes up again the thread of logical thought. He usually waits some time before answering a question; it seems as if it required great mental exertion for him to understand what is said. During the evening of the seventh day, suddenly great restlessness;he hears everywhere threatening voices, officers come to arrest him, to seize his furniture, and to expel him from his lodgings; the voices come from the pillow, the mattress; they enter by the window, where he sees people, and they consult about him with closed doors; he gets up, looks for his clothing, wants to run away, to his lodge, etc. The next morning he sits at the edge of his bed, the eyes fixed steadily to the window, or looking about in a restless manner; he recognizes all persons around him, replies correctly to all questions, but cannot recollect what he ate yesterday, whether his bowels moved or not, and looks to his wife in an interrogating manner insists, though as if afraid to acknowledge it, on the reality of his hallucinations. He had, some time back, illusions of vision; saw castles, palaces, but these have ceased since he entered the hospital. Has a cachectic look; cheeks hollow and pale; yellow complexion; no signs of lead poisoning, aside from the cerebral symptoms.
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