Focal Sepsis and Mental Disease
Review of New Outlook on Mental Diseases. By F. A. Pickworth, M B., B.S., B.Sc. (PD. 296; illustrated. £3.) Bristol: John Wright and Sons. 1952.
British Medical Journal, 6 December 1952, p. 1245
This lavishly produced and illustrated book represents the results of a lifetime of research into the pathology of mental illness. The author has been particularly interested in the influence of focal sepsis, especially in the nasal sinuses, on mental health. In his experience vascular changes, of a kind to be ascribed to the absorption of toxins, are important factors in the causation of mental disorder. He takes the view that pathological changes can always be found in the mental patient post mortem, and usually during life, and that the mental illness itself was caused by these changes. Thus he regards manic-depressive psychoses as being caused by multiple local ischaemic foci in the brain; post mortem he has found changes in the alimentary mucosa and in the mesenteric glands suggesting the absorption of toxic products, and, suggesting their effects, minute scars in brain, liver, and kidneys.
The focal-sepsis theory of mental pathology has been repeatedly criticized in the past, and the author is no doubt aware that his views run counter to the general consensus of opinion to-day, according to which other causes than those he mentions have to be ranked high in importance. One must regret, therefore, that he has not taken the opportunity of discussing the case against as well as for the views he holds. The psychiatric approach to problems of aetiology is much subject to changes of fashion, and it may well be that the climate of opinion of the future will be less hostile to his standpoint than it is now.