THE INSANE DIATHESIS. The ideal human system would be one of perfection, that is, it would be one so constituted as to discharge all its functions perfectly. Yet, its capacities would be limited as they now are, though not to the same extent. Digestion of such articles of food as the system requires would be perfect, though this might not be true as to many other articles, which are appropriate as food for other animals. Sight and hearing would be perfect, but only within certain ranges and distances; memory would be perfect in reference to every thing comprehended and understood. The limitations would be dependent on the inherent nature of the organism, in its relation to the external world. What is stated above as true, in relation to certain parts of the system, would be equally true of the functions of all parts of the human system, both physical and psychical. Now, the actual human system approaches toward this ideal one in a greater or less degree. It possesses all the faculties, both physical and psychical, A few simple statements in reference to differences existing among persons, as to those physical and mental conditions which are inherited, may be in point, and prepare the way for other considerations. I. Though we may not be able to determine the causes of these differences, yet it is quite evident that there exists, from the time of birth, the largest diversity in reference to the physical constitution of persons: while some are strong and vigorous, and capable of large effort, and of enduring exposure to the heat and cold with almost indifference, others are so delicate and sensitive as to be easily affected by such influences; while the muscles of some are susceptible of making the most delicate and difficult Again, these physical conditions are more or less variable with many persons. They are conscious of feeling more active and vigorous, of experiencing a larger degree of pleasure in physical activity at one time than at another; they may be conscious of more or less painful sensations, experience a measure of indisposition to make effort; they may be more restless and uneasy, and feel discomfort from slight causes which had rarely before produced such results. In short, there may exist not only a difference in the constitution of the different organs of the body, but these natural conditions are more or less changeful in their states, within certain limits, while still in a state of health. There may exist a condition of over-activity, or of under-activity, in any or all portions of the body, and from the operation of causes, the nature of which we are entirely ignorant, and concerning which persons do not much care, so long as they do not experience so much discomfort as to Passing now to the conditions of the mental side of the human system, we find, in what are called healthy states, that there exists as broad a diversity of character as in the physical. While some apprehend any thing a little abstruse with great difficulty, or fail to do so at all, others understand it with a readiness which we are accustomed to call intuition; while many occurrences seem merely to impinge upon and glance off the minds of some persons never to be remembered again, they pass from the minds of others only after long years, or remain through life. Some persons always look upon and judge of occurrences and results in an unusual way. They are odd or singular in their mental constitution, and are accustomed to do odd and out-of-the-way things just as naturally as others would do the same things in such a manner as to attract no attention. Some persons see, hear, taste, touch, and smell so much more quickly and delicately than others, that we must conclude there exists a radical difference in the perfection of the organization of the nerve-cells of these various organs of special sense. Again, there are periods in the experience of some persons, when they see, hear, touch, taste, and The same is true to even a larger extent of the emotional nature. Persons, in certain states of the nervous system, are pleased with persons, objects, and sensations, which afford them no pleasure at other times; they are displeased and pained, while in other conditions, with sentiments which would at other times produce no such effect. They sometimes feel that the world and its possessions and pleasures are so great and grand that they can never leave them, and the thought of doing so causes the keenest anguish; while in another state all these pleasures and possessions appear as empty and valueless as a bubble of air, and the thought of leaving them, and throwing off the burdens and cares of life, which are usually so much enjoyed, seems almost pleasurable. Again, some persons have periods of being irritable, restless, nervous; they cannot bear much; little incidents which, in other conditions of the The same changes occur among the impulses; these are at times almost irresistible. Nearly every one, while standing on a high cliff or house-top, has felt an impulse to jump off or push his friend off, reckless of the consequences. In the usual condition of the nervous system persons love their children and relatives, and are ready to do and suffer and at times even to die for them, if need be, while at other times all these sentiments fade away, so that they are unconscious of them, and even the opposite sentiment of dislike or hatred takes their place. Periods of mental lethargy come over many persons at times, so that they care neither to talk nor engage in any of their usual intellectual or physical pursuits; and such stimuli as are usually sufficient to rouse the brain into action appear to have very little effect. They feel and say that there is a state of only partial brain-activity. At other times the brain acts with the greatest freedom; occurrences which Now all this grand play of diverse emotions and conditions in the psychical functions takes place in a state of health; still, there can be no doubt that it comes from an unstable condition of the nervous elements of the brain, or from changes produced in some manner in these varied and delicate structures. It may be from varying states which are constantly occurring in the blood, in the processes of reception and elimination; or from those delicate chemical operations which must be forever going on in the nerve elements of the brain hemispheres, affecting their recipient and sensitive capacities; or it may be from other unknown causes: and these changes occur much more readily and frequently in some persons than in others. Bearing in mind, now, these conditions of the physical and mental systems, the tendencies to which This unstable condition, both physical and mental, may exist not only as an inherited condition, but it may be produced, or become greatly increased by causes external to the system, which are brought into contact so as to influence it. A few illustrations may serve to make this more clear: 1. When a person who has not been accustomed to use the muscles of the arm in active and vigorous exercise, lifts, or makes a strong effort to lift, a heavy weight, if the effort is continued any considerable length of time, two conditions result therefrom: First, a state of tremulousness, or spasm of the arm, hand, and especially of the fingers. The largest effort the individual can make toward controlling this irregularity of movement, is insufficient, and these parts remain in a condition of more or less spasmodic action, until the nervous energy is restored. Second, there results a sensation of pain, more or less severe, according to the time the exertion has continued. This would indicate positive injury, to some extent, in the nerve filaments of the muscles which have been so unusually exercised. The degree of effect will be dependent upon the condition of the nerves of the hand and arm at the time the If the effort is repeated soon, there will result a similar condition, and ultimately the nerve would cease to respond to the call for action in any degree,—the arm would be paralyzed. 2. All are more or less familiar with that condition which is usually termed the writer’s cramp. Sometimes persons of a peculiar nervous organization, who have been accustomed to spend many hours a day in the mechanical process of writing, experience such a loss of nervous energy that the arm fails to respond to the will power. There results spasmodic and irregular movements in the arm, and more especially in the fingers, indicating that some morbid condition of the median nerve has been produced. If the case is neglected, and the exciting causes continue in operation, after awhile the nerve will become less and less responsive to the call of the will, and the arm may become seriously affected, after a longer or shorter period of more or less pain. In this case, as in the former one, there may exist all degrees of impairment of nerve function, from that of slight unsteadiness or instability, up to entire failure. 3. The condition of the nervous system in chorea presents another illustration. Between the ages of ten and fifteen years, in some children, there may Now the primary condition in the above cases is one of instability of nerve function. Such a change has occurred in the elemental tissue of the nerve, as to injure its power of activity so far as it is under the control of the will. The nerve has been stimulated to over-activity, or its energy impaired by other causes arising within the system itself. These illustrations have related to those portions of the nervous system which are more immediately connected with motion, and which, consequently, are located in the muscular system. If, now, we pass from these portions of the nervous system up to its grand centre, or that part of it whose function is connected with mental operations, we shall find similar effects resulting from like causes. If a person experiences a sudden mental shock, occasioned, it may be, by sad intelligence of some kind, or if he passes suddenly through some great personal peril, or if he has made unusual mental effort in some In this case, also, as in the others, there may result any degree of effect, from a sensation of fatigue up to mental spasm, and the amount will depend on the condition of the brain during the time the effect continues, and its intensity. The two conditions of instability and pain may be less marked in the case of the brain than in the nerves of motion, but there can be little doubt there has resulted something of a similar character in both. Precisely in what this change which has taken place consists, may not be easily determined. There may have occurred actual lesion of nerve element, or only impairment or exhaustion of functional power without lesion; probably the latter condition only, in the primary stages of the operation. Certain portions of the brain have been over-stimulated II. Again, if the arm or hand of a vigorous person, which has long been trained to make either large efforts, or the more delicate movements, or again, to make but little effort in any direction, be placed in splints, or be suspended in a sling so that there is little or no activity for a few weeks, more or less, there results a failure of nerve-function; and there may be any degree of impairment, from that of slight degree, such as may be evinced by spasm, to that of paralysis. The same is true in reference to any portion of the nervous system which can be placed in a state of inactivity. A few sentences of recapitulation in our process of reasoning will now be in order. 1. We have seen that imperfection and instability of nerve-function may be inherited; that weakness, or impairment, exists with many persons from the time of birth, which affects more or less the functions of the various portions of the nervous system; and that this is seen not only in the mechanical operations of the hand and arm, in the execution of all the more delicate movements of which it may be susceptible, but also in the mental operations. By 2. We have also observed that disturbance and imperfection of nerve-function may be produced in all persons by the action of causes operating from without upon the nervous system, and that the results may be similar in character, whether there has been too great or too little exercise of function. It will further be observed, that we have in a definite and somewhat continuous line passed from the production of disturbance and irregularity of the function of simple motion in the hand and arm, up to the more complicated and less understood activities of the hemispheres of the brain. We have seen that there exists at least a similarity in the I think there can be little doubt that there exists some such condition of that portion of the brain which is concerned in mental operations, as I have in a somewhat crude manner attempted to illustrate, which is the primary condition in a large number of persons who become insane. Precisely in what it may consist during the earlier stages we may not be able to explain. There doubtless is no change which can be termed organic in either the nerve cell or any other portion of the substance of the brain during the primary stages of this failure in function, but rather an exhaustion or lack in functional power, which after a longer or shorter period may lead to organic change of structure. Now we have only to suppose a person with a nervous system so constituted that these conditions, which I have described as temporarily occurring with many persons from exciting causes, are permanent, though in a latent state, and we have that peculiar organization which we term The Insane Diathesis. That is, we have a nervous system so sensitively constituted, and illy adjusted with its surroundings, that when brought in contact with unusually exciting influences, there may occur deranged instead of natural mental action, and it becomes more or less continuous instead of evanescent. The husband hates his wife, and the wife her husband; the parent his child, and the child the parent. We have the person, whose brain is so perverted in its action that he feels no pleasure and experiences no satisfaction in life, but hates it, and longs to throw off its burdens and cares, and leaves no effort untried to accomplish it; while another is so filled with joyous emotion, his brain is so excited in functional activity, that he can neither eat nor sleep, but ideas flow forth in one constant stream of words—words; bright visions appear on every side, and his life is worth a thousand worlds. Or, we may have any other of the ten thousand perverted mental activities which attend the “mind diseased.” “And he * * * (a short tale to make) If these views, in relation to the principal condition of insanity, are correct, it is evident that the question of largest interest in relation to its prevention, relates, not so much to the long catalogue of exciting or secondary causes, as to the avoidance of such courses of life, habits, and tendencies of society, as specially assist to develop and perpetuate this diathesis. It now becomes necessary to suggest THE INFLUENCE OF EDUCATION. |