Mental medicine and nursing : for use in training-schools for nurses and in medical classes and a ready reference for the general practitioner . ditions are often referred to as imperativeideas or concepts. CONSTITUTIONAL PSYCHOPATHIC STATES 141 In the mild forms they are common and occurnot infrequently in normal persons. We are allfamiliar with the tendency of the constant recur-rence in the mind of a tune that runs in thehead after attendance at a concert or listeningto the Victrola. Then there is the more pro-nounced case of theperson who goes tobed but is anxiousfor fear he may nothave lo
Mental medicine and nursing : for use in training-schools for nurses and in medical classes and a ready reference for the general practitioner . ditions are often referred to as imperativeideas or concepts. CONSTITUTIONAL PSYCHOPATHIC STATES 141 In the mild forms they are common and occurnot infrequently in normal persons. We are allfamiliar with the tendency of the constant recur-rence in the mind of a tune that runs in thehead after attendance at a concert or listeningto the Victrola. Then there is the more pro-nounced case of theperson who goes tobed but is anxiousfor fear he may nothave locked thefront door. Beforehe can settle intosleep he is forced togo down to test hisdoubt. Obsessions areof various are threegreat classes tobe distinguished, de-pending upon theinfluence that theimperative idea ex-ercises upon the pa-tient: (1) Intellecualobsessions, which are unaccompanied by anyvoluntarv activity; (2) impulsive obsessions, inwhich the idea tends to be transformed into anact; (3) inhibiting obsessions, the action of whichtends to paralyze certain voluntary acts. 1. Intellectual Obsessions.—In this form the. Fig. 58.—A noted case of sexual per-version, who appeared for thirty yearsin female attire. i42 MENTAL MEDICINE AND NURSING mind of the patient is occupied either by someconcrete idea—such as a word, an object, animage of some person or of some scene—or by-some abstract idea—such as life, the Deity, the imperative idea takes a negativeform, and in other instances it is expressed bydoubt, thus constituting a transitional form be-tween intellectual and inhibiting obsessions. 2. Impulsive Obsessions.—Theseare very numer-ous. The following are some of the principal forms: Onomatomania: a persistent desire to pro-nounce certain words, sometimes obscene words(coprolalia). Associated with a tic, coprolaliaconstitutes the disease of convulsive tics (thedisease of Gilles de la Tourette). Arithmomania: a persistent desire to cou
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