17C 



KNOWLEDGE 



[Due. M, 1881. 



bility." Tho eta-ength of the body failed more and more as 

 " the organ on which the power of motion depends " 

 h(>camo more and more diseased. " The lower extremities, 

 the muscles of which were always weak, liegan to totter 

 under tlie wciglit of tho hody, and at the sam(! time 

 tiiP. power of combination for the motions of those parts 

 was impaired, and the king was troubled with vertigo, 

 jiarlieularly accompanying the movements of the head, 

 and witli vomiting, which symptoms, iu combination with 

 diminution of strength and the occurrence^ of involuntary 

 muscular spasms, indicated tlie exLstence of a more deeply- 

 seated affection, probably a softening in the central nervous 

 system." (One could imagine that as, of old, Spanisli 

 courtiers adopted the conventional hypothesis that a t^ueen 

 of Spain has no legs, Dr. Liljewalch held that the Kings of 

 Swedi-n, and " royal personages " generally, have no brains). 

 'I'lie means employed to combat tho disease produced 

 no good effects; "the paralysi.s, which commenced 

 in the lower extremities, gradually increased, and after 

 the king, feeling his inability any longer to fill the high 

 position to which Pro\-idencc had called him, transferred 

 into the hands of the crown prince the government of the 

 United Kingdoms, his deep melancholy gave way to a 

 progressive indifference, even for those things which in his 

 health he had regarded with the most lively interest." The 

 rest of Dr. Liljewalch's account relates to the gradual 

 failure of King Oscar's powers, mental and bodily, and is 

 too technical to bo quoted verbatim. It is noteworthy that 

 the power of speech began to be affected early during the 

 progress of the disorder, and later was lost altogether. 

 From this we should be led to regard failure in the power 

 of verbal expression as a later, and therefore a more 

 alarming, symptom of cerebral mischief, than diminution 

 of the power of fixing the attention. The post-inortcm 

 examination of King Oscar revealed extensive disorganisa- 

 tion of the brain. 



A case somewhat similar to that of King Oscar is thus 

 related Ijy Dr. Forlies Winslow : — " A gentleman connected 

 with the Stock Exchange was suspected to have disease of 

 the brain. His symptoms were as follow : general muscu- 

 lar weakness, occasional paroxysms of severe lieadache, 

 slight paralysis of the supeiior palpebral and of the left eye, 

 occasional sensation of numbness in the right foot. The 

 mind was not apparently at all impaired. He continued, 

 up to the period of my being consulted, fully competent to 

 discharge all his commercial duties, attended to] liis 

 accounts, and wrote letters of business with his usual 

 ability and clearness. His brother informed me that at 

 times he was greatly abstracted and f/ii'tractcd ; that 

 whilst engaged in conversation, he would suddenly pause 

 put his hand to his head, and appeared vexed with himself 

 at having lost all consciousness of wliat ho was saying. 

 This symptom was observed tico years before any question 

 arose, or suspicion existed, as to the state of the brain ! 

 The family, judging from the subsequent progress of the 

 case, were of opinion that the cerebral disorder was first 

 exhibiti^d by the sudden lapses of thought to which he was 

 subject for many years pre\'iously to tho manifestations of 

 other and more unequivocal symptoms of brain disease. 



Such, also, was my opinion In about a year 



and a half he died, quite paralytic. Considerable organic 

 disease of the brain was discovered after death." 



In a'lother case, which also ended fatally, an Irish bar- 

 rister, three yeai-s before an attack of acute mania, was 

 observed to stop occasionally whilst addressing tho courts 

 of law, as if for tlie moment lost. " So marked was this 

 symptom, that a professional friend, often associated with 

 him in tho conduct of legal matters, considered it his duty 

 to direct the attention of the gentleman's wife to the fact. 



considering that such attacks of mental distraction, on 

 occasions when it was of essential importance for the mind 

 to bo in a state of continuous activity, looked suspicious, 

 and, according to his judgment, were not consistent with 

 a healthy state of the brain." Alx)ut two years after this 

 peculiarity had been noticed, this patient experienced a 

 slight epileptiform seizure whilst at his chamljers, t'uring 

 a very hot day in the month of July. "As tliis attack 

 was considered to have been one of syncope, and to be 

 caused by the then high state of the temperature, little or 

 no notice was taken of it. Previously to travelling on the 

 Continent, he had been working unusually hard, eating and 

 drinking very sparingly, sitting up late at night, and rising 

 early in the morning. In fact, he acted with great indis- 

 cretion and imprudence, and the result was an acute attack 

 of brain disease, affecting the mind, a fortnight after his 

 arrival in Paris." In this case, the posl-mortem examina- 

 tion revealed the existence of chronic disease of the 

 membranes of tho brain — mischief which seemed to have 

 lasted for a considerable time before death. 



As we have already explained, it is not so easy to find 

 illustrative cases of the less alarming forms of distrac- 

 tion. Even in cases where serious mischief has followed 

 these slighter mind troubles, the symptoms immediately 

 preceding such serious illness have commonly been of a 

 more marked kind, and these alone have usually been 

 regarded as reaUy belonging to the case. Nevertheless, all 

 who have given careful attention to mental maladies, caU 

 speak of instances in which the less serious forms of dis^ 

 traction have been noticed early in the progress of cerebral 

 disorders ; so that though they need not alarm those who 

 note them in their own case, they should not be neglected' 

 They are al^\ays signs that the mind wants rest, and they 

 may be signs that some more specific remedy is required, 

 which can be readily determined by noting whether rest 

 brings relief. " I am anxious," says Dr. Forbes Winslow 

 (and it could be wished that throughout his valuable work 

 he had been similarly careful to avoid occasioning unne^ 

 cessary alarm), " to attach no undue impoi-tance to this 

 evidence of morbid intelligence, but I cannot close my eye^ 

 to the fact that a debilitated power of attention is a prO; 

 minent symptom in the early stage of cerebral disorder. 

 Cases of incipient brain disease have occurred in which 

 patients have, pre%'iously to other symptoms, lost all ability 

 to read continuously twenty lines of a book without a 

 painful effort of thought." It will be noticed that Dr;' 

 Winslow here puts distraction as a phenomenon preceding 

 in cases of cerebral disorder, the loss of memory : albeit^ 

 we believe that had he had the means of ascertaining the' 

 precise progress of mental disorder, in cases where he 

 supposed this to have been the case, he would have found 

 that the memory had begun to go in the first instancft 

 " If," ho proceeds, " there be impairment of attention and 

 debility of memory, it is illusory for the patient to imagine' 

 that he is able, until his physical condition of ill\ 

 health is attended to, by repeated and persevering efforts, 

 to resuscitate these prostrated powers. In his attempt 'to 

 do so he still further taxes tho morbid state of these facm- 

 ties " (meaniiig, apparently, that he overtaxes the facultior 

 and makes their state still more morbid), "and, instead of 

 invigorating, still further debilitates, and often entirely 

 extinguishes his intelligence." This caution cannot be too 

 carefully attended to. Returning to the analogy between 

 bodily and mental powers, which we touched upon at the 

 outset, we may compare the power of attention to actual 

 muscular strength, — as the power of memory may l* 

 compared to skill in mastering such and such feats of 

 muscular dexterity, and acquired mental knowledge to 

 the various athletic exercises which a man has learned to 



