The mental symptoms of heart disease / by T. Duncan Greenlees.

  • Greenlees, T. Duncan.
Date:
[1903]
Catalogue details

Licence: In copyright

Credit: The mental symptoms of heart disease / by T. Duncan Greenlees. Source: Wellcome Collection.

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    the situation and nature of the lesion. It will, therefore, be of interest if his conclusions are briefly referred to:— Mitral stenosis.—In this condition the patient is frequently found to be excitable, impulsive, and discontented, having delusions of ill-usage or that his food is being poisoned. He is querulous and most difficult to manage.1 Mitral regurgitant.—This disease is usually associated with some depression, together with delusions of suspicion and per¬ secution; sometimes with gnawing sensations in the head; subjects are often morose and of a sullen disposition. Aortic stenosis.—This condition is frequently found in cases of general paralysis, and in these cases mental failure occurs early in the course of the disease. The patient is usually impulsive and violent, has delusions of persecution, or expresses the delusion that his food is poisoned. Aortic regurgitant.—The heart in this condition is generally enlarged, weighing from 20 oz. to 25 oz., and this form of heart disease induces sleeplessness and restlessness. Loquacity and excitability characterise the temperament of the patient, who later may express delusions of exaltation, although in the earlier stages depression of spirits is common. Delusions, referable to internal sensations, such as magnetic influences and hallucinations of the various senses, may occur. Mitral and aortic disease combined.—In such cases the mental symptoms presented areusually thosemore characteristic of aortic rather than mitral disease. Such a condition is often associated with, or results in, gross brain lesions. The patient is generally dirty in habits, growing rapidly gloomy and demented, and the delusions expressed are frequently referable to the diseased organ, such as that the heart is being eaten away by worms, &c. 1 In this connection it is interesting to note that the rare mental con¬ dition named “ Quernlantenwahr ” by the Germans, where the subject is litigiously inclined, happy only when engaged in a law suit, no matter its nature or its cost, or his power of paying legal fees. So long as these fees are forthcoming, the disease is encouraged by the legal fraternity, and it is only when pauperism results that it is legally recognised as one of insanity. The famous Mrs. Cathcart may be taken as a type of this condition—a mental state associated, according to Griesinger and Kraipelin, frequently with phthisis or mitral stenosis. Whether the cardiac trouble is the actual cause of this mental condition it is difficult to say, but it might be said that it is but an exaggeration of the cantankerousness, querulousness, and resistance to all forms of opposition so generally met with in sane cases of mitral disease.—(1Tidc Diet. Psych. Med., Hack-Tuke, p. 1061.)
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