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her teeth to be extracted. People must pray for her, that God might pardon her sin. In vain her friends attempted to talk her out of her fears, to assure her that the extraction of teeth was really no sin; it availed nothing. At daybreak she became somewhat quieter; she worked throughout the day. On following nights the attacks were repeated. When consulted by the patient I found her quiet, but she wore a rather vacant expression. I talked to her about the operation, and she assured me it was not so dreadful to have teeth extracted, but still it was a great sin, from which position, despite every persuasion, she could not be moved. She continually repeated in plaintive, pathetic tones, “I should not have allowed my teeth to be extracted; oh yes, that was a great sin which God will never forgive me.” She gave the impression of real insanity. A few days later her condition grew worse, and she had to be brought into the asylum. The anxiety-attack had extended and was persistent, and the mental disorder lasted for months.
The history shows a series of entirely unrelated symptoms. Why all the queer story of the hat and pince-nez? Why those anxiety-attacks? Why this delusion that the extraction of her teeth was an unpardonable sin? Nothing here is clear. The morphologically-minded psychiatrist would say: This is just a typical case of dementia praecox; it is the essence of insanity, of madness, to talk of nothing but mysteries; the standpoint of the diseased mind towards the world is displaced, is “mad.” What is no sin for the normal, the patient finds a sin. It is a bizarre delusion characteristic of dementia praecox. The extravagant lamentation about this supposed sin is what is known as “inadequate” emotional emphasis. The queer ornamentation of the hat, the pince-nez, are bizarre notions such as are very common in these patients. Somewhere in the brain certain cells have fallen into disorder, and manufacture illogical, senseless ideas of one kind and another which are quite without psychological meaning. The patient is obviously a hereditary
- In psychiatry “inadequate” is employed to denote disproportion between feeling and idea whether in excess or the reverse.