Lectures on Clinical Psychiatry

"All those who have at any time given clinical demonstrations on disease must have felt the desire to impress more firmly on their hearers the remembrance of what they have seen than is possible in an ordinary lecture. After many attempts to arrive at this in some other way, I have now tried to preserve, in a measure, the impressions of a term’s clinical work in the form of the lectures contained in the following pages. In my descriptions I have endeavoured, as far as possible, to follow the actual course of the lectures. Naturally, not only must this work give up all claim to the actual presentation of the patients, for which the student can only be compensated by personal experience in the hospital, but we must also forego the great help to teaching afforded by the assistant’s little awkwardnesses and blunders, which so often serve to point out to the teacher the right method of instruction. On the other hand, the material can in this way be worked up more concisely, more systematically, and more completely than is generally possible in the hospital.



In these lectures I have always kept the diagnostic point of view in the foreground, being convinced of its fundamental importance, not only to our scientific ideas, but also as affecting the advice we shall have to give in our medical practice, and the methods of treatment to be adopted by us. In my opinion, what the student ought to learn in the hospital, besides the examination of patients, is not text-book knowledge, which he can acquire just as well, or better, at home, but how to turn his observations to account, and the careful judgment of any given case. These lectures, then, must not in any way be looked upon as a textbook of alienism. Their aim will be far better attained if they prove of some value as a guide to the clinical investigation of the insane.



The examples of disease, which for obvious reasons have been taken from entirely separate years, and some of which have been utilized elsewhere, do not profess in their brief outline to be scientific records. Nevertheless, each individual case is delineated with the greatest possible truth to life, while the diagnostic developments are almost entirely taken directly from notes upon clinical demonstrations. Inquiries as to the further history of the patients were carried on, as far as possible, up to going to press, and, for the most part, were only added after the whole was complete."



This classic includes the following chapters:



I. Introduction: Melancholia

II. Depressed Stages of Maniacal-Depressive Insanity (Circular Stupor)

III. Dementia Praecox

IV. Katatonic Stupor

V. States of Depression in General Paralysis

VI. Epileptic Insanity

VII. Maniacal Excitement

VIII. Mixed Conditions of Maniacal-Depressive Insanity

IX. Katatonic Excitement

X. Megalomania in General Paralysis

XI. Alcoholic Mental Disturbances

XII. Insanity in Acute Diseases

XIII. Varieties of Delirium

XIV. Puerperal Insanity

XV. Paranoia, or Progressive Systematized Insanity

XVI. Paranoidal Forms of Dementia Praecox

XVII. Different Forms of Delusions

XVIII. Chronic Alcoholism

XIX. Morphinism and Cocainism

XX. Final Stages of General Paralysis of the Insane

XXI. Final Stages of Dementia Praecox

XXII. Dementia From Coarse Brain Lesions

XXIII. Senile Dementia

XXIV. Epileptic Feeble-Mindedness

XXV. Hysterical Insanity

XXVI. Insanity After Injuries to the Head

XXVII. Irrepressible Ideas and Irresistible Fears

XXVIII. Congenital States of Disease

XXIX. Morbid Personalities

XXX. Morbid Criminals and Vagabonds

XXXI. Imbecility-Idiocy

XXXII. Cretinism—Concluding Remarks