. A treatise on nervous and mental diseases, for students and practitioners of medicine. Photograjih of a case of melancholia agitata. Melancholia with stupor is a form in which the stupidity comesearly in the disease, and is to be distinguished by this feature, aswell as by the degree of the melancholia, from the slight temporarystupidity which sometimes supervenes in convalescence from theother forms of insanity. In this form the patient sits mute, mo-tionless, almost expressionless {melancholia aftonita; angedonnerteMelaneholie of the ). (Figs. 164 and 168.) Occasionallythere are sl
. A treatise on nervous and mental diseases, for students and practitioners of medicine. Photograjih of a case of melancholia agitata. Melancholia with stupor is a form in which the stupidity comesearly in the disease, and is to be distinguished by this feature, aswell as by the degree of the melancholia, from the slight temporarystupidity which sometimes supervenes in convalescence from theother forms of insanity. In this form the patient sits mute, mo-tionless, almost expressionless {melancholia aftonita; angedonnerteMelaneholie of the ). (Figs. 164 and 168.) Occasionallythere are slight cataleptoid symptoms. The silence may at times beIjroken by some muttered expressi(^n of mental distress. When the 594 MENTAL DISEASES. patient is addressed, it is evident that he is confused mentally, and hewill look at one with a bewildered expression. Little as the face indi-cates it, however, these cases are tormented by the most frightfulmental terrors, and the patients will afterward speak of this period Fig. 1. Photograph of a case of melancholia attonita. with horror when they have retained memory of it. Fortunately,however, in this melancholia with stupidity, as well as in hallucina-tory melancholia, the memory is generally impaired throughout theworst periods of the disease. In any of these forms the patient may have certain vague distress-ing sensations in the prsecordia, causing great fear, and sometimesproductive of sudden outbreaks of violence (Prcecordialangst of theGermans). These sensations are probably ordinary prtecordial sen- . MELANCHOLIA. 595 sations, as of palpitation from intestinal reflex or functional cardiactrouble; and when we consider how apt they are to cause alarm inthe perfectly sane, we can imagine with what terror they will inspirea melancholiac as they are transmitted to his woe-producing cases subject to this prsecordial fear are dangerous. All these forms of melancholia have certain peculiarities in com-mon, namely : Suicidal
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