MENTAL ASPECTS OF ORDINARY DISEASE. 569 



has stood still some time and the steam-pressure is becoming dan- 

 gerously high. 



Much mental instability is found among sufferers from chronic 

 heart-disease, and many and pronounced are the mental modifications 

 induced. In one case, I remember well, a very old patient, who was 

 the subject of aortic obstruction, became remarkably polite when the 

 results of the cardiac lesion were very marked, a mental attitude far 

 removed from that which he habitually assumed. Usually a totally 

 opposite character of change is produced, and the effect is to cause the 

 mental operations to be imperfect, unsustained and unequal, while 

 there are present suspicion, doubtfulness, vacillation, and caprice. 

 Indeed, the mental change is usually for the worse ; and along with 

 intellectual enfeeblement there is an alteration of the emotional prod- 

 ucts which we have seen to be allied with cerebral depletion. The 

 false and morbid feelings which are the products of imperfectly 

 nourished cerebral centres bear the same relation to normal thought 

 that Emerson says evil does to good it is good in the making; and 

 more perfect elaboration of the outcomes of emotional centres would 

 give us healthy instead of morbid feeling. 



The mental attitude of sufferers from heart-disease is usually one 

 of caprice, unsustained volition, together with suspiciousness and 

 groundless fear imperfect emotional products. 



Another marked mental attitude is furnished by those who suffer 

 from gout in any of its forms, for suppressed gout is the most protean 

 of diseases. We have already seen how gout-poison stimulates the 

 intellect in the earlier stages of granular kidney ; what we may now 

 consider is the mental modification produced by advanced disease. 

 There is a mixture of explosiveness, the gouty temper, with suspicion 

 and depression, the consequences of spasm of the intra-cranial arte- 

 ries. Instead of the well-sustained blood-pressure of the early stages 

 with the stimulant gout-poison irritating the cerebral cells into activ- 

 ity, we have the stimulant quality of the blood together with an im- 

 paired and insufficient supply. The resultant product is a blended 

 compound of irritability and suspicion, bad temper and anxiety, the 

 latter all the more aggravating from a consciousness that it is not 

 mere illusion, but an emotional hallucination. 



Such individuals are the terror of their dependents and the betes 

 noires of their domestics. There is such a villainous state of temper, 

 at times ascending to ferocity, that the person becomes simply intol- 

 erable ; the unfortunate sufferers themselves being still further tor- 

 tured by the haunting impression that they are utterly unreasonable, 

 and that their attitude does not arise from any provocation from with- 

 out, but that it takes its origin in some abnormal condition existing 

 within. In one case well known to me the sufferer sought relief in 

 religious exercises, in resort to her Bible and to prayer it is needless 

 to say without the desired result. What she needed was not spiritual 



