Nervous and mental diseases . symptoms of a true mania. Periodic mania is a formin which attacks of mania follow one another with perfectly normal butgenerally irregular intervals of days, months, weeks, or years. Theattacks themselves last from a few days to a few months. Usually theprodromal depressive stage is absent, the culmination rapid, and conva-lescence seldom marked by the interesting depressive affects of ordinarymania. The periodic attacks are very apt to be distinguished by thepresence of special symptoms, such as a reasoning tendency, tendenciesto impulsive acts, arson, stealing,
Nervous and mental diseases . symptoms of a true mania. Periodic mania is a formin which attacks of mania follow one another with perfectly normal butgenerally irregular intervals of days, months, weeks, or years. Theattacks themselves last from a few days to a few months. Usually theprodromal depressive stage is absent, the culmination rapid, and conva-lescence seldom marked by the interesting depressive affects of ordinarymania. The periodic attacks are very apt to be distinguished by thepresence of special symptoms, such as a reasoning tendency, tendenciesto impulsive acts, arson, stealing, assaults, sexual and alcoholic excesses,and to severe headaches. The longer periodic mania endures, the lessdistinct become the normal features of the intervals. Recurrent maniaand intermittent mania are only other names for periodic mania. Variousetiological factors have in times past given rise to such designations a&epileptic, alcoholic, morphin, puerperal, senile mania, etc., in some of MANIC-DEPRESSIVE INSANITY, 797. Fig. 30-4.—Manic phase of long duration. which the maniacal excitement takes a special color from its , the toxic deliria are generally acute hallucinatory conditions. Course of the Disease.—Re-covery takes place in some seventyper cent, of cases. Sometimes it is^exceedingly rapid, but usually theprogress is gradual and rhythmicalto the normal state. This rhythmis a sort of oscillation bet\yeen goodand bad days, but with constantimprovement. Occasionally thepatient improves steadily and un-interruptedly until recov^ered. Re-covery is sometimes not perfect, sothat we speak of it as recoverywith defect. Death takes place in but five percent, of cases. The cause of deathis sometimes exhaustion, as in acutedelirium ; more often an intercurrentaffection, such as pneumonia, neph-ritis, and the like. Heart di.^easeand alcoholism add greatly to thedanger of lethal termination. Diagnosis.—One must be care-ful not to confound delirium from fever with an
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