Acute Intestinal Obstruction in Infancy and Childhood: Congenital Abnormalities: Acquired Causes: Treatment

Abstract

SECTION OF DISEASES OF CHILDREN.had generalized from one case. It was a commonplace in psychiatry to-say that eaeh easee wa an d i-dvidual problem, butinstead of accepting this DrW. Iu4ti6r is-aid, 'Here is;one eases see the sbrilliant esuIt aocorgpisie.d; there mu.t be hundreds like it." Take 'the case -which Dr. Hunter had quoted with so 'much enthusiasm and commendation. SNot only' was it imnperfectly described, but it was diagnosed as a-septic psychosis:" In the speaker's opinion the case would be more accurately described as one of agitated depression occurring at the involutional period, and( i-f it had been properly recognized at first the patienit would never have been sent to the chronic ward. The course of the illness was quite in accord with psychiatric experience, and the increased attention, the c~hange to better surroundings, and the building up of resistance lhad as much to do witlh recovery as the removal of her teethi. To say that the failure to remove the teeth in the first instance caused the patient's detention inl hospital for two years was an unw-arrantable assumption. Similarly in Dr. Hunter's second case, witlh its acute onset, tempestuous course, and recovery with good insight, a good prognosis would have been given, and tle operative p ecedures were merely concomitant. Dr. Hunter had attempted to coin a new psyclhiatric term;for many years psychoses with toxins and infectionis had been recogniized, anid such a term as " septic psychosis " was not required. To -divide all psychoses into the septic and the otlhers was not permissible on the actual facts.It was very dangerous to state that because something existed in a given mental case that something was the specific agent. If in some half a dozen cases there was a B. coli or streptococcal infection which had not giveni r'ise to clinical symptonms pointing to a toxic involvement, such a factor was merely incidental, and might or might riot have any influence on the course of the psychosis. Dr.Hunter had given no clinical picture of the disease which he had named " septic psychosis." It was important to investigate all the facts careftlly in every case, and not to jump to conclusions. Many a' healthy abdomen had been mutilated, and many a serviceable tooth removed as the result of ill-grounded theories of the etiology of mental illness.Dr. W. F. MENZIFS (Cheddleton) agreed witlh Dr. Henderson, anid said that the evidences of clhroniic sepsis were no more frequent in the insane than in the sane. Sepsis was as a rule a secondary cause of meiital disorder.The hypothesis that sepsis wats an important cause of mental illness was not new; fortv years ago colonic lavage and Bouchard's mixture of inaphthaline, char coal, and glycerin were popular in the asylumiis. As long ago as 1902 he had asked a surgeon to perform a short-circuiting operation in a patient with dementia praecox. The recovery rate hald niot been materially raised by antiseptic measures.Autogenous vaccines were disappointing. The results of serological, metabolic, anid enidocrinol...