PART II. SPECIAL PSYCHIATRY. CLASSIFICATION. THIRTEEN years ago, when the first French edition of this Manual was published, the author felt it incumbent on himself to offer a sort of apology for following Kraepelin's classification of mental disorders. Since then this classification has largely supplanted all others throughout the world, so that to-day an apology seems no longer necessary. We have, however, changed the arrangement of the clinical groups, placing them in an order as far as possible according to etiology. I. CONSTITUTIONAL DISORDERS: Idiocy, imbecility, and feeble-mindedness. Dementia præcox. Paranoia. Manic-depressive psychoses. Involutional melancholia. Other psychopathic conditions. II. ALCOHOLIC DISORDERS: Pathological drunkenness. Acute hallucinosis. Delusional states. The polyneuritic psychosis. III. SYPHILITIC DISORDERS: General paresis. Cerebral syphilis. Cerebral arteriosclerosis. IV. TRAUMATIC DISORDERS. Delirium. Neurasthenic states. Dementia. V. MISCELLANEOUS GROUPS: Infective, exhaustive, toxic, autotoxic, thyro genic, organic, and senile. CHAPTER I. ARRESTS OF DEVELOPMENT: IDIOCY, IMBECILITY, AND FEEBLE-MINDEDNESS. Etiology. - Bad heredity is by far the most common and important cause of arrests of development. There are, however, other factors acting during intra-uterine life or in infancy or early childhood which may cause them; two of these deserve special mention, parental alcoholism and parental syphilis. Alcoholism in all its forms is encountered in the parents of idiots and imbeciles: chronic alcoholism, drunkenness at the moment of conception or during pregnancy, etc. Statistics compiled by Bourneville show that 48% of idiots and imbeciles are the offspring of alcoholic parents. These figures correspond approximately to those published by most other authors. Yet the question of the effect of parental alcoholism upon the offspring cannot be said to have been fully answered. The fact that a large percentage of the parents of defective children are alcoholic lacks significance in view of the great general prevalence of alcoholism and in the absence of accurate data concerning the frequency of alcoholism in the parents of normal children. Further, there is some evidence which suggests that alcoholism is often but a symptom of neuropathic constitution, so that abnormal traits in the offspring of alcoholic parents may possibly be attributable to inheritance of the neuropathic taint rather than to the injurious effect of alcohol upon the germ plasm. Unfortunately statistics bearing upon this important subject have not always been very critically examined. In a recent memoir from the Francis Galton Laboratory for National Eugenics, University of London,1 consisting of a careful and apparently trustworthy statistical research of this subject, we find, among others, the following conclusions: "There is a higher death rate among the offspring of alcoholic than among the offspring of sober parents. "Owing to the greater fertility of alcoholic parents, the net family of the sober is hardly larger than the net family of the alcoholic. "The general health of the children of alcoholic parents appears on the whole slightly better than that of the children of sober parents. There are fewer delicate children and in a most marked way cases of tuberculosis and epilepsy are less frequent than among the children of sober parents. "Parental alcoholism is not the source of mental defect in offspring. "The relationship, if any, between parental alcoholism and filial intelligence is so slight, that even its sign cannot be determined from the present material." 1 Ethel M. Elderton and Karl Pearson. A First Study of the Influence of Parental Alcoholism on the Physique and Ability of the Offspring. London, 1910. |