Bauhaus-Universität Weimar

Titel:
Dictionary of philosophy and psychology including many of the principal conceptions of ethics, logics, aesthetics ... and giving a terminology in English, French, German and Italian, vol. 2 [lead-zwing]
Person:
Baldwin, James Mark
PURL:
https://digitalesammlungen.uni-weimar.de/viewer/image/lit29448/415/
PSYCHOSIS 
cation due to the abnormal parasitic presence 
or symbiosis. So, too, diabetes, although no 
definite cause of it is known, is a disease, 
because it presents recognizable criteria (non¬ 
elaboration of the sugar in the blood, and its 
elimination with the urine), and presents a 
fairly definite course and complex of symptoms. 
Hemiplegia, however, although a definite 
symptom-complex, is not a disease, but a 
residual, due to the transitory or permanent 
interruption of the cerebral efferent pathway. 
The disease-process leading to it is usually 
a vascular disorder, either at the point of 
damage, as in hemorrhage or thrombosis, 
or in the heart or aorta, as in embolism. 
A further distinguishable type of patho¬ 
logical abnormality is represented by the dis¬ 
orders produced by abnormal development ; 
these may be due to conditions of the environ¬ 
ment, or may be irregularities of the balance 
of function of special organs (such as cretinism 
and myxoedema due to disease of the thyroid 
gland), and yet in other instances we have 
no factor to account for the abnormality 
except that of heredity. The fundamental 
purpose of pathology (i. e. the study of ab¬ 
normal life, not merely morbid anatomy and 
bacteriology) is a recognition of actual disease- 
processes and of the natural relation of 
symptoms. 
The introduction into psychiatry of the 
principle of pathology, that the study of the 
natural development and causal relation of 
symptoms should replace the speculative 
analysis of single features (e. g. ‘ delusions on 
special topics,’ hallucinations, or more com¬ 
plex groups of symptoms, like excitement, 
depression, &c.), was mainly due to Kahlbaum, 
and has been notably furthered by Kraepelin 
and his followers. For this purpose the effort 
to determine definite disease-processes in 
psychiatry is undoubtedly the most fruitful 
and helpful method, although it is not so easy 
to pursue as in the disorders of the non-psychic 
mechanisms. It seems possible to distinguish 
the following types : 
(a) Aberrations in growth and fundamental 
development (a) not of the character of a real 
disease-process, but referable to poor heredity 
(Anlagen) and unfortunate external conditions 
of growth, or (b) due to actual disease- 
processes, affecting the brain directly or in¬ 
directly (traumatism at birth, meningitis, 
encephalitis, &c.). 
(b) Disease-processes of an etiologically 
vague character, called constitutional, but of 
remarkably well-defined symptomatological 
and clinical nature : epilepsy, hysteria, con¬ 
stitutional neurasthenia, manic-depressive 
insanity (mania and melancholia), and para¬ 
noia. 
(c) Disease-processes on the basis of an 
intoxication (alcoholism, cocainism, morphin¬ 
ism), or exhaustion, or auto-intoxication 
(myxoedematous insanity and general para¬ 
lysis), and yet others which depend on un¬ 
known consequences of developmental and 
involutional irregularities, especially in the 
sexual sphere : as perhaps the processes of 
deterioration, dementia praecox, and certain 
forms of paranoic condition, and, in the period 
of involution, of melancholia, &c. 
(d) As residuals may be classed the terminal 
dementias, certain paranoic conditions, re¬ 
covery without insight into the morbidity of 
abandoned delusions, &c., comparable to the 
formation of scars and defective readjustment 
after the active disease-process has dis¬ 
appeared. 
At first sight this general biological outline 
may appear unimportant to the psychologist ; 
but disregard of such principles is bound to 
lead to serious misconceptions in the valua¬ 
tion of the current nomenclature of mental 
diseases in the psychiatric literature and in 
the actual problems of psychopathology. A 
short discussion of this point seems warranted 
by the recent introduction of psychophysical 
and psychological methods into psychiatry 
and the resulting reaction upon normal 
psychology. We must distinguish the follow¬ 
ing groups of concepts : 
(i) The elementary abnormal symptoms : 
disorders of sensation (including hallucina¬ 
tions), of memory, of the stream of thought, 
of elaboration of impressions (orientation), of 
attention (indifference or distractibility), of 
self-direction, of various states of conscious¬ 
ness, activity (inhibition, retardation, or faci¬ 
litation), &c. 
(ii) The symptom-complexes, i. e. sufficiently 
frequent combinations of symptoms to form 
definitely recognized groups or pictures, such 
as the symptom-complexes of exaltation (as in 
mania), depression (as in melancholia), delu¬ 
sional states with only little or no formal dis¬ 
order (paranoia), or confusion, and delirium. 
Most of the descriptions of mental diseases pub¬ 
lished are mainly descriptions of symptom- 
complexes, many of which cannot make any 
pretensions to be recognized as disease-entities. 
For sketches of these symptom-complexes see 
Mania, Melancholia, Moral Insanity, and 
Paranoia. 
393
        

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