Licence: Public Domain Mark
Credit: Mental diseases / by Charles F. Folsom. Source: Wellcome Collection.
Provider: This material has been provided by the University of Massachusetts Medical School, Lamar Soutter Library, through the Medical Heritage Library. The original may be consulted at the Lamar Soutter Library at the University of Massachusetts Medical School.
114/122 page 202
![attacks of sliort cluratiou, and so is always, potentially, a dangerous pei'son. In the prodromal period the risk is small; in all stages there will, in the majority of cases, be some warning; but in the developed disease the only safe way is to have some responsible person near at hand, both to prevent the patient from doing harm to others and to save him from injuring him- self, whether by intent or through not knowing better than to wander off or fall into all sorts of accidents. In many conditions several should be readily available, or else the security of an asylum must be sought. In the treatment of general paralysis by society the same rule should obtain as in all forms of insanity—that distinct mental disease is pre- sumptive proof of irresponsibility, or at least of limited resi^onsibility; that a diseased mind means lessened intellectual power throughout and diminished ability to choose the right and avoid the wrong; that there are changes in circulation or nutrition, or some unknown condition in the brain, especially in general paralysis, by virtue of which the mental state and power of self-control vary from time to time, and as a result of which a person seeming responsible one day may have been quite irresponsible some previous day. IxsANiTY FROM Gross Lesioxs OF THE Brain (tumors, new growths of all kinds, exostoses, spicules or portions of depressed bone, embolisms, hemorrhages, wounds, injuries, cysticerci, etc.) is attended with the usual indications of those conditions which may determine diffuse disorders of the brain, giving rise to any of the symptoms of the various psycho- neuroses and cerebro-psychoses. The lowered mental and moral tone after cerebral hemorrhages is a matter of common observation, and after one an individual is rarely observed to be fully himself again. The PROGNOSIS is very unfavorable. Although there are rare cases of improvement, the tendency is toward profound dementia. Cerebral Syphilitic Insanity comes either under the head of the insanity last described or belongs to the slowly-advancing dementia with final paralysis already referred to under the head of Diagnosis in General Paralysis, and called by some authorities on mental disease pseudo-par- alytic dementia from syphilis. Antisyphilitic treatment is of value in the first class of cases, and although most of the recoveries end in relapses and incurability, the pro- longed use of iodide of potassium seems sometimes to effect a permanent cure. It is claimed that similar treatment is followed by the same result in the cases of dementia with paresis, but the weight of authority, and certainly my own experience, are against that statement. Chronic Alcoholic Insanity depends upon the vascular and other changes due to abuse of alcohol so long continued that the pathological condition has become organic and incurable. It is commonly associated with delusions of suspicion or persecution. It may be a purely moral insanity, with gross beliefs rather than distinctly insane delusions, and it i-arely fails to be at least that when the persistent excessive drinking is kept up until the age of beginning dissolution of the brain. It then gives rise to all sorts of embarrassing complications in regard to proper- ty, family relations, and wills. Chronic alcoholic insanity may take the form of mild dementia, by virtue of which the jxitient cannot control himself, but can l)e easily kept within bounds of reasonable conduct by various degrees of restraint, from the constant ]iresence of a responsible](https://iiif.wellcomecollection.org/image/b2119760x_0114.jp2/full/800%2C/0/default.jpg)
