Mental diseases: a public health problemMay, James Vance
Science
Mental diseases: a public health problem
May, James Vance
Mental health services; Psychology, Pathological
In the parathyroid form of tetany von Frankl-Hochwart found depressions
and confused states with hallucinations. Depressions were reported by
him in fourteen of thirty-seven cases examined. Excitements were also
noted in some instances. Falta refers to "a characteristic apathy, a
want of initiative, and a slowing of speech" in acromegaly. In rare
cases he has also noted mental exaltation. Oppenheim (1914) has called
attention to cases of acromegaly presenting the picture of general
paresis but due to an alteration of glandular functions and not
syphilitic in origin.
Falta includes the following in his description of the symptomatology
of Addison's disease: "Almost always the disease manifests itself
in ready fatigability, disinclination for work, and apathy; to
these symptoms are sometimes added headaches, poor sleep, sometimes
obstinate insomnia, psychical ill humor and depression, often too,
abnormal irritability; further, diminution in memory, noises in
the ears, vertigo and commonly fainting attacks, singultus, and
rheumatoid pains in the back and in the extremities, sometimes, also
epileptiform convulsions. Extremely stormy manifestations on the part
of the nervous system may, especially in the later stages, make their
appearance—violent delirium, acute confusion, convulsions, deep
stupor, and coma."
Raeder[111] has made an analysis of glandular involvements found in
the study of one hundred cases of feeblemindedness at autopsy. He
classifies these as 1, extreme changes—in which three or four glands
were involved and where there were marked anomalies of growth,
underdevelopment, disproportion of the body parts, etc.; 2, marked
changes—in which at least two glands were involved and where there
were distinct changes in growth and anomalous development; 3, moderate
changes—in which one or two glands were involved; and 4, cases where
no glandular involvement was found. He noted extreme changes in ten per
cent of the series, marked changes in eleven per cent, moderate changes
in fifty-three per cent and none at all in twenty-six per cent. Sixty
per cent of these individuals showed deviation from the normal in size,
fifty-one per cent were undersized and nine per cent were above the
average height, while thirty-eight per cent were normal. The pituitary
was found to be involved in forty per cent of the one hundred cases,
the thyroid in nineteen per cent, the suprarenal in twenty-seven per
cent, the sex glands in thirty-eight per cent, the thymus in twelve
per cent and other glands in six per cent. He frequently found several
involved: "Pituitary with gonads in nine cases, was the most common
dual adenosis, though there were combinations of sex and thyroid in
four instances, sex and suprarenal in four cases, and in three cases
the thyroids, pituitary and gonads were affected in triple involvement.
Furthermore, there were six cases in which the gonads were combined
with three other glands; two included the gonads, thyroid, pituitary
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