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CHAPTER Ⅰ INTRODUCTION1

The Foundations of Psychiatry1

Diagnosis6

The Field of Psychiatry8

Psychiatry and Medicine9

Psychiatry and Sociology9

Psychiatry and Psychology10

Contemporary Schools of Psychiatry12

Kraepelin＇s System and its Influence12

Wernicke and the Cerebral Localizers14

Psychobiology15

Psychoanalysis16

The Multidimensional Approach24

CHAPTER Ⅱ EXAMINATION OF THE PSYCHIATRIC PATIENT31

Introductory31

History35

Mental State37

Scheme for Case-Taking39

History39

Mental State41

Examination of Non-co-operative or Stuporose Patients43

Schema for the Examination of Organic Cases45

CHAPTER Ⅲ MENTAL DEFICIENCY53

Definitions and Classifications53

Incidence55

Aetiology and Pathology55

Genetical Aspects of Mental Defect55

Aetiology and Pathology other than Genetical64

Clinical Features68

Early Diagnosis68

Disorders of Development69

The Feeble-Minded (Moron)71

The Low-Grade Mental Defective (Imbecility)75

Idiocy77

Special Forms of Mental Deficiency78

Other Forms of Mental Defect with a Definite Pathology81

Diagnosis and Differential Diagnosis84

Prognosis86

Treatment87

Prevention87

Treatment and Training89

CHAPTER Ⅳ PSYCHOPATHIC PERSONALITY AND NEUROTIC REACTIONS91

Historical Development of the Concept of Psychopathy91

Modern Development of the Concept of Psychopathy94

Aetiological Aspects of Constitution98

Heredity98

Somatic Factors102

Psychological Factors104

Pathological Factors105

Special Forms of Reaction and of Personality109

The Depressive Reaction109

The Neurasthenic Reaction114

The Anxiety Reaction117

Hysteria123

Anorexia Nervosa138

Obsessional States140

Irritability150

Hypochondriasis154

The Paranoid Reaction157

The Unstable Drifter164

The Cold and the Emotionally Callous166

The Sexually Perverse169

Psychological Treatment of Neurosis and Psychopathy181

Group Therapy184

CHAPTER Ⅴ AFFECTIVE DISORDERS187

Definition187

Incidence and Aetiology187

Basic Personality190

Precipitation191

Physical Constitution191

Pathology and Psychopathology193

Clinical Picture196

Affective Constitutions196

Affective Psychoses197

Course and Prognosis206

Diagnosis and Differential Diagnosis208

Treatment211

CHAPTER ⅥSCHIZOPHRENIA218

Definition218

Incidence219

Aetiology and Pathology219

(1) Heredity219

(2) The Schizoid Constitution221

(3) Endocrines223

(4) Metabolism224

(5) Central Nervous System225

(6) Precipitation226

Psychopathology230

(1) Disturbance of Thinking231

(2) Disturbance of Emotions234

(3) Disturbances of Volition235

(4) Catatonic Symptons236

(5) Primary Delusions237

(6) Hallucinations238

Occurrence of Symptoms：General Qualities240

Clinical Picture242

(1) Simple Schizophrenia242

(2) Hebephrenic Schizophrenia244

(3) Catatonic Schizophrenia248

(4) Paranoid Schizophrenia252

(5) Atypical and Mixed Clinical Pictures258

Outcome262

Residual States，Deterioration，Death262

Course and Prognosis264

Pointers of Prognostic Significance268

Diagnosis and Differential Diagnosis270

Diagnostic Value of Symptoms271

Differential Diagnosis275

Treatment277

(1) Prophylaxis277

(2) Psychological and Social Treatment280

(3) Physical Treatment283

CHAPTER Ⅶ SYMPTOMATIC PSYCHOSES291

Aetiology and Pathology291

Clinical Picture294

(1) General294

(2) Special Clinical Features in Various Physical Conditions298

Course and Prognosis315

Diagnosis and Differential Diagnosis315

Treatment316

CHAPTER Ⅷ CHEMICAL INTOXICATIONS AND ADDICTIONS318

Anoxaemia318

Carbon Monoxide Poisoning320

Chronic Carbon Monoxide Poisoning322

Cyanide323

Industrial Intoxications323

Lead323

Mercury324

Manganese324

Arsenic324

Other Industrial Poisons325

Alcohol and Alcoholism325

Incidence326

Aetiology and Pathology329

Clinical Picture331

The Diagnosis of States of Alcoholic Aetiology342

Treatment343

Ether347

Sedative Drugs：Bromides and Barbiturates347

Bromides348

Barbiturates349

Amphetamine351

Morphine352

Cannabis356

Cocaine359

Mescaline361

CHAPTER Ⅸ THE EPILEPSIES365

Definition365

Physiological Basis366

Incidence369

Aetiology369

Heredity370

Associations372

Clinical Manifestations374

Major Epilepsy (Grand Mal)374

Petit Mal377

Mood Changes378

Psychomotor Attacks，Automatisms，Twilight States and Fugues379

Epileptic Psychoses382

Personality Deterioration and Dementia383

Differential Diagnosis386

Treatment388

CHAPTER Ⅹ MENTAL DISORDER IN TRAUMA，INFECTION AND TUMOUR OF THE BRAIN392

Introductory392

Psychological Changes Produced by Organic Brain Disease393

Clouding of Consciousness393

The Dysmnesic Syndrome394

Dementia394

The General Behaviour of the Patient with Organic Disease of the Brain396

Injuries of the Brain398

Aetiology and Pathology398

Mental Symptoms in the Acute Stage399

The Convalescent Stage401

The Chronic Stage402

Differential Diagnosis409

Prognosis and Treatment410

Meningitis412

Acute Meningitis412

Tuberculous Meningitis412

Encephalitis413

Sub-acute Encephalitis414

Epidemic Encephalitis415

Paralysis Agitans418

Hepato-lenticular Degeneration (Wilson＇s Disease)419

Syphilis of the Central Nervous System419

Psychological Reactions to Infection419

Mental Changes in the Primary and Secondary Stages420

Meningo-vascular Syphilis420

Parenchymatous Syphilis422

Prognosis and Treatment of Neurosyphilis427

Cerebral Tumour429

Incidence429

General Features431

Focal Symptoms432

Diagnosis441

Aids to Diagnosis443

Treatment444

Cerebral Abscess444

Disseminated Sclerosis444

Diagnosis446

Treatment446

CHAPTER Ⅺ AGEING AND THE MENTAL DISEASES OF THE AGED448

General Aspects448

Dementia in Middle Age455

The Significance of Presenile Dementia455

Alzheimer＇s Disease457

Pick＇s Disease460

Jakob-Creutzfeldt＇s Disease462

Huntington＇s Chorea463

Presenile Dementia with Cerebellar Atrophy467

Dementia due to Thalamic Degeneration468

Kraepelin＇s Disease468

Schilder＇s Disease468

Marchiafava＇s Disease468

Other Forms of Presenile Dementia468

Investigation and Differential Diagnosis of Dementia in Middle Age470

Mental Disease in Old Age473

Introduction473

The Natural History of the Five Main Groups of Old-Age Mental Disorder475

Affective Psychosis478

Senile Psychosis482

Psychoses due to Cerebrovascular Disease485

Aetiological Aspects485

Morbid Anatomy489

Clinical Picture490

Diagnosis494

Treatment494

Cerebral Thromboangiitis Obliterans496

Other Cerebrovascular Syndromes498

Delirious States498

Late Paraphrenia501

Suicide in Old Age502

General Management of Old Patients504

CHAPTER Ⅻ CHILD PSYCHIATRY507

Introductory507

Incidence：Child Psychiatric Services509

Psychiatric Examination of the Child510

Mental Deficiency511

Psychoneurotic Reactions and Psychopathic Personalities512

The Parent-Child Relationship513

Single Psychopathic Symptoms514

Depressive and Neurasthenic Reactions530

Fear Reactions and Anxiety530

Hysteria531

Irritability533

Obsessional-Compulsive States534

Affective Psychoses535

Schizophrenia536

Symptomatic Psychoses and Psychological Reactions to Physical Illness538

Epilepsy and Other Organic Conditions540

Epilepsy540

Encephalitis542

Early Dementias542

Focal Symptoms543

CHAPTER ⅩⅢ ADMINISTRATIVE AND LEGAL PSYCHIATRY545

Voluntary Treatment545

Procedure Governing Commitment548

England and Wales548

Scotland and Ireland550

Scandinavian Countries551

Switzerland，Germany and Austria553

Other European Countries554

United States of America556

Considerations for Reform of Present Procedures557

Mental Deficiency559

Boarding-out and Guardianship560

The Organization and Administration of Psychiatric Services562

The Mental Patient in Civil Law563

Marriage and Divorce564

Sterilization565

Criminal Responsibility567

England567

Scotland571

United States of America572

Scandinavian Countries574

Other European Countries576

Possible Improvement of the British System577