Psychiatry : a text-book for students and physicians / by Stewart Paton.

  • Paton, Stewart, 1865-1942.
Date:
1905
Catalogue details

Licence: In copyright

Credit: Psychiatry : a text-book for students and physicians / by Stewart Paton. Source: Wellcome Collection.

Provider: This material has been provided by King’s College London. The original may be consulted at King’s College London.

    480/670 (page 448)
    The Dementing Form.—According to some observers the so-called dementing type of paresis is becoming more frequent. This view, however, needs further confirmation, and it can readily be conceived that the apparent increase in frequency is due to the fact that these cases, which were formerly overlooked and classed among the various forms of dementia, are now recognized as instances of dementia paralytica. Indifference and apathy are the chief characteristics of individuals afflicted by this form of the disease. In the prodromal period we may meet with periods of depression, but gradually the affective state is replaced by one of apathy. At first the patients show a dis- inclination to work or to exert themselves, and although for a time retaining some appreciation of their condition, gradually lose it entirely. They sit about the house, taking but little in- terest in anything that goes on about them; they neglect their work, their families, and become utterly devoid of any sense of duty. When asked to explain their apathy they may make a feeble attempt to do so, but, as a rule, are unable to offer a sat- isfactory explanation for their conduct. The hypochondriacal complaints which have been more or less pronounced in the prodromal period disappear. The patients, when spoken to, reply in rather a low, monotonous voice, not infrequently in monosyllables, and are unable to give any satisfactory account of themselves or the onset of their disease. The lapses in attention are more passive than active. The distractibility is not excessive; the instant the patient is left to himself he immediately lapses into this apathetic condition. As a rule, the impairment of the general sensibility seems to be more marked than in the other types of the disease. The patient can be pricked with a needle, pinched, or made to suffer quite a severe injury without any corresponding emotional reaction. As the disease progresses the apathy becomes more and more profound and may, as a rule, be easily distinguished from that characterizing the other forms of dementia. The primary sen- sations are apt to be greatly impaired, and it is almost impos- sible to stimulate the patient sufficiently to evoke an emotional reaction of any degree of intensity.