Mental Disease and Defect 



39 



Martha C, now aii inmate of an insane hospital, is a high 

 school graduate and also a graduate nurse. She is alcoholic and 

 insane because of syphilis. Her father died of j)aralysis ; her 

 mother had hysteria ; one brother died of paresis in an insane 

 hospital ; and one sister has a son who is an imbecile. 



Margaret H., age forty, was committed to an insane hospital 

 with a diagnosis of manic-depressive psychosis. She was paroled 

 after four months and later discharged. Soon after this she mar- 

 ried a wealthy farmer and her subsequent history is unrecorded. 

 However, her family history shows an insane mother, a brother 

 with dementia praecox now held in an institution, and a cousin 

 who is insane. 



Lula L. was forty-eight years old when she was first brought 

 to the City Dispensary. She was insane due to syphilis, and had 

 attempted suicide because her husband threatened to place her 

 in an institution. Her husband is alcoholic and their 8 children 

 are incorrigible. One son was sent by J uvenile Court to the Indi- 

 ana Boys' School and the other 2 children were also sent to 

 correctional institutions. 



Psychoses, not true insanity, are the functional disturbances 

 psychic in origin, which may be brought about by external 

 causes, where there is an unstable nervous make-up. These 

 include hysteria and neurasthenia. The 'Var neuroses" men- 

 tioned in Chapter I belong to this group. The prognosis in these 

 cases is usually good; the treatment consists largely in psycho- 

 analysis to discover the idea which is the cause of the patient's 

 illness, and the introduction of a new and opposing idea in its 

 place. . Often a change of environment is necessary to prevent a 

 return to the morbid mental attitude. Of hysterical insanity Dr. 

 Kraepelin says : "It is the expression of a peculiar, morbid tend- 

 ency, and can be brought to further development, but not origi- 

 nated, by external causes."'^ 



Heredity then is the inciting cause, and prevention must begin 

 with the preceding generation. However, since improvement, if 

 not complete cure, can be brought about in the majority of these 

 cases thru proper treatment under expert medical advice, the 

 outlook is encouraging. Social workers, as friends of the patients 

 who may receive their confidence, can be of service to the alienist, 

 first, in discovering the etiology of the patient's condition; and, 

 secondly, in bringing about such environmental changes as may 



' Dr. Emil Kraepelin, Clinical Psychiatry, p. 253. 



