Goldsol test in mental disease
Bedford, Percy William Page
The increasing prevalence of the plea of insanity in criminal prosecutions, and the frequency of its failure as a defence, would seem to indicate that there are mental diseases from the Medical standpoint which are not equivalent to the legal status of insanity.According to Southard, of 119 cases diagnosed as General Paralysis, post -mortem examination showed a diagnostic error of 26%.It follows that the diagnosis of the form of Mental disease may become a social function of the greatest delicacy, and the margin of error a matter of very great importance.General Paralysis is often very difficult to diagnose, and the responsibility of coming to a decision is not lessened by the fatal character of the disease.It is a problem in the present tense and impera- tive mood.Robertson puts the case very clearly in his Morison Lectures. He says - "In_ the whole field of psychological Medicine there is still not a more responsible problem, nor one requiring the exercise of more prudence and caution, than the early and definite diagnosis of General Paralysis. The anxiety produced by this uncertainty (of diagnosis) was often very trying, and, when important matters are at stake, it has been found so intolerable that the skull has been trephined and a small portion of the cortex removed and examined microscopically to settle the question one way or another."Nowadays such heroic measures are uncalled for. The modern method of diagnosis consists of the clin- ical examination of the patient in the usual way, supplemented, but not supplanted, by the laboratory examination of his spinal fluid. For laboratory tests have come to play a greater guiding part in the diagnosis and treatment of syphilis than in that of any other bacterial disease.If anyone had been able to devise a less intricate test for the recognition of active Syphilis in all its stages, the Wassermann Reaction would never have survived to the present day.The general utility of any test, and in a measure its reliability, is determined chiefly by the simplicity of its unspecialised technique. It is from this point of view that I have made the Goldsol test the subject of my thesis; for any simple test which promises increased precision in diagnosis is worthy of that careful investigation which is the half -way house to knowledge.As will be shown later, the Goldsol Test is more delicate than the Wassermann'Reaction, cell count, or globulin estimation, and the margin of error quite small. Its technique is so simple that the performer cannot make a mistake without bringing the most ingenious carelessness to his aid.