Paralytic Insanity and its Organic Nature

1866 ◽  
Vol 12 (59) ◽  
pp. 348-367
Author(s):  
Franz Meschede ◽  
G. F. Blandford
Keyword(s):  
Mental Disease ◽  
General Paralysis ◽  
Points Of Interest ◽  
Fatal Form ◽  
The Subject ◽  
Morbid Anatomy ◽  
Postmortem Examinations

The disorder commonly called “general paralysis of the insane” presents so many points of interest to the pathologist and the physician, that as a necessary consequence it forms the commonest topic among the writings of those who specially study insanity. But after so much observation and so many treatises, it is disheartening to find that even now scarcely more than one fact with regard to it is laid down as settled and established beyond the possibility of doubt. One there is, the saddest that can be. It is, that for this malady we hitherto have found no cure; that to diagnose it is to pronounce the sentence, not only of incurable insanity, but also of speedy death. The marvel of the whole is, that although death occurs in every case at no very distant period, though postmortem examinations of general paralytics are made by hundreds every year in this and other countries, yet even at this day no two observers are agreed as to the pathology and morbid anatomy, as to the part in which it has its origin, or which constitutes its peculiar and proper seat. No wonder that the whole of the morbid anatomy of insane brain is vague and ill-defined, when this, the specially fatal form of mental disease, still hides itself from usâ still wraps itself in the mystery which envelopes all that relates to mind. I make no apology for drawing the attention of the readers of this Journal to a paper on the subject, published in the October and November numbers of ‘ Virchow's Archives/ 1865, and for giving a short and necessarily imperfect summary of its contents, it being too long for reproduction. But as every outline must needs be unsatisfactory, I trust my readers will go themselves to the original. In default of opportunity of examining many brains of paralytic patients, I present as a contribution to the English treatises on the subject these observations of another.

scholarly journals Classification of Insanity

1886 ◽  
Vol 32 (138) ◽  
pp. 233-234
Keyword(s):  
Mental Disorders ◽  
Mental Disease ◽  
International System ◽  
General Paralysis ◽  
The Subject ◽  
The University

It will be remembered by readers of the Journal that the subject of the classification of mental disorders was discussed at the Congress of Psychiatry, held at Antwerp in September last, and that certain members of the Congress representing different nationalities were appointed to obtain the best-recognised classifications of medico-psychologists in their respective countries, in the hope of obtaining an international system on which all might agree for practical purposes. The nomination of this Commission arose out of a paper read by M. Lefebvre, Professor in the University of Louvain, in which he himself laid down as types of mental disease, idiocy, cretinism, general paralysis, dementia, toxic forms of insanity, mania, melancholia, and circular insanity. The author did not confine himself to classification, but included in his statistical investigations, the number of insane persons in a given area, the causes of insanity in general, the duration of the disease, and its termination and mortality. However, the question of classification took precedence of all others.

The Bacteriological Examination of the Urine in some Cases of General Paralysis

1913 ◽  
Vol 59 (247) ◽  
pp. 596-605 ◽  
Author(s):  
E. Barton White
Keyword(s):  
Mental Disease ◽  
Intestinal Flora ◽  
Bacteriological Examination ◽  
General Paralysis ◽  
Pathological Conditions ◽  
Mental Diseases ◽  
The Subject ◽  
Micro Organisms

The occurrence of micro-organisms in the urine is well known to be associated with a variety of pathological conditions, among which mental diseases have been included. A definite connection between urinary bacteria and insanity, however, does not seem to have been made out, the subject being even more obscure than the relation of the intestinal flora to mental disease, which has been much more frequently investigated.

On General Paralysis

1860 ◽  
Vol 6 (32) ◽  
pp. 198-205
Author(s):  
Harrington Tuke
Keyword(s):  
Mental Disease ◽  
General Paralysis ◽  
Tongue Muscles ◽  
History Of ◽  
Fatal Form ◽  
Last Stage ◽  
The Brain ◽  
Blue Gum

In attempting to describe the rise and progress of the paralysis, that forms one of the most remarkable symptoms of ‘paralytic insanity,’ I propose to notice first the affection of the muscles of the tongue, which is generally that which most strongly arrests the attention of the physician, who sees a patient in the second or fully-developed stage of the malady. In the last stage, the power of articulation is entirely gone; in both of these the paralysis is so marked, and the evidence of mental disease so clear, that the nature of the case can hardly be mistaken. It is in the very onset of the malady, that the peculiar lisp or failure of utterance, indicating disorder of the nervous centres, at or near the orifice of the nerves supply in the tongue muscles, is of paramount importance in the diagnosis, because if this symptom be superadded to eccentricity of conduct, or distinct delusion, there can remain but little doubt as to the existence of this special and almost invariably fatal form of disease. The alienist physician accustomed to watch the progress of general paralysis, and to recognize its slightest indication, cannot mistake the faulty pronounciation in question, for that of any other form of malady; but inasmuch as there are several affections of the speech that might mislead an unskilled practitioner, it may be useful to describe some of these derangements of the apparatus of articulation, and specify their points of difference. In the first place, an affection of the speech, very much resembling the embarassed articulation of incipient paralytic insanity, may be the result of temporary local congestion at the base of the brain, or may be produced by sudden fright, or by the action of poisons, particularly aconite; the indistinct utterance attending intoxication, is a familiar instance of poisoning of this kind: and all these are easily distinguished by the suddenness of their occurrence, and by their history, from the stutter of general paralysis. The articulation of the habitual stammerer is sometimes not unlike that which is the result of serious organic mischief; and still more striking in its resemblance, is the hesitation of speech, that may be observed in some cases of poisoning by lead. The ordinary signs of saturnine poisoning, the blue gum-line, the dropping of the wrist, &c., will mark this latter malady—the history of the case will prevent any mistake in the former. I may mention here, that I believe it to be an exceptional occurrence to find a person of unsound mind who stammers; such a case at least must be very uncommon, a fact which I can only account for on the supposition that the greater disease prevents any manifestation of the minor nervous derangement.

Italian Retrospect

1899 ◽  
Vol 45 (191) ◽  
pp. 804-806
Author(s):  
W. Ford Robertson
Keyword(s):  
Physical Health ◽  
Cardiac Disease ◽  
Mental Disease ◽  
Natural Sleep ◽  
General Paralysis ◽  
Physical Conditions ◽  
Therapeutic Value ◽  
Sensory Motor ◽  
The Subject

The Use of Lactophenin as an Hypnotic.—Christiani (Il Manicomio moderno, 1898, No. 2) has recently very strongly advocated the use of lactophenin as an hypnotic in the sleeplessness of the insane. Although his paper has already been noticed in this country (see Brit Med. Journ., 1898, vol. ii, Epitome, par. 448), in view of the probable importance of the subject, and the fact that the alleged therapeutic value of the drug has received strong confirmation from the experiments of Namirez (Brit. Med. Journ., 1899, vol. i, Epitome, par. 128), it may perhaps be useful to give an account of his observations here. He states that he has used lactophenin as an hypnotic in over two hundred cases of insanity, including practically all its various forms. He administered it in doses of from two to three grammes suspended in sweetened mucilage, one hour after supper. He concludes that the drug has an hypnotic action which is certain, rapid, intense, prolonged, and free from any danger. This action manifests itself in from half an hour to one hour after administration. The sleep induced resembles natural sleep. It is profound, quiet, and restorative, lasting generally from four to nine hours. Return to consciousness is not accompanied by any sensory, motor, or gastro-intestinal disturbances. The drug has no cumulative action. Its prolonged use does not give rise to inconvenience of any kind. In one case of general paralysis its administration was followed by jaundice, which, however, he thinks may have been due to some other cause. He has not found any contra-indication to its use in the existence of morbid physical conditions in the insane, such as nephritis cardiac disease, senility, pneumonia. & c. It may be given in any form of mental disease. In some instances it has failed, chiefly in cases of severe delirium. Like other hypnotics, it tends in many cases to gradually lose its effect. He believes that lactophenin is the hypnotic par excellence in insomnia of the insane accompanied by serious involvement of the physical health.

On General Paralysis

1860 ◽  
Vol 6 (32) ◽  
pp. 198-205
Author(s):  
Harrington Tuke
Keyword(s):  
Mental Disease ◽  
General Paralysis ◽  
Tongue Muscles ◽  
History Of ◽  
Fatal Form ◽  
Last Stage ◽  
The Brain ◽  
Blue Gum

In attempting to describe the rise and progress of the paralysis, that forms one of the most remarkable symptoms of ‘paralytic insanity,’ I propose to notice first the affection of the muscles of the tongue, which is generally that which most strongly arrests the attention of the physician, who sees a patient in the second or fully-developed stage of the malady. In the last stage, the power of articulation is entirely gone; in both of these the paralysis is so marked, and the evidence of mental disease so clear, that the nature of the case can hardly be mistaken. It is in the very onset of the malady, that the peculiar lisp or failure of utterance, indicating disorder of the nervous centres, at or near the orifice of the nerves supply in the tongue muscles, is of paramount importance in the diagnosis, because if this symptom be superadded to eccentricity of conduct, or distinct delusion, there can remain but little doubt as to the existence of this special and almost invariably fatal form of disease. The alienist physician accustomed to watch the progress of general paralysis, and to recognize its slightest indication, cannot mistake the faulty pronounciation in question, for that of any other form of malady; but inasmuch as there are several affections of the speech that might mislead an unskilled practitioner, it may be useful to describe some of these derangements of the apparatus of articulation, and specify their points of difference. In the first place, an affection of the speech, very much resembling the embarassed articulation of incipient paralytic insanity, may be the result of temporary local congestion at the base of the brain, or may be produced by sudden fright, or by the action of poisons, particularly aconite; the indistinct utterance attending intoxication, is a familiar instance of poisoning of this kind: and all these are easily distinguished by the suddenness of their occurrence, and by their history, from the stutter of general paralysis. The articulation of the habitual stammerer is sometimes not unlike that which is the result of serious organic mischief; and still more striking in its resemblance, is the hesitation of speech, that may be observed in some cases of poisoning by lead. The ordinary signs of saturnine poisoning, the blue gum-line, the dropping of the wrist, &c., will mark this latter malady—the history of the case will prevent any mistake in the former. I may mention here, that I believe it to be an exceptional occurrence to find a person of unsound mind who stammers; such a case at least must be very uncommon, a fact which I can only account for on the supposition that the greater disease prevents any manifestation of the minor nervous derangement.

Insane Movements and Obsession

1909 ◽  
Vol 55 (230) ◽  
pp. 500-509
Author(s):  
J. Lougheed Baskin
Keyword(s):  
Mental Disease ◽  
Early Period ◽  
Advanced Age ◽  
Nervous Disease ◽  
General Paralysis ◽  
Open Window ◽  
The Subject ◽  
The Mind

One cannot visit the wards of an asylum without realising that there are many types of mental disease, each with its own symptoms and physical signs, and that intercurrent and overlapping affections of the mind are especially common; thus, in maniacal excitement you may find delusions, in paranoia you find delusions with marked impairment of judgment, in general paralysis you get, in addition to physical signs, delusions, which vary from the facility of the early period to the more difficult mentation found in the advanced age, so that here we have three distinct types of disease, each of which may have delusions, and the delusions may all be of the exalted variety— the patients may consider themselves gods, kings, or mighty personages. The progress of research has had more difficulties to contend with in the subject of mind than in almost any other. It is a subject which is intangible, yet its reactions can be timed. It is unseen, yet its force can manifest itself in various ways through various channels, and it is even possible to transfer it from one person to another if the medium is so constituted, as in hypnotism, thought transference, and similar phenomena. It may occur to you to ask why has the subject of insane movement and obsession been chosen for this paper; well, gentlemen, for some years it has been my lot to witness, on my daily round of the wards, grotesque movements, antics and pantomimic display by patients, which, were they not interesting as symptoms and physical signs of nervous disease, might otherwise be depressing because of their meaninglessness. About three years ago, however, I had my attention drawn to a woman who seemed engaged in making movements, the precise character of which I had not read of or seen before in any asylum. I shall show you this patient making these movements by means of the cinematograph. We would have brought her here only she obstinately refuses to operate when watched, and it was necessary to have the cinematograph pictures focussed through a partly open window when she least suspected observation. Gentlemen, we are well acquainted with such terms as insane acts, insane expression, insane language, insane conduct, and insane movements.

scholarly journals Hubert Maitland Turnbull, 1875-1955

1957 ◽  
Vol 3 ◽  
pp. 289-304 ◽  
Keyword(s):  
Original Work ◽  
Medical Schools ◽  
Medical College ◽  
Hospital Medical ◽  
London Hospital ◽  
The Subject ◽  
Morbid Anatomy ◽  
High Degree ◽  
Attention To Detail

Hubert Maitland Turnbull, who died on 29 September 1955 some eight years after retirement from the Chair of Morbid Anatomy at the London Hospital Medical College, occupied a position of eminence in British pathology. Not only was he greatly esteemed by his colleagues at the London but his influence extended widely throughout the medical schools of this and other countries of the Commonwealth. This was due not so much to his ability as an initiator and director of research, even though he was responsible for a considerable amount of valuable original work during his forty years at the London Hospital, but to a particular genius for accuracy of observation and meticulous attention to detail which he possessed in high degree and applied with almost religious fervour to everything that he did. Entering pathology at a time when many in this country held that morbid anatomy was a dead subject, Virchow, in their opinion, having left little new territory to be explored, Turnbull set himself to revolutionize morbid anatomical practice and to raise the subject to the level of a science. And so well did he succeed that he proved a source of inspiration not only to his fellow pathologists and those young graduates who chose to emulate him, but also to the much wider circle of clinicians who sought the privilege of working for a time in his department as a prelude to specialization in some other branch of medicine.

Lantern Demonstration of Gross Lesions of the Cerebrum

1901 ◽  
Vol 47 (199) ◽  
pp. 729-737 ◽  
Author(s):  
Joseph Shaw Bolton
Keyword(s):  
Cerebral Cortex ◽  
Dura Mater ◽  
Royal Society ◽  
Mental Disease ◽  
Post Mortem ◽  
Pyramidal Layer ◽  
Gross Lesions ◽  
The Subject ◽  
The Brain ◽  
Morbid Conditions

This demonstration was a further report on the subject laid before the Association at the meeting at Claybury in February last, viz., the morbid changes occurring in the brain and other intra-cranial contents in amentia and dementia. In a paper read before the Royal Society in the spring of 1900, and subsequently published in the Philosophical Transactions, it was stated, as the result of a systematic micrometric examination of the visuo-sensory (primary visual) and visuo-psychic (lower associational) regions of the cerebral cortex, that the depth of the pyramidal layer of nerve-cells varies with the amentia or dementia existing in the patient. At the meeting of the Association referred to it was further shown, from an analysis, clinical and pathological, of 121 cases of insanity which appeared consecutively in the post-mortem room at Claybury, that the morbid conditions inside the skull-cap in insanity, viz., abnormalities in the dura mater, the pia arachnoid, the ependyma and intra-cranial fluid, etc., are the accompaniments of and vary in degree with dementia alone, and are independent of the duration of the mental disease. Since that date the pre-frontal (higher associational) region has been systematically examined in nineteen cases, viz., normal persons and normal aments (infants), and cases of amentia, of chronic and recurrent insanity without appreciable dementia, and of dementia, and the results obtained form the subject of the present demonstration. A paper on the whole subject will shortly be published in the Archives of the Claybury Laboratory.

The Sexual and Reproductive Functions, Normal and Perverted, in Relation to Insanity. I. Menstruation: its Commencement, Irregularities, and Cessation. II. the Sexual Instinct and its Abuse. III. Pregnancy, Parturition, etc

1888 ◽  
Vol 34 (147) ◽  
pp. 383-393
Author(s):  
Campbell Clark
Keyword(s):  
Open Field ◽  
Mental Disease ◽  
General Medicine ◽  
Wide Range ◽  
Psychological Medicine ◽  
Collective Experience ◽  
The Subject ◽  
Present Opportunity

In undertaking to introduce a discussion on this very large and important question, I am conscious of my inability to do it justice. No one can possibly cover the wide range of subjects comprised in it; and I am anxious rather to elicit the convictions of more experienced men than to obtrude my own crude and imperfect ideas. My purpose is, therefore, to state the case as briefly as possible, and to introduce questions for discussion in preference to merely ventilating my own ideas. In this way we may arrive at some common points of agreement and materially advance our knowledge of the subject. There can be no two opinions as to the advantage of bringing to a focus the collective experience and conclusions of the various sections of our profession interested in this field of research, and the present opportunity is a particularly good one. The title of the discussion embraces a great deal, and yet does not strictly include topics which might be considered relevant, particularly therapeutics. My aim at the outset will be to invite your special attention to a few questions only, and in order to make the most of our time and concentrate the discussion as much as possible I propose to take each division separately. The subject, viewed as a whole, is so far-reaching and practical as to possess uncommon interest, for it links together medicine and psychological medicine, it gives an open field of discussion to general medicine, obstetrics, and psychology, and it views insanity on its less speculative side, because the more materialistic functions are brought out in strong relief, and sometimes even overshadow the characters of mental disease.

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