A treatise on mental diseases : based upon the lecture course at the Johns Hopkins University, 1899, and designed for the use of practitioners and students of medicine / by Henry J. Berkley.
- Berkley, Henry J. (Henry Johns), 1860-1940.
- Date:
- 1901
Licence: In copyright
Credit: A treatise on mental diseases : based upon the lecture course at the Johns Hopkins University, 1899, and designed for the use of practitioners and students of medicine / by Henry J. Berkley. 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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![or perhaps months, there has been a sense of bodily ill-being, with digestive disturbances, sometimes with jaundice of the con]iinctivj3e. The patient complains of a feeling of increasing physical and mental disability and loss of appetite; there is an increasing dislike for exercise, a tendency to sit inertly brooding for hours, and an inclina- tion to avoid the other meml)ers of the family or friends. Later, as this apathy grows, the patient becomes untidy in her habits, she loses all care for her personal appearance, the world presents to her jaundiced mind an appearance that is dark and dismal, and no com- pensation is afforded by attempts at work or in the pursuit of pleasure; everything has become irksome. With the physical inertia there is a corresponding amount of mental pain, although no delusions of any kind are apparent. The majority of cases probably do not go beyond this point, as the larger number of these simple forms are amenable to treatment and soon recover under appropriate measures. Let the disease proceed a little further and the defects in the nutrition of the entire body become of an order such as can hardly escape attention. The skin presents an earthy, muddy tint, and feels dry and harsh to the hand. The mouth and lips are dry, and herpes is not infrequent. The bowels are constipated, the urine contains an excess of phosphates, the pulse is slow, the arteries are contracted, the body temperature is lowered. If the disturbance be very marked, there may be anomalies of the deep reflexes which usually under these circumstances are exaggerated, being more rarely subnormal. Loss of weight is very considerable. Sleep in the acute cases is profoundly disturbed, while in the lighter forms there is always nocturnal restlessness, and even under the influence of hypnotics there are frightful dreams and frequent terrors which prevent sound repose. Headache or nuchial pain is a fre- quent symptom, particularly among the anaemic, and neuralgias and parsestliesias are the rule. With women the menstrual flow is either decreased or ceases for the time. The patient is anxious, fearful of everybody around her, resists attention passively rather than actively; she shows a noticeable degree of mental confusion, or, at any rate, a slowness in thought and association of ideas; indeed, the fundamental characteristics of melanchoha are passivity and inertia. This mental inhibition is an important factor in the psychalgia of the aflfticted individuals on account of the incapacity to reach beyond one line of thought, the patients recognising only too clearly their altered state. Inability](https://iiif.wellcomecollection.org/image/b21294690_0186.jp2/full/800%2C/0/default.jpg)
