has stood still some time and the steam-pressure is becoming dangerously high.
Much mental instability is found among sufferers from chronic heart-disease, and many and pronounced are the mental modifications induced. In one case, I remember well, a very old patient, who was the subject of aortic obstruction, became remarkably polite when the results of the cardiac lesion were very marked, a mental attitude far removed from that which he habitually assumed. Usually a totally opposite character of change is produced, and the effect is to cause the mental operations to be imperfect, unsustained and unequal, while there are present suspicion, doubtfulness, vacillation, and caprice. Indeed, the mental change is usually for the worse; and along with intellectual enfeeblement there is an alteration of the emotional products which we have seen to be allied with cerebral depletion. The false and morbid feelings which are the products of imperfectly nourished cerebral centres bear the same relation to normal thought that Emerson says evil does to good—it is good in the making; and more perfect elaboration of the outcomes of emotional centres would give us healthy instead of morbid feeling.
The mental attitude of sufferers from heart-disease is usually one of caprice, unsustained volition, together with suspiciousness and groundless fear—imperfect emotional products.
Another marked mental attitude is furnished by those who suffer from gout in any of its forms, for suppressed gout is the most protean of diseases. We have already seen how gout-poison stimulates the intellect in the earlier stages of granular kidney; what we may now consider is the mental modification produced by advanced disease. There is a mixture of explosiveness, the gouty temper, with suspicion and depression, the consequences of spasm of the intra-cranial arteries. Instead of the well-sustained blood-pressure of the early stages with the stimulant gout-poison irritating the cerebral cells into activity, we have the stimulant quality of the blood together with an impaired and insufficient supply. The resultant product is a blended compound of irritability and suspicion, bad temper and anxiety, the latter all the more aggravating from a consciousness that it is not mere illusion, but an emotional hallucination.
Such individuals are the terror of their dependents and the bêtes noires of their domestics. There is such a villainous state of temper, at times ascending to ferocity, that the person becomes simply intolerable; the unfortunate sufferers themselves being still further tortured by the haunting impression that they are utterly unreasonable, and that their attitude does not arise from any provocation from without, but that it takes its origin in some abnormal condition existing within. In one case well known to me the sufferer sought relief in religious exercises, in resort to her Bible and to prayer—it is needless to say without the desired result. What she needed was not spiritual
