FORMS OF NEUROSIS
A brief outline of a classification of nervous and mental diseases,
made by me in my various works, may be of help towards a clear
understanding of neurotic disturbances.
The different forms of nervous and mental diseases may be
classified into _Organic_ and _Functional_.
By _organic_ affections I mean to indicate pathological
modifications of the neuron and its processes taking place in the
very structure (probably the cytoreticulum) of the nerve cell.
Under this category come such maladies as general paresis, dementia
praecox, all mental and nervous affections of a degenerative
and involutionary character. Such diseases are termed by me
_Organopathies_, or _Necropathies_.
By _functional_ affections I mean to indicate all neuron changes
in which the functions of the neuron and its reactions to external
and internal stimulations are involved in the pathological process
without, however, affecting the anatomical structure of the nerve
cell. The pathological changes are not permanent,--recovery of
normal function is possible with the restitution of favorable
conditions of nutrition and elimination.
Functional nervous and mental diseases are in turn subdivided into
_Neuropathies_ and _Psychopathies_.
Neuropathic diseases are disturbances of functioning activity,
due to defective neuron matabolism, brought about by external
stimuli, and more specially by harmful internal stimuli--glandular
secretions, hormones, toxic and autotoxic agencies. The
pathological, neuropathic process produces few, if any anatomical,
changes in the structure of the neuron. The pathology of
neuropathic diseases, (probably of the cytoplasm) is essentially
_chemico-physiological_ in nature.
Neuropathic diseases include maladies in which the neuron undergoes
degenerative changes. At first there is an apparent increase,
then an inhibition, and finally a complete suspension of neuron
function, not terminating in the destruction of the neuron. Neuron
restitution is possible.
Such affections are produced by mild poisons, organic,
or inorganic, by autotoxic products, by hyposecretion or
hypersecretion, or by absence of hormones in the economy of the
organism. Here belong all the temporary, or recurrent maniacal,
melancholic, delusional states, puerperal mania, epileptic
insanity, the mental aberrations of adolescent and climacteric
periods, periodic insanity, alternating insanities, and in
general all the mental affections known under the description of
manic-depressive insanity.
Where the disease depends on the _interrelation_ of neurons in
a complex group, on _association of systems_ of neurons, the
condition is _psychopathic_ in nature.
In psychopathic troubles the neuron itself may remain unaffected,
may be perfectly normal and healthy. The disorder is due to
association with systems of neurons which are usually not called
into action by the function of that particular neuron system.
By _Organopathies_ or _Necropathies_ I indicate a group of
psychophysiological symptoms, accompanied by structural, necrotic
changes of the neuron, terminating in the ultimate death of the
neuron systems, involved in the pathological process.
By _Neuropathies_ I indicate a group of psychophysiological
manifestations due to pathological functional neuron modifications,
capable of restitution through normal metabolism.
By _Psychopathies_ I designate pathological phenomena of
psychophysiological dissociation and disaggregation of neuron
systems and their functions in clusters, the neuron itself and its
special function remaining undamaged.
The psychopathies are further subdivided into _Somatopsychoses_
and _Psychoneuroses_ or _Neuropsychoses_.
The _Somatopsychoses are characterized by somatic symptoms_, by
disturbances of bodily functions, such as paralysis, contractures,
convulsions, anesthesia, analgesia, hyperalgesia, and other sensory
disturbances, as well as by intestinal, cardiac, respiratory, and
genito-urinary troubles.
The _psychoneuroses or Neuropsychoses are characterized by mental
symptoms_. The patient’s whole mind is occupied with mental
troubles.
Such conditions are found in obsessions, fixed ideas, imperative
impulses, emotional compulsions, and other allied mental and
nervous maladies.
Somatopsychoses simulate physical and organic nervous troubles.
Thus, many “hysterical” forms simulate tabes, or paralysis
agitans, hemiplegia, paraplegia, or epilepsy, while many of the
neurasthenic, hypochondriacal, and their allied states may simulate
tumor, cancer, intestinal and glandular derangements, cardiac,
laryngeal, pneumonic, hepatic, splanchnic ovarian, tubal, uterine,
renal, and other bodily afflictions.
The neuropsychoses or psychoneuroses simulate all forms of mental
disease, beginning with melancholia and mania, and ending with
general paresis and dementia.
_Psychoneurosis_ and _somatopsychosis_ are diseases of the
subconscious; in the former mental, in the latter physical symptoms
predominate.
_Psychopathic states should be rigidly differentiated from
other disturbances, such as neuropathies and organopathies, or
necropathies._ The following diagram may be of help:
[Illustration: _Nervous and Mental Diseases_
DIAGRAM I]