Be that as it may, we secured several lines of attack on the delusions of
personality by our study of quasi-environmental delusions. First, we were
irresistibly led to a consideration of the emotional (pleasant or
unpleasant) character of the delusions. We heaped up a large number of
unpleasant delusions in that (quasi-environmental, but actually) personal
group. It is interesting to inquire, accordingly, whether our more obviously
autopsychic cases will also be possessed of an unpleasant tone. Secondly, we
came upon the curious fact that cardiac and various subdiaphragmatic
diseases were correlated with unpleasant emotion as expressed in the
delusions. It was therefore important to inquire whether similar conditions
prevailed in the new group. Thirdly, we found ourselves inquiring whether
our patients were victims of what might be termed a spreading inwards of the
delusions (egocentripetal) or a spreading outwards thereof (egocentrifugal
delusions). But this difference in trend, clear as it often is from the
patient's point of view, remains to be defined from the outsider's point of
view.
Again, it remains to determine, if possible, how far delusions are dominated
respectively by the intellect or the emotions, or even by the volitions.
As before, I begin with a brief statistical analysis.
SUMMARY
Danvers autopsy series, unselected cases 1000
Cases with little or no gross brain disease 306
Cases listed as having autopsychic delusions 106
Cases listed as having only autopsychic delusions 50
Cases for various reasons improperly classified 13
Cases of general paresis in which gross brain lesions were not observed 15
Residue of autopsychic cases 22
The group of 22 cases thus sifted out can be studied from many points of
view. We may recall that our former study of allopsychic delusions proved
that a large proportion of delusions concerning the environment were in all
probability not essentially derived from the environment. Their contents
might relate to the environment, but their genesis could better be regarded
as autopsychic (intrapersonal). In fact we really found only 6 out of 58
cases of pure allopsychic delusions, which could be safely taken as showing
so much coincidence between anamnesis and delusions that a correlation could
be risked.
Following the method of our former work on somatic and on environmental
delusions, we sought in the first instance PURE cases of autopsychic
delusion-information. For a variety of reasons, more than half of the
original list, namely, 28 cases, had to be excluded. Many of these
exclusions were due to the strong suspicion that the cases were really cases
of general paresis, despite the normality of the brains in the gross. The
residue of 22 cases include, we are confident, no instance of exudative
disease of the syphilitic group, though general syphilization cannot safely
be ruled out in all cases.
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