very enthusiastic, intense, inclined to exaggerate in all he does, easily excited, irritated and made angry shows tendencies and characteristics which have been found to make up the normal temperament of the maniac. Another who is easily disturbed and made unhappy by trifling occurrences and worries much about them, fights his battles over and over, has "blue spells," and for whom it seems more easy to hold disturbing and disquieting thoughts than to banish them from mind, gives evidence of tendencies which the symptoms of the depressive psychosis only intensify. Another who is oversensitive, habitually tired and "nervous,' hesitating and wavering, worried about the past and anxious about the future, continually harassed by some bodily discomfort or pain, disturbed by fears and forebodings, disquieting thoughts and feelings reveals mildly the symptoms of the psychoneuroses. Obviously is it imperative that these persons should the more assiduously conserve their physical strength and vigor, form habits which are temperate and healthful, and with more than usual vigilance guard against everything which could contribute to weaken and derange the nervous system, which already gives evidence of abnormality. Intellectual function. Of the three functions attributed to the mind, thinking, feeling and acting, there remains for summary the intellectual, or thinking. Sensations are impressions which are received from the outer world by means of the sense organs and from one's own body, and are brought into consciousness by a mechanism already described in the first part of the chapter. The sensations are: Visual, received from the eye, giving impressions of light and color; auditory, from the ear, giving impressions of sound; tactile and thermal, from the skin, giving impressions of touch and temperature (heat and cold); gustatory, from the mouth, giving impressions of taste; olfactory, from the nose, giving impressions of smell or odor; kinæsthetic, from the muscles and structures of the inner ear, giving impressions of weight and resistance, of the movement of one's body and its position in space. Other sensations are: Cutaneous pain, arising chiefly from the skin, and deep pain, chiefly from the muscles; hunger, from the stomach, thirst, from the mucous membranes of the throat, and fatigue from the muscles. Professor James has defined sensations as "first things in the way of consciousness," and asserts that only in infancy are pure sensations received, for the conscious impression or sensation is immediately given a meaning or is interpreted in the light of former experiences and becomes a percept. Perception is, therefore, the conscious recognition of the cause of a given sensation. In the course of nervous and mental disease, sensation may be rendered more acute, or it may be dulled or lost, and as sensation is impaired, perception suffers. For neurological examinations the nurse must always have ready the sensation tray or basket. A basket 7"X 10"X3" with a low, firm handle, made of reed or willow, which can be easily scrubbed and kept clean, with a light partition of wood making a compartment for small bottles, will be found most convenient and satisfactory. This basket should contain the following articles: Six small bottles containing solutions of sugar, salt, acetic acid or vinegar and quinine for testing taste, and peppermint and camphor, or some other well-known aromatic solutions for testing smell; toothpick swabs for use with the solutions; tuning fork for testing hearing; an applicator pierced at one end with a black dressing pin for testing touch and cutaneous pain to locate areas of anesthesia and hyperesthesia; flecks of cotton for lightly touching the skin; test tubes containing hot and cold water for testing temperature; a flash light for testing the light reflex of the eye; percussion hammer for testing the deep tendon reflexes, and a blue pencil for marking the skin. Memory is the storehouse of the mind in which sense impressions and experiences are held in such manner that at a future time they may be again brought into conscious ness to aid in determining the activity. Memory is made up of three elements: Retention, the power to hold and store impressions and experiences; recall, the power to reproduce them again in consciousness; and recognition, the power to know they belong to past. Retention depends primarily upon the inborn characteristics of the nervous system and also upon the health and age of the individual and other factors like fatigue. In the early years of life impressions and experiences are well retained, due to the great plasticity of the nervous system, and the intensity of the impression, due to freedom from interference with the new ideas by older ones; but in old age, when these characteristics are diminished, or lost, new ideas and experiences are retained with greater difficulty, and sometimes not at all. Countless numbers of impressions are continually being received by the sense organs and by them conducted to the cerebrum, where they are brought either clearly or dimly into consciousness. It is believed that all impressions and experiences are imprinted on the mind and retained by it, for impressions which never came into consciousness at the time they were received may years afterwards, or during illness, be reproduced. Much of normal function has been learned from pathological conditions and the belief that all impressions tend to be retained by the mind has been strengthened by evidence disclosed during periods of mental derangement, when impressions and experiences of which the patient had no knowledge, arise in consciousness. Impressions which gain the attention and arouse a feeling of interest, are associated with other ideas and experiences according to certain laws of association, that is, because of some natural relationship, similarity or contrast, and proximity in time and space. In this way experiences are associated with or bound together with other experiences, ideas with other ideas and feelings and muscular reactions into groups, and these groups are associated with other groups and form systems. Recall depends upon previous impression, retention and association. The order in which ideas and experiences are brought back or revived in consciousness depends upon what ideas and experiences they have been associated with most frequently or habitually, most recently, most closely, and most vividly or intensely. Recall is always accompanied by recognition. Recognition, however, may take place without recall. Certain ideas and experiences which have become associated with other ideas and experiences into groups to which strong feelings have been attached have been termed "complexes." The belief is held that some of the functional nervous disorders have their origin in these complexes, many of which are buried deep in mind, of whose presence the patient is not conscious and which he cannot recall. Various association tests and experiments have been devised and applied by physicians in order to discover the existence of these hidden complexes and as a means of ferreting them out so that they can be analyzed and their significance explained. Reasoning and judgment. As the mind has the power of association, so also it has the power of dissociation or analysis, by which a given situation may be broken up into its component parts, and from these, by comparison and association a new idea or judgment is formed. Dissociation is later in developing than association and is a very important part of the mental life. By experience and training it is developed, and represents the highest form of intellectual activity - reasoning. From this brief summary it is hoped the student nurse will have learned something about the laws which control human thought and conduct, and realize that for everything in the mental life, every thought, every feeling, every action, there is a reason, which will make her more tolerant of and sympathetic with peculiarities in the behavior of patients under her care who otherwise would appear uninteresting, unreasonable and disagreeable; that she will be more eager to understand the causes of abnormal mental activity, and to have a part in the restoration to health of those who are mentally ill, for to her is afforded the extraordinary opportunity of supplementing the physician's efforts to modify and change tendencies and characteristics which may be harmful, to hold ever before the patient the ideals for which he should strive, to form such habits of thought and conduct as will help him to attain them, and so secure for him the greatest measure of health, happiness, usefulness and efficiency in the future. REFERENCES "Text-book of Physiology," Howell. |