PATENSON
542
PATHOLOGY
1883), 231: Aldenkibchen, Drci liturg. Schaaselnd. M.A. (Bonn,
1883): Kaufmann, //amii>. d.c.Archtol. (Paderborn, 1901), 503
eq.; KleiNSCHMIDT in Thcal. Prak. Quarlatschrifl (1901), 32,
(1902). 289.
Herbert Thdrston.
Patenson, William, Venerable, English mar- tyr, b. in Yorkshire or Durham; d. at Tyburn, 22 January, 1591-2. Admitted to the English College, Reims, 1 May, 15S4, he was ordained priest Sep- tember, 1587, and left for the English mission 17 January, 1588-9. On the third Sunday of Advent, 1.591, he said Mass in the house of Mr. Lawrence Mompesson at Clerkenwell, and while dining with another priest, James Young, the priest-catchers sur- prised them. Y'oung found a hitling-place, but Pat- enson was arrested and condemned at the Old Bai- ley after Christmas. According to Y'oung, while in prison he converted and reconciled three or four thieves before their death. According to Richard Vcrstegan, he converted, the night before his martyr- dom, six out of seven felons, who occupied the con- demned cell with him. On this account he was cut down while still conscious.
Pollen. Acts of the English Martyrs (London. 1891), 115-7; English Martyrs 1384-1603 (London, 190S), 208. 292; Ch.iI/- LONER. Missionary Priests, I, no. 94; Knox, Douay Diaries (Lon- don, 1878), 201, 217, 222.
John B. Wainewright.
Pathology, Mental. — I. Localization of Men- tal F.^culties. — In the cerebral cortex — that is, the thin covering which envelopes the entire surface of the brain — are distinguished various areas, connected by long nerve tracts with the organs of sense, the skin, the muscles, and in fact with the entire surface of the body. These connexions constitute what is known as the Pro- jection System. There are other areas which are not connected with the outer world, but are related in the closest manner by numerous nerve fibres one with another, and with the areas of the projection system. These constitute the Association System. In the for- mer, definite elementary psycho-physiological func- tions are accurately localized. There are sharply defined centres for the movements of the individual members (the tongue etc.), for the sensations (taste etc.), for hearing, sight etc. In the left cerebral hemi- sphere (in the right for left-handed persons), there is a specifically human centre, that for speech; destruc- tion of this definite portion of the brain cortex causes a loss of the power of speech and of the understanding of spoken words, even though there be no deafness, paralysis of the tongue, mental disorder, or anything of this order.
The higher and specifically psychical functions, and indeed all psychical processes (attention, mental moods, will, etc.) are localized in the association cen- tres, the entire massive frontal lobes serving exclu- sively aa such. Modern attempts to localize the individual mental faculties are as little successful as Gall's endeavours to deduce scientifically defects or developments from the formation of the skull.
The external forms of normal psychical conduct have a normally functionating foundation — a healthy brain cortex; unhealthy changes in this latter dis- turb the normal psychical processes, that is, they lead to mental disease.
II. Causes of Mental Disturbances. — The nor- mal mechanism of the eorebr;il cortex may be impaired in a variety of ways. Impairment may result from the originally insufficient or defective construction of the entire brain (a.s in congenital dementia, idiocy), or by the destruction of extensive nortions of the normally developed brain by injurj', inflammation, softening, malignant new growths etc. In very many cases it is due to the action of poisons, which either temporarily or permanently affect the activities of the sound and well-proportioned elements of the cortex. The num- ber and variety of such active poisons is extremely
great; among them are alcohol, morphine, cocaine,
hashish, lead, poison products of microscopically .small
organisms or bacteria (fever deliria), :il)ii()nii.i'l pnid-
ucts of metabolism coming from the gastro-inlcsliniil
tract (gastro-intestinal auto-intoxication — h:dlucina-
tory confused states), syphilis (in general ])aresis),
poisons from the disturbance of important glandu-
lar organs (e. g. disease of the thyroid glands in the
dementia of cretinism). In other ca.ses, a disease pro-
cess of the blood-vessel system affects also (he blood
vessels of the brain, and thus injures the cerebral
cortex (mental diseases due to the calcification of the
blood vessels, arterio-scelerotic psychosis).
One and the same poisonous agent (e. g. alcohol) may be taken within definite limits and withstood by one individual, whereas another individual's reaction to the drug may occasion a nervous or mental disease. The personal predisposition plays an important causa- tive factor. This individual constitution (i. e. inferi- ority, lower capacity for resistance) of the central nervous system is for the most part congenital and hereditary, just as temperament, talent etc. Mental diseases due to alcoholism or nervousness are doubly severe in persons to whom a corresponding taint has been transmitted by their ancestors. In some in- stances this inferiority may be induced in previously healthy and normally constituted nervous systems by sunstroke, concussion of the brain etc. Injuries to the head, especially those accompanied by concussion of the brain, cause not only an increased disposition to mental diseaise, but are not infrequently its direct cause. A chronic state of exhaustion produces psy- choses, severe and protracted luemorrhages, weakness due to chronic purulent disease, malignant new growths, etc. Occasionally the mental disturbance bears a direct relation to phases of the female sexual life (menstruation, pregnancy, labour, suckling, change of fife).
In some markedly predisposed individuals, very intense bodily pain or continuous physical irritations may occasion attacks of mental disturbance (confused states in migraine, toothache, polypi in the ear, worms in the intestines etc.). In very many instances we are entirely ignorant of any direct cause, and can only interpret the unstable disposition as due to a strong hereditary taint. In many forms of mental disease we know absolutely nothing concerning the causes.
It is striking that psychical factors themselves (worry, care, shock etc.) as sole and direct causes of mental disease play a very minor role — a fact in strik- ing contrast to the popular notion. Only in extremely hysterical individuals, i. e. those already disposed to disease, do violent psychical emotions frequently give rise to rapidly-passing attacks of mental disorder. Furthermore, long-continued excitement, trouble, and the like, work only indirectly in the a;tiology of the psychoses — e. g. by reducing the power of resistance of the central nervous system, that is, by giving rise to an increased disposition to nervous and mental dis- ease, which itself is transmissible to posterity. Alco- holics make up a third, paretics almost two-thirds of all the mentally diseased. If the teachings of Chris- tianity were to be generally followed, there would very rarely be a paretic, since for the most part syphilis is acquired only from illegitimate intercour.se; there would be no alcoholism; and the untold distress caused by mental disturbance would be spared man- kind.
With reference to the question whether one may through one's own fault bring on psychoses [as was ex- pressly taught by the Protestant psychiatrist Hein- roth (d. 1843)1, modern psychiatry teaches as follows: as has been said above, there are many purely bodily causes of mental disease, in connexion with which there can be no question raised as to personal responsibility. In the ca.se of alcoholism the matter is not so simple. While it is certain that the abuse of alcohol is one of
