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Manual Of Psychiatry | by Aaron J. Rosanoff



In the course of the World War I unprecedented opportunities enabled psychiatry to make great strides. The movement for mental hygiene is developing direction, organization, and force. Psychiatrists no longer confine their activities within the walls of institutions for the insane, but are constantly organizing connections with general hospitals, schools, charitable organizations, courts of law, penal institutions, etc.

TitleManual Of Psychiatry
AuthorAaron J. Rosanoff
PublisherJohn Wiley & Sons, Inc
Year1920
Copyright1920, A. J. Rosanoff
AmazonManual of Psychiatry

Edited By Aaron J. Rosanoff, M.D., Formerly Clinical Director, Kings Park State Hospital, N. Y.

Fifth Edition, Revised And Enlarged Total Issue, Eight Thousand

-List Of Contributors
J. Rogues de Fursacy, M.D., formerly Chief of Clinic at the Medical Faculty of Paris, Physician in Chief of the Public Insane Asylums of the Seine Department. Chapters or sections dealing with sympto...
-Preface To The Fifth Edition
In the course of the World War unprecedented opportunities enabled psychiatry to make great strides. The movement for mental hygiene is developing direction, organization, and force. Psychiatrists no ...
-Introduction
Psychiatry is that branch of neurology which treats of mental disorders and of the organic changes associated with them. Mental disorders arrange themselves in two fundamental categories, characteriz...
-Part I. General Psychiatry. Chapter I. Etiology
On studying closely the etiology of mental diseases one soon recognizes the fact that in the great majority of cases the disease is produced - not by a particular or specific cause, but by a series o...
-General Psychiatry. Etiology. Part 2. Heredity
This term is applied to the fact of recurrence of traits in a number of blood relatives, due to their possession of a common germ-plasm. Hereditary traits are those whose development depends chiefly ...
-General Psychiatry. Etiology. Part 3
Alcoholism The most trustworthy experimental data that are available, among which may be mentioned those of Schneider,2 Hellsten,3 Mayer,4 Aschaffenburg,5 Smith,6 Kurz and Kraepelin,7 seem to show th...
-Sec. 2. Incidental Or Contributing Causes of Mental Disorders
The incidental or contributing causes are remarkable for their multiplicity and complexity; one might almost say that they are as many as there are individual cases and that in no two cases is their m...
-Sec. 3. Other Etiological Factors for Mental Disorders
Race An excellent opportunity of investigating the influence of race on the occurrence of mental disorders is afforded by the experience of the hospitals for the insane serving the city of New York, ...
-Other Etiological Factors for Mental Disorders. Continued
Marital Condition Of all patients admitted to the institutions for the insane in the United States during the year 1910, 48.4% among men and 33.4% among women were single. In the adult population at ...
-Chapter II. Symptomatology - Disorders Of Perception. Insufficiency Of Perception - Illusions-Hallucinations
The senses, says Johannes Mueller, inform us of the various conditions of our body by the special sensations transmitted through the sensory nerves. They also enable us to recognize the qualities a...
-Sec. 2. Illusions (Inaccurate Perceptions)
An illusion may be defined as a perception which alters the qualities of the object perceived and presents it to consciousness in a form other than its real one. One who hears insulting words in the s...
-Sec. 3. Hallucinations (Imaginary Perceptions)
A person who has an inmost conviction of a sensation actually perceived, when no external object capable of exciting such sensation is within reach of the senses, is in a state of hallucination (Esq...
-A. Properties Common To All Varieties Of Hallucinations
Hallucinations exercise an influence upon the general psychic condition of the patient, which varies with the subject, the nature of the disease, and the different stages of the same disease. In a ge...
-A. Properties Common To All Varieties Of Hallucinations. Continued
Reactions The influence of hallucinations upon the will depends upon the state of the judgment and of the affectivity. If the judgment is sound, if the hallucinations are looked upon as pathological ...
-B. Special Features Of Each Variety Of Hallucinations. Hallucinations Of Hearing
In pathological states, as in the normal state, auditory sensations occupy a position of primary importance among the psychic functions; thus, of all hallucinations those of hearing are clinically the...
-Hallucinations Of Sight
Hallucinations of sight chiefly occur in toxic and febrile deliria. They vary greatly in distinctness. At times they are so clear that the patient is able to make a sketch of them; often they are, on...
-Hallucinations Of Taste And Smell
The senses of taste and smell are as closely associated in pathological states as they are in the normal state. Therefore hallucinations of these senses are usually considered together. Their clinica...
-Hallucinations of Touch, Thermal Sense, and Sense of Pain
These are often placed in a single group under the name of hallucinations of general sensibility. Hallucinations of touch are frequent in certain toxic psychoses (delirium tremens, cocaine delirium),...
-Motor Hallucinations
A motor hallucination may be defined as an imaginary perception of a movement. It constitutes a disorder of that kind of sensibility which has been designated by the term muscular sense. Analogous ph...
-Theories Of Hallucinations
Johannes Mueller was of the opinion that hallucinations are the consequence of abnormal irritation of peripheral sensory organs. According to Meynert they result from automatic activity of subcortica...
-Chapter III. Symptomatology. Sec. 1. Disorders Of Consciousness
Consciousness may be lost: unconsciousness; or weakened: clouding of consciousness. Unconsciousness And Clouding Of Consciousness Unconsciousness exists physiologically in dreamless sleep, and patho...
-Sec. 2. Disorders Of Memory
An act of memory comprises three distinct operations: 1. The fixation of a representation; 2. Its conservation; 3. Its revival, that is to say, its reappearance in the field of consciousness. Thes...
-Sec. 3. Attention And Association Of Ideas
Disorders Of Attention Attention manifests itself in two forms: spontaneous and deliberate or voluntary. Spontaneous attention, the inferior and less complex of the two forms, consists in a directio...
-Sec. 4. Disorders Of Judgment
Judgment is the act by which the mind determines the relationship between two or more representations. When the relationship is imaginary the judgment arrives at a false conclusion. This becomes a de...
-Disorders Of Judgment. Melancholy Ideas
Very common at the beginning of psychoses, melancholy ideas may persist through the entire duration of the disease, as in involutional melancholia. The principal varieties are: (A) Ideas of humility...
-Chapter IV. Symptomatology. Affectivity - Reactions - Ccenesthesia - Notion Of Personality. Sec. 1. Disorders Of Affectivity
Pathological modifications of affectivity are encountered in the course of all psychoses. They always appear early, and often before any of the other symptoms. The principal ones are: (a) Diminution...
-Passive Depression
The fundamental features of passive depression are lassitude, discouragement, resignation. It is always associated with a marked degree of psychic inhibition, aboulia, and moral anaesthesia, and may b...
-Active Depression
The special feature of active depression is psychic pain, which is distinct and sufficiently intense to render the subject subjectively conscious of it. The appearance of this new phenomenon modifies ...
-Morbid Anger
Pain, associated with a representation of its cause, and sufficiently intense to overcome the psychic paralysis which is an essential accompaniment of depression, results in anger. The violent and di...
-Morbid Joy Or Morbid Euphoria
This presents itself in two forms: one, a calm joy, analogous to passive depression; the other, an active, exuberant joy, analogous to active depression. The first, when of average intensity, manifes...
-Sec. 2. Disorders Of The Reactions
The different psychic operations which we have so far considered - perception, association of ideas, affective phenomena - find their outward expression in the reactions. Like association of ideas, re...
-Sec. 3. Disorders Of Ccenesthesia And Of The Personality
Disorders Of Coenesthesia By ccenesthesia or vital sense is understood the general feeling which results from the state of the entire organism, from the normal or abnormal progress of the vital func...
-Chapter V. The Practice Of Psychiatry. History Taking - Methods Of Examination
The data for diagnosis, prognosis, and treatment are obtained in psychiatry, as in other branches of medicine, from the case history and from the direct examination of the patient. Sec. 1. History Ta...
-Sec. 2. Methods Of Examination
Physical Examination Height, weight (compared with usual weight), malformations (especially of skull), general state of nutrition, pallor (haemoglobin estimation and cell count, if indicated), temper...
-Methods Of Examination. Continued
It goes without saying that any hallucinations or delusions that may be elicited should be gone into thoroughly: Do you hear the voices all the time or only occasionally? Are they distinct? Are they v...
-Chapter VI. The Practice Of Psychiatry. Special Diagnostic Procedures
Special Diagnostic Procedures: Lumbar Puncture - Wassermann Reaction - Chemical Tests - Intelligence Tests - Examination For Aphasia-Association Tests - Other Tests - Medical Consultations It is not ...
-Chapter VII. The Practice Of Psychiatry. Applications Of Psychology In Psychiatry
Mental Measurements In psychiatry, as in other sciences, precise measurement and objective statement present great advantages. It is desirable to express whenever possible in quantitative terms the c...
-Applications Of Psychology In Psychiatry. Continued
Measures Expressed In Terms Of Maturity Another important method of measurement takes advantage of the fact that, up to a certain point in growth, achievement is a function of maturity. The average f...
-Chapter VIII. The Practice Of Psychiatry. General Therapeutic Indications
General Therapeutic Indications: Institution-Commitment - Treatment Of Excitement, Suicidal Tendencies, And Refusal Of Food-Psychotherapy - Parole And Discharge - Aftercare. There is no general treat...
-Treatment Of Excitement
Perhaps the greatest progress in the therapeutics of mental diseases within the past twenty years has been in our methods for the treatment of excitement. By degrees, means of restraint, always usele...
-Suicidal Tendencies
Suicide among the insane is perhaps the greatest source of anxiety to the practical psychiatrist.1 All forms of mental alienation may give rise to ideas of suicide, but the first place from this stan...
-Refusal Of Food
Refusal of food l may result from: (a) Delusions with or without coexisting hallucinations: fear of being poisoned or of not being able to digest the food; hypochondriacal ideas; (6) The desire to s...
-Psychotherapy
Psychotherapy is the use of psychic factors in the treatment of disease. An essential element of psychotherapy is suggestion. Its successful practice is dependent on the nature of the disorder, the a...
-Parole And Discharge - After-Care
A patient who presents no dangerous or troublesome tendencies and who has improved sufficiently to justify his trying to live outside again may be, according to the growing custom of modern institutio...
-Chapter IX. The Practice Of Psychiatry. Psychoanalysis
Mental phenomena, like physical ones, arise not spontaneously or at random, but from adequate causes in accordance with natural law; i.e., here, as elsewhere, applies the doctrine of determinism. Men...
-Sexual Theory (Freud)
Elements of sexuality are present from birth. It rather seems to us that the child brings into the world germs of sensual activity and that even while taking nourishment it at the same time also enj...
-Psychopathology Of Everyday Life
The mental mechanisms which underlie such commonplace occurrences as forgetting names or words and making slips of speech, writing or conduct have been investigated by the psychoanalytic method. It se...
-Interpretation Of Dreams
Psychoanalytic experience has shown that the mechanism of dreams is closely related to that of phobias, obsessions, delusions, and other psychoneurotic and psychotic symptoms. Therefore the study of d...
-Symbolism In Dreams
When one has become familiar with the abundant use of symbolism for the representation of sexual material in dreams, one naturally raises the question whether there are not many of these symbols whi...
-Dream Mechanisms
In the translation of dream thoughts into dream content three principal mechanisms are at work: condensation, displacement, and moulding for presentability. The first thing which becomes clear to th...
-Two Kinds Of Thinking: Realistic And Autistic
No deep insight into mental mechanisms is possible without taking cognizance of the fact of two kinds of thinking: one variously designated logical, directed, or realistic, the other dream, phantasy, ...
-Technique Of Psychoanalysis
Psychoanalysis may be undertaken either for the purpose of gaining insight into underlying mental mechanisms of normal or abnormal conduct, or for a therapeutic purpose. If for the latter, it is impor...
-Chapter X. The Practice Of Psychiatry. Applications Of Sociology In Psychiatry
The origin of social work is found, not in the science of sociology, but in the primitive impulse to relieve distress, which, gradually growing into organized form under the auspices of the church, wa...
-Interrelation Of Social And Mental Disorders
The necessity for close cooperation between psychiatrist and sociologist is evident when it is considered that mental disorder and social disorder are but two aspects of the same condition. 1 Kellogg...
-The Psychiatric Social Worker
By reason of general recognition of the above a demand has arisen for psychiatric social work and special training is being provided.1 Not everybody is equipped for psychiatric social work. The psych...
-Functions Of A Sociological Department
The sociological or social service department of a hospital for mental diseases has functions related to (a) diagnosis, (6) treatment, (c) research, and (d) education. Every patient admitted requires ...
-Organization Of A Sociological Department
The organization of a sociological department in a hospital conducting an out-patient clinic must make provision primarily for social work contributing to diagnosis and treatment. The routine duties m...
-Chapter XI. The Practice Of Psychiatry. Prognosis - Prevalence Of Mental Disorders: Are They On The Increase?
Prognosis In the early part of the nineteenth century, when the care of the insane had passed from the hands of the clergy, penal authorities, and poor-law officials to those of physicians, the hope ...
-Prevalence Of Mental Disorders: Are They On The Increase? Continued
The need of standards of normality is felt not only in connection with attempts of enumeration of the insane in communities, but also in daily practice in connection with every case of alleged insanit...
-Chapter XII. The Practice Of Psychiatry. Prophylaxis In Psychiatry
Relationship Between Bad Heredity And Other Causes - Prevention Of Bad Heredity - Prevention Of Alcoholism, Drug Addictions, And Syph-Lis - The Individual - Immigration As stated in the chapter on et...
-Relationship Between Bad Heredity And Other Causes
The prevention of bad heredity affords a hope of reducing not only the constitutional mental disorders, but also those which develop on the basis of alcohol and drug addictions and of syphilis, as may...
-Prevention Of Bad Heredity
The means that have been suggested for combating bad heredity are legal restriction of marriage, surgical sterilization, and segregation. This would, perhaps, hardly be the place for a full discussion...
-Prevention of Alcoholism, Drug Addictions, and Syphilis
Direct efforts for the prevention of alcoholism, drug addictions, and syphilis, independently of the measures for-combating bad heredity, are by no means to be neglected. Abstinence The most trustwo...
-Head Injuries
There is but little to be said with reference to head injuries which, like other injuries resulting in either disability or death, have become common as a result of the great modern development of ind...
-Chapter XIII. The Practice Of Psychiatry. Commitment - Legal Competence - Testamentary Capacity - Criminal Responsibility - Relation-Ship Between Vice, Crime And Mental Disorders
Medico-Legal Questions In Psychiatry The most important medico-legal questions that may arise in connection with cases of alleged mental disorders are those of necessity of commitment, competence in ...
-Criminal Responsibility Of A Psychiatrist
Perhaps the most difficult position in which a psychiatrist may find himself is when he is consulted on the question of criminal responsibility. Here the difficulty lies not so much in the nature of t...
-Relationship between Vice, Crime, and Mental Disorders
The almost exclusive preoccupation of criminal courts with the question of guilt and punishment has led to their overlooking largely the important relationship which there is between vice and crime an...
-Chapter XIV. The Practice Of Psychiatry. Extramural Psychiatry
Twenty or twenty-five years ago it was a common assumption that psychiatric clinical material was mainly contained in institutions for the insane. With increasing knowledge of mental disorders, howeve...
-Part II. Special Psychiatry. Classification
Sixteen years ago, when the first French edition of this Manual was published, the author felt it incumbent on himself to offer a sort of apology for following Kraepelin's classification of mental dis...
-Chapter I. Arrests Of Development: Idiocy, Imbecility, Moronism, Borderline Conditions
Etiology Bad heredity is by far the most common and important cause of arrests of development. There are, however, other factors acting during intra-uterine life or in infancy or early childhood whic...
-Arrests Of Development: Idiocy, Imbecility, Moronism, Borderline Conditions. Part 2
Idiots are persons so deeply defective in mind from birth or from an early age that they are unable to guard themselves from common physical dangers, such as, in the case of young children, would prev...
-Arrests Of Development Complications, Diagnosis and Prognosis
Complications The most common physical complications are epilepsy and more or less marked residuals of infantile cerebral paralysis. In some cases the epilepsy, in the course of years, produces ment...
-Arrests Of Development Treatment
The general measures of treatment are: (a) Training and education. (6) Segregation, (c) Boarding out and employment under supervision. (a) The training and education may be carried out either in spec...
-Chapter II. Psychic Disorders Associated With Epilepsy
From a psychiatric standpoint epilepsy manifests itself by permanent disorders and by paroxysmal accidents. Permanent Psychic Disorders These impart to the epileptic personality a peculiar stamp and...
-Paroxysmal Psychic Disorders
These are either associated with, or replace, the epileptic seizures. We shall review briefly their principal forms. (A) Sensory And Psychic Auras The first consist in hallucinations or illusions; t...
-Paroxysmal Psychic Disorders. Continued
An attack of epileptic delirium lasts from a few minutes to several days. It may be reduced to a single automatic act. Like the other manifestations of epilepsy, it may be produced always by the same ...
-Epilepsy Treatment
Some cases of epilepsy, suffering but infrequently from seizures - perhaps only at night - and being free from psychic disability, can and do, with the aid of occasional medical advice, lead normal li...
-Chapter III. Constitutional Psychopathic States
There is a large group of persons who, though not necessarily suffering from epileptic, psychotic, or psychoneurotic symptoms, alcoholic or drug addiction, or feeblemindedness in the strict sense of t...
-Inadequate Personality
These cases, either from lack of initiative, ambition, perseverance, or judgment; or through shiftlessness or tactlessness; or a planless, improvident existence, and often in spite of good educational...
-Paranoid Personality
To understand this condition, one needs but to make a study of paranoia, from which it differs but in degree.2 Conceit and suspicion, which are the fundamental traits of paranoia, here, too, lie at th...
-Criminalism
By reason of its complexity the moral sense is one of the most delicate and most vulnerable functions of the mind. Thus we find it altered in most of the psychoses, especially those accompanied by men...
-Pathological Lying
This consists in falsification entirely disproportionate to any discernible end in view, engaged in by a person who, at the time of observation, cannot definitely be declared insane, feeble-minded, o...
-Sexual Psychopathy
Among the anomalies of sexual life it is usual to distinguish: (A) Anomalies of degree: eroticism; frigidity. (B) Anomalies of nature: sexual perversion; sexual inversion. (A) Anomalies Of Degree ...
-Nomadism
The nomadic tendency is present in most of us in some degree and, as all know, is in certain races so pronounced as to govern their mode of existence and social organization.2 In persons in whom the w...
-Chapter IV. Dementia Praecox
Under the name hebephrenia, Hecker, inspired by his preceptor, Kahlbaum, described a psychosis which develops by predilection at the age of puberty and which terminates in a peculiar state of mental d...
-A. Simple Dementia Praecox
In this form the symptoms are reduced to phenomena of mental deterioration together with more or less pronounced changes in disposition. The onset is almost always insidious, and it is usually imposs...
-B. Catatonia
Onset Prodromata are almost constant; they possess no specific features: change of disposition, inaptitude for work, insomnia. Often the symptoms of melancholia open the series of grave phenomena. I...
-Catatonic Stupor
This may follow a period of depression or one of catatonic excitement, or it may be primary, constituting the onset of the disease. In its true sense the term stupor implies the existence of a prof...
-C. Dementia Praecox Of Delusional Form
The prodromata consist, as in most psychoses, in change of disposition, insomnia, and impairment of general health. Schematically we may distinguish in the delusional form of dementia praecox two ext...
-Principal Varieties Of Delusional Dementia Praecox
The systematized type of delusional dementia praecox is met with in three principal varieties: (a) Persecutory variety; (6) Melancholic variety; (c) Megalomaniacal variety. (A) Persecutory Variety ...
-Delire Chronique A Evolution Systematique
Isolated by Magnan from the poorly defined group of paranoic conditions, delire chronique presents a striking analogy to certain forms of dementia praecox, which fact led Krae-pelin to include it unde...
-Diagnosis, Prognosis, Etiology, Nature And Treatment Of Dementia Praecox
Diagnosis This is based on: (a) Early appearance of disorders of affectivity and of the reactions; (6) Delayed appearance of intellectual disorders proper and their less marked intensity; (c) The ...
-Etiology Of Dementia Praecox
Statistics show that dementia praecox is a disease chiefly of young life. According to Kraepelin, in 60% of the cases it begins before the twenty-fifth year. It is rare after the age of thirty. It see...
-Pathological Anatomy Of Dementia Praecox
Until recently most psychiatrists placed dementia praecox among the so-called functional disorders. The newer studies have, however, revealed fairly constant, though not pathognomonic, anatomical chan...
-Chapter V. Paranoia
Paranoia is to be looked upon as the development of a morbid germ the existence of which manifests itself in early life by anomalies of character. These anomalies may be, to use the apt expression of ...
-Chapter VI. Manic-Depressive Psychoses. Manic Type
Manic-depressive psychoses are manifested in attacks presenting a double characteristic: a tendency toward recovery without mental deterioration and a tendency toward recurrency. From a symptomatic st...
-Delusional Mania
The fundamental symptoms are the same as those of simple mania. The excitement may be more marked and the lucidity perhaps transitorily disturbed. The delusions are usually mobile and consist in idea...
-Confused Mania
Clouding of consciousness is here permanent. The attack begins suddenly or after a short prodromal period, characterized from the beginning by complete disorientation, very great excitement, and total...
-General Course, Duration, and Prognosis of a Manic Attack
The course of mania is capricious. In a general way it may be represented by a curve which at first ascends, then remains horizontal for some length of time, and finally gradually descends. But this c...
-Sec. 2. Manic-Depressive Psychoses. Depressed Type
The fundamental symptoms of the depressed type are: Psychic inhibition; A painful emotional state associated with indifference; Aboulia. As in the case of mania, we distinguish here three forms: s...
-Sec. 3. Manic-Depressive Psychoses. Mixed Types
Attacks of Mixed Form, Properly so Called Kraepelin has thrown light upon the true nature of these cases, which are more frequent than is generally supposed and in which the symptoms of excitement an...
-Sec. 4. Manic-Depressive Psychoses. General Course - Prognosis - General Considerations - Treatment
Manic-depressive attacks present a very marked tendency to recur. According to the particular forms assumed by the successive attacks, several types of manic-depressive psychoses are distinguished. (...
-Homogeneity Of Manic-Depressive Psychoses. Fundamental Symptoms
The conception of manic-depressive psychoses is due to Kraepelin and constitutes one of the most important advances in psychiatry. Although the grouping of such apparently different and even opposite ...
-Sec. 5. Chronic Mania
The diagnosis of chronic mania was at one time one of the most common in psychiatry. To-day there can be no doubt that many cases formerly thus labeled belong to excited forms of dementia praecox, par...
-Chapter VII. Involutional Melancholia
The essential cause of this disease seems to be bad heredity. Among other factors those most frequently mentioned are grief and stress. Occurring chiefly after forty-five years of age, it seems to be ...
-Involutional Melancholia. Continued
Delusional Melancholia All varieties of melancholy delusions are encountered in this affection: ideas of culpability, of humility, of ruin, hypochondriacal ideas, and ideas of negation. It is not unc...
-Chapter VIII. Psychoneuroses Hysteria - Neurasthenia - Psychasthenia. Sec. 1. Hysteria
Many conditions with which psychiatrists have to deal demand a certain broadening of the traditional conception of disease - that of some morbid material or influence engrafted upon the organism. Amon...
-Heredity And Constitutional Make-Up
Of 100 cases of hysteria observed in soldiers in the U. S. Army Hospital for War Neuroses at Plattsburg Barracks, N. Y., there was a neuropathic family history in 64, a negative family history as rega...
-Etiological Factors Other Than Heredity
In the early months of the war medical writers mentioned physical and psychic factors in the etiology of hysteria more or less indiscriminately. Gradually, as the distinction became clear between true...
-Psychic Mechanisms Underlying Cures
The viewpoint advanced here with reference to the mechanism of hysteria is borne out not only by the conditions under which the disabling symptoms arise, but also by the conditions under which they di...
-Relationship Between Hysteria And Malingering
This brings us to the question of the relationship between hysteria and malingering. Opinions differ as to when a diagnosis of hysteria should be made and when one of malingering would be justified. Y...
-Sex Factors. Intrapsychic Conflicts
There remain two other points in connection with hysteria which merit discussion in the light of the war experiences: (1) the part played by sex factors, (2) the theory of intrapsychic conflicts. Both...
-The Hysterical Personality
The family and personal histories of hysterics indicate some sort of relationship to the constitutional psychoses, epilepsy, mental deficiency, constitutional psychopathic states, etc. But the hysteri...
-Sec. 2. Neurasthenia
The cases classed under the heading of neurasthenia may be roughly divided into four groups which are superficially very similar to each other but which, on closer study, may be found to be based on w...
-Sec. 3. Psychasthenia. Obsessions, Morbid Fears And Doubts
Psychasthenia is characterized by obsessions, morbid fears and doubts. An obsession l consists in an imperative idea associated with a state of anxiety, there being no marked disorder of consciousnes...
-(2) Psychasthenia. Impulsive Obsessions
These are very numerous. The following are the principal forms: Onomatomania: an irresistible desire to pronounce certain words, sometimes obscene words (coprolalia). Arithmomania: an irresistible d...
-(3) Psychasthenia. Inhibiting Obsessions
Like the preceding ones, these assume very varied forms. One of the most frequent is doubting mania. Its characteristic feature is the inability on the part of the patient to affirm a fact or to ma...
-Chapter IX. Huntington's Chorea
Huntington's chorea, a constitutional affection in the strictest sense, occurring on a hereditary basis, forms a group apart from and apparently entirely independent of the other constitutional disord...
-Chapter X. Acute Alcoholism; Pathological Drunkenness
The term drunkenness is here used to designate the nervous and mental symptoms by which acute alcoholic intoxication manifests itself. The predisposition to the state of drunkenness, quite variable i...
-Chapter XI. Chronic Alcoholism
Chronic alcoholism manifests itself: (1) in permanent symptoms (the stigmata of alcoholism), and (2) in episodic accidents. I. Permanent Symptoms The Permanent Symptoms Are Psychic And Physical. A. P...
-Chronic Alcoholism. Continued
Diagnosis Chronic alcoholism is to be differentiated chiefly from those diseases in which there is mental deterioration: dementia praecox, general paralysis, and senile dementia. The student is refer...
-II. Episodic Accidents Of Chronic Alcoholism
The episodic accidents of chronic alcoholism are of four kinds: delirium tremens, acute hallucinosis, delusional states, and the polyneuritic psychosis. The prodromata consist in an accentuation of t...
-Episodic Accidents Of Chronic Alcoholism. Continued
Complications Among those involving the nervous system the most frequent are epileptiform seizures which may precede by thirty-six or forty-eight hours the onset of the delirium, or they may occur du...
-Acute Hallucinosis; Delusional States
Acute hallucinosis differs from delirium tremens: (1) in the predominance of hallucinations of hearing over those of sight; (2) in the absence of any marked disorder of consciousness; and (3) in its c...
-Polyneuritic Psychosis
The polyneuritic psychosis or Korsakoff's diseasel is an affection characterized by the association of phenomena of polyneuritis with specific mental disturbances among which amnesia of diverse forms ...
-Chapter XII. Drug Addictions
It would seem that the use of narcotics in one form or another is based on a deeply rooted universal human craving. The manner of gratification of this craving varies in different parts of the world ...
-Drug Addictions. Four Periods Of A Morphine Addict
According to Chambard four periods may be distinguished in the career of a morphine addict, which follow one another by imperceptible transitions. First Period: Initiation Or Euphoria It has been ap...
-Adjuvant Therapy for Drug Addictions
The diet should be tonic and reconstructive. In cases of marked cachexia it is advisable to improve the state of general nutrition before complete demorphinization.2 The digestive tract and the heart...
-Chapter XIII. Syphilitic Disorders Mesoblastic Invasion: Cerebral Syphilis. Early Involvement - Meningitic Type - Gummatous Type - Endarteritic Type
Early Involvement Recent developments have shown that the occurrence of syphilis of the central nervous system, more particularly of the meninges, is much more common in the secondary stage than has...
-Chapter XIV. Syphilitic Disorders. Parenchymatous Invasion: General Paralysis
Synonyms Chronic arachnitis and chronic meningitis (Baylc). Incomplete general paralysis (Delaye). General paralysis of the insane or chronic diffuse periencephalo-meningitis (Calmiel). Paralytic ins...
-Sec. 1. Parenchymatous Invasion: General Paralysis. Essential Symptoms
It will be necessary to consider these apart from accessory and inconstant symptoms, by the presence of which they are often masked. The essential symptoms are: (A) Mental deterioration; (B) Disord...
-Sec. 2. Parenchymatous Invasion: General Paralysis. Inconstant Symptoms
Many symptoms, though not constant are, however, frequent and important. This group comprises: (A) Mental disorders; (B) Motor disorders; (C) Disorders of the reflexes; (D) Disorders of sensation;...
-Parenchymatous Invasion: General Paralysis. Inconstant Symptoms. Continued
(B) Motor Disorders The most frequent are phenomena of paralysis and of paresis, which may assume the most varied types: monoplegia, hemiplegia, facial paralysis. The latter, generally slight, consti...
-Sec. 3. Parenchymatous Invasion: General Paralysis. Forms. Evolution. Diagnosis
The principal forms of general paralysis are: (A) Demented form; (B) Expansive form; (C) Excited form; (D) Depressed form; (E) Spinal forms tabetic; spastic. A. Demented ...
-Parenchymatous Invasion: General Paralysis. Pathological Anatomy
We shall describe separately the lesions of the encephalon, spinal cord, peripheral nerves, and viscera. Pathological Anatomy. A. Encephalon Dura mater: often congested, presenting occasionally the ...
-Parenchymatous Invasion: General Paralysis. Etiology
In 1857 Esmarch and Jessen were led by the clinical histories of their cases to conclude that syphilis was the cause of general paralysis; but their view gained ground very slowly. In France Charcot a...
-Parenchymatous Invasion: General Paralysis. Prevention And Treatment
The prevention of general paralysis consists mainly in measures for the prevention of syphilis, which have already been discussed in Part I, Chapter XII (Drug Addictions). Early and thorough treatmen...
-Chapter XV. Syphilitic Disorders. Cerebral Arteriosclerosis
Cerebral arteriosclerosis is not always of syphilitic origin, though probably much more frequently so than would be indicated by clinical statistics. Disease of the arteries of the brain is often fou...
-Chapter XVI. Traumatic Disorders
Traumatisms may play a part in the etiology of psychoses essentially of a constitutional nature, and they have been known to cause the development of general paralysis in syphilitic persons; it is bel...
-Chapter XVII. Miscellaneous Groups Deliria Of Infectious Origin
The mental disorders which appear in the course of infectious diseases are brought about by the combined action of several factors: elevation of temperature, congestion of the nervous centers, and poi...
-Chapter XVIII. Miscellaneous Groups. Psychoses Of Exhaustion: Primary Mental Confusion, Acute Delirium
Well described by Georget and by Delasiauve, primary mental confusion has only recently been brought again into prominence in French medical literature through the labors of Chaslin and of Seglas.1 T...
-Psychoses Of Exhaustion: Primary Mental Confusion, Acute Delirium. Continued
Delirious Form This form, much more frequent than the preceding one, owes its peculiar aspect to a more or less marked exaggeration of the activity of the mental automatism, which gives rise to: (a) ...
-Chapter XIX. Miscellaneous Groups. Psychoses Of Autointoxication: UraeMic Delirium
Uremic delirium presents the usual features of toxic deliria: more or less complete clouding of consciousness, disorientation, phenomena of psychic automatism, among which psycho-sensory disorders occ...
-Chapter XX. Miscellaneous Groups. Thyrogenic Psychoses
Hypothyroidism: Myxcedema; Cretinism. - Hyperthyroidism: Exophthalmic Goiter Destruction of the thyroid gland gives rise to peculiar autointoxication which is met with in two clinical forms: myxoedem...
-Sec. 1. Myxcedema
The external aspect of a myxedematous patient is characteristic. The puffed and expressionless face together with the general attitude reflect both mental inertia and profound disorder of general nutr...
-Sec. 2. Cretinism
Cretinism may be defined as an arrest of somatic and psychic development dependent generally upon a goiter, and more rarely upon simple atrophy of the thyroid gland. 1 Briquet. Valeur comparee des me...
-Sec. 3. Hyperthyroidism: Exophthalmic Goiter
In 1835 Graves, a Dublin physician, described an affection characterized by exophthalmos, swelling of the thyroid gland, and tachycardia. In 1840 Basedow, in Germany, more fully described this affecti...
-Chapter XXI. Miscellaneous Groups. Mental Disorders Due To Organic Cerebral Affections
All organic cerebral affections, whether diffuse or localized, have an influence upon the psychic functions. The most important among those which have not already been considered are tumors, multiple...
-Chapter XXII. Miscellaneous Groups. Senile Dementia
Senile dementia may be defined as a peculiar state of mental deterioration, with or without delusions, resulting from cerebral lesions determined by senility. Age is here, therefore, the great etiolo...
-Part III. Appendices Dealing With Technique Of Special Diagnostic Procedures. Appendix I. Lumbar Puncture - Cell Count - Chemical Tests
Lumbar puncture is a simple and harmless procedure. The only danger, that of infection, can be entirely avoided by the exercise of ordinary precautions of asepsis. The only contraindication is high i...
-Lumbar Puncture - Cell Count - Chemical Tests. Part 2
The following are the most useful procedures for examining spinal fluid for psychiatric diagnosis: (a) Cell count. (6) Lange's colloidal gold test, (c) Special protein tests (Noguchi, Ross-Jones, Pand...
-Lumbar Puncture - Cell Count - Chemical Tests. Part 3
If this titration is satisfactory, the solution is further tested with a specimen of spinal fluid known to have given a paretic curve. 1 Carl Lange. Die Ausflokkung kolloidalen Goldes durch Cerebro-s...
-Appendix II. Wassermann Reaction
Principle Of The Wassermann Reaction When blood corpuscles of an animal of a given species are injected into an animal of a foreign species the blood serum of the second animal develops the power of ...
-Wassermann Reaction. Part 2
Preparation Of Reagents Complement is derived from fresh guinea-pig serum, the following being the most convenient way. A full-grown guinea pig is held by an assistant over a large Petri dish in a hy...
-Wassermann Reaction. Part 3
Antigen thus prepared possesses, on the one hand, true antigenic power, that is to say, the power of binding complement in the presence of a syphilitic serum and thus inhibiting haemolysis, and, on th...
-Appendix III. Examination For Aphasia
Cases of organic brain disease with lesions involving the speech areas and therefore presenting symptoms of aphasia require a special method of examination. An outline for guidance in such examination...
-Appendix IV. Normal Course Of Mental Development
From Birth to Third Year (From Preyer, Paton, Church and Peterson, and others) The study of the early years of infancy resulted long ago in the formulation of outlines showing the normal course of de...
-Appendix V. Stanford Revision Of The Binet-Simon Intelligence Scale
Materials And Equipment The following materials and equipment are required: (1) A set of printed cards consisting of four pictures used in 3-, 7-, and 12-year tests; lines for comparison used in 4-y...
-The Binet-Simon Intelligence Scale. Instructions For Year III
1. Pointing To Parts Of The Body. Procedure After getting the child's attention, say: Show me your nose. Put your finger on your nose, Same with eyes, mouth, and hair. 1 See Chapter I, Part II, ...
-The Binet-Simon Intelligence Scale. Instructions For Year IV
1. Comparison Of Lines. Procedure Present the appropriate accompanying card with the lines in horizontal position. Point to the lines and say: See these lines. Look closely and tell me which one is...
-The Binet-Simon Intelligence Scale. Instructions For Year V
1. Comparison Of Weights. Procedure Place the 3-and 15-gram weights on the table before the child some 2 or 3 inches apart. Say: You see these blocks. They look just alike, but one of them is heavy ...
-The Binet-Simon Intelligence Scale. Instructions For Year VI
1. Distinguishing Right And Left. Procedure Say to the child: Show me your right hand. After this is responded to, say: Show me your left ear. Then: Show me your right eye. Stress the words lef...
-The Binet-Simon Intelligence Scale. Instructions For Year VII
1. Giving The Number Of Fingers. Procedure How many fingers have you on one hand? How many on the other hand? How many on both hands together? If the child begins to count in response to any of...
-The Binet-Simon Intelligence Scale. Instructions For Year VIII
1. The Ball-And-Field Test. Procedure Say: Let us suppose that your baseball has been lost in this round field. You have no idea what part of the field it is in. You don't know what direction it cam...
-The Binet-Simon Intelligence Scale. Instructions For Year VIII. Part 2
3. Comprehension, Third Degree The procedure is the same as in previous comprehension questions. Each question may be repeated once or twice, but its form must not be changed. No explanations are per...
-The Binet-Simon Intelligence Scale. Instructions For Year VIII. Part 3
5. Giving Definitions Superior To Use. Procedure The words for this year are balloon, tiger, football, and soldier. Ask simply: What is a balloon? etc. If it appears that any of the words are not f...
-The Binet-Simon Intelligence Scale. Instructions For Year IX
1. Giving The Date. Procedure Ask the following questions in order: (a) What day of the week is it to-day? ' (6) What month is it? (c) What day of the month is it? (d) What year is it? If th...
-The Binet-Simon Intelligence Scale. Instructions For Year X
1. Vocabulary: Thirty Definitions Procedure and scoring as in VIII, 6. At year X, thirty words should be correctly defined. 2. Detecting Absurdities. Procedure Say to the child: I am going to read...
-The Binet-Simon Intelligence Scale. Instructions For Year X. Continued
Scoring The test is passed if the selection is read in thirty-five seconds with not more than two errors, and if the report contains at least eight memories. By underscoring the memories correctly ...
-The Binet-Simon Intelligence Scale. Instructions For Year XII
1. Vocabulary: Forty Definitions Procedure and scoring as in previous vocabulary tests. 2. Defining Abstract Words. Procedure The words to be defined are pity, revenge, charity, envy, and justice. ...
-The Binet-Simon Intelligence Scale. Instructions For Year XII. Continued
5. Interpretation Of Fables. Procedure Present the fables in the order in which they are given in the record booklet. The method is to say to the subject: You know what a fable is? You have heard ...
-The Binet-Simon Intelligence Scale. Instructions For Year XIV
1. Vocabulary: Fifty Definitions Procedure and Scoring, as in VIII, X, and XII. 2. Induction Test: Finding A Rule. Procedure Provide six sheets of thin blank paper, say 8 1/2 by 11 inches. Take the...
-The Binet-Simon Intelligence Scale. Instructions For "Average Adult"
1. Vocabulary: Sixty-Five Definitions Procedure and Scoring, as in previous vocabulary tests. 2. Interpretation Of Fables (Score 8). Procedure As in year XII, test 6. Use the same fables. Scoring ...
-The Binet-Simon Intelligence Scale. Instructions For "Average Adult". Continued
5. Repeating Six Digits Reversed The series used are: 4-7-1-9-5-2; 5-8-3-2-9-4; and 7-5-2-6-3-8. Procedure and Scoring, as in year VII, alternative 2. 6. Using a Code. - Procedure. - Show the subjec...
-The Binet-Simon Intelligence Scale. Instructions For "Superior Adult"
1. Vocabulary: Seventy-Five Definitions Procedure and Scoring, as in previous vocabulary tests. 2. Paper-Cutting Test. Procedure Take a piece of paper about 6 inches square and say: Watch carefull...
-Appendix VI. Free Association Test (Kent-Rosanoff)
Instructions One uses a sheet with the stimulus words printed on it and with space opposite each stimulus word for the reaction.2 In a room reasonably free from distracting influences the subject is ...
-Free Association Test (Kent-Rosanoff). Continued
Association To Preceding Stimulus Here is placed any individual reaction that is shown by the frequency tables to be related to the stimulus preceding the one in question. Association To Preceding R...
-The Frequency Tables
Association tests may be found useful in studying disturbances of the flow of thought, and they have been used in the technique of psychoanalysis. For whatever object employed, it would seem advisable...
-The Frequency Tables. Part 2
Appendix To The Frequency Tables General Rules 1. Any word combination which is to be found in the frequency tables, but only in the reverse order from that in which it occurs in a test record under...
-The Frequency Tables. Part 3
42. Working Any occupation, profession, art, or labor. Direct results or consequences of work. Any place of employment. Rest, recreation, inaction, or disinclination to work. Word denoting energy...
-The Frequency Tables. Part 4
63. Bath Word denoting or implying an effect of bathing on the body. Any body of water. Any kind of bath; any part of bath, lavatory, or toilet equipment. Any material of which a bathing equipme...
-The Frequency Tables. Part 5
82. Doctor The name of any physician. Any medical specialty or practice. Any medical or surgical procedure. Any therapeutic remedy or method. Any organization for the treatment of disease. Na...
-Appendix VII. Standard Psychological Group Tests
The following tests can be applied not only to individual subjects, but also to groups of subjects. They can be best conducted in a classroom containing the usual equipment of desks, blackboards, etc....
-Appendix VIII. Classification Of Mental Diseases Adopted By The American Medico-Psychological Association May 30, 1917, And By The New York State Hospital Commission July 1, 1917
1. Traumatic psychoses, (a) Traumatic delirium. (6) Traumatic constitution, (c) Post-traumatic mental enfeeblement. 2. Senile Psychoses. (a) Simple deterioration. (6) Presbyophrenic type. (c) Delir...
-1. Traumatic Psychoses
The diagnosis should be restricted to those mental disorders arising as a direct or obvious consequence of brain (or head) injury which produces psychotic symptoms of a fairly characteristic kind. The...
-2. Senile Psychoses
A well-defined type of psychosis which as a rule develops gradually and is characterized by the following symptoms: Impairment of retention (forgetfulness) and general failure of memory more marked f...
-3. Psychoses With Cerebral Arteriosclerosis
The clinical symptoms, both mental and physical, are varied, depending in the first place on the distribution and severity of the vascular cerebral disease and probably to some extent on the mental ma...
-4. General Paralysis
The range of symptoms encountered in general paralysis is too great to be reviewed here in detail. As to mental symptoms, most stress should be laid on the early changes in disposition and character, ...
-5. Psychoses With Cerebral Syphilis
Since general paralysis itself is now known to be a parenchymatous form of brain syphilis, the differentiation of the cerebral syphilis cases might on theoretical grounds be regarded as less important...
-6. Psychoses With Huntington's Chorea
Mental symptoms are a constant accompaniment of this form of chorea and as a rule become more marked as the disease advances. Although the disease is regarded as being hereditary in nature, a diagnosi...
-7. Psychoses With Brain Tumor
A large majority of brain tumor cases show definite mental symptoms. Most frequent are mental dullness, somnolence, hebetude, slowness in thinking, memory failure, irritability and depression, althoug...
-8. Psychoses With Other Brain Or Nervous Diseases
This division provides a place for grouping a variety of less common mental disorders associated with organic disease of the nervous system and not included in the preceding larger groups. On the card...
-9. Alcoholic Psychoses
The diagnosis of alcoholic psychosis should be restricted to those mental disorders arising with few exceptions in connection with chronic drinking and presenting fairly well-defined symptom-pictures....
-10. Psychoses Due To Drugs And Other Exogenous Toxins
The clinical pictures produced by drugs and other exogenous poisons are principally deliria or states of confusion; although sometimes hallucinatory and paranoid reactions are met with. Certain poison...
-11. Psychoses With Pellagra
The relation which various mental disturbances bear to the disease pellagra is not yet settled. Cases of pellagra occurring during the course of a well-established mental disease such as dementia prae...
-12. Psychoses With Other Somatic Diseases
Under this heading are brought together those mental disorders which appear to depend directly on some physical disturbance or somatic disease not already provided for in the foregoing groups. In the...
-13. Manic-Depressive Psychoses
This group comprises the essentially benign affective psychoses: mental disorders which fundamentally are marked by emotional oscillations and a tendency to recurrence. Various psychotic trends, delus...
-14. Involution Melancholia
These depressions are probably related to the manic-depressive group; nevertheless the symptoms and the course of the involution cases are sufficiently characteristic to justify us in keeping them apa...
-15. Dementia Praecox
This group cannot be satisfactorily defined at the present time, as there are still too many points at issue as to what constitute the essential clinical features of dementia praecox. A large majority...
-16. Paranoia And Paranoic Conditions
From this group should be excluded the deteriorating paranoic states and paranoic states symptomatic of other mental disorders or of some damaging factor such as alcohol, organic brain disease, etc. ...
-17. Epileptic Psychoses
In addition to the epileptic deterioration transitory psychoses may occur which are usually characterized by a clouded mental state followed by an amnesia for external occurrences during the attack. (...
-18. Psychoneuroses And Neuroses
The psychoneurosis group includes those disorders in which mental forces or ideas of which the subject is either aware (conscious) or unaware (subconscious) bring about various mental and physical sym...
-19. Psychoses With Constitutional Psychopathic Inferiority
Under the designation of constitutional psychopathic inferiority is brought together a large group of pathological personalities whose abnormality of make-up is expressed mainly in the character and i...
-20. Psychoses With Mental Deficiency
This group includes the various types of intellectual deficiency or feeblemindedness. The degree of mental deficiency should be determined by the history and the use of standard psychometric tests. Th...
-21. Undiagnosed Psychoses
In this group should be included cases in which a satisfactory diagnosis cannot be made and the psychosis must therefore be regarded as an unclassified one. The difficulty may be due to lack of inform...
-22. Not Insane
This group should receive the occasional case which after investigation and observation gives no evidence of having had a psychosis. The only difficulty likely to be encountered in the statistical rep...









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