scholarly journals A Pathological Classification of Mental Disease

1870 ◽  
Vol 16 (74) ◽  
pp. 195-210 ◽  
Author(s):  
J. Batty Tuke

Nothing which has been written of late years so fully demonstrates the fact that Insanity is not regarded by the profession at large as a somatic disease, as the book intituled “The Nomenclature of Diseases, drawn up by a Joint Committee appointed by the Royal College of Physicians of London.” This work has been forwarded to every member of the medical profession in Great Britain and Ireland by the authority of the Registrar-General, and contains a list of some nine hundred diseases, a large assortment of poisons, and fifty-seven pages of accidents and malformations under which the British public is authorised to suffer or die. The mind of the Briton, however, is authorised to suffer from only six “Disorders of the Intellect;” the idea of disease as connected with madness is studiously ignored. On what principle the differentiation between a disease and a disorder is founded, or on what system of pathology the distinction is based, it is difficult to say; still, there the opinion stands expressed by very high authority, that Insanity is not a disease of the body, merely a disorder of the intellect.

1912 ◽  
Vol 58 (242) ◽  
pp. 465-475 ◽  
Author(s):  
Ivy Mackenzie

In bringing forward some evidence which would point to the biological course followed by some forms of nervous disease to be considered, I would first of all accept as a working hypothesis two generalisations which apply to all forms of disease. The first of these generalisations is that there is essentially no difference in kind between a physiological and a pathological process. The distinction is an arbitrary one; the course of disease is distinguished from that of health only in so far as it tends to compromise the continuation of a more or less perfect adaptation between the organism and its surroundings. There is no tendency in Nature either to kill or to cure; she is absolutely impartial as to the result of a conflict between organisms and a host; and it is a matter of complete indifference to her as to whether toxins are eliminated or not. In the same way diseases of the mind are the manifestation of a perfectly natural relation of the organism, such as it is, to the environment. If the mental processes are abnormal, it goes without saying that the brain must be acting abnormally whether the stimuli to abnormal action originate in the brain itself or in some other part of the body. For example, if a child with pneumonia be suffering from delirium and hallucinations, as is not infrequently the case, this must be considered a perfectly natural outcome of the relation of the brain to its environmental stimuli outside and inside the organism. The actual stimuli may originate in the intestine from masses of undigested food and the stimuli may play on the brain rendered hypersensitive by the toxins from the lungs; the process and its manifestations, as well as the final outcome, are matters in which nature plays an impartial part. It cannot be admitted that there is any form of nervous disease which does not come under this generalisation. It has been argued by some authorities that because insidious forms of insanity are marked only by the slightest variation from the normal course of mental life, and that because the mental abnormalities are only modifications, and often easily explainable modifications, of normal mental processes, that the so-called insanity originates in these processes, and not in the material substratum of the organism. The fallacy of such an interpretation is obvious; it is tantamount to saying that slight albuminuria is the cause underlying early disease of the kidneys, or that a slight ódema may have something to do with the origin of circulatory disease. It is only natural that in the milder forms of mental disease the abnormal manifestations of brain activity should resemble normal mental processes; and even in the most advanced forms of mental disease there must be a close resemblance between abnormal ideation and conduct and perfectly normal ideation and behaviour. Even in advanced cases of Bright's disease the urinary elimination is more normal than abnormal; the abnormal constituents do not differ so much in kind as in degree from those of urine from healthy kidneys. It is not to be expected that in kidney disease bile or some other substance foreign to the organ would be the chief constituent of the eliminated fluid. The signs of insanity in any given case are the natural products of normal brain action mingled with the products of abnormal action. This does not, of course, preclude the possibility that under certain circumstances these abnormal products, such as delusions, hallucinations and perverted conduct, may not themselves be the direct stimuli to further abnormalities. The suicidal character of pathological processes is well seen in other organs of the body. A diseased heart, for example, is its own worst enemy; it not only fails to supply sufficient nutrition to the rest of the organism, but it starves itself by its inability to contract and expand properly, thereby increasing its own weakness. In the same way, certain phenomena of abnormal brain processes are in all probability due to the recoil on the brain of its own abnormal products in the matter of ideation and conduct.


1894 ◽  
Vol 40 (168) ◽  
pp. 64-65

Mr. Asquith has done wisely in commuting the capital sentence passed on Lewis in this case to one of penal servitude. The circumstantial evidence against the prisoner was utterly inconclusive; and his confession of guilt—deliberate and complete as in point of form it undoubtedly was—had a soupçon of insanity about it of which the mind has some difficulty in getting rid. The jealousy with which the criminal law regards naked confessions of guilt is justified by experience. There can be no doubt that it was mental disease which prompted the witches of old to make their false revelations as to the hideous mysteries of the sabbat. And other cases are recorded in which sometimes from insane delusion, sometimes from insanity without delusion, sometimes from sheer tódium vitó, and at other times from an infamous desire for notoriety, or a laudable impulse to shield the guilty, men have confessed, with the utmost circumstantiality, crimes which it was subsequently demonstrated that they had never committed. The case of Hubert, who falsely confessed that he had set fire to London in 1666, and paid for his falsehood with his life, is an instance in point. A still more remarkable case is that of the two Boorns, convicted in the Supreme Court of Vermont, September, 1819, of the alleged murder of Russell Colvin seven years before (Cf. Taylor, “Evid.,” Vol. i., p. 240, n. 2). It appeared that Colvin, who was the brother-in-law of the prisoners, was a person of weak mind, that he was considered burdensome to the family of the prisoners, who were obliged to support him; that on the day of his disappearance, being in a distant field, where the prisoners were at work, a violent quarrel broke out between them, and that one of them struck him a violent blow on the back of the head with a club and felled him to the ground. Some suspicion arose at that time that he had been murdered, and these were increased a few months afterwards by the finding of his hat in the same field. These suspicions in process of time subsided; but in 1819 one of the neighbours having repeatedly dreamed of the murder with great minuteness of circumstance, both in regard to his death and the concealment of his remains, the prisoners were vehemently accused, and generally believed guilty of the murder. Upon a strict search, the pocket-knife of Colvin and a button of his clothes were found in an old open cellar in the same field, and in a hollow stump, not many yards from it, were discovered two nails and a number of bones, believed to be those of a man. Upon this evidence, together with their deliberate confession of the fact of the murder and the concealment of the body in these places, the prisoners were convicted and sentenced to death. Fortunately they were not executed, as their supposed victim turned out to be in New Jersey, and came home in time to prevent their execution. He had fled for fear they would kill him. The bones were those of some animal, and the prisoners had confessed on the advice of some foolish friends, who told them it was their only chance of saving their lives in view of the strong popular prejudice and the circumstances proved against them. A similar case in Virginia recently came under our own observation. In the light of such miscarriages of justice, it is impossible not to feel a sense of relief that the convict in the Limehouse murder case was not permitted to go to the gallows.


1881 ◽  
Vol 26 (116) ◽  
pp. 566-567

One is quite used to see attacks of mental disease shortened or relieved by acute bodily illnesses, such as fever, erysipelas, pneumonia and the like; and in some the mind seems to improve directly the body suffers. We have had, on the other hand, two cases of asthma in which the breathing was better when the patient was insane, and only became bad as the mind improved.


2019 ◽  
Vol 26 ◽  
pp. 27-40
Author(s):  
María Teresa González Mínguez

According to Cartesian principles, in the seventeenth century the body was thought to be subordinated to the mind. Later in the eighteenth-century male authors of medical treatises supported the idea that the interaction of body and mind produced passion and could dangerously turn into mental breakdown. In all her novels Jane Austen showed an enormous interest in all matters concerning medical treatment. In Sense and Sensibility(1811), Austen emphasized illness and suffering by mixing physical health and mental disease with moral and philosophical doctrines. My contention in this article is that moralists, philosophers and thinkers such as Dr Johnson, William Blake, William Godwin, and Adam Smith collaborated with Austen to shape the idea that sensibility was no disease and sense no virtue; instead they propose that human beings, especially women, can obtain individual and collective profit and promote changes not only in the past but also in the present if they regulate their reason and feeling with a practical mindset. Key words: physical health, mental breakdown, medicine, moral thoughts, regulation of feelings.      


Author(s):  
Voula Tsouna

This chapter aims to give a fairly comprehensive account of Epicurean hedonism, highlighting its philosophical interest and its complex relation to rival doctrines. Evidence is used from relatively unexplored sources, in particular Philodemus and Diogenes of Oenoanda, as well as from Epicurus, his early associates, and Lucretius. The discussion will bring out the distinctive nature of Epicurean hedonism, its originality and sophistication, and its enduring core as well as its peripheral developments over time. The topics discussed include the following: Epicurus’s conception of the moral end and his theory of motivation; Epicurus’s conceptual amplification and defense of his hedonism (especially the controversial distinction between kinetic and katastematic pleasure, the claim that the removal of pain is the highest pleasure, and the respective roles of the body and the mind in the achievement of the supreme good); the Epicurean classification of desires and its ethical implications; and the unique importance of virtue in the rational pursuit of pleasure. Finally, the chapter considers some of the criticisms rehearsed by Cicero against Epicurean hedonism and discusses whether the Epicureans have sufficient resources to respond to them.


1903 ◽  
Vol 49 (205) ◽  
pp. 236-245 ◽  
Author(s):  
A. R. Urquhart

I have ventured to suggest that we should now consider what we are going to do about the classification of mental disorders. Lately, the Royal College of Physicians of London decided to revise the Nomenclature of Diseases, and publish another edition. The President of this College is on the Committee; as is also Dr. Savage, our colleague in London, who has taken much interest in this question. I was somewhat surprised the other day when I asked for a copy of the Nomenclature of Diseases in the Royal Medical Society of London, to find that they did not have a copy in their library—a book which is supposed to guide the profession in the statistical registration of diseases. In 1896, for the third edition, an attempt was made to reform the nomenclature of mental diseases, under the direction of Dr. Hack Tuke and Dr. Savage. In its present state it is still unsatisfactory. The classification with which we have to deal is as follows:—First, there is “idiocy (cretinism), and then mania (acute or chronic), delirious, hysterical, puerperal, epileptic, traumatic, syphilitic, gouty, from either acute or chronic disease, alcoholic, plumbic, or other poisons.” Acute is an absurd word, because we specially want to mark the duration. Acute should be rendered Recent. Then there is “melancholia (acute or chronic), delirious, hypochondriac, climacteric, puerperal, epileptic, syphilitic, acute, other diseases.” Then there is “dementia (primary or secondary), senile, climacteric, puerperal, epileptic, traumatic, syphilitic, acute, other diseases.” Then there is “mental stupor, anergic, delusional.” Then there is “general paralysis.” That is not a mental disease. Lastly, there is “delusional insanity.”


2018 ◽  
Vol 32 (1) ◽  
pp. 30-42 ◽  
Author(s):  
Claudia Traunmüller ◽  
Kerstin Gaisbachgrabner ◽  
Helmut Karl Lackner ◽  
Andreas R. Schwerdtfeger

Abstract. In the present paper we investigate whether patients with a clinical diagnosis of burnout show physiological signs of burden across multiple physiological systems referred to as allostatic load (AL). Measures of the sympathetic-adrenergic-medullary (SAM) axis and the hypothalamic-pituitary-adrenal (HPA) axis were assessed. We examined patients who had been diagnosed with burnout by their physicians (n = 32) and were also identified as burnout patients based on their score in the Maslach Burnout Inventory-General Survey (MBI-GS) and compared them with a nonclinical control group (n = 19) with regard to indicators of allostatic load (i.e., ambulatory ECG, nocturnal urinary catecholamines, salivary morning cortisol secretion, blood pressure, and waist-to-hip ratio [WHR]). Contrary to expectations, a higher AL index suggesting elevated load in several of the parameters of the HPA and SAM axes was found in the control group but not in the burnout group. The control group showed higher norepinephrine values, higher blood pressure, higher WHR, higher sympathovagal balance, and lower percentage of cortisol increase within the first hour after awakening as compared to the patient group. Burnout was not associated with AL. Results seem to indicate a discrepancy between self-reported burnout symptoms and psychobiological load.


Sign in / Sign up

Export Citation Format

Share Document