Case of Acute Loss of Memory
Authors: Savage Geo. H. 
Published: February 2018

In describing the accompanying case, it will be seen that the loss of memory has been more sudden and more extreme than generally happens. This case suggests the difficult question as to whether loss of memory is to be considered as unsoundness of mind. Legally, one has no doubt but that persons who have extreme losses of memory would be considered as unfit to transact business. In noticing the development of the higher nervous organisms, one has to place memory as the great builder of nerve power. The mere fact that impressions are received goes for little in the construction of a mind, but the fact that these impressions can be stored and compared, points to the commencement of a highly-organised power. If, then, we meet with cases in which the perceptions remain, but the storage is wanting, the patient must be looked upon in very much the same way as the undeveloped. Those of us who are used to mix much with the insane, are aware of the persistence of memory in the majority of persons suffering from ordinary insanities, but we are also used to cases in which the memory is affected in various ways and in various degrees, so that in one patient suffering from acute delirious mania we learn, after recovery, that there has been a blank in his recollection—a blank that was represented by the period of extreme delirious excitement, the time in which the incoherence and inconsequence of ideas were most marked—when perception seemed clear, but appeared to be associated with a peculiar reflection, so that when a word was said or an action done, it was repeated or mimicked by the insane person; or else the memory was so affected that groupings and verbal associations of words existed, but the memory of them afterwards was not retained. Again, we have patients in whom the memory is lost after a severe convulsive seizure, whether epileptic, apoplectic, or general paralytic. In these the memory may be only temporarily affected, or may be permanently affected. In epilepsy the memory is generally but temporarily affected, the patient having no recollection of what has happened during the attack, so that either with the petit mal or grand mal the patient is unconscious of what takes place. This was seen by me the other day in a little girl of 11, who had neurotic inheritance, which was exhibited by falls which were incomprehensible to her mother. The child, without any cry or change of appearance, suddenly fell, wherever she happened to be, or whatever she had in her hand, frequently caused injury to herself and destruction of property, but without the slightest knowledge that there had been a lapse in her life. This case was treated as due to epilepsy with the greatest advantage. Epilepsy, sooner or later does affect the memory, and it is said that the loss of memory depends directly upon the number of the fits, and not upon their severity. In apoplexy one is quite used to meet with cases in which the progressive dementia is most marked by the progressive loss of memory; and again, in general paralysis, of whatever nature the fits may be, the loss of memory is progressive, increasing after each fit, then for a time improving, to become again still more marked after the next convulsive seizure. The case that I have to report differs from all the classes I have already mentioned, and I find it difficult to fix on a definite diagnosis. If forced to give one, I should say that my opinion is that the case will prove to be one of general paralysis. But if this is to be the case there are sufficient points of interest still left to make it worth while recording.