Dr. van Loon, the 'Psychiater and Neurologist of the S.T.O.V.I.A., Batavia', has had the opportunity of studying cases of Amok and Lattah at close quarters in the temporary lunatic asylum in Batavia, and he gives us a clearer insight into these conditions than has hitherto been presented.
Amok is usually regarded as 'a sudden attack of mad rage of the Malay man' in which he 'blindly attacks everybody he comes across, very often injuring and killing a good many people before he is "laid low, " as the saying goes'; but van Loon finds that 'the cause of the aggressive attack is not temper or rage, but an agony of fear, the patient in his hallucination imagining himself to be attacked by a tiger, a snake or a human enemy'. The
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reaction is frequently flight, and aggression only occurs when the patient meets obstacles, animate or inanimate.
Amok occurs as a symptom of acute confusion, which accounts for 50 per cent. of the cases admitted to the asylum, and is caused in 75 per cent. by malaria and syphilis. Nearly one-quarter of the cases are due to syphilis.
The reason why weapons play an important rôle is merely that the knife is the Malay's normal defence against plunder, etc.
Kraepelin classified Amok as an epileptic dream state, but van Loon tells us that not a single Malay epileptic out of a fairly large number ever 'ran Amok'.
Lattah, on the other hand, is a disease almost exclusively of women (98 per cent.) usually of middle age. Nearly all the patients are of the servant class, trained to obedience, and in Lattah, which is initiated by fright or other strong emotion, the patient screams, does everything she is told to do, however absurd or obnoxious, and is echopraxic and echolalic (pathologically imitative). Such symptoms can always be prolonged or induced by frightening the patient and alleviated by soothing her.
The initial fright is usually a highly sexual dream, such as numerous erect wriggling penes trying to attack the sleeper—or they have to be fried and eaten, and so forth.
Thus Lattah is a 'primitive affect reaction', and van Loon remarks that the reason why the Malays are subject to these curious maladies is that their Oriental psyche is normally more 'infantile-primitive', imitative and suggestible than that of Western races.
It is to be noticed that Lattah patients rarely present hysterical phenomena; therefore the malady is not a variety of hysteria, as was suggested by Kraepelin, Jelgersma and others.
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Stoddart, W.H. (1927). Clinical. Int. J. Psycho-Anal., 8:284-285