Atlanta tri-weekly journal. [volume] (Atlanta, Ga.) 1920-19??, 1922-12-30
TYPES OF INSANITY
Bv ri. AddinqtOn Bruce

- though not always, developing il the
! early years Of life. 1t has various forms, the
| commonest Of which are characterized, in the
! one by an irrational talkativeness, il the
other by an abnormal dsinclination to talk,
| eat, or take action Of any sort
To all appearance this is one Of the most
| hopeless Of all kinds of mental disease. But
sometimes there is spontaneous and lasting
| return to normaity. When recovery does not
occur there is gradual disintegration of the
mind until true dementia is reached.
| The outlook for patients of the inert, do
nothing sort is usually better than for the eX-
citable patients. The latter often need to
| be closely watched. For, Block notes:
without any previous warning they may
commit some act which is perhaps dangerous.
Thus they may suddenly strike some one or
throw some object, and then continue what
they were doing before as if nothing at all
had happened.
The impulse to the dangerous acts in ques-
ton originates from delusive beliefs mostly
of persecution. Such beliefs, without any
marked mental disintegration are character
istic of another type Of insanity known as
paranoa
There are many gradations of this affic-
ton, the most serious being tLat in which a
false belief of persecution by one person or
group of persons is firmly entertained. When,
in addition, the paranoiac becomes imbued
with overestimate of his own worth
thinking himself for example. dvinely in
spired-he may stop at nothing to assert his
superiority and to be rid of his alleged enc
mics
Less dangerous to other people, but more
dangerous to the victim himself, is the type
of insanity to which the name manic-depress-
i've insanity has been given. AS this name
implies, ic-depressives are sometimes SUBJ
ject to an extreme excitability, sometimes to
profound depression.
In the latter case they need to be carefully
guarded lest they kill themselves. In the
&c hn TAX nf G.
ures to reduce the excitability and save the
afflicted from eXha ustiOn. Left to them
selves manc-depressives may talk wildly for
hours at a time, wander aimlessly from
place to place, etc.
AS to the cause of their sad malady 1t has
been found in the words of one alienist:
These cases usually give history OF
heredity upon which a severe mental shock
has been engrafted. death in the family, a
financial loss, prolonged Illness or other
mental strain may be the eXcitin.; cause
AS in dementia precoX, the outlook for
many manic-depressives is good. In this re-
spect they contrast favorably with paranolacs
and with sufferers from two other sadly COM
mon mental diseases-dementia paralytica
and senle dementla.
OF all the insanites none present more
pathetic picture than so-called dementia
naralvtica and senile dementia The
former popularity known as paresis or soften
ing of the brain, is of special significance
from social viewpoint by of it's
| prevalence, its cause, and the peculiar be-
havior of many paretics in the early stages OF
! their disease.
| So common indeed, is dementia paralytica
| that from Is to 20 per cent more of the
! inmates of hospitals for the mentally diseased
! are afflicted with it. Yet it is an enlinently
preventable disease, being germ-caused, and.
| to a large extent, the result of infection con-
| trac n6 in in1n Reduce
| and reduction in the occurrence of dementia
Laralytica is to follow.
Specifically it is a late product Of the germ
| responsible for the disease of syphilis. Wheth-
er it is due to a certain type of the syphilis
! germ whether it develops only when this
| germ finds Judgment in persons predisposed by
| inheritance or otherwise, is still pro5lematcaL
lin any case the resulting dementia paralytica
| usually does not make its appearance until
| the lapse of from ten to twenty Jears after the
| infection.
i Its first manifestations are physical rather
! than mental, and so slight as ordinarily to
| pass unnoticed. Gradually character changes
! set in. Persons formerly thrifty become reck-
| less spendthrifs. The honest turn into the
shamelessIy dishonest. Or there may be in
! diligence in scandalOus conduct of gross
! sort.
1t would be difficult to overestimate the
! number of legal errors made, the number OF
| tafnlileS neeQleSSly disrupted, OecaSe or falure
! to recognize dementia paralytica In this stage
| of It's development. Soon late, recognition
| is compelled by an unmistaGable crumbling
| Of the mental towers the process Of decay
| continuing until death gives q welcome re-
! lease
Until lately this was accounted one Of the
| absolutely incurabe insanities. Now, however.
| hope is entertained that by intensive anti.
! syphilitic treatment, given before actual de
! mentia has appeared, genuinely curative re
! suits may be obtained or the disease at least
! checked from further progress AS yet though
| this is scarcely more than a hope.
In the case of sene dementa the same
| fatality of progress prevails as in most in.
| stances of dementia paralytca. AS its name
| implies, senie dementia is an insanity Of old
! age. Its principal cause is arterial HARDENING
| involving the brain.
! Usually unless for any reason home care IL
| impossible there is no necessity for sending
senile dement's to hospitals for the insane
! Also. as Cabot has remarked, the disease us
! very gradual process not entailing very
much unhaLpiness, as insanities go.
But it has only one outcome And TO those
| who have to witness, without possibility of
! rendering preventive aid. the increasing men
| tai disintegration of some loved relative it
must seem among the unhappest of all in.
! sanites.
Copyright 1929