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Updated: May 27, 2025
Chronic nephritis, as well as acute diabetes and Addison's disease are thought by Ziehen to produce certain chronic forms of mental defect which he terms autotoxic dementia, but he regards most of these cases as really cases of arteriosclerotic dementia. It does not appear that Wernicke has considered renal correlations systematically.
This same principle is also seen in such reactions as the repetition of the question or the senseless repetition of a former answer. These phenomena remind us of what we see in epileptic confusions, in epileptic deterioration and in arteriosclerotic dementia.
Very hot baths are also inadvisable; but pleasantly warm baths, taken at such frequency as found to be of benefit to the individual, relax the peripheral circulation relieve the tension of the internal vessels, lessen the work of the heart, and promote healthy secretion of the skin, the skin of arteriosclerotic patients often being dry.
This dry skin is especially frequent if there is any kidney insufficiency, which so soon and so readily becomes a part of the arteriosclerotic process. If the patient is old, small doses of alcohol may act physiologically for good. In these arteriosclerotic patients the activities of alcohol should be considered from the drug point of view, not from that of all intoxicating beverage.
White found that about half of his cases of pulsus alternans showed an increased blood pressure of 160 mm. or more; 62 percent. were in patients over 50 years of age, and 69 percent. were in men. Necropsics on patients who died of this condition showed coronary sclerosis and arteriosclerotic kidneys.
This may occur in a previous rheumatic heart and in a heart which has suffered endocarditis and has valvular lesions, or it may occur from valvular strain or heart strain from various causes; it is typically a part of the arteriosclerotic process of age, and is then mostly manifested at the aortic valve.
Pulmonary and mesenteric tuberculosis. Of these two, XIV probably had renal arteriosclerosis and was in any case very gravely arteriosclerotic in general and suffered from cystitis. Case XV died apparently of starvation with hepatic atrophy; it is a question whether "poverty" was or was not a delusion. An attack at 39, another at 70. "Both poor wife and son will starve."
He adds that these are all too frequently the forerunners of arteriosclerotic brain degeneration. A brief mention of renal disease in the general etiology of mental disease is made by Ballet.
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