ENDEMIC FUNICU LITIS 407 



The patienl is conscious, bui cannot apparently control his actions. 

 The hand spontaneously rises to the head. 



There is a loss of memory of what has taken place. 



The actions may be impulsive or mimetic. 



It is not unlike the " jumpers " or " jerks " seen in Europe during 

 the Middle Ages. 



It is sometimes present during religious revivals of to-day. 



It has a medico-legal aspect of considerable importance. 



These subjects are often teased, irritated and made worse. 



Auto suggestion can be tried. 



Determination on the part of the patient is essential. 



(5) AMOK ( = an impulse to murder). 



This is a term applied to a condition, partly physical, partly 

 psychical, following a period of depression. 



They are capable of self-violence and of wounding and killing 

 others. 



Memory fails them as to what they have done. 



The attack is followed by a condition of stupor. 



It is seen in Malaysia, Trinidad, India and Liberia. 



The exciting causes are excessive smoking of Cannabis indica, or 

 opium, or some strong emotion, such as anger, fear or sorrow. 



After this the patient broods over his wrongs for davs or w'eeks, 

 then complains of the appearance of devils, and goes forth to kill them 

 with his flame-shaped knife or his gun. 



The attack lasts but a short time. 



ENDEMIC FUNICULITIS. 

 DEFINITION. 



An acute specific suppurative inflammation of the spermatic cord 

 of uncertain aetiology. The theories of causation are legion. 



DISTRIBUTION. 



It is seen in Southern India, Egypt, West Indies, Ceylon. 



PATHOLOGY. 



The whole cord is wholly inflamed, infiltrated and swollen. 



It may be 3^ inches in circumference. 



On incising it transversely, yellow pus exudes from the veins of 

 the pampiniform plexus and the vas deferens. 



The inflammation also attacks the epididymis. 



There is usually some oedema and a little clear fluid in the tunica 

 vaginalis. 



