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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    exaltation, rather a maniacal than a melanchohc tendency; but when the aortic arch as well as the valves becomes diseased and dilated, a general mental deterioration and subsidence of the previous expansive and exalted condition supervenes. When mitral and aortic disease coexist, it is usually found in senile and organic dementia cases, and, on the whole, the symptoms are aortic in type; whereas, when the heart develops a condition of dilated hypertrophy, the symptoms are of the depressed and demented mitral type, and are very chronic. Thoracic and abdominal aneurysm may be merely indicated by false perception and interpretation of the inevitable pressure symptoms, but the nodulated aorta is most frequently found in general paralysis and other demented and syphilitic cases, often associated with patches of cerebral sclerosis and toughened meninges. These conclusions were arrived at after a study of 236 instances of disease, of which 163 were heart, and 73 aortic, cases; while, of 165 separate diseased individuals, 107 had heart, and 48 aortic disease. Greenlees has also studied this relation between cardiac disease and mental symptoms and disease, and in 672 patients he found that almost 13 per cent had organic heart disease, while 44 per cent exhibited functional disorders of the heart. The organic diseases occurred with greatest frequency in cases of dementia and imbecility, being 223 per cent; then of general paralysis, in 153 per cent; of mania, in 122 per cent; and of melancholia, in 98 per cent. Functional heart disease was exhibited in an almost inverse order—viz., 50'8 per cent in melancholia, 435 per cent in general paralysis, 41'1 per cent in mania, and 40'2 per cent in dementia. As regards arterial disease, 222 post-mortems showed thirteen cases of this affection, and when clinically compared in relation to the mental symptoms, it was found that it occurred as follows—viz., in general paralysis, 696 per cent; in dementia, 62 9 per cent; in melancholia, 57'5 per cent; and in mania, 51'02 per cent. This arterial degeneration does not appear, however, to occur at an earlier age in the insane, except in the case of general paralysis, where the arterial disease is dependent rather on the duration of the disease, than on the age of the patient. The influence of the blood pressure on mental symptoms, and the converse, may be better appreciated by giving the following conclusions, at which Greenlees arrived after an examination of many sphygmo- graphic tracings in all forms of insanity :—1. In the various forms of insanity the influence of the nervous system on the heart and circulation is such that in nearly every case the: