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In fact we really found only 6 out of 58 cases of pure allopsychic delusions, which could be safely taken as showing so much coincidence between anamnesis and delusions that a correlation could be risked. Following the method of our former work on somatic and on environmental delusions, we sought in the first instance PURE cases of autopsychic delusion-information.
In short, we seemed to show that environment is seldom responsible for the delusions of the insane. Be that as it may, we secured several lines of attack on the delusions of personality by our study of quasi-environmental delusions. It is interesting to inquire, accordingly, whether our more obviously autopsychic cases will also be possessed of an unpleasant tone.
Suggestion that allopsychic delusions are as a rule in some sense autopsychic. Work on fifth-decade psychoses. Statistical summary. Three cases of senile dementia, delusions of grandeur, and frontal lobe changes. Three cases with religious delusions. Remainder of pleasant-delusion group. Group with unpleasant delusions. Nephrogenic group.
Put briefly, the deluded patient is more apt to divine correctly the diseases of his body than his devilments by society. Our statistical analysis, therefore, set us drifting toward disorder of personality as the source of many delusions apparently derived ab extra and tended to swell the group of autopsychic cases at the expense of the allopsychic group,
Danvers autopsy series, unselected cases 1000 Cases with little or no gross brain disease 306 Cases listed as having autopsychic delusions 106 Cases listed as having only autopsychic delusions 50 Cases for various reasons improperly classified 13 Cases of general paresis in which gross brain lesions were not observed 15 Residue of autopsychic cases 22
After orientation questions she might say “This is this is this is ” all this, together with a rather perplexed appearance, gave the impression of considerable bewilderment, but at no time did she complain of autopsychic perplexity.
One genetic hint was obtained from a correlation of delusions with lesions in general paresis, in which disease perhaps the most profound and disastrous of all alterations of personality are found. Amidst the other alterations of personality found in paresis, autopsychic delusions are characteristic: indeed allopsychic delusions are conspicuously few in our series.
Of these, 106 had autopsychic delusions and of these 106, 50 cases had delusions of no other sort. 15 of these 50 cases appeared to have been cases of General Paresis in which gross brain lesions were not observed at autopsy, and upon investigation 13 other cases were found to be, for various reasons, improperly classified.
The residue of 22 cases was subject to analysis and readily divides itself into two groups of 11 cases each, or two groups of normal-looking brain cases having autopsychic delusions and these only are cases which may be termed the "pleasant" and "unpleasant" groups, in the sense that the delusions in the first group were either pleasant or not unpleasant, whereas the delusions in the second group were of clearly unpleasant character.
Now it was precisely the cases with autopsychic delusions, as well as with profound disorder of personality in general, that showed the brunt of the destructive paretic process in the frontal region. The other not-so-autopsychic cases did not show this frontal brunt, but were less markedly diseased at death and had a more diffuse process.
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