838 OF THE JUNCTIONS OF THE NERVOUS SYSTEM. 



transition from the one to the other. 1 A very similar condition presents itself, 

 as the result of the complete exhaustion of Cerebral power, in those extreme 

 forms of Dementia, or rather Amentia, which are frequently consequent upon 



1 The subject of this case -was a young woman of robust constitution and good health, 

 who accidentally fell into a river and was nearly drowned. She remained insensible for 

 six hours after the immersion ; but recovered so far as to be able to give some account of 

 the accident and of her subsequent feelings, though she continued far from well. Ten 

 days subsequently, however, she was seized with a fit of complete stupor, which lasted for 

 four hours; at the end of which time she opened her eyes, but did not seem to recognize 

 any of her friends around her ; and she appeared to be utterly deprived of the senses of 

 hearing, taste, and smell, as well as of the power of speech. Her mental faculties seemed 

 to be entirely suspended ; her only medium of communication with the external world 

 being through the senses of sight and touch, neither of which appeared to arouse ideas in 

 her mind, though respondent movements of various kinds were excited through them. Her 

 ^vision at short distances was quick ; and so great was the exaltation of the general sensi- 

 bility upon the surface of the body, that the slightest touch would startle her; still, unless 

 she was touched, or an object or a person was so placed that she could not help seeing the 

 one or the other, she appeared to be quite lost to everything that was passing around her. 

 She had no notion that she was at home, nor the least knowledge of anything about her ; 

 she did not even know her own mother, who attended upon her with the most unwearied 

 assiduity and kindness. Wherever she was placed, there she remained during the day. 

 Her appetite was good; but having neither taste nor smell, she ate alike indif- 

 ferently whatever she was fed with, and took nauseous medicines as readily as delicious viands. 

 All the automatic movements unconnected with sensation, of which the spinal cord is the 

 instrument, seemed to go on without interference ; as did also those dependent upon the 

 sensations of sight and touch ; whilst the functions of the other ganglia, together with 

 those of the cerebral hemispheres, appeared to be in complete abeyance. The analysis of 

 the facts stated regarding her ingestion of food seems to make this clear. She swallowed 

 food when it was put into her mouth ; this was a purely automatic action, the reception 

 by the lips being probably excited by sensation, whilst the act of deglutition, when the 

 food is carried within reach of the pharyngeal muscles, is excited without the necessary 

 concurrence of sensation. She made no spontaneous effort, however, to feed herself with 

 the spoon ; showing that she had not even that simple idea of helping herself, which in- 

 fants so early acquire. But after her mother had conveyed the spoon a few times to her 

 mouth, and had thus caused the muscular action to become associated with the sensorial 

 stimulus, the patient continued the operation. It appears, however, to have been neces- 

 sary to repeat this lesson on every occasion ; showing the complete absence of memory for 

 any idea, even one so simple and so immediately connected with the supply of the bodily 

 wants. The difference between an instinct and a desire or propensity, heretofore dwelt on 

 (g 772), is here most strikingly manifested. This patient had an instinctive tendency to 

 ingest food ; as is shown by her performance of the actions already alluded to ; but these 

 actions required the stimulus of the present sensation, and do not seem to have been con- 

 nected with any notion of the character of the object as food; at any rate, there was no 

 manifestation of the existence of any such notion or idea, for she displayed no desire for 

 food or drink in the absence of the objects, even when she must have been conscious of 

 the uneasy sensations of hunger and thirst. The very limited nature of her faculties, and 

 the automatic life she was leading, appear further evident from the following particulars. 

 One of her first acts on recovering from the fit had been to busy herself in picking the 

 bedclothes ; and as soon as she was able to sit up and be dressed, she continued the habit 

 by incessantly picking some portion of her dress. She seemed to want an occupation for 

 her fingers, and accordingly part of an old straw bonnet was given to her, which she 

 pulled to pieces of great minuteness ; she was afterwards bountifully supplied with roses ; 

 she picked off the leaves, and then tore them into the smallest particles imaginable. A 

 few days subsequently, she began forming upon the table, out of these minute particles, 

 rude figures of roses and other common garden flowers ; she had never received any in- 

 structions in drawing. Roses not being so plentiful in London, waste paper and a pair of 

 scissors were put into her hands ; and for some days she found an occupation in cutting 

 the paper into shreds ; after a time these cuttings assumed rude figures and shapes, and 

 more particularly the shapes used in patchwork. At length she was supplied with pro- 

 per materials for patchwork ; and after some initiatory instruction, she took to her needle 

 and to this employment in good earnest. She now labored incessantly at patchwork from 

 morning to night, and on Sundays and week-days, for she knew no difference of days ; nor 

 could she be made to comprehend the difference. She had no remembrance from day to 

 day of what she had been doing on the previous day, and so every morning commenced 



