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3. La folie communiquée, in which a lunatic communicates his hallucinations and his false conceptions to another person hereditarily predisposed to insanity.

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An interesting case of communicated insanity is that of the Dubourques, father and son, the latter of whom is in confinement in a lunatic asylum for attacking women and killing one, and whose case has already been alluded to under another head. Here the father had imbibed the delusion that his brother had died in California, leaving him a large fortune, which had been appropriated by the government to its own use. Talking to his son, a weak-minded young man, he had gradually indoctrinated him with the truth of his false conceptions, and the two for several years were seen every day on Broadway carrying signs on their backs, stating that they had been defrauded out of a large fortune by the United States Government, and demanding the restitution of the money. There was no truth whatever in these statements, except that a brother of the old man had died in California. Neither he nor the son ever took the least pains to ascertain whether any money was left or not. At last the father died, and for a year or more the son walked alone. Finally, he committed the acts for which he is now in confinement.

Kiernan,' in an interesting communication on the subject, has adduced the case of a clergyman who, being insane, indoctrinated five other lunatics with his delusions. He also mentions the interesting fact that general paralytics very frequently enter into each other's delusions. To this point I shall return when the subject of general paralysis comes to be considered.

The term folie à deux does not apply to all cases of the affection, as in some more than two persons are affected. It appears to me that, at any rate for English writers, the name "Communicated Insanity" is preferable.

2 "Contributions to Psychiatry," Journal of Nervous and Mental Disease, October, 1880, p. 639.

CHAPTER VI.

IV.

VOLITIONAL INSANITIES.

THE forms of mental aberration comprised under the designation of volitional insanities are those in which the will is deranged, either in the way of exaltation or of excessive action, or in that of depression or of diminished action. By some authors it is contended that there can be no derangement of the will, for the reason that this faculty, if it ever is a faculty, is simply the result of ideation, and were there no ideas there would be no will. It is only sufficient, without going into the metaphysics of the question, to call to mind the fact that many of those persons who are strong of will are weak in ideas, both as regards their quantity and strength. An obstinate person, for instance, is by no means necessarily markedly intellectual.

Besides, experience teaches us that there are cases of mental aberration characterized by the features mentioned, and by very little disturbance of the other categories of mental faculties. It is these which I propose to bring to the notice of the reader, leaving to metaphysicians the task, if they desire it, to determine the exact nature of the will. That we have such a faculty every person who moves his finger knows.

a-VOLITIONAL MORBID IMPULSES.

By a volitional morbid impulse we understand those mental factors which cause the perpetration of acts which are neither dictated by an idea or an emotion. They are, therefore, motiveless, and are often perpetrated against the ideas and the desires of the subject.

Neither are they to be confounded with those acts performed by epileptics in a state of unconsciousness, and which resemble, in their external and more obvious characteristics, morbid volitional impulses. Very little observation is required to distinguish the one from the other.

The paroxysm may arise suddenly without any premonitory symptoms; and, when the act to which the individual is blindly impelled is committed, the normal balance between the several mental faculties is at once restored. A similar act,

or any other from like excitation, may never again be performed. Usually, however, there is more or less tendency to a repetition of some kind.

Or there may be cerebral symptoms for a longer or shorter period before the culminating phenomenon occurs. These consist of pain, vertigo, heat, a sensation of fulness, of tightness, or of weight, and generally of insomnia.

It is related of Garrick, the celebrated comedian of the last century, that one day, while riding along the road in company with some friends, he suddenly descended from his horse, and, rushing toward a rider who was approaching, dragged him to the ground, and began applying his whip to him with a degree of vigor more astonishing than agreeable to the recipient. After he had administered a sound thrashing, the actor took off his hat, and was profuse in his apologies, both to the victim and his friends, who had looked on in amazement. "I could not help it," he said. "I never saw the gentleman before, and I beg ten thousand pardons for my outrageous conduct. I am willing to make any reparation in my power. Here is my whip; he may revenge himself on my hide; but I could no more have helped acting as I did than I could have flown." This is a good example of a volitional morbid impulse in which there was neither an idea to be executed nor an emotion to be gratified.

Marc' cites the following case:

K., aged eleven years and a half, was of backward mind, nervous, lazy, malicious, and obstinate. One day, when he refused to work, his mother permitted him to stay at home with her, and made him assist her in cleaning the housemoving the furniture, bringing hot water, etc. Finally, she told him to remain in the kitchen, and to keep the fire going in the stove. While thus occupied, he saw under the table a little hollow gourd used as a cup. Into this he put a live coal, and placed the whole in the thatch of the roof. "It came to me suddenly," he said, "and I was obliged to do it." A month subsequently he experienced an "infernal heaviness" in his head, and again he felt obliged to kindle a fire. On both occasions, as soon as the act was committed the impulse was satisfied, and he was the first to endeavor to extinguish the flames.

1 "De la folie considerée dans ses rapports avec les questions médico-judiciaires," Paris, 1840, t. ii, p. 390.

Georget' gives a full account of the case of Pierre Joseph Delépine, a backward boy of sixteen. This youth had, without motive, attempted eight times to set fire to his father's house. He even, while in prison, put live coals in his bed, and then lay down on it while it was on fire.

Jacoby' quotes the case of Barbara Erkhow, a Russian peasant, who was delivered of a son, and was, two weeks afterward, left at home with her husband's mother. While. Barbara was nursing her infant, the mother-in-law made a fire in the stove, and soon afterward left the room. In an instant Barbara seized her child and threw it into the stove. She then lay down on a bed which was in the chamber. Almost immediately afterward her mother-in-law re-entered the room, saw the infant in the fire, and snatched it from the flames. The child died in her arms. Barbara could not explain her conduct otherwise than by declaring that she had been seized with a sudden impulse to throw her infant into the stove, and that she had done so without thought or cause.

In 1828, a man, named Papavoine, killed in the forest of Vincennes two little boys, who were there on a holiday with their mother. He had never seen these children before, and, when seized with the impulse to kill them, went and bought a knife for the purpose, and, returning, murdered them before their mother's eyes, and made his escape. On being arrested and identified, he at first denied the charge, but subsequently admitted its truth. Confined in prison, he set fire to his bed, and attempted to murder a fellow-prisoner. When interrogated during his trial, he declared that at the time of the double murder he was in bad health, had been unable to sleep, and was nervous. He asserted that he had had no motive whatever to kill the two children. Inquiry into his antecedents showed that, though he had been quiet and taciturn in his habits, he had never exhibited any indications of insanity, but had discharged with fidelity the duties of an office he had held under the government, and had retired with a pension. The plea of insanity was put forward by his counsel, but it was disregarded by the jury, and he was found guilty and executed.

A few weeks since, a lady of this city brought her daughter to me, to be treated, as she said, for "nervousness." The 1 "Discussion médico-légale sur la folie," Paris, 1826, p. 130.

"Considérations sur les monomanies impulsives," Thèse de Berne, 1868, p. 12.

patient was eighteen years of age, in good general health, and suffered from no disorder of her menstrual function. While I was talking with her she suddenly rose, and, walking rapidly across the room, overturned a chair which stood against the wall. She then returned, and went on with her conversation. Her face was a little more flushed than it had been, but I noticed no other change.

After a few minutes I said to her: "Why did you throw over that chair?"

it."

"I don't know," she answered.

"Do you know that you did throw it down?" "Oh, yes; of course I know all about it."

"Then why did you do it?"

"I was obliged to. I cannot tell you any more." "Did you want to do it?"

"No; I had no wish about it."

"Had you been thinking about the matter?"

"No; I had no thought about it; I felt compelled to do

"Have you ever done the like before?"

Many times. I have torn books, broken plates and other things, and once I rushed out in the rain without any shoes." "And you can't tell me why you do these things?"

"No, except that I am obliged to do them. As soon as I feel an impulse of the kind I do it, and then I am satisfied." "Have you never tried to resist!"

"No, for there is nothing to resist. I don't think I could stop. I have no wish to do them, and no thought of doing them. I just do them, and that is all there is about it."

"But you might do serious injury some day."

"Yes, I have thought of that, and it gives me a great deal of trouble. But what can I do?"

In another case the patient, a gentleman who had received a serious wound of the head during the late civil war, consulted me for the cerebral symptoms that were developed, as well as for the irresistible impulses to which he was subject. I found on examination that the missile-a fragment of shell -had struck him in an oblique direction immediately over the external angle of the left eye, doing at the time apparently no greater damage than to plough a furrow in his skull, and to knock him senseless for a few minutes. The wound healed without trouble, and in a couple of weeks he was fit for duty.

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