Mental diseases: a public health problem — John Shaqi
Mental diseases: a public health problemMay, James Vance
Science
Mental diseases: a public health problem
May, James Vance
Mental health services; Psychology, Pathological
There are many reasons why every hospital of any consequence that
is engaged in the care of mental diseases should be provided with a
well trained and experienced pathologist. Examinations of urine and
sputum must be made daily. Widal tests are sometimes necessary for
the diagnosis of typhoid fever. Analyses of water and milk should
be made at frequent intervals. Bacteriological vaccines should be
available at any time. Only laboratory investigations can throw any
light on the source of the frequent infections which are found in large
institutions. Diphtheria is a disease which must be guarded against
constantly. Lumbar punctures, Wassermann tests, the colloidal gold
reaction, cell counts, etc., are daily necessities in a large hospital.
We lose much information of value to us if autopsies are neglected. A
definite program of pathological research work should be carried on in
every hospital for mental diseases. It has been suggested frequently
that the microscope has no part to play in studying the etiology of
the psychoses and that they are purely functional in origin. Many of
them are functional. It is nevertheless equally true that we have a
definite pathological basis for the traumatic psychoses, the senile
conditions, cerebral arteriosclerosis, general paresis, brain syphilis,
cerebral growths, mental deficiency and many other brain and nervous
diseases. The psychosis most clearly understood from the standpoint of
etiology, pathology, symptomatology and diagnosis is general paresis.
Our definite knowledge of that condition was obtained entirely from the
laboratory. Further information may be secured in the same way. While
it is true that we have not had any great amount of success as yet with
the treatment of general paresis with salvarsan, the positive knowledge
that the disease is of syphilitic origin should encourage us in our
efforts to solve the problem of curing it. Histological, pathological,
bacteriological, chemical, clinical and psychological researches must
be pushed vigorously if psychiatry is to keep pace with the general
progress shown by modern medicine in other fields.
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