In the mid years of life, between forty and sixty, a decline begins,
which in the older years results in decay; it is especially true at
this period of the sexual life and the organs underlying it. While
these organs undergo a very definite change constituting the so-called
climacteric period in women, it is not at first sight so evident in
men; however, the evidence is that a somewhat similar process, though
much slower, tends to occur in the male. Associated with the decay
of the sexual organs is a disturbance presumably of the internal
secretions; if this latter disturbance takes place slowly and evenly
the body may not notice any marked changes; on the other hand, if it
takes place more quickly, or unevenly, it may give rise to distinct
symptoms which indicate a disturbance of the nervous system in general
and often even of the mentality. Hence, the significance of the term,
Involutional Psychosis. In a large majority of cases the mental
disorder is marked by the dominance of depression and is frequently
referred to as melancholia. For a long time it was considered that
this represented a special mental disorder having little or nothing
in common with other psychoses. In recent times Dumas has studied
this group very carefully and shown that it in reality has very much
in common with the depressed phases of the Manic Depressive Group of
psychoses. Kraepelin himself, who was the first to demonstrate the
unity of the Manic Depressive Group, has accepted the conclusions of
Dumas and incorporated the Involutional Depressions as a sub type of
his Manic Depressive Psychosis. Among etiologic factors have been
mentioned hereditary elements, which have been claimed to have been
found in at least fifty per cent of all cases, forming presumably a
predisposition; it is also stated that a predisposition may be acquired
through various debilitating causes. Exciting factors are claimed
to be present, such as mental shock, grief, worry and the like. The
disease would then seem to occur when we have a combination of exciting
factors and predisposition. Careful consideration will show, however,
that no such mental disturbance occurs at this age in many people
who show evidences of such predisposition and of exciting factors,
therefore it would seem that still other causes were necessary; if
we consider the suggestion above mentioned that there are atrophic
processes taking place in the sexual glands leading to a loss of the
internal secretions and if we further consider that this may take
place unevenly and in an unbalanced way, thus aiding in giving rise
to the symptoms, we will find a definite point of contact for the
osteopathic conception. Osteopathically considered, we may say that
the spinal lesions lead to a disturbance of innervation and nutrition
to the ductless glands, and therefore produce disordered secretions in
those patients developing the disease, whereas such a condition may
not be present in others who at the same age period do not develop the
psychosis.