Delirium febrile

In Medical Jurisprudence. A form of mental aberration incident to febrile disease, and sometimes to the last stages of chronic diseases. The aberration is mostly of a subjective character, maintained by the inward activity of the mind rather than by outward impressions. "Regardless of persons or things around him, and scarcely capable of recognizing them when aroused by his attendants, the patient retires within himself, to dwell upon the scenes and events of the past, which pass before him. in wild and disorderly array, while the tongue feebly records the varying impressions, in the form of disjointed, incoherent discourse, or of senseless rhapsody." Ray, Med. Jur. 346. It comes on gradually, being first manifested by talking while asleep, and by a momentary forgetfulness of persons and things on waking. Fully aroused, however, the mind becomes clear and tranquil, and so continues until the return of sleep, when the same incidents recur. Gradually the mental disorder becomes more intense, and the intervals between its returns of shorter duration, until they disappear altogether. Occasionally the past is revived with wonderful vividness, and acquirements are displayed which the patient, before his illness, had entirely forgotten. Instances are related of persons speaking in a language which, though acquired in youth, had long since passed from their memory. See the definition of delirium by Bland, Ch., in Owing's case, 1 Bland, (Md.) Ch. 3S6, 17 Am. Dec. 311. The only acts which are liable to be affected by delirium are wills, which are often made in the last illness during the periods when the mind is apparently clear. Under such circumstances it may be questioned whether the apparent clearness was or was not real; and it is a question not always easily answered. In the early stages of delirium the mind may be quite clear no doubt, in the intervals, while it is no less certain that there comes a period at last when no really lucid interval occurs and the mind is reliable at no time. The person may be quiet, and even answer questions with some degree of pertinence, while a close examination would show the mind to be in a dreamy condition and unable to appreciate any nice relations. In all these cases the question to be met is, whether the delirium which confessedly existed before the act left upon the mind no trace of its influence; whether the testator, calm, quiet, clear, and coherent as he seemed, was not quite unconscious of the nature of the act he was performing. The state of things implied in these questions is not fanciful. In every case it may possibly exist, and the questions must be met. After obtaining all the light which can be thrown on the mental condition of the testator by nurses, servants, and physicians, then the character of the act itself and the circumstances which accompany it require a careful investigation. If it should appear that the mind was apparently clear, and that the act was a rational act rationally done, consistent one part with another, and in accordance with wishes or instructions previously expressed, and without any appearance of foreign influence, then it would be established. A different state of things would to that extent raise suspicion and throw discredit on the act Yet at the very best it will occasionally happen, so dubious sometimes are the indications that the decision will be largely conjectural. 1 Hagg Eccl. 146, 256, 502, 577; 2 id. 142; 3 id. 790; 1 Lee Eccl. 130; 2 id. 229. See Insanity. DELIRIUM TREMENS (called, also, mania-a-potu). In Medical Jurisprudence. A form of mental disorder, usually accompanied by tremor, incident to habits of intemperate drinking, which generally appears as a sequel to a period of unusual excess or after a few days' abstinence from stimulator acute inflammatory disease, such as pneu monia. The nature of the connection between this disease and abstinence is not yet clearly understood. Where the former succeeds a broken limb, or any other severe accident that confines the patient to his bed and obliges him to abstain, it would seem as if its development were favored by the constitutional disturbance then existing. In other cases, where the abstinence is apparently voluntary, there is some reason to suppose that it is really the incubation of the disease, and not its cause. Its approach is generally indicated by a slight tremor and faltering of the hands and lower extremities, a tremulousness of the voice, a certain restlessness and sense of anxiety which the patient knows not how to describe or account for, disturbed sleep, and impaired appetite. These symptoms having continued two or three days, at the end of which time they have usually increased in severity, the patient ceases to sleep altogether, and soon becomes delirious at intervals. After a while the delirium becomes constant, as well as the utter absence of sleep. There is usually an elevation of temperature of two or three degrees. This state of watchfulness and delirium continues three or four days, when, if the patient recover, it is succeeded by sleep, which at first appears in uneasy and irregular naps, and lastly in long, sound, and refreshing slumbers. If sleep does not supervene about this time, the disease may prove fatal. The mental aberration of delirium tremens is marked by some peculiar characters. Almost invariably the patient manifests feelings of fear and suspicion, and labors under continual apprehensions of being made the victim of sinister designs and practices. He imagines that people have conspired to rob and murder him, and insists that he can hear them in an adjoining room arranging their plans and preparing to rush upon him, or that he is forcibly detained and prevented from going to his own home. One of the most common hallucinations in this disease is that of constantly seeing devils, snakes, or vermin around him and on him. Under the influence of the terrors inspired by these notions, the wretched patient often endeavors to cut his throat, or jump out of the window, or murder his wife, or some one else whom his disordered imagination identifies with his enemies. Delirium tremens must not be confounded with other forms of mental derangement which occur 1b connection with intemperate habits. Hard drinking may produce a paroxysm of maniacal excitement, or a host of hallucinations and delusions, which disappear after a few days' abstinence from drink and are succeeded by the ordinary mental condition. In U. S. v. Mc Glue, 1 Curt. cc. 1, Fed. Cas. No. 15,679, for instance, the prisoner was defendant on the plea that the homicide for which he was indicted was committed in a fit of delirium tremens. There was no doubt that he was laboring under some form of insanity; but the fact, which appeared in evidence, that his reason returned before the recurrence of sound sleep, rendered it very doubtful whether the trouble was delirium tremens, although in every other respect it looked like that disease. By repeated decisions the law has been settled in this country that delirium tremens annuls responsibility for any act that may be committed under its influence: provided, of course, that the mental condition can stand the tests applied in other forms of insanity. The law does not look to the remote causes of the mental affection; and the rule on this point is, that if the act is not committed under the immediate influence of intoxicating drinks, the plea of insanity is not invalidated by the fact that it is the result of drinking at some previous time. Such drinking may be morally wrong; but the same may be said of other vicious indulgences which give rise to much of the insanity which exists in the world; Whart. Cr. L. § 48; Beasley v. State, 50 Ala. 149, Am. 292; Cluck v. State, 40 Ind. 263; Rob- 435: U. S. T. Mc Glue, 1 Curt. cc. 1, Fed. Cas. No. 15,679; U. S. v. Drew, 5 Mas. 28, Fed. Cas. No. 14,993; State v. Wilson, Ray, Med. Jur. 520; State v. Harrigan, 9 Houst. (Del.) 309, 31 Atl. 1052: Ayres v. State (Tex.) 1:6 S. W. 396. In England, the existence of delirium tremens has been admitted as an excuse for crime for the same reasons; Reg v. Watson and Reg v. Simpson, 2 Tayl. Med. Jur. 599; 14 Cox, Cr. Cas. 565, In the case of Birdsall, 1 Beck, Med. Jur. 808. it was hold that delirium tremens was not a valid defence, because the prisoner knew, by repeated experience, that Indulgence in drinking would probably bring on an attack of the disease; see also in Roberts y. People, 19 Mich. 401. See Drunkenness.

In medical jurisprudence. A form of menial aberration incident to fevers, and sometimes to the last stages of chronic diseases.

Defined under Delirium in Black's Law Dictionary.

In medical jurisprudence. A form of mental aberration incident to fevers, and sometimes to the last stages of chronic diseases.