Insanity : its classification, diagnosis, and treatment : a manual for students and practitioners of medicine / by E.C. Spitzka.

  • Spitzka, E. C. (Edward Charles), 1852-1914.
Date:
1889, ©1887
Catalogue details

Licence: Public Domain Mark

Credit: Insanity : its classification, diagnosis, and treatment : a manual for students and practitioners of medicine / by E.C. Spitzka. Source: Wellcome Collection.

Provider: This material has been provided by the Harvey Cushing/John Hay Whitney Medical Library at Yale University, through the Medical Heritage Library. The original may be consulted at the Harvey Cushing/John Hay Whitney Medical Library at Yale University.

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    mentia from organic disease and dementia from cerebral syphilis are not ranked with rheumatic, pellagrous, and post-febrile insanity. It may be alleged that they should be so ranked because they are all equally among the un- usual manifestations of other diseases than those which fall within the ordinary ken of the alienist, and are hence true complicating forms. To this weight)- objection it can be rep'led, that insanity from the physiological psychologist's point of view is a manifestation of brain disorder ; that we are correct in assuming that the ordinary psychoses are true cerebral affections, primarily of cerebral origin, and that it would be unwise from a patho-anatomical point of view—little as we actually know of mental morbid anatomy —to separate the organic affections of the brain producing insanity, even though they produce it but occasionally, from the known and hypothetical diseases of the same organ producing those symptoms more regularly. Besides, by retaining the distinction between those forms which never exist without an essential extra-cerebral disorder from those in which a cerebral disorder is the primary determining factor, attention is prominently directed to certain useful therapeutical purposes. About one fact there can be no dispute, that, excluding the complicating forms, the majority of the distinctions made will be recognized as necessary by the practical alienist. In a properly drawn up table of any asylum of over five hundred beds the reader will find that mania, melancholia, stuporous insanity, primary, terminal (second- ary), senile, and paretic dementia, dementia from organic disease, acute delirium, alcoholic, hysterical, epileptic, and periodical insanity, states of arrested development, and monomania—possibly under the more popular though less exact title of chronic delusional insanity—all have a place. It may be assuredly claimed that these distinctions having stood the test of time must possess a practical value. The day is past when the asylum physician can content himself with such a classification as this one.* Mania: acute, sub-acute, chronic, recurrent. Melancholia: acute, chronic. Dementia: primary, secondary, senile. Amentia (!): idiocy, imbecility. General paresis. * Taken from the annual report of the New York City Asylum for the Insane, dated January 1st, 1879.