See also:

• IDIOCY (from Gr. iblwrrls, in its secondary meaning of a deprived person)

IDIOCY (from Gr. iblwrrls, in its secondary meaning of a deprived See also:

• PERSON, OFFENCES AGAINST THE

person)  . In treating of See also:

• IDIOCY (from Gr. iblwrrls, in its secondary meaning of a deprived person)

idiocy it must be carefully599 See also:

• BORNE, KARL LUDWIG (1786–1837)

borne in mind that we are dealing with See also:

• MENTAL

mental phenomena dissociated for the most See also:

• PART

part from active bodily disease, and that, in whatever degree it may exist, we have to See also:

• DEAL

deal with Idly a See also:

• BRAIN (A.S. braegen)

brain See also:

• CONDITION (Lat. condicio, from condicere, to agree upon, arrange; not connected with conditio, from condere, conditum, to put together)

condition fixed by the pathological circum- stances under which its possessor came into the See also:

• WORLD

world or by such as had been See also:

• PRESENT

present before full cerebral activity could be See also:

• DEVELOPED

developed, and the symptoms of which are not dependent on the intervention of any subsequent morbid See also:

• PROCESS

process . From the earliest ages the See also:

• TERM

term Amentia has been applied to this condition, in contradistinction to Dementia, the mental weakness following on acquired See also:

• INSANITY (from Lat. in, not, and sanus, sound)

insanity . The causes of congenital idiocy may be divided into four classes: (I) hereditary predisposition, (2) constitutional conditions of one or both parents affecting the constitution of the See also:

• INFANT (in early forms enfaunt, enfant, through the Fr. enfant, from Lat. infans, in, not, and fans, the present participle of fari, to speak)

infant, (3) injuries of the infant See also:

• PRIOR (from Lat. prior—former, and hence superior, through O. Fr. priour)
• PRIOR, MATTHEW (1664-1721)

prior to or at See also:

• BIRTH (a word common in various forms to Teutonic languages from the root of the verb " to bear ")

birth, and (4) injuries or diseases affecting the infant See also:

• HEAD (in 0. Eng. heafad; the word is common to Teutonic languages; cf. Dutch hoofd, Ger. Haupt, generally taken to be in origin connected with Lat. caput, Gr. KerbOvi7)
• HEAD, SIR EDMUND WALKER, BART
• HEAD, SIR FRANCIS BOND, BART

head during See also:

• INFANCY

infancy . All these classes of causes may See also:

• ACT (Lat. actus, actum)

act in two directions: they may produce either non-development or abnormal development of the See also:

• CRANIAL

cranial bones as evidenced by microcephalism, or by deformity of the head; or they may induce a more subtle morbid condition of the constituent elements of the brain . As a See also:

• RULE

rule, the pathological process is more easily traceable in the See also:

• CASE
• CASE, JOHN (d. 1600)

case of the last three classes than in the first . For instance, in the case of constitutional conditions of the parents we may have a See also:

• HISTORY

history of syphilis, a disease which often leaves its traces on the bones of the See also:

• SKULL

skull; and in the third case congenital malformation of the brain may be produced by See also:

• MECHANICAL

mechanical causes acting on the See also:

• CHILD
• CHILD, FRANCIS JAMES (1825-1896)
• CHILD, L
• CHILD, LYDIA MARIA (1802-1880)
• CHILD, SIR FRANCIS (1642-1713)
• CHILD, SIR JOHN (d. 1690)
• CHILD, SIR JOSIAH (163o - 1699)

child in utero, such as an See also:

• ATTEMPT (Lat. adtemptare, attentare, to try)

attempt to procure See also:

• ABORTION (from Lat. aboriri, to fail to be born, or perish)

abortion, or deformities of the maternal See also:

• PELVIS (Lat. for " basin," cf. Gr. 7rEX?a )

pelvis rendering labour difficult and instrumental interference necessary . In such cases the bones of the skull may be injured; it is only See also:

• FAIR

fair, however, to say that more brains are saved than injured by instrumental interference . With regard to the See also:

• FOURTH

fourth class, it is evident that the term congenital is not strictly applicable; but, as the See also:

• PERIOD
• PERIOD (Gr. irepioSos, a going or way round, circuit, aepi, round, and &Sis, way, road)

period of See also:

• LIFE

life implicated is that prior to the potentiality of the manifestation of the intellectual See also:

• POWERS, HIRAM (1805-1873)

powers, and as the result is identical with that of the other classes of causes, it is warrantable to connect it with them, on pathological principles more than as a See also:

• MERE
• MERE, ADALBERT (1838-1909)

mere See also:

• MATTER

matter of convenience . Dr See also:

• IRELAND
• IRELAND, CHURCH
• IRELAND, CHURCH OF
• IRELAND, JOHN (1761-1842)
• IRELAND, JOHN (1838- )
• IRELAND, WILLIAM HENRY (1777-1835)

Ireland, in his See also:

• WORK

work On Idiocy and Imbecility (1877), classifies idiots from the standpoint of See also:

• PATHOLOGY (from Gr. raBos, suffering)

pathology as follows: (1) Genetous idiocy: in this See also:

• FORM (Lat. forma)

form, which he holds to be See also:

• COMPLETE

complete before birth, he believes the presumption of See also:

• HEREDITY

heredity to be stronger than in other forms; the vitality of the See also:

• GENERAL
• GENERAL (Lat. generalis, of or relating to a genus, kind or class)

general See also:

• SYSTEM

system is stated to be See also:

• LOWER

lower than normal; the See also:

• PALATE (Lat. palatum, possibly from the root of pascere, to feed)

palate is arched and narrow, the See also:

• TEETH (O.E. Eel); plural of tooth, O.E. top)

teeth misshapen, irregular and prone to decay and the patient dwarfish in See also:

• APPEARANCE (from Lat. apparere, to appear)

appearance; the head is generally unsymmetrical and the commissures occasionally atrophied; (2) Microcephalic idiocy, a term which explains itself; (3) Eclampsic idiocy, due to the effects of infantile See also:

• CONVULSIONS

convulsions; (4) Epileptic idiocy; (5) Hydrocephalic idiocy, a term which explains itself; (6) Paralytic idiocy, a rare form, due to the brain injury causing the See also:

• PARALYSIS, or PALSY (from Gr. aapal,6a , to relax; Wycliffe has palesy, and another old form of the word is parlesy)

paralysis; (7) Traumatic idiocy, a form produced by the third class of causes above mentioned; (8) Inflammatory idiocy; (9) Idiocy by deprivation of one or more of the See also:

• SPECIAL

special senses . The general conformation of the idiot is generally imperfect; he is sometimes deformed, but more frequently the See also:

• FRAME

frame is merely awkwardly put together, and he is usually of See also:

• SHORT, FRANCIS JOB (1857– )

short stature . Only about one-fourth of all idiots have heads smaller than the See also:

• AVERAGE

average .

Many cases are on See also:

• RECORD (Lat. recordari, to recall to mind, from cor, heart or mind)

record in which the cranial measurements exceed the average . It is the irregularity of development of the bones of the skull, especially at the bast, which marks the condition . Cases, however, often present themselves in which the skull is perfect in form and See also:

• SIZE

size . In such the See also:

• MISCHIEF

mischief has begun in the brain matter . The palate is often highly arched; See also:

• HARE
• HARE, SIR JOHN (1844– )

hare-See also:

• LIP (a word common in various forms, to Teutonic languages, cf Ger. Lippe, Dan. laebe; Lat. labium is cognate)

lip is not uncommon; in fact congenital defect or malformation of other See also:

• ORGANS

organs than the brain is more commonly met with among idiots than in the general community . Of the special senses, See also:

• HEARING (formed from the verb " to hear," O. Eng. hyran, heron, &c., a common Teutonic verb; cf. Ger. Koren, Dutch hooren, &c.; the O. Tent. form is seen in Goth. hausjan; the initial h makes any connexion with " ear," Lat. audire, or Gr. &Kobew very doub

hearing is most frequently affected . Sight is See also:

• GOOD, JOHN MASON (1764-1827)

good, although co-ordination may be defective . Many are See also:

• MUTE (Lat. tnutus, dumb)

mute . On See also:

• ACCOUNT
• ACCOUNT (through O. Fr. acont, Late Lat. comptum, cornputare, to calculate)

account of the mental dullness it is difficult to determine whether the senses of See also:

• TOUCH (derived through Fr. toucher from a common Teutonic and Indo-Germanic root, cf. " tug," " tuck," O. H. Ger. zucchen, to twitch or draw)

touch, See also:

• TASTE (from Lat. taxare, to touch sharply; tangere, to touch)

taste and See also:

• SMELL (connected etymologically with " smoulder " and " smoke ")

smell suffer Forms of Insanity . impairment; but the impression is that their acuteness is below the average . It is needless to attempt a description of the mental phenomena of idiots, which range between utter want of intelligence and mere weakness of See also:

• INTELLECT (Lat. intellectus, from intelligere, to understand)

intellect . The term Imbecility has been conventionally employed to indicate the less profound degrees of idiocy, but in point of fact no distinct See also:

• LINE

line of demarcation can be See also:

• DRAWN

drawn between the conditions .

As the See also:

• SCALE
• SCALE (1) A

scale of imbeciles ascends it is found that the condition is evidenced not so much by obtuseness as by irregularity of intellectual development . This serves to See also:

• MARK
• MARK, CARL (1858– )
• MARK, GOSPEL OF ST
• MARK, ST

mark the difference between the extreme stupidity of the lowest of the healthy and the highest forms of the morbidly deprived type . The two conditions do not See also:

• MERGE

merge gradually one into the other . See also:

• ABSOLUTE (Lat. absolvere, to loose, set free)

Absolute stupidity and sottishness mark many cases of idiocy, but only in the lowest type, where no dubiety of See also:

• OPINION (Lat. opinio, from opinari, to think)

opinion can exist as to its nature, and in a manner which can never be mistaken for the dulness of the See also:

• MAN
• MAN, ISLE OF (anc. Mona)

man who is less talented than the average of mankind . Where in theory the morbid (in the sense of deprivation) and the healthy types might be supposed to approach each other, in practice we find that, in fact, no debatable ground exists . The uniformity of dulness of the former stands in marked opposition to the irregularity of mental conformation in the latter . Comparatively speaking, there are few idiots or imbeciles who are uniformly deprived of mental See also:

• POWER [WILLIAM GRATTAN] TYRONE (1797-1841)

power; some may he utterly sottish, living a mere See also:

• VEGETABLE

vegetable existence, but every one must have heard of the See also:

• QUAINT (O. Fr. cointe, from Lat. cognitus, known, probably influenced by association with Lat. corn plus, neat)

quaint and crafty sayings of See also:

• MANIFEST (Lat. manifestus, clear, open to view)

manifest idiots, indicating the presence of no mean power of applied observation . In institutions for the treatment of idiots and imbeciles, See also:

• CHILDREN, LAW RELATING TO

children are found not only able to read and write, but even capable of applying the simpler rules of See also:

• ARITHMETIC (Gr. apeOµ7run7, sc. TEXVn, the art of counting, from (ipLBµos, number)

arithmetic . A man may possess a very considerable meed of receptive See also:

• FACULTY (through the French, from the Lat. facultas, ability to do anything, from facilis, easy, facere, to do; another form of the word in Lat. facilitas, facility, ease, keeps the original meaning)

faculty and yet be idiotic in respect of the power of application; he may be physically disabled from relation, and so be manifestly a deprived See also:

• PERSON, OFFENCES AGAINST THE

person, unfit to take a position in the world on the same See also:

• PLATFORM (Fr. plateforme, i.e. ground plan)

platform as his See also:

• FELLOWS, SIR CHARLES (1799-1860)

fellows . Dr Ireland subdivides idiots, for the purpose of See also:

• EDUCATION

education, into five grades, the first comprising those who can neither speak nor understand speech, the second those who can understand a few easy words, the third those who can speak and can be taught to work, the fourth those who can be taught to read and write, and the fifth those who can read books for themselves . The treatment of idiocy and imbecility consists almost entirely of See also:

• ATTENTION (from Lat. ad-tendo, await, expect; the condition of being " stretched " or " tense ")

attention to See also:

• HYGIENE (Fr. hygiene, from Gr. ir'taivety, to be healthy)

hygiene and the See also:

• BUILDING

building up of the enfeebled constitution, along with endeavours to develop what small amount of faculty exists by patiently applied educational influences . The success which has attended this line of treatment in many public and private institutions has been very consider-able .

It may be safely stated that most idiotic or See also:

• IMBECILE (through the French from Lat. imbecillus or imbecillis, weak, feeble; of unknown origin)

imbecile children have a better See also:

• CHANCE (through the O. Fr. cheance, from the Late Lat. cadentia, things happening, from cadere, to fall out, happen; cf. " case ")

chance of amelioration in asylums devoted to them than by any amount of care at See also:

• HOME
• HOME, DANIEL DUNGLAS (1833-1886)
• HOME, EARLS OF

home . In the class of idiots just spoken of, imperfect development of the intellectual faculties is the prominent feature, so prominent that it masks the See also:

• ARREST (Fr. arrester, arreeter, to stop or stay)

arrest of potentiality of development of the moral sense, the See also:

• ABSENCE (Lat. absentia)

absence of which, even if noticed, is regarded as relatively unimportant; but, in conducting the See also:

• PRACTICAL

practical study of congenital idiots, a class presents itself in which the moral sense is wanting or deficient, whilst the intellectual powers are apparently up to the average . It is the See also:

• CUSTOM (from O. Fr. costume, costume or coustume; Low Lat. costuma, a shortened form of consuetudo)

custom of writers on the subject to speak of " intellectual " and " moral " idiots . The terms are convenient for clinical purposes, but the two conditions cannot be dissociated, and the terms therefore severally only imply a specially marked deprivation of intellect or of moral sense in a given case . The everyday observer has no difficulty in recognizing as a fact that deficiency in receptive capacity is See also:

• EVIDENCE (Lat. evidentia, evideri, to appear clearly)

evidence of imperfect cerebral development; but it is not so patent to him that the See also:

• PERCEPTION (from Lat. percipere, to perceive)

perception of right or wrong can be compromised through the same cause, or to comprehend that loss of moral sense may result from disease . The same difficulty does not present itself to the pathologist; for, in the case of a child See also:

• BORN, IGNAZ, EDLER VON (1742–1791)

born under circumstances adverse to brain development, and in whom no process of education can develop an appreciation of what is right or wrong, although the intellectual faculties appearto be but slightly blunted, or not blunted at all, he cannot avoid connecting the See also:

• PHYSICAL

physical peculiarity with the pathological evidence . The world is See also:

• APT

apt enough to refer any See also:

• FAULT (Mid. Eng. faute, through the French, from the popular Latin use of fallere, to fail; the originallof the Latin being replaced in English in the 15th century)

fault in intellectual development, manifested by imperfect receptivity, to a definite physical cause, and is willing to See also:

• BASE

base opinion on comparatively slight data; but it is not so ready to accept the theory of a pathological implication of the intellectual attributes concerned in the perception of the difference between right and wrong . Were, however, two cases pitted one against another—the first one of so-called intellectual, the second one of so-called moral idiocy—it would be found that, except as regards the psychical manifestations, the cases might be identical . In both there might be a See also:

• FAMILY

family history of tendency to degeneration, a See also:

• PECULIAR

peculiar cranial conformation, a history of previous symptoms during infancy, and of a See also:

• SERIES (a Latin word from serere, to join)

series of indications of mental in-capacities during See also:

• ADOLESCENCE (Lat. adolescentia, from adolescere, to grow up, past part. adultus, grown up, Eng. " adult ")

adolescence, differing only in this, that in the first the prominent indication of mental weakness was inability to add two and two together, in the second the prominent feature was incapacity to distinguish right from wrong . What complicates the question of moral idiocy is that many of its subjects can, when an abstract proposition is placed before them, See also:

• ANSWER (derived from and, against, and the same root as swear)

answer according to the dictates of morality, which they may have learnt by rote . If asked whether it is right or wrong to See also:

• LIE, JONAS LAURITZ EDEMIL (1833—1908)
• LIE, MARIUS SOPHUS (1842–1899)

lie or steal they will say it is wrong; still, when they themselves are detected in either offence, there is an evident non-recognition of its See also:

• CONCRETE
• CONCRETE (Lat. concretes, participle of concrescere, to grow together)

concrete nature . The question of moral idiocy will always be a See also:

• MOOT

moot one between the casuist and the pathologist; but, when the whole natural history of such eases is studied, there are points of differentiation between their morbid depravation and mere moral depravity .

Family history, individual peculiarities, the general bizarre nature of the phenomena, remove such cases from the See also:

• CATEGORY (Gr. Karrlyopia, " accusation ")

category of See also:

• CRIME (Lat. crimen, accusation)

crime . See also:

• STATISTICS

Statistics.—According to the See also:

• CENSUS (from Lat. censere, to estimate or assess; connected by some with centum, i.e. a count by hundreds)

census returns of 1901 the See also:

• TOTAL

total number of persons described as idiots and imbeciles in See also:

• ENGLAND
• ENGLAND, THE CHURCH OF

England and . See also:

• WALES (Cymru, Gwalia, Cambria)

Wales was 48,882, the equality of the sexes being remarkable. namely, 24,480 See also:

• MALES

males and 24,402 See also:

• FEMALES

females . Compared with the entire See also:

• POPULATION (Lat. populus, people; populare, to populate)

population the ratio is T idiot or imbecile to 665 persons, or 15 per 10,000 persons living . Whether the returns are defective, owing to the sensitiveness of persons who would See also:

• DESIRE

desire to conceal the occurrence of idiocy in their families, we have no means of knowing; but such a feeling is no doubt likely to exist among those who look upon mental infirmity as humiliating, rather than, as one of the many physical evils which afflict humanity . Dr . Ire-See also:

• LAND

land estimates that there is T idiot or imbecile to every 500 persons in countries that have a census . The following table shows the number of idiots according to See also:

• OFFICIAL (Late Lat. QJicialis, for class. Lat. apparitor, from officium, office, duty)

official returns of the various countries: Males . Females . Total . Proportion to 100,000 of Pop . England and Wales 24,480 24,402 48,882 150 See also:

• SCOTLAND
• SCOTLAND, CHURCH OF
• SCOTLAND, EPISCOPAL CHURCH OF

Scotland .

. . 3,246 3,377 6,623 148 Ireland . . 2,946 2,270 5,216 I17 See also:

• FRANCE
• FRANCE, ANATOLE (1844– )

France (including . 20,456 14,677 35,133 97 cretin) (1872) See also:

• GERMANY
• GERMANY (Ger. Deutschland)

Germany (1871) . . — — 33,739 82 See also:

• SWEDEN
• SWEDEN [Sverige]
• SWEDEN, NORWAY AND

Sweden (1870) . .: — — 1,632 38 ~I 1,074 2,431 121 See also:

• NORWAY
• NORWAY (Norge)

Norway (1891) . 1,357 See also:

• DENMARK
• DENMARK (Danmark)

Denmark (1888–89) . 2,106 1,751 3,857 200 For the See also:

• UNITED

United States there are no later census figures than 1890 when the feeble-minded or idiotic were recorded as 95,571 (52,940 males and 42,631 females) . In 19o¢ (Special See also:

• REPORT (O.Fr. report or raport, modern rapport, from O.Fr. reporter, mod. rap porter, Lat. reportare, to bring back, in poetical use only, of bringing back an account, news, &c.)

Report of See also:

• BUREAU (a Fr. word from burel or bureau, a coarse cloth used for coverings)

Bureau of Census, 1906) the " feeble-minded " were estimated at 150,000 . The relative frequency of congenital and acquired insanity in various countries is shown in the following table, taken from See also:

• KOCH
• KOCH, ROBERT (1843–1910)

Koch's statistics of insanity in See also:

• WURTTEMBERG

Wurttemberg, which gives the number of idiots to Too lunatics: See also:

• PRUSSIA
• PRUSSIA (Ger. Preussen; Lat. Borussia)

Prussia 158 France . . 66 See also:

• BAVARIA (Ger. Bayern)

Bavaria 154 Denmark . 58 See also:

• SAXONY
• SAXONY (Ger. Provinz Sachsen)

Saxony .

162 Sweden . 22 See also:

• AUSTRIA
• AUSTRIA, LOWER (Ger. Niederosterreich or Osterreich unter der Enns, " Austria below the river Enns ")
• AUSTRIA, UPPER (Ger. Oberosterreich or Osterreich ob der Enns, " Austria above the river Enns ")

Austria . 53 Norway . . 65 See also:

• HUNGARY
• HUNGARY (Hungarian Magyarorszdg)

Hungary . . . . 140 England and Wales 74 See also:

• CANTON
• CANTON (borrowed from the Ital. cantone, a corner or angle)
• CANTON (more correctly KWANG-CHOW Fu)
• CANTON, JOHN (1718-1772)

Canton of See also:

• BERN (Fr. Berne)

Bern . . 117 Scotland . 68 See also:

• AMERICA

America . . 79 Ireland . . . . 69 It is difficult to understand the wide divergence of these figures, except it be that in certain states, such as Prussia and Bavaria. dements have been taken along with aments and in others cretins . This cannot, however, apply to the case of France, which is stated to have only 66 idiots to every too lunatics .

In many districts of France See also:

• CRETINISM

cretinism is See also:

• COMMON

common; it is practically unknown in England, here the proportion of idiots is stated as higher than in France; and it is rare in Prussia, which stands at 158 idiots to too lunatics . Manifestly imperfect as this table is, it shows how important an See also:

• CLEMENT (Lat. Clemens, i.e. merciful; Gr. K)4gs)
• CLEMENT, FRANCOIS (1714-1793)
• CLEMENT, JACQUES (1567-1589)

clement idiocy is in social statistics; few are aware that the number of idiots and that of lunatics approach so nearly . II . Acquired Insanity.—So far as the mental symptoms of acquired insanity are concerned, See also:

• PINEL, PHILIPPE (1745–1826)

Pinel's See also:

• ANCIENT
• ANCIENT (also spelt ANTIENT; derived, through the Fr. ancien, old, from the late Lat. antianum, from ante, before)

ancient See also:

• CLASSIFICATION (Lat. classis, a class, probably from the root cal-, cla-, as in Gr. icaMce, clamor)

classification, into See also:

• MANIA

Mania, See also:

• MELANCHOLIA

Melancholia and Dementia, is still applic- able to every case, and although numberless classifica- tions have been advanced they are for the most part merely terminological See also:

• VARIATIONS
• VARIATIONS, CALCULUS
• VARIATIONS, CALCULUS OF

variations . Classifications of the insanities based on pathology and etiology have been held out as a See also:

• SOLUTION (from Lat. solvere, to loosen, dissolve)

solution of the difficulty, but, so far, pathological observations have failed to fulfil this ideal, and no thoroughly satisfactory pathological classification has emerged from them . Classifications are after all matters of convenience; the following system admittedly is so: Melancholia . Mania . Delusional Insanity . Katatonia . See also:

• HEBEPHRENIA

Hebephrenia . Traumatic Insanity . Insanity following upon arterial degeneration .

Insanities associated or caused by: General Paralysis; See also:

• EPILEPSY (Gr. &L, upon, and kaµ)3avew, to seize), or FALLING

Epilepsy . Insanities associated with or caused by Alcoholic and See also:

• DRUG
• DRUG (from Fr. drogue, a word common in Romance languages, cf. Span. and Ital. droga; the origin of the word is obscure, but may possibly be connected with Dutch droog, dry)

Drug intoxi- cation: See also:

• DELIRIUM (a Latin medical term for madness, from delirare, to be mad, literally to wander from the lira, or furrow)

Delirium Tremens, Chronic Alcoholic Insanity, See also:

• DIP (Old Eng. dyppan, connected with the common Teutonic root seen in " deep ")

Dip- somania, Morphinism . Senile Insanity . The general symptoms of acquired insanity See also:

• GROUP

group themselves naturally under two heads, the physical and the mental . The physical symptoms of mental disease generally, if not invariably, precede the onset of the mental symptoms, and the patient may complain of indefinite symptoms of General symptoms. malaise for See also:

• WEEKS, EDWIN LORD (1849-1903)

weeks and months before it is suspected that the disorder is about to terminate in mental symptoms . The most general physical disorder common to the onset of all the insanities is the failure of See also:

• NUTRITION

nutrition, i.e. the patient rapidly and apparently without any apparent cause loses See also:

• WEIGHT

weight . Associated with this nutritional failure it is usual to have disturbances of the alimentary See also:

• TRACT (from Lat. tractare, to treat of a matter, through Provencal tractat and Ital. trattato)

tract, such as loss of appetite, See also:

• DYSPEPSIA (from the Gr. prefix Sur-, hard, ill, and 'irirreiv, to digest)

dyspepsia and obstinate See also:

• CONSTIPATION (from Lat. constipare, to press closely together, whence also the adjective " costive ")

constipation . During the prodromal See also:

• STAGE (Fr. 6/age; from Lat. stare, to stand)

stage of such conditions as mania and melancholia the See also:

• DIGESTIVE

digestive functions of the See also:

• STOMACH (Gr. vrbsaxos from arbga, a mouth)

stomach and See also:

• INTESTINE (Lat. intestinus, internal, usually in neuter plural intestina. from intus, within)

intestine are almost or completely in See also:

• ABEYANCE (O. Fr. abeance, " gaping")

abeyance . To this implication of other systems consequent on impairment of the trophesial (nourishment-regulating) See also:

• FUNCTION

function of the brain can be traced a large number of the errors which exist as to the See also:

• CAUSATION

causation of idiopathic melancholia and mania . Very frequently this secondary condition is set down as the See also:

• PRIMARY

primary cause; the insanity is referred to derangements of the stomach or bowels, when in fact these are, concomitantly with the mental disturbance, results of the cerebral mischief . Doubtless these functional derangements exercise considerable See also:

• INFLUENCE (Late Lat. influentia, from influere, to flow in)

influence on the progress of the case by assisting to deprave the general See also:

• ECONOMY

economy, and by producing depressing sensations in the region of the stomach . To them may probably be attributed, together with the See also:

• APPREHENSION (Lat. ad, to; prehendere, to seize)

apprehension of impending insanity, that phase of the disease spoken of by the older writers as the See also:

• STADIUM

stadium melancholicum, which so frequently presents itself in incipient cases .

The skin and its appendages—the See also:

• HAIR (a word common to Teutonic languages)

hair and the nails—suffer in the general disorder of nutrition which accompanies all insanities . The skin may be abnormally dry and scurfy or moist and offensive . In acute insanities rashes are not uncommon, and in chronic conditions, especially conditions of depression, crops of papules occur on the See also:

• FACE (from Lat. fades, derived either from facere, to make, or from a root fa-, meaning " appear "; cf. Gr. cbatvstv)

face, See also:

• CHEST (Gr. Kiarl, Lat. cista, O. Eng. cist, test, &c.)

chest and shoulders . The hair is generally dry, loses its lustre and becomes brittle . The nails become deformed and may exhibit either excessive and irregular or diminished growth . Where there are See also:

• GRAVE

grave nutritional disorders it is to be expected that the See also:

• CHIEF (from Fr. chef, head, Lat. caput)

chief excretions of the See also:

• BODY

body should show departures from the See also:

• STATE
• STATE, GREAT OFFICERS OF

state of See also:

• HEALTH

health . In this See also:

• ARTICLE (from Lat. articulus, a joint)

article it is impossibleto treat this subject fully, but it may suffice to say that in many states of depression there is a See also:

• GREAT

great deficiency in the See also:

• EXCRETION (Lat. ex, out of, cernere, cretum, to separate)

excretion of the solids of the urine, particularly the nitrogenous See also:

• WASTE (O. Fr. wast, guast, gast, gaste; Lat. vastus, vast, desolate)

waste See also:

• PRO

pro-ducts of the body; while in conditions of excitement there is an excessive output of the nitrogenous waste products . It has lately been pointed out that in many forms of insanity indoxyl is present in the urine, a substance only present when putrefactive processes are taking See also:

• PLACE (through Fr. from Lat. platea, street; Gr. IrAar6s, wide)

place in the intestinal tract . The See also:

• NERVOUS

nervous system, both on the sensory and motor See also:

• SIDE
• SIDE (mod. Eski Adalia)

side, suffers very generally in all conditions of insanity . On the sensory side the special senses are most liable to disorder of their function, whereby false sense impressions arise which the patient from impairment of See also:

• JUDGMENT

judgment is unable to correct, and hence arise the psychical symptoms known as hallucinations and delusions . Common sensibility is generally impaired . On the motor side, impairment of the See also:

• MUSCULAR

muscular power is present in many cases of depression and in all cases of dementia .

The incontinence of urine so frequently seen in dementia and in acute insanity complicated with the mental symptom of See also:

• CON

con-See also:

• FUSION

fusion depends partly on impairment of muscular power and partly on disorder of the sensory apparatus of the brain and See also:

• SPINAL

spinal See also:

• CORD (derived through the Fr. corde, from the Lat. chorda, Gr. xop(5rt, the string of a musical instrument)

cord . The outstanding mental symptom in nearly all insanities, acute and See also:

• RECENT

recent or chronic, is the failure of the capacity of judgment and loss of self-See also:

• CONTROL (Fr. contrdle, older form contre rolle, from Med. Lat. contra-rotulus, a counter roll or copy of a document used to check the original; there is no instance in English of the use of " control " in this, its literal, meaning)

control . In See also:

• EARLY
• EARLY, JUBAL ANDERSON (1816-1894)

early acute insanities, however, the two chief symptoms which are most evident and easily noted are depression on the one See also:

• HAND
• HAND (a word common to Teutonic languages; cf. Ger. Hand, Goth. handus)
• HAND, FERDINAND GOTTHELF (1786-185r)

hand and excitement or See also:

• ELEVATION

elevation on the other . Some distinction ought to be made between these two terms, excitement and elevation, which at present are used synonymously . Excitement is a mental state which may be and generally is associated with confusion and mental impairment, while elevation is an exaltation of the mental faculties, a condition in which there is no mental confusion, but rather an unrestrained and rapid See also:

• SUCCESSION (Lat. successio, from succedere, to follow after)

succession of fleeting mental processes . The symptoms which most strongly See also:

• APPEAL

appeal to the See also:

• LAY

lay mind as conclusive evidence of mental disorder are hallucinations and delusions . Hallucinations are false sense impressions which occur without normal stimuli . The presence of hallucinations certainly indicates some functional disorder of the higher brain centres, but is not an evidence of insanity so See also:

• LONG, GEORGE (1800-1879)
• LONG, JOHN DAVIS (1838– )

long as the sufferer recognizes that the hallucinations are false sense impressions . So soon, however, at conduct is influenced by hallucinations, then the boundary line between sanity on the one hand and insanity on the other has been crossed . The most common hallucinations are those of sight and hearing . Delusions are not infrequently the result of hallucinations . If the hallucinations of a melancholic patient consist in hearing voices which make accusatory statements, delusions of See also:

• SIN
• SIN (O. Eng. syn: a common Teutonic word, cf. Dutch zonde, Ger. Siinde)

sin and unworthiness frequently follow .

Hallucinations of the senses of taste and smell are almost invariably associated with the delusion that the patient's See also:

• FOOD
• FOOD (like the verb " to feed," from a Teutonic root, whence O. Eng. foda; cf. " fodder "; connected with Gr. lrareicOae, to feed)

food is being poisoned or that it consists of objectionable matter . On the other hand, many delusions are apparently the outcome of the patient's mental state . They may be pleasant or disattreeable according as the condition is one of elevation or depression . The intensity and quality of the delusions are largely influenced by the intelligence and education of the patient . An educated man, for instance, who suffers from sensory disturbances is much more ingenious in his explanations as to how these sensory disturbances result from See also:

• ELECTRICITY

electricity, marconigrams, X-rays, &c., which he believes are used by his enemies to See also:

• ANNOY (like the French ennui, a word traced by etymologists to a Lat. phrase, in odio esse, to be " in hatred " or hateful of someone)

annoy him, than an ignorant man suffering from the same abnormal sensations . Loss of self-control is characteristic of all forms of insanity . Normal self-control is so much a matter of See also:

• RACE

race, See also:

• AGE (Fr. age, through late Lat. aetaticum, from aetas)

age, the state of health, moral and physical up-bringing, that it is impossible to lay down any See also:

• LAW
• LAW (0. Eng. lagu, M. Eng. lawe; from an old Teutonic root lag, " lie," what lies fixed or evenly; cf. Lat. lex, Fr. loi)
• LAW, JOHN (1671—1729)
• LAW, WILLIAM (1686-1761)

law whereby this mental quality can be gauged, or to determine when deficiency has passed from a normal to an abnormal state . In many cases of in-sanity there is no difficulty in appreciating the pathological nature of the deficiency, but there are others in which the conduct is other-See also:

• WISE, HENRY ALEXANDER (1806-1876)
• WISE, ISAAC MAYER (1819-1900)

wise so rational that one is apt to attribute the deficiency to physiological rather than to pathological causes . Perversion of the moral sense is common to all the insanities, but is often the only symptom to be noticed in cases of imbecility and idiocy, and it as a rule may be the earliest symptom noticed in the early stages of the excitement of manic-depressive insanity and general paralysis . The tendency to commit See also:

• SUICIDE (from Lat. sui, of oneself, and cidium, from cued ere, to kill)

suicide, which is so common among the insane and those predisposed to insanity, is especially prevalent in patients who suffer from depression, sleeplessness and delusions of persecution . Suicidal acts may be divided into accidental, impulsive and premeditated . The accidental suicides occur in patients who are partially or totally unconscious of their surroundings, and are generally the result of terrifying hallucinations, to See also:

• ESCAPE (in mid. Eng. eschape or escape, from the O. Fr. eschapper, modern echapper, and escaper, low Lat. escapium, from ex, out of, and cappa, cape, cloak; cf. for the sense development the Gr. iichueoOat, literally to put off one's clothes, hence to sli

escape Acquired Insanity .

from which the patient jumps through a window or runs blindly into See also:

• WATER

water or some other danger . Impulsive suicides may be prompted by suddenly presented opportunities or means of self-destruction, such as the sight of water, See also:

• FIRE (in O. Eng. f j'r; the word is common to West German languages, cf. Dutch vuur, Ger. Feuer; the pre-Teutonic form is seen in Sanskrit pu, pavaka, and Gr. irup; the ultimate origin is usually taken to be a root meaning to purify, cf. Lat. purus)

fire, a See also:

• KNIFE (0. E. cuff, a word appearing in different forms in many Teutonic languages, cf. Du. knijf, Ger. Kneif, a shoe-maker's knife, Swed. knif; the ultimate origin is unknown; Skeat finds the origin in the root of " nip," formerly " knip "; Fr. canif is a

knife, cord or See also:

• POISON

poison . Premeditated suicides most frequently occur in states of long continued depression . Such patients frequently devote their attention to only one method of destruction and fail to avail them-selves of others equally practicable . As a rule the more educated the patient, the more ingenious and varied are the methods adopted to attain the desired result . The faculty of attention is variously affected in the subjects of insanity . In some the attention is entirely subjective, being occupied by sensations of misery, depression or sensory disturbances . In others the attention is See also:

• OBJECTIVE, or OBJECT GLASS

objective, and attracted by every accidental See also:

• SOUND
• SOUND, THE (Danish Oresund)

sound or See also:

• MOVEMENT

movement . In most of the early acute insanities the capacity of attention is wholly abolished, while in hebephrenia the stage of exhaustion which follows acute excitement, and the condition known as secondary dementia, loss of the power of attention is one of the most prominent symptoms . The memory for both recent and remote events is impaired or abolished in all acute insanities which are characterized by confusion and loss or impairment of consciousness . In the excited stage of manic-depressive insanity it is not uncommon to find that the memory is abnormally active . Loss of memory for recent but See also:

• NET

net remote events is characteristic of chronic alcoholism and senility and even the early stage of general paralysis .

Of all the functions of the brain that of See also:

• SLEEP (0. Eng. slcepan; Ger. schlafen; cf. Lat. labi, to glide, and " slip ")

sleep is the most liable to disorder in the insane . Sleeplessness is the earliest symptom in the onset of Insanity; it is universally present in all the acute forms, and the return of natural sleep is generally the first symptom of recovery . The causes of sleeplessness are very numerous, but in the See also:

• MAJORITY (Fr. majorite; Med. Lat. majoritas; Lat. major, greater)

majority of acute cases the sleeplessness is due to a state of toxaemia . The toxins act either directly on the brain cells producing a state of irritability incompatible with sleep, or indirectly, producing physical symptoms which of themselves alone are capable of preventing the condition of sleep These symptoms are high arterial tension and a rapid See also:

• PULSE

pulse-See also:

• RATE

rate . The arterial tension of health ranges between no and 120 millimetres of See also:

• MERCURY
• MERCURY (MERCU1uus)
• MERCURY (symbol Hg, atomic weight = 2oo)

mercury, and when sleep occurs the arterial tension falls and is rarely above too millimetres . In observations conducted by See also:

• BRUCE
• BRUCE, ALEXANDER BALMAIN (1831-1899)
• BRUCE, JAMES (1930-1794)
• BRUCE, MICHAEL (1746-1767)

Bruce (Scottish Medical and Surgical See also:

• JOURNAL
• JOURNAL (through Fr. from late Lat. diurnalis, daily)

Journal, See also:

• AUGUST (originally Sextilis)

August 1900) on cases of insanity suffering from sleepless. ness the arterial tension was found to be as high as 140 and 150 millimetres . When such sleep was obtained the tension always sank at once to no millimetres or even lower . In a few cases suffering from sleeplessness the arterial tension was found to be below Too millimetres, accompanied by a rapid pulse-rate . When sleep set in, in these cases, no alteration was noted in the arterial tension, but the pulse was markedly diminished .