Delirium

“ When the disease grows worse, the delirium becomes continual, the trembling increases, the muscles swell to such a degree that it seems as though they would burst. One might almost think that a furious demon were hidden within, agitating the body in the bed, distorting it, hurling it to and fro, as though to shatter it completely. The most terrible apparitions are those of spectres. ”

“ Everything seemed flaming and tottering and falling in a wild delirium. The earth itself opened to swallow the last survivors. In the trenches the bodies of the dead were heaped, and twisted or bleeding corpses choked the passageways. ”

“ Step by step the British were forced back, fighting in that delirium which descends on men in desperate straits, taking their business through grimly, hand to hand, thrusting, hacking, beating down, rolling in mud and water and snatching wire, staggering to their feet again and hewing with arms that seemed to be steel. ”

“ For it was well known that many of the pest-stricken in their delirium rushed into the street to die; that the passer-by might at any moment be confronted by some miserable wretch who, seized with madness, would rise and clasp him in an embrace of hideous contagion. ”

“ Apocalyptic visions rose, mingled, vanished—monstrous clouds far in the depths of the fantastic abyss into which the soul of the sufferer gazed with horror. He saw the nuraghe with the giant and the saint of Aunt Varvara's delirium. But the moon detached itself from the Saint and fled over the heaven. ”

“ There in the whitewashed wards with the smell of blood and ether, where the maimed lie stiff and still and the dying moan and the mad rave in wild delirium, stand there and your soul shall shrivel in horror at the destruction of men! ”

“ The character of the delirium is seldom wild or noisy, but is much more commonly a combination of busy restlessness and indefinite fear. When spoken to, the patient can answer correctly enough, but immediately thereafter relapses into his former condition of incoherence. Occasionally maniacal symptoms develop themselves, the patient becoming dangerously violent, and the case thus assuming a much graver aspect than one of simple delirium tremens. ”

“ Even the extraordinary brilliancy of the eyes of patients suffering from delirium was supposed, in conformity with the prevailing superstition, to convey a malignant and fatal influence upon all within the range of their glances. The air was so tainted that domestic animals, cattle, horses, sheep, even the birds, died by hundreds of strange and fatal distempers. The mortality was so great in some districts that the helpless convalescents were unable to perform the burial rites for their friends and neighbors. ”

“ In my delirium I wandered deep beneath the ground through a thousand of these dens, and behind locked doors of iron I suffered and died a thousand deaths. And when I would come upon my father, seated at table in these subterranean crypts, gambling with Chinese for great stakes of gold, all my outrage gave vent in the vilest cursing. I would rise in bed, struggling against the detaining hands, and curse my father till the rafters rang. All the inconceivable filth a child running at large in a primitive countryside may hear men utter was mine ”

“ But the most invariable accompaniment of the final stage of delirium, and frequently also that of sopor, is in the incessant picking at real or imaginary objects. At one time the patient seizes hold of parts of his clothes or bedding, pulls at his fingers and toes, takes up dirt and stones from the ground, or as often snatches at imaginary objects in the air, on his body, or anything near him. ”

“ Instantly the spirit of hell awoke in me and raged. With a transport of glee, I mauled the unresisting body, tasting delight from every blow; and it was not till weariness had begun to succeed, that I was suddenly, in the top fit of my delirium, struck through the heart by a cold thrill of terror. ”

“ Delirium is by no means evil, but when it comes by gift of the gods, a very great benefit. In delirium the sibyls of Delphi and Dodona were of great service to Greece, but when in cold blood were of little or none. Frequently, when the gods afflicted men with epidemics, a sacred delirium inspired some men with a remedy for these. ”

“ This was the crisis of the delirium. In the midst of it, the chief actor made his appearance, waving his wand, like Prospero, to work new wonders. Dressed in a long robe of lilac-coloured silk, richly embroidered with gold flowers, bearing in his hand a white magnetic rod; and, with a look of dignity which would have sat well on an eastern caliph, he marched with solemn strides into the room. He awed the still sensible by his eye, and the violence of their symptoms diminished. ”

“ In his delirium the sick man began to feel oppressed by the density and number of these beings, white and bony, with eyeless sockets and malevolent grins, skeletons of a vanished life, obstinately determined to continue to subsist, dominating everything. ”

“ He is next seized with violent delirium, and in his horrible paroxysms froths at the mouth, tears the flesh from his hands and arms, pulls his hair, and beats himself violently against the ground, meanwhile uttering the most piercing cries, till, completely exhausted, he remains without motion or feeling, and death ensues. ”

“ The shrieks and lamentations of survivors, who could not be prevented from attending the remains of a husband or child to the place of interment, frequently struck her senses. Sometimes urged by a furious delirium, the sick would break from their attendants, rush into the street, and expire on the pavement, amidst frantic outcries and gestures. ”

“ Delirium is often a sort of cloud-castle, a sort of magnified and distorted shadow of actualities, but it is a very difficult thing, almost an impossible thing, to reconstruct the real house from the distortion of it, thrown on the clouds of the patient’s brain. ”

“ Every psychiatrist knows the insane whose delirium is combined with religious or mystic exaltation, and who by the mysticism of their delirium have exercised and continue to exercise a profound influence on the mass of humanity which surround them—"Panurge's Sheep," if I may use the expression. These people are themselves so dominated by the pathological influence of their auto-suggestions or their delirium that they behave with the fanaticism of fakirs, and exhibit an extraordinary energy and perseverance in the pursuit of the object of their morbid ideas. ”

“ Then, in the attacks of delirium, the things and persons that were the occasion of the emotion—fright, grief—reappear as hallucinations. This influence of what has happened in the past establishes an important difference between the delirium of the insane and that of persons suffering from hysteria. The visions of the insane, whatever they may be, generally have no immediate relation to anterior events, while the form of delirium in hysteria is nearly always determined by an incident which has formerly played an important part in the life of the patient. ”

“ The crawling vermin and the scuttling rats, the noises that suggested monsters, made their delirium real. The atmosphere of the prison was foul, compounded of the fumes of alcohol exhaled by all those gaping mouths, of the feculence of all those filthy bodies, of the foul odors of the slop-pails, of the germs of all the diseases that had been brought to the place in forty years. Archie could not sleep; no one could sleep except those who were overcome by liquor, and they had awful nightmares. ”

“ Forasmuch as, however, in the recovery from delirium a patient may marvel over the incredulity of neighbours who refuse to give credence to the presentments that have been ipso facto to him, so, the nation being sound again, and its constitution hale, I expect little but a laugh for my piety in relating of the following incident; which, nevertheless, is as essential true as that he who shall look through the knot-hole in the plank of a coffin shall acquire the evil eye. ”

“ And the aspect of each was that of some demon clock-face with one sinister hour always figured thereon - the dreaded, the doom-delivering hour of four.
Baffled in every attempt to shake off the circling and relentless delirium, I glanced once more toward the unshuttered window and beheld again the monster which had come from the grave. Horrible it had been before; indescribable it had now become. The creature, formerly of indeterminate substance, was now formed of red and malignant fire; and waved repulsively its four tentacled claws - unspeakable tongues of living flame. ”

“ It is, as a rule, most marked at night, and in mild cases may occur only at that time or upon waking in the morning. When the delirium is active the patient may shout and scream, or leave his bed and attempt to throw himself from the window, being endowed apparently for the moment with strength sufficient to enable him to commit these acts of violence. ”

“ Leading questions should never be put, nor any attempt made to induce the patient to make any statement. When we consider the condition of the patient, the possibility of delirium induced by the severity of the injury, together with the dread of death, it is, to say the least, injudicious to introduce the suspected party into the room for the purpose of identification, though this procedure has been suggested by some writers. ”

“ Such was the regular course of this miliary fever, but its progress was often accelerated by very dangerous symptoms, and occasionally it proved fatal within a very few hours. If at the time of the attack the patients were very restless and talkative, the eyes glistening, the pulse, without being hard, tumultuous, and the edges of the tongue reddened, delirium soon succeeded and then convulsions and death. ”

“ If the sickness is severe enough to cause delirium, it would be as though madmen were at the telegraph keys dispatching trains of passenger cars which could hardly fail to bring injury and destruction to unwary travelers. ”

“ They were as eager to bestow, as he to ask, the benevolence required; and Louis soon found assistance under their charitable roof.
For three long weeks, he lingered between suffering and the grave. His fever was on the nerves, and attended with delirium, and every other prognos [74] tic of a speedy termination of his days. Lorenzo shared the constant vigilance of the good Fathers, in watching by his side; and at the commencement of the fourth week, the delirium left him. His present recovery to recollection was not like that in the cave, dim and distressing. ”

“ Did Weeks tell you when this delirium began?"
"The night after Hatton left, or, rather, very early in the morning of the next day. He had been alarmed at McLean's symptoms during the evening, and ordered the nurse to wake him if he saw any indications of delirium. The man came to him at three in the morning and said the lieutenant was wild. Weeks went over at once,—and ten minutes after he got there he sent the attendant away, and shut himself up with his patient."
The major pondered a moment. "Is the man close-mouthed? ”

“ Where, on the other hand, the quantity of alcohol taken has been very large, the attack is sometimes ushered in by fits of an epileptiform character. Males are much more frequently the subjects of delirium tremens than females. One of the earliest indications of the approaching attack of delirium tremens is sleeplessness, any rest the patient may obtain being troubled by unpleasant or terrifying dreams. ”

“ The delirium of these patients, en resume, has for essential characteristics, exaltation of the intelligence, peculiar fixity of ideas, perversion of the sentiments, absence of will power, tendency to erotism. In a number of observations on delirium among hysterical cases in a state of hypnotism recently published, patients have been noted who believed that they cohabited with cats and monkeys, while some had hallucinations of phantoms and assassins—visions that resulted from complex hallucinations and have a certain similarity to those of hystero-demonomania observed in the Middle Ages ”

“ Fervently she prayed that, if his life could not be spared, at least the delirium, which continued with increasing violence from the first few hours of his disorder, might vanish before death, and leave enough of light and of calm for making his peace with offended Heaven. After several days, however, nature seemed quite exhausted, and he sunk into a state to like death to be mistaken for the repose of sleep. ”

“ Alcoholic subjects are very liable to unexpected death from a good many causes. Patients suffering from delirium tremens, for instance, may die suddenly in the midst of a paroxysm of excitement. Such a termination is not frequent, but it has occurred often enough to make it the custom, at asylums for inebriates, to warn friends who bring patients of the liability of such an accident. It is not so apt to happen during a first attack of delirium tremens as during subsequent attacks. ”

“ Each patient generally has a form of delirium peculiar to herself, so that the different attacks in the same subject always bear a resemblance to one another. The same personages appear, the same scenes are repeated in all the attacks. The order in which the hallucinations come on does not vary, and one who has witnessed a few attacks suffered by the same patient can always judge when the end of the fit is near from the nature of these hallucinations. ”

“ In the hours of waking and depression between the raging intervals of delirium he had speculated, with a sort of detached, listless indifference, on the chances of his getting back to life and strength and energy. The prospect of filling a corner of some lonely Siberian graveyard or Finnish cemetery had seemed near realisation at times, and for a man who was already half dead the other half didn’t particularly matter. ”