Bonhoeffer,[10] in a monograph devoted to the subject, endeavors to
establish the existence, on the basis of degeneracy, of acute psychotic
processes which do not belong to either the manic-depressive,
hysterical, or epileptic temperaments, which cannot be placed under any
of the known forms of dementia præcox, and which develop as wholly
independent psychotic manifestations in particularly predisposed
individuals. The material which served for his thesis was gathered from
the Berlin Observation Ward for Criminals, among the inmates of which
institution he found a great number of degenerative psychoses. In a
recent work on the subject of psychogenesis he upholds his former views,
and believes he has been able to separate his cases into three distinct
groups. The first group comprises certain unstable individuals who show
a tendency to the development of simple paranoid psychoses. It concerns
patients of a very labile make-up with increased affective reactions,
with marked tendencies to impulsions and antisocial acts. These cases
are characterized by the fact that they do not concern psychogenetic
psychotic exaggerations of a certain temperamental predisposition, but
psychically evoked disease states which appear to be irreconcilably
opposed to the original personality.
He calls attention to the epileptic seizures of these individuals, which
have been so ably described by Bratz.[11] In contradistinction to the
genuine endogenetic epilepsy, these patients manifest epileptic seizures
as reactions to situations purely psychic in nature. In them, without
ever resulting in epileptic dementia, there occur along with the
epileptic seizures attacks of unconsciousness, of excitement, dream
states, and porio-maniacal outbreaks. They differ from the genuine
epilepsy by the absence of the characteristic dementia, of attacks of
_petit mal_, and by the fact that the seizures are never purely
endogenous in origin. They are always due to extraneous causes,
eminently such of a psychic nature. He believes that more frequently
even than actual epileptic seizures are the dream states, excitements,
and maniacal outbreaks brought about in these individuals by emotional
experiences, and as a result of certain ideas and concepts. He places in
this group the proverbial "wild man", the man who goes into a frenzy
upon seeing a policeman, etc. Although alcohol may in these individuals
prepare the way, the immediate causative factor, however, is the
emotional experience, or the recollection of such an experience.
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