1934.] PSYCHIATRY. 443

Epilepsy. XIII : Aura in Epilepsy. (Arch. of Neur. and Psychiat., vol. xxx,
p.@ Aug. , 1933.) Lennox, 11―.G., and Cobb, S.

The authors analysed the reports on 1,359 non-institutional epileptics. Aur@e
were present in 562%, which agrees with Gowers' 57% on 2,013 cases. They
were less frequent in patients having only petit nial or its equivalent than in

others. A history of aura was not less common in the mentally deteriorated. In
those who had had attacks for five years or longer the incidence of a history of
aura was 27% greater than in those who had had less than five years of seizures.
The mentally deteriorated more frequently had visceral aura@ ; the mentally
normal, aurie of pain, pariesthesia@ or numbness. Aura@ of potential localizing
value occurred in 70% of the patients with a history of injury of the brain

antedating the seizures, and in 41% of those without such a history.
G. W. H. T. FLEMING.

A mbulatory A utomatism in Epilepsy [L ‘¿�automatisme ambulatoise épileptique].
(Ann. Med. Psych., vol. xiv (ii), p. 609, Dec., 1933.) Marchand, C.

Of a series of 1,052 epileptics observed at the out-patients' department of the

Henri-Rousselle Hospital, 69 (64°@) had a history of ambulatory automatism.
This paper includes full reports and details on 43 cases (@@‘attacks). In 36 cases
the automatism occurred in persons previously subject to classical epilepsy ; in
5 cases convulsions only appeared at a later date, while in 2 cases there were typical

epileptic automatism without fits.
@Etiology differed in no way from that of other epileptics (infantile convulsions,

8 ; cranial trauma, 6 ; neuro-syphilis, i ; hereditary syphilis, 2). It is noted that

practically all subjects were adults at the time of the first fugue. The onset is
sudden, rarely preceded by an aura (2 cases), and very seldom directly by a convul
sion. Duration is variable—a few minutes to 24 hours. Return to consciousness

is usually sudden ; there is marked fatigue, the subject often sleeping for several

hours. In practically all the attacks there is complete amnesia for the incidents
of the automatism ; in a very few cases vague memory traces are observed. During
the automatism, in 37 cases the subject walked only ; in the others he bicycled,
trained, “¿�trammed ‘¿�‘¿�or motored. Characteristic of the epileptic fugue is the

absence of motive or end. The individual is clearly in a somnambulistic state ; the

higher faculties have ceased to function and walking is rarely normal.
The writer recognizes three degrees. In the first, medullary and motor centres

concerning walking alone persist. In the second, associated habitual reflexes

permitting the avoidance of obstacles and dangers are also uninhibited. In the

third degree the individual accomplishes in a mechanical fashion complicated
acts sufficiently correctly for his condition not to be commented upon.

A section is devoted to the differential diagnosis, which is considered to be
straightforward in the majority of cases. There is a further section on medico
legal problems. In the writer's experience, contrary to popular belief, the epileptic
in a fugue state is nearly always calm, showing no evidence of agitation, violence

or brutality. Of the patients observed, one attempted to strangle his wife, one

violated a grave, another stole, one left a restaurant without paying his bill and
three urinated in public. S. ‘¿�vI.COLEMAN.

Presbvophrenia [Uber Presbyophreniei. (Arch. f. Psychiat., vol. xcix, p.@ 1933.)
Bostroem, A.

The author thinks that presbyophrenia, although a definite clinical entity,
cannot be distinguished anatomically from other senile psychoses. He defines it

as a senile disorder in which there are no particular defects except disturbance
of memory and impressionability (Merkfahigkeit). He purports to discover

why. in some cases, the senile changes in the brain give rise to a clinical picture
of presbyophrenia. Twelve cases are described (i i females and i male) . All
patients not only showed a slightly hypomanic temperament, but were also very
active personalities, who had previously succeeded in coping with the stresses

LXXX. 30



444 EPITOME. - [April,

and realities of life. The somatic constitution showed that eight were pure pyknics,
and only one showed no pyknic traits at all. The course of the disease is very
protracted, six of the patients being over 8o years. Only three showed clinical
symptoms of cerebral arteriosclerosis.

The author believes that the pathogenic factor is represented by changes in
the brain, which could consist of arteriosclerosis or senile degeneration, and that
the personality constitutes the pathoplastic factor. But he presumes that the
cycloid temperament (personality) at the same time tends to prevent dementia
and volitional inertia, in contrast with the non-cycloid seniles, who do not use
their abilities, even if they are preserved to a certain extent. S. L. LAST.

Mental Aspects of Brain Tumours in Psychotic Patients. (Journ. Nerv. and Ment.
Dis., vol. lxxviii, pp.@ and 500, Oct—Nov., 1933.) Jameison, G. R.,
and Henry, G. IV.

From their experience with 26 psychotic patients who developed brain tumour,
the presence of which was established at autopsy, the authors draw various conclu
sions. They point out that there is no psychosis characteristic of brain tumour.
The clinical picture of brain tumour manifestations, superimposed upon a psychosis,
is characterized by changing contrasts and incongruities in the symptoms and signs,
and by evidence of organic disease of brain, which becomes increasingly obvious.

More than half of the patients are depressed, and a larger percentage are
distinctly apprehensive. At least one-fourth of the patients were suicidal. One
fourth had some insight into the fact that a serious complication had arisen in
their illness. G. W. T. H. FLEMING.

General Paretics Before and After Malarial Treatment : An Experimental Psycho
logical Investigation [Progressive Paraivtiker vor und nach der Malaria
behandlung : Eine experi@nentellpsychologische A rbeit] . (Zeitschr. f. d. ges.
Neurol. u. Psvchiat., vol. cxlvi, p. 66r, 1933.) lVeisfeld, M.

The author examined 29 paretics with various tests. He sets out to show
how the improvement achieved by malarial treatment can be demonstrated by
different tests. Such tests were carried out twice, first before, secondly after the
treatment. The following different psychical and psychomotor functions were
tested in this investigation : Memory, impressionability, the mental horizon (and
imaginative power), calculation, intellectual activity, the intelligence (in a more
restricted sense than usual), the power to deliver moral judgments, attention,
handwriting and manual speed. As the results are given in figures, the
improvement can be expressed in percentages.

Of all the cases, 45% only showed an improvement in the power to reach moral
judgments, 56% @flattention and 6, % in their manual speed, whereas 68—78%
of the patients had better results in the various other tests.

The author is not satisfied with the explanation given by other authors that
the intellectual improvements are due to an increase in activity only, but holds
that the various functions themselves have been changed for the better by the
malarial treatment. S. L. LAST.

Psychic Trauma and Hvperlh3roid Conditions [El trauma psIquico y los estados
hipertiroideos@.(La Semana Med., vol.xli,p.@ Feb.8, 1934.)RodrIguez,
A. D'A., and Lejtman, S.

Nine cases, uncomplicated by pathological antecedents or concurrent ailments,
have been fully studied. The emotional shock constantly reacts upon the thyroid
function, and is capable of disturbing it even in quite healthy subjects. The cases
present a clinical picture which is nearly always incomplete; the diagnosis is at
times difficult, but not impossible. The history of psychic trauma with the
immediate commencement of the symptoms should put us on the track of the