Cerebral and mental symptoms in relation to somatic disease, anaesthetics and toxic agents, traumata and surgical procedures : with a review of the treatment of some cerebral and mental symptoms by operation ... / by James Christian Simpson.

  • Simpson, J. Christian (James Christian)
Date:
1898
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Licence: Public Domain Mark

Credit: Cerebral and mental symptoms in relation to somatic disease, anaesthetics and toxic agents, traumata and surgical procedures : with a review of the treatment of some cerebral and mental symptoms by operation ... / by James Christian Simpson. Source: Wellcome Collection.

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    it requires rather a purely emotional disturbance to upset the mental equilibrium, such as occurred to Ahsfeld, who had a patient become insane after the introduction of a vaginal speculum ; or Billroth's two cases of rhinoplastic operation, where doubtless the disfigurement and deformity led to morbid introspection and melancholia. Then there is the actual physical trauma to various more or less sympathetic organs and structures, and along with this must be included those cases where an organ is re- moved, such as the thyroid, ovaries, testes, &c., and in which nervous symptoms may appear, in the former case certainly as a result of the absence of the special thyroid secretion, and in the latter perhaps partly so, and partly on account of the trauma to the rich sympathetic plexuses effected during ablation. Savage of Birmingham says he has never seen insanity follow the removal of only one ovary, though statistics show that in the majority of cases in which insanity has followed ovariotomy, the disease has been unilateral. Althaus describes two forms of insanity following oophorectomy : (1) a violent delirium lasting a few days; (2) pronounced melan- cholia ; but in other cases there may be a more or less hypochondriacal condition, or one of hysteria, stupor or even dementia. Cullingworth states he has never seen a case of insanity following removal of normal ovaries, because he never did such an operation, and he did not believe that the removal of abnormal organs would be likely to cause mental trouble. Such belief, however, is untenable in the face of facts, though it may be difficult to see why the loss of two ovaries that are practically physiologically functionless, should produce such an impression on the nervous system. Again, in the case of hysterectomy. Dr. T. Keith's experience shows that insanity follows in 10 per cent, of the cases. In 138 cases of all sorts that I have collected, there are 16 hysterectomies, so that though some authorities state that 10 per cent, is unusually high, it does not seem to be so from these figures. In cases of insanity following ophthalmic surgery, Frankl- Hochwart gives the following reasons for the occasional occurrence of this sequel:—(1) There are numerous nerve trunks connecting the eye and brain, and lesion of the eye itself occasionally produces psychical affections. (2) Irrita- tion of any sensory organ is reckoned a cause of insanity. (3) Predisposition by the depression caused by the blindness. (4) Advanced age at which cataract operations are often