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Page 54
Certain parts of the brain are associated with definite functions;
thus, there are areas which influence or control speech and motion of
parts as the arm or leg, and there are large areas known as the silent
areas whose function we do not know. All activity of the central
nervous system, however expressed, is due to cell activity and is
associated with consumption of cell material which is renewed in
periods of repose and sleep. Fig. 13 shows a nerve cell of a sparrow
at the end of a day's activity and the same after the repose of a
night.
Diseases of the nervous system have a special interest in that they so
often interfere with man in his relations with his fellows. In
diseases of other organs the disturbances set up concern the
individual only. Thus, others need not be disturbed save by the
demands made on their sympathies by an individual with a cold in the
head or a cancer of the stomach. Disease of the nervous system is
another affair, instead of those reactions and expressions of activity
to which we are accustomed and to which society is adjusted, the
reactions and activities are unusual and the individual in consequence
does not fit into the social state and is said to be anti-social.
There are all possible grades of this, from mere unpleasantness in the
social relations with such an individual, to states in which he is
dangerous to society and must be isolated from it. Insanity is an
extreme case. There is no disease signified in the expression, but it
is merely a legal term to designate those individuals whose actions
are opposed to the social state and who are not responsible for them.
In insanity there is falsity in impressions, in conceptions, in
judgment, a defective power of will and an uncontrollable violence of
emotion. The individual is prevented from thinking the thoughts or
feeling the feelings and doing the duties of the social body in the
community in which he lives. The insane are out of harmony with their
social environment, but not necessarily in opposition to it.
There is no very sharp line between insanity and criminality. The
criminal is in direct antagonism to the laws of social life. An insane
person may cause the same injury to society as a criminal, but his
actions are not voluntary, whereas the criminal is one who can control
his actions, but does not. Mentally degenerated persons, however, can
be both insane and criminal. Whatever the state of society, this
reprobates the actions of one opposed to it; in a society in which it
were usual to appropriate the possessions of others or to devour
unpleasant or useless relatives, virtue and lack of appetite would be
reprobated as unsocial.
The symptoms of insanity or the manner in which the defective action
of the brain expresses itself and the various underlying pathological
changes vary, and by combining these it has been possible to subdivide
insanity into a number of distinct forms. There are both intrinsic and
extrinsic causes of insanity. The intrinsic are the structural
differences in the brain as compared with the normal or usual, whether
these are due to imperfection in development or to defective heredity
or to the injury of disease; the extrinsic causes are those which come
from without and bring the intrinsic into activity. Syphilis is a
frequent cause of insanity, and probably the only cause of the
condition known as general paralysis of the insane, acting by means of
the injury which it produces in the cortex of the brain. The abuse of
alcohol is another fertile cause, but the changes produced in this are
not so obvious as in the case of syphilis. Tumors of the brain are not
infrequently a cause, and the same is true of infections, even those
not located in the brain. How susceptible the brain is to the effects
of the toxines of the infectious diseases is shown in the frequency of
delirium in these diseases. There is an interesting relation between
this and alcoholism. Alcohol abuse may produce injury, but not
sufficient to manifest itself under ordinary conditions; when,
however, the action of toxic substance is superadded to the effect of
the alcohol the delirium of fever is more marked.
Probably of greater importance than the acquired pathological
conditions of the brain in producing insanity is a congenital
condition in which the nervous system is defective. The most fertile
cause of insanity lies in the inheritance; by this it must not be
understood that insane parents produce insane offsprings, but that
conditions inherited from immediate or remote ancestors appear in a
diminished resistance of the nervous system which is sooner or later
expressed as insanity. Given such a defective nervous system,
extrinsic conditions which would have no effect on another individual
or would be felt in different ways may produce insanity. In these
cases occupation plays a great role. The excitement and privations of
war especially in the tropics and the ennui of camps leads to insanity
in soldiers; occupations such as that of the baker in which there is
loss of sleep and the mental strain of students can all act in the
same way. A woman who gives no sign of nervous defect may become
insane under the strain of pregnancy.
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