For this, it is not essential that the victim's mind be pervaded by the infantine cosmogony which parades often as religious truth. Without anything of the sort, there may arise naive interpretations, hardly even having explicit reference to supernatural agents. For example, a patient may say "If I begin on Friday, a certain undertaking will fail," "If I do not turn my vest twice, misfortune will occur," "It is incumbent upon me to turn round in my chair, or the negotiations will fail." The enumeration of expedients would be useless. The above are from three different patients, one a boy of fourteen now completely cured; the second from the son of a prominent public man now quite restored to health; the third from a case still under care. In none of these was the bodily state of importance, the psychological reactions were the sole object of therapeutic effort, and their ordination was accomplished by purely psychological means.
DATA CONCERNING DELUSIONS OF PERSONALITY WITH NOTE ON THE ASSOCIATION OF BRIGHT'S DISEASE AND UNPLEASANT DELUSIONS.[*]
[*] Presented in abstract at the Sixth Annual Meeting of the American Psychopathological Association, held in New York City, May 5, 1915. Being Contributions of the State Board of Insanity, Whole Number 47 (1915. 13). The material was derived from the Pathological Laboratory of the Danvers State Hospital, Hathorne, Massachusetts, and the clinical notes were collected by Dr. A. Warren Stearns, to whom I wish to express my indebtedness but to whom no one should ascribe the somewhat speculative character of the present conclusions. (Bibliographical Note.—The previous contribution was State Board of Insanity Contribution, Whole Number 46 (1915.12) by D. A. Thom and E. E. Southard entitled "An Anatomical Search for Idiopathic Epilepsy: Being a First Note on Idiopathic Epilepsy at Monson State Hospital, Massachusetts," accepted by Review of Neurology and Psychiatry, 1915.)
E. E. SOUTHARD, M. D.
Pathologist, State Board of Insanity, Massachusetts; Director, Psychopathic
Hospital, Boston, Mass., and Bullard Professor of Neuropathology, Harvard
Medical School, Boston, Mass.
ABSTRACT
Previous work on somatic delusions. Suggestion that allopsychic delusions are as a rule in some sense autopsychic. A genetic hint from general paresis (frontal site of lesions in cases with autopsychic trend.) Mental symptomatology of general paresis. Work on fifth-decade psychoses. Statistical summary. Group with pleasant (or not unpleasant) delusions. Three cases of senile dementia, delusions of grandeur, and frontal lobe changes. Three cases with religious delusions. Remainder of pleasant-delusion group. Group with unpleasant delusions. Nephrogenic group.
THE suggestions here put forward concerning personal (autopsychic) delusions are based on material of the same sort as that previously analyzed for a study of somatic and of environmental (allopsychic) delusions. Our conclusions are also influenced by two analyses of the types of delusion found in general paresis. Moreover, at a period subsequent to the analysis presented here, some work on fifth-decade insanities had been completed, and the delusional features constantly found in the functional cases of insanity developing at the climacteric, entered to modify our general point of view.
The situation may be summed up as follows:
The accessibility to analysis of the clinical and anatomical data at the Danvers State Hospital was such as to prompt the use of its card catalogues for statistical work upon delusions. The more so, because in a period of enthusiasm over the Wernickean trilogy (autopsyche, allopsyche, somatopsyche) of conscious phenomena, the Danvers catalogue had attempted to divide the delusions recorded into the three Wernickean groups. Putting these clinical data side by side with the anatomical data, we were speedily able to single out those cases with normal or normal-looking brains and thus to secure a group approximately composed of functional cases of insanity.