finds no expression. If the power to which all mental processes are due be impaired, those actions, among others, will be affected, The Psychological Nature and Significance of which are the most detailed and elaborate, General Paralysis and its Pathology. BY EDWARD C. MANN, M. D., Supt. Sunnyside Retreat for Mental and Nervous Diseases, IN As the most varied, the least rigidly defined and the least organically registered. Of all mental processes, those involved in the consideration of self are at once the most gen. eral, extensive, changeable and complicated, N writing on general paralysis, it may be as well as the most vague and undefined. defined as a disease characterized by Self occupies in the mind the widest, most general and progressive loss of co-ordinating frequent and most capricious attention. power on the muscles, especially those of in general paralysis, this mind-power is the speech and locomotion, combined with men- seat of the main lesion, the psychical processes tal enfeeblement, always tending to dementia, concerned in the consideration of self will be and frequently characterized by a sense of the first involved, and will present the most well-being or actual delusions of an exalted prominent symptoms. In general paralysis, the ideal self runs riot, the man, not as he is, but as he has pictured himself, and as he would have himself be. In the inception of his disease the patient feels himself "bang character. It is doubtless true that in certain states of the brain mental action, or the actions of the higher centers of the brain, may become at times automatic, and be performed without up" and "perfect." Everything "elegant the intervention of consciousness. A con- and rose-colored. His wealth is unbounded, stant repetition of any given mental action and he orders" a million " cigars, and orders causes it to become organically registered in palaces built of gold and diamonds, with the the brain centers, so that while at first a series utmost indifference and nonchalance, thorof thoughts is performed consciously by the oughly believing in his capacity to do all individual, it ultimately becomes reflex, re- these things. The patient's delusions are sponding to the recognized stimulus without markedly progressive in number, absurdity consciousness, and independent of any effort and exaggeration. Being rather feeble, he or intervention of consciousness. It is to imagines himself capable of immense sussome injury of this mind-power that we must tained exertions. In general paralysis the look for an explanation of the mental symp- mental processes which are the most autotoms of general paralysis. Two classes of matic are the last to be affected, and the mental actions will necessarily be involved in patient entertains perfectly reasonable ideas this disease. First, those which are of so about his actual self, and although possessing recent an origin as not to have become or- thousands of ideal dollars and estates, will ganically registered; and, second, those which tell you correctly that he earns but $10 per are still unable to be performed without con- week, as this idea has from frequent and conscious interference. One of the most promi- stant repetition become automatic. In the nent instincts or ideas in the human mind is same manner a patient under my care tells the importance of self. In a healthy state me correctly that his suit of clothes cost him we draw up and surround ourselves with an $15; and in the same breath says that he has ideal self which, if we are healthy minded, ordered a silk velvet suit with diamond but 147361 |