Nervous and mental diseases / by Archibald Church and Frederick Peterson. With 338 illustrations.

  • Church, Archibald, 1861-1952
Date:
1903
Catalogue details

Licence: Public Domain Mark

Credit: Nervous and mental diseases / by Archibald Church and Frederick Peterson. With 338 illustrations. Source: Wellcome Collection.

Provider: This material has been provided by the Augustus C. Long Health Sciences Library at Columbia University and Columbia University Libraries/Information Services, through the Medical Heritage Library. The original may be consulted at the the Augustus C. Long Health Sciences Library at Columbia University and Columbia University.

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    properly. In nervous diseases the family history is often of paramount importance. Taken with the appearance of the patient, it gives valu- able indications as to the constitutional make-up of the individual. The family history, then, is to be investigated first, after noting the name, age, sex, nationality, occupation, and social state of the patient. Neurotic Heredity.—In seeking information regarding the ante- cedents of a patient, much tact must sometimes be employed. Patients are loath to detail matters of this character, not always from a wish to conceal them, but from disinclmation to admit even to themselves any serious shortcoming or morbidity. To the half that is directly learned an equal amount may sometimes be reasonably added. Much can be learned by interrogating other members of the family, especially if related by marriage, the family physician, and old acquaintances, but the confidence and rights of the patient must not be forgotten. Nor is it sufficient to seek for instances of the identical disease in the family history of the case. The significant factor is a neuropathic liability, and this is indicated with more or less force by the appearance of ner- vous and mental diseases of any sort, of slight or serious degree, in the ascendants. For instance, a hysterical mother has an epileptic child and an idiotic grandchild ; or highly wrought nervous organizations in mother and father eventuate in neurasthenic and unstable children. Atavism in mental and nervous diseases is quite common. Insanity in the same or neighboring generations may alternate with neuroses or mild psychoses, and any combination may exist. Consanguinity on the part of parents, in addition to furnishing a tendency to infecundity, is likely to bring together the subjects of similar neurotic taints, which are thereby reinforced in the offspring. In itself, however, consanguinity has probably been overestimated as a causal factor in nervous and mental diseases. The association of crime, precocity, genius, neuroses, and psychoses in related individuals may be encountered. Certain nervous diseases are of direct hereditary character, being transmitted from generation to generation or appearing in a group of cases in a given generation. It is only needful to mention Friedreich's ataxia and Huntingdon's chorea, but tabes dorsalis, paralysis agitans, multiple sclerosis, muscular atrophies, and practically every organic and functional nervous disease occasionally presents family groups of this nature. ^ Many of the familial diseases which have been described as essentially distinct are found to insensibly merge through the observation of inter- mediate cases; and Baumlin^ contends that all typical diseases of a familial character drift into each other through such connecting links. A family constitutional defect is the only essential feature. Debilitating diseases, like tuberculosis, rheumatism, and gout, are significant. Indeed, Charcot was inclined to consider arthritism as a congener of nervous diseases. Inherited syphilis is on an entirely diiferent footing. Not only is it cajiable of producing embryological ^ Ch. Fere, La Famille Nevropathique, Paris, 1894. 2 Deut. Zeit. f. Nervenheilk., Oct., 1901.
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