1988 DISEASES OF THE NERVOUS SYSTEM 



Amok. 



Definition. — Amok is a psychical disturbance, which, after a 

 period of depression, suddenly develops into a violent attempt to 

 kill people, of which no memory may be left, and after which a 

 stuporous condition supervenes. 



Remarks. — ^Amok, which means ' an impulse to murder,' is a 

 disease frequently found among the Malays, but also occasionally 

 in other Oriental races. Abraham thinks that there may be some 

 relationship between amok and latah. 



Climatology. — Amok is found in Malaysia among the Bugis of 

 Celebes, the Malays of Indo-China, Malacca, and the Malay States. 

 It is also said to occur at times in Trinidad and among the inhabi- 

 tants of India and Siberia. 



etiology. — The exciting cause appears to be a strong emotion of 

 anger, sorrow, or fear, after which a pause or incubation period of 

 depression follows, which may last for days or weeks, during which 

 the patient broods over his wrongs. The Dutch believe that it is 

 induced by opium smoking, and Miall that it is due to smoking 

 haschisch {Cannabis indica) ; but these causes are insufficient. 



Symptomatology. — The attack is ushered in by colour sensations 

 of red or black, with or without vertigo, and the patient complains 

 of the appearance of devils, which he attempts to kill. The 

 amoker usually rushes out of his abode and attacks friends or foes, 

 young or old, males or females, with his kris, or flame-shaped knife, 

 or by firing on them with a gun. The attack usually lasts but a 

 short time, and the deeds performed during that period are not 

 remembered. After the attack the patient passes into a stuporous 

 condition or deep sleep, which may last for a long time, after which 

 he remains in a peculiar excitable condition for some months. 



Allied Complaints. — This is a curious pathological entity, and may 

 be a genuine psychical obliquity closely related to those epileptoid 

 seizures investigated in Europe by Lombroso. 



Medico-Legal. — If a case is considered genuine, the patient must 

 not be regarded as responsible for his actions, but each case should 

 be judged on its own merits. 



Treatment. — No treatment has so far been tried in the prodromal 

 stage, as far as we know. 



TROPICAL NEURASTHENIA. 



No disease among Europeans in the tropics deserves more careful 

 study by the practitioner than neurasthenia, because, though not 

 in itself fatal, still it leads to many of the petty worries felt and bad 

 tempers exhibited, and, in worse cases, may seriously hamper good 

 work being performed. The subject has been ably studied by Fales 

 in Americans returning from the Philippine Islands. 



etiology. — Tropical neurasthenia is apt to develop in white 

 people in any part of the tropics, but especially in those which are 



