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Daniel's Conc. Tr. Passiflora
Incarnata is the truest Remedy
for the nervous diseases of Women
and Children. In suppressed
Menstruation, Dysmenorrhea, and
nervousness arising from over-
work, or complications in the Fe-
male sex Passiflora asserts its
supremacy as a nerve calmative.
In convalescence from La Grippe
and Malarial Fever it gives rest to
the tired nerves and nourishment

to famished organs.

Unlike the

Opiates, its effects are natural, and
therefore healthful.

WRITE FOR LITERATURE.

SAMPLES SUPPLIED PHYSICIANS PAYING EXPRESS CHARGES.

LABORATORY OF

JNO. B. DANIEL,

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is lost if the quality of the blood is poor. Build up the quality of the blood by increasing the amount of Hæmoglobin and the number of red corpuscles, and like the force of Niagara, the power of the blood to build new tissue and repair waste will be tremendous.

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53 Warren Street, NEW YORK.

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DEERING J. ROBERTS, M.D.

EDITOR AND PROPRIETOR

Vol. XXVI.

NASHVILLE, JUNE, 1904.

No. 6

Original Communications.

THE RELATION OF THE GENERAL PRACTITIONER TO INSANITY.*

BY M. CAMPBELL, M. D., OF KNOXVILLE, TENN.

When I was requested by your Committee to prepare a paper on the above subject, I complied very willingly, because I consider it unfortunate that there is a disposition on the part of the majority of the general practitioners to neglect the study of insanity more than any other department of medicine. This doubtless arises from the difficulty of treating the disease elsewhere than in a hospital especially fitted for the reception of the insane. The insane are more cheerfully turned over to the specialist, than those suffering from any other form of disease. However true this may be, I do not think the reason is sufficient

*Read at the Annual Meeting of the Tennessee State Medical Association, April 14, 1904.

for neglecting the study of so serious and common a disease. The prevention of disease is more important than its cure; especially is this true of insanity, and it goes without saying that without a knowledge of its causes, the immense influences of the general practitioner in preventing this disease will be lost. Then too, the physician, who in a given case of mental disease is able to make a diagnosis and prognosis, and order a line of treatment, will find his knowledge to his own advantage, as well as to his patients; to the patients, if for no other reason than that it is often impossible to get them admitted in a hospital.

The diagnosis and prognosis of insanity, in the majority of cases, is not more difficult than in other forms of disease. As a first requisite, some knowledge of classification should be obtained. The classical mania, melancholia, and dementia, of course is familiar to you all. The objection to this classification is that it does not include in its three groups, all forms of mental disease, and that it is symptomatic only, telling nothing of the underlying pathological conditions; these conditions may, in one case, produce the symptom of mania and, in another, that of melancholia, or they may alternate; and further, the symptoms of mania and melancholia may indicate different pathological conditions, one kind curable and another not. Nevertheless, the terms are useful, and should not be abandoned.

The limits of this paper will not permit me to go into an exhaustive classification that will include all forms of insanity, but I wish to call your attention to certain prominent groupings, that as a rule are easily recognized.

We have then, simple mania, characterized by excitement, insomnia, volubility and restlessness, with rapid ideation, and usually delusions.

Melancholia simplex, characterized by profound depression, slow ideation, with delusions of unworthiness and impending disaster.

Melancholia agitata, in which there is accompanying the depression, agitation and motor excitement.

Acute and terminal dementia, characterized by stupidity. Allied to acute dementia is confusional insanity, lacking in the excitement of mania or the depression of melancholia.

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