SEXUAL PSYCHOSES AND NEUROSES 223 



In those very rare cases in which the patient is Reproductive 

 hysterical and excitable, or becomes insane, it appears inBanity * 

 probable that the cause emanates from the foetus, and 

 is of the nature of a toxaemia. 



Whitridge Williams 1 records a case in which the 

 patient, during the later months of pregnancy, suffered 

 with delusions of persecution. A large amount of 

 albumen was found in the urine, associated with a 

 diminished excretion of urea. Under treatment the 

 patient entirely recovered, only to relapse if treatment 

 were suspended. Complete recovery followed par- 

 turition. 



During the puerperium insanity is more common Puerperal 

 and the patient then usually suffers with delusions m8amfcy * 

 and hallucinations, especially of hearing 2 . The onset 

 is marked by insomnia and headache. The patient 

 then rapidly passes from a state of restlessness and 

 excitability to a condition of acute mania. Sexual 

 excitement and shamelessness, religious exaltation and 

 blasphemy, are usually prominent ; and sometimes there 

 is special aversion from the husband and child. It 

 appears as though the accumulation of sexual and 

 gestational stimuli, instead of reaching an harmonious 

 finale, end in a discordant clash. It is probable that 

 in most of these cases — as, indeed, in all forms of in- 

 sanity — there is a bad neuropathic family history, and, 

 further, that the insanity is produced by exhaustion 

 or sepsis (toxaemia) subsequently to labour, which 

 probably involves the organs of internal secretion. 



The insanity seen at a later period during lacta- 

 tion is no doubt partly caused by the drain on 

 the maternal resources brought about indirectly by 

 lactation, rather than by the direct influence of the 

 hormonopoietic organs. 



1 Williams, J. Whitridge, Obstetrics, 4th ed., 1919. 



2 Jones, R., Journ. Obstet. and Qyncecol. Brit. Emp., 1905, vol. iii, 

 p. 109. 



