PREFACE

Interest in mental disorders is no longer confined to the relatively small number of persons whose duties or family ties bring them into daily contact with the mentally ill. Disorders that so profoundly affect human conduct were certain, sooner or later, to attract the attention of those who are interested in the study of human behavior in its broadest relations or who have special responsibilities with reference to the conduct of individuals and require all the information that they can secure on factors that modify the reactions of men, women or children in the social environments in which they live and die. Uncertain of themselves until they made sure of the sciences upon which their future work was to develop, social workers since the commencement of organized social work in this country demanded of the sciences concerned with the human mind some information that might aid them in dealing with the difficult problems in human adaptation which they found constituted the chief part of social work. Judges and those who are interested in penology have within recent years turned also to the students of abnormal human behavior for light upon problems of crime and delinquency. With mental hygiene becoming firmly established as a practical field of preventive medicine, another group of persons not directly concerned with the care of the mentally ill has become deeply interested in the forms, types and causes of mental illness. It is by such readers, quite as much as physicians, medical students and nurses, that Dr. May's work in bringing together the main facts regarding mental diseases and the people who suffer from them will be appreciated. For those whose interest in the subject is incidental and not part of a life-long study, the information here presented will be of special value. There are, it is true, many technical works on mental diseases in their medical, social and legal relations, but it is doubtful whether elsewhere there can be found in a single volume as much varied information as that which Dr. May has brought together.

There is probably no group of diseases about which there is such widespread popular ignorance or misinformation as those that affect the mind. People who would be ashamed not to have accurate information regarding the more important infectious diseases and more than general knowledge of the means by which they are transmitted speak of "insanity" as if there were a single disorder to which that name could properly be applied, and are without the slightest knowledge of the different forms of mental diseases, the periods of life in which they appear, their main characteristics and the means by which they terminate. Statistics relating even to those persons with mental disorders who are cared for in special institutions are usually quite unfamiliar to persons who have more than an ordinary amount of information regarding the prevalence of other diseases. Such a book as this will go far toward supplying the extraordinary lack of knowledge of conditions that have exceedingly important social and economic relations and from the study of which many lessons can be drawn that are applicable to human affairs far removed from those relating to patients in our hospitals for the insane.

Thomas W. Salmon.

Larchmont, New York, January 11, 1922.

CONTENTS

PART I. GENERAL CONSIDERATIONS.

CHAPTER PAGE

I. The Social and Economic Importance of Mental Diseases 15

II. The Evolution of the Modern Hospital 34

III. Legislation and Methods of Administration 50

IV. The State Hospitals—Their Organization and Functions 68

V. The Hospital Treatment of Mental Diseases 84

VI. The Development of the Psychopathic Hospital 104

VII. The Mental Hygiene Movement 121

VIII. The Etiology of Mental Diseases 138

IX. Immigration and Mental Diseases 155

X. Mental Diseases and Criminal Responsibility 169

XI. The Psychiatry of the War 185

XII. Endocrinology and Psychiatry 202

XIII. The Modern Progress of Psychiatry 217

XIV. The Classification of Mental Diseases 234

PART II. THE PSYCHOSES

I. The Traumatic Psychoses 253

II. The Senile Psychoses 266

III. The Psychoses with Cerebral Arteriosclerosis 280

IV. General Paralysis 293

V. The Psychoses with Cerebral Syphilis 308

VI. The Psychoses with Huntington's Chorea, Brain Tumor and other Brain or Nervous Diseases 323

VII. The Alcoholic Psychoses 344

VIII. The Psychoses Due to Drugs and other Exogenous Toxins 363

IX. The Psychoses with Pellagra 378

X. The Psychoses with other Somatic Diseases 392

XI. The Manic-Depressive Psychoses 409

XII. Involution Melancholia 427

XIII. Dementia Præcox 440

XIV. Paranoia and the Paranoid Conditions 461

XV. The Epileptic Psychoses 475

XVI. The Psychoneuroses and Neuroses 489

XVII. The Psychoses with Psychopathic Personality 504

XVIII. The Psychoses with Mental Deficiency 524

Index 537