CHAPTER XVIII

THE PSYCHOSES WITH MENTAL DEFICIENCY

The literature of mental deficiency is almost as old as that of medicine. Imbecility was studied at some length by Plato and Galen and was recognized by Felix Plater, who has been accredited with the first classification of mental diseases known (seventeenth century). Fitzherbert[345] in his "Natura Brevium" in 1652 included the following interesting definition of idiocy: "He that shall be said to be a sot and idiot from his birth, is such a person who cannot count or number twenty pence, nor tell who was his father or mother, nor how old he is, so as it may appear that he hath no understanding or reason what shall be for his profit, or what for his loss; but, if he have sufficient understanding to know and understand his letters, and to read by teaching or information, then it seems he is not an idiot." One of the first medical writers to discuss mental defects at any length was Esquirol. In differentiating them from mental diseases he said: "Idiocy is not a disease, but a condition in which the intellectual faculties are never manifested; or have never been developed sufficiently to enable the idiot to acquire such an amount of knowledge as persons of his own age, and placed in similar circumstances with himself, are capable of receiving. Idiocy commences with life, or at that age which precedes the development of the intellectual and affective faculties, which are from the first, what they are doomed to be during the whole period of existence." ... "A man in a state of Dementia is deprived of advantages which he formerly enjoyed. He was a rich man, who has become poor. The idiot, on the contrary, has always been in a state of want and misery." An elaborate treatise on the subject of cretinism was published by Fodéré in 1792.

Tredgold,[346] in discussing the etiology of mental deficiency, divides the causes into factors indicative of, or producing, a variation of the germ plasm and those acting directly upon the offspring. The former include neuropathic inheritance, alcoholism, tuberculosis, syphilis, consanguinity and the age of the parents. Among the latter are abnormal mental and physical conditions of the mother during pregnancy, or injury to the fœtus; abnormalities of labor, primogeniture and premature delivery; and after birth—traumatic, toxic, convulsive and nutritional factors. He found neuropathic inheritance in over eighty per cent of the cases studied. In 64.5 per cent the heredity took the form of mental defects, insanity or epilepsy, and in eighteen per cent paralysis, cerebral hemorrhage, neuroses of various kinds, or psychoses. There was a history of alcoholism in 46.5 per cent of the series investigated. Tuberculosis occurred in the families of thirty-four per cent, syphilis in 2.5 per cent, consanguinity in five per cent, and a marked disparity in the ages of the parents in four per cent. Factors acting directly on the offspring, either before, during or after birth, were found to be present in sixty-five per cent. Goddard[347] in a study of 327 cases found a history of inherited mental deficiency in fifty-four per cent, probable heredity in 11.3 per cent, neuropathic ancestry in twelve per cent, accidents of various kinds in nineteen per cent, and no ascertainable cause of any kind in 2.6 per cent of the total number.

The definition of a feebleminded person, proposed by the Royal College of Physicians of London, and subsequently adopted by the English Royal Commission, reads as follows:—"One who is capable of earning a living under favorable circumstances, but is incapable, from mental defect existing from birth, or from an early age, (a) of competing on equal terms with his normal fellows; or (b) of managing himself and his affairs with ordinary prudence." The English Mental Deficiency Act of 1913 included the following definition:—"Persons in whose case there exists from birth or from an early age mental defectiveness not amounting to imbecility, yet so pronounced that they require care, supervision, and control for their own protection or for the protection of others, or, in the case of children, that they, by reason of such defectiveness, appear to be permanently incapable of receiving proper benefit from the instruction in ordinary schools." It will be noted that imbeciles and idiots do not come within the scope of these definitions. This is due to the fact that the term feeblemindedness as used in England includes only the High Grade Amentia of Tredgold or the Morons as defined by Goddard. The classification of the latter is as follows:

1. High Grade Morons—Those that can do fairly complicated work, with only occasional or no supervision, run simple machinery or take care of animals, but are unable to plan.

2. Middle Grade—Those capable of doing routine institution work only.

3. Low Grade—Those who are only capable of running errands, doing light work, making beds, scrubbing or caring for rooms—if there is no great complexity of furniture.

Tredgold describes imbecility as Medium Grade Amentia and idiocy as Low Grade Amentia.

The Mental Deficiency Act of England defines idiots as "persons so deeply defective in mind from birth, or from an early age, as to be unable to guard themselves against common physical dangers." It also refers to moral imbeciles as "persons who from an early age display some permanent mental defect coupled with strong vicious or criminal propensities on which punishment has had little or no deterrent effect." The imbecile as defined by the Royal Commission of England is "one who by reason of mental defect existing from birth or from an early age is incapable of earning his own living, but is capable of guarding himself against common physical dangers."

Tredgold classifies either feeblemindedness, imbecility or idiocy if due to pathological germinal variations (caused by alcoholism, tuberculosis, syphilis, etc., and manifested by amentia, insanity, epilepsy, etc.) as being either simple, microcephalic, or Mongolian. He describes those which represent somatic modifications due to gross cerebral lesions as syphilitic, amaurotic, hydrocephalic, porencephalic, sclerotic, paralytic and other toxic, inflammatory or vascular forms. The somatic modifications due to defective cerebral nutrition he divides into epilepsy, cretinism, nutritional forms and isolation (sense deprivation).

The classification of mental defects used by Fernald at the Massachusetts School for the Feebleminded and based on mental ages is as follows:—Idiot,—low grade, less than one year; middle grade, one year or more; high grade, two years. Imbecile,—low grade, three and four years; middle grade, five years; high grade, six and seven years. Moron,—low grade, eight and nine years; middle grade, ten years; high grade, eleven and twelve years. Fernald calls attention to the fact that the diagnosis cannot be based on the mental age alone. The intelligence quotient must be taken into consideration. This is determined by dividing the mental by the physical age. It is a comparison of the average intelligence of the child, using the normal as a standard. The diagnosis cannot be definitely made until the age of sixteen, or until the probable mental age at sixteen is determined.

The following definitions are used by the American Association for the Study of the Feebleminded:—"An idiot is a mentally defective person having a mental age of not more than 35 months, or, if a child, an intelligence quotient of less than 25. An imbecile is a mentally defective person having a mental age between 36 months and 83 months inclusive, or, if a child, an intelligence quotient between 25 and 49. A moron is a mentally defective person having a mental age between 84 months and 144 months inclusive, or, if a child, an intelligence quotient between 50 and 74."

Tredgold expresses the opinion that "the insanity of the feebleminded and high grade imbeciles does not, on the whole, differ from that occurring in ordinary persons." In sixty-two cases under his observation he found the following forms:—Mania, thirty-two; melancholia, sixteen; alternating mania and melancholia, six; stupor, one; delusional insanity, one; and juvenile general paresis, six. He also speaks of epileptic insanity and terminal dementia in his cases.

Kraepelin[348] describes certain characteristics as applying very generally to the mental deficiency group which he prefers to speak of as "Oligophrenia." Sense perception is often interfered with by defective vision, opacities of the lens and cornea, errors of refraction, optic atrophy or deafness. The apprehension of external impressions may be prevented to a certain extent also by disturbances of attention. Only the sharper and stronger stimuli reach the patients as a rule and these impressions are retarded. Many occurrences escape their notice entirely and their sense perceptions are poor and scanty at best. Disturbances of attention are shown by the attitude, facial expression, carriage and conduct, so that they have an appearance of apathy and indifference when their real feelings are entirely different. An increased effort cannot be produced by an exertion of the will, nor can the fatigue which such attempts result in, be overcome. Repeated tests of various kinds show a marked decrease in the power of apprehension. In profound idiocy it is difficult to determine whether any impression can be made on the sense organs or not. When the patients react to a severe pin prick it is only after a considerable delay, apprehension and attention being equally impaired. Schlesinger found fifty-five per cent of his cases lacking in interest, thirty-five per cent were distractible and ten per cent showed an increased fatigability. An evidence of the lack of attention is the fact that the weakminded as a rule are not susceptible to hypnotism.

The apprehension of colors, form and dimensions is uncertain and difficult. The patients learn to distinguish colors very late usually. They can form no clear conception as to the outlines, surface or contents of objects. They have considerable difficulty in putting syllables and sentences together. They recognize the details but not the significance of pictures. In the elaboration of impressions they are unable to distinguish between the real and the accidental or nonessential. This gives rise to a confusion of ideas. Changes in size, color, shape, etc, always annoy them. Their lack of observation and discrimination explains the absence of timidity in the presence of strangers which characterizes normal children. There is also a defective apprehension of auditory impressions and they are unable to understand very familiar sounds. Ley showed that they were often unable to identify letters they heard pronounced. There is a marked inability to grasp the meaning of ordinary words. The sense of taste and smell is comparatively much less impaired. Very defective children object at once to quinine when it is placed on the tongue. Nevertheless, many do not notice unpleasant odors or even the taste of excreta, etc.,—things which are exceedingly offensive to normal individuals,—and are entirely indifferent as to the quality of their food. Sensory disturbances of the skin are not very marked. In a series of esthesiometric tests, however, Ley obtained unsatisfactory "automatic" responses in eighteen cases, meaningless answers in forty-eight, and intelligent responses in eleven of 127 mental defectives examined. The application of the sense of touch in recognizing articles is acquired with difficulty. Pain sensations are somewhat diminished also and some defectives are apparently insensible to blows, etc. That the sense of position and location is not well developed is often shown by coarse, awkward movements. The sense of weight and motion is lacking. Demoor found that the feebleminded usually pointed out the larger article as being the heavier even when lighter in weight. Claparede found this characteristic present in one per cent of ninety-seven pupils rejected as a result of mental tests, in eight per cent of the mildly weakminded, and in sixty-five per cent of the markedly defective cases. Memory is always involved. Superficial impressions are easily lost. Johnson subjected seventy-two defective children to retention tests. Seventy could correctly repeat only three numbers; sixty-six only four; fifty-one only five; twenty-seven only six; fourteen only seven, and four only eight. Ranchburg's tests showed them to be very susceptible to suggestion. Some defectives, on the other hand, have a peculiar faculty for remembering dates, numbers, performing feats of arithmetic, etc. The memory defect is usually shown more especially by the inability to take advantage of the experience of the past. The patients learn with difficulty, read little and forget what they are taught. The events of life leave few traces and make only a superficial impression on them. The intellectual horizon for this reason is very limited. Their thoughts are confined largely to the matter of clothing, food, etc.

The fundamental obstacle in the mental progress of the defectives is the inadequate elaboration of general impressions and conceptions. There is an absence of any understanding of the importance of time, events, numbers, etc. They often have no idea whatever as to the significance of money. Dates mean nothing usually and they are often unable to determine the time of day. The train of thought as shown by tests made by Buccola is delayed. Their poverty of thought is shown by the fact that defective children can think of only about one-fourth as many words during a given time as suggest themselves to the normal child—a test suggested by Binet. Tests reported by Sommer, Nathan, Binet and others show a marked delay in association time and an impoverished mental capacity. They frequently repeat the test word or give entirely meaningless replies. Associations do not become fixed on repeated tests as they do with normal individuals (Wreschner). It is not easy for them to repeat numbers, the months of the year or days of the week backwards. They cannot supply omitted words or syllables in sentences (Ebbinghaus test). It is hard for them to assemble picture puzzles or pieces of cards. Revesz found that it was more difficult for them to learn to divide than to subtract or add. Multiplication he found to be most easily acquired. They did not do well in tests requiring any reason or judgment. They are entirely incapable of defining or explaining abstract conceptions of any kind. They cannot explain the meaning of fables and have no appreciation of irony. Nor can they correct the most obvious faults in test sentences. They have no insight into their own condition and no grasp on either past or present events. Their capacity for efficient occupation and employment is much diminished. Their ability to acquire an education is also limited. Of 286 cases examined in school Schlesinger found only fifteen per cent to be industrious in their habits. Nine per cent failed in writing, eighteen in reading and twenty-four per cent in arithmetic tests.

The emotional life is also much impoverished and unstable. There is no sense of shame and no feeling of family pride or patriotism. There is often a tendency to commit criminal acts. As a rule the mood is indifferent and apathetic—in strange surroundings they are sometimes timid and anxious. Some feel ashamed of their speech defects and awkwardness. Others show a childish cheerfulness, or satisfaction and self-confidence. There is a tendency to uncontrollable laughter, attacks of anxiety, angry excitement, or childish despair with hysterical manifestations which disappear quickly. Usually the patients are inoffensive, manageable and well behaved, but easily susceptible to bad influences. Often they are queer, whimsical, capricious, obstinate and childish. Henneberg, who examined a large series of cases, described 33.8 per cent as anxious, timid, sensitive and inclined to weep; 15.7 per cent as apathetic, dreamy, sluggish and seclusive; 12.6 per cent as quiet, serious, good-natured, sociable and pleasant; 18.7 as active, cheerful, shallow, playful and talkative; and nineteen per cent as rude, malicious, obstinate, irritable and bad-tempered. The sexual life is sometimes undeveloped or may show actual perversions. Bonhöffer found six idiots and fifty-three feebleminded persons in an examination of 190 prostitutes. The volitional expressions of the defective are very largely impulsive. They act without reflection or regard to consequences and are easily induced to do improper acts. The inhibition of will is shown by the defective control of ordinary movements in responding to commands. They are always slow in learning to walk. The childish inability to perform finer and more precise movements does not disappear later as it does in the course of normal development. This is shown in their gait, awkward movements, etc. Kraepelin interprets the tendency to bedwetting as an evidence of volitional disturbance, also the stereotyped, rhythmical movements of the idiot. Laser found that forty per cent of his cases had the habit of biting the finger nails.

Dependent upon the inhibition of volitional impulses, two clinical groups of the feebleminded have been described by Kraepelin,—the excitable and the apathetic or dull. The excited forms are much more common. Schlesinger, however, found thirty-one per cent of his cases of the apathetic variety; twenty-nine per cent were excitable; twenty-eight per cent had simple mental defects, and the remainder showed antisocial tendencies. In the apathetic or dull form there is a marked disturbance of the attention; the patient takes no interest in his surroundings, appears sluggish, awkward, emotionally dull, and devoid of any voluntary impulse, often doing only what he is urged to do. They are usually good-natured, contented, and do simple work under direction, in a slow and mechanical way. The lighter grades are of a dull, weak-willed, readily influenced type. They are timid, unconcerned and agreeable. The excitable variety, on the other hand, show a purposeless, mercurial variability. Their attention is easily distracted from one thing to another. They cannot sit still, are restless and constantly on the go. Occasionally they are violent.

The defective control of motor impulses by the will is also shown in defectives by the disturbance of speech and writing. Crailsheimer found speech disturbances in 36.3 per cent of his cases, Schlesinger in thirty per cent, and Leubuscher in fifty per cent. They can often hear although mute, sometimes recovering their speech during an attack of excitement. Ley reported stammering in twelve per cent of his cases and stuttering in thirteen per cent. Agrammatism and akataphasia sometimes occur. Word-blindness is also referred to as a symptom and various disturbances of reading and writing have been observed.

According to Kraepelin, the important developmental landmarks in the life of the young are the acquisition of speech (one year), the beginning of the school life (six years), the appearance (fourteen years) and the completion (eighteen years) of sexual development. The first and second periods represent the relative levels of low and high grade idiocy, the third imbecility and the fourth feeblemindedness. This classification is somewhat similar to that of Weygandt. The education ordinarily acquired by the higher grade of the feebleminded is somewhat limited. They may even excel in certain occasional lines of work, for example, in music, art, etc. They are usually poor in mathematics and lack interest and application as a rule. Difficult apprehension and mental fatigability are to be expected. They have to go over things repeatedly, as their memory is not good. Their education is often ample in some directions and very lacking in others. Their judgment is onesided, their viewpoint narrow and their worldly knowledge childish. What they acquire at school is soon forgotten. They take no interest in religion, politics or current events of importance, and very impractical ideas are expressed on all questions. The emotional manifestations vary. Some are agreeable, cheerful, tractable; others timid, tenderhearted, sensitive, slightly emotional or anxious. They are more likely to be obstinate, stubborn, unruly, rude, irritable, unsociable and violent-tempered. Some have periods of active excitement and become threatening, abusive and violent. Occasionally suicidal attempts are made, although they are usually not genuine. Some are addicted to sexual excesses, lying or swindling. Sexual perversions also occur in some cases. They are usually incapable of any continuous occupation and drift from one thing to another. As a rule they have little conception of the value of money and spend it recklessly. They are very susceptible to alcoholism and often commit petty crimes. Occasionally hysterical manifestations—syncopes, seizures, etc.—appear. Clouded and confused states have been observed. Frequently impulsive tendencies are noted. In some instances psychopathic traits are very striking. Excitable, unstable, impulsive, quarrelsome and antisocial types appear as well as liars and swindlers. Periodical excitements and depressions suggest manic-depressive forms.

Considerable confusion has been occasioned by the relation thought by some to exist between mental deficiency and dementia praecox. Kraepelin[349] has spoken of an engrafted hebephrenia, as shown by the following quotation from his eighth edition:—"I made the suggestion a long time ago that certain, not very frequent, forms of idiocy with well developed mannerisms and stereotypies were an early expression of dementia praecox." He is of the opinion that "the affected manners of certain idiots, as well as the associated stereotypies of attitude and movement in addition to the negativistic impulses and the permanent obstinate inaccessibility to all attempts at approach, show no relation whatever to ordinary childish peculiarities and belong on the contrary to the well-known picture of dementia praecox." He interprets the "demenza precocissima" of Sante de Sanctis and the "dementia infantilis" of Heller as belonging to dementia praecox rather than the mental deficiency group. He further makes the suggestion that "weakmindedness existing from youth without focal symptoms, and later leading to deterioration, is as a rule to be looked upon as pfropfhebephrenia, if epilepsy and cerebral syphilis can be excluded, the former by the absence of seizures, the latter by the results of the Wassermann reaction." Engrafted hebephrenia or "pfropfhebephrenia" has been studied by various observers. After an analysis of ten cases Wasner reached the conclusion that feeblemindedness predisposes to dementia praecox. Weygandt and various other writers are not in accord with Kraepelin on this subject. It is, however, generally conceded that the occurrence of manic-depressive and other affective psychoses in mental defectives is not at all infrequent.

As special types Kraepelin described microcephalic varieties, the tuberous sclerosis of Hartdegen and Bourneville (1880), vascular and other cerebral defects, infantilismus, dysadenoid and other endocrine conditions, Mongolian idiocy, hydrocephalus, encephalitic forms, etc. Alzheimer, Hammarberg, and Bourneville have made pathological classifications of the mental deficiencies.

Psychoses which render the commitment of mental defectives to hospitals for mental diseases necessary are comparatively infrequent, as is shown by statistics. In the words of the statistical manual, "the most common mental disturbances are episodes of excitement or irritability, depressions, paranoid trends, hallucinatory attacks, etc." Cases diagnosed as showing manic-depressive psychoses or dementia praecox are not shown in the mental defective group. Three and forty-eight hundredths per cent of the admissions to the Massachusetts hospitals during 1919 were diagnosed as psychoses with mental deficiency. During a period of eight years the admission rate to the New York hospitals amounted to 2.8 per cent. The admissions to twenty-one institutions in other states constituted 4.33 per cent of the whole number reported. In 70,987 admissions to forty-eight hospitals in sixteen states the psychoses with mental deficiency amounted to 3.22 per cent of all first admissions.

INDEX

Abbot, E. Stanley, 248

Abraham, Karl, 419

Abrahamson, Isador, 341

Acute chorea, 338

Acute hemorrhagic polioencephalitis superior, 356, 357

Administration and legislation, 50

Adrenal diseases, 214

Adrenal stigmata, 204

Adrenals, lesions of, 214

Agnew, D. Hayes, 34

Albany Hospital, 107

Albrecht, 436

Alcoholic psychoses, 344 acute hallucinosis, 356 acute intoxication, 348 alcoholic deterioration, 350, 351 alcoholic paralysis, 357 chronic hallucinosis, 357 chronic intoxication, 349 delirium tremens, 352 delimitation, 358 history, 344 Korsakow's psychosis, 354 pathological intoxication, 349 pathology, 356 statistics, 360, 361

Aliens in hospitals, 160

Alzheimer, A., 225, 286, 302, 303, 304, 325, 354, 356, 485, 486, 536

Alzheimer's disease, 274

Amentia, 401

American Institute of Criminal Law, 176

American Psychiatric Association, 173, 231, 234, 245, 247, 263, 276, 291, 307, 320, 325, 331, 358, 390, 405, 421, 438, 453, 473, 487, 501, 521

Anderson, Victor V., 178

Anxiety neuroses, 501

Appropriations, hospital, 26

Aretaeus, 234, 409

Arnold, 142

Arsenic psychoses, 373

Arteriosclerosis, cerebral, 280 apoplectiform attacks, 288 delimitation of psychoses, 291 depressions, 287 deterioration, 287, 288 epileptiform attacks, 287, 288 excitements, 287, 288 pathology, 281, 282, 285, 286 statistics, 292

Aschaffenburg, G., 398

Aurelianus, 235, 409

Babcock, J. W., 379

Babinski, J., 494

Bailey, Pearce, 188

Baillarger, J., 411

Ball, Jau Don, 32

Ballet, G., 197

Barker, Lewellys F., 282, 309, 310, 364, 383

Barrett, Albert M., 115, 248

Baths, continuous, 98

Bayle, A. L., 221, 293

Beers, Clifford W., 121, 122, 123, 124, 127, 129

Bellevue Hospital, 106

Bianchi, L., 384

Billigheimer, E., 211

Binswanger, Otto, 191

Birnbaum, K., 197

Bleuler, E., 130, 145, 275, 436, 444, 445, 446, 447, 471

Bloomingdale Hospital, 38

Blumer, G. Alder, 46, 124

Blumgarten, A. S., 203, 205

Boards of Charities and Corrections, 52

Boards of control, 52

Boards of managers, 51

Boards of trustees, 51

Bonhöffer, K., 188, 347, 352, 353

Boston Police Act, 64

Boston State Hospital, 43

Boveri, Piero, 341

Brachet, J. L., 490

Brain or nervous diseases, psychoses with, 332 acute chorea, 338 cerebral embolism, 332 cerebral hemorrhage, 332 cerebral thrombosis, 332 encephalitis lethargica, 339 meningitis, tubercular, 336 multiple sclerosis, 336 paralysis agitans, 334 statistics, 343 tabes dorsalis, 337

Brain lesions, symptoms due to, 282, 283

Brain tumors, 326 frequency, 327 psychoses, 328, 329, 330, 331 statistics, of psychoses, 331 symptoms, 327

Brattleboro Retreat, 43

Breuer, 494, 495

Briggs, L. Vernon, 248

Briquet, 490

British Association, 240

Bromide psychoses, 371

Buckley, A. C., 422, 453

Bucknill, J. C., 234, 393, 394

Bumke, 436

Burnham, Wm. H., 131

Burr, C. W., 338

Buzzard, E. F., 340

Cabot, Richard C., 20

Calmeil, J. L., 221, 293

Camp, Carl D., 334

Campbell, C. Macfie, 115, 132, 248, 497

Casamajor, Louis, 371, 373

Case rate, general diseases, 18

Causes of death, 17, 18

Celsus, 139, 234, 253

Central neuritis, 437

Cerebral embolism, 332

Cerebral hemorrhage, 332

Cerebral syphilis, 308 delimitation of psychoses, 320 gummatous, 310 meningeal, 309 pathology, 309 salvarsan therapy, 319 statistics, 321, 322 symptomatology, 311 treponema in inactive cases, 320 vascular, 310

Cerebral thrombosis, 332

Cerebropathica psychica toxaemica, 404

Chloral hydrate, 370

Chorea, acute, 338

Civil war psychoses, 186

Clark, L. Pierce, 478, 479, 480

Classification of mental diseases, 234 American Psychiatric Association, 248, 249, 250 Aretaeus, 234 Aurelianus, 235 British Association, 240 Celsus, 234 Cullen, 235 Esquirol, 236 Flemming, 236, 237, 238 Galen, 235 Griesinger, 239 Hippocrates, 234 Kraepelin, 242 Krafft-Ebing, 240 Linnaeus, 235 Maudsley, 239 Pinel, 236 Plater, 235 Pritchard, 236, 239 Régis, 240 Roman, 235 Sauvages, 235 Vogel, 235

Clouston, T. S., 7, 8, 140, 144, 266, 304, 346, 508

Cobb, Stanley, 133

Cocaine psychoses, 367

Colajanni, 178

Collapse delirium, 400

Columbia State Hospital, 41

Columbus State Hospital, 43

Commitment, methods of, 58

Communicable diseases, 23

Compression of brain, 253

Concord State Hospital, 43

Concussion of brain, 253

Continuous baths, 98

Copp, Owen, 67, 81, 131

Cramer, 463

Criminal responsibility, 169

Criminal responsibility, laws relating to, 172

Criminals, psychoses in, 180, 181, 182

Crowbar case, 254

Cullen, William, 235, 490

Curtin, Roland G., 35

Cushing, Harvey, 326, 327

DaCosta, J. C., 253

Davenport, Chas. B., 146

Davis, Thomas K., 210

Death rate: diseases of the nervous system, 18 mental diseases, 19 registration area, 17 state hospitals, 28

Definition of insanity, legal, 172

DeFursac, J. R., 197

Delirium: acute, 400 collapse, 400 exhaustion, 403 febrile, 396 infection, 395 initial, 398 tremens, 352

Dementia praecox, 440 delimitation, 453, 454, 455 hebephrenia, 441 history, 440 katatonia, 441 Kraepelin's views, 450, 451, 452, 453 mental mechanisms, 442, 443 schizophrenia, 444, 445 statistics, 455, 456, 457

Diagnosis, errors in, 20

Dickens, Charles, 43

Diefendorf, A. R., 229, 324, 422, 429, 455, 492, 506

Diem, 149

Diseases, communicable, 23

Diseases, general case rate, 18

Diseases, general, cause of death, 17

Diseases, mental, social and economic importance of, 15

Dix, Dorothea, 47, 48, 123, 126

Dreyfus, G, L., 429

Drugs and other exogenous poisons, 363 arsenic, 373 bromides, 371 chloral hydrate, 370 cocaine, 367 gases, 374 lead, 372 mercury, 374 morphine, 363, 364 silver, 374 statistics, 375

Drusen, senile, 273

Dublin, Louis I., 21

Dunlap, Chas. B., 309, 337

Earle, Pliny, 106

Eastern State Hospital, Ky., 40

Eastern State Hospital, Va., 36

Economic loss on account of mental diseases, 28

Economo, C. von, 339

Eder, Montague D., 196

Edsall, David L., 372, 374

Embolism, cerebral, 332

Emerson, H., 210

Encephalitis lethargica, 339

Endocrinology and psychiatry, 202

Epilepsy, 475 delimitation of psychoses, 487 epileptic delirium, 483 epileptic deterioration, 485 epileptic dream states, 482 epileptic ill-humor, 481 etiology, 478, 479, 480 pathology of, 485 statistics, 488

Epileptic personality, 478

Epileptics, institutions for, 29

Erlenmeyer, A., 365, 367

Errors in diagnosis, 20

Esquirol, J. E. D. 142, 236, 293, 524

Etiology of mental diseases, 138, 154 alcoholism, 152 arteriosclerosis, 152 brain tumor, 152 cerebral syphilis, 152 epilepsy, 152 heredity, 145 other factors, 153 pellagra, 152 psychic traumata, 152 senility, 152 traumatism, 152

Evolution of the modern hospital, 34

Exhaustion delirium, 403

Expenditures, hospital, 26

Falret, J., 411

Falta, Wm., 203, 206, 207, 208

Farrar, Clarence B., 122, 189

Febrile delirium, 396

Fernald, Walter E., 527

Ferri, E., 177

Feuchertsleben, E. von, 141, 394, 462, 489

Flemming, C. F., 236, 237, 238, 346, 410, 461

Focal symptoms due to brain lesions, 282, 283

Foreign born in hospitals, 160

Fracastoro, 293

Franz, S. I., 372

Friedreich, J. B., 394, 395

Freud, S., 130, 145, 225, 226, 448, 472, 473, 494, 495, 496, 497, 498, 499, 500, 501

Furbush, Edith M., 27, 29, 248

Galen, 235, 253, 409

Garofalo, 178

Garretson, W. V. P., 206

Gases, 374

General diseases: case rate, 18 cause of death, 17

General paralysis, 293 delimitation, 307 etiology, 294 history, 293 juvenile form, 304 pathology, 303 physical signs, 301 statistics, 306, 307 types, 298

Georgia State Sanitarium, 51

Gesell, Arnold, 131

Goddard, H. H., 525

Goldberger, J., 381, 382

Gonadal stigmata, 205

Grasset, Joseph, 509

Gregor, A., 386

Griesinger, W., 105, 142, 239, 260, 383, 411, 462

Hamilton, A. S., 324

Handcock, Thos., 39

Harlow, John M., 254

Harrisburg State Hospital, 48

Hartford Retreat, 40

Hartung, M. U., 200

Haslam, J., 293, 344

Hecker, E., 222, 241, 440, 441

Heinroth, J., 104, 239, 394, 395, 462

Hemorrhage, cerebral, 332

Henderson, D. K., 336

Heredity, Mendelian, 145

Heredity in mental diseases, 145, 150

Heubner, 310

Hippocrates, 138, 253, 344, 392, 409, 461, 475

History-taking, 85

Hitzig, 105

Hoch, Aug., 115, 198, 234, 248, 372, 422, 445, 446, 448

Holmes, Oliver Wendell, 230

Hospitals: Albany, 107 Bellevue, 106 Bloomingdale, 38 Boston Psychopathic, 108 Boston State, 43 Brattleboro Retreat, 43 Columbia State, 41 Columbus State, 43 Concord State, 43 Eastern State, Ky., 40 Eastern State, Va., 36 Georgia State Sanitarium, 51 Harrisburg State, 48 Hartford Retreat, 40 Maryland, 37 McLean, 39 New York, 38 Pennsylvania, 35 Philadelphia, 34 Sheppard and Enoch Pratt, 48 Spring Grove State, 38 St. Elizabeths, 48 Trenton State, 47 Utica State, 46 Worcester State, 42

Hospital social service, 113

Hospital treatment, 84

Hübner, 435

Hunt, J. Ramsey, 284

Huntington, Geo., 323

Huntington's chorea, 323 classification, 325 mental symptoms, 324, 325 statistics, 326

Hurst, A. F., 200

Huss, Magnus, 345

Hydrotherapy, 97

Hysteria, 493

Idiocy, 527, 528, 529

Imbecility, 527

Immigration and mental diseases, 155

Immigration laws, 164

Incidence of mental diseases, 25

Infantilismus, 211

Infection delirium, 395

Insanity, legal definition of, 172

Institutions for mental defectives, 29

Institutions for mental diseases, 25

Involution melancholia, 427 (see Melancholia)

Ireland, M. W., 200

Janet, Pierre, 222, 493, 494, 500

Jelliffe, S. E., 235, 236, 293, 461

Jung, C. G., 145, 225, 448, 484, 497

Kahlbaum, K. 222, 412, 440, 441

Kaplan, D. M., 206

Karpas, M. J., 347

Kehrer, F., 434, 435, 436

Kempf, E. J. 245

Kirby, Geo. H., 84, 115, 248, 342, 430

Kirkbride, Thos., 71

Kline, Geo. M., 56, 67

Knapp, P. C., 329

Knauer, A., 211, 405

Koch, 504, 505

Koch, M. L., 380

Koller, 149

Köppen, M., 256, 258

Koren, John, 51

Korsakow's psychosis, 354, 357, 358

Kraepelin, E., 106, 149, 151, 211, 214, 224, 229, 242, 260, 267, 274, 286, 288, 290, 298, 300, 316, 324, 329, 334, 337, 348, 353, 365, 369, 395, 398, 415, 419, 431, 434, 440, 450, 453, 467, 470, 481, 484, 492, 511, 518, 520, 521, 528, 532

Krafft-Ebing, R. von, 240, 296, 335, 346, 364, 368, 412, 463, 464, 465, 491

Lambert, C. I., 281, 282

Laws, immigration, 164

Laws, Massachusetts, 63, 64, 65, 66

Laws, New York, 61

Laws relating to criminal responsibility, 172

Laws relating to mental diseases, 57, 61

Lead psychoses, 372

Legal definition of insanity, 172

Legislation and administration, 50

Lesions of the adrenals, 214

Lhermitte, J., 284

Life insurance statistics, 21

Linnaeus, 235

Local boards of control, 52

Locomotor ataxia, 337

Lombroso, C., 177, 379, 508

Louis, Pierre, 230

Lust, F., 199

MacCurdy, J. T., 199

Magnan, V., 466, 506

Manic-depressive psychoses, 409 delimitation, 421 depressed type, 417 history, 409 manic type, 416 mixed type, 417 psychological mechanisms, 419 statistics, 422, 423, 424, 425, 426

Mannheim, Paul, 363

Maryland Hospital, 37

Massachusetts legislation, 64, 65, 66

Massachusetts temporary care laws, 63

Maudsley, H., 239, 476

McCarthy, D. J., 323, 335, 338

McLean Hospital, 39

McNaughton case, 171

Melancholia, involution, 427 delimitation, 438 history, 427 statistics, 439

Mendel, E., 463

Mendel, G., 145

Mendelian heredity, 145

Meningitis, tubercular, 336

Mental cases in jails, 63

Mental deficiency, 524 criminals, 179 etiology, 525 history, 524 institutions for, 29 pfropfhebephrenia, 535 statistics, 536 types, 526, 527

Mental diseases: appropriations for, 26 classification, 234 criminal responsibility, 169, 172 death rate, 19 economic loss, 28 expenditures for, 26 heredity in, 145, 150 history-taking, 85 hospital treatment, 84 incidence of, 25 institutional care of, 25 laws relating to, 57, 61 mental examination, 93 military problems, 188 physical examination, 88 social and economic importance, 15 state care of, 79

Mental hygiene movement, the, 121 Canadian committee, 128 French society, 129 history, 122, 123, 124, 125 National Committee, 124 objects and purposes, 127 state societies, 126

Mercury psychoses, 374

Methods of commitment, 67

Methods of control, 67

Metropolitan Life Insurance statistics, 21

Meyer, Adolf, 84, 106, 115, 116, 122, 130, 251, 346, 427, 452, 463, 471, 504, 505

Meyer, E., 198

Meynert, Th., 401

Miliary plaques, 273

Military problems, 188

Misaurus, 393

Mitchell, S. Weir, 80

Möbius, 493

Modern hospital, evolution of the, 34

Modern progress of psychiatry, 217

Mongeri, L., 384

Morel, Jules, 177, 504

Morgagni, G. B., 142, 410

Morons, 526

Morphine psychoses, 364, 365

Mortality statistics, 16

Mortality statistics, wage earners, 22

Mott, Frederick W., 195, 196, 215, 302

Multiple sclerosis, 336

Murray, J. H., 489

National Committee for Mental Hygiene, 54, 124

Neubürger, 210

Neurasthenia, 498

Neuritis, central, 437

Neuroses, 489

New York Hospital, 38

New York laws, 61

Niles, G. M., 378

Nissl, F., 225, 269, 302, 303, 325, 354, 356, 370, 392, 398, 486

Nolan, Wm. J., 180, 459

Nonne, Max, 190

Norbury, Frank P., 67

Nordau, Max, 178, 508

Nothnagel's syndrome, 283

Nurses, training schools for, 74

Observation wards, 106

Occupational therapy, 100

Occupations, 32

O'Malley, Mary, 372, 374, 375

Opium, use of, 376

Oppenheim, H., 190, 208, 308

Orton, Samuel T., 248

Osler, Wm., 280

Out-patient clinics, 77, 78

Paralysis agitans, 334

Paranoia and paranoid conditions, 461 delimitation, 473 history, 461 statistics, 474

Parant, 335

Paraphrenia, 468, 469

Parathyroid stigmata, 204

Pathologists, 75

Paton, S., 228 364, 422

Pavilion F., Albany Hospital, 107

Pellagra, 378 classification, 390 etiology, 378, 380 history, 378 psychoses, 387, 388, 389 statistics, 390 symptoms, 383

Pennsylvania Hospital, 35

Pfropfhebephrenia, 535

Philadelphia Hospital, 34

Phipps Clinic, 115

Physical examination, 88

Pilgrim, Chas. W., 67

Pineal stigmata, 205

Pinel, 142, 219, 220, 223, 236

Pituitary stigmata, 204

Plater, Felix, 235

Plato, 138

Plocquet, 236

Pollock, Horatio M., 27, 29, 248, 360, 361, 456, 458, 459

Portal, 222

Post-infectious psychoses, 402, 403

Post-rheumatic psychoses, 404

Pritchard, J. C., 236, 239, 410, 462, 506

Procopiu, G., 385

Psychasthenia, 500

Psychiatric Institute, N. Y., 106

Psychiatry, modern progress of, 217

Psychiatry of the war, 185

Psychoneuroses and neuroses, 489 classification, 501 history, 489 hysteria, 493 neurasthenia, 498 psychasthenia, 500 statistics, 503

Psychopathic Hospital, Boston, 108

Psychopathic Hospital, development of the, 104

Psychopathic Hospital, University of Michigan, 107

Psychopathic hospitals, 108, 110, 111, 112, 113, 114, 115

Psychopathic personality, 504 classification, 521, 522 statistics, 522 the antisocial, 519 the eccentric, 516 the excitable, 511 the impulsive, 515 the quarrelsome, 521 the unstable, 513

Psychoses: alcoholic, 344 arteriosclerotic, 280 dementia praecox, 440 due to drugs and other exogenous poisons, 363 epileptic, 475 general paralysis, 293 involution melancholia, 427 manic-depressive, 409 of criminals, 181 of different races, 163 of recruits, 188 of the civil war, 186 of the Russo-Japanese war, 187 paranoia and paranoid conditions, 461 psychoneuroses and neuroses, 489 senile, 266 traumatic, 253 with brain tumor, 326 with cerebral syphilis, 308 with Huntington's chorea, 323 with mental deficiency, 524 with other brain and nervous diseases, 332 with other somatic diseases, 392 with pellagra, 378 with psychopathic personality, 504

Quincke, 295

Races of patients, 162

Races, psychoses of, 163

Raeder, O. J., 209, 319

Ray, Isaac, 169, 170

Rayner, H., 373

Régis, E., 240, 266, 296, 384, 506, 507

Rehm, 435

Richards, R. L., 187

Roberts, S. R., 382

Roman classification, 235

Rosanoff, A. J., 147, 148

Rush, Benjamin, 141, 218, 219, 220

Russell, Wm. L., 127

Sachs, 337

Salmon, Thos. W., 54, 124, 156, 157, 160, 165, 192, 193, 194, 195, 201

Salvarsan therapy, 319

Sandy, Wm. A., 388, 389

Sankey, W. H., 414

Sauvages, 235

Savage, G. H., 240, 241

Schaudinn, 218

Schizophrenia, 444, 445, 446, 447

Schläger, 260

Scholz, 105

Schüle, H., 415, 442, 480

Schuster, 329

Seelert, 436

Senile drusen, 273

Senile psychoses, 266 Alzheimer's disease, 274 delimitation, 276 delirious and confused states, 272 depressed and agitated types, 272 errors in diagnosis, 279

Senile psychoses, paranoid forms, 272 pathology, 273, 274 presbyophrenia, 272 presenile conditions, 267, 268, 269 senile deterioration, 271 statistics, 275, 277, 278

Shadwell, A., 360

Shell shock, 189

Sheppard and Enoch Pratt Hospital, 48

Sibbald, J., 105

Silver psychoses, 374

Simon, T. W., 229

Singer, H. Douglas, 387

Sinkler, Wharton, 338

Smith, Frank R., 105

Social and economic importance of mental diseases, 15

Social service, hospital, 113

Somatic diseases with psychoses, 392 acute delirium, 400 amentia, 401 classification, 405 collapse delirium, 400 febrile delirium, 396 history, 392 infection delirium, 395 infectious exhaustions, 403 initial delirium, 398 post-infectious psychoses, 402, 403 post-rheumatic psychoses, 404 statistics, 407 types, 395

Southard, E. E., 115, 117, 134, 245, 246, 279

Specht, 435

Spratling, Wm. P., 477

Spring Grove State Hospital, 38

St. Elizabeths Hospital, 48

State care of mental diseases, 79

State hospitals: construction, 70 death rate, 28 location, 69 management of, 73 number of, 49 organization and functions, 68 reception buildings, 72 statistics, 27, 76

Statistics: case rate, general diseases, 17 communicable diseases, 23 death rate and psychoses, 19 death rate, mental diseases, 19 epileptics, 29 errors in diagnosis, 20 hospitals for mental diseases, 25 incidence of mental diseases, 25 mental defectives, 29 mortality, 16 psychopathic hospitals, 108, 110, 111, 112, 113, 114, 115 psychoses: alcoholic, 360 dementia praecox, 455 epileptic, 488 general paralysis, 306 manic-depressive, 422 melancholia, involution, 439 paranoia or paranoid conditions, 474 psychoneuroses and neuroses, 503 senile, 275 traumatic, 264 with brain or nervous diseases, 343 with brain tumor, 331 with cerebral arteriosclerosis, 292 with cerebral syphilis, 321 with drugs or other exogenous poisons, 375 with Huntington's chorea, 326 with mental deficiency, 536 with pellagra, 390 with psychopathic personality, 522 with somatic diseases, 407 wage earners, 22

Stigmata: adrenal, 204 gonadal, 205 parathyroid, 204 pineal, 205 pituitary, 204 thymus, 205 thyroid, 203

Stöcker, Wm., 347

Stransky, 435, 443

Straus, S. G., 210

Striatum syndrome, 284, 285

Sutton, Thos., 352

Sydenham, 409

Symptoms due to brain lesions, 282, 283

Syphilis, cerebral, 308

Tabes, 337

Tanzi, 385

Temporary care laws, 63

Thalmic syndrome, 284

Thomas, Henry M., 332, 333

Thymus stigmata, 205

Thymus subinvolution, 215

Thyroid stigmata, 203

Thrombosis, cerebral, 332

Timme, Walter, 215, 216

Training schools for nurses, 74

Traumatic psychoses, 253 compression, 253, 260 concussion, 253, 260 delimitation, 263 Friedmann's complex, 255 mental enfeeblement, 262 Meyer's classification, 257 statistics, 264, 265 traumatic constitution, 254 traumatic neuroses, 256

Tredgold, A. F., 525

Trenton State Hospital, 47

Treponema pallidum, 295

Tubercular meningitis, 336

Tuke, D. Hack, 138, 171, 234, 235, 344, 409, 411, 475

Turner, 437

Turro, R., 211

Ullman, A. E., 229

Utica State Hospital, 46

Verrücktheit, 467

Voegtlin, Karl, 380

Vogel, 235

Vogt, Cecile and Oskar, 284

Voluntary patients, 62

Wage earners, mortality statistics, 20

Wahnsinn, 467

War psychoses, 185

Warthin, Alfred S., 320

Wassermann reaction, 295

Waters, C. O., 323

Weber-Gubler syndrome, 283

Weber, Hermann, 400

Wernicke, C., 224, 356, 444

Westphal, A., 316

Weygandt, Wm., 187

White, Wm. A., 130, 148, 227, 297, 339, 364, 420, 431, 448

Widal, 295

Williams, Frankwood E., 67, 248

Willis, Thos., 140, 410

Wilson, J. C., 371

Wilson, S. A. K., 284

Wilson's syndrome, 284

Wolfsohn, Julian M., 191

Worcester, Dean A., 189

Worcester State Hospital, 42

Wright, R. B., 97

Ziehen, Th., 240, 266, 415, 506

FOOTNOTES:

[1] Cabot, Richard C.: Diagnostic Pitfalls Identified During a Study of 3000 Autopsies. Journal of the American Medical Association. December 28, 1912.

[2] Dublin, Louis I.: Mortality Statistics of Insured Wage Earners and Their Families. 1919.

[3] Statistical Directory of State Institutions, Department of Commerce, Bureau of the Census, 1919.

[4] Pollock, Horatio M., and Furbush, Edith M.: Patients with Mental Disease, Mental Defects, etc., in Institutions of the United States. Mental Hygiene, January, 1921.

[5] Ibid.

[6] Pollock, Horatio M., and Furbush, Edith M.: Patients with Mental Disease, Mental Defects, etc., in Institutions of the United States. Mental Hygiene, January, 1921.

[7] Ball, Jau Don: The Correlation of Neurology, Psychiatry, Psychology and General Medicine as Scientific Aids to Industrial Efficiency. The American Journal of Insanity, April, 1919.

[8] Nineteenth Annual Report of the State Commission in Lunacy, N. Y., 1908.

[9] Curtin, Roland G.: The Philadelphia General Hospital. Philadelphia General Hospital Reports Vol. VIII, 1910.

[10] The Institutional Care of the Insane in the United States and Canada, Vol. III, 1916.

[11] Ibid.

[12] Ibid.

[13] Friends' Asylum for the Insane, Frankford, Pa. Annual Report, 1853.

[14] The Institutional Care of the Insane in the United States and Canada, Vol. II, 1916.

[15] Ibid.

[16] The Institutional Care of the Insane in the United States and Canada, Vol. II, 1916.

[17] Reports and other documents relating to the State Hospital at Worcester, Mass. Published by order of the Senate, Boston, 1837.

[18] Reports and other documents relating to the state Hospital at Worcester, Mass. Published by order of the Senate, Boston, 1837.

[19] The Institutional Care of the Insane in the United States and Canada, Vol. III, 1916.

[20] Dickens, Charles: American Notes, 1842.

[21] The Institutional Care of the Insane in the United states and Canada, Vol. III, 1916.

[22] The Institutional Care of the Insane in the United States and Canada, Vol. III, 1916.

[23] Koren, John: Summaries of State Laws Relating to the Insane. National Committee for Mental Hygiene, New York, 1917.

[24] Koren, John: Summaries of State Laws Relating to the Insane. National Committee for Mental Hygiene, New York, 1917.

[25] Salmon, Thomas W.: The State Care of the Insane under State Boards of Control. State Hospital Bulletin, February 15, 1915.

[26] Kline, George M.: Proposed Reorganization and Correlation of State Institutions in Massachusetts. American Journal of Insanity, January, 1920.

[27] Thirteenth Annual Report, New York State Hospital Commission. Albany, 1919.

[28] Fourth Annual Report of the Massachusetts Commission on Mental Diseases. Boston, 1920.

[29] Mitchell, S. Weir: Address before the Fiftieth Annual Meeting of the American Medico-Psychological Association. Transactions, 1894.

[30] Copp, Owen: Barriers to the Treatment of Mental Patients. Mental Hygiene, April, 1918.

[31] Kirby, G. H.: Guides for History Taking and Clinical Examination of Psychiatric Cases. 1921.

[32] Wright, R. B.: Medical Staff Manual—Hydrotherapy. Boston State Hospital. 1920.

[33] Sibbald, John: Psychiatry in General Hospitals. Review of Neurology and Psychiatry. January, 1903.

[34] Smith, Frank R.: Extracts from the Writings of Wilhelm Griesinger, a Prophet of the Newer Psychiatry. American Journal of Insanity, July, 1903.

[35] Earle, Pliny: The Psychopathic Hospital of the Future. Address at the laying of the corner stone of the General Hospital for the Insane of the State of Connecticut, June 20, 1867. Utica, 1867.

[36] Meyer, Adolf: The Aims of a Psychiatric Clinic. Proceedings of the Mental Hygiene Conference at the College of the City of New York, November, 1912.

[37] Ibid.

[38] Beers, Clifford W.: A Mind That Found Itself, 1908.

[39] Notes and Comments. The American Journal of Insanity, July, 1908.

[40] Farrar, Clarence B.: The Autopathography of C. W. Beers. American Journal of Insanity, July, 1908.

[41] Notes and Comments. The American Journal of Insanity, July, 1908.

[42] Beers, Clifford W.: A Mind That Found Itself. Revised. Fourth edition, 1917.

[43] Beers, Clifford W.: A Mind That Found Itself. Revised. Fourth edition, 1917.

[44] Ibid.

[45] Russell, William L.: Community Responsibilities in the Treatment of Mental Disorders. Mental Hygiene, July, 1918.

[46] Notes and Comments. Mental Hygiene, July, 1920.

[47] Ibid., October, 1920.

[48] White, William A.: Childhood: the Golden Period for Mental Hygiene. Mental Hygiene, April, 1920.

[49] Copp, Owen: The Duty of the State and the Physician to the Mental Patient. The Pennsylvania Medical Journal, December, 1919.

[50] Burnham, William H.: The Scope and Aim of Mental Hygiene. Boston Medical and Surgical Journal, December 19, 1918.

[51] Gesell, Arnold: Mental Hygiene and the Public School. Mental Hygiene, January, 1919.

[52] Campbell, C. Macfie: The Responsibilities of the Universities in Promoting Mental Hygiene. Mental Hygiene, April, 1919.

[53] Cobb, Stanley: Applications of Psychiatry to Industrial Hygiene. The Journal of Industrial Hygiene, November, 1919.

[54] Ibid.

[55] Southard, Elmer E.: Notes and Comments. Mental Hygiene. January, 1921.

[56] Tuke, D. Hack: A Dictionary of Psychological Medicine. 1892.

[57] Tuke, D. Hack: A Dictionary of Psychological Medicine. 1892.

[58] Clouston, T. S.: Unsoundness of Mind. 1911.

[59] Morgagni, G. B.: De Sedibus et Causis Morborum per Anatomem Indegatis. 1761.

[60] Journal of Mental Science. January, 1870.

[61] Clouston, T. S.: Unsoundness of Mind. 1911.

[62] Mendel, Gregor J.: Versuche über Pflanzen Hybriden. 1865.

[63] Davenport, Charles B.: Heredity in Relation to Eugenics. 1911.

[64] Rosanoff, A. J., and Orr, Florence: A Study of Heredity in the Light of the Mendelian Theory. American Journal of Insanity, October, 1911.

[65] Rosanoff, A. J.: On the Inheritance of the Neuropathic Constitution. New York State Hospitals Bulletin, August 15, 1912.

[66] White, William A.: Outlines of Psychiatry. 1919.

[67] Kraepelin, Emil: Psychiatrie. Eighth edition. Vol. 1. 1909.

[68] Ibid.

[69] Kraepelin, Emil: Psychiatrie. Eighth edition. Vol. 1. 1909.

[70] Kraepelin, Emil: Psychiatrie. Eighth edition. Vol. 1. 1909.

[71] Salmon, Thomas W.: Immigration and the Mixture of Races in Relation to the Mental Health of the Nation. Modern Treatment of Nervous and Mental Diseases. White and Jelliffe. Vol. 1, 1913.

[72] Salmon, Thomas W.: Immigration and the Mixture of Races in Relation to the Mental Health of the Nation. Modern Treatment of Nervous and Mental Diseases. White and Jelliffe. Vol. 1, 1913.

[73] Twenty-fifth Annual Report of the State Hospital Commission. Albany, 1914.

[74] Salmon, Thomas W.: Immigration and the Mixture of Races in Relation to the Mental Health of the Nation. Modern Treatment of Nervous and Mental Diseases. White and Jelliffe. Vol. I, 1913.

[75] Thirtieth Annual Report of the State Hospital Commission. Albany, 1919.

[76] Thirty-first Annual Report of the State Hospital Commission. Albany, 1920.

[77] Salmon, Thomas W.: Immigration and the Mixture of Races in Relation to the Mental Health of the Nation. Modern Treatment of Nervous and Mental Diseases. White and Jelliffe. Vol. I, 1913.

[78] Ray, Isaac: A Treatise on the Medical Jurisprudence of Insanity. 1838.

[79] Ray, Isaac: A Treatise on the Medical Jurisprudence of Insanity. 1838.

[80] Tuke, D. Hack: A Dictionary of Psychological Medicine. 1892.

[81] Report of the Committee on Medical Expert Testimony. Transactions of the American Medico-Psychological Association. 1910.

[82] Anderson, Victor V.: Mental Disease and Delinquency. Mental Hygiene, April, 1919.

[83] May, James V.: Mental Diseases and Criminal Responsibility. New York State Hospitals Bulletin, November, 1912.

[84] Nolan, William J.: Some Characteristics of the Criminal Insane. The State Hospital Quarterly, May, 1920.

[85] Medical and Surgical History of the War of the Rebellion. Part Third. Vol. 1, 1888.

[86] Weygandt, W.: Psychiatry in the Field. Medizinische Klinik. Abstract of, Journal of American Medical Association, November 7, 1914.

[87] Richards, R. L.: Nervous and Mental Disorders in their Military Relations. Modern Treatment of Nervous and Mental Disease. White and Jelliffe, 1913.

[88] Physical Examination of the First Million Draft Recruits. Bulletin No. 11, War Department, Burgeon General, 1919.

[89] Bailey, Pearce: Reconstruction in Nervous and Mental Diseases, Medical Record, June 16, 1919.

[90] Farrar, Clarence B.: The Problem of Mental Diseases in the Canadian Army. Mental Hygiene, July, 1917.

[91] Oppenheim, H.: The War and the Traumatic Neuroses. Berlin klin. Woch., March 15, 1915. Abstract of War Work Committee of the National Committee for Mental Hygiene, 1918.

[92] Nonne, Max: Shall War Injuries Still Be Diagnosed as Traumatic Neuroses? Med. klin., Berlin, August 1, 1915. Abstract of the Journal of the American Medical Association. Sept. 18, 1915.

[93] Binswanger, Otto: Hystero-somatic Symptoms in War Hysteria. Monat. für Psych. u. Neurol., Berlin, July and August, 1915. Abstract of War Work Committee of the National Committee for Mental Hygiene, 1918.

[94] Wolfsohn, Julian M.: The Predisposing Factors of War Psychoneuroses. Lancet, London, Feb. 2, 1918.

[95] Salmon, Thomas W.: The Care and Treatment of Mental Diseases and War Neuroses (Shell Shock) in the British Army. War Work Committee of the National Committee for Mental Hygiene, 1917.

[96] Mott, Frederick W.: Effects of High Explosives upon the Central Nervous System. Lancet, London, February 26, 1916.

[97] Mott, Frederick W.: The Brain in Shell Shock. Brit. Med. Journal, November 10, 1917.

[98] Eder, Montague D.: War Shock: the Psychoneuroses in War. Psychology and Treatment. 1917.

[99] Ballet, Gilbert, and de Fursac, Rogues J.: The Concussion Psychoses: Psychoses from Nervous "Commotion" or Emotional Shock. Paris Méd., January 1, 1916. Abstract of the War Work Committee of the National Committee for Mental Hygiene. 1918.

[100] Lust, F.: War Neuroses and Prisoners. München Med. Woch., Dec. 26, 1916. Abstract of the Journal of the American Medical Association. Feb. 24, 1917.

[101] MacCurdy, John T.: War Neuroses. Psychiatric Bulletin, July, 1917.

[102] Hartung, M. U.: German Experiences of War Neuroses. Zeitschrift für d. ges. Neur. u. Psych., 1918. Abstract of the Journal of Nervous and Mental Diseases, Oct., 1919.

[103] Hurst, A. F.: Observations of the Etiology and Treatment of War Neuroses. Brit. Med. Journal, September 29, 1918. Abstract of the Journal of Nervous and Mental Diseases. Oct., 1919.

[104] Ireland, Merritte W.: Care of the Army's Mental Defectives. Journal of Nervous and Mental Diseases, December, 1920.

[105] Salmon, Thomas W.: The Insane Veteran and a Nation's Honor. The American Legion Weekly, January 28, 1921.

[106] Falta, Wilhelm: The Ductless Glandular Diseases. Trans. by Milton K. Meyers. 1916.

[107] Blumgarten, A. S.: The Rôle of the Endocrine System in Internal Medicine. New York Medical Journal, February 5, 1921.

[108] Kaplan, D. M.: Internal Secretions. New York Medical Journal, February 5, 1921.

[109] Garretson, William V. P.: The Dominance of the Endocrines. New York Medical Journal, May 17, 1921.

[110] Falta, Wilhelm: The Ductless Glandular Diseases. Trans. by Milton K. Meyers. 1916.

[111] Raeder, Oscar J.: Endocrine Imbalance in the Feebleminded. Journal of the American Medical Association, August 21, 1920.

[112] Neubürger: Arch. für Psychiatrie. Vol. 55. Abstract of, Psychiatric Bulletin, January, 1916.

[113] Walter and Krumbach: Zeitschrift f. d. g. Neurologie und Psychiatrie. Vol. 28. Abstract of, Psychiatric Bulletin, January, 1916.

[114] Emerson, H.: A Note on the Incidence of Status Lymphaticus in Dementia Praecox. Arch. Int. Medicine, December, 1914.

[115] Davis, Thomas K.: Status Lymphaticus; Its Occurrence and Significance in the War Neuroses. Arch. of Neurology and Psychiatry, October, 1919.

[116] Straus, S. G.: Thyroidal Constipation. New York Medical Journal, February 14, 1920.

[117] Turro, R.: Emotions and Endocrine Functions. Abstract of Journal of the American Medical Association, December 13, 1919.

[118] Knauer, A., and Billigheimer, E.: Concerning Organic and Functional Disturbances of the Vegetative Nervous System with Special Reference to the Fear Neuroses. Zeitschrift f. d. g. Neurologie und Psychiatrie, 1919, Vol. 50. Abstract of the Journal of Nervous and Mental Diseases, August, 1920.

[119] Kraepelin, E.: Psychiatrie. Vol. 4, 1915.

[120] Kraepelin, E.: Psychiatrie. Vol. 4, 1915.

[121] Mott, Frederick W.: British Medical Journal, November, 1919.

[122] Timme, Walter: Clinical Endocrinology. Neurological Bulletin, January 1921.

[123] White, William A.: Outlines of Psychiatry. Seventh edition, 1919.

[124] Paton, Stewart: Psychiatry. 1905.

[125] Diefendorf, A. Ross: Clinical Psychiatry. 1918.

[126] Simon, T. W.: The Occurrence of Convulsions in Dementia Praecox, Manic-Depressive Insanity and the Allied Groups. The State Hospital Bulletin, November 15, 1914.

[127] Ullman, A. E.: Proceedings of the Inter-hospital Meeting at the Central Islip State Hospital. The State Hospital Bulletin, November 15, 1914.

[128] Kraepelin, E.: Psychiatrie. Vol. 3, 1913.

[129] Thirty-first Annual Report of the New York State Hospital Commission. 1918.

[130] Bucknill, J. C., and Tuke, D. H.: A Manual of Psychological Medicine. 1879.

[131] Bucknill, J. C., and Tuke, D. H.: A Manual of Psychological Medicine. 1879.

[132] Ibid.

[133] Jolliffe, S. E.: A Summary of the Origins, Transformations and Present-day Trends of the Paranoia Concept. The Medical Record, April 5, 1913.

[134] Bucknill, J. C., and Tuke, D. H.: A Manual of Psychological Medicine. 1879.

[135] Pritchard, J. C.: A Treatise on Diseases of the Nervous System. 1822.

[136] Flemming, C. F.: Ueber Classification der Seelenstörungen, etc. Allgemeine Zeitschrift für Psychiatrie. 1844.

[137] Pritchard, J. C.: A Treatise on Insanity. 1835.

[138] Griesinger, W.: Die Pathologie und Therapie der psychischen Krankheiten. 1845.

[139] Krafft-Ebing, R. v.: Lehrbuch der Psychiatrie. Third edition. 1888.

[140] Ziehen, Th.: Psychiatrie, 1894.

[141] Savage, G. H.: Insanity and Allied Neuroses. Fourth edition. 1907.

[142] Savage, G. H.: Insanity and Allied Neuroses. Fourth Edition. 1907.

[143] Kempf, E. J.: The Mechanistic Classification of Neuroses and Psychoses Produced by Distortion of Anatomic-Affective Functions. The Journal of Nervous and Mental Diseases. August, 1919.

[144] Southard, E. E.: A Key to the Practical Grouping of Mental Diseases. Journal of Nervous and Mental Diseases. January, 1918.

[145] Southard, E. E.: Recent American Classification of Mental Diseases. Transactions, American Medico-Psychological Association, 1918.

[146] Southard, E. E.: A Key to the Practical Grouping of Mental Diseases. Journal of Nervous and Mental Diseases. January, 1918.

[147] DaCosta, J. C.: Modern Surgery. Seventh edition. 1918.

[148] Ibid.

[149] Harlow, John M.: Recovery from the Passage of an Iron Bar through the Head. Boston, 1868.

[150] Witmer, Lightner: Brain: Functions of the Cerebral Cortex. Reference Handbook of the Medical Sciences. 1899.

[151] Meyer, Adolf: The Anatomical Facts and Clinical Varieties of Traumatic Insanity. Transactions of the American Medico-Psychological Association, 1903.

[152] Meyer, Adolf: The Anatomical Facts and Clinical Varieties of Traumatic Insanity. Transactions of the American Medico-Psychological Association, 1903.

[153] Meyer, Adolf: The Anatomical Facts and Clinical Varieties of Traumatic Insanity. Transactions of the American Medico-Psychological Association, 1903.

[154] Griesinger, W.: Mental Pathology and Therapeutics. Translated by C. L. Robertson and James Rutherford. 1867.

[155] Kraepelin, E.: Psychiatrie. Eighth edition. Vol. 2. 1910.

[156] Clouston, T. S.: Unsoundness of Mind. 1911.

[157] Ziehen, Th.: Psychiatrie. 1894.

[158] Kraepelin, E.: Psychiatrie. Eighth edition. Vol. 2, 1910.

[159] Kraepelin, E.: Psychiatrie. Eighth edition. Vol. 2, 1910.

[160] Kraepelin, E.: Psychiatrie. Eighth edition. Vol. 2, 1910.

[161] Bleuler, E.: Lehrbuch der Psychiatrie, 1918.

[162] Southard, E. E.: Anatomical Findings in Senile Dementia, etc. Transactions of the American Medico-Psychological Association, 1909.

[163] Lambert, Charles I.: A Clinical-Anatomical Classification of the Senile and Arteriosclerotic Disorders. Transactions of the American Medico-Psychological Association. 1910.

[164] Ibid.

[165] Barker, Lewellys F.: Monographic Medicine. Vol. 4, 1916.

[166] Lhermitte, J.: The Anatomical and Clinical Syndromes of the Corpus Striatum. Translated by J. H. Huddleson and W. M. Kraus. The Neurological Bulletin. May, 1921.

[167] Kraepelin, E.: Psychiatrie. Eighth edition. Vol. 2, 1910.

[168] Kraepelin, E.: Psychiatrie. Eighth edition. Vol. 2, 1910.

[169] Kraepelin, E.: Psychiatrie. Eighth edition. Vol. 2, 1910.

[170] Kraepelin, E.: Psychiatrie. Eighth edition. Vol. 2, 1910.

[171] Krafft-Ebing, R. v.: Lehrbuch der Psychiatrie. 1888.

[172] Régis, E.: A Practical Manual of Mental Medicine. Translated by H. M. Bannister. 1894.

[173] White, William A.: Outlines of Psychiatry. 1919.

[174] Kraepelin, E.: Psychiatrie. Eighth edition. Vol. 2, 1910.

[175] Kraepelin, E.: Psychiatrie. Eighth edition. Vol. 2, 1910.

[176] May, James V.: A Résumé of the Work of the Pathological Laboratory of the Binghamton State Hospital. July 1, 1911.

[177] Ibid.

[178] May, James V.: A Review of the Recent Studies of General Paresis. American Journal of Insanity. April, 1910.

[179] Mott, F. W.: Oliver-Sharpey Lectures on the Cerebro-Spinal Fluid. Lancet, July 2 and 10, 1910.

[180] Alzheimer, Alois: Histologische Studien zur Differentialdiagnose des Progres s. Paralyse. Hist. und Histopath. Arbeiten. 1904.

[181] Movimiento de la Casa de Orates de Santiago, 1920.

[182] Oppenheim H.: Diseases of the Nervous System. Translated by Edward E. Mayer, 1900.

[183] Barker, Lewellys F.: Monographic Medicine. Vol, 4, 1916.

[184] Dunlap, Charles B.: Anatomical Borderline between the So-called Syphilitic and Metasyphilitic Disorders in the Brain and Spinal Cord. American Journal of Insanity, April, 1913.

[185] Barker, Lewellys F.: Monographic Medicine. Vol. 4, 1916.

[186] Kraepelin, E.: Psychiatrie. Eighth edition. Vol. 2, 1910.

[187] Raeder, Oscar J.: Interim Report of the Neurosyphilis Investigation of the Massachusetts Commission on Mental Diseases. Transactions of the American Medico-Psychological Association, 1919.

[188] Warthin, Alfred S.: The Persistence of Active Lesions in the Tissue of Clinically Inactive or "Cured" Syphilis. American Journal of Medical Sciences. October, 1916.

[189] McCarthy, Daniel J.: Paralysis Agitans, Chorea, etc. Modern Medicine, Osler and McCrae. 1915.

[190] Hamilton, Arthur S.: A Report of Twenty-seven Cases of Chronic Progressive Chorea. American Journal of Insanity. January, 1908.

[191] Diefendorf, A. Ross: Neurographs. May, 1908.

[192] Kraepelin, E.: Psychiatrie. Eighth edition. Vol. 2, 1910.

[193] Cushing, Harvey. Tumors of the Brain and Meninges. Modern Medicine, Osier and McCrae. 1915.

[194] Redlich, E. The Pathogenesis of Psychic Disturbances in Brain Tumors. Reviewed by Morris J. Karpas. State Hospitals Bulletin, June, 1911.

[195] Kraepelin, E.: Psychiatrie. Eighth edition. Vol. 2, 1910.

[196] Thomas, Henry M.: Diseases of the Cerebral Bloodvessels. Modern Medicine, Osler and McCrae. 1915.

[197] Thomas, Henry M.: Diseases of the Cerebral Bloodvessels. Modern Medicine. Osler and McCrae. 1915.

[198] Kraepelin, E.: Psychiatrie. Eighth edition. Vol. 2, 1910.

[199] Camp, Carl D.: Paralysis Agitans and Multiple Sclerosis and Their Treatment. Modern Treatment of Nervous and Mental Diseases. White and Jelliffe. 1913.

[200] McCarthy, Daniel J.: Paralysis Agitans, Chorea, etc. Modern Medicine. Osler and McCrae. 1915.

[201] Kraepelin, E.: Psychiatrie. Eighth edition. Vol. 2, 1910.

[202] Henderson, D. K.: Disseminated Sclerosis with Psychosis. State Hospitals Bulletin. March, 1910.

[203] Kraepelin, E.: Psychiatrie. Eighth edition. Vol. 2, 1910.

[204] Sachs, Bernard: Syphilitic Diseases of the Central Nervous System. Modern Medicine, Osler and McCrae. 1915.

[205] Kraepelin, E.: Psychiatrie. Eighth edition. Vol. 2, 1910.

[206] McCarthy, Daniel J.: Paralysis Agitans, Chorea, etc. Modern Medicine, Osler and McCrae. 1915.

[207] White, William A.: Outlines of Psychiatry. 1919.

[208] Economo, C. von: Wien Klin. Wochenschrift. July 26, 1917.

[209] Buzzard, E., Farquhar, and Greenfield, J. G.: Lethargic Encephalitis Brain, 1919.

[210] Boveri, Piero: The Cerebrospinal Fluid in Epidemic Encephalitis. Journal of Nervous and Mental Diseases. October, 1920.

[211] Abrahamson, Isador: Mental Disturbances in Lethargic Encephalitis. Journal of Nervous and Mental Diseases. September, 1920.

[212] Kirby, George H., and Davis, Thomas K.: Psychotic Aspects of Epidemic Encephalitis. Archives of Neurology and Psychiatry. May, 1921.

[213] Tuke, D. Hack: A Dictionary of Psychological Medicine. 1892.

[214] Tuke, D. Hack: Alcohol, Use of, as a Beverage in Asylums. A Dictionary of Psychological Medicine. 1892.

[215] Flemming, C. F.: Ueber Classification die Seelenstörungen. Allgemeine Zeitschrift für Psychiatrie. 1844.

[216] Clousten, T. S.: Clinical Lectures on Mental Diseases. 1898.

[217] Krafft-Ebing, R. von: Text book of Insanity. Translated by C. G. Chaddock. 1905.

[218] Meyer, Adolf: Modern Psychiatry: Its Possibilities and Responsibilities. New York State Hospitals Bulletin. September, 1909.

[219] Stöcker, Wilhelm: Klinischer Beitrag zur Frage der Alkoholpsychosen. Jena, 1910. Abstract of Morris J. Karpas in State Hospitals Bulletin, December, 1910.

[220] Ibid.

[221] Kraepelin, E.: Psychiatrie. Eighth edition. Vol. 2, 1910.

[222] Shadwell, A.: Article on Temperance. The Encyclopedia Britannica, Vol. 26, 1911.

[223] Pollock, H. M.: A Statistical Study of 1739 Patients with Alcoholic Psychoses. State Hospital Bulletin. August, 1914.

[224] Krafft-Ebing, R. von: Text-book of Insanity. Translated by C. G. Chaddock. 1905.

[225] Paton, Stewart: Psychiatry. 1905.

[226] Barker, Lewellys F.: Monographic Medicine, Vol. 4, 1916.

[227] White, William A.: Outlines of Psychiatry. 1919.

[228] Erlenmeyer, A.: Die Morphiumsucht und ihre Behandlung. 1887.

[229] Kraepelin, E.: Psychiatrie. Eighth edition. Vol. 2, 1910.

[230] Mannheim, Paul: Ueber das Cocain und seine Gefahren, etc. Zeitschrift für klinische Medicin. 1891.

[231] Erlenmeyer, A.: Cocainsucht. 1886. Abstract in Zentralblatt für Nervenheilkunde, Psychiatrie, etc., by Goldstein. November, 1887.

[232] Kraepelin, E.: Psychiatrie. Eighth edition. Vol. 2, 1910.

[233] Wilson, James C.: The Opium Habit and Kindred Affections. System of Medicine. Pepper. 1886.

[234] Casamajor, Louis: Bromide Intolerance and Bromide Poisoning. Journal of Nervous and Mental Diseases. June, 1911.

[235] Hoch, August: A Study of Some Cases of Delirium Produced by Drugs. Review of Neurology and Psychiatry. February, 1906.

[236] O'Malley, Mary, and Franz, Shepherd Ivory: A Case of Delirium Produced by Bromides. Bulletin No. 1. Government Hospital for the Insane. Washington, 1909.

[237] Edsall, David L.: Chronic Lead, Arsenic and Other Forms of Poisoning. Modern Medicine. Osler and McCrae. Vol. 2, 1914.

[238] Rayner, H.: Journal of Mental Science. 1880.

[239] Edsall, David L.: Chronic Lead, Arsenic and Other Forms of Poisoning. Modern Medicine. Osler and McCrae. Vol. 2, 1914.

[240] O'Malley, Mary: A Psychosis Following Carbon-Monoxide Poisoning with Complete Recovery. American Journal of the Medical Sciences. June, 1913.

[241] Drug Addiction in the United States. Journal of Nervous and Mental Diseases. August, 1920.

[242] Niles, George M.: Pellagra. 1912.

[243] Babcock, J. W.: The Prevalence and Psychology of Pellagra. Transactions of the American Medico-Psychological Association, 1910.

[244] Studies in Pellagra. U. S. Treasury Department. Hygienic Bulletin. No. 106. January, 1917.

[245] Voegtlin, Carl: The Treatment of Pellagra. Journal of the American Medical Association. September 26, 1914.

[246] Koch, M. L., and Voegtlin, Carl: Chemical Changes in the Central Nervous System in Pellagra. Hygienic Laboratory Bulletin No. 103, February, 1916.

[247] Goldberger, J.: Pellagra: Causation and a Method of Prevention: A Summary of Some of the Recent Studies of the Public Health Service. Journal of the American Medical Association, February 12, 1916.

[248] Goldberger, J., Wheeler, G. A., and Sydenstricker, Edgar: A Study of the Diet of Nonpellagrous and of Pellagrous Households. Journal of the American Medical Association. September 21, 1918.

[249] Roberts, Stewart R.: Types and Treatment of Pellagra. Journal of the American Medical Association, July 3, 1920.

[250] Barker, Lewellys F.: Monographic Medicine, Vol. 4, 1916.

[251] Babcock, J. W.: The Prevalence and Psychology of Pellagra. Transactions of the American Medico-Psychological Association, 1910.

[252] Griesinger, W.: Pathology and Therapeutics of Mental Diseases. 1887.

[253] Mongeri, L.: Malattie Mentali. Milan, 228. Quoted by Babcock.

[254] Bianchi, Leonardo: A Textbook of Psychiatry. Translated by James H. Macdonald. 1906. Quoted by Babcock.

[255] Régis, E.: Precis de Psychiatrie. 1909. Quoted by Babcock.

[256] Procopiu, G.: La Pellagre. Paris. 1903. Quoted by Babcock.

[257] Tanzi, Eugenio: Textbook of Mental Diseases. Translated by Robertson. 1909.

[258] Gregor, A.: Jahrb. Psychiat. Neurol. Leipsig, 1907

[259] Singer, H. Douglas: Mental and Nervous Disorders Associated with Pellagra. Archives of Internal Medicine. January, 1915.

[260] Sandy, William A.: Psychiatric Aspects of Pellagra. Transactions of the American Medico-Psychological Association. 1916.

[261] Bucknill, J. C., and Tuke, D. Hack: A Manual of Psychological Medicine. 1879.

[262] Bucknill, J. C., and Tuke, D. Hack: A Manual of Psychological Medicine. 1879.

[263] Feuchtersleben, E. von: Lehrbuch der Aerzlichen Seelenkunde. 1845. Translated by H. E. Lloyd. 1847.

[264] Friedreich, J. B.: Historisch kritische Darstellung der Theorieen über den Wahnsinn. 1839. Quoted by von Feuchtersleben.

[265] Kraepelin, E.: Psychiatrie. Eighth edition. Vol. 2, 1910.

[266] Knauer, A.: The Psychoses Occurring as a Result of Acute Articular Rheumatism. Zeitschrift f. d. ges. Neurol. u. Psychiatrie. Vol. 21, 1916.

[267] Tuke, D. Hack: A Dictionary of Psychological Medicine. 1892.

[268] Ibid.

[269] Ibid.

[270] Pritchard, James C.: A Treatise on Insanity and Other Disorders Affecting the Mind. 1835.

[271] Flemming, C. F.: Ueber Classification der Seelenstörungen. Allgemeine Zeitschrift für Psychiatrie. 1844.

[272] Griesinger, Wilhelm: Die Pathologie und Therapie der psychischen Krankheiten. 1845.

[273] Tuke, D. Hack: A Dictionary of Psychological Medicine. 1892.

[274] Sankey, W. H. O.: Lectures on Mental Disease. 1884.

[275] Schüle, Heinrich: Klinishe Psychiatrie. Third edition. 1886.

[276] Ziehen, Th.: Psychiatrie. 1894.

[277] Kraepelin, E.: Psychiatrie. Sixth edition. 1899.

[278] White, William A.: Outlines of Psychiatry. 1919.

[279] Diefendorf, A. Ross: Clinical Psychiatry. 1918.

[280] Buckley, Albert C.: The Basis of Psychiatry. 1920.

[281] Paton, Stewart: Psychiatry. 1905.

[282] Kraepelin, E.: Psychiatrie. Eighth edition. Vol. 3, 1913.

[283] Diefendorf, A. Ross: Clinical Psychiatry. 1918.

[284] Dreyfus, G. L.: Die Melancholia ein Zustanbild des Manisch-Depressiven Irreseins. 1907. Reviewed by Dr. George H. Kirby. The State Hospitals Bulletin, December 1, 1908.

[285] Dreyfus, G. L.: Die Melancholia ein Zustandbild des Manisch-Depressiven Irreseins. 1907. Review by Dr. George H. Kirby. The State Hospitals Bulletin, December 1, 1908.

[286] Kraepelin, E.: Psychiatrie. Eighth edition. Vol. 2, 1910.

[287] Kraepelin, E.: Psychiatrie. Eighth edition. Vol. 2, 1910.

[288] Kraepelin, E.: Psychiatrie. Eighth edition. Vol. 3, 1913.

[289] Kehrer, F.: Die Psychosen des Um- und Rückbildungsalters. Zentralblatt für die gesamte Neurologie und Psychiatrie, April 1, 1921.

[290] Kehrer, F.: Die Psychosen des Um- und Rückbildungsalters. Zentralblatt für die gesamte Neurologie und Psychiatrie, April 1, 1921.

[291] Kehrer, F.: Die Psychosen des Um- und Rückbildungsalters. Zentralblatt für die gesamte Neurologie und Psychiatrie, April 1, 1921.

[292] Meyer, Adolf: Insanity: General Pathology. Reference Handbook of the Medical Sciences. 1909.

[293] Meyer, Adolf: Insanity: General Pathology. Reference Handbook of the Medical Sciences. 1909.

[294] Kraepelin, E.: Psychiatrie. Eighth edition, Vol. 3, 1913.

[295] Bleuler, E.: Lehrbuch der Psychiatrie. Second edition, 1918.

[296] Ibid.

[297] Hoch, August: Review of Bleuler's "Schizophrenia." New York State Hospitals Bulletin, August 15, 1912.

[298] Bleuler, E.: Lehrbuch der Psychiatrie. Second edition, 1918.

[299] Hoch, August: Review of Bleuler's "Schizophrenia." New York State Hospitals Bulletin, August 15, 1912.

[300] Bleuler, E.: Lehrbuch der Psychiatrie. Second edition, 1918.

[301] Meyer, Adolf: Fundamental Conceptions of Dementia Praecox. British Medical Journal, September, 1906.

[302] Hoch, August: Constitutional Factors in the Dementia Praecox Group. Review of Neurology and Psychiatry, August, 1910.

[303] Jung, C. G.: The Psychology of Dementia Praecox. 1909.

[304] White, William A.: Outlines of Psychiatry. 1919.

[305] Kraepelin, E.: Psychiatrie. Eighth edition, Vol. 3, 1913.

[306] Ibid.

[307] Meyer, Adolf: The Nature and Conception of Dementia Praecox. The Journal of Abnormal Psychology. Dec., 1910, Jan., 1911.

[308] Buckley, Alfred C.: The Basis of Psychiatry. 1920.

[309] Diefendorf, A. Ross: Clinical Psychiatry. 1918.

[310] Kraepelin, E.: Psychiatrie. Eighth Edition, Vol. 3, 1913.

[311] Kraepelin, E.: Psychiatrie. Eighth edition, Vol. 3, 1913.

[312] Pollock, Horatio M., and Nolan, William J.: Sex, Age, and Nativity of Dementia Praecox First Admissions to the New York State Hospitals, 1912-1918. The State Hospital Quarterly, August, 1919.

[313] Pollock, Horatio M.: Dementia Praecox as a Social Problem. The State Hospital Quarterly, August, 1918.

[314] Jelliffe, S. E.: A Summary of Origins, Transformation and Present-Day Trend of the Paranoia Concept. New York Medical Record, April 5, 1913.

[315] Flemming, C. F.: Ueber Classification die Seelenstörungen. Allgemeine Zeitschrift für Psychiatrie. 1844.

[316] Quoted by Cramer. Abgreugung und Differenzial-Diagnose der Paranoia. Allgemeine Zeitschrift für Psychiatrie. 1894.

[317] Krafft-Ebing, R. von: A Text-book of Insanity. Translated by C. G. Chaddock. 1905.

[318] Krafft-Ebing, R. von: A Text-book of Insanity. Translated by C. G. Chaddock. 1905.

[319] Kraepelin, E.: Psychiatrie. Sixth edition. 1899. Book Review, American Journal of Insanity. July, 1900.

[320] Kraepelin, E.: Psychiatrie. Eighth edition. Vol. 3, 1913.

[321] Kraepelin, E.: Die Erscheinungsformen des Irreseins. Zeitschrift für die gesamte Neurologie und Psychiatrie. December, 1920.

[322] Bleuler, E.: Affectivität, Suggestibilität, Paranoia. Translated by Charles S. Ricksher. New York State Hospitals Bulletin. February, 1912.

[323] Meyer, Adolf: Paranoia and Paranoid States. The Modern Treatment of Nervous and Mental Diseases. White and Jelliffe. 1913.

[324] Meyer, Adolf: Paranoia and Paranoid States. The Modern Treatment of Nervous and Mental Diseases. White and Jelliffe. 1913.

[325] Tuke, D. Hack: A Dictionary of Psychological Medicine. 1892.

[326] Spratling, William P.: Epilepsy and its Treatment. 1904.

[327] Clark, L. Pierce: Clinical Studies in Epilepsy. Psychiatric Bulletin. January, 1916.

[328] Clark, L. Pierce; Clinical Studies in Epilepsy. Psychiatric Bulletin. January, 1916.

[329] Clark, L. Pierce: Clinical Studies in Epilepsy (Concluded). Psychiatric Bulletin. January, 1917.

[330] Clark, L. Pierce: A Further Study of Mental Content in Epilepsy. Psychiatric Bulletin, October, 1917.

[331] Kraepelin, E.: Psychiatrie. Eighth edition, Vol. 3, 1913.

[332] Murray, James A. H.: A New English Dictionary. 1888.

[333] Brachet, J. L.: Traité de l'hysteria. 1847.

[334] Krafft-Ebing, R. von: Lehrbuch der Psychiatrie. Translated by C. G. Chaddock. 1905.

[335] Janet, Pierre: État mental des hystériques. Translated by C. R. Corson. 1901.

[336] Freud, Sigmund: Sammlungen kleiner Schriften zur Neurosenlehre. 1906 and 1909. Translated by A. A. Brill. 1909.

[337] Morel, Jules: The Treatment of Degenerative Psychoses. International Congress of Charities, etc., Chicago, 1893.

[338] Meyer, Adolf: Constitutional Abnormality. C. P. Obendorf. Discussion. State Hospitals Bulletin, March, 1910.

[339] Ziehen, Th.: Psychiatrie. 1911. Quoted by Hickson. Report of the Psychopathic Laboratory, etc., Chicago, 1917.

[340] Diefendorf, A. Ross: Degenerative Insanity. Reference Handbook of the Medical Sciences. 1909.

[341] Régis, E.: A Practical Manual of Mental Medicine. Translation of H. M. Bannister, 1894.

[342] Grasset, Joseph: The Semi-Insane and the Semi-Responsible. Translated by Smith Ely Jelliffe. 1907.

[343] Kraepelin, E.: Clinical Psychiatry. Translated by Thomas Johnstone. 1906.

[344] Kraepelin, E.: Psychiatrie. Eighth edition. Vol. 4, 1915.

[345] Bucknill, J. C., and Tuke, D. Hack: Psychological Medicine. Fourth edition. 1879.

[346] Tredgold, A. F.: Mental Deficiency, 1915.

[347] Goddard, H. H.: Feeblemindedness. 1914.

[348] Kraepelin, E.: Psychiatrie. Eighth edition. Vol. 4, 1915.

[349] Kraepelin, E.: Psychiatrie. Eighth edition. Vol. 3, 1913.