THE NEURASTHENIC FACTOR IN THE DEVELOP- 

 MENT OF MENTAL DISEASE. 



A. B. Richardson, M. D., Superintendent of the Columbus 

 Asylum for Insane. 



To have an intelligent conception of thq relation of nerve 

 exhaustion to the development of mental disorders it is neces- 

 sary to learn something of the manner in which the brain cells 

 receive their nutritive supply and how the products of their 

 physiological activity are removed. We will assume that the 

 cells of the cerebral cortex are the chief organs concerned in 

 the evolution of mental phenomena, and that a study of the 

 physical basis of mind is a study of these microscopic bodies, 

 their connections, supports, sources and methods of renewal and 

 the manner of their riddance of waste and deleterious products. 

 After these have been as fully investigated as the facts at hand 

 will permit, we will then be in position to investigate in what 

 manner they are disordered in the various stages of the develop- 

 ment of mental disease, and I have chosen the name which 

 heads this paper because I believe it wise to impress the fact 

 that these incipient changes are in every instance such as cause 

 errors in the nutrition of the cell elements and derange the nor- 

 mal balance between their supply of assimilative material, on 

 the one hand, and the demands made upon their stores of en- 

 ergy, on the other. 



The histology of the cells of the cerebral cortex has been 

 carefully studied of recent years. Many useful facts have been 

 established, but much remains more or less uncertain. We 

 shall not attempt a review of this further than to describe their 

 relations to the other constituents of the cortex. 



The brain cells of the cortex lie imbedded in a soft matrix 

 of delicate branching cells, composed of numerous branching 

 fibrils from a small central focus, v\fhich entwine in all directions 

 and form a most delicate cushion for the support of the more 

 highly developed brain cells. Their uses seem to be those of 

 support of these cells and possibly a share in their nutrition. 



