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Originally appearing in Volume V14, Page 599 of the 1911 Encyclopedia Britannica.
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MEDICAL AND GENERAL] symptoms. Physiological instability is usually manifested by neurotic persons under the strain of any unusual change in their environment. If, for instance, any material change in the food supply consisting either in a decrease of its quality or quantity, or in a failure to assimilate it properly, the nerve-cells become exhausted and irritable, sleep is diminished and a condition known as the delirium of collapse or exhaustion may supervene. An extreme instance of this condition is presented by the delirium occurring in shipwrecked persons, who having to take to the boats are suddenly deprived of food, water or both. Poisoning of the nervous system may also result from the defective action of special glands such as the thyroid, the liver or the kidneys. These conditions are specially exemplified in the mental disturbances which accompany exophthalmic goitre, uraemic poisoning, and the conditions of depression which are observed in jaundice and other forms of hepatic insufficiency. The results of modern research point to a growing belief in the frequency of infection of the nervous system from the hosts of micro-organisms which infest the alimentary tract. No definite or substantiated discoveries have as yet been formulated which would justify us in treating this source of infection as more than a highly probable causative influence. (b) When we turn, however, to the potentiality of infection by micro-organisms introduced from without into the system we are upon surer if not upon entirely definite ground. A special form of insanity called by Weber, who first described it, the delirium of collapse, was observed by him to follow certain infectious diseases such as typhus fever and pneumonia. In later years it has been frequently observed to follow attacks of influenza. Recently our views have broadened and we find that the delirium of collapse is an acute, confusional insanity which may arise without any previous febrile symptoms, and is in fact one of the common forms of acute insanity. The nature of the physical symptoms, the mental con-fusion and hallucinations which accompany it, as well as the fact that it frequently follows some other infective disease, leave no doubt as to its toxic origin. A similar and analogous condition is presented by incidence of general paralysis after a previous syphilitic infection. The symptoms of general paralysis coupled with the extensive and rapid degeneration of not only the nervous but of the whole of the body tissues point to a microbic disease of intense virulence which, though probably not syphilitic, is yet induced, and enhanced in its action by the previous devitalizing action of the syphilitic toxin. There is abundant evidence to show that emotions which powerfully affect the mind, if long continued, conduce towards a condition of metabolic change, which in its turn deleteriously affects the nervous system, and which may terminate in inducing a true toxic insanity. One of the best examples of insanity arising from micro-organisms is that form which occurs after childbirth, and which is known as puerperal mania. Other insanities may, it is true, arise at this period, but those which occur within the first fourteen days after parturition are generally of infective origin. The confusional nature of the mental symptoms, the delirium and the physical symptoms are sufficient indications of the analogy of this form of mental aberration with such other toxic forms of insanity as we find arising from septic wounds and which sometimes accompany the early toxic stages of virulent infectious diseases such as typhus, diphtheria or malignant scarlet fever. The infective origin of puerperal mania is undoubted, though, as yet, no special pathogenic organism has been isolated. Dr Douglas (Ed. Med. Journ., 1897, i. 413) found the staphylococcus pyogenes aureus present in the blood in one case; Jackman (quoted loc. cit.) found the micrococcus pneumonial crouposae in one case; while Haultain (Ed. Med. Journ., 1897, ii. 131) found only the bacillus coli communis in the blood and secretions of several cases. From our experience of similar mental and physical symptoms produced as a result of septic wounds or which succeed surgical operations there seems to be no doubt that several forms of micro-cocci or streptococci of a virulent character are capable by means of the toxins they exude of causing acute delirium or mania of a confusional clinical type when introduced into the body. (c) Accidental and voluntary poisonings of the system which result in insanity are illustrated by the forms of insanity which follow phosphorus or lead poisoning and by Pellagra. The voluntary intoxication of the system by such drugs as morphia and alcohol will be treated of below. 2 and 3. Mechanical injuries to the brain arise from direct violence to the skull, from apoplectic hemorrhage or embolism, or from rapidly growing tumours, or from arterial degeneration. The forms of insanity may be divided into (I.) Congenital Mental Defect and (II.) Acquired Insanity. I. Congenital Mental Defect.—The morbid mental conditions which fall to be considered under this head are Idiocy (with its modification, Imbecility) and Cretinism (q.v.).
End of Article: MEDICAL AND
MEDIATIZATION (Ger. Mediatisierung, from Lat. media...

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