The Journal of Abnormal Psychology | ||
DR. MORTON PRINCE, Boston, read by title a paper entitled "The Theory of `Settings' and the Psychoneuroses."
DR. L. PIERCE CLARK, New York, N. Y., read a paper entitled, `The Mechanism of Essential Epilepsy."[3]
DISCUSSION
DR. E. E. SOUTHARD, Boston: Idiopathic epilepsy as found in Massachusetts material and estimated from the appearances in the gross anatomy of the brain occurs in about one of every three cases. There are accordingly more idiopathic epilepsies than there are idiopathic or "functional" psychoses, if the data of gross anatomy form a reliable index.
It was a somewhat curious thing that in a series of cases investigated by Dr. Thom and myself, that the more frequent the attacks of epilepsy the less there seemed to be to show for them in the autopsied brains. In certain cases with daily attacks the brains were strictly normal in gross appearances. It was the frankly organic cases with large focal lesions that had the occasional attacks. These frankly organic cases rarely had high frequency attacks.
DR. TOM A. WILLIAMS, Washington, D. C.: Will Dr. Clark explain the eccentric convulsions such as when there is uraemia, on similar grounds? Also, if he will postulate in such cases as recover with metabolic treatment. I have published cases in which recurrent attacks of some years duration were removed by means which considered only the metebolesia. (See Journal of Neurology and Psychiatry, March, 1915.)
DR. JOHN T. MACCURDY, New York: I have held the opinion for some years that the study of epilepsy was going to be of greater psychiatric moment than that of any other condition. I feel that this promise has been very largely
L. PIERCE CLARK: For the time being I am anxious to limit my remarks to the mechanism of essential epilepsy, and, not to convulsive disorders in general, however closely allied to idiopathic epilepsy. At some future time I hope to take up the epileptoid convulsions and show their relationship and variation from that of the mechanism of essential epilepsy. I may say, however, that I have some data already at hand in which certain types of epileptic phenomena connected with infantile cerebral hemiplegia would show that the so-called epileptic constitution is much less marked in these cases, but is present, however, to a certain degree. As has been well known for a number of years and commented upon by such observers as Gowers, Jackson and Binswanger, the so-called hemiplegic epilepsies sooner or later develop the epileptic alteration in a character analogous to that seen in idiopathic epilepsy. I hope to show that the main roots of the so-called epileptic alteration in general necessarily lie in the primary make-up of such individuals, and that the seizure phenomena of epilepsy only intensify and make more marked the fundamental make-up when the disease has definitely fastened itself upon the individual. My next paper on this whole subject will attempt to show more conclusively that the epileptic seizures are but an unfoldment of that which has already been existent in the biological make-up of the individual epileptic.
The Journal of Abnormal Psychology | ||