Text-book of insanity : based on clinical observations for practitioners and students of medicine.

  • Richard von Krafft-Ebing
Date:
1904
Catalogue details

Licence: Public Domain Mark

Credit: Text-book of insanity : based on clinical observations for practitioners and students of medicine. 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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    The same landse'ape iiulucrs iu us entirely dillVreut ciiiütions—indeed, ajjpears to us with a different coloring—if our mood be one of joy or sorrow. This physiologic law holds good also under pathologic conditions. To the melancholic llio external world seems somber and changed—in other colors; even objects which under other conditions would give rise to pleasant impressions seem now, in the mirror of his abnormally changed sense of self, to be M'orthy of aversion (psychic dysesthesia). A furtlior source of psychic pain lies in the fact that the intellect is under the impelling influence of feelings, and only such ideas as are in harmony with the state of the emotions can be entertained in con- sciousness. Owing to this law, the melancholic is unable to retain in con- sciousness any other than painful and depressed images and ideas. The immediate result of this is monotony of thought and consequent weariness. Along with the melancholic depression, the formal activity of the process of thought is also hindered, and there is therefore a notable inhibition of the psychomotor aspect of the mind. This inhibition of the will, this opposition to the expenditure of psychic force, brings about a great increase in the feeling of depres- sion, which is further augmented by the fact that the patient feels him- self overpowered by the disturbance of his ])syehic mechanism, and powerless to resist it. At the height of the disease another important source of mental pain is added, in that the patient realizes that his ideas are no longer colored by the usual feelings of pleasure or pain ; that he can no longer take delight in or worry about anything (psychic anesthesia). Thus, all kinds of stimuli are without effect upon him. Since the disturbance of nutrition is general, along with the psychic neurosis, there are various sensory disturbances (neuralgias, paralgias, paresthesias, anesthesias, and a changed state of general feel- ing) ; the vegetative functions and muscular tone suffer as well. The e multifarious disturbances of the general state of feeling form another and fruitful source of psychic pain in the depressed consciousness. If the latter elements of painful feeling predominate, the depression takes on hypochondriac features. The abnormal painful depression is in itself objectless. In the milder and more transitory cases of this kind it remains so, and, as a rule, is recognized by the individual as abnormal. As the disease progresses and the disturbance of conscious- ness increases the patient seeks to explain his depression; and, since it