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Apoplexy

mental, power, capacity, words, sufficient, loss, act, communicate and usually

APOPLEXY. In Medical Jurisprudence.

The group of symptoms arising from rupture of a minute artery and consequent hem orrhage into the substance of the brain or from the lodgment of a minute clot in one of the cerebral arteries.

The symptoms consist usually of sudden loss of consciousness, muscular relaxation, lividity of the face and slow stertorous res piration, lasting from a few hours to several days. Death frequently ensues. If con sciousness returns, there is found paralysis of some of the voluntary muscles, very fre quently of the muscles of the face, arm, and leg upon one side, giving the symptom of hemiplegia. There is usually more or less mental impairment.

The mental impairment presents no uniform char acters, but varies indefinitely, in extent and sever ity, from a little failure of memory, to an entire abolition of all the intellectual faculties. The pow er of speech is usually more or less affected; it may he a slight difficulty of utterance, or an in ability to remember certain words or parts of words, or an entire loss of the power of articula tion. This feature may arise from two different causes—either from a loss of the power of language, or a loss of power in the muscles of the larynx. This fact must be borne In mind by the medical jurist, and there can be little difficulty In distin guishing between them. In the latter, the patient is as capable as ever of reading, writing, or under standing spoken language. In the former, hs is unable to communicate his thoughts by writing, cause they are disconnected from their articulate signs. He recognises their meaning when he sees them, but cannot recall them by any effort of the perceptive powers. This affection of the faculty of language is manifested in various ways. One per son loses all recollection of the names of persons and things, while other parts of speech are still at command. Another forgets everything but substan tives, and only those which express some mental quality or abstract idea. Another loses the memory of all words but yes or no. In these cases the pa tient is able to repeat the words on hearing them pronounced, but, after a second or third repetition, loses them altogether.

See APHASIA.

Wills and contracts are not unfrequently made in that equivocal condition of mind which sometimes follows an attack of apo plexy or paralysis ; and their validity is contested on the score of mental incompeten cy. In cases of this kind there are, gene rally, two questions at issue, viz., the abso lute amount of mental impairment, and the degree of foreign influence exerted upon the party. They cannot be considered independ ently of each other. Neither of them alone might be sufficient to invalidate an act, while together, even in a much smaller degree, they would have this effect.

In testing the mental capacity of para lytics, reference should be had to the nature of the act in question. The question is not, had the testator sufficient capacity to make a will? but, had he sufficient capacity to make the will in dispute? 'A capacity which might be quite adequate to a distribution of a little personal property among a few near relatives would be just as clearly inadequate to the disposition of a large estate among a host of relatives and friends possessing very unequal claims upon the testator's bounty. Here, as in other mental conditions, all that is required is mind sufficient for the purpose, neither more nor less. See DEMENTIA; DE LIRIUM; IMBECILITY; MANIA. In order to arrive at correct conclusions on this point, we must be careful, among other things, not to confound the power to appreciate the terms of a proposition with the power to discern its relations and consequences.

In testing the mental capacity of one who has lost the power of speech, it is always difficult, and often impossible, to arrive at correct results. If the person is able and willing to communicate his thoughts in writ ing, his mental capacity may be clearly re vealed. If not disposed to write, he may communicate by constructing words and sen tences by the help of a dictionary or block , letters. Failing in this, the only other tellectual manifestation possible is the ex pression of assent or dissent by signs to prop ositions made by others. Any of these means of communication, other than that of writing, must leave us much in the dark respecting the amount of intellect possessed by the par ty. If the act in question is complicated in its relations, if it is unreasonable in its dis positions, if it bears the slightest trace of foreign influence, it cannot but be regarded with suspicion. If the party has only the power of assenting or dissenting, it must always be impossible to decide whether this does not refer to the terms rather than the merits of the proposition; and, therefore, an act which bears no other evidence than this of the will of the person certainly ought not to be established. Besides, it must be considered that a will drawn up in this man ner is, actually, not the will of the testator, since every disposition has originated in the minds of others ; Ray, Med. Jur. 363. The phenomena and legal consequences of para lytic affections are extensively discussed in Clark v. Fisher, 1 Paige (N. Y.) 171, 19 Am. Dec. 402 ; 1 Hagg. Eccl. 502, 577 ; 2 id. 84 ; 1 Curt. Eccl. 782; Parish Will Case, 4 vols. N. Y. 1858. And see DEATH; INSANITY.