The most positive results of this orienting study appear to be the
unlikelihood of euphoria and allied symptoms in the "mild" or non-atrophic
cases and the unlikelihood of certain symptoms, here termed
contra-environmental, in the severe or atrophic cases. Perhaps these
statistical facts may lay a foundation for a study of the pathogenesis of
these symptoms. Meantime the pathogenesis of such symptoms as amnesia and
dementia cannot be said to be nearer a structural resolution, as these
symptoms appear to be approximately as common in the "mild" as in the
"severe" groups.
But in both papers dealing with paresis [2,4] we rest under the suspicion
that the delusions are possibly of cerebral manufacture. Of course, a lesion
somewhere outside the brain is not unlikely to be projected through the
diseased brain, and SOMATIC delusions in the paretic are rather likely to
represent something in the viscera.
It was desirable to get back to normal-brain material, to learn how the
INTRINSICALLY NORMAL brain[5] could perhaps produce delusions from a
particular environment. Could a particularly "bad" environment actually
PRODUCE delusions?
By chance, at about this stage in our studies of delusions, some work on
fifth-decade insanities[6] was completed. This work seemed to show that the
most characteristic (non-coarsely-organic) cases of involutional origin were
much given to delusions (each of 24 cases studied), somewhat more so than to
the hypochondria and melancholia which we commonly ascribe to the involution
period. But this result is equivocal as to the environmental (i. e.
allopsychogenic) power to produce delusions, since one could not rid oneself
of the suspicion that the delusions were due to the degenerating brain.
To return to our former results with the normal-looking brain:
Case after case of the quasi-environmental group proved to be more
essentially personal than environmental, until at last it almost seemed that
the environment could seldom be blamed for any important share in the
process of false belief. In short, we seemed to show that environment is
seldom responsible for the delusions of the insane.
Public-domain text, read in full here on John Shaqi.
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