On Post-Epileptic States: A Contribution to the Comparative Study of Insanities. First and Second Installment. (all publ.)

Jackson, John Hughlings

Data di pubblicazione: 1888

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J. Ment. Sc., 34. - Kewes, H. Wolff, Printer, High Street, Oct. 1889, 8°, 17 pp.; Jan. 1889, 10 pp., 2 orig. wrappers in fine card board. Offprint! John Hughlings Jackson (1835-1911) "considered the behavioral changes during the postictal period as a key to understanding psychiatric disorders. By 1889 when he wrote his classic paper "On Post-epileptic States: A Contribution to the Comparative Study of Insanities," =* post ictal behavioral changes were receiving increased attension *." Jackson reversed his early (1867) belief that epileptic mania was the direct result of an epileptic discharge from some portion of the brain. Initially, he considered that in some cases of true mania a prior seizure is not witnessed and the mania occasionally "replaces" a fit. However, he later (1873) stated that "The duplex condition is found . . when the discharge is over. The mental Automatism is one of the indirect results of the (epileptic) discharge" *. Jackson explained postepileptic states and other mental disorders by a model in which the highest centers, the "organ of mind," were composed of four theoretical layers (which he did not believe corre sponded to layers of cerebral cortex). Thus, after a seizure all the cells involved in the discharge tempo rarily lost their function. This transient lesion led to the production of both positive and negative symptoms *. Negative symptoms included the paralysis noted by Robert Todd years earlier and, in severe cases, coma. Jackson proposed that if the first layer of the highest center were to discharge, its exhaustion would lead to "dissolution" of the second layer, which would remain active and would be expressed due to its loss of inhibition or modulation by the higher layer. He wrote: Thus in the first degree of post-epileptic states the patient's then highest layer is the second layer of his normal highest centres, and his mentation is correlative with activities of that layer. What we call the insane man's extravagant conduct displays his Will; what we call his illusions are his Perceptions (Memory); what we call his delusions are his beliefs (his Reasoning); and what we call his caprice is evidence of his Emotional change.* While the functional loss of the first layer might lead to impairment of consciousness, temporary lesions of the second layer would lead to loss of consciousness and the subsequent expression of the third and fourth layers, which could resemble insanity to the observer. Thus, deprived temporarily of his or her highest faculties, the patient would unconsciously express lower level automatisms, which could consist of relatively complex behaviors ranging from the harmless to the homicidal: In the process of slow re-evolution, during return to complete consciousness after slight fits, there are really often actions which are little heeded as post-epileptic states; the patient may take out his watch, look at his papers, ask what day it is, what o'clock it is, etc. (reorientation).*" Shawn L. Masia & Orrin Devinsky: Epilepsy and Behavior: A Brief History. Epilepsy & Behavior 1 (2000): pp.37-36.

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• Titolo: On Post-Epileptic States: A Contribution to the Comparative Study of Insanities. First and Second Installment. (all publ.)
• Data di pubblicazione: 1888
• Rilegatura: Brossura
• Cataloghi dei venditori:
  • Neuroscience