PAR'ANOI'A (Neo-Lat., from Gk. rapciroca, madness, from 7aparosiv, puranoein, to be de ranged, from rrapii, pure, beside, beyond + retie, ?Wein, to think). A chronic form of insanity in which for many years the intellect of the patient remains unimpaired, though dominated by a sys tematized delusion. There is almost invariably present an acquired or transmitted neuro-de generative taint, though an attack may be based on a sudden or severe injury to the nervous system. It may follow a severe fever or an in jury to the head. It may equally well be caused by great emotional strain or a constantly harass ing thought.
Paranoiacs usually present somatic evidences of degeneration, such as a deformed or asymmetri cal skull, badly developed teeth, strabismus, atro phy of one side of the body, and differences in size of hands or feet. In several cases examined by Spitzka anomalies of the cerebrum were found.
Mild forms of paranoia are presented by per sons who exhibit perverse acts, morbid ideas, persistence in absurd notions, and who are commonly called 'cranks.' These persons become imbued with an idea and are dominated by it, and talk constantly of it. They are suspicious, consider themselves slighted or the subject of remark. They think they are neglected or mar
tyred, fancy there is a combination against them, and are frequently melancholic. These patients are able to carry on a business or practice a pro fession.
The variety of paranoia demanding more at tention is the ordinary type of chronic delusional lunatic who was eccentric in childhood and hypo chondriac in his youth, and is excessively ego tistical, whose failures are considered to be due to conspiracy, who betrays delusions of persecution and halludinations of sight and hearing. The usual delusion of persecution may• be replaced by systematized delusions of erotic, religious, or patriotic nature. The paranoiac is usually homicidal, either because of mandatory hallucinations or of persecutory delusions. Early moral control may do much for mild cases, even aborting the psychosis. The regularity of life in asylums, with their discipline, recreations, and employment, is often beneficial. Consult: Seglas, "Paranoia," translated by Noyes, in Jour nal of Nerrous and Mental Diseases (New York, 1888) : Ferris, "Clinical Notes on a Case of Paranoia ," in Philadelphia Medical Journal (Philadelphia, Slay 26, 1900).