Clinical Cases

Abstract

A man, E. C—, aged twenty-eight, is at present a patient in the Northampton County Asylum. This man has since childhood suffered from epilepsy, and although at one time the fits were for several years in abeyance, just now they are frequent and often severe. The attendants, who have known him for many years, state that while the severe fits are of the usual type, the lesser ones are often followed by “antics” and “playing the fool.” In one of these less severe attacks, which I witnessed recently, the convulsions had all the characters of a genuine epilepsy, and were followed by the usual stage of stertorous passivity. But this stage was of short duration only, the patient suddenly springing up and adopting the “segment of a circle” position, the occiput and heels alone touching the ground. Suddenly relaxing, he then raised his trunk from the ground and bent forwards towards his feet five or six times in succession. Then, falling on his back, the knees were flexed and the thighs drawn up on the abdomen, and then as rapidly stretched out. This he repeated several times. Drawing up the thighs again, he placed his hands on his buttocks and rocked backwards and forwards, shouting loudly a stave or two of “We won't go home till morning.” Finally he burst into a loud laugh, gesticulated extravagantly, got up from the ground, picked up his hat, and sat down complacently on a bench. These last movements were performed quite automatically, and without the least evidence of conscious appreciation. In fact, he continued for some hours in a dreamy state, and not till the next day was he fully and clearly conscious. I have no doubt at all that the convulsion was a genuine epilepsy, and it is quite obvious that the subsequent performance corresponded in detail to the series of movements demonstrated by Richer in hysteria major.