90 



♦ KNOWLEDGE ♦ 



[Dec. 



1881. 



HRAIN TROUBLES. 



Impaired Memory — (coulinued). 



rpilE following rase is onr of those in which su<l(l<n 

 I failure of inoinory iinpliid serious cf-rebral mischief. 

 " An eminent provincial sur;:eon, of large and anxious prac- 

 tice, was seized with a sudden failure of memory. He forjjot 

 all liis ap{)ointment.s, and to sudi a degree was thi' fa<ulty 

 of retention impaired" (so far as the names and cases of 

 patients were concerned) " that he was obliged to make 

 memoranda of every trifling and minute circumstance 

 which it was important for him to reniemlier, and to these 

 he was constantly referring in order to refresh his memory. 

 This attack was preceded by headache, of which he had 

 complained for nearly a fortnight.'' Up to the period of 

 the case being brought to the attention of Dr. Forbes 

 Winslow, who treated it, no suspicion had been entertained 

 of tlie existence of any [)rior state of cerebral ill-health, 

 sufficient to account for the patient's sudden loss of mental 

 power. Dr. Winslow ascertained, however, that " about 

 eight weeks, or nearly three months previously" (not a 

 \ery clear way of putting the matter, by the way), the 

 l>atient had been seized, whilst in the act of applying a 

 stethoscope to the chest of a patient, with severe epileptic 

 vertigo. FoT about a .second he lost consciousness. 'fhis 

 liad been succeeded by an attack of distressing sick liead- 

 ache. " Three days subsequently he had a second paroxysm 

 of giddiness, and nearly fell out of the carriage in which he 

 was sitting at the time. His spirits subsequently became 

 mudi depressed, but in a few days he again rallied, 

 flattering himself that he had quite recovered. He made 

 no mention of these attacks to any member of his family, 

 and carefully avoided all conversation on the sidiject of his 

 health with his medical brethren." "When I saw this 

 gentleman," says Dr. Winslow, "the only appreciable 

 mental symptom was inability to retain in his mind, for 

 many consecutive minutes, any recent impressions. His 

 pulse was feeble, face pallid, and general health shattered. 

 His spirits were, however, at times buoyant, and the 

 j)rognosis whicli he formed of his own case was favour- 

 able." Tlic result showed that he was a false prophet. 

 Two weeks later he had an epileptic fit. He then became 

 rapidly worse, and ten months after he died " in a de- 

 j>lorable state of mental imbecility." 



But against such a case as this, which was obviously 

 exceptional, may be set the following case, in which, under 

 similar conditions, so far as appearances were concerned, 

 a complete cure was effected : — A barrister complained to 

 Dr. Winslow of occasio7ial attacks of enfeebled memory. 

 " Heattril)uted this mental impairment, ' says Dr. Winslow, 

 " to the fact of his ha\ing been engaged as counsel the 

 pn^vious year in several anxious and severely-contested 

 election cases. I advised an entire cessation from all pro- 

 fessional work, but had great difficulty in persuading him 

 to recognise the necessity for a completi; abstinence from 

 mental occupation. He promised a guarded actpiiescence 

 in my strict injunctions, but finding himself relieved after 

 an interval of a few weeks, he returned, in opposition to 

 my solicitations, to his chambers, and recommenced active 

 practice. As 1 predicted,' proceeds Dr. Winslow, "he 

 soon broke down, and 1 was once more conferred with. 

 ]fe then acknowledged it to be a matter of vital necessity 

 th.at he should give his mind prolonged rest, and agi'eed 

 unreservedly to do so. I kept him for a period of /i/<i 

 i/rnrs from all anxious and severe mental occupation, and 

 by that time his powers of mind had rallied to a sui-prising 

 extent ; in fact, they became, according to his own impres- 

 sion, more vigorous than they were prior to liis attack of 



illnecs. P'or many years tliis patient has continued 

 steadily at work, never ha\ing had a return of loss of 

 memory. I should )iremise tliat I exacted from liim a 

 promi.s<- that he wrjuld read no briefs aft'T dinner. He has 

 rigidly adhered to this understanding, but being an early 

 riser and a man of remarkable quickness of apprehension, 

 he is enabled to ma.ster a large amount of work before 

 breakfast. I also made it a aim f/uil >io,i that he should go 

 abroad every year for a periocl of two months, thus ensur- 

 ing for him a com[)lete diversion and relaxation of mind 

 from all injurious jiressure. He has scrupulously complied 

 with my instructions, and the result is an entire freedom 

 from all symptoms of mental impairment and cerebral dis- 

 order." A case such as this is full of encouragement, 

 because here it would seem that at tlie outset overwork 

 had seriously injured the brain, yet attention to a few- 

 simple rules resulted in a complete cure. 



Apart from actual injury to the substance of the brain, 

 transient loss of memory seems to be usually caused by a 

 deficient supply of blood to the brain, whether through 

 loss of blood generally, or owing to defective circulation. 

 This is illustrated V'y the following ca.se : — A lady had 

 been reduced to a state of such extreme prostration by 

 liH'morrhage, that for nearly a week she seemed simply 

 lingering between life and death. After this she remained 

 for a long time in a state of extreme mental depression 

 and vital prostration. When she was able to articulate, her 

 husband was astonished to find that her memory was 

 paralysed. " She had forgotten where she lived, who her 

 husband was, how long she had been ill, the names of her 

 children, and, in fact, her own name was obliterated from 

 her recollection. She was unable to call anything by its 

 right name. In attempting to do so she made the most 

 singular mistakes. 8he had been in the habit, before her 

 illness, of speaking in French, her husband being a French- 

 man ; but while in the state of mind described, she 

 seemed to have lost all recollection of the French language. 

 When her husband spoke to her in French, she did not 

 seem to understand in the least what he was saying, 

 though she could at this time speak English without diffi- 

 culty. Seven or eight weeks elapsed before her memory 

 began to improve, and months passed before her mimt 

 regained its original strength." 



Intense cold seems to have the power of paralysing tip 

 memory. During the retreat from Moscow, many vi 

 Bonaparte's officers and men found their memories gi'eatly 

 enfeebled. Bonaparte himself was atlected, especially as 

 to dates and names. " For a time he was constantly 

 confusing one person witli another, and making odd 

 mistakes in date.s." In his case the att'ecticn of the. 

 memory lasted only a few days ;* imt one of Bona- 

 parte's aid<'!<-(h'.-fiimp lost his memory tor several years. 



Instances such as these enable us to understand the true 

 meaning of those comparatively slight attacks of failure 

 of memory which most of us experience from time to time. 

 In the fir.st place, we do not find much evidence enabling 

 us to assign to one or other of the two da-sses of memory- 

 failings above indicated a gi-eater or less degree of im- 

 portance, whether such failings occur in a marked or sliglit 



• Duriiiq^ this time Bon.apartc's mind seems to have been 

 afToctcd. " He merely made some pc'twres of melancholy resig- 

 imtioii on every occasion when,'' durinp the baTtIo of b'cinenowskn . 

 the aides-de-camp sent by Xey "informed him of the death of his 

 best generals. lie rofe sevenil times to take n few turns, but 

 imnictiiately sat down again. Everyone looked at the Emperor 

 with astonishment. Hitherto, during these great shocks, he had 

 displayed an active coolness ; but \\eTP only a dead calm, a milit 

 and sluggish inactivity." Count Segur, referring to Napoleon's 

 state at this time, says: "The Russian autumn had triumphed 

 over him." 



