A treatise on the theory and practice of medicine / by John Syer Bristowe.

  • John Syer Bristowe
Date:
1887
Catalogue details

Licence: Public Domain Mark

Credit: A treatise on the theory and practice of medicine / by John Syer Bristowe. Source: Wellcome Collection.

    1237/1322 (page 1191)
    were visibly to play his part in the fantastic and unreal world in which he seems to live—there would be little to distinguish between the condition of the sleeper and that of the lunatic, except perhaps that the lunatic is more or less alive to all that is going on round about him, and that the facts of the external world and his relations to them (it may be falsely seen and falsely interpreted) are mingled with his insane moods, his insane ideas, and his other insane subjective phenomena. B. Special description.—There are two fundamental divisions of insanity : the one characterised mainly by perversion or disease of the emotions or passions, the other characterised mainly by perversion or disease of the reasoning powers. The former is termed affective insanity, the latter ideational or intellectual iiisanity. It is not pretended that all lunatics can be placed in one or other of these categories, or, indeed, that affective insanity and ideational insanity ever exist wholly independently of one another ; but it is a fact that in the great majority of cases insanity commences with some change in the feelings, some perversion of the moral qualities, some affection of the passions, which stamps itself on the features and demeanour and influences the conduct ; and that it is only subsequently that delusions and other distinct evidences of intellectual disease manifest themselves. It is a fact too that the patieiat may never pass beyond the stage of affective insanity ; and it may be repeated that moral perversion persists as perhaps the most important factor in the constitution of all cases even of ideational insanity. Again, it is now generally acknowledged, as Guislain was the first to establish, that m by far the larger number of cases the earliest indications of insanity consist in a ' state of profound emotional perversion of a depressing and sorrowful character,' and that it is only at a later stage, if at all, that morbid feelings and passions of exaltation show themselves. Although fully admitting the truth of the principles just enunciated, we shall not attempt, any more than other authors have done, to classify the varieties of insanity according to one or other of them ; and while acknowledging most thoroughly that different forms of insanity pass into one another, and that many cases are met with which can only with a certain amount of violence be assigned to any particular division, we shall adopt, in the mam, the system of classification which has been accepted— at any rate in principle—by most writers on the subject. Accordingly we shall arrange mental diseases under the following six heads :— 1. Melancholia, madness characterised by mental depression ; 2. Mania, madness characterised by mental exaltation ; 3. Monomania, or partial madness, generally attended with exaltation ; 4. Dementia, madness characterised especially by mental weakness ; 5. General paralysis of the insane ; 6. Idiocy, amentia, or congenital mental defect. 1. Melanc}wlia.—T]ie specific charactei-, the fundamental phenomenon, of melanchoHa is the presence of a profound sense of painful depression— a feeling of oppression, anxiety, dejection, and gloom. This condition, indeed, as has already been stated, constitutes the early stage of most