Vol. 71, 1915 - The University of North Carolina at Chapel Hill

8 THE CHARLOTTE MEDICAL JOURNAL.
relationship of mind and body. ^ overlooking the fact that the nervous
Practically speaking, however Psycho- manifestations may be, and often are
Neuroses arc disorders of the Nervous preeminently psychic in character.
System which are functional in character, fhe brain interests the average physiand
have cither a psychogenic or soma- cian only when there is hyperaemia or
togenic basis according to the inherent anemia, hemorrhage or thrombosis, mentemperament
and environment of the ingitis or tumors, but when it is affected
individual affected. In the study of them, only in its functions, the unfortunate
the interesting point for determination patient is too readily transferred to the
alienist for diagnosis and treatment.
In addition to these neuroses of purely
psychic orgin, there is undoubtedly a
tion.
small group of somatogenic neuroses that
This is no easy task, and statistics are bears important relations to chronic infections,
but in a careful examination of a
perfectly valueless upon this question,
because everything depends upon the very large number of suspected cases, extending
over some years of private and re-
"
experience and the knowledge of the
person making the diagnosis.
ferred practice, it has not been my for-
Time was, and not more than a decade tune to positively incriminate special inor
two ago, when it was the fashion to fections as directly causative of the
is the relative preponderance, as it were,
of the innate psychical or acquired physical
element in the case under considera-
describe every psycho-neurosis as a re- psychopathic conditions in as many cases
flex from some non-nervous organ, and as I expected. This has been the more
if disease, either primary or coincident, astonishing to me, because I have been
for example, of any of the thoracic ever ready to accept such a solution,
abdominal or pelvic viscera was found. The uterus and its adnexa has had the
the mental symptoms were supposed to honor of being the most frequently under
be thoroughly explained, for the medical suspicion, particularly when some form
world has no heredity of training
diagnosing nervous diseases.
Indeed, if these abnormal nervous conditions
are to be thoroughly understood,
it must be admitted that in the great
of hysterical nervousness was under consideration,
but I do not think that lesions
in this locality are any more prone to
act reflexly than lesions of other nonnervous
organs except so far as they act
majority, there is an inherent personal psychically, because every woman is only
psychopathic element that must be considered
and properly valued.
These psychopathic elements and conditions
are legion, and may occur singly,
forming an imitation of morbid entities,
such as Psychasthenia, neurasthenia,
hysteria, hystero-ncurasthenia, hypotoo
prone to believe that every uneasy
feeling is due to a uterine or pelvic disorder,
and if this opinion is confirmed
by some attending physician, it but adds
a certain satisfaction to her increasing
mental torture.
Likewise, there is no necessary relachondria,
melancholia, and conditions of tion between pelvic disease and hysteria,
nervous unbalance and degeneracy, as or pelvic disease and neurasthenia, even
well as diturbing elements in the symp- when the two affections coexist in the
tomatology of many surgical and medical same case, and while occasionally surgidiseases,
and in fact, in human suffering cal intervention may be demanded for
under all its forms and in all its degrees, other reasons, still it cannot be expected
The psychoneurotic, properly speaking, that it will be curative in a rational way
has no physical suffering; it is always of the existing nervous state
psychic, even when it results from
traumatism or an atomical lesion.
The patient himself is aware of this,
It was an old delusion that removal
of the ovaries would cure Epilepsy in
the female, but there is not a case upon
but oftentimes the physician, impressed record in which Epiplepsy has been cured
with his role as physician to the body by such an operation, or by any operaalonCj
is unmindful of these mental tion upon the female pelvic organs.
changes which are often very serious, Diseases of the male urethra, seminal
and which much more frequently than vesicles, etc., have been supposed to play
organic troubles, destroy the happiness as large a part through chronic infections
of individuals and of families.
in the causation of psychoneuroses as the
Instead of interesting himself in the pelvic . lesions and infections of the femental
life of his patient, the physician male, but the one belief seems as much
is frequently found hunting among the due to defective observation as the other,
different organs of the body for the cause The absorption of toxins from the
of all these psychic and nervous troubles, blood in some of the exhausting diseases