Cerebral and mental symptoms in relation to somatic disease, anæsthetics and toxic agents, traumata and surgical procedures : with a review of the treatment of some cerebral and mental symptoms by operation / by James Christian Simpson.

  • Simpson, James Christian.
Date:
1898
Catalogue details

Licence: Public Domain Mark

Credit: Cerebral and mental symptoms in relation to somatic disease, anæsthetics and toxic agents, traumata and surgical procedures : with a review of the treatment of some cerebral and mental symptoms by operation / by James Christian Simpson. Source: Wellcome Collection.

Provider: This material has been provided by King’s College London. The original may be consulted at King’s College London.

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    doubt that lowered nervous tone predisposes to albuminuria; but, as Elwjg remarks, few of us reach middle life without mental strain and anxiety, and that the amount of nervous tension is due rather to temperament and disposition than to the actual circumstances of the person's life. Roche reports five cases of herpes zoster, in all of which there was mental depression before the appearance of the eruption; and Bateman has noticed a similar occurrence after a fit of ani^er, while Schwartz had three cases after a similar outburst. Quite lately I had a patient who had had considerable worry, and who presented symmetrical herpetic eruption at the margins of symmetrical patches of alopecia areata in the course of the occipital nerves. The herpes improved, but the hair which grew in the bald places came in quite white. There is often a marked absence of pain in many diseases, which in the sane are accompanied by considerable suffering. Thus the pain of acute pleurisy or peritonitis may never be felt. Extensive cellulitis and suppuration may be quite unattended by any suffering to all appearance, and free incisions may be made with absolute indifference on the part of the patient. As a rule, however, this anaesthesia does not seriously interfere with the success of an operation if such be required, or with the ultimate healing and cicatrisation of other cutaneous maladies, such as furuncles or Raynaud's disease. Acute cerebral symptoms or actual insanity not infrequently occurs in the course of active bodily disease, either of an infective febrile or general constitutional nature, or in associa- tion with some more purely local disease of the viscera. This consideration opens up the whole question of the dissolution of the functions of the nervous system, which is much too complex a problem to attempt to unravel on this occasion, so that only the more probable theories will be shortly stated, and subsequently some cases will be quoted illustrating the general bearing of cerebral symptoms in the course of bodily disease of one kind or another. Hughlings Jackson takes, as a working basis, the hypothesis that there are four depths of dissolution which may take place, and also four factors in relation to the insanity which results. It is impossible to fully appreciate the disordered mechanism of an insane case; it is so complicated, and no one case can be allocated to any one depth or to any one factor. But the consideration of these depths and factors seriatiin is most helpful in aiding us to comprehend the fearful complexity of symptoms exhibited by an insane patient.