Of the complicating insanities, the traumatic variety is a Variety of mania following severe injury, such as guinshot wound. and is charae terized by great restlessness, delirium, and jaw titation. Choreic insanity rarely occurs in pro tracted cases of chorea, maniacal outbreaks, confused delirium. emotional change. and impair ment of memory resulting. Dementia may fol low. The post febrile insanities are psychoses complicating diseases. accompanied by high fever. such as scarlet fever, smallpox. pneumonia, typhus and typhoid fevers. As a rule, the pa tients are lucid during the day, hut suffer from delirium, illusions and hallucinations, delusions of identity. and generally anxiety, during the night. Even though maniacal and melancholic states alternate, and confusion of ideas is con stant throughout. the prol_mosis for recovery is generally favorable. Ilhemnatie. gouty and toxic insanitie, are similar. Phthisieal insanity, which is intercurrent in some cases of fatal tuber culosis. resendoles the post-febrile variety, but there is also a considerable egotism and sonic delusions of grandeur.
It will he seen that perversion of the will is present in almost every ease of insanity. This tact led Hammond to incorporate in his definition of the term the statement that in insanity 'mental freedom is weakened. perverted. or de
stroyed.' Free determination of the will is pre sented by delusions, by inferences from delusions, by abnormal emotional states, by delirium, by incoherence of ideas, or by dementia. Often the mental processes of the insane are identical with those of the sane. hut the premise from which the argument springs is false. In many torus of insanity the ego is preeminent. A lunatic may consider himself powerfully equipped, mentally and physically. Ile is ex pansive, elated, extravagant, arrogant. and gar rulous. This condition is termed hyperbulin. Another may be depressed. dejected, apathelie, mentally slow and impeded. hopeless, and even suicidal. This condition is termed abulin. Faneiful subdivisions have been Made by some animists, founded upon certain trains of thought or often reeurring ideas, and terms have been devised to indicate the trend of imagination in patients experiencing these ideas. For example, agoraphobia denotes fear of being in an open place or street; claustrophobia, fear of hying shut in a room or house; mysophobin, fear of defilement, pollution. or contamination: pyro phobia, fear of tire: nsfraphobin. fear of light ning; nuthropophobia. fear of soeiety. This list might be prolonged indefinitely.