1923.] PSYCHO-PATHOLOGY.

525

appear denser and more numerous than in normal tissues. There is

also an increase in the number of the capillaries. The hypertrophy
may be general orlocal, inwhichcaseitcompensatesvascular defects
in other parts of the gland. Atrophy was found in three cases, all
ofwhom were greatly emaciated.The connective tissue
was greatly
in excess and the parenchyma almost absent.
The specimens taken from 150 cases fell into four groups:
i. Cases with cerebral tumours of various kinds: In most of these
the pineal showed hyperplasic changes.
2. Cases with long-standing cardio-vascular disorders: These also
showed hyperplasia ofa lessintense character.
In thesetwo groupsthe pinealchangesappearto be due forthe
most part to abnormal cerebral or vascular pressure.
3. Hyperplasia occurring in a variety of other conditions, including
dementia pr@cox, imbecility and manic-depressive psychosis.
4. Cases without hyperplasia, which included several cases of
dementia pr@cox and other psychoses.
In the cerebral tumour and cardio-vascular groups the hyperplasia
was quite outstanding and in marked contrast with the other cases.
Toxic conditions appear to cause no definite changes with the exception
of general paralysis, in which there is lymph and plasma-cell infil
tration, and glial overgrowth without hypertrophy of the paren
chymatous cells. The r@lesof passive hyper@mia and lymph stagnation
in the causation of the hyperplasia are discussed. It is pointed out
that the chief vessels of the pineal come from the tela choroidea,
together with a rich supply of sympathetic nerve-fibres. Possibly
the pineal has a regulating action upon the intracranial circulatory
system. Dr. Walter finds no evidence for an internal secretion, and
considers that the cases of sexual precocity first described by Marburg
(macrogenito somia pr@ecox)are not definitely associated with abnor
malities in the pineal body. W. S. DAWSON.

4. Psycho- Pathology.
Certain Neurotic Mechanisms in Jealousy, Paranoia, and Homo
sexuality. (Internal. Journ. Psycho-Analysis, vol. iv, April, 1923.)
Freud, S.
In a short paper Prof. Freud describes three degrees of jealousy as
revealed by psycho-analysis. In the first place there is the normal
feeling of envy of a rival which has its origin in the infantile @dipus,
or family complex. The second stage, which also is a normal mecha
nism, is one of projection, derived from actual marital infidelity, or
repressed tendencies towards such action. Finally, jealousy may reach
the stage of a true delusion, in which case the repressed impulses
towards unfaithfulness are no longer ambivalent, but directed solely
towards a person of the same sex as the subject. The study of two
cases described in the present paper has led Prof. Freud to add
another contribution to the development of paranoia. The first
case was one with fully developed persecutory ideas, who came under
notice on account of homosexual impulses towards his father-in-law.
526 EPITOME. [Oct.,

Freud traces the whole development of the psychosis from the

maternal fixation stage. The paranoid nature of the second case
was apparent only after analysis. In fact the persecutory ideas,
though present, were not accepted by the patient. The case was
therefore one of paranoia in the making. The moral to be gained
from this is one which has already been well appreciated by
psychiatrists outside the Freudian school, namely, that neurotics
and psychotics differ mainly in the degree of attention which the
subject pays to his neurotic formations, and, in fact, that normal
and abnormal are questions of degree rather than of type.
In the development of homo-sexuality certain psychic processes
are commonly observed. In the first place, there is attachment to,
and as an outcome, identification with the mother. This is followed
by a narcissistic phase in which the subject seeks a male object having
his own characteristics. Thirdly, there is the castration complex,
leading in the male to aversion from an object which does not possess
the male primary sexual characteristics. The new formation which
was revealed in the two cases studied is the mechanism of the homo
sexual object choice arising from the feeling of rivalry and repressed
aggressive impulses. This mechanism may be traced back to feelings
of jealousy against rivals for the mother's affection. Such feelings
are commonly directed against the brothers of the patient. By
repression and transformation, hate becomes changed into affection.
Special development of the social instincts may occur as a reaction
against repressed aggressive impulses. W. S. DAwsoN.

@. Treatment of Insanity.

General Paresis: What it is and its Therapeutic Possibilities. (Amer.

@ourn.of Psychiat., April, 7923.) Solomon, H. C.
The first part of the paper is devoted to discussing the various
criteria on which the diagnosis may be based, as the author believes
that some of the divergent views on the value of treatment are due
to different conceptions as to the scope of the disease. First,
considering the pathological aspect, the principal difficulty is the
differentiation from the non-paretic form of chronic syphilitic
meningo-encephalitis. He concludes the differentiation is one of
degree, depending on the amount of nerve-cell destruction and
of plasma-cell infiltration; as these changes occur in non-paretic
neuro-syphilis differentiation may be impossible, and one condition
may merge into the other.
‘¿ The
varying conditions seen in the brains in general paresis are
discussed, and how the meningitis, perivascular infiltration and
atrophy varies widely in the extent and degree of each of these.
Atypical cases receive particular attention, and the classification
of Nonne is quoted, i.e., (i) typical general paresis, (2) Lissauer's
paresis, (3) atypical paresis—(a) catatonic, (b) senile, (c) Foudroyante,
(4) stationary. The proportions in which spiroch@tes are found in
the brains is discussed at length, and the theory of Jahnel that a
seizure is due to swarming of spiroch@tes and Jakob's description