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Updated: June 1, 2025
The existence of such species of insanity is not difficult to discover. The second and more common form of insanity, and that which it is often difficult to discover and pronounce upon with certainty, is that which I have called delusional or illusional.
Our conclusions are also influenced by two analyses of the types of delusion found in general paresis. Moreover, at a period subsequent to the analysis presented here, some work on fifth-decade insanities had been completed, and the delusional features constantly found in the functional cases of insanity developing at the climacteric, entered to modify our general point of view.
Her blood pressure was taken with a Riva Rocci Sphygmomanometer morning and evening, sometimes oftener, during the greater part of 1912-13, and it was noted that her depressed or delusional states were marked by a low pressure, while a high or relatively high pressure marked her sane and cheerful states, contrary to what is usually observed in melancholia, though similar to what is seen in agitated melancholia and mania.
Case VIII should be excluded as probably not delusional. Case X might perhaps be transferred with propriety to the unpleasant-delusion group. These subtractions leave seven cases to deal with. Three of these seven, viz. I, II and III, are apparently best regarded as examples of frontal lobe atrophy, and their grandiosity may resemble that of certain cases of general paresis.
There then seems to be more reality about somatic than about personal delusions: the contents of somatic delusions are rather more apt to correspond with demonstrable realities than the contents of personal delusions. Accordingly our analysis of delusional contents includes a hint also as to genesis.
Certainly, striking instances may be cited; for example, let us quote from a recent study in psychiatry: "One such patient with a very complicated delusional system states that he is the father of Adam, that he has lived in his present human body thirty-five years, but in other bodies thirty million years, and that during this time he has occupied six million different bodies.
So, throughout the ages, man has sought release from the realities of his existence into a fanciful and pleasantly delusional flight into a hereafter. "There is no salvation in that sickly obscurantism which attempts to evade realities by confusing itself about them. Safety lies only in clarity and the struggle for the light.
He accused his wife of infidelity, felt that he was being followed by spies and police, claimed that dictagraphs were installed everywhere to spy on him and had a classical delusional state. He was committed, but later he escaped from the hospital and is now at large. The State officials are making no effort to find him, mainly because they are glad to get rid of him.
Whenever any one has been "weak" or "foolish" or "sinful," his mind at once seeks avenues of escape from the blame, from the painful feeling of inferiority and self-reproach. The avenue of escape selected may be to blame others as tempting or not warning and not teaching, may become entirely delusional, or it may take the religious form of confession, expiation and repentance.
Every place for these unfortunates should provide for them ample room and congenial employment, whether profitable to the State or not, and the labor should be induced, not enforced, and always timed and suited to their malady. A variety of interesting occupations tends to divert from delusional introspection.
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