BELL'S MANIA
S. H. Kraines M. D.1
1 Chicago
(1) There are cases of acute excitement that are classified under several headings with apparently no recognition as to the uniformity of symptomatology. These cases have been diagnosed as Bell's Mania, typhomania, acute delirious mania (manic-depressive psychosis), delirium grave, acute delirium, specific febrile delirium, and collapse delirium.
(2) Luther Bell described these cases in 1849 and the description is slightly modified as follows: There is a sudden onset; exceedingly great overactivity; marked sleeplessness; great push of speech with statements that are disconnected at times by reason of the rapidity of flow; disconnected and poorly systematized delusions; transient hallucinations that border on illusions; appearance of confusion, but when one insists that the patient answer the questions, the patient can "suspend the intellectual wanderings" long enough to answer correctly as to orientation. The course of the illness is from three to six weeks, with a fatal termination in a large percentage of cases, apparently from cardio-vascular failure due to overactivity. The cases that recover have no after symptoms. No pathological evidence of note has been found by later workers.
(3) Treatment is recommended in the form of sufficient sedative, regardless of the dosage, to enable the patient to get some rest. In our case ordinary sedatives failed and though over 125 grains of sodium amytal were given in three days the patient slept comparatively little. However, the overexcitement was quelled.
(4) For the sake of clarity in the studying of this group, and until more definite findfngs are brought forth, it is suggested that these cases be called Bell's Mania, after the original observer.
