CLASSIFICATION OF MENTAL DISEASE.
.A. Mental diseases without apparent organic lesions.
I. Psychoneuroscs, in healthy brain.
1. Melancholia.
a, simple.
b, with delusions.
c, with agitation.
d, with stupor.
2. Mania.
a, simple.
b, with frenzy.
3. Confusional insanity.
4. Stuporous insanity.
a, simple. Primary dementia.
b, with periods of ecstasy. Kata tonia.
5. Terminal dementia.
If. Psychical degeneration in brain.
1. Periodical psychoneuroses.
2. Partial degenerative insanity.
a, emotional. Hysterical.
b, moral.
c. impulsive.
3. Paranoia.
B. Mental diseases with organic lesions.
1. Alcoholic insanity.
2. Senile dementia.
3. Syphilitic dementia.
4. Paretic dementia.
C. Mental defects with maldeveloped brain.
1. Imbecility.
2. Idiocy.
An additional group might be added. including the complicating i»sanitirs, embracing traumatie. choreic. post febrile. rheumatic. gouty, phthisieal, sympathetic, and pellagrous insanity, as suggest ed by Spit zka.
Melancholia is characterized by a depressed emotional state. (See METANcnor.i.t..) Mania is characterized by an exalted emotional state. :MANIA.) Confusional insanity is characterized by incoherence and confusion of ideas without essential emotional disturbance. it is a rare condition. dependent upon cerebral exhaustion. and follows emotional shock. cerebral overstrain, or exhausting disease. Some class it as a form of dementia. Stuporous insanity resembles con fusional insanity. in it there is an impairment or suspension of the mental energies, without emotional disturbance; an indifference and in dolence; an apathy. It is an acute primary de terioration following exhausting disease, excesses, shock, or hemorrhage, from which recovery is generally rapid. Katatonia is characterized by periods of ecstasy, during which the patient may be very voluble, alternating with cataleptic or apathetic intervals. (Spitzka.) Dementia is a weakened intellectual state in which thought, reason, and volition are impaired or suspended, considerable indifference or total apathy existing. The patient is 'childish,' lives a vegetative existence, gradually losing intel lectual ground, and drifting into mental decay. When this condition follows mania. melancholia, or other mental disease, it is called ter minal dementia. Some terminal dements have periods of excitement, and are noisy and restless; but most are quiet, tractable, and childish. Periodical insanity is the term given to the mental state in neurotic patients who have recur ring attacks of mental disease at fairly regular intervals. Some will have an annual attack of mania for many years. Others will have a brief attack of melancholia with each menstrual period. Some have an attack of melancholia of
a few days' duration, followed by an explosion of maniacal violence, lasting a week, and this in turn followed by a period of stupor or eon fusion. From the last the patient emerges in a few weeks, and a lucid interval of a few months follows. This is called circular insanity. Par tial degenerative insanity occurs in people who have little self-control, defective reasoning power, and impatience of restraint. It includes emo tional insanity (folic raisonnonle), in which baseless irritability. jealousy. outbursts of rage and fury occur; moral insanity, in which there seems to he an absolute want of appreciation of right and wrong, and the patient ignores all laws of custom, conventionality, decency, and morality; and impulsive insanity, in which the patients act on sudden impulses. without reason ing,. obeying imperative ideas. right or wrong. in spite of their wish to control themselves and do otherwise. ( See DirsomANIA KLEtrrom.% x PYROMANIA.) Paranoia is a chronic delusional insanity in which intellection is unimpaired. (See PARANotA.) Alcoholic insanity is charae terized by erotic ideas. hallucinations of sight, hearing, and smell, delusions of marital infidelity, and great. restlessness. In the chronic form the patient suffers from violent attacks of temper and fairly constant irritability, and the hallucina tions constitute a daily torture. These hallucina tions are always fearful; the patient fancying that he sees horrible animals, devils, enemies, or pitfalls, and that he hears threats. curses. ob scene language, and noisy shouts, and that he smells foul odors. or dangerous electricity. or poisonous gases. (See ALCOHOLISM.) In senile dementia the patient manifests a loss of af fection for his relatives, delusions of grandeur or great egotism. suspicion without cause, im pairment of memory and of judgment, and delu sions regarding his possessions and money, gen tearing poverty or then. Syphilitic dementia ttecurs in victims of syphilis. They evince excitement or depression. loss ineinOrY, and failure of other intellectual processes, finally relapsing into It condition resembling terminal] th militia of the quiet type. of short duration, during whieh partial :end temporary paralyses often precede death. Partin- dementia is also called general paresis. progressive genera] parab ysis of the brain, and, improperly. 'softening of the brain.' See PArtrsis. See also 1 VI IMCIL lTY and Inn•y.