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Systematised insanity of persecution: with an analysis of its elements and a consideration of its pathology and medico-legal aspects

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Date
1896
Author
Macpherson, John
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Abstract
 
 
In the following description of persecution mania my object has been to present as forcibly as possible the fact that the old monomanias of suspicion, persecution, and grandeur are but stages in the development of a homogeneous disease which is known as Persecution Mania. The term 'persecution mania' is for many reasons an unfortunate one, and it is better to be accurate and to describe it as the "systematised progressive insanity of persecution, progressing from delusions of suspicion, hallucinations of hearing,and delusions of persecution with great mental distress and unrest to a period of ambition with delusions of grandeur and corresponding hallucinations, ending finally in a state of hopeless dementia". The insanity of persecution, however, is met with in individuals that do not at all come under the definition just laid down. In some it begins suddenly with symptoms of persecution, and these symptoms continue throughout the course of the malady, or perhaps throughout the life of the patient. Or it may happen, on the other hand, that at a certain period they may develop ideas of grandeur. Again it may begin with ambitious ideas which in the same way may continue during the course of the malady or throughout the life of the patient, or it may end in delusions of persecution. Or finally, the two manias of ambition and persecution may occur simultaneously in the same individual, progress side by side, alternate with each other, end abruptly, or continue during the life of the patient. The three latter forms of persecution mania only occur in a class of patients who are hereditarily degenerate, and who present the mental and physical stigmata of degeneracy. I have commenced the explanation of the subject by an analysis of the cardinal symptoms of delusional insanity, viz., the emotional affections, the intellectual disturbance and the sensory disorders. I have sketched in each of these the historical development of opinion, and the theories held by various writers as to their explanation and origin, and J have endeavoured to set forth as clearly as possible the most modern explanatory views with regard to these extraordinary mental manifestations. In Chapter II. I have described the special views of medico-psychological authors with regard to the classification of the monomanias and the various forms of mental alienation that are naturally grouped under the Insanity of Persecution. Commencing with the opinions held at the beginning of the century, I have sketched the development of the work accomplished, especially by Lasègue, Falret, and Magnan in this connection. Chapter III. deals with persecution mania proper, the systematised progressive form of the malady which is typical and includes the four stages (1) the stage of invasion, (2) the stage of general hallucinations of the senses except sight, with delusions of persecution, (3) the stage of delusions of ambition and grandeur with corresponding hallucinations, and (4) the stage of dementia of a limited and imperfect kind. In Chapter IV. a description of the mental and physical peculiarities of the degenerate is given followed by a clinical description of the various forms of persecution mania that occur in that class. These forms include (1) Folie à deux (2) the essential systematised persecution mania of the degenerate (3) the form which I have called "aggressive persecution mania" and which French Writers term "Persécuté's persécuteurs" and the Germans as "Paranoia Querelens". At the conclusion of the Chapter is described cursorily the systematised persecution insanity of Alcoholism in its acute and chronic forms. Chapter V. deals with the pathology of the disease which presents nothing that is distinctively characteristic, and the line adopted is to show as far as possible a comparison between the morbid appearances of the brain in persecution insanity of an advanced stage, and the same morbid appearances in typical insanity of a grosser and more acute kind. The second division of Chapter V. is occupied with a review of the medico-legal aspects which are of the greatest importance in this affection; and the third and last division of this Chapter refers to the treatment,, prophylactic, moral, and medical, of the subjects of this very grave malady. An attempt has been made to illustrate by Diagrams, photographs of the patients, selections from their writings and microphotographs of the microscopic appearances so far as the limited phenomena of the disease have permitted.
 
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http://hdl.handle.net/1842/35097
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