Hans Förstl


From

A.L.J. Bayle's

Recherches sur L'arachnitis Chronique, [Paris, 1822].

Translated by Merril Moore and Harry Solomon.

OBSERVATIONS ON CHRONIC ARACHNITIS WITH MENTAL DISTURBANCE,
FIRST OBSERVATION: CHRONIC ARACHNITIS, MONOMANIA, DEMENTIA


         Claude-Francois L., of a quite robust general make-up, 48 years old, was a lemonade seller who had
drunk excessively in the past, who had indulged immoderately in the pleasures of venery, and who had
recently met with losses that had caused him great sorrow.
        In April 1818, he suddenly lost consciousness, which he regained a short time afterward. This attack
was followed by a hemiplegia of the right side, which slowly disappeared; from then on his intellectual
faculties were disordered and there followed a sort of 'ambitious délire' which dominated the patient
incessantly, and which gradually increased.
        In the month of October he is the Emperor Napoleon, he has immense wealth; frothy thousand barrels of  gold; but on other subjects his ideas keep a certain coherence. Ordinarily calm, he is sometimes extremely excited, and even violent if he is opposed. He speaks with great difficulty and walks with a staggering gait.  He does not sleep; he eats well, and his legs are slightly edematous.
        On October 27 he is brought into Charenton Royal Hospital in a demented state, with ideas that are
predominantly ambitious, and with his partial paralysis more advanced.
        During the first two month little change is noted in his condition.
        On Jan. 4 1819, there are general paleness and flaccidity; sensations are obtuse, and no attention is paid to objects around him, nor does he busy himself with things near him. He hears with difficulty any
questions put to him, and in order to make him understand anything it must be repeated to him several
times and presented to him in several different manners. He retains only a few incoherent ambitious
ideas, which he expresses when he is spoken to. No matter what he is asked his replies are that he is
emperor, that his two sons are emperors, that they live at the Tuileries, that he has millions and still more millions and that his wife has three croix d'honneur. On any other matter he is unable to associate even
the simplest ideas. If he is asked of what country he is emperor, he replies 'of Besançon,' to which he joins
Germany and France.
        He can hardly stand up; he walks slowly, staggering with each step he makes and dragging his feet. He is calm, apathetic and silent, and stays usually in an armchair to which he is tied to keep from falling. At other times he walks in the yard or halls. At moments he talks in a low voice, repeating endlessly the
words emperor, millions, diamonds, etc. His voice is broken and trembling; his pronunciation is very
difficult. He is incontinent of feces and urine. He eats well and asks for food often, but he is very thin.
        On January 14, he cannot get up; his face is greatly altered; his faculties are more obliterated, and he
has excoriations on various parts of his body.
        On January 30, there are weakness, emaciation, edematous legs, continual silence, no reply to
questions put to him, except occasionally when they relate to his 'ambitious délire,' in which case he says
merely, 'emperor, I am emperor...'
        On February 8, there is complete physical and mental prostration. He cannot offer a single word or make any motion to indicate that he understands questions. His face is disturbed by slight convulsive
movements, and his eyes are fixed and inexpressive. All the parts of his body that are exposed to pressure
or even slight rubbing, such as the sacrum, the trochanters and the elbows, have become the site of livid
excoriations and gangrenous sores. The pulse is weak and slow, and these symptoms increase. On February 9 there is a period of agony lasting a few hours, then death.