X., formerly healthy, and of blameless life, was infected with syphilis in 1867. In 1879 paralysis of the left abducens occurred. Thereafter mental weakness was noticed, with a change of his disposition and character. Headache, occasional incoherence of speech, failure of power of thought and logic, occasional inequality of pupils, and paresis of the right facial muscles, were observed.
X., aged 37, shows no trace of lues when examined. The paralysis of the left abducens is still present. The left eye is amblyopic. He is mentally weak. Concerning the trial that was before him, he said it was nothing but a harmless misunderstanding. Indications of aphasia. Weakness of memory, particularly for recent events. Superficial emotional reaction; rapid exhaustion of memory and ability to speak. Proved: that the ethical defect and the perverse sexual impulse are the symptoms of an abnormal condition of brain induced by lues.
Suspension of criminal proceedings. (Personal case. Jahrbücher für Psychiatrie.)
(5) Paretic Dementia.
Here the sexual life is usually abnormally affected; in the incipient stages of the disease, as well as in episodical states of excitement, it is intensified, and sometimes perverse. In the final stages libido and sexual power usually become nil.
Just as in the prodromal stage of the senile forms, one sees here, in connection with more or less evident losses in the moral and intellectual spheres, expressions of an apparently intensified sexual instinct (obscene talk, openness in intercourse with the opposite sex, thoughts of marriage, frequenting of brothels, etc.), which is characteristic of the clouding of consciousness.
Seduction, abduction, and public scandal are here the order of the day. At first there is still some appreciation of the circumstances, though the cynicism of the acts is striking enough. As the mental weakness increases, such patients become criminal by reason of exhibition, masturbation in the streets, and attempts at immoral acts with children.
If conditions of mental excitement come on, attempts at rape are committed, or, at least, grossly immoral acts,—the patient attacks women on the street, appears in public in very imperfect dress; or, half-clothed, tries to force his way into strange houses, to cohabit with the wife of an acquaintance, or to marry the daughter on the spot.
Numerous cases belonging to this category are cited by Tardieu (“Attentats aux moeurs”); Mendel (“Progressive Paralyse der Irren,” 1880, p. 123); Westphal (Arch. f. Psych., vii, p. 622); and a case by Petrucci (Annal. méd. Psychol., 1875) shows that bigamy may also occur here.
The brutal disregard of consequences with which the patients in the advanced stages attempt to satisfy their sexual instinct, is characteristic.