Duplessis

“ The demonomaniacal hysteria of the Cloister, of which we have enumerated a few examples of a most remarkable kind, was present, in the Middle Ages, in the form of an epidemic neurosis, characterized by complex disturbances of the nervous system between the life of relation and of organic life; that is to say, by functional symptoms dependent on the general sensibility of the organs of sense, the active organs of movement, and the intelligence. ”

“ Touraine was cruelly devastated by this disease. The patient attacked by fever soon had the surface of his body covered by vesicles and small pustules. The vesicles were white and very hard, presenting no element of softness, and were accompanied by great pain; when they had attained maturity they broke and allowed the humor within to escape. Their sticking to the clothing of the body added considerably to the pain. Medical art was wholly impotent in the presence of this malady, at least when God did not come to the doctor’s aid. ”

“ Armand was flushed and delirious; he stammered out disconnected words, in which only the name of Marguerite could be distinctly heard.
“Well?” I said to the doctor when he had examined the patient.
“Well, he has neither more nor less than brain fever, and very lucky it is for him, for I firmly believe (God forgive me!) that he would have gone out of his mind. Fortunately, the physical malady will kill the mental one, and in a month’s time he will be free from the one and perhaps from the other.” ”

“ Dominated by this selfish instinct the human mind shamelessly displayed its cowardice, egotism and superstition. Social ties were rudely sundered, the affections of the heart laid aside. The sick were deserted by their relatives; all flew with horror from the plague-breathing air and contact with the dreadful disease. The corpses of the victims of the epidemic abandoned without sepulture exhaled a horrible putrid odor, and became the starting point of new infectious centres. The worse disorder overthrew all conditions of existence. Human passion raged uncontrolled ”

“ We find dropsy spoken of as a disease, a disease to be treated on definite principles, but it is indeed but very lately that we find the true connection thoroughly recognized, as that which exists when we place such a state of the system in its true position, and realize the importance of following to the very fountain-head that train of events which has led to those conditions of tissue change which demand the exudation of serous fluid as a necessary complement. ”

“ From a painful slumber I awoke in about an hour with red-heat at my brain and with a sickening dread at my heart. 'It is fever,' thought I; 'I am going to be ill; and what is there to do in the morning at the ebb of the tide before Winifred can go upon the sands? I ought not to have come home at all,' I said. 'Suppose illness were to seize me and prevent my getting there?' The dreadful thought alone paralysed me quite. ”

“ The ancient writers who treat systematically of dropsy generally describe four varieties of it, namely, dropsy from disease of the liver, from disease of the spleen, from fever, and from a sudden draught of cold water. See De Morbis, and Paulus Ægineta, B. III., 48, Sydenham Society’s edition.
[476] On this variety I have remarked in the Comment. on Paulus Ægineta: “Hippocrates refers one species of dropsy to disease of the parts situated in the loins, by which Galen and Stephanus agree that he means the jejunum, mesaraic veins, and kidneys.” (Paulus Ægineta, l. c.) ”

“ True, there are functional disorders and others which are toxic or parasitic; but it is the object of the study of Morbid Anatomy to limit, and, as nearly as may be, to abolish the former group by tracing disordered functions to structural changes or to poisonous or parasitic influences. We may measure the progress of medical science during the present century by the fact that Fever, Dropsy, Paralysis and Apoplexy are for us no longer diseases but only symptoms which leave us unsatisfied till we have traced them to their origin. ”

“ I have before remarked, that the debility which occurs in the beginning of the yellow fever, arises from a depressed state of the system. The debility in the plague is of the same nature. It has long been known that debility from the sudden abstraction of stimuli is to be removed by the gradual application of stimuli, but it has been less observed, that the excess of stimulus in the system is best [273] removed in a gradual manner, and that too in proportion to the degrees of depression, which exist in the system. ”

“ Any peculiar feeling, such as that of the hand or foot going to sleep, is set down at once as a symptom of a serious nervous disease, or if the patient has heard that in old people numbness of the extremities is a forerunner of apoplexy, he is sure to conclude that apoplexy is threatening in his own case. ”

“ Whatever the symptoms, the mechanism of the puzzling malady is always the same. There has been an abnormal dissociation. The ideas connected with the original shock, although submerged beneath the threshold of consciousness—in a word, forgotten—remain vividly alive in the subconscious, to act as perpetual irritants of the [234] nervous system and in time to give rise to the appearance of the symptoms of which the sufferer complains. Often, indeed, the dissociation is instantaneous, and the appearance of the disease symptoms equally rapid. ”

“ Dropsies may be general, as in anasarca, or local, as dropsy of the heart, called cardiac dropsy: [pg 423] dropsy of the peritoneum, the serous membrane which lines the abdominal cavity, called ascites; dropsy of the chest, called hydrothorax; dropsy of the head, called hydrocephalus; dropsy of the scrotum, called hydrocele.
Dropsy is not, therefore, of itself a disease, but only the symptom of a morbid condition of the blood, kidneys, liver, or heart. Thus disease of the valves of the heart, may obstruct the free flow of blood and thus retard its circulution. ”

“ I explained, however, to His Highness what was wrong.
To the hakims dropsy is a disease, and can be cured by the treatment set forth in their books. No attempt is made to discover the cause of the dropsy—whether it is due to kidney disease, heart, liver, [124] lung or blood disease—it is simply an accumulation of gas (bâd) in the tissues! In diseases of the chest, they do not, of course, employ auscultation with a stethoscope, nor percussion; and bronchitis, pneumonia, and phthisis are classed together under the name of sûrfa, or cough. ”

“ Major insists that it is purely a delusion, that so far as being choked is concerned, it is the incipient tuberculosis, and that his stomach trouble comes from the same thing; but by association of ideas, or delusion, he thinks some one is trying to choke him and poison his food, when it isn’t so at all. ”

“ Dropsy, supervening, along with fever, upon a great discharge of blood, is of a most intractable nature, and the physician should intimate the danger to some other person beforehand. When great swellings suddenly subside and rise again, there is more hope in such a case than in dropsies connected with a discharge of blood. ”

“ Under our gaze the subject follows the movements of our hands, the eyes blinking.” It is while giving the treatment for catalepsy that the Roman physician, the contemporary of Galen, initiates us in magnetic practice. After giving a description of the neurosis,37 which he characterizes by prostration, immobility, rigidity of neck, loss of voice, stupor of the senses, widely opened eyelids, fixity of the eyes and ocular expression, the Latin author teaches us how to relieve the disease and partially waken the movement, senses, and intelligence of the patient ”

“ That is Greek to you, Katy. Pain in the heart, then."
"What made her have it?"
"That is a deep question in the most interesting of sciences,—that of the metamorphoses of diseases. Many men would answer it according to their many minds. To the best of my belief, the cause of Miss Dudley's having a pain in her heart lay in her great-grandfather's toe." ”

“ Constitution nervous. What are the symptoms?"
"Sir," began Leonard, "a little girl—"
Dr. Morgan, (impatiently) —"Little girl! Never mind the history of your sufferings; stick to the symptoms—stick to the symptoms."
Leonard.—"You mistake me, Doctor; I have nothing the matter with me. A little girl—"
Dr. Morgan.—"Girl again! I understand it! it is she who is ill. Shall I go to her? she must describe her own symptoms—I can't judge from your talk. You'll be telling me she has consumption, or dyspepsia, or some such disease that don't exist: mere allopathic inventions—symptoms, sir, symptoms." ”

“ It will be seen that lesions which affect not only nutrition of parts, but also the higher functions of the nervous system, can be developed by hereditary tendencies, when artificially provoked, through those nerves which minister to organic functions—belonging to the so-called sympathetic system. ”

“ Take that latest young person who was coming here now in his good clothes and with his car, fairly bursting with his knowledge of what he called psychiatrics, looking into Davidson’s eyes so hard and smoothing his temples and throat—massage, he called it—saying that he had incipient tuberculosis of the throat and stomach trouble, and utterly disregarding the things which he, Davidson, could personally see and hear! ”

“ In my time, I have had opportunities of witnessing, stage by stage, that disease—call it dyspepsia, hypochondriasis, or what you will—it has all names and all forms—which is peculiar to our present state of high civilization, where the mind and the body seem cultivated into perpetual warfare one with the other. ”

“ Under the influence of strong stimulation such as mechanical and chemical agencies, and psychic affections, such as intense emotions of fear, anger, grief, anxiety, or worry, the degenerative process of disaggregation sets in, affecting first the higher aggregates and then with the continuity and intensity of the stimulations the process descends deeper and deeper affecting less complex aggregates, finally reaching the simplest aggregates of moments. The higher types of moments degenerate and fall to lower and lower stages of consciousness. ”

“ Each stimulation leaves after it some moment-disaggregation, a condition that makes further disaggregation more difficult. The more intense the stimulation is, the more extensive and deeper is the disaggregation, and hence, the more difficult further disaggregation becomes. If the stimulation is continued or made highly intense, a point is soon reached beyond which no stimulation can pass without giving rise to disaggregation having as its manifestation the different forms of pathological mental dissociation. ”

“ On the one hand, a physiologist is bound to accept that the disease was originally developed as a consequence of an anatomical alteration of a certain organ or nerve-cell or fibre; and on the other he is bound to consider that the same disease or consequence develops itself in a young one which has no such circumstances of anatomical alteration of a certain organ or nerve-cell or fibre—at least detectable by any means of investigation at present employed. ”

“ The trouble is, doctor, that Mr. Davidson is suffering from the delusion that he is pursued by evil spirits. He was not committed here by any court, but came of his own accord about four months ago, and we let him wander about here at will. But he seems to be growing worse, as time goes on.
“One of his worst delusions, doctor, is that there is one spirit in particular who is trying to choke him to death. Dr. Major, our superintendent, says he has incipient tuberculosis of the throat, with occasional spasmodic contractions. ”

“ Late Syphilis of the Nervous System—General Paralysis.—General paralysis, or paresis, is a progressive mental degeneration, with relapses and periods of improvement which reduce the patient by successive stages to a jibbering idiocy ending invariably in death. Such patients may, in the course of their decline, have delusions which lead them to acts of violence. ”

“ After I had described my symptoms, the doctor smiled rather more expansively than was to my liking and said:—
“You may have a little post-nasal catarrh, but I think it is only a neurosis.”
I thought to myself that if it was “only” a neurosis it was one with great possibilities. The fact that collapses are frequent among brain-workers was not easily dismissed from [Pg 25] my mind. I feared insanity and began to picture how I would disport myself in a madhouse. ”

“ Like psycho-sensorial hallucinations of the other senses, that of the genesic sense may assume the erotic type of disease, and is due undoubtedly, in some men, to a repletion of the spermatic vesicules. It is this that Saint Andre, physician in ordinary to Louis XIV., gives as an explanation of incubism. ”

“ Catalepsy, in the immobility of the body, the fixity of the regard, and the rigidity of the limbs in all attitudes, that we desire to place them (a very rare phenomenon) .
Lethargy, in the depression of all parts of the body, and a predisposition on the part of the muscles to contract.
Delirium, finally, in the impossibility of hoping to discern false from true sensations.
We find, after this, that in analyzing the principal symptoms of hystero-demonomania, we easily note the characteristics of ordinary hysterical folly; we see that it always attacks by preference the impressionable woman. ”

“ Adopting the hypothesis of evolution as enunciated by Herbert Spencer, Dr. Hughlings Jackson thinks that cases of insanity, and indeed all other nervous diseases, may be considered as examples of Dissolution, this being, I need not say, the term Spencer uses for the process which is the reverse of Evolution. Insanity, then, according to this view, is dissolution beginning at the highest cerebral centres, which centres, according to Jackson, represent or re-represent the whole organism. ”