ACTIVITY.
is in the series of morbid phenomena peculiar to mental diseases that the processes of automatic activity generally present themselves with their most signifi cant characters of intensity, and in the most diverse forms.
It is, in fact, the automatic activity of the cerebral cell that always more or less comes into play, in general or partial delirium, and in irresistible impulse, being every where essentially active, and everywhere present. It is always this that reveals itself with those characters of irresistibility, and that evident freedom from voluntary action which are its special characteristics.
Thus general delirium, with that exuberance of thoughts which clash and associate in the most unex pected manner in the brain of the patient, is the highest expression of the automatic activity of the cerebral cells in a condition of irrepressible erethism. It is enough to have seen patients at this period of extreme over-excitement, to recognize the fact that the NVill is powerless to repress the disorder ; that the very elements that constitute human personality are them selves in disarray ; and that in this agitation these incoherent words, these sonorous explosions to which all the cerebral elements contribute in so unconscious a manner, we cannot fail to recognize the tumultuous expression of the forces of normal energy, unchained and hurried into a very whirlwind of morbid over activity.
In some forms of partial delirium, we see patients less vehemently hurried along in spite of themselves ; incessantly delirious on certain points, conceiving the same delirious conceptions, always repeating the same phrases, without perceiving that their ideas are in complete discord with reality. Thus they say they are ruined, robbed by every one, poisoned ; and even if anyone should reason with them, proof in hand, re specting the folly of their apprehensions, and reassure them in a thousand ways, the automatic activities of their brain are so set in a false direction that they incessantly return to it, just as a contracted member on being extended will resume its former position. They are perpetually complaining, they incessantly repeat the same phrases, the same vague apprehensions, and unconsciously fall back into the same ruts followed without conviction, without participation of their con scious personalty, merely by dint of the automatic forces of their troubled mind.* In other circumstances automatic activity is exercised in a morbid manner within a comparatively limited circle, and only engages certain zones of the cortical substance, the others remaining comparatively un affected ; as we see for instance, certain cutaneous phenomena reveal themselves in patches, in little islets on the surface of the skin, leaving sound regions at intervals. Thus, in the cases to which we allude, the perceptive regions of the in which the manifestations of conscious personality take place, are sometimes spared, and in a condition of complete integrity, while the neighbouring regions are invaded by different kinds of morbid processes ; and then we witness a strange phenomenon—a sort of duplication of the mental unity. The individual, thus divided into
two parts—one portion of himself remaining healthy, while the other is at the mercy of the phenomena automatic, involuntary impulse—looks on, as a conscious spectator, at certain extravagant acts that he is forced to commit, at certain senseless words that he utters. He is in a manner reduced to the painful position of the tetanic patient, who at the moment of the attack sees his muscles escape from the influence of his will, con tract under the influence of the cells of the spinal cord, in a paroxysm of automatic, irresistible activity, and thus become unwieldable instruments which cease to belong to him.
The annals of mental diseases include numerous ex amples of this state of dissociation of the vital forces of cerebral activity. There are patients sometimes who write and describe their distresses—the involuntary agonies through which they pass, the words they have pronounced unwittingly ; how they are impelled to speak in spite of themselves, to say what they N\ ould not have wished to say, to go through ridiculous gesti culations, and to commit extravagances they believe themselves incapable of restraining.
A lady described by Falret uttered cries, committed all sorts of disorderly acts, and felt herself the more to be pitied, because she knew that they were acts of madness, but could not avoid committing them.* A patient described by Moreau (of Tours) presented analogous symptoms :— X—, in consequence of grief; became irritable in temper, and was seized with eccentric ideas which his reason disapproved. Suddenly the idea of tossing his bed would occur to him ; but he would ask himself what was the good of it. Or he would be tempted to throw his hat upon the ground without a motive. In conversation if any one dared to contradict him, a sud den desire to beat his adversary seized him, but he re strained himself by thinking of the absurdity he would thus commit ; and a crowd of delirious ideas would in cessantly traverse his mind without his permitting any one to suspect him of madness, so short was the duration of his paroxysm.t These strange phenomena, these general or partial deliriums, these strange impulses, of which we see abor tive specimens in certain pregnant women, constitute, in the form of suicidal or homicidal impulses, the essen tial morbid elements, and in a manner the primary factors of mental pathology. They are all, in different degrees, derived from the fundamental properties of the cerebral cell, from its automatic activity past into a phase of inveterate erethism. It is always the same fundamental property which is at the bottom of all morbid manifestations of the brain, and which, always present, always identical with itself, either in normal or conditions of the life of the brain, becoriles the source of all the disorders and all the anomalies of mental life.