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October 7, 1893

SOME REMARKS ON INSANITY OF THE AGED.Read in the Section of Neurology and Medical Jurisprudence, at the Forty-fourth Annual Meeting of the American Medical Association.

JAMA. 1893;XXI(15):519-520. doi:10.1001/jama.1893.02420670009001a

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Abstract

The tenure of normal mentality in old age, depends on the sum total of vitality originally deposited and the maintenance of normal equipoise in the brain machinery during the years of active engagements in the affairs of life.

The blending of the normal and abnormal mental states renders the psychological study of old age difficult, because what is the normal tenure of one approaches the abnormal change in another; the result is, as Clouston has remarked," the psychology of old age has yet to be written."To the confusion arising from the differentiation of ordinary functional derangements from organic brain diseases, is due the difficulty of diagnosis and clinical classification, which must be experienced to be appreciated.

In a clinical study of 196 cases of insanity, occurring in men over sixty years of age, coming under my care, I have been struck by the heterogenous aymptoms, yet similarity of mental affections,

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