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Mental

persons, brain, insane, nervous, inherited, insanity, children and disease

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MENTAL DISEASES.—General term for affections of those portions of the brain which are connected with mental processes. Insanity, therefore, is as truly a bodily ailment as is pneumonia, diphtheria, or cancer of the stomach. All other explanations, in part result from entirely imaginative conceptions, are unsatisfactory. A mentally deranged person is neither " possessed by a demon," as vas assumed in the Middle Ages, nor " swayed by an unnatural passion." Neither is insanity a " consequence of sin," as was asserted by moral philosophers of a hundred years ago. The period of executions for N•itchcraft, to which many unfortunate demented persons fell victims, is now gone by ; and the moral contemplations regarding the nature of mental disturbance are now found only in novels, upon the stage, and among ignorant people. Science recognises only this—that an insane person is a patient ; and it is necessary always and constantly to point to this simple truth, which constitutes the foundation upon which are based the judging and the treatment of insanity. Although investigators have not vet succeeded in demonstrating morbid changes in the brain in every form of mental disturbances, still such pathological alterations are known for the majority of mental maladies. Scientific knowledge in this respect has been greatly increased, particularly during the last ten years.

The causes of insanity, as those of disease in general, are divided by alienists into two groups—internal and external ones. The internal causes are based upon the physicomental constitution of man. The human consti tution is largely inherited ; to a smaller extent it is acquired. Heredity, therefore, becomes a prominent factor in the causation of mental diseases. The brain of a person with an " inherited taint " is constructed somewhat differently from that of a normal brain ; it is usually more susceptible to disease, more vulnerable physically. External harmful influences (fault y education, mental emotions, abuse of alcohol, etc.) may cause the inherited susceptibility of such a brain to become manifest. More than half of the mentally diseased are hereditarily tainted. Transmission is apt to take place in a direct line—that is, fron, the parents to the children. Sometimes, however, one generation may remain unaffected, the disease of a grandparent being inherited by the grandchildren. The predisposition to mental derange ment may be inherited, not only by the descendants of insane persons, but also by the children or grandchildren of nervously affected individuals, of persons addicted to alcoholic excesses, and of epileptics. Conversely,

the children of mentally deranged persons may become subject to nervous diseases, to epilepsy, or to dipsomania. The children of syphilitic parents are frequently born weak-minded. The enormous influence of heredity emphasises the importance of a rational selection in marrying. It is possible that three-fourths of all insane asylums could close their doors if it were possible to regulate marriage in accordance with hygienic principles.

The deleterious effects of inter-marriages among blood-relations are somewhat over-rated. If the individuals contracting marriage be perfectly healthy, there is little cause for alarm. In most families, however, there are slight deviations from average conditions, insignificant nervous disturbances, or peculiarities of character ; and in such cases continued inter-marriages often result in doleful consequences. Entire lines of princes and nobles have perished in this manner Among the external causes leading directly to mental disease, psychic emotion is one of the most significant. Persistent exertion of the mind along the same channels, even over-exertion, will scarcely be followed by harmful consequences ; it becomes injurious only when associated with severe mental emotion, such as great responsibility, disappointed ambition, dissatisfaction, or constant worry. A scholar living a life free from care need apprehend less, in spite of assiduous mental activity, than a labourer who is never without serious worry concerning his daily bread. Mental emotions are disastrous because they destroy the appetite and, what is worse, cause insomnia, thereby exhausting the body and affecting the very finely constructed nervous tissues. An inappropriate mode of living, debauchery, and, above all, alcoholic abuse, increase the danger still more. Mental disturbances resulting from severe bodily diseases (such as typhoid fever, scarlatina, or consumption) or following a debilitating childbed, may he explained on the ground of continued exhaustion. On the other hand, acute mental excitements, such as fright, rarely cause aberrations of mind. Nor should the danger of mental infection from constant intercourse with insane persons be over-estimated. This danger only threatens persons of a nervous predisposition. Alienists and nurses of the insane are no more subject to become mentally deranged than are other persons. On the other hand, there are some forms of imitation, as is seen in mental epidemics in times of great nervous excitement and exaltation. See ST. VITUS'S DANCE.

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