A system of practical medicine. By American authors. Vol. 5 : $b Diseases of the nervous system
Science
A system of practical medicine. By American authors. Vol. 5 : $b Diseases of the nervous system
Medicine -- Practice
disease, of low febrile states, starvation, etc. Delusions are
sometimes named in groups, according to the prevailing type of mental
action; then, we have exalted delusions, in which the false notions
and beliefs are rose-colored or extremely exaggerated (as in paralytic
dementia, etc.). Again, we speak of delusions of persecutions, where
the patient fancies himself pursued, maltreated, insulted, or where he
insanely follows up and persecutes others. Such classification is
useful for purposes of clinical and psychical study.
Imperative conceptions or controlling morbid ideas and desires are
ideal delusions presenting certain peculiarities; one of which is that
of growth by accretion and assimilation by a sort of false logic and
grotesque analogical reasoning, until from a mere fancy or notion the
growth invades and governs the entire subjective life of the subject.
VIOLENCE is a complex symptom always deserving of study and
psychological analysis. It may present itself as an increase of a
naturally bad disposition or as a wholly new exhibition of
irritability and temper. Beyond these limits it may assume the shape
of abusive and foul language (not before employed by the subject), or
of physical acts of a destructive or dangerous character. Viewing the
condition from a psychological standpoint, we should endeavor to
distinguish between merely impulsive or animal violence due to
over-activity of the emotional state or to a loss of self-control
(cortical inhibition), and quasi-deliberate acts due either to special
delusions or to delirium. Abnormal irritability, or increase in an
{24} originally bad temper, is met with in hysteria, neurasthenia, and
partial dementia. Masturbators and epileptics frequently exhibit this
condition. In a state less pathological, from mere fatigue or
overwork, irritability may temporarily show itself as a result of
reduced cortical energy; and in such cases rest, a cup of tea or
coffee, alcohol, or even ordinary food, restores good-nature and
equanimity as by magic. In little children bad temper is a frequent
precursor of illness, more especially of cerebral disease. Greater
degrees of violence in speech and acts are met with in hysteria,
neurasthenia, and in many forms of insanity, in the guise of
exaggerations of animal propensities, to make a noise, break objects,
injure persons in an aimless general way. Voluntary or quasi-voluntary
acts of violence are those which are done under the influence of
hallucinations, delusions, or of delirious ideas, usually by insane
patients. The delirium of acute or inflammatory disease or of the
typhous state is rarely active, although pericarditis sometimes gives
rise to very violent delirium, and the mild delirium with picking and
gesticulating of pneumonia, typhoid fever, etc. may sometimes simulate
mania. In general terms, the words and acts of patients represent the
ideas passing through their minds in a rapid confused way, much as in
dreams.
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