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The Personal Equation in Alienism

Published online by Cambridge University Press:  19 February 2018

Thomas Drapes*
Affiliation:
Enniscorthy Asylum

Extract

I feel that some kind of apology is due for my venturing to bring before a society which concerns itself mainly with practical questions what I fear will be regarded as a decidedly unpractical paper. Still, it may not be without advantage once in a way to step aside from the more arduous path of observational or experimental investigation in the region of psychiatry with its exacting conditions, and view things from a more general standpoint. And, while confessedly it may lead to no practical outcome, if by challenging some acknowledged views, and raising a breeze of controversy, however gentle, which may ruffle the quiescent surface of the pool of accepted opinion, it should at least suggest some grounds for a reconsideration of certain important questions connected with psychology and psychiatry, the object of the writer will be achieved.

Type
Part I.—Original Articles
Copyright
Copyright © Royal College of Psychiatrists, 1911 

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References

(1) Dr. Marshall, in a paper on “Periodic Attacks of Excitement and Depression in the Chronic Insane” (Journ. Ment. Sci., January, 1911, p. 79), says: “Alternating mental states may appear as episodes in the most diverse forms of alienation, imbecility, secondary dementia, organic dementia, paranoia.” Whether such cases shall be classed under the heading of manic-depressive insanity, or as belonging to one of the other forms in which that condition occurs as an episode, will, of course, altogether depend on the personal bias of the classifier.Google Scholar

(2) Sankey's Lectures on Menial Disease, 1884, p. 196.Google Scholar

(3) Amongst numerous dicta bearing on this subject may be quoted a statement of Dr. Hughlings Jackson (Journ. Ment. Sci., July, 1875): “There is nothing in any kind of nervous symptom which enables us to diagnose syphilitic disease of the nervous system; the pathological processes by which syphilis causes nervous symptoms simply imitate non-syphilitic morbid processes.” And Dr. Byrom Bramwell in his address in medicine at the annual meeting of the British Medical Association in July last said: “The differential diagnosis of tumour of the frontal lobe and general paralysis of the insane is sometimes attended with great difficulty.” In other words, the clinical evidences of disease, and I would say particularly in disease of the nervous system, give frequently little or no clue to the underlying pathological condition, and not seldom give rise to quite an erroneous diagnosis.Google Scholar

(4) Outlines of Psychiatry,” by Prof. William A. White, Washington.Google Scholar

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