Physical Signs of Insanity
The physician who is skilled in psychiatry finds in very many insane patients marked physical signs. There are pains, insensitive areas, hypersensitive areas, changes in the pupils of the eyes, unrestrained reflex action, and partial loss of muscular control, as shown in talking, walking, and writing. Constipation and insomnia are very early symptoms of disease in a very large proportion of the insane.
It is productive of no good result for a layman to try to classify the insane. The matter of classification will be for several years in a condition of developmental change. It is enough to speak of the patient as depressed or excited, agitated or stupid, talkative or mute, homicidal, suicidal, neglectful, uncleanly in personal habits, etc.
Illustrations of Various Types
There are very interesting features connected with typical instances of several varieties of insanity, as they were noted in certain cases under the writer's care. A depressed patient with suicidal tendencies cherished the delusion that war with Great Britain was imminent, and that in such an event British troops would be landed on Long Island between New York City and the spot where he conceived the cattle to be kept. This, he argued, would cut off the beef and milk supply from the city. He therefore decided to do his part toward husbanding the present supply of food by refusing to eat; an act which necessitated feeding him through a rubber tube for many weeks. He also attempted suicide by drowning, throwing himself face downward in a shallow swamp, whence he was rescued. This young man was an expert chess player even during his attack.
A maniacal patient wore on her head a tent of newspaper to keep the devil from coming through the ceiling and attacking her. She frequently heard her husband running about the upper floor with the devil on his back. As a further precaution she stained her gray hair red with pickled beet juice, and would occasionally hurl loose furniture at the walls and ceilings of her rooms and assault all who approached her.
A man who presented a case of dementia pulled the hairs from his beard and planted them in rows in the garden, watering them daily, and showing much astonishment that they did not grow. He spent hours each day in spelling words backward and forward, and also by repeating their letters in the order in which they appear in the alphabet. When he wanted funds he signed yellow fallen leaves with a needle, and they turned into money.
A case of general paresis (commonly though improperly called "softening of the brain") passed into the second stage as a delusion was uppermost to the effect that there was opium everywhere; opium in his hat, opium in his newspaper, opium in his bath sponge, opium in his food. He thereupon refused to eat, and was fed with a tube for two years, at the end of which time he resumed natural methods of nutrition and ate voraciously. Another general paretic promised to his physician such gifts as an ivory vest with diamond buttons, boasted of his great strength while scarcely able to walk alone, and declared he was a celebrated vocalist, while his lips and tongue were so tremulous he could scarcely articulate.