Mental pathology and therapeutics / By W. Griesinger, M.D. ... Translated from the German (second edition) by C. Lockhart Robertson, M.D. ... and James Rutherford, M.D.

  • Wilhelm Griesinger
Date:
1882
Catalogue details

Licence: Public Domain Mark

Credit: Mental pathology and therapeutics / By W. Griesinger, M.D. ... Translated from the German (second edition) by C. Lockhart Robertson, M.D. ... and James Rutherford, M.D. Source: Wellcome Collection.

Provider: This material has been provided by the Francis A. Countway Library of Medicine, through the Medical Heritage Library. The original may be consulted at the Francis A. Countway Library of Medicine, Harvard Medical School.

    139/396 page 125
    New York, 7 cases occurred in a single year in which mental disease originated from diseases of the internal ear CHanbury Smith, ' Annal. Med. Psychol.,' 1854, vi., p. 450). Cases have been observed in which a violent attack of mania ensued on cessation of a purulent discharge from the ear, and ceased, or at least con- siderably diminished, on the return of the discharge (L. Meyer, ' ]3eutsche Klinik,' 1855, No. 6). Along with injuries to the head we may also mention insolation as a cause, though not of frequent occurrence, of insanity. This acts, perhaps, by causing great cerebral hypersemia (and oedema?); perhaps the insanity is due to exces- sive nervous irritation of the brain caused by prolonged exposure to the rays of a burning sun. Ellis^ mentions two cases of insanity caused by insolation: one of them ended in recovery, the other in dementia. Those cases in which insanity originates after (and, without doubt, in consequence of) a relatively insignificant injury of a peripheral nerve (above all,, wounds of the soft tissues), or disease of a nerve of sense commencing at the periphery—for example, peripheral deafness—are of very great pathological interest. Thus we have seen an attack of pro- found melancholia occur in a hysterical woman after a slight injury of the eye caused by a splinter of wood; insanity has also been observed (Herzog) to occur after the operation for strabismus.^ Foville^ mentions numerous cases of superficial disease of the cerebellum in the insane in consequence of peripheral disorders of the fifth and auditory nerves; to this pathogenic category belongs also the case already quoted from Jor- dens,* of a boy who became maniacal through a small piece of glass pene- trating the sole of his foot, and continued so until the glass was removed. It is very probable, too, that the cases mentioned by Zeller,^ of insanity consecutive to simple external wounds of the head, may also be ranged under this head.^ Inasmuch as these cases vividly remind us of the delirium nervosum observed after and sometimes during operations, this cerebral affection may be compared to that affection of the spinal cord which determines traumatic tetanus; but with this difference—that the spinal cord and the brain always react according to their own peculiar energy. In the next place, we may here mention various other powerful or long-continued nervous irritations from the periphery of the organism. As an example of the first series, we may mention that remarkable case recorded by Esquirol, of mania occurring after a strong impression of smell; of the second series, perhaps, e. g., the irritation produced within the bowels by taenia and other entozoa, or even of pruritus chronicus. Yery severe pain may also call forth an attack of insanity in an individ- ual who is predisposed. The ^Keport of the Vienna Asylum' (1858, p. 60) contains a case of this kind, in consequence of severe pain resulting from inflammation of one of the tendinous sheaths in the palm of the hand. § 104. Formerly existing spinal neuroses, whether manifested in states of developed hysteria, or merely in limited convulsive or neuralgic affections, may become important causes of insanity. Here it seems that mental disorders may originate as well from a gradual extension over more considerable portions of the nerve centres—and this is very fre- ^ • Traite de PAlienation,' etc., par Archambault, 1840, p. 81. 2 Oppenheim's ' Zeitschrift,' xxi., 1842, p. 101. From the 'St. Petersburg Transactions,' where I, alas! could not read the case in the original. 2 ' Note an die Academic, I'lnstitut,' Jan., 1843, ^ ' Hufeland's Journal,' vol. iv., p. 244. ^ ' Zeitschrift ftir Psychiatric,' i., 1, p. 49. ** See moreover the case mentioned by Hirsch (' Spinalneurosen,' p. 131).
    digitised image 1
    digitised image 2
    digitised image 3