Dementia by Ames, David; Burns, Alistair S.; O'Brien, John

By Ames, David; Burns, Alistair S.; O'Brien, John

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251) and suggested six clinical groups: hereditary, toxic, associated with the neuroses, idiopathic, sympathetic and dementia. In regards to the latter, Morel (1860) believed that: y if we examine dementia (amentia, progressive weakening of the faculties) we must accept that it constitutes a terminal state. There will, of course, be exceptional insane individuals who, until the end, preserve their intellectual faculties; the majority, however, are subject to the law of decline. This results from a loss of vitality in the brain y Comparison of brain weights in the various forms of insanity shows that the heavier weights are found in cases of recent onset.

The answer is that it is most unlikely he did, his only intention having been to point out that such a syndrome could occur in younger people (Alzheimer, 1911). This is confirmed by commentaries from those who worked for him: Perusini (1909) wrote that for Alzheimer ‘these morbid forms do not represent anything but atypical form of senile dementia’ (p. 143). 3 THE NAMING OF THE DISEASE Kraepelin (1910) coined the term in the eighth edition of his Handbook: at the end of the section on ‘senile dementia’ he wrote: the autopsy revels, according to Alzheimer’s description, changes that represent the most serious form of senile dementia y the Drusen were numerous and almost one third of the cortical cells had died off.

It is clear that the debate had less to do with the nature of the brain lesions than with how mental symptoms and their contents were produced in general: how could the ‘typical’ content of paralytic delusions (grandiosity) be explained? Since the same mental symptoms could be seen in all manner of conditions, Baillarger believed that chronic periencephalitis could account only for the motor signs – mental symptoms ‘therefore, having a different origin’ (p. 389). The absence of a link between lesion and symptom also explained why some patients recovered.

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