Insanity
2 of the 7 encyclopedias on this shelf carry an entry for Insanity. Both are reproduced below, so you can see where they agree and where they differ.
Collier's New Encyclopedia (1921)
a more or less impaired condition of any or all of the mental functions involving the intellect, emotion, or will. There can be no absolute test of insanity-or of sanity for that matter. Sanity is proved by normal selfcontrol, and insanity by the loss of it from disease. The most common mental symptoms are morbid emotional depression and mental pain. In many cases of insanity to energize mentally is to suffer pain. Another symptom in other cases is an undue emotional exaltation; this is commonly associated with a loss of the great controlling or inhibitory functions of the brain, and occurs in mania. There is morbid brain excitement, commonly exhibited in restless motions or shouting. Such cases may go on to complete loss of any consciousness of all the former brain impressions and mental life. The patient remembers nothing and does not know his nearest friends. Another common symptom is a diminution or loss in the power of attention. This is common to nearly all forms of insanity. Then we have perversion of the reasoning power, as seen more frequently in insane delusions, which are common in most cases and varieties of insanity. They are divided into fixed delusions and changing delusions, the former being the more serious and incurable. Hallucination is sensation without an object. The hearing of voices, when none exist, is a good illustration. Hallucinations are usually subjective and psychical in their origin, though unquestionably both a psychical and a sensorial element may enter into their genesis. Hallucinations may be of hearing, which are the most common and the most serious, as a symptom of incurability if long continued; of sight, the next most common and more likely to be recovered from; of smell and taste, which are rare, and not favorable. Another mental symptom of insanity very common is impulsiveness of action in an automatic, unreasoning way sometimes without any conscious intention on the patient's part, and without power . of control by the will. A man sees a large plate glass window and he impulsively hurls a stone through it. Another cannot resist the impulse to tear his clothes, a third cannot resist the impulse to set a haystack on fire. Uncontrollable impulse naturally goes with diminished volition in insanity. One of the most common and most painful symptoms of insanity is a change of natural affection toward relatives. This is not universal, but in nearly half the cases of insanity the affective condition is thus perverted or reversed. The memory is not necessarily affected in insanity. In many patients it is exaggerated; things come back with unnatural vividness. One of the chief bodily symptoms in insanity is sleeplessness. Almost every kind of insanity is sleeplessness in its early stages. Another is morbidness of speech; it may be incoherent or partially coherent; it may be over-rapid, slow, or entirely absent. Often the conventionalities of speech are lost or dropped in insanity. The articulation of words may be changed. Next in importance to speech is the expression of the face and eyes. This is given by the most delicate combined muscular and nervous apparatus that exists in nature, being in the most intimate connection with the mental part of the brain, and acting as its chief expositor and interpreter. In the depressed and demented cases the eye loses its luster and brilliancy; in maniacal cases it has abnormal feverish brilliancy; the pupil enlarging and the eye-lids being drawn too far apart produce staring, by exposing not only the cornea, but much of the sclerotic as well. Irregularity of the pupil is suggestive of organic brain disturbance. The natural expression of the face is greatly changed, and little beauty of feature survives during acute attacks. The conventional control over the outward expression of the emotions is lost, and the face accurately shows the state of the melancholic, the maniacal, or the demented patient. Clouston has thus classified the forms and varieties of insanity: Melancholia, comprising all states of depression, and having emotional depression or mental pain and sense of ill-being as its leading and dominant symptom. There may in addition be loss of self-control, insane delusions, which are usually suggested by the depression or impulses toward suicide, as well as incapacity to follow ordinary avocations in melancholia. These distinguish it from sane melancholy. Suicide is the great risk in such cases; four-fifths of melancholic cases being suicidal. The recoveries from melancholia are the most complete of all forms of insanity. It would seem to be caused by a more entirely functional and dynamical brain disturbance than any other form of insanity that may leave no trace whatever behind it after recovery. Mania, comprising all states of mental exaltation, such as joyousness and rage, and commonly accompanied by muscular excitement, restlessness, sleeplessness, the speech tending to become incoherent, the conduct violent or uncontrolled. The symptoms range from a joyous elevation with talkativeness and merely want of common sense and foolish conduct up to complete incoherence, delirium, and raving madness, or "acute mania." Folie circulaire, or states of regular alternation between melancholia and mania, forms a small but distinct variety of insanity. Monomania, or delusional insanity, is that form where insane delusions are the chief signs of the mental aberration. In such cases the intellect is chiefly affected rather than the affective nature. The delusions are morbid in a particular direction, the chief forms being monomania of grandeur or pride, of unseen agencies, and of unfounded suspicions. Electricity, mesmerism, telephones, gases, noises made by imaginary persecutors are the common subjects of the second form; while utterly perverse interpretations of the conduct of friends or strangers is the common form of the latter. The two together are sometimes classed as monomania of persecution. Hallucinations of the senses-i. e., imaginary sights, sounds, smells, and tastes are very common in this form of insanity. It is not very curable when the delusions get fixed. Dementia, or conditions of general mental enfeeblement, is the state of mind where the memory is impaired, the reasoning weakened, the feelings diminished, the will especially lacking, the attention and curiosity far below normal, these changes having occurred in a person who had at one time been normally constituted. It is in fact silliness, want of mental force, imbecility not congenital, but acquired. Stupor, embraces those cases where there is mental torpor, in which_impressions on the senses produce no effect, the patient neither speaking nor taking notice of anything, and having no volition except to resist, but being able to stand, walk, and to eat. Trance and catalepsy are forms of stupor, the heart's action is low and the body is cold, and the muscles are flabby. Stupor commonly occurs in young people of both sexes, and is very curable, 50 per cent. recovering. Impulsive insanity, or states of defective control, is the most interesting of all the divisions of the mental classifications, inasmuch as will is the highest of all the mental faculties, and volitional disturbances have a close relationship to morals, law, social life, and conduct. The children of insane or drunken parents are lacking in the normal power of control, and in their perception of the sense of right and wrong, their conduct being apt to be impulsive and not guided by reasonable motives. All forms of insanity are more or less distinguished by lessened control, but there are persons without general depression or excitement, afeeblement of insane delusions, or mind, who will suddenly smash furniture, tear clothing, steal, set things on bey gross animal impulses, or kill fire, obey themselves or others. The function of mental inhibition residing in the highest regions of the brain, controls mental action in other portions of the brain convolutions. In this form of insanity it is controlling supposed that the inhibitory ry portions or "centers of mental inhibition have lost their power. Clinical Varieties. - Chief among these eral paralysis, a types of insanity is general specific disease of those portions of the brain ain that subserve mind and motion. It is always incurable, getting progressively worse, gradually impairing and at ng speech, motion, ion, mind, length destroying s and, usually in about three years' time, life itself. In this form of insanity patients commonly have extravagant delutic sions of wealth and power. Paralytic insanity is that connected with apoplex- , softenings and tumors of the brain, ies, es which cause ordinary paralysis first, and one form of dementia afterward. Epipsy. leptic insanity may accompany epilepsy. It is often attended by great violence and irritability, and by danger to those around the patient. Many murders are committed by insane epileptics. Syphilitic insanity is the result of brain poiof husoning by this terrible scourge manity. Alcoholic insanity is a very frequent form. It may be very short in duration or very long continued, or incurable. Rheumatic and gouty insanities are very rare. Phthisical insanity, or that connected with consumption, is a very interesting variety. The patients are suspicious and unsocial, and often have no cough or spit or outward sign of consumption, which may not be discovered till the chest is examined. In some cases it is curable. There are various forms of insanity connected with derangement of the reproductive functions. Uterine, , ovarian, hysterical, and amenorrhœal, eal masturbational insanities; while pregnancy, childbirth, and nursing are the causes of the insanity of pregnancy, puerperal insanity, and lactational insanity. These form 10 per cent. of mental They are the disease in the female sex. most curable of all forms, recovering in over 80 per cent. of the cases. Puerperal insanity occurs commonly within a fortnight of childbirth, and is the most acute and one of the most dangerous to life of all insanities, while the most curable, and is attended by the highest temperatures, sometimes reaching 105°. The different periods of life have each their own form of insanity. Pubescent and adolescent insanity is always hereditary, commonly acute and maniacal, usually has remissions and exacerbations and recovers in over 60 per cent. of the cases, those not recovering commonly passing into the most typical form of secondary dementia. It is one of numerous diseases to which the period of development is subject. Climacteric insanity occurs at the period of the menopause or the "change of life." It is usually melancholic in character and recovers in 53 per cent. of the cases under proper treatment and conditions of life. Senile insanity is typically seen in the senile dementia of extreme old age, when the memory and all the faculties have faded away. A number of rarer and less important clinical varieties of insanity have been described. Traumatic insanity, from injuries to the head; anæmic insanity, from thinness of blood; diabetic insanity; insanity from Bright's disease; post - febrile insanity, following all kinds of fevers, especially scarlatina; the insanity of lead-poisoning; and myxedematous insanity. Causes of Insanity. - Hereditary tendency is the chief predisposing cause of insanity. All sorts of disturbing influences to the brain bring out this predisposition into actual disease. No doubt 70 per cent. of all cases have an insane or neurotic heredity. Epilepsy, drunkenness, all nervous diseases, consumption, too exciting or depressing or exhausting employment, or unfavorable conditions of life in ancestry may cause insanity in the offspring. Marriage of near relatives causes it if the stock is bad; not if it is good. The physical causes of insanity affecting the body, such as alcohol in excess, produce insanity y in four times the proporti proportion which mental and moral causes, such as affliction, losses, love-affairs, and religious excitement, do. Nature of Insanity. No one doubts that it is due to disorder of function of a certain portion of the brainviz., that part of the cortex which is the vehicle of all mental function. The exact pathology of many forms of insanity has not as yet been ascertained; but in 80 or 90 per cent. of the cases that die some abnormality can be found in the brain. Treatment of Insanity. The general principles of modern treatment may be divided into bodily and mental or moral. The bodily treatment may be generally said to be to put all the organs and functions right if wrong; to get up the strength and fat of the body; to restore the tone and right working of the nerv ous system; to restore the sleep; to invigorate and soothe by life in the open air; and to let off undue and morbid nervous energy by much exercise, gymnastics, and massage in some cases, and to secure complete brain and body rest for others. The mental treatment consists chiefly in careful observation, companionship, control, distraction of the mind from morbid thought and feeling, by suitable occupations and amusements, and guarding against the dangers of suicide, homicide, and self-neglect. All the States and many of the larger cities in the United States are equipped with hospital facilities for the insane. In 1918 there were reported in the entire United States 239,820 insane per- Of these 125,919 were males and sons. 113,901 females. In the State hospitals were 109,994 insane males and 97,711 insane females.
Aiton's Encyclopedia (1910)
a disordered condition of the mind. The ancients considered a loss of mind due to the bewitching influence of Luna, or the Moon, hence the words lunacy and lunatic. Loss of mental power is due to any one of many causes and takes many forms. Insanity may or may not be accompanied by wasting away of the brain, that is to say, a breaking down of cells. Popular names for insanity consisting merely of derangement are melancholy, stupor, hallucination, mania, epilepsy, and hysteria. Melancholy is accompanied by depression; mania by unusual exaltation or similar mental acuteness. A third class of cases is entirely distinct from these mentioned. Weak-mindedness, idiocy, and imbecility are due to an undeveloped brain. We cannot speak of loss of mind in these cases, for the patients have never possessed well ordered minds. The American Indian considered a weak-minded person as having been touched by the great spirit. In his Last of the Mohicans Cooper introduces Hetty, a weak-minded girl, whom the hostile Indians permitted to wander at will in their encampment without molestation. In other forms of insanity there is a breaking down and wasting away of brain cells. The dementia sometimes noticed in extreme old age is of this sort. Certain grievous diseases bring about the same result. Insanity may be produced by sickness or a disease; it may be the immediate result of a mental shock, such as comes from loss of property, grief, fright, shame, religious enthusiasm, or political excitement. Some people-go insane from living too much alone; others keep their minds too active, and are stimulated by overstudy or the excitement of society. The study of the various forms of insanity is one of the profoundest and most difficult subjects of medical inquiry. No reputable physician will claim to have mastered more than one form of insanity. The condition of the insane was formerly wretched in the extreme. If accounts may be credited, places of detention were once little better than pens for dangerous beasts. The more enlightened common-wealths have now made generous provision for the care and, if possible, cure of the insane. Public asylums are maintained at great expense. Trained nurses are in attendance, as well as a corps of physicians. Great progress has been made in the adaptation of diet, exercise, and labor. Some patients require society, others solitude; some rest for the body, others rest for the mind. Some require exercise for both. In order to prevent injustice the laws of most countries require that a patient shall be examined by competent medical authority in the presence of an officer, usually the probate judge. With this precaution it is difficult for over zealous friends or eager relatives to hurry a patient away to an asylum when there is no proper reason for it. 2026 Editor's Note: This entry's asylum era — vast state hospitals, moral treatment faded — was itself replaced by the pharmacological revolution and deinstitutionalization of the 1950s–70s; the vocabulary here has been retired wholesale. See history of psychiatry . (Ed: BR 2026-06-13)