gested, irritable, confused, and trembled all over; he appeared excited; consciousness was disturbed, and remained so for hours.
At times, when he is free from the sensations that start from the scar, he seems kind, free, willing, and open, though he is mentally weak and cloudy. P. was not sentenced. (Vide Friedreich's Blätter for full report.)
Periodical Insanity.
Just as in cases of non-periodical mania, an abnormal intensity or a noticeable prominence of the sexual sphere is very often manifested in the periodical attacks (v. infra, "Mania").
The following case, reported by Servaes (Arch. f. Psych.), shows that it then may also be perverted:—
Case 161. Catharine W., aged 16; she has not yet menstruated; previously healthy.
Seven weeks before admission (December 3, 1872), melancholic depression and irritability. November 27th, maniacal outbreak, lasting two days; thereafter, melancholic. December 6th, normal condition.
December 24th (twenty-eight days after the first maniacal attack), silent, shy, depressed. December 27th, exaltation (jolly, laughing, etc.), with violent love for an attendant (female). December 31st, suddenly melancholic catalepsy, which disappeared after two hours. January 20, 1873, new attack like the previous one. A similar one on February 18th, with traces of menses. The patient had no memory whatever for what occurred in the paroxysms, and blushed scarlet with astonishment and shame when told about them.
Thereafter there were abortive attacks, which entirely disappeared, to give place to the normal mental condition in June.
In a case reported by Gock (Arch. f. Psych., v), which was probably circular insanity, in a man of very bad heredity, during the stage of exaltation there was manifestation of sexual feeling for men. In this case, however, the patient thought himself a girl, and it is questionable whether the sexual inclination was induced by the delusion or by a contrary sexual instinct.
In connection with these cases of abnormal manifestation of the sexual instinct are those which, as a symptom of mania, manifest an abnormal and frequently a perverse sexual instinct in an impulsive way, analogous to dipsomania, which forms the nucleus of the psychical disturbance, while in the intervals the sexual instinct is neither intense nor perverse.
