PROGNOSIS AND TREATMENT

Abstract

death. This is associated with a deep clouding of consciousness, with perceptive difficulties resulting in incompletely perceivedl Gestalten, and in motor difficulties with increased impulses to rhythmic movements. By this combination the visual motor Gestalten in copied figures are profoundly disturbed, and the figure is reproduced incompletely and distorted by perseverated strokes. In Korsakoff psychosis, with less clouding of consciousness, the motor impulses to perseverate tendencies in the figure may be more prominent. In the chronic alcoholic hallucinatory states the Gestalt, as a whole, may be well preserved, but the outlines are hazy, perhaps partly from tremulousness and partly from the motor impulse to reiterate the lines. In the alcoholic confusional states there are less marked motor difficulties, but the perceptive difficulties are in the foreground and show disturbances of integration of the parts into the whole and in the orientation of the figure on its background. In traumatic psychoses the acute confusional stages following the trauma are characterized by clouding of consciousness, with difficulties in the synthesis of the perception and the Gestalt function. Visual motor Gestalten show reversions to primitive features. Especially there is seen the disorientation of the figure on its background. As the clouding of consciousness clears and. a chronic Korsakoff picture is left, there may be typical Korsakoff features characterized by correct grasp of the figure as a whole, and its orientation on its background, with a tendency to some reversions to primitive responses and bizarre replacements of parts of the figure without interference with the structure of the Gestalt. In acute confusional states the disturbance resolves itself into difficulties in the integration of the parts of the figure to the whole, and of the whole figure to its background or situation. Tendencies to primitive reversions are secondary to this primary difficulty.