Mental diseases: a public health problemMay, James Vance
Science
Mental diseases: a public health problem
May, James Vance
Mental health services; Psychology, Pathological
The progress made by Kraepelin, Stransky, Wernicke, Bleuler, Ziehen
and other modern psychiaters led to renewed interest in pathological
research. This was to a considerable extent due to the suggestion
of Kraepelin that dementia praecox was autotoxic and endogenous in
origin. The neurons were exhaustively studied by Alzheimer and changes
in metabolism thoroughly investigated by Folin and many others. To
the researches of Nissl and Alzheimer in 1904 we are largely indebted
for an accurate knowledge of general paresis. Studies of the cortex
in dementia praecox by Alzheimer and many others have been extremely
interesting if not conclusive. The introduction of lumbar puncture
by Quincke and the studies of the cerebrospinal fluid made by Widal,
Plaut, Nonne, Mott and others were of great aid in diagnostic
procedure. These have been supplemented by the Wassermann reaction, the
colloidal gold test, etc. The isolation of the treponema pallidum in
the cortex settled the question of the identity of general paresis and
cerebral syphilis for all time.
Another line of research responsible in no small measure for the
remarkable progress of psychiatry during the last few decades was
that instituted by Freud, Jung and others in their studies of
psychological mechanisms. It is a rather remarkable fact that it is
only in comparatively recent years that a study of the psychological
processes of the normal mind has been looked upon as essential to an
understanding of the mental reactions involved in the development of a
psychoneurosis or psychosis. This is really the basis of Freud's work.
Psychiatry may be said to be practically the only branch of medical
science in which a study of pathological processes has not been based
largely upon physiological and anatomical foundations. Our textbooks
for many years have insisted that "insanity" was a disease of the
brain but have not given much consideration to a correlation of the
physiology with the pathology of that organ. The application of
psychological methods to psychiatric research was largely a result
of the studies of hysteria by Janet. This was supplemented by the
important contribution of Breuer and Freud in 1895 calling attention
to their theories in regard to the production of the psychoneuroses
by psychic traumas, usually of a sexual nature. Freud's views
were outlined more fully in his "Selected Papers on Hysteria,"
"Three Contributions to the Sexual Theory," and his studies of the
"Psychopathology of Everyday Life," etc. The psychological processes of
dementia praecox and paranoia were subjected to elaborate studies by
Freud, Jung and various other authors.
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