Richardson, Neurasthenic Factor in Mental Disease . i8i 



duced are increased. During the periods of quiescence in cell 

 activity, the blood pressure is diminished, the amount of nour- 

 ishment sent to cells is lessened and the waste products dimin- 

 ished, yet it is then that the cells store up energy "because their 

 activity is almost nil and the balance is far on the credit side of 

 the account. 



Reasoning from these data, then, we see that the incipient 

 variations in cell nutrition and consequent mental derangement, 

 come from two sources, the first those that diminish the amount 

 of material assimilated by the cell, the second, those that in- 

 crease the demands made upon it. The first of these may be 

 induced indirectly by a diminution in the amount of the blood 

 or a deterioration in its quality. In such states there is an 

 anaemia of the brain cell, in some cases, and, in others, a passive 

 hyperaemia, the result of a want of proper tonic in the vessels. 

 Much oftener, however, the diminution in the nutritive supply 

 depends upon a genuine hyperaemia of the cortex. The in- 

 creased pressure of this, which is either excessive in degree or 

 continued beyond the normal limit, prevents the healthy transfer 

 of nutritive material through the vessel walls. The cause of 

 this abnormal hyperaemia is usually the over stimulation of the 

 cells themselves. This of itself endangers the safety of the cells 

 by increasing their requirements for nourishment. It is impos- 

 sible to separate the effects of these two causes. Overstimula- 

 tion of the cells accompanies the thousands of exciting causes 

 of mental disorder. None, however, is more effective in its pro- 

 duction than worry. Whatever may be its origin this induces a 

 rapid destruction of tissue in the cerebral cortex. There is a 

 prolongation of the normal hyperaemia, and an inability of the 

 vessels to contract upon their contents with the normal diminu- 

 tion in their stimulation, due to exhaustion and paresis of their 

 nervous control. It is not difficult for any one to test this in 

 himself. Apply yourself to intellectual work which is felt to be 

 a strain on you and continue this to an hour beyond that usual 

 for your retirement. You will notice how difficult you will find 

 it to settle your brain for repose, and how long before re- 

 freshing slumber comes to your relief. Worry acts in a similar 

 manner and we have all felt its disquieting influence, lying 

 awake hour after hour in a vain attempt to calm the restless ac- 



