MENTAL AND PHYSICAL
ACTION
AND REACTION
A CASE OF INSANITY:
SICK GENIUSES:
THE SUBCONSCIOUS MIND:
THE EXAMPLE OF JESUS
We cannot escape the conclusion that mind influences function just as
function influences mind. It is also virtually axiomatic that continued
functional derangement finally ends in organic disease, and organic
disease gives rise to characteristic mental states that vary from the
fearful anxiety of the sufferer from neuralgia of the heart to the hopeful
attitude of the dying consumptive.
It is an established feet that drugs, however powerful, do not affect the structure of brain tissue; and it is equally well known that in most instances of insanity there is no apparent deterioration in quality or structure of nerve substance. In these phenomena lies strong collateral proof that the sources of mental disease are to be sought elsewhere than in the brain. Injuries and ailments that involve structural change in brain matter will necessarily interfere with brain function, and in softening of the brain and in certain forms of paralysis there are organic alterations that may be noted on dissection. But in hysteria, epilepsy, or any of the manias, no changes in structure of either brain or nerve substance can be discovered, notwithstanding the presence of extreme mental alienation.
To illustrate the effect of abnormal physical condition upon mind function, the following case is cited. The patient, a man thirty years of age, presented a history of continuous digestive trouble accompanied by melancholia. Examination pointed to the conviction that the morbid mental symptom was the result of functional inactivity of the digestive tract, complicated with decided indications of organic disease. A tentative dietary of fruits and vegetable broths afforded the relief usual when organic labor is thus lightened. But skill in observing and determining the sequelae of dietetic changes caused delay in prognosis, for it is always needful to distinguish between mitigation of the distress of disease that is temporary in character, and that which evinces progress towards recovery. Hence, though symptoms in some respects were favorable, no predication was made as to the ultimate outcome. At the end of three weeks of the regimen imposed, the major signals all pointed to organic disability of extreme gravity, and at his request for definite opinion for or against recovery, the patient was informed that there seemed no possible hope of restoration to health. He then ceased his office visits, and a month later was discovered dead by suicide, an act committed, as the condition of the body showed, within a few days after discontinuing treatment. The previous conduct of the man, his brooding depression, and the contents of a number of scribbled letters found among his effects, now definitely fixed the case as one of insanity, whatever the state of his body might prove to be. The latter was in condition such that an autopsy could be performed, and it revealed the following: the kidneys were normal; the lungs and the heart were congested, but functionally equal to their tasks; the liver was hardened, and there was but a rudimentary gall sac, which contained no bilious fluid and gave no indication that the liver had been functioning, no characteristic stain being present, the color of the sac being a chalky white; the stomach was dilated and filled with food, and glandular activity in the organ must have been inoperative for some time previous to death; the small intestines showed bleached portions that had undoubtedly been without function for an indefinite period; the transverse section of the colon was much dilated, contained a large amount of hardened feces and had fallen shaping the whole organ into a letter "M", with the vertex of the dropped portion resting upon the pelvis; it, as well as the ascending and descending parts, were adherent at their angles for several inches; the bladder was apparently normal; the pancreas was a soft degenerated mass; the spleen was hardened; the mesentery exhibited old lesions, while no trace of the omentum was found; but the brain was structurally perfect.
The instance cited shows a body exceedingly deformed internally in which, despite its faulty structure, the processes of growth and maintenance progressed for thirty years. The cause of the organic defects discovered is to be attributed to digestive activity partially inhibited in early life through disease, the effects of which were very probably augmented by the use of drugs. In this case progressive inability to function produced morbid mental disturbance. It may be asked why a similar result was not observed in each of the instances related elsewhere in the text, or for that matter in any diseased human body; and reply is made that physical unbalance in any degree invariably affects mind-function, and this usually in adverse manner. But here again we enter the domain of the idiosyncrasy of individuality, of the limitations and requirements of a subject segregated from other individuals by his own constitutional peculiarities and tendencies, be these mental or physical. For instance, it is well known that there are certain temperaments that develop delirium in fever, even when the latter is mild in type, while there are others who may experience rise in body heat of as much as four or five degrees above register without sign of loss in mental equilibrium. But the close observer notes that the latter in the circumstances will exhibit certain other vagaries of the mind that are not apparent when function is normal in character.
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