Postcataract extraction delirium : report of eleven cases / by Walter R. Parker.

  • Parker, Walter Robert, 1865-
Date:
[1913]
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Credit: Postcataract extraction delirium : report of eleven cases / by Walter R. Parker. Source: Wellcome Collection.

Provider: This material has been provided by UCL Library Services. The original may be consulted at UCL (University College London)

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    not otherwise ailing. Burr« says that transitory confu- sion or delirium rarely occurs in the aged without the presence of severe arteriosclerosis and marked disease of the kidneys, even when the immediate cause is auto- intoxication from the intestines or stomach, or from some unknown endogenous source. He does not think the cerebral arterial disease is the cause of the attack, how- ever, as practically all the aged have hardened arteries and may show no mental illness. These transitory attacks are not due to the fact that the thickened arteries do not carry enough blood to supply the brain, but are caused by a poison or poisons carried by the blood. Phillips'^ holds that in old age trivial causes may produce a wandering of the mind, due no doubt to the impaired nutrition of the nerve-cells from a diseased heart or sclerosed cerebral vessels. Gressinger, as quoted by Lowy,* advocates the theory that the causative factor for the origin of the psychoses lies in peripheral nerve injury or a disease of the sensory nerves originating peripherally from operative traumatism. Schultze concludes that postoperative psychoses occur after all forms of operation but most frequently after predisposed diseases. In a large number of cases a hereditary tendency is found. He agrees with Picque that definite cases of real post- operative psychoses, in contrast to the false postoperative delirium, are reduced to a small number. In the great majority of cases fever, lasting toxic condition after the operation, inanition and condition of weakness, the cause of which is to be sought in the underlying disease itself, offer the explanation for the oncoming condition of psychosis. Englehardt^ concludes (1) that postopera- tive psychoses develop in individuals predisposed by heredity, chronic intoxication, grief or care; (2) that the weakness incident to the operation or disease preced- ing can scarcely be considered essential—at most it may be considered as the determining factor in predisposed cases, and (3) that there are cases of postoperative psychoses in which an etiologic understanding is not as yet accessible. It has been contended that serious operations on the pelvis and genital organs and operations on cataracts 6. Burr: Transitory Mental Confusion and Delirium In Old Age. The Journal A. M. A., Dec. 30. 1911, p. 2118. 7. Phillips : Cleveland Med. Jour., 1909, vili, 531. 8. Liiwv, Rudolph : AIIr. Ztschr. f. Psychiat, 1896, 111, 166. 9. Schiiltze: Deutsch. Ztschr. f. Chlr.. 1910, civ. 584t 10. Engelhardt: Deutsch. Ztschr. f. Chlr., 1910, Ivill, 46.