Indigenous Organization Studies:

Exploring Management, Business and

Community Tyron Rakeiora Love
Visit to download the full and correct content document:
https://textbookfull.com/product/indigenous-organization-studies-exploring-manageme
nt-business-and-community-tyron-rakeiora-love/
More products digital (pdf, epub, mobi) instant
download maybe you interests ...

Biota Grow 2C gather 2C cook Loucas

https://textbookfull.com/product/biota-grow-2c-gather-2c-cook-
loucas/

Pragmatism and Organization Studies Philippe Lorino

https://textbookfull.com/product/pragmatism-and-organization-
studies-philippe-lorino/

Modern Business Management: Creating a Built-to-Change

Organization 1st Edition Doug Dockery

https://textbookfull.com/product/modern-business-management-
creating-a-built-to-change-organization-1st-edition-doug-dockery/

Exploring Business Karen Collins

https://textbookfull.com/product/exploring-business-karen-
collins/
History in Management and Organization Studies From
Margin to Mainstream 1st Edition Behlül Üsdiken
Matthias Kipping

https://textbookfull.com/product/history-in-management-and-
organization-studies-from-margin-to-mainstream-1st-edition-
behlul-usdiken-matthias-kipping/

Exploring Business Language And Culture Urszula

Michalik

https://textbookfull.com/product/exploring-business-language-and-
culture-urszula-michalik/

Routledge Handbook of Critical Indigenous Studies 1st

Edition Brendan Hokowhitu

https://textbookfull.com/product/routledge-handbook-of-critical-
indigenous-studies-1st-edition-brendan-hokowhitu/

The Fungal Community : Its Organization and Role in the

Ecosystem, Fourth Edition Dighton

https://textbookfull.com/product/the-fungal-community-its-
organization-and-role-in-the-ecosystem-fourth-edition-dighton/

Organization the cognitive truth method organization

strategies cleaning and life management Third Edition
Joyson

https://textbookfull.com/product/organization-the-cognitive-
truth-method-organization-strategies-cleaning-and-life-
management-third-edition-joyson/
Indigenous
Organization Studies
Exploring Management,
Business and Community

Tyron Rakeiora Love

Indigenous Organization Studies
 Tyron Rakeiora Love

Indigenous
Organization Studies
Exploring Management, Business and Community
Tyron Rakeiora Love
UC Business School
University of Canterbury
Christchurch, New Zealand

ISBN 978-3-030-01502-2    ISBN 978-3-030-01503-9 (eBook)

https://doi.org/10.1007/978-3-030-01503-9

Library of Congress Control Number: 2018961564

© The Editor(s) (if applicable) and The Author(s) 2019

This work is subject to copyright. All rights are solely and exclusively licensed by the
Publisher, whether the whole or part of the material is concerned, specifically the rights of
translation, reprinting, reuse of illustrations, recitation, broadcasting, reproduction on
microfilms or in any other physical way, and transmission or information storage and retrieval,
electronic adaptation, computer software, or by similar or dissimilar methodology now
known or hereafter developed.
The use of general descriptive names, registered names, trademarks, service marks, etc. in this
publication does not imply, even in the absence of a specific statement, that such names are
exempt from the relevant protective laws and regulations and therefore free for general use.
The publisher, the authors and the editors are safe to assume that the advice and information
in this book are believed to be true and accurate at the date of publication. Neither the
publisher nor the authors or the editors give a warranty, express or implied, with respect to
the material contained herein or for any errors or omissions that may have been made. The
publisher remains neutral with regard to jurisdictional claims in published maps and
institutional affiliations.

Cover illustration: © John Rawsterne/patternhead.com

This Palgrave Pivot imprint is published by the registered company Springer Nature
Switzerland AG
The registered company address is: Gewerbestrasse 11, 6330 Cham, Switzerland
For Ngātata Love
 Acknowledgements

I wish to thank my family. My grandfather, Ngātata Love, was perhaps the

first indigenous professor in business in Aotearoa New Zealand. He was a
great storyteller and without him this book would not have been written.
I want to thank Professor C. Michael Hall from the University of
Canterbury, who helped with the crafting of the final version of the book,
as well as Jody for her diligence in proofreading. As Professor of Māori
Research at the University of Canterbury, Professor Angus Macfarlane
remains one of the most important people in indigenous education. I
thank him for his continued support and wisdom. I also thank my doctoral
researchers and colleagues in the business school at the University of
Canterbury for their continued friendship and scholarship.

Tyron Rakeiora Love

vii
 Warning
Readers should be aware that this book includes names of deceased
people that may cause distress to Aboriginal and Torres Strait
Islander peoples and other indigenous peoples.

ix
 Contents

1 Contemporary Indigenous Organization Studies 1

2 Theorizing and Its Importance in Indigenous Organization

Research15

3 Methodological Guidelines in Indigenous Organization

Research31

4 People, Place, and Time in the Study of Indigenous

Organization47

5 The Possibilities for Indigenous Organization Studies59

Index73

xi
 CHAPTER 1

Contemporary Indigenous Organization

Studies

Abstract There is a rich, powerful, and diverse pool of research emerging

from university business schools in colonial states looking into indigenous
people at work, companies and their impacts on indigenous communities,
the structure of tribal entities, indigenous management, indigenous busi-
ness enterprises, indigenous governance, indigenous leadership, and so
on. Drawing from this work, along with insights from the expressive voices
of indigenous studies researchers outside business schools and the power-
ful writings of critical organization studies scholars challenging their main-
stream peers, this chapter, in the context of this short book, proposes a
new field of research: indigenous organization studies. The purpose of this
is to explore indigenous peoples at the centre and at the periphery of man-
aging and organizing and to further consider what workplaces and com-
munities might look like when their organizing principles are based on
indigenous knowledges and ways of doing things.

Keywords Indigenous organization studies • Management • Managing

• Organization • Organizing • Communities • Business • Entrepreneurship
• Leadership • Critical management studies • Organization studies •
Indigenous studies • Identity

© The Author(s) 2019 1

T. R. Love, Indigenous Organization Studies,
https://doi.org/10.1007/978-3-030-01503-9_1
2 T. R. LOVE

Introduction
Organizations have been, and continue to be, forces of domination and
suppression for indigenous peoples as well as for many other minority
peoples around the world. For a considerable period of time colonizers
and governments have worked in an orderly fashion to suppress indige-
nous movements and ways of knowing, to replace people and ideas in
coordinated and highly organized ways. But the formation of organiza-
tions has also been an important part of indigenous peoples’ collective
efforts in the struggle for the recognition of rights through the mobiliza-
tion of people both within and between nation states (Smith, 1999, 2012).
Efforts have led to social movements aimed at bringing about essential
change for indigenous and other minority peoples in the pursuit of
empowerment and emancipation (Kymlicka, 2014).
Research too has both a problematic and liberating past and present for
indigenous peoples and communities. Speaking about research at a recent
forum, Linda Tuhiwai Smith (2016) made the biting comment that for
indigenous peoples, “research penetrates their bodies and their emotions
and their thoughts and … it hurts … research hurts”. For Alaskan Natives,
researchers themselves have been likened to mosquitos: “they suck your
blood and leave” (Cochran et al., 2008, p. 22). Yet when done ‘right’,
research driven by indigenous people and communities can be a powerful
endeavour. That’s probably because indigenous research, and the harness-
ing of knowledges, “are as old as the hills and the valleys, the mountains
and the seas, and the deserts and the lakes that indigenous people bind
themselves to as their places of belonging” (Cram, Chilisa, & Mertens,
2013, p. 11). Much like organizations, research projects can be offensive
and damaging or they can be natural and organic.
Studies on indigenous business, entrepreneurship, leadership, and
management—by way of business school research—have offered some
interesting and valuable insights over the past few decades (see e.g. Cahn,
2008; Foley, 2005; Haar, Roche, & Brougham, 2018; Henry, Newth, &
Spiller, 2017; Julien, Somerville, & Brant, 2017; Peredo, Anderson,
Galbraith, Honig, & Dana, 2004; Prendergast-Tarena, 2015; Spiller,
Erakovic, Henare, & Pio, 2011). Combined with the inspiring work
emerging from indigenous studies (IS) and the stimulating writings of
critical management studies (CMS) and organization studies (OS) schol-
ars, I propose a new field of research: indigenous organization studies. The
intention with this book is to say some things about it. That is, to say
 CONTEMPORARY INDIGENOUS ORGANIZATION STUDIES 3

something about the study of organizations and organizing insofar as they

have relevance for indigenous peoples and their communities.
The book doesn’t speak on behalf of indigenous peoples; it’s far more
abstract than that. It’s about the kind of study or research that is done in
university business schools. It considers indigenous people at the centre
and at the periphery of managing and organizing, the ongoing life and
‘functioning’ of organizations and the indigenous people within and
around them, and what workplaces and communities might look like
when their organizing principles are based on indigenous knowledges and
ways of doing things. It also encourages conversations between indige-
nous and non-indigenous peoples and researchers.
Perhaps ironically, this book is wary of research and scholarship, par-
ticularly that research fuelled by many governments, universities, and busi-
ness schools. As I have already canvassed, indigenous scholars and
communities have drawn our attention to the fact that ‘research’ has had
a bad reputation among indigenous communities for some time now
(Smith, 1999, 2012). Readers of this text should not see it as a ‘license to
operate’ or as a ‘right to access’ indigenous communities and peoples.
What makes research so appalling at times is when indigenous peoples and
communities are treated as commodities in the production of knowledge.
From the outset, this text is a warning that any predetermined research
agendas driven by business schools—without critical engagements with
indigenous peoples and communities—are likely to be met with resistance
and disdain.
There may be several reasons why you are reading this book and so
what follows is a section on who it is for. Given the important role identity
plays in indigenous research, two further sections consider identity in
doing research as well as the role of the researcher in doing those studies.
Towards the end of the chapter the intersection between indigenous and
organization studies is touched on to canvas issues and opportunities
addressed in the remainder of the text. Finally, as could be expected, there
is a conclusion to the chapter.

Who this Book is for

If you are an indigenous person with a passion for indigenous knowledges
and peoples and you want to research the kinds of things university busi-
ness schools study, then this book is definitely for you. Māori peoples
(Aotearoa New Zealand); Pacific Peoples (Pacific Islands); First Nations,
4 T. R. LOVE

Métis, and Inuit peoples (Canada); Native American peoples (USA); and
Aboriginal peoples (Australia) are likely to find it most useful. Saami peo-
ples (Norway, Finland, Sweden, and Russia) and indigenous peoples from
the African and Asian continents may also be interested in the book’s
content. Some of the writing in this text may also have relevance for the
Mapuche peoples (Chile), the Huichol or Wixáritari peoples (Mexico),
and the Kichwa/Quichua/Quechua peoples (Ecuador) as their valuable
stories, research discourses, and knowledges are part of the fabric of this
book.
This book is for researchers who wish to prioritize indigenous peoples
in their studies of organizations and organizing whether they identify as an
indigenous person or not. As such, it is a text for organization researchers
who are committed to particular research processes so long as those pro-
cesses are paired with the aspirations of indigenous peoples and grounded
in the research discourses of indigenous scholars who have written—often
quite critically—about the role organization(s) and research(ers) have
played in crafting knowledges and coming up with solutions to everyday
problems or opportunities for self-determination.
Parts of this text may be useful in research methods courses run in busi-
ness schools in colonial and postcolonial countries and territories because
the text maintains a healthy-ish respect for established organization and
management theories and processes, which often dominate the conversa-
tions, whilst tempering those conversations in the pursuit of greater plu-
rality, teasing out their relevance for indigenous organization studies.
Academic deans and managers of business and management schools will
also find the book useful. In addition, this book is for those who are con-
cerned that indigenous and critical knowledges are not making their way
into business school teaching and research curricula.
The book is also relevant for managers, advisors, consultants, and prac-
titioners outside academic institutions. Parts of it will be appropriate for
those people who may not be part of any formal research institution but
have an interest in the business, management, and entrepreneurial prac-
tices of organizations and people and whose activities are loosely or closely
intertwined with the interests of indigenous peoples. Increasingly, in colo-
nial societies, organizations are employing indigenous peoples as cultural
advisors and consultants. Whilst this text deals with research and theory
building processes—that might appear to be academic in nature—it does
so only insofar as those processes have relevance for practices and which
 CONTEMPORARY INDIGENOUS ORGANIZATION STUDIES 5

seek to uncover the complexity of everyday work operations, solving prob-

lems and taking advantage of opportunities.
There may be some merit in articulating a hierarchy of research audi-
ences for this text; business schools often maintain the difference between
students, junior faculty, senior faculty, and professors. But research hierar-
chies in business schools have a lot to answer for. These hierarchies have
usually determined, either explicitly or implicitly, that particular groups of
people are less capable of accomplishing certain tasks. It’s a way of main-
taining dependence upon academic systems that I don’t have much time
for: ‘student-researchers’ and ‘faculty-researchers’ are researchers, and
when it comes to indigenous organization studies, there’s little need to
make these kinds of institutional distinctions. We will avoid them as much
as possible in this text.

Identity and Doing Research

The question of who should study organizations and processes of organiz-
ing has a relatively straightforward answer: anyone. But who should study
indigenous organizations and processes of organizing? The answer to this
question is not so clear. Some researchers in business schools would have
reservations about entering indigenous organizations or interviewing
indigenous workers as non-indigenous researchers. Such hesitation is war-
ranted given “research has been a source of distress for indigenous people”
(Cochran et al., 2008, p. 22). Indigenous researchers working outside of
their traditional homelands may also be anxious about their potential
intrusion on indigenous peoples, organizations, and communities other
than their own. So, who should study indigenous organizations and pro-
cesses of organizing?
This question is a common concern among researchers in business
schools when indigenous people are involved. It is also a source of appre-
hension for researchers whose role it is to provide practical solutions to
practical problems when indigenous organizations and workers are
involved. Some methodologists look to researchers’ identity for guidance:
how researchers identify as indigenous and/or non-indigenous. Some
argue that only indigenous people should do indigenous research. I have
heard this point made in conversation and some write about it (see Henry
et al., 2017; Irwin, 1994). Others suggest there is space for non-­indigenous
researchers but only if they have indigenous involvement to guide their
6 T. R. LOVE

projects or investigations (e.g. an indigenous advisory or consultative

group) (see Smith, 1999, 2012).
The measurement of indigenous identity has a complex and, in many
ways, a problematic history tied up in problematic systems of human clas-
sification which are bound politically and philosophically. Some societies
and states measure the amount of blood you have, others rely on self-­
identification, and still others are more interested in historical understand-
ings involving ethnicity and race, social marginalization, the impact of
imperialism and colonization, and/or connections to land, and place
(Daes, 2000). Many ways of measuring indigenous identities are mis-
guided and intrusive, and as such, the ways indigenous identities are
crafted and negotiated deserve further attention.
In Aotearoa New Zealand (where I come from), indigenous Māori and
non-indigenous Pākehā have intermarried, and it is the prevailing under-
standing that if you are descended from an indigenous Māori ancestor or
ancestors (as I am), then you are an indigenous Māori person (Smith,
2013). Although some are criticized for not being Māori enough, such an
assessment is the misguided product of colonization. Of course, few uni-
versity and business school researchers are clear in their publications about
where they come from (Cram et al., 2013). Furthermore, some indige-
nous peoples may not adopt indigenous research approaches, focus their
research on indigenous peoples, or choose to be known as indigenous
researchers and there are no doubt multiple and seriously legitimate rea-
sons for this. Human identities are complex, and for the indigenous orga-
nization researcher, reducing people to categories of actors and attaching
numerical values to them in ways which make broad sweeping cultural
generalizations is far from the kind of research advocated for here.

The Role of the Researcher

Linda Tuhiwai Smith (1999, 2012) suggests research has been something
‘done to’ indigenous peoples for the purposes of colonization whilst at the
same time denying indigenous peoples their own legitimacy and self-­
determination in the knowledge space. Inspired by the writings of Edward
Said (1978), and in particular his work on Orientalism, Smith (1999) cre-
ates two different researching peoples to help make sense of the research
space: ‘researchers’ and ‘the researched’. ‘Researchers’ are “the human
carriers of research” (Smith, 1999, p. 3). These people are the measurers,
the comparers, and the extractors of knowledge. The second type are ‘the
 CONTEMPORARY INDIGENOUS ORGANIZATION STUDIES 7

researched’. From their outlook, research is offensive, breeds distrust, and

suppresses knowledge. Smith’s (1999, 2012) point is commanding and
the lessons are transferable to the kind of research that concerns us in this
book. Whether you see yourself as an indigenous researcher, a non-­
indigenous researcher, or a researcher who is both indigenous and non-­
indigenous (or perhaps you reject the binary altogether but see the
‘indigenous’ space as a useful place to start), you have a responsibility to
consider the role organizations and organizing play in building strong
societies. In other words, your research can become respectful, develop
trust, and encourage the sharing of knowledge.
If you are someone interested in studying indigenous organizations and
forms of organizing, then this book is about you in your role as a researcher,
as an inquirer. It is not about the ‘personal you’. It is more occupational
than that. It is about the ‘person’ you embrace or become when you for-
mally pursue research processes and activities and as such it’s about the
‘researching you’ (see Allan, 2006). What comes with this label is a whole
history of human activities which, for better or worse, have had their part
in shaping people and societies for a considerable period of time. As such,
choosing to become a researcher is an active subscription to a past and a
research field which has been both credited and blamed for the ways we
live and interact (see Allan, 2006; Grey, 2005) as indigenous peoples and
non-indigenous peoples. So what might that role look like?
There is no doubt that doing indigenous organization research is about
accepting an ongoing accountability of some kind. You can start a research
project and get some agreement with participants and communities but
then those people want to know about the research and they’ll ask ques-
tions; “they’re gonna be big questions, they’re gonna start with ‘Who are
you?’, ‘Who’s this for?’, ‘Why you?’, ‘What are you gonna do about it or
what are you gonna do with it?’, ‘Why are you doing it this way?’” (Smith,
2013). And just because someone may be an ‘insider’ (of the same ethnic
or cultural identity) does not mean they have unlimited and unrestricted
access to those people and knowledges (Geleta, 2014).
The role of the researcher and what they are prepared to do are funda-
mental to the likely ‘success’ of any research project. Researchers whose
purposes are honourable and whose practices seek to do right by indigenous
people are likely to be important in determining the value of a research
project. Ethicists and ethics committees maintain that people have ethical
responsibilities as researchers to cause no harm, “but even well-­intentioned
research has been a source of distress for indigenous people because of its
8 T. R. LOVE

implications, methods, and lack of responsiveness to the community and

its concerns” (Cochran et al., 2008, p. 22). Community-based participa-
tory and action research methodologies call for indigenous people to be
part of, if not leaders of, research teams in order to build culturally respon-
sive ways of researching and we’ve seen their popularity flourish of late.
Yet, no matter how well intentioned we may be, or hope to be, we are
mostly ignorant when we walk into communities we don’t belong to and
try to engage with people we don’t know that well (Dell, 2017).
Some researchers have a preference for scrutinizing the likely conse-
quences resulting from the researcher’s activities. If indigenous people do
not benefit, then there is little point carrying out indigenous-focussed
research (Walker, Eketone, & Gibbs, 2006). University ethics committees
try to keep their researchers honourable in the pursuit of knowledge. But
they often get quite defensive when indigenous communities are involved.
Predicting the results or outcomes of a research project is difficult. It is
probably the reason why ‘quantitative’ and statistical-type research is
favoured over ‘qualitative’ research. But quantitative research is often too
simplistic and reduces people to products and outcomes—much like when
doing identity work—and they don’t engage with people that much. On
the other hand, qualitative research can be overly intrusive. Furthermore,
the binary opposites can be overly simplistic and unhelpful. Chapter 3
takes this conversation further.

Indigenous and Organization Studies

Western science says that the natural and social sciences have different things
to achieve. The division is most obvious at university or college where degree
programmes are run by schools that separate the sciences out into biology,
physics, and chemistry, on the one hand, and arts, sociology, and business, on
the other. Indigenous knowledges and ways of knowing are not so quick to
make the distinction; everything in the world is essentially combined, living
together, and interconnected. Indigenous knowledges are about an enduring
connection of people with land and other things all of which are animate
(living, alive, conscious). To manage the lands and the environments in
which they live and depend, traditional indigenous communities rely heavily
on the guidance of local and evolved ancestral knowledges.
For the Cree of James Bay in Canada, traditional ecological knowledges
have been built over a considerable period of time and passed on from
generation to generation to navigate the intricate relationships amongst
 CONTEMPORARY INDIGENOUS ORGANIZATION STUDIES 9

objects which are all animate and living (Whiteman, 2004). For Māori
people in New Zealand, identity and culture are principally built on the
mutual relationships formed with “whanau [extended family] and whenua
[land/place]” (Reid, Varona, Fisher, & Smith, 2016, p. 32), a philosophy
which places emphasis on “individuals with family, younger generations
with older generations, physical health with mental health, and well-being
with natural and built environments” (Durie, 2017, p. 22).
As Leroy Little Bear (2000, p. x) writes, “the Native American para-
digm is comprised of and includes ideas of constant motion and flux, exis-
tence consisting of energy waves, interrelationships, all things being
animate, space/place, renewal, and all things being imbued with spirit.”
This paradigm has important relevance for the ways indigenous peoples
see the world and engage in knowledge work. For Gregory Cajete, Native
science is located in human participations with nature whereby “the
dynamics of this participation are founded on an ancient human covenant
with plants, animals, the forces of the earth, and the universe” (Cajete,
2000, p. 5). So, how are these knowledges integrated into the teaching
and research curricula of business schools?
Anyone who has picked up a management-related textbook as part of a
business degree programme will know that Native/indigenous knowl-
edges don’t appear to be the foundation for modern-day forms of operat-
ing and organizing. One explanation for their omission is that the world
has become overly consumed with ideas of global progress, international
markets, and foreign trade to be bothered with local knowledges, Native
ways of doing things, and traditional techniques for the preservation of
resources and livelihood. Another account is that business school educa-
tors have mostly failed to challenge the primacy of ‘classical’ organization
and management theorists (e.g. Frederick Winslow Taylor, Max Weber,
Henri Fayol, Mary Parker Follett). Whatever the reasons, indigenous
knowledges are blatantly omitted and concealed in the narratives of
authors who continue to privilege Western forms of business knowledge.
This book seeks to do something about that. It also sets out to challenge
‘quantitative’ forms of researching.
Attempts by researchers to quantify human, spiritual, and natural
things have led to abstract ways of dealing with intimate and local prob-
lems. Statistical measurements and social indicators have been particularly
damaging, maintaining indigenous peoples and associated social prob-
lems as the ills of ‘postcolonial’ societies; people to be helped, social issues
to be fixed, problems to be solved, policies to be created in aid, and so on
10 T. R. LOVE

(see Crane, 1999; Smith, 1999, 2012). The classical theorists built mod-
els and created rules predicated on the assumption that objective factors
(e.g. pay, reward, and promotion) were likely to play a significant role in
the organization and management of workers from which the quantita-
tive study of managing has emerged. For them, efficiency and effective-
ness came down to the operation and, more crudely, the ‘manipulation’
of labour. Quantitative forms of managerial practice and research are
under the spotlight here.
The legitimacy of indigenous organization research is firmly grounded
in indigenous knowledges and processes. In addition, it draws some inspi-
ration from critical organizational scholarship (e.g. Boje, 2019; Clegg,
1990; Clegg & Hardy, 1999; Crane, 1999; Deetz, 1996; Grey, 2005).
Like contemporary indigenous thinkers, critical organization theorists
have challenged conventional ways of analysing and looking at their sub-
jects of study including organizations and ways of organizing. If indige-
nous knowledges are integrative and embrace the interconnected nature
of indigenous peoples with non-indigenous peoples as well as with the
world, the universe, and all things, what do organizations and forms of
organizing, as well as studying them, look like? Chapters 2 and 3 consider
this question in further detail.

Conclusion
When we search for books and articles on ‘colonization’ or ‘indigenous
ways of knowing’ from our respective jurisdictions (e.g. New Zealand or
Africa or Australia or Canada or America), the results of the searches are
anything but open or value-free. Search engines (like Google) know our
past searches and give us what they think we want. That is, my search from
my computer is likely to reveal a different set of findings to that of another
researcher with their history different to mine. As such, this book is the
product of the ‘particular’, driven by technology and scrutinized by me
producing an output which is distinctive and local.
I try to incorporate a variety of indigenous knowledges in this text but
the book is grounded in a history of reading and searching which is dis-
tinctively Aotearoa New Zealand in nature. As such, Māori knowledges (as
told mostly by researchers) and ways of doing things are privileged in this
book. I do not apologize for that. Much will be missed. And, as I have
mentioned, I do not intend to speak for, or on behalf of, any indigenous
peoples, communities, or groups. There is no single ‘right way’ to do
 CONTEMPORARY INDIGENOUS ORGANIZATION STUDIES 11

research on the kinds of things discussed in this book. The book does not
present a finite set of steps for creating and producing good research. The
aim is more modest than that.
The aim is to say some things which might be useful for new indige-
nous organization researchers. People have more or less useful things to
say. In this text I focus on things I think may be more valuable for research-
ers starting to think about the relevance of organizations and ways of orga-
nizing for indigenous peoples. I prefer to mention researchers’ names in
full where possible and any key publications in-text. For instance, as you
have seen, I frequently refer to Linda Tuhiwai Smith and her 1999 and
2012 books, Decolonizing Methodologies: Research and Indigenous Peoples,
given her significant contribution to the field through this book. Certainly,
citations are used (e.g. Smith, 1999), but texts are written by people and
it is those people who deserve the acknowledgement, not the dated manu-
script itself.

References
Allan, K. (2006). Contemporary social and sociological theory: Visualizing social
worlds. Thousand Oaks, CA: Pine Forge Press.
Boje, D. M. (2019). Organizational research methods: Storytelling in action.
Abingdon: Routledge.
Cahn, M. (2008). Indigenous entrepreneurship, culture and microenterprise in
the Pacific Islands: Case studies from Samoa. Entrepreneurship & Regional
Development: An International Journal, 20(1), 1–18.
Cajete, G. (2000). Native science: Natural laws of interdependence. Santa Fe, NM:
Clear Light Publishers.
Clegg, S. R. (1990). Modern organizations: Organisation studies in the postmodern
world. London, UK: Sage.
Clegg, S. R., & Hardy, C. (1999). Introduction to studying organization. In S. R.
Clegg & C. Hardy (Eds.), Studying organization: Theory and method. London,
UK: Sage.
Cochran, P. A. L., Marshall, C. A., Garcia-Downing, C., Kendall, E., Cook, D.,
McCubbin, L., et al. (2008). Indigenous ways of knowing: Implications for
participatory research and community. American Journal of Public Health,
8(1), 22–27.
Cram, F., Chilisa, B., & Mertens, D. (2013). The journey begins. In D. M.
Mertens, F. Cram, & B. Chilisa (Eds.), Indigenous pathways into social research:
Voices of a new generation (pp. 11–40). Walnut Creek, CA: Left Coast Press.
Crane, A. (1999). Are you ethical? Please tick yes or no. On researching ethics in
business organizations. Journal of Business Ethics, 20(3), 237–248.
12 T. R. LOVE

Daes, E.-I. A. (2000). Protecting knowledge: Traditional resource rights in the new
millennium. Defining Indigenous Peoples’ Heritage Conference, Union of
British Columbia Indian Chiefs, Vancouver, February 23–26.
Deetz, S. (1996). Crossroads—Describing differences in approaches to organiza-
tion science: Rethinking Burrell and Morgan and their legacy. Organization
Science, 7(2), 191–207.
Dell, K. M. (2017). Te Hokinga ki te Ū kaipō : Disrupted Māori Management
Theory: Harmonising Whānau Conflict in the Māori Land Trust. Unpublished
doctoral thesis, University of Auckland, Auckland, New Zealand.
Durie, M. (2017). Kaupapa Māori: Indigenizing New Zealand. In A. Jones &
T. K. Hoskins (Eds.), Critical conversations in Kaupapa Māori (pp. 13–21).
Wellington, New Zealand: Huia Publishers Ltd.
Foley, D. (2005). Understanding indigenous entrepreneurship. Unpublished doc-
toral thesis, University of Queensland, Brisbane, Australia.
Geleta, E. B. (2014). The politics of identity and methodology in African develop-
ment ethnography. Qualitative Research, 14(1), 131–146.
Grey, C. (2005). A very short, fairly interesting and reasonably cheap book about
studying organizations. London, UK: Sage.
Haar, J., Roche, M., & Brougham, D. (2018). Indigenous insights into ethical
leadership: A study of Māori leaders. Journal of Business Ethics. https://doi.
org/10.1007/s10551-018-3869-3
Henry, E., Newth, J., & Spiller, C. (2017). Emancipatory indigenous social inno-
vation: Shifting power through culture and technology. Journal of Management
& Organization, 23(6), 786–802.
Irwin, K. (1994). Māori research methods and processes: An exploration. Sites
Journal, 28, 25–43.
Julien, M., Somerville, K., & Brant, J. (2017). Indigenous perspectives on work-­
life enrichment and conflict in Canada. Equality, Diversity and Inclusion: An
International Journal, 36(2), 165–181.
Kymlicka, W. (2014, November 25). Multiculturalism’s moral impulse [Video
file]. Retrieved from https://www.youtube.com/watch?v=2W689QD849Y
Leroy Little Bear, J. D. (2000). Foreword. In G. Cajete (Ed.), Native science:
Natural laws of interdependence (pp. ix–xii). Santa Fe, NM: Clear Light
Publishers.
Peredo, A. M., Anderson, R. B., Galbraith, C. S., Honig, B., & Dana, L. P. (2004).
Towards a theory of indigenous entrepreneurship. International Journal of
Entrepreneurship and Small Business, 1(1/2), 1–20.
Prendergast-Tarena, E. (2015). Indigenising the corporation. Indigenous organisa-
tion design: An analysis of their design, features, and the influence of indigenous
cultural values. Unpublished doctoral thesis, University of Canterbury,
Christchurch, New Zealand.
 CONTEMPORARY INDIGENOUS ORGANIZATION STUDIES 13

Reid, J., Varona, G., Fisher, M., & Smith, C. (2016). Understanding Māori ‘lived’
culture to determine cultural connectedness and wellbeing. Journal of
Population Research, 33(1), 31–49.
Said, E. (1978). Orientalism. London, UK: Vintage Books.
Smith, L. T. (1999). Decolonising methodologies: Research and indigenous peoples.
London, UK: Zed Books.
Smith, L. T. (2012). Decolonising methodologies: Research and indigenous peoples
(2nd ed.). London, UK: Zed Books.
Smith, L. T. (2013, April 29). INQ13 | Linda Tuhiwai Smith and Eve Tuck—
“Decolonizing Methodologies” [Video file]. Retrieved from https://www.you-
tube.com/watch?v=rIZXQC27tvg&t=2070s
Smith, L. T. (2016, November 15). Professor Linda Tuhiwai Smith [Video file].
Retrieved from http://mediacentre.maramatanga.ac.nz/content/professor-
linda-tuhiwai-smith
Spiller, C., Erakovic, L., Henare, M., & Pio, E. (2011). Relational well-being and
wealth: Māori business and an ethic of care. Journal of Business Ethics, 98,
153–169.
Walker, S., Eketone, A., & Gibbs, A. (2006). An exploration of Kaupapa Māori
research, its principles, processes and applications. International Journal of
Social Research Methodology, 9(4), 331–344.
Whiteman, G. (2004). The impact of economic development in James Bay,
Canada: The Cree Tallymen speak out. Organization & Environment, 17(4),
425–448.
 CHAPTER 2

Theorizing and Its Importance in Indigenous

Organization Research

Abstract With empirical research on indigenous business, entrepreneur-

ship, leadership, and management flourishing, there is an increasing need
for theorizations to integrate and weave together the seemingly disparate,
yet increasingly complex, elements of indigenous organizations and orga-
nizing. To address the need, this chapter considers the importance of theo-
rizing to indigenous organization studies and further assesses the value of
discourse and narrative/story to that theorizing. Ideas and concepts drawn
from these fields are developed in ways which encourage new researchers to
consider theorizing in their research strategy and the role theorizing can
play in the construction of indigenous organization knowledges.

Keywords Indigenous organization studies • Management • Managing

• Entrepreneurship • Leadership • Organization • Organizing •
Communities • Business • Theorizing • Theory • Discourse • Narrative
• Story

Introduction
If you are interested in pursuing indigenous organization studies as a field
of inquiry, you must wrestle with how little we know about the relevance
of business, entrepreneurship, leadership, and management for indige-
nous peoples and their communities, as well with the prejudices, cultural

© The Author(s) 2019 15

T. R. Love, Indigenous Organization Studies,
https://doi.org/10.1007/978-3-030-01503-9_2
16 T. R. LOVE

preferences, and power dynamics at play that may cause us to think we

know more than we do or which force us to use irrelevant or unsuitable
research methods for the research objectives we set ourselves as students
of indigenous organization.
There is no certainty about what indigenous organization is or should
be. There are simply more or less useful investigations and conversations
which reflect on, contribute to, ignore, and perhaps even discount previ-
ous research work. Conversations evolve through emergent vocabularies
which seek to elaborate on and discipline researchers’ imaginations, creat-
ing the permeable boundaries for what may or may not be possible (see
Clegg & Hardy, 1999). The measure of good writing and research, I will
try to maintain in this book, is whether writers and researchers have useful
and interesting things to say (see Deetz, 1996) when it comes to the study
of indigenous organization.
I will argue in this chapter, and throughout this book, that the central
element behind doing good indigenous organization research is theorizing
and that two types of language work in particular—discourses and narra-
tives/stories—are useful components in the process of theorizing. I hope
that by discussing them I can draw your attention to their value for study-
ing and writing about the kinds of things that interest us here. Discourse,
narrative/story, and theory are of course broad terms or constructs and
many researchers and writers have divergent views about them and their
role in research and theorizing.

The Value of Discourse

The aim of this book is to say something about the study of organiza-
tions and organizing insofar as they have relevance for indigenous peo-
ples and their communities. A useful place to start is to consider the
role language plays in research processes, and I am an advocate for a
particular type of language form: discourse. Influential indigenous
researchers such as Linda Tuhiwai Smith (1999, 2012) and Cora
Voyageur (2015) frequently use the term discourse to help explain the
language structures at play ­(academic discourses, scientific discourses,
media discourses, colonial discourses, indigenous discourses) which
have power and an active and constructive effect on indigenous peo-
ples. Part of understanding language through a discursive lens is to
understand how to deconstruct and be critical of them and their use
(see Foucault, 1977).
 THEORIZING AND ITS IMPORTANCE IN INDIGENOUS ORGANIZATION… 17

A discourse is a piece of language (written, verbal, visual) which tells us

about something or some phenomenon (e.g. the successes of a group of
indigenous people) but also tries to convince of that something (e.g. that
a group of indigenous people are successful). That is, discourses have a
constructive effect—they both represent and construct things (Hardy &
Maguire, 2016). So, people who believe that we live in a discursive world
believe that language not only mirrors a lived and perceived world, it also
seeks to create and maintain that world as well as challenge and change
that world. Discursive language does not “name objects in the world; it is
core to the process of constituting objects” (Deetz, 1996, p. 192).
Given this line of thought, our understanding of indigenous organiza-
tions, management, entrepreneurship, decision-making, and so on is criti-
cally and reflexively formed by the discourses of practitioners, writers,
researchers, and other commentators who have chosen to say and write
things about them. We do not simply adopt their ideas but we engage
critically with them, at times rejecting them and so on. Some examples of
the many texts which in part construct indigenous organization include
academic articles like ‘Centralized Decentralization for Tribal Business
Development’ (Barr & Reid, 2014), annual reports such as Indigenous
Business Australia Annual Report 2016–2017 (Indigenous Business
Australia, 2017), media reports like Boosting Indigenous Businesses in
Katherine (Lynch, 2017), YouTube clips such as The New Reality of
Aboriginal Business (Gladu, 2015), and conference keynote addresses by
people such as Ella Henry and Dennis Foley (2011).
A range of practices is also part of constituting indigenous organiza-
tion. They include the establishment of indigenous entrepreneurship
programmes (e.g. The Ahikaa Entrepreneurship Programme), the cre-
ation and management of indigenous higher education institutions (e.g.
Te Whare Wānanga o Awanuiārangi), the establishment of university
education programmes (e.g. the Executive MBA in Indigenous Business
and Leadership at the Beedie School of Business), managing Native
corporations/institutions (e.g. Sealaska), monitoring Twitter accounts
(e.g. @ChiefsofOntario), as well as developing websites, drafting reports,
and analysing material s­ pecifically relevant to First Nations business, tribal
governance, indigenous entrepreneurship, and so on.
Some commentators seek to inspire us by offering stories and accounts
of indigenous successes and achievements and do so in commanding and
authoritative ways. When media outlets, writers, bloggers, tweeters, and so
on talk and write about indigenous people, they do so with some p ­ olitical
18 T. R. LOVE

intent: to convince us of something often in a pithy way. In many instances,

it is to inform us of some particular event, incident, or moment for the
purpose of arousing controversy or to create conflict. Some writers offer
accounts of avoidance; they seek to warn us of something that has hap-
pened and/or about to happen (see Gabriel, 2000). In some cases, these
tellings are politically motivated and directed and are intended to help us
steer clear of making the same mistakes.
One area of investigation for new indigenous organization researchers
might be the relationship between power and self-determination at work.
As a researcher of indigenous organization you might have an interest in a
particular industry (i.e. military, medical, education, penal), and you may
look to understand the relationship between people (e.g. indigenous and
non-indigenous), in particular roles (e.g. workers and managers), in a cer-
tain organization (e.g. a local tribal organization, a small enterprise, a mul-
tinational corporation, a government department). Understanding power
has been the job of discourse analysts and others and you may decide it is
a useful avenue to pursue. For indigenous people, power may and can be
an opportunity to self-determine, to determine work on our own terms.
But for too long indigenous workers have been told what to do and when
to do it in organizations which mostly fail to account for their historical as
well as their people and time-honoured values.
Discourses are also at play in the research methodology space. A domi-
nant discourse in the area of research methodology is the somewhat artifi-
cial quantitative-qualitative binary. The creation of binaries is almost
unavoidable in research (Grey, 2005). There has been an ongoing debate
about the primacy of quantitative and qualitative studies to get research
done. Actually, most researchers new to studying will join one camp or the
other and at times will join both and create mixed-method approaches.
However, there are some issues in maintaining this binary-opposite and
the most obvious is that a lot of qualitative studies quantify things. This
normally happens at the level of analysis. So, discourses are prevalent in
the day-to-day jobs of workers as well as the day-to-day work of research-
ers. This is something we will come back to.
Discourse analysis has a lot to offer indigenous organization researchers
because it draws attention to the kinds of things indigenous researchers have
been, and are, dealing with in their studies—the constructive effects of lan-
guage, the dominance of some discourses, power and hierarchy at work
within organizations, to name a few. But not all discourses carry the kind of
meaning we are looking for as students of indigenous organization studies.
 THEORIZING AND ITS IMPORTANCE IN INDIGENOUS ORGANIZATION… 19

The Usefulness of Narrative/Story

Narratives and stories are privileged forms of discourses which reveal depth
of meaning when they are prioritized in research processes. Narratives and
stories are central to indigenous ways of knowing. Many indigenous
researchers use storying as a method for exploring and explaining the lived
experiences of indigenous peoples. For example, Gregory Cajete (2000)
suggests scientific explanations are stories which create the world around
us and are central devices for constructing meaning, and in another pow-
erful example, Willox et al. (2012) bring together digital media and story-
telling in an innovative way to capture the voices of indigenous people in
the Inuit community of Rigolet, Nunatsiavut, Labrador, Canada.
Narratives and stories are fundamental to the way indigenous people make
sense of the world around them in active, contextualized, and living ways
(Boje, 2016; Boje & Cajete, 2014).
Both narratives and stories (two different but related things), as well as
what narrators do (narrative work) and storytellers do (story work),
require elaboration and depth of detail. As discourses, narratives and sto-
ries both seek to represent and create things. They represent and create
states of affairs (incidents and events) which are plotted together into a
meaningful whole over time using causal connections involving implicated
characters (Czarniawska-Joerges, 1998). It is plotted causality that is cen-
tral to the narrative device distinguishing it from positivist forms of know-
ing (Ricoeur, 1991). Thus, the truth of a narrative/story lies in its
meaning, not its accuracy (Gabriel, 2000). The narrative/story method-
ologists, Barbara Czarniawska (1999; Czarniawska-Joerges, 1998) and
Steph Lawler (2002) have given similar accounts.
Narratives (and stories) seek to explain and educate us researchers.
When organizational actors—managers, workers, supervisors, leaders,
business people, entrepreneurs—tell us about their working and social
experiences, the people they interact with, as well as the incidents and
events that take place which consume their working lives, sometimes they
narrate or tell stories. There are good narrators and good storytellers, but
there are also bad ones and some people are at times both good and bad
narrators and storytellers.
When we talk or write about our interactions with people, we often
describe them (“I saw Jane today, she’s good”). But we can also narrate or
story them, something different from description. Think about the last
time you walked past someone you knew and you greeted each other with
20 T. R. LOVE

a few words and/or facial expressions but continued to move on and go

about your day. Your (inter)actions ‘in’ the encounter and reflections ‘on’
the encounter after it happened constitute discursive work as you make
sense of the encounter. But would you consider the interaction a narrative
or a story? What about the subsequent reflections?
Take a popular form of narrative/story in indigenous contexts: the leg-
end. A ‘legend’ has come to mean ‘fictitious’ in a colonial world that has
maintained a distinction between fact and fiction. This fact-fiction binary—
like the ‘qualitative-quantitative’ one—is misleading in many indigenous
contexts. We are taught, at least in mainstream schools, to dismiss things
that have not been proven by scientific rigour or said by influential people.
The distinction between fact and fiction is mostly irrelevant in indigenous
contexts. There are only more or less useful accounts that help us negoti-
ate our indigenous organizational worlds. Yiannis Gabriel (2000) offers
useful insights in this domain.
There is something else to say here about the types of narratives and
stories we encounter as indigenous organization researchers. Often narra-
tives or stories written about indigenous peoples are not good ones as
Linda Tuhiwai Smith (1999, 2012) has drawn our attention to. Accounts
authored by the popular press are often particularly damning (Love &
Tilley, 2013). They often tell of indigenous people being dislocated from
their lands, subjected to domestic violence, and reported in the lower por-
tions of social indicators. They often cast indigenous people as ‘objects’—
in a broader and ‘more important’ national agenda—and as ‘radicals’
when we stand up for our rights. Some research perpetuates and directly
fuels these kinds of assessments: mostly statistical based, quantitative proj-
ects. Andrew Crane (1999) offers a powerful criticism of quantitative
research that is worth looking into. One need is for more narrative research
which seeks to explore the lived lives of indigenous leaders, workers, man-
agers and entrepreneurs that offer narratives which inspire people into
action and level out the preference for narratives which reduce indigenous
peoples to numbers and statistics (Gabriel, 2000).
Short pithy descriptive accounts—that is, newspaper articles, news bul-
letins, social media posts, or snippy comments at work—would not be
considered narratives or stories. Most of these accounts give us the basic
idea about a point a writer/speaker is making. Some points may be embel-
lished for effect, or theatre, to arouse a reaction, to get us to buy into their
ideas, or simply to get us to purchase a product. They are discursive. But
these brief accounts fall short of convincing us of something and, as David
 THEORIZING AND ITS IMPORTANCE IN INDIGENOUS ORGANIZATION… 21

Boje (2019) and Gregory Cajete (2000) remind us, leave out most of who
we are. Some of us are interested in more detail, in accounts which elabo-
rate on the incidents, the events which took place, the specific people
involved, their interactions with others, the emotions they engaged in,
their ethics, the places and times the events took place, and so on. Narrators
and storytellers offer the detail. Indigenous organization researchers who
examine how narrators and storytellers do what they do are called narrative/
story analysts and theorists.
Let us take the narrative/story study of indigenous managers as an
example. The narratives/stories that indigenous managers produce are
privileged forms of language: they are socially produced interpretive
devices through which indigenous managers represent themselves, both to
themselves and to others, including other workers, researchers, and so on
(see Feldman, Skölberg, Brown, & Horner, 2004). To study the narra-
tives/stories of indigenous managers is a serious undertaking. The narra-
tives and stories that they experience in the course of everyday organizational
life are inherently related to culture, meaning, and language systems upon
which they draw their substance (Berger & Luckmann, 1966). As such,
narratives and stories are seen to circulate culturally, to provide a repertoire
(though not an infinite one) from which indigenous managers can pro-
duce their own narratives or stories (Lawler, 2002). Usefully, they allow us
as researchers to make sense of indigenous managers’ experiences.
For one thing—and keeping with our interest in the narrative/story
work of indigenous managers—a narrative/story approach is useful for
understanding the motivations and intentions of indigenous managers
because the narrative/story form of knowing is about organizing experi-
ence around the intentionality of human action (see Czarniawska, 1999).
How indigenous managers attribute motive to themselves (e.g. “my inten-
tion was to…”, “I sought to understand…”), their organisations (e.g.
“the corporation intended on producing…”, “the business never intended
to…”), other workers, actors, agents (“she went about her work…”),
including in groups (“they were meant to complete…”), can tell us much
about the outcomes people—working independently or in groups—hoped
and hope to achieve. Narratives carry other meanings as well. Yiannis
Gabriel (2000) usefully refers to narrative work as the attribution of mean-
ing to people, things, incidents, and events.
But how do we ‘get’ these narratives or stories as indigenous organiza-
tion researchers? Methodologists in the South Pacific have some answers. In
the Pacific Island nation of Vanuatu, there is an indigenous data collection
22 T. R. LOVE

technique based on Storian (‘stories’) or Talanoa (in Fijian, meaning to talk

or speak) which is used as a way of sharing feelings and emotions in a con-
text that challenges the oppressiveness of hierarchical relationships and
places emphasis on conversational relationships. It leverages off friendships
through the telling of stories. Face-to-face conversations are a privileged
form of knowledge creation (Thomas, 2013). In indigenous societies where
the full effects of colonization and globalization have been realized, there
has been a tendency to move away from face-to-face conversations and to
use information technology to create virtual settings. In many ways, virtual
settings are problematic because they often encourage us to ‘get to the
point’ rather than to create meaningful encounters.
There is something else to say here. Computer software is colonizing
qualitative narrative and story methods (Boje, 2019). David Boje (2019)
writes about the interconnectedness of people, communities, histories,
and the earth and therefore stories as living: we live in storytelling worlds;
living story has a mind, an aliveness whereby things unfold in the present,
in a web of answerable spheres of relationships. Boje (2019) draws our
attention to processes of interviewing and warns us of the shallow forms
of interviewing which have dominated organizational research methods.
Engaging in narrative/story work as an indigenous organization
researcher therefore means a commitment to two primary types of research
processes: (1) the narrative and storytellings you seek out as a researcher in
the organizational field and (2) the narrative and story arguments you craft
as a researcher to communicate your research findings. That is, doing narra-
tive/story research is about interweaving the lived experiences of indige-
nous people and the rigour of research processes for the purpose of
stimulating action through processes of theorizing those lived experiences.

The Role of Theory and Theorizing

Okay, so if the narratives and stories people tell are insightful and useful to
us as indigenous organization researchers, then how do we craft our own
research accounts in ways that do not just retell what those people have
told us? Well, that’s where theorizing comes in. For some time we have
been told that good theory is about explanation and prediction (Bacharach,
1989), and that theorizing is in part a commitment to these two things.
The creation of modern theories by indigenous peoples is a very recent
phenomenon (Smith, 1999), and they hold significant value for indigenous
organization studies. For now, let’s consider a working surface-level defini-
Another random document with
no related content on Scribd:
In some cases the primary delusion is of personal exaltation,
attended with persecution and mental depression. The individual
thinks himself some great personage unjustly deprived of his rights.

Delusions of grandeur or of personal exaltation develop in the same

way, usually subacutely from what might seem a foolish fancy rather
than an insane belief. The Napoleons, kings, queens, greatest
financiers, gods, etc. of the insane asylums are those who reason
correctly if one concedes the truth of their false premises, until the
progress of the disease produces such general brain-enfeeblement
that their premises and their reasoning from them are both insane.
The delusions lose their fixedness, and their force too, in the general
lowering of the mind's strength, and complaints and boasts and acts
of anger become fewer, and finally cease.

The COURSE of the disease is nearly always subacute in the

beginning and chronic to the end in the two forms of primary
delusional insanity—that is, with (1) delusions of persecution and
mental depression, and (2) delusions of grandeur. A few cases with
acute development result in recovery, most of which relapse. The
course is for the most part to chronic delusional insanity attended
with moderate dementia.

The MORBID ANATOMY is not known, except that atrophic and

degenerative changes—not distinctive, however—are found in the
terminal stages.

The patient is rarely willing to be treated as an ill person, for he is

sure of the correctness of his delusions. If during the first attack he
can be entirely removed from his daily associations by change of
scene and travel, or, if that is not possible, by admission or
commitment to an asylum, before the delusions become fixed and
while it is still safe for him to be at large, there is reasonable chance
of recovery. Second or third attacks very seldom end in recovery
unless they arise from alcoholic excess, when entire abstinence for a
sufficient length of time affords fair hope of a favorable result, except
in cases of long-standing drunkenness.
TREATMENT, when the delusions have become fixed, involves, chiefly,
safety to society or its comfort. The patients rarely commit suicide,
driven to desperation by their delusions of persecution when they are
particularly horrible. The more common tendency is to acts of
violence toward others, so that seclusion in an asylum is usually the
only safe course to pursue for delusions which one week may be
directed against certain persons who can easily be gotten out of the
way, the next week may be directed against others, and so on
indefinitely. Delusions of grandeur may be only a nuisance or
annoyance, but may at any time become sources of danger. The
course is, for the most part, to slowly-advancing dementia. Asylum
treatment offers no chances of recovery in cases not depending
upon alcoholic excess, but becomes necessary for the protection of
society.

Transformed delusions (sensorielle Verrücktheit) arise usually in

some anomaly of sensation, which probably directs the delusions
already forming in a mind in the early stage of disease rather than
causes the disease. The causes lie in a deep-seated exhaustion of
the nervous system, especially in the neuropathic constitution and
profound hysteria. Various anomalous sensations give rise to a belief
in delusions as to their being caused by individuals for a purpose, or
to their being an indication of all sorts of impossible and most
extraordinary changes in the part: the chest is of stone, the leg of
brass, the head on fire, the hand ice, and so on indefinitely.
Hallucinations and a cataleptiform state are common. The variety of
delusions which may arise is almost endless, and they may have
their origin in the unhealthy action of any organ in the body: one of
the most troublesome forms, called ovarian insanity by Skae, causes
single women of severely continent lives to imagine all sorts of
impossible marital relations with men whose lives are equally beyond
scandal and above suspicion.

Without proper care the COURSE of the disease is to slowly-advancing

dementia; and this may be expected when there is organic disease
of any important organ of the body.
Before the delusions are fixed, diversion, change of scene, travel
under agreeable circumstances and judiciously regulated, may be of
great benefit. In the later stage of firmly-fixed delusion asylum
treatment offers more chances of success.

In all the forms of primary delusional insanity the whole history of the
case is difficult to get at, and there may be, and usually is, so strong
a tinge of possibility at least, if not of actual probability, in the
delusions, in the early stage of the disease, that a correct diagnosis
cannot be arrived at until the time and opportunity for a cure have
passed.

DOUBTING INSANITY (Folie du doute, Maladie du doute, Grübelsucht) is

classed by Régis22 as a form of melancholia (mélancolie délirante),
on the ground that it has the three elements of melancholia—namely,
fixed ideas (délire) of a sad nature, general mental depression, and
tendency to suicide. The melancholia is secondary, however, rather
than primary, and doubting insanity belongs more properly under the
head of a psycho-convulsive mental disease closely allied to
delusional insanity, like which it is more commonly a manifestation of
psychoneurotic heredity, appearing for the most part among the
cultivated classes. It consists in an uncontrollable doubt and
indecision, unanswerable by any degree of rational explanation,
regarding the occupations, duties, or events of the day, religion, a
future life, the commonest acts, or the most abstruse problems of
life. Doubting insanity essentially depends upon an anomalous
action of the will, with imperative conceptions and impulses. It is
classed by some writers as a monomania of the degenerative type.
Schüle calls it Verrücktheit sensu strictiori, using the term
Verrücktheit also for the three forms of primary delusional insanity
just described.
22 Manuel pratique de Médecine mentale.

Délire du toucher, an insane dread of touching certain objects, and

the morbid fear of defilement, called by Hammond mysophobia
(similar names may be multiplied indefinitely), belong in the same
category.
There are mild cases of all these forms of disease, which seem like
simple weakness of character, others requiring for treatment the
conveniences of the retreat for nervous and mental diseases, with a
fair prospect of recovery, and still others tending to chronicity in
which hallucinations, delusions, and dementia appear only as a
further development into another form of insanity. They may, in mild
degrees, be symptoms in the course of other mental diseases,
especially melancholia, like many other manifestations of morbid
mental energy, such as Doctor Johnson's inability to enter a room
with his left foot first or to pass a lamp-post without striking it with his
cane, etc.

PRIMARY MENTAL DETERIORATION or PRIMARY BRAIN ATROPHY is a term

suggested for a curable impairment of the mind arising from brain-
exhaustion in persons, usually men, between the ages of from fifty-
five to sixty-five. I have found it in some cases associated with
interstitial nephritis and with degenerative disease of the walls of the
heart, and have suspected atheroma of the cerebral arteries or
possibly endo-arteritis of specific or other origin. It occurs at a time
when atrophy of the brain is naturally taking place. There are the
usual indications of physical wear and such marked deterioration of
the mental powers as to seriously interfere with the capacity to
attend to customary business and every-day duties, and to closely
simulate the early stage of paralytic dementia. There occur also, in a
certain proportion of cases, epileptiform convulsions, slight attacks of
dizziness, petit mal, and always disappearance of sexual power and
desire. There may or may not be headache. The patient recognizes
his condition, his mental depression does not far exceed the
physiological limit, and there is no reasonable risk of suicide, except
from reasons which would impel a sane man to it.

Under the influence of rest, if begun early, tonics, and a strict regard
to the laws of health the symptoms commonly disappear if there is
no organic disease. I have never seen the brain recover its tone to
the extent of making it safe or even possible to resume the previous
kind and amount of work. In a certain proportion of cases there is
striking mental impairment, even dementia, and the primary atrophy
of the brain sometimes makes rapid progress to unconsciousness
and death.

It is not possible to say, by the degree of atrophy found post-mortem,

whether there was or was not primary mental deterioration during
life.

The TREATMENT consists in entire freedom from care, rest from work,
travel, tonics, etc.

As mental disease is more than a brain disease, and is a disease of

the intellect, each age from infancy up (and each individuality)
impresses its peculiar mark upon it, and there are certain terms in
common use to express insanity associated with certain
physiological processes whose meaning should be explained.

INSANITY OF CHILDHOOD is for the most part only a further development

of a congenital state of mental defect. I have seen, however, well-
marked mania, melancholia, primary dementia, and primary
delusional insanity before the age of puberty. Typical acute mania I
have seen twice in children two years old, apparently arising in
normal brains after severe injuries to the head. This is quite
uncommon, and the number of cases thus far observed is too few to
make me feel sure that my own experience of a favorable result as
to recovery in uncomplicated cases will be generally confirmed. At
best, after a cure there is a more or less decided arrest of brain
development.

HEBEPHRENIA (insanity of pubescence and adolescence) occurs

within the ages of fourteen and twenty-three or thereabouts. Like
insanity in general among persons in early life, it most commonly
indicates an hereditary predisposition to mental or nervous diseases
or an early-developed brain defect or injury, possibly an exalted
emotional state or an increased nervous sensitiveness produced by
masturbation. It is a mild form of primary dementia, modified by the
mental changes going on during adolescence. Indeed, it is simply an
exaggeration and prolongation of the curious psychological
development of that period, too well known to need description,
which goes on in the most insidious way possible through months or
years of what seems silliness, absurd fancies, foolish sentimentality,
egotism, impaired common sense, and diminished judgment and
self-control, to a slowly-advancing dementia, which even then is not
always recognized as disease. The result is an arrest of brain
development on various planes of intellect, and a preservation of the
youth's tastes and sense and intelligence, as modified by the morbid
propensities characterizing an unhealthy development of the change
from boyhood or girlhood and youth to adult life, with the adult's
strength—a curious combination of intellectual brightness, it may be,
with lack of mind. For this characteristic condition Westphal uses the
expressive term Permanenz der Flegeljahre (permanence of the
usually transitory state, which then commonly results in permanent
arrest of brain development on the plane of the mind at a definite
age of adolescence); and yet there may be more than that—mental
deterioration, which in years may lead to pronounced dementia.
Cases of primary dementia occurring within the years of puberty and
adolescence are often classed as hebephrenia and conversely, so
that one term, primary dementia, is thought sufficient by many
writers on insanity.

In the early stage there is sadness, hardly amounting to melancholia,

and it usually constitutes an important symptom to the end, although,
like all the other changes in the mental state, it is superficial to the
extent of at times seeming almost insincere. Masturbation is
common. Occasional outbursts of violence are also common, often
with mental confusion, incoherence, or stupor, and in severe cases
there occur, usually, attacks of temporary fury, with distressing or
agonizing hallucinations of sight and hearing, and delirium, which
may all last for a very short time or for a number of days. In young
women and girls these outbursts may be coincident with
menstruation or in the intervals. The countenance loses somewhat in
expression in all cases, and becomes almost vacant or quite so in
those in which the dementia becomes well marked. A mild form of
the disease is quite common, and consists in an undue intensity or a
prolongation of the curious psychological phenomena commonly
observed during adolescence. It is marked by aimlessness,
changeability, self-assertion, exaggerated self-consciousness, with,
perhaps, propensity to lie or steal or run away from home, and
ending without any apparent damage to the mind, except that the
individual is less of a success in life than he would have been but for
his illness.

The course is slow, and although in the majority of cases mental

impairment is arrested before reaching what may be properly called
complete dementia, in well-marked cases the duration of the disease
is long and its results last for life. In many cases progress continues
with extreme slowness to extinction of the mental faculties. Oftener
the individual simply, in a certain sense, fails to reach that stage of
intellectual maturity and strength which he otherwise would have
attained. It is not always easy to draw the line between the
psychological and the pathological changes that take place during
the years of adolescence, and there are many mild cases of
hebephrenia in which various kinds of failure in life are due to this
disease rather than to the faults or vices to which the failure may be
attributed.

In TREATMENT irritability, restlessness, absence of a power and sense

of responsibility, and sleepless, excitable nights, are the most difficult
symptoms to combat. The restlessness and irritability often lead to
refusal to be reasonably controlled and to a tendency to wander
away from home with theatrical displays, so as, in the case of girls
particularly, to require restraint, especially if the excitability should be
so great as to amount to outbursts of violence or should lead to
sexual improprieties.

The fact should be borne in mind that there is a diseased brain which
needs nutrition, rest, and discipline, which must be proportioned to
suit each case. Outdoor, simple life, with sea-bathing, carefully-
selected diet, without too much meat, exercise, mental training
limited to the requirements of each patient, are the chief reliances.
Iron, cod-liver oil, and arsenic are useful tonics. Stimulants, including
tea and coffee, should be avoided. Quiet nights and necessary
repose can be secured by bromides, exercise, and opiates used
sparingly, which also control the impulse to masturbation. A sound
education, a healthy experience of the rough and tumble of youthful
life, and the careful avoidance of processes and habits of indulgence
will often prevent the symptoms of disease from growing into traits of
character and habits of life. On the other hand, in some cases there
is a half-conscious struggle between the fine traits of character and
the demoralizing influences of the disease, and a most pathetic effort
to keep the better nature's supremacy over the lower impulses set
free or developed by the destructive tendencies of a fearful malady.

MENSTRUAL INSANITY differs from other periodic insanity in not being

necessarily a further development of an hereditary or acquired state
of mental degeneration, and in being curable in a fair proportion of
cases.

INSANITY OF GESTATION, PUERPERAL INSANITY, AND INSANITY OF LACTATION

do not call for any further comment than the remark that they
represent causes and conditions rather than types of disease.

CLIMACTERIC INSANITY in women and in men is usually a curable folie

raisonnante—insanity of action or affective insanity, which may
develop into secondary dementia or chronic insanity with delusions.
It does not necessarily include all acute forms of insanity occurring at
the climacterium, but only those slowly developing with the
physiological changes going on.

The course is usually subacute, the duration a couple of years or

more, and the termination in about half the cases is in recovery.
Permanent change of character and further progress to incurable
insanity are perhaps about equally common.

TREATMENT consists in a sedative and fattening diet, simple, healthful

conditions of life. Removal to an asylum or some form of restraint is
needed where the conduct is such as to demand seclusion and
control.

SENILE INSANITY arises in suspicions and a generally deluded state of

mind regarding those persons whom there is every reason to trust—
namely, relations and near friends—and as extraordinary
credulousness of designing persons whose interest and character
would naturally suggest being on the guard against them. There is
impaired judgment, as shown by the mismanagement of property
and diminished capacity for business, usually some perversion of the
sexual instinct. The suspicions and credulousness in time amount to
insane delusions, and if life lasts the end is in marked dementia. But
there may be no mental impairment evident to casual observers or to
ordinary acquaintances for many years. The improper relations
assumed with the opposite sex, the neglect or abuse of those
nearest by ties of blood, the squandering of property on strangers,
and the omission to provide properly for the members of the family,
are wrongly attributed to a character become bad rather than to
destructive brain disease, where they belong. Not seldom senile
insanity is a moral insanity, and shows itself by an entire change of
character not explainable by other circumstances than disease, and
is then marked by indecent exposures, loss of the fine sense of the
decencies and proprieties of life, destruction of the discriminating
power between right and wrong acts.

The course of senile insanity is slow, unless there be also some fatal
disease with it, and evident mental impairment may be so late that
the disease may be overlooked for years.

The TREATMENT is abundant nutrition, including wine, removal from

irritating conditions of life, protection of the individual against himself,
and guarding the community against harm or indecencies. Small
doses of morphia daily are often of great benefit, and there is no real
danger of acquiring the opium habit if reasonable discretion is
exercised in its use.

SENILE DEMENTIA is simply an excess of the natural mental weakness

of old age out of proportion to the bodily state, an exaggerated
childishness of senility to the extent of producing irresponsibility. It is
in reality a subacute primary dementia modified by the peculiarities
of old age. Memory fails first, and a condition of general weakness of
mind follows rapidly afterward. Secretiveness, suspicions, delusions,
and hallucinations of the special senses are almost always present.

It is not uncommon for the early symptoms to consist in an inhibition

of the higher faculties of the mind, so that the lower impulses
become prominent. The sense of right and wrong and the moral
perceptions may become entirely weakened. Acts of indecency,
dishonesty, injustice, depravity may follow impaired judgment, and
yet so far precede strikingly perverted memory and general
intelligence as to make the insanity, which is obvious to an
experienced observer, entirely fail to impress itself upon the minds of
the community.

The TREATMENT consists in caring for the comfort of the patient, which
can usually be done at home or at least in a private family, unless
there are persistent impulses requiring the control of an asylum. The
preparations of opium are useful to control extreme restlessness,
and may be given freely, avoiding narcotism. A bland diet of fattening
food is best suited to the wants of the aged. A simplified life often
serves every purpose, especially in the quiet of the country, although
it is best not to remove them from familiar scenes unless as a matter
of necessity.

Complicating Insanities.

Complicating insanities simply add to the usual symptoms of the

special forms of mental disease many of the characteristics of the
particular disease, rheumatism, gout, phthisis, organic diseases of
the heart, etc. Choreic movements depend upon the same
pathological changes as are found in the sane, and certain diseases
are attended with such profound changes in the nutrition of the brain
as to give rise to mental impairment, which amounts to almost
extinction of the mind, such as myxœdema and chronic nephritis.
Acute mania occurs in the last stage of Bright's disease, which may
be difficult to differentiate from uræmia. Mania, melancholia, and
delusional insanity occur in the course of acute febrile diseases or
appear during the period of convalescence; in the latter case the
prognosis is much more unfavorable than in the former. The close
alliance between insanity and pulmonary consumption is a matter of
frequent observation. The two diseases are interchangeable, and
they often coexist. The relation between rheumatism and insanity is
less close.

Insanity from Specific Poisons.

Maniacal symptoms have been reported from the use of various

drugs, including iodoform, mercury, etc. Hasheesh dementia is not
uncommon in the East. Acute delirium arises from hydrate of chloral
and the preparations of opium analogous to acute alcoholic mania
from excessive drinking, and chronic impairment from their
prolonged use. Bromide of potassium rarely produces symptoms
similar to those of mania; taken for a long time in even moderate
doses, it tends to mental sluggishness, and in long-continued large
quantities given uninterruptedly there is a danger of well-marked
dementia.

All of these conditions may be prolonged beyond the usual action of

the particular drug or give rise to symptoms in excess of those
usually observed. The characteristic indications of the particular
drug, sometimes marked by the combined use of several, will be
found if they are carefully looked for.

The TREATMENT consists in breaking off the bad habit gradually or

abruptly as each case may require, and in otherwise treating the
persisting symptoms in accordance with the general principles
already stated in considering the various mental diseases.

ALCOHOLIC INSANITY includes mental disorder from the use of alcohol

in both the acute and chronic forms.
Acute alcoholic mania may come from a single excess in drinking,
which in some individuals is always attended with maniacal
symptoms. It may constitute the alcoholic trance described under the
head of Transitory Insanity. From long drinking and exhaustion or by
withdrawal of the accustomed stimulant we may have the familiar
mania-a-potu or delirium tremens.

Under the prolonged use of alcohol primary delusional insanity,

melancholia, mania, and dementia occur.

From long-continued drinking of alcohol, even to slight excess, for

many years, it is rare not to find some mental impairment, if only an
“uncontrollable violence of the instincts and emotions,” a sort of
moral insanity.

The PROGNOSIS is more favorable than in most forms of insanity

uncomplicated by the abuse of alcohol, especially in the case of
primary delusional insanity, if the bad habits can be effectually
corrected and if the alcoholic excesses have not been continued
long enough to produce organic changes in the cerebral blood-
vessels. In the latter case the dementia sometimes simulates that of
general paralysis so closely as to be called pseudo-paralytic
dementia from alcohol.

TREATMENT is rarely successful outside of some asylum.

SYPHILITIC INSANITY does not properly include those cases of mania,

melancholia, and delusions of persecution of the ordinary type of
which the exciting cause is found in the train of thought aroused and
kept up by the consciousness of having contracted syphilis, but only
such as depend upon the presence of the syphilitic poison in the
system. There are no diagnostic marks to distinguish it from insanity
not caused by syphilis, except in a certain proportion of cases of
organic syphilitic disease of the brain.

The PROGNOSIS is rendered much less favorable from the fact of the
syphilitic cachexia.
In addition to the usual means of TREATMENT for the several forms of
insanity, the appropriate measures for syphilis should also be tried,
except where there is evidence of diffuse organic disease.

Organic Mental Diseases.

GENERAL PARALYSIS OF THE INSANE is a disease marked by definite

pathological changes in the central nervous system, chiefly in the
cortex of the brain, but which may extend to any part of the cerebro-
spinal tract or to the sympathetic ganglia and cranial and spinal
nerves. Its constant symptoms are—(1) vaso-motor disturbance
ending in vaso-motor paresis; (2) mental impairment, which makes
progress, for the most part unevenly, to complete terminal dementia
or extinction of mind; (3) impaired muscular control, which advances
more or less uniformly to almost entire paresis or nearly total
paralysis. Expansive delusions, the delirium of grandeur,
megalomania (which may change suddenly to micromania), or
simply a feeling of elation, happiness, self-satisfaction, or undue
complacency, are found, but often not until or near the end. The
other symptoms vary in individual cases within a wide range, so as
to simulate almost every form of insanity; and it is quite possible that
they include what a more exact pathology will hereafter recognize as
several distinct diseases.

SYNONYMS.—General paralysis is also known as general paresis,

progressive paralysis of the insane, paretic dementia, paralytic
dementia, cirrhosis of the brain, paralysie-générale, folie paralytique,
démence paralytique, periencephalite chronique diffuse, meningo-
myélo-encephalite chronique interstitielle diffuse, encephalite
généralisée, periencephalite chronique diffuse, encephalite
interstitielle diffuse, encephalite avec proliferation sclereuse
interstitielle, Allgemeine Paralyse, progressive Paralyse der Irren,
chronische progressive parenchymatöse Encephalitis der
Rindensubstanz, pericerebritis, periencephalo-meningitis diffusa
chronica, periencephalo-myelitis chronica diffusa, encephalitis
interstitialis corticalis, paralytische Blödsinn, primäre Encephalitis
interstitialis mit Ausgang in Sclerose. Griesinger placed general
paralysis among the complications of insanity. It is popularly known
as softening of the brain (Gehirnerweichung).

HISTORY.—The combination of the two series of symptoms, paralysis

and dementia, was recognized by Haslam, and at the beginning of
this century by French writers, who also knew their fatal import.
Esquirol describes a typical case of general paralysis of the insane
under the head of monomania in his Maladies mentales. His pupils,
especially Bayle and Calmeil, have studied and described general
paralysis. At the time of his first visit to England, forty years ago, the
late Luther Bell had never recognized a case, and there can be no
doubt of the fact that it has rapidly increased, particularly in the last
dozen or twenty years, with the rapid increase in the aggregation of
the population.

ETIOLOGY.—So far as heredity is concerned, general paralysis has

not such close relations with mental diseases as insanity in general.
It is estimated to be hereditary, in the sense of being closely related
to other forms of insanity, about one-half as often, and it is nearly
allied to apoplexy and epilepsy. My own experience leads me to the
conclusion that in those cases of general paralysis without a
previous history of syphilis (and the same statement is true in less
degree of persons who have had syphilis) the vast majority occur in
families in which there have been cases of insanity, epilepsy, or
apoplexy. It is rare among people living simple agricultural lives, but
is intimately connected with the faults and vices of civilization—
specialized overwork, involving strain in the office, study, factory,
mine, etc., especially if to bodily exhaustion and brain wear and
worry there be added hard living and hard drinking, sexual excesses,
and syphilis. The Scotch Highlander rarely has the disease until he
comes to Edinburgh or Glasgow. In Ireland general paralysis is so
rare that of 9271 cases of insanity in 1882, only 6 were general
paralytics, as compared with 1151 out of 13,581 in England the
same year; during which, in Scotland, of 238 deaths from insanity, 10
were from general paralysis; but the Irishman has no special
exemption from general paralysis in American cities or in large
English towns and mines and factories, where he works hard, drinks
hard, and lives hard generally. It is, so far as I am able to learn,
unreported thus far among our negro population until they come to
the great centres of population; it is said to have been unknown
among the slaves. Among the English, Scotch, and Americans it
prevails most among those people who are in, or who have dropped
down to, the lower strata of society. Of 2212 private patients in
England, 139, or about 6 per cent., were general paralytics, while
1012, or about 9 per cent., were found among 11,359 pauper
patients. French and German writers report it as most common
among the brain-workers. In women of the upper class it exceedingly
seldom occurs. In some of our Western asylums not more than 1 or
2 per cent., or even less, of the patients are reported as general
paralytics, coming chiefly from farms. In the asylum for the centre of
the manufacturing districts of Massachusetts about 9 per cent. of the
patients are general paralytics. From the iron- and coal-mines of
England from 14 to 17 per cent. of the insane confined in asylums
are general paralytics. It is more common in cold climates than in
warm, other things being equal. From one-sixth to one-tenth of the
cases, varying in different localities, are women.

General paralysis not only is most frequent in the stronger sex, but it
selects the strong individuals in the prime of life, between the ages of
thirty-five and fifty. It is extremely rare under the age of twenty,
although Turnbull has reported an unique case at the age of
twelve;23 it is not common under thirty or over sixty; I have seen two
cases in men sixty-five years old. It is seldom seen in individuals
who have been weak from childhood, unless as the probable result
of syphilis.
23 Journal of Mental Science, October 1881.

The excesses of the habits of the city and of mining and

manufacturing centres, hard work, high living, late hours, predispose
to general paralysis in strong constitutions at the period of their
greatest activity, especially if the physical strain, the violent struggle
for existence, has begun early in life with insufficient food and
excessive work, and if ordinary paralysis be not uncommon in the
family. Alcoholic and sexual excesses are considered to be
particularly common predisposing causes. Recent investigators find
syphilis to be a part of the antecedent history of from one-half to
three-fourths of the cases, but chiefly in those slowly advancing or
subacute from the beginning. By some writers syphilis is considered
to be in those cases only a diathesis, as is held by Fournier, or a
debilitating antecedent, like chronic malarial poisoning. Others think
that so large a proportion can be accounted for only by some specific
relation between the two diseases. If the fact so often stated is true,
that syphilis is rapidly increasing, perhaps part at least of the
increase in general paralysis can be thus accounted for.

Mental shocks of various kinds, excessive emotional strain with

mental exhaustion, and injuries to the brain, are the commonly
reported exciting causes of general paralysis, but it is not certain that
—in many cases, at least—they do more than hasten the
pathological process and call attention to the symptoms. So far as
my observation goes, the injury to the head, supposed to be the
cause of general paralysis, often has appeared to probably come
from an accident due to the impaired physical strength and to the
vaso-motor disturbance in the brain incident to the early stage of the
disease and while it was still unrecognized. Cases are observed in
which no predisposing or exciting cause is found by the physician. I
have seen it following diphtheria and other debilitating diseases,
after long exposure to malaria, and apparently due simply to
prolonged mental strain in persons otherwise living in moderation
under circumstances exceptionally favorable to health.

SYMPTOMATOLOGY AND COURSE.—As a rule, to which the exceptions

are few, the early symptoms of general paralysis are obscure. Their
appearance and progress are so gradual and insidious that they are
usually overlooked for a period varying from several weeks to a year
or more, sometimes for four or five years, perhaps even longer.
There is a slight change in character, which is frequently attributed to
wilfulness or perverseness arising from some disagreeable
circumstance; to want of a reasonable attention to the little affairs of
daily life; to indifference, temper, carelessness, or recklessness; to a
want of aptitude and receptivity having an ethical rather than medical
significance; to an impaired moral sense. The patient may be
observed to be simply more quiet and heavy; inclined to be
depressed rather than distinctly melancholy; a little heedless;
unusually indifferent, and indisposed to worry over things that
formerly would have disturbed him; drowsy or dropping off to sleep
at work or in the theatre; disturbing the household by his
restlessness at night—in and out of bed, up and down stairs, for
trivial and yet not seemingly insane reasons. He may become easily
disturbed by trifles, and yet careless to more important matters. He
begins to overlook, perhaps rather than forget, recent little things.
His power of attention is diminished, his will weakened, his self-
control impaired. He becomes less careful of the niceties and
proprieties of life, less interested in his family and all that is nearest
to him—self-absorbed, egotistic, indulging in inconsequent stories
and remarks. Although the memory is not distinctly at fault, fresh
impressions do not make their usual imprint on the mind. His moods
are unnaturally changeable. A certain slovenliness in habits or
carelessness in dress, an inattention to customary little courtesies
and attentions, slight yet noticeable, are not uncommon early
symptoms of general paralysis. There is soon observed, often
noticeable to the patient, a lack of endurance, an early sense of
fatigue from exertion, a sense of muscular prostration, physical
discomfort, or general pains which may be attributed to malaria or
rheumatism. Commonly, not always, there is disturbed sleep or
restlessness. There may or may not be headache, slight or severe,
transient or persistent. There may be a sense of pressure or an
uncomfortable feeling about the head, especially the forehead, or it
may be the seat of no pain or discomfort whatever. There may be a
slight or severe local or general sensation of distress or uneasiness
in the head after mental effort only. There is often pain, anæsthesia,
hyperæsthesia, paræsthesia affecting any sensitive nerve, often
none at all, or impaired muscular sense.
The average daily temperature is higher in general paralytics than in
health. It is sometimes lower, and the range is greater than the
normal. In the only extremely rapid case which I have seen (two
months in all) it was 97° F., and thereabouts for a number of days,
and then rapidly rose to 103° and 104°, where it remained until near
death. After the congestive, epileptiform, and apoplectiform attacks it
rises from two to seven degrees, and remains high for a
considerable time, while in pure epilepsy it quickly falls. This
difference, however, is not sufficient, as between epilepsy proper
and epilepsy as an early symptom of general paralysis, to establish
the differential diagnosis with certainty in all cases.

The vaso-motor disturbances in the brain are indicated by transient

congestions or local anæmia, dizziness, faintness, temporary
outbursts of anger, excitement, or confusion, and rapid changes in
the mental and emotional state. Convulsive attacks are not common
in the early stage of the disease, except in those cases due to
syphilis, but may occur, and may so resemble hysteria, petit mal,
epilepsy, and apoplexy as to be confidently diagnosticated for those
diseases. The emotional state is of indifference, despondency,
gloom, melancholia, elation, a feeling of self-satisfaction, or mania.

The symptoms thus far are not clear except on minute examination.
The family and most intimate friends of the patient observe that he is
changed, but cannot tell how, and are apt to say that he is not the
same man that he was, that his troubles have been too much for
him, that he does foolish things as never before, etc. Sometimes he
estimates his symptoms correctly, sees the downward change
himself, and is oppressed by it; oftener he is indifferent to it, or still
oftener quite well satisfied with his condition and prospects, or even
mildly elated. He may squander his fortune, ruin his reputation,
become addicted to drink. His sexual appetite, not held back by his
normal power of self-control or exaggerated with a general physical
and intellectual erethism, may lead him into all sorts of improprieties
and immoralities or to exhausting excesses, which are perhaps more
common among the married than among the unmarried; and yet his
disease is not recognized, because the later symptoms of general
paralysis—namely, grand delusions, staggering gait, tremor, and
marked dementia—have not yet appeared.

The pianist loses his skilled touch; the actor fails to learn a new part;
the ready salesman no longer has his great facility of selling; the
singer does not see that his notes have become false and harsh; the
engraver's fine lines are no longer possible to him; the preacher
reads the same hymn three times in his Sunday service; the man of
promptness fails to keep his appointments; the speech seemingly
clear to others becomes indistinct to a deaf wife; the eye trained to
close, exact work loses its capacity of fine distinctions of form or
color; the expert accountant can no longer add up his three columns
of figures at a time; the doctor writes prescriptions showing
unwonted carelessness or impaired judgment to the extent of injuring
his practice; a banker loses his property by foolish ventures; the
saving business-man buys quantities of useless articles; the moral
man becomes licentious or the temperate a drunkard; the respected
father of a family goes to the State prison for running off with a pretty
servant-girl; the lawyer ruins his client's cause; the considerate
husband shows unwonted harshness and violence to his wife; the
industrious worker becomes a tramp or a vagabond; the amiable
friend becomes irritable, disagreeable, perverse, hard to please,
easily excited, cranky. These are some of the facts I have known to
occur in the early stage of general paralysis without giving rise to the
suspicion of cerebral disease, the conduct of the individual generally
not suggesting insanity. In one case the cerebral vaso-motor
disturbance caused marked intoxication from a small amount of
wine, previously taken habitually without showing it, for several
weeks before the most careful examination revealed other
indications suggesting general paralysis. In the upper walks of life,
wherever a nice intellectual adjustment or fine muscular co-
ordination is required in the daily duties, symptoms to put the
physician at least on his guard against general paralysis will rarely
be overlooked in this early stage of the disease if they are sought for
with sufficient care and appreciation of their import. In proportion as
the employment is coarser, and not requiring much mental or
muscular exactness, the symptoms are more difficult of correct
apprehension, until we get to the day-laborers, in whose dull nervous
organizations quick reactions do not occur, and in whose simple
labor, requiring little thought and only muscular co-ordination of a low
grade, a partially demented brain and muscles considerably impaired
in strength serve their purpose so well that an early diagnosis is next
to impossible. Routine work, to which he is long accustomed, is often
done well by a general paralytic, provided it does not require exact
mental or muscular co-ordination, when the disease has so far
advanced that any new work except of the simplest kind could not be
performed.

It is seldom that general paralysis, in its early stage, receives careful

enough attention to be recognized or to create a suspicion of its
existence until exhaustion, a long period of sleeplessness, perhaps a
violent shock, a strong emotion, a fall or a blow, a congestive attack,
an epileptiform seizure, an apoplectiform convulsion, or some
unknown cause—probably a vaso-motor disturbance in the brain—
hastens the progress of the disease, and the previously slight or
obscure symptoms (at least some of them) are suddenly so
aggravated as to make them of unmistakable signification. It is usual
in such cases to date the appearance of general paralysis from this
point, and to overlook its previous existence for the weeks, months,
or it may be years, of its prodromal period. It is especially easy to
overlook the period of invasion of general paralysis of the insane, as
the symptoms may, and generally do, have that temporary, transient,
and variable character which is common to diseases or stages of
disease in which vaso-motor disturbances predominate; inasmuch,
also, as the individual character has to be taken so much into
account in estimating the import of particular symptoms, and as few
or many of the leading indications of general paralysis may be
present in a particular individual, while the physician might happen to
make several examinations of his patient at times when the
symptoms did not appear at all. For now and then all symptoms
absolutely disappear in a time which may be short or long. In two
cases of general paralysis in the period of invasion, where the moral
perversion was said by the other members of the family to be a
source of great trouble, I sent both patients to an insane asylum