Types of the nervous system, their main properties and differences

NS classification

The nervous system is divided into: central and peripheral.

The central nervous system is the main part, which includes the spinal cord and brain. Both of these organs are reliably protected by the skull and spine. The PNS is the nerves responsible for movement and sensory. It ensures human interaction with the environment. With the help of the PNS, the body receives signals and reacts to them.

There are two types of PNS:

Somatic - sensory and motor nerve fibers. Responsible for coordination of movement; a person can consciously control his body.
Autonomic - divided into sympathetic and parasympathetic. The first gives a response to danger and stress. The second is responsible for peace and normalization of the functioning of organs (digestive, urinary).

Despite their differences, both systems are interconnected and cannot work autonomously.

How to write a term paper on speech therapy

07.09.2010 228870

These guidelines are compiled to help students gain an understanding of the content and structure of coursework in speech therapy.

Logopedia of pedagogical science that studies anomalies of speech development with normal hearing, explores the manifestations, nature and mechanisms of speech disorders, develops the scientific basis for overcoming and preventing them means of special training and education.

The subject of speech therapy as a science is speech disorders and the process of training and education of persons with speech disorders.

The object of study is a person suffering from a speech disorder.

The main task of speech therapy as a science is the study, prevention and elimination of various types of speech disorders.

Coursework in speech therapy is a student's scientific and experimental research. This type of educational activity, provided for by the educational and professional program and curriculum, contributes to the acquisition of skills in working with literature, analyzing and summarizing literary sources in order to determine the range of insufficiently studied problems, determining the content and methods of experimental research, processing skills and qualitative analysis of the results obtained. The need to complete coursework in speech therapy is due to the updating of knowledge concerning the content, organization, principles, methods and techniques of speech therapy work.

As a rule, during their studies, students must write two term papers - theoretical and practical.

The first course work should be devoted to the analysis and synthesis of general and specialized literature on the chosen topic. Based on this analysis, it is necessary to justify and develop a method of ascertaining (diagnostic) experiment.

In the second course work, it is necessary to provide an analysis of the results obtained during the ascertaining experiment, as well as determine the directions and content of speech therapy work, and select adequate methods and techniques of correction.

So, let’s present the general requirements for the content and design of coursework in speech therapy.

The initial and most important stage of working on a course project is the choice of a topic, which is either proposed by the supervisor or chosen by the student independently from a list of topics that are consistent with the areas of scientific research of the department.

Each topic can be modified, considered in different aspects, but taking into account a theoretical and practical approach. Having chosen a topic, the student needs to think through in detail its specific content, areas of work, practical material, etc., which should be reflected both in the formulation of the topic and in the further construction of the study. It should be recalled that the chosen topic may not only have a purely theoretical orientation, for example: “Dysarthria. Characteristics of the defect”, “Classification of dysgraphia”, but also take into account the practical significance of the problem under consideration, for example: “Speech therapy work on speech correction for dysarthria”. It should also be taken into account that when formulating a topic, excessive detail should be avoided, for example: “Formation of prosodic components of speech in preschoolers of the sixth year of life attending a preschool institution for children with severe speech impairments.”

The course work includes such mandatory parts as: introduction, three chapters, conclusion, bibliography and appendix.

The text of the term paper begins with the title page . An example of its design can be seen here.

Then the content of the work is given, in which the names of chapters, paragraphs, and sections are formulated in strict accordance with the content of the thesis. An example of its design can be seen here.

In the text, each subsequent chapter and paragraph begins on a new page. At the end of each chapter, the materials are summarized and conclusions are formulated.

The introduction reveals the relevance of the problem under consideration in general and the topic being studied in particular; the problem, subject, object, and purpose of the study are defined. In accordance with the goal and hypothesis, objectives and a set of research methods aimed at achieving the objectives must be defined.

The relevance of the topic lies in reflecting the current level of pedagogical science and practice, meeting the requirements of novelty and usefulness.

When defining the research problem, it is important to indicate what practical tasks it will help to implement in training and educating people with speech pathology.

The object of research is understood as certain aspects of pedagogical reality, perceived through a system of theoretical and practical knowledge. The ultimate goal of any research is to improve this object.

The subject of research is some part, property, element of an object, i.e. the subject of research always indicates a specific aspect of the object that is to be studied and about which the researcher wants to gain new knowledge. An object is a part of an object.

You can give an example of the formulation of the object, subject and problem of research:

– The object of the study is the speech activity of preschool children with phonetic-phonemic speech disorders.

– The subject of the study is the features of intonation speech of children with phonetic-phonemic speech disorders.

– The research problem is to determine effective directions for speech therapy work on the formation of intonation expressiveness of speech in the system of correctional intervention.

The purpose of the study contributes to the specification of the object being studied. The goal of any research is to solve a specific problem. The goal is specified in tasks taking into account the subject of research.

The research objectives are formulated in a certain sequence, which determines the logic of the research. The research objectives are set on the basis of a theoretical analysis of the problem and an assessment of the state of its solution in practice.

The first chapter is an analysis of literary sources, which examines the state of this problem in historical and modern aspects, and presents the most important theoretical principles that formed the basis of the study.

When writing the first chapter, you should pay attention to the fact that the text of the course work must be written in a scientific style. When presenting scientific material, it is necessary to comply with the following requirements:

– Specificity – a review of only those sources that are necessary to disclose only a given topic or solve only a given problem;

– Clarity – which is characterized by semantic coherence and integrity of individual parts of the text;

– Logicality – which provides for a certain structure of presentation of the material;

– Reasoning – evidence of thoughts (why this and not otherwise);

– Precision of wording, excluding ambiguous interpretation of the authors’ statements.

A literary review of the state of the problem being studied should not be reduced to a consistent presentation of literary sources. It should present a generalized description of the literature: highlight the main directions (currents, concepts, points of view), analyze in detail and evaluate the most fundamental works of representatives of these directions.

When writing a work, the student must correctly use literary materials, make references to the authors and sources from which the results of scientific research are borrowed. Failure to provide required references will reduce your coursework grade.

As a rule, in coursework on speech therapy, references to literary sources are formatted as follows: the number of the cited source in the general list of references is placed in square brackets. For example: General speech underdevelopment is a speech pathology in which there is a persistent lag in the formation of all components of the language system: phonetics, vocabulary and grammar [17].

When using quotations, in square brackets, in addition to indicating the source number, the page number from which this excerpt is taken is indicated, for example: Speech rhythm is based on a physiological and intellectual basis, since, firstly, it is directly related to the rhythm of breathing. Secondly, being an element that performs a communicative function, “correlates with meaning, i.e. controlled intellectually” [23, P.40].

However, course work should not be of a purely abstract nature, so you should not abuse the unreasonable abundance of citations. Quoting should be logically justified, convincing and used only when really necessary.

In the second chapter , devoted to experimental research, the organization should be described and the program of the ascertaining experiment should be presented. The survey methodology, as a rule, consists of a description of several series of tasks, with detailed instructions, visual and lexical material, the procedure for completing tasks by experiment participants, and scoring criteria. This chapter also provides a qualitative and quantitative analysis of the results obtained.

When analyzing the results of an experiment, it is necessary to use a scoring system. Examples of various criteria for quantitative and qualitative assessment are presented in the following works:

– Glukhov V.P. Formation of coherent speech in preschool children with general speech underdevelopment. - M.: Arkti, 2002. - 144 p.

– Fotekova T.A. Test methodology for diagnosing oral speech of primary schoolchildren. - M.: Arkti, 2000. - 56 p.

– Levchenko I.Yu. Pathopsychology: Theory and practice. - M.: Academy, 2000. - 232 p.

In order to visually present the results obtained during the experimental study, it is recommended to use tables, graphs, diagrams, etc. Histograms can be used in a variety of ways - columnar, cylindrical, planar, volumetric, etc. An example of the design of tables, figures, and histograms can be found here.

The third chapter provides a rationale for the proposed methods and techniques and reveals the content of the main stages of correctional work.

The conclusion contains a summary of the material presented and the main conclusions formulated by the author.

The bibliography must contain at least 25 sources. The list includes bibliographic information about the sources used in preparing the work. An example of its design can be seen here.

In the application you can present bulky tables or illustrations, examination protocols, observation records, products of activity (drawings, written works of children), notes from speech therapy classes, etc.

The volume of one course work must be at least 30 pages of typewritten text.

In general, coursework in speech therapy is the basis for a future thesis, in which the study of the begun problem can be continued, but from the standpoint of a different approach or a comparative analysis of the disorders being studied in different age categories of people with different types of speech disorders.

The content and format of theses in speech therapy can be found here.

Literature:

1. How to write a term paper on speech therapy: Methodological recommendations. Educational and methodological manual / Comp. Artemova E.E., Tishina L.A. / Ed. Orlova O.S. – M.: MGOPU, 2008. – 35 p.

2. Research work of students in the system of higher professional pedagogical education (specialty 031800 - Speech therapy). Methodological recommendations for completing the thesis / Compiled by. L.V. Lopatina, V.I. Lipakova, G.G. Golubeva. - St. Petersburg: Publishing house of the Russian State Pedagogical University named after. A. I. Herzen, 2002. - 140 p.

What are signaling systems

The signaling system is a set of reflexes that connect the body with the environment. They serve as a step in the formation of higher nervous activity.

There are two signaling systems:

reflexes to specific stimuli - light, sound (available in animals and humans);
speech system - developed in a person in the process of work.

Higher nervous activity

Higher nervous activity (HNA), carried out by the cerebral cortex, ensures the most perfect adaptation of humans and animals to constantly changing environmental conditions and underlies higher mental functions of humans, such as thinking, memory, consciousness and learning.

“Father of Russian physiology” - I.M. Sechenov wrote the book “Reflexes of the Brain,” where he put forward a theory about the reflex principle that underlies the activity of the internal nervous system. These ideas were continued and developed by I.P. Pavlov, who experimentally proved that conditioned reflexes underlie GNI.

While studying the digestive system, you learned about the experience of I.P. Pavlov, with the help of which he studied the mechanism of salivation. After conducting experiments, Pavlov discovered that some of the reflexes are innate - permanent, and the other - acquired.

With numerous coincidences of the conditioned (signal) and the unconditioned stimulus reinforced by it, a conditioned reflex is formed. That is, a conditioned reflex always arises on the basis of an unconditioned reflex with repeated coincidence of the above stimuli.

Conditioned and unconditioned reflexes

Now let’s look in more detail at the differences between conditioned reflexes and unconditioned ones:

Acquired - congenital

Conditioned reflexes are acquired: they are absent in a newborn and can arise and fade throughout life. Unconditioned reflexes are innate, genetically determined and inherited.

Individual - group

Conditioned reflexes are individual, determined by previous experience: a child who sees a lemon for the first time in his life does not salivate, but after eating it, even the thought of a lemon can cause profuse salivation. Unconditioned reflexes are characteristic of all individuals of the species without exception.

Nonspecific - specific

Conditioned reflexes arise in response to a nonspecific stimulus, for example, light, if the dog has a conditioned reflex to light. Unconditioned reflexes arise in response to a specific stimulus: sound is perceived by the receptors of the inner ear, light - by the rods and cones of the retina.

Changeable - constant

Conditioned reflexes are acquired as an adaptation to specific environmental conditions; when the environment changes, they also change and can be lost and reappear. Unconditioned reflexes are constant, given from birth and do not fade throughout life.

With bark - without bark

Conditioned reflexes always arise and are carried out with the participation of the cerebral cortex; unconditioned reflexes can do without its participation. The main thing is to remember and realize that any conditioned reflex is carried out on the basis of an unconditioned reflex.

The mechanism of conditioned reflex formation

The study of conditioned reflexes is closely connected with Pavlov and his students. Now we will conduct an experiment on a dog.

Let's assume that we need to develop a salivation reflex in an animal in response to turning on the light. We will use food as an unconditional stimulus, and turning on a light bulb as a conditioned stimulus.

A few seconds before we give food to the dog, we need to turn on the light bulb. If we repeat this manipulation several times, the dog will develop a conditioned reflex to turn on the light bulb, and in the future, salivation will begin at the moment the light turns on.

This effect is due to the fact that in the dog’s brain a temporary connection arises between the visual center (in the occipital lobe of the CBP) and the food center. As our manipulation is repeated, this temporary connection becomes stronger - a closure occurs and a conditioned reflex is formed.

Inhibition of reflexes

Inhibition processes are obligatory concomitants of excitation processes in the nervous system. Sechenov was the first to discover and describe the process of inhibition, proving that irritation of the nerve centers of the diencephalon inhibits the reflex activity of the spinal cord.

Pavlov developed the teachings of Sechenov and also studied the processes of inhibition. He came to the conclusion that in the nervous system the processes of excitation and inhibition are interconnected and occur continuously. Moreover, thanks to inhibition, the conditioned reflex is of the most accurate and perfect adaptive nature in relation to the environment.

Pavlov described two types of cortical inhibition:

Unconditional (external)
Conditional (internal)

Unconditional (external) inhibition is associated with the emergence in the cerebral cortex of a new (external) focus of excitation caused by the action of some external stimulus (sharp sound, loud noise). The action of this stimulus causes a weakening or complete disappearance of the current conditioned reflex.

This is an innate inhibition; it does not require development, which is why Pavlov called it unconditional (external).

Conditioned (internal) inhibition occurs in the same area of the cortex where the center of the conditioned reflex is located. Conditioned inhibition develops gradually. Remember how we developed a conditioned reflex in a dog to turn on a light bulb. If we stop giving food and continue to turn on the light bulb, then gradually the dog’s salivation will fade away - this is conditioned inhibition.

In order for the conditioned reflex to be maintained, it is necessary to reinforce it as often as possible: in our case, light (the conditioned stimulus) is reinforced with food (the unconditioned stimulus). If you stop turning on the light bulb before giving the dog food, the conditioned reflex will gradually weaken and disappear. This process is called extinction - the disappearance of a conditioned reflex, but if desired, it can be created again.

Pavlov's doctrine of the first and second signal systems

Animals have only the first signaling system. Pavlov considered it as a set of nervous structures with the help of which the perception of the surrounding world occurs through the senses. The signals in the first signaling system are smell, color, sound - they cause unconditioned reflexes and serve as the basis for the formation of conditioned reflexes.

Pavlov also proved that animals do not have a second signaling system. His experiment consisted of placing a monkey on a raft in the middle of a lake. The monkey could use a pole to climb onto two other rafts. On one of them there was a bailer and a tank of water, on the other raft a fire started. The monkey put out the fire by performing complex actions: each time he climbed onto a raft with a water tank and scooped water from there, instead of scooping water from a lake, which was much closer. Consequently, animals are not capable of generalization and abstract thinking.

In the process of work and communication, a person developed a second signaling system, closely related to the emergence of speech. Here, the specific irritant is the words into which a person puts meaning, some concept.

Words have a generalizing meaning, which served as the basis for the possibility of generalization, abstraction and operating with concepts. Language puts the results of human activity into words, so you can imagine a monkey even if you don't see it. Thanks to oral and especially written speech, it becomes possible to transfer experience to future generations. For any book, including this textbook, it is also worth saying special thanks to the second signaling system.

Temperament types

Pavlov identified four types of temperament, depending on the strength, balance and mobility of nervous processes in the cerebral cortex. Choleric is an easily excitable type, sanguine is balanced. Phlegmatic - processes of excitation and inhibition of weak strength, persistent and diligent in work. And finally, a melancholic person - the processes of excitation and inhibition are unbalanced and weak - are very vulnerable and weak-willed, prone to deep experiences.

Emotions, thinking and memory

Emotions are a person’s subjective reactions to external and internal stimuli. Emotions can be positive and negative; they reflect subjective experiences about the objective surrounding reality.

Thinking is a set of mental processes aimed at understanding the surrounding reality and thanks to which a person understands the essence of phenomena and things - as a result of thinking, concepts are formed. A distinction is made between elementary thinking, which is inherent in all animals (the first signaling system), and abstract thinking, which is characteristic only of humans (the second signaling system).

Memory is the ability of the nervous system (brain), which consists in the possibility of consolidating, storing and further reproducing received information. Based on the storage time of information, memory is divided into short-term and long-term.

Any information we receive first goes into short-term memory, only with repeated reproduction does this information move into long-term memory. The following types of memory are distinguished: visual, auditory, motor, tactile, mixed.

Dream

Sleep is a state of depression of consciousness, during which all types of sensitivity are reduced. Normally, the duration of sleep in an adult is 7-8 hours; in newborns, the duration of sleep reaches 18-20 hours a day. During sleep, information received during the day is transferred to long-term memory. Without sleep for more than 1-2 weeks, death is possible.

There are two phases of sleep: slow and fast, which alternate several times in one night. The slow-wave sleep phase consists of physiological rest of all body systems: heart rate, blood pressure, and body temperature decrease. Hormones begin to be released more actively, the action of which is associated with tissue restoration.

The REM sleep phase is the phase in which we dream. In this interval, the eyeballs actively move, breathing may become more frequent, and the hands make movements. This phase occurs approximately every 60-80 minutes (after the slow-wave sleep phase). Thus, in one night we see many dreams, most of which we forget. By the way, various “smart” alarm clocks catch exactly the moment of the REM sleep phase, in which it is easiest to wake a person, and upon awakening, the dream is usually remembered.

A dream is a unique representation of received information in the form of visual images. Let me note an interesting fact: we have already seen all the people we see in our dreams in reality. It could have been the face of a random passerby we met several years ago: such information is hidden deep in the subconscious.

Many of us, including me, have experienced a state of altered consciousness - a lucid dream. This is surprising, but sometimes during sleep a person can realize that he is dreaming, his dream is unreal, and it can be changed as soon as he pleases. After such moments, you experience extreme euphoria, dreams with your own scenario are remembered for a long time.

Diseases

Somnambulism (obsolete - sleepwalking) is a painful condition in which people perform any actions while in a state of sleep. Most often, sleepwalking occurs during a period of incomplete awakening after a deep sleep phase. An attack of sleepwalking can last up to several hours; sleepwalking most often occurs in children.

This condition has been known since ancient times, but its causes still remain a mystery. There is also no information whether sudden awakening harms a sleepwalker in a state of sleepwalking or not. Most often, sleepwalkers perform stereotypical actions: getting up, cleaning, walking, after which they go to bed and the next morning they do not remember anything about what happened.

Sometimes the actions of sleepwalkers pose a danger to themselves and others. There are cases when sleepwalkers traveled hundreds (!) kilometers from their home, and after waking up they found themselves in another part of the country completely disoriented.

This article was written by Yuri Sergeevich Bellevich and is his intellectual property. Copying, distribution (including by copying to other sites and resources on the Internet) or any other use of information and objects without the prior consent of the copyright holder is punishable by law. To obtain article materials and permission to use them, please contact Yuri Bellevich

Evolution of the central nervous system

The evolution of the functions of CNS cells occurred in several stages:

improvement of individual cells;
the formation of new properties that can interact with the environment.

The main stages of phylogenesis that the nervous system went through are:

The diffuse type is one of the oldest; it is found in organisms such as coelenterates (jellyfish). It is a type of network that consists of clusters of neurons (bipolar and multipolar). Despite its simplicity, the nerve plexuses, in response to irritations, give a reaction throughout the body. The speed at which excitation propagates through the fibers is low.
In the process of evolution, a stem type emerged - a number of cells gathered into trunks, but diffuse plexuses also remained. It is represented in the group of protostomes (flatworms).
Further development led to the emergence of the nodal type - some of the cells of the central nervous system are collected in nodes with the ability to transmit excitation from one node to another. The improvement of cells and the development of reception apparatuses occurred in parallel. Nerve impulses arising in any part of the body do not spread throughout the body, but only within the segment. Representatives of this type are invertebrates: mollusks, arthropods, insects.
Tubular - the highest, characteristic of chordates. Multisynaptic connections appear, which leads to qualitatively new relationships between the organism and the environment. This type includes vertebrates: animals that differ in appearance and have different lifestyles, and humans. They have a nervous system in the form of a tube that ends in the brain.

PNS damage in patients with COVID-19

Despite the abundance of publications devoted to the problem of PNS damage in patients with COVID-19, new variants of the course of the disease, studying the mechanisms of development of damage to the nervous system and the search for optimal treatment options, many aspects of the problem are far from being resolved. In particular, questions about the specificity of damage to the nervous system during COVID-19, the mechanisms of entry of the virus into nervous tissue and a number of aspects of the pathogenesis of its damage remain difficult. The issues of optimal therapeutic tactics for managing patients with neurological complications of COVID-19 also require study. The results of large-scale studies indicate that damage to the nervous system in patients with COVID-19 is secondary (circulatory disorders, immune-mediated disorders, etc.) and is not caused by direct invasion of the virus into the nervous tissue. Thus, when observing 2,750 patients hospitalized for COVID-19 (Madrid, Spain), 71 (2.6%) were diagnosed with certain neurological disorders (in some cases, a combination of them) [4]. The most common neuromuscular (including PNS lesions, 33.7%) and cerebrovascular (27.3%) disorders, epileptic seizures (7.8%) and other rare disorders (11.6%), including myoclonic tremor, transverse myelitis, Horner's syndrome. The most common diagnoses were neuromuscular disorders (33.7%), cerebrovascular diseases (27.3%), acute encephalopathy (19.4%), seizures (7.8%) and other diseases (11.6%), PNS lesions were significantly more common after the acute phase of COVID-19 had passed (p=0.005). It is noteworthy that when examining the cerebrospinal fluid using the polymerase chain reaction method, none of the 15 patients detected RNA from the SARS-CoV-2 virus. Similarly, a study conducted in Copenhagen (Denmark) found no traces of RNA in the cerebrospinal fluid of any COVID-19 patients hospitalized in a specialized hospital [5].

It should be noted that, despite the significant amount of information on the problem of neurological manifestations of COVID-19, many publications are devoted to individual clinical observations and do not always comply with methodological and methodological requirements (this concerns following uniform diagnostic procedures for verifying COVID-19 and its complications, the validity of the statements assumptions about the pathogenetic connection between the SARS-CoV-2 infection and the neurological disorders that developed in the patient, etc.). For these reasons, in some cases it may not be possible to collate the results of individual studies and prepare systematic reviews on a given topic. A major challenge is comparing the results obtained from examining patients with COVID-19 of varying severity, in particular those being treated at home and in the intensive care unit. Many systematic reviews and meta-analyses published in the most cited journals initially exclude publications prepared in languages other than English from the analysis, which limits the ability to obtain an objective picture of the prevalence of neurological complications of COVID-19 in different regions. It is likely that many questions will be answered through the results of properly designed and executed studies that can provide insight into the true prevalence of neurological complications of COVID-19, the mechanisms of their development and treatment options. At the same time, the currently available information allows us to understand the nature of the main variants of PNS damage in COVID-19, the features of their clinical manifestations and course.

To date, the most common neurological manifestation of COVID-19 is damage to the olfactory and taste analyzers. Interestingly, the results of observational studies conducted in Wuhan (PRC) demonstrated the prevalence of anosmia and dysgeusia in 5.1% and 5.6% of observed patients, respectively [6]. Subsequent studies conducted in European countries revealed a higher incidence (from 30% to 65%) [7]. The results of one of the latest prospective studies examining the neurological manifestations of COVID-19 (417 patients from 12 EU countries) demonstrated an even higher prevalence of taste and smell disorders (85.6% and 88.0%, respectively) [8].

Studies have found that disorders of taste and smell develop more often in women and precede all other manifestations of COVID-19, and, importantly, occur in patients without severe symptoms of rhinitis or in their complete absence. These features suggest a primary neurotropic lesion during virus invasion into the nerve fibers of the olfactory system and their subsequent entry into the olfactory bulbs. Convincing morphological and histochemical evidence of such viral invasion has not yet been obtained. In some patients, disturbances of taste and smell are accompanied by signs of damage to other cranial nerves. Considering the significant prevalence of olfactory and gustatory sensitivity disorders in patients with COVID-19, the identification of these disorders can be considered as a screening test, which is most effective in young patients and women [9].

One of the most severe forms of PNS damage is Guillain-Barré syndrome (GBS), which creates a real threat to the patient’s life and often leads to persistent neurological deficit. As a rule, GBS occurs against the background of various infectious diseases, including viral ones. An increased risk of developing GBS has been noted in patients with various variants of coronavirus infection, in particular MERS-CoV and, currently, SARS-CoV-2 [10, 11].

In a cohort of 71,904 patients with COVID-19 admitted to 61 emergency departments in Barcelona, Spain, GBS was diagnosed in 11 of them [12]. The prevalence of GBS was found to be significantly higher among patients with COVID-19 than among patients without COVID-19 (0.15% vs 0.02%, OR 6.30, 95% CI 3.18–12.5), which standardization rates were 9.44 and 0.69 cases per 100,000 person-years, respectively (OR 13.5, 95% CI 9.87–18.4). Patients with GBS due to COVID-19 were more likely to have taste and smell disturbances than patients with GBS due to an infection other than SARS-CoV-2 (OR 27.59, 95% CI 1.296–587.0) . The authors noted that although patients with COVID-19 and GBS were more likely to require treatment in intensive care units, the combination of these diseases was not associated with a significant increase in mortality.

An analysis of the available data on the relationship between SARS-CoV-2 and the development of GBS revealed that the presence of coronavirus infection is associated with the development of one additional case of GBS per 63,762 cases of SARS-CoV-2 infection [13]. This is significantly lower compared to the frequency of GBS that develops against the background of other infectious agents, in particular Camplylobacter jejuni

(~1 case per 1000 cases) and Zika virus (~1 case per 4000 cases). According to some authors, the high incidence of GBS in patients with SARS-CoV-2, noted in early studies (March–April 2021), was to a certain extent due to the use of broad and heterogeneous diagnostic criteria, as a result of which patients with GBS were included in the studies , the etiology of which was confirmed by various diagnostic tests (serological, polymerase chain reaction) or only clinically. Subsequently, as diagnostic criteria became more stringent, the number of cases of GBS caused by SARS-CoV-2 decreased.

According to the results of two systematic reviews, clinical manifestations of GBS in patients with COVID-19 occur on the 14th day (interquartile range 7–20 days) and after 11.5 days (7.7–16.0 days) [13, 14 ]. It is likely that immunomodulatory therapy and glucocorticosteroids used to treat patients with COVID-19 can change the timing of the development of GBS, positively influencing its course and consequences [15]. It was also noted that in patients with COVID-19 and GBS, myalgia and radiculopathies are observed relatively infrequently (14.2%), which are recorded in approximately 2/3 of patients with GBS without COVID-19 [14, 16].

Cases of isolated lesions of cranial nerves (oculomotor, abducens, etc.) in patients with COVID-19 have been described [17, 18]. As a rule, cranial neuropathy is combined with disturbances in the sense of smell and taste. Due to the relatively low incidence of cranial nerve lesions, it is not possible to clearly assess their diagnostic and prognostic significance.

Of exceptional interest are cases of delayed development of neurological deficits in patients who have had COVID-19. Thus, we described the development of GBS in a 46-year-old patient who had a confirmed coronavirus infection with pneumonia, with a complete recovery, who, on the 54th day from the onset of the first symptoms of COVID-19, acutely developed tetraparesis and paresis of the respiratory muscles (requiring artificial ventilation). , weakness of facial muscles and neuropathic pain syndrome [19]. The diagnosis was confirmed by the results of a study of cerebrospinal fluid (protein content 2.8 g/l), a decrease in the speed of impulse conduction along the peripheral motor nerves (according to electroneuromyography). The specific nature of GBS in this patient was excluded based on the serological study; the authors did not provide information about possible re-infection with SARS-CoV-2 and antibody levels. Complete recovery was noted in the 4th week from the moment of development of the neurological deficit.

To date, there is no convincing evidence that all cases of delayed development of PNS damage in patients who have had COVID-19 are caused by the SARS-CoV-2 virus. Further observation of patients who have had COVID-19 will answer the question about the possibility and specificity of this type of delayed lesion.

Varieties

The scientist Pavlov conducted laboratory research for many years, studying the reflexes of dogs. He concluded that in humans, the type of nervous system mainly depends on innate characteristics. It is the nervous system, its properties, that physiologically affect the formation of temperament.

However, modern scientists argue that this is influenced not only by hereditary factors, but also by the level of upbringing, training and social environment.

Thanks to all the research, the following types of nervous system have been identified, depending on the processes of excitation, inhibition and balance:

Strong, unbalanced - choleric. In this type, excitation of the nervous system predominates over inhibition. Cholerics are very energetic, but they are emotional, hot-tempered, aggressive, ambitious and lack self-control.
Strong, balanced, agile - sanguine. People of this type are characterized as lively, active, easily adapt to different living conditions, and have high resistance to life's difficulties. They are leaders and confidently move towards their goals.
Strong, balanced, inert - phlegmatic. He is the opposite of sanguine. His reaction to everything that happens is calm, he is not prone to violent emotions, and I am sure he has great resistance to problems.
Weak - melancholic. A melancholic person is not able to resist any stimuli, regardless of whether they are positive or negative. Characteristic signs: lethargy, passivity, cowardice, tearfulness. With a strong irritant, behavioral disturbances may occur. A melancholic person is always in a bad mood.

Interesting: psychopathic disorders are more common in people with a strong unbalanced and weak type of GND.

Types of temperament I. P. Pavlova - classification of temperaments based on types of nervous system.

I. P. Pavlov showed that the basis of higher nervous activity is three components: strength (the individual maintains a high level of performance during long and intense work, recovers quickly, does not react to weak stimuli), balance (the individual remains calm in a stimulating environment, easily suppresses his inadequate desires) and mobility (the individual quickly reacts to changes in the situation, easily acquires new skills). I.P. Pavlov correlated the types of nervous systems he identified with psychological types of temperaments and discovered their complete similarity. Thus, temperament is a manifestation of the type of nervous system in human activity and behavior. As a result, the relationship between types of nervous system and temperaments is as follows:

1) strong, balanced, active type (“lively”, according to I. P. Pavlov - sanguine temperament;

2) strong, balanced, inert type (“calm”, according to I.P. Pavlov - phlegmatic temperament;

3) strong, unbalanced, with a predominance of excitement (“unrestrained” type, according to I.P. Pavlov - choleric temperament);

4) weak type (“weak”, according to I.P. Pavlov - melancholic temperament).

A weak type cannot in any way be considered a disabled or not entirely full-fledged type. Despite the weakness of nervous processes, a representative of a weak type, developing his own individual style, can achieve great achievements in learning, work and creative activity, especially since a weak nervous system is a highly sensitive nervous system.

Sanguine temperament. A representative of this type is a lively, inquisitive, active (but without sudden, impetuous movements) person. As a rule, he is cheerful and cheerful. Emotionally unstable, easily succumbing to feelings, but they are usually not strong or deep. He quickly forgets insults and experiences failures relatively easily. He is very team-oriented, easily establishes contacts, sociable, friendly, friendly, quickly gets along with people, and easily establishes good relationships.

Phlegmatic temperament. A representative of this type is slow, calm, unhurried. In his activities he demonstrates thoroughness, thoughtfulness, and perseverance. He is inclined towards order, familiar surroundings, and does not like changes in anything. As a rule, he brings the job he starts to completion. All mental processes in a phlegmatic person proceed slowly. This slowness can interfere with his educational activities, especially where he needs to quickly remember, quickly understand, figure out, and do quickly. In such cases, a phlegmatic person may show helplessness, but he usually remembers for a long time, thoroughly and firmly.

In relationships with people, a phlegmatic person is always even-tempered, calm, moderately sociable, and has a stable mood. The calmness of a person of phlegmatic temperament is also manifested in his attitude towards the events and phenomena of life: a phlegmatic person is not easily enraged and emotionally hurt, he avoids quarrels, he is not unbalanced by troubles and failures.

Choleric temperament. Representatives of this type are distinguished by their speed (sometimes feverish speed) of movements and actions, impetuosity, and excitability. Their mental processes proceed quickly and intensely. The imbalance characteristic of a choleric person is clearly reflected in his activities: he gets down to business with enthusiasm and even passion, takes initiative, and works enthusiastically. But his supply of nervous energy can quickly be depleted in the process of work, especially when the work is monotonous and requires perseverance and patience, and then cooling may set in, elation and inspiration disappear, and the mood drops sharply. The predominance of excitement over inhibition, characteristic of this temperament, is clearly manifested in communication with people with whom the choleric person allows harshness, hot temper, irritability, emotional restraint (which often does not give him the opportunity to objectively evaluate people’s actions) and on this basis sometimes creates conflict situations in the team .

Melancholic temperament. In representatives of this temperament, mental processes proceed slowly, people have difficulty reacting to strong stimuli; prolonged and strong stress causes them to slow down their activity, and then stop it. They get tired quickly. But in a familiar and calm environment, people with this temperament feel calm and work productively. Emotional states in people of melancholic temperament arise slowly, but are distinguished by depth, great strength and duration; melancholic people are easily vulnerable, they have a hard time withstanding insults and grief, but outwardly these experiences are expressed weakly in them.

Representatives of a melancholic temperament tend to be withdrawn, avoid communicating with unfamiliar, new people, are often embarrassed, and show great awkwardness in a new environment. Melancholic people are often distinguished by softness, tact, delicacy, sensitivity and responsiveness: those who are vulnerable themselves usually subtly feel the pain that they themselves cause to other people.

October

Dmitry Seryogin

Evidence-based psychosomatics. Theory and practice

22 of October

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How to determine a person's temperament

It is not easy to determine what type of nervous system a person has, since this is influenced by the cerebral cortex, subcortical formations, the level of development of signaling systems and intelligence.

In animals, the type of NS is influenced to a greater extent by the biological environment. For example, puppies from the same litter but raised in different environments may have different temperaments.

Exploring the central nervous system and human psychology, Pavlov developed a questionnaire (test), after passing which, you can determine your belonging to one of the types of GNI, provided that the answers are truthful.

The nervous system controls the activity of all organs. Its type affects a person’s character and behavior. People with a common type are similar in their reactions to certain life situations.

Types of the nervous system. Strong and weak type

Published: 12/20/2018
We all behave differently in difficult situations, work at different paces, and react to criticism. These differences are largely due to the type of nervous system. The type of nervous system can be strong or weak, inert or mobile, balanced and unbalanced. The characteristics of the nervous system determine the known types of temperament: choleric, sanguine, phlegmatic, melancholic. According to I.P. Pavlov, the strength of the nervous system is...

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PHYSIOLOGICAL STUDY ABOUT TYPES OF THE NERVOUS SYSTEM, TEMPERAMENTS AND TEAMS[ 32 ]

In this meeting, dedicated to the memory of the great Russian doctor, I am allowed, as a sign of admiration for the talent, scientific merits and life of Nikolai Ivanovich Pirogov, to make a report about my, together with my colleagues, experimental work, although not specifically surgical, but still physiological. medical nature. Temperament is an important part of the constitution, and since the constitution is now extremely occupying the attention of the medical world, my message among doctors will thus be justified.

The physiological doctrine of temperaments was the fruit of a new study of higher nervous activity using a new method. And since this study has not yet become common property, has not yet been included in physiology textbooks, from where we draw basic information about the animal organism, then, willy-nilly, in order to be understandable, I have to touch on some general provisions from this study and only then move on to the special topic of my message.

The most general characteristic of a living being is that a living being responds with its certain specific activity not only to those external irritations, the connection with which exists ready from the day of birth, but also to many other irritations, the connection with which develops during individual existence, otherwise saying that a living being has the ability to adapt.

For the sake of greater clarity of the subject, I will go straight to the higher animals. Specific reactions of higher animals, as is known, are called reflexes, and these reflexes constantly establish the relationship of the organism with the environment. Of course, this relationship is a necessity, because if the organism did not enter into appropriate, definite relationships with the environment, then it could not exist. Reflexes are always of two types; constant reflexes, to certain stimuli, and existing in every animal from the day of birth, and temporary, variable reflexes, to various stimuli that each animal encounters during its life. As for higher animals, for example dogs, to which all our studies relate, these two types of reflexes are even confined to different parts of the central nervous system. Constant reflexes, what have always been called reflexes, are connected with all parts of the central nervous system, right up to the cerebral hemispheres, and the hemisphere is specifically the place, the organ of temporary connections, temporary relations of the animal with the outside world, temporary reflexes.

You know very well that until recently, until the end of the last century, these temporary relationships, temporary connections of the animal organism with the environment were not even considered physiological, and another word was used to designate them - “mental relationships”. Current work has shown that there is no reason to exclude them from the power of physiological research.

Now I will move from these general words to a number of specific facts. Take harmful conditions, harmful influences, from which the animal, of course, is immediately eliminated, for example, the fire that burns the animal if it falls into the sphere of its action and comes into contact with it. This, of course, is an ordinary innate reflex, a matter of the lower parts of the central nervous system. And if the animal is protected at a distance from the red color and the corresponding pattern characteristic of fire, then this reaction was obtained during life, it will be a temporary connection, a temporary acquired reflex, which one animal may have, but another animal that has not yet come into contact with fire, will be completely absent. Take another area of stimulation, for example the food reflex, i.e. grasping food. This is, first of all, a constant reflex: both the child and the newborn animal immediately make certain movements and introduce food into the mouth. But when an animal runs to this food from afar, by the sight of some of this food, or by the sound that is made, for example, by a small animal serving as food for another animal, this is also a food reflex, but such a reflex was formed during life with the help of cerebral hemispheres. This is a temporary reflex; From a common everyday point of view, it could be called a signal reflex. In this case, the stimulus signals the real object, the real goal of a simple innate reflex.

Currently, the study of these reflexes has gone very far. Here is an ordinary example that we constantly have before our eyes. You give the dog food or show it. A reaction arises to this food: the dog strives for food, takes it into its mouth, it salivates, etc. We can replace this food, in order to cause the same reaction, motor and secretory, with whatever we want, with any random stimulus, only it must first be associated with food in time. If you call, or whistle, or raise your hand, or scratch the dog, whatever - and then immediately give food and repeat this several times, then all these stimuli will cause the same food reaction; the animal will reach out to the stimulus, lick its lips, salivate, etc. - there will be the same reflex as before when showing food. It is clear that it is extremely important for an animal in the conditions of life to be physiologically connected so remotely and in such a variety of ways with those favorable conditions that it needs for existence, or with those harmful conditions that threaten its existence. If some danger, for example, is signaled by sound from afar, then the animal will have time to take measures against it, etc. It is clear that the highest adaptation of animals, the highest balance with the environment, is certainly associated with this type of temporarily formed reflexes. We usually designate two types of reflexes with two special adjectives: innate, constant ones we call unconditioned reflexes, and those that are attached to innate reflexes during life - conditioned reflexes. If we open and close a lamp and a telephone every day and repeatedly, then it would be an incredible inconsistency for the grandiose conductive nervous system that connects the body with the surrounding infinite world, for it to deviate from this technical principle, for this not to be its usual physiological technique. For theoretical thought, therefore, there is no reason to object to this, and physiologically this is completely confirmed. A conditioned reflex, under certain conditions, is naturally formed and exists, like any other nervous phenomenon.

Let's get acquainted with one more fact related to conditioned reflexes. Let a tone, for example, of 1000 vibrations per second, be made a conditioned food stimulus through the usual procedure, that is, by simultaneous application of the tone and food. This is a reflex where a conditioned stimulus causes a process of irritation in the cortex, a positive food reaction. We call this reflex a positive conditioned reflex. But next to these conditioned positive reflexes, there are also negative ones - those that cause in the central nervous system not a process of excitation, but a process of inhibition. If, after the just-mentioned reflex to a tone of 1000 vibrations per second has formed, I try other tones, close to this one, maybe 10-15 tones in both directions, then they also have an effect, but the less, the further away from my tone, on which I developed a reflex. Now, if I act in such a way that I constantly accompany my initial tone with food, as before, and I apply those tones that have begun to act on their own without accompanying food, then in this case the latter will gradually and completely lose its conditioned food action.

So, have they become indifferent? No. Instead of a positive effect, they have acquired an inhibitory effect; they excite the process of inhibition in the central nervous system. The proof of this is quite simple. You try a tone of 1000 vibrations per second. It causes, as always, a positive reflex, a food reaction. You now continue to apply one of those tones that have ceased to work. Now after this, the applied tone of 1000 vibrations will also temporarily lose its effect. Consequently, the neighboring tone produced inhibition in the central nervous system, and it takes some time for this inhibition to leave the nervous system. Thus, you see that these temporary agents can produce processes of both irritation and inhibition in the central nervous system. You understand, of course, that this is of the greatest importance in the lives of animals and us, because our life boils down to this: in a certain situation and at a certain moment we must demonstrate a certain activity, and in another - delay it.

The highest orientation in life is based on this. Thus, the constant and correct balancing of these two processes results in the normal life of both humans and animals. One must be imbued with the idea that these two opposing processes are equally important, equally significant in nervous activity.

With this, I think, we can limit the preliminary explanations and proceed to the main topic. When developing conditioned reflexes, sometimes positive, sometimes negative, we observe in dogs a huge difference in how quickly these reflexes are developed, how firmly they are held and to what extent they reach absoluteness. In some animals it is very easy to develop a positive reflex; the positive reflex is very stable under different conditions, but it is very difficult to obtain inhibitory reflexes in them; In some animals they cannot be developed to complete precision; they certainly contain some element of positive action. Here is the characteristic, therefore, of some. On the other hand, at the opposite end there are animals in which positive conditioned reflexes are developed with great difficulty, remain constantly highly unstable, and are inhibited by the slightest change in the situation, that is, they lose their positive effect; on the contrary, the inhibitory reflexes are quickly ready and always hold up perfectly. Between these extremes there is a central type of dog, or a central type of nervous system. These are precisely those for whom both are easy, who both inhibit well and form positive conditioned reflexes well, for whom both types of reflexes remain strong and can be completely accurate. Consequently, the entire mass of dogs falls into three main groups: the excitable group, the inhibited group (edge groups) and the central group, in which the processes of irritation and inhibition are balanced. Since conditioned reflexes are confined to the cerebral hemispheres, then in the three indicated groups we are dealing with three types of character and, accordingly, activity of the cerebral hemispheres.

But we have even more convincing evidence for the existence of these three types of nervous systems.

If a very difficult meeting of irritative and inhibitory processes is carried out, then completely different attitudes of the three types of the central nervous system to this technique are observed. I will describe to you in some detail a method that we constantly use and which is, so to speak, the highest test of the fitness or strength of the nervous system. We place a device on the skin with which we mechanically irritate the skin at a certain rhythm, for example, every second - and this is done as a conditioned stimulus. This stimulus can be differentiated, that is, it can force the nervous system to react differently to different frequencies of mechanical stimulation. Suppose I apply, in addition to thirty irritations in 1/2 minute, as before, also fifteen, and I can achieve the point that when I apply thirty, the dog detects a positive food reaction, and with fifteen this reaction will be delayed. Of course, this is done in such a way that thirty irritations are accompanied by food, but fifteen are not.

Thus, two irritations that differ little from each other cause two opposite processes in the nervous system. And so, if you bring these two processes together, arrange one directly after the other, as if pushing them against each other, you get a very interesting result. Suppose I start with fifteen irritations - the dog does not detect a food reaction. If I immediately change fifteen to thirty stimuli, this will be a test of the nervous system, which will most obviously distinguish between the three indicated types. If the technique is performed on a dog of one pole, say the irritable one, in which irritation and weak inhibition predominate, then the following happens: either now, or after repeating this procedure several times, the dogs become sick. They are left with only the irritative process, and the inhibitory process is almost completely lost. In the laboratory we call this condition neurasthenia, and this disease can last for months in a dog. If I apply the same procedure to dogs of the opposite pole, then, on the contrary, their irritative process weakens, and inhibition remains extremely predominant. We call such dogs hysterical. In both cases, the normal relationship between inhibition and irritation disappeared. We call this a breakdown. Obviously, we have neuroses before us, two true neuroses: one with a predominance of excitation, the other with a predominance of inhibition. These are serious illnesses, they drag on for months, and dogs need to be treated for them. Our main treatment is to stop all experiments, but sometimes we resort to other means. As for diseases of the inhibitory type, we have not found any other means, except that sometimes we leave the dog without experience for six months or more. And for another neurosis, bromine and calcium salts turned out to be good remedies. In a week and a half, the sick animal becomes normal. So, undoubtedly, these are very different dogs; under the influence of the same pathogenic treatment, they get sick differently.

But next to these extreme types, the central one remains. The same technique has no effect on the central type of animals; they remain healthy, they do not get sick. It becomes absolutely clear that there are three different types of the nervous system: the central one - balanced and the two extreme ones - excitable and inhibited. This means that the two extreme ones work, one might say, predominantly with one half of the nervous system. We can call them half-hearted types. And between them there is an integral type in which both processes work constantly and evenly.

The following is interesting. The central type is available in two forms, very different in appearance from one another, but in relation to our main criterion the difference between these forms is very insignificant. One form makes all kinds of balancing of opposing nervous processes very easy, while the other makes it somewhat more difficult - and that’s all. It does not reach a painful state.

If we now pay attention to the general external behavior of all our dogs, we observe something like the following. The excitable type in its highest manifestation is mostly an animal of an aggressive nature. For example, if the owner, whom they know well and to whom they completely obey, treats them harshly, hits them, they may bite him and cannot resist. The extreme inhibited type is expressed in the fact that as soon as you shout at the dog, swing your hand, it will tuck its tail, sit down, and even urinate. This is what is called a cowardly animal. As for the central type, it appears in the form of two forms: sedentary, calm animals, which seem to completely ignore everything that is happening around them (we usually call them solid), and, on the contrary, animals that are very animated in an alert state, extremely mobile, examining everything, sniffing everything. But what is unique about the latter to the highest degree is the following: these same animals are at the same time strangely inclined to sleep. As soon as they are introduced into our environment, left alone in a separate room, taken to the pen, as soon as the environment around them stops sharply fluctuating, they immediately begin to doze off and fall asleep. This is a truly amazing combination of mobility and drowsiness.

Thus, all our animals are distributed into four specific groups: two groups of marginal - excitable and inhibited animals and two - central, balanced animals, but, however, different: some - very calm and others - extremely animated. We must consider this an accurate fact.

Can this be transferred to humans? Why not? I think that it cannot be considered an insult to a person if a person turns out to have the basic characters of the nervous system in common with dogs. We are now so biologically educated that anyone could protest against this comparison. We can rightfully translate the types of nervous system established in dogs (and they are so accurately characterized) to humans. Obviously, these types are what we call temperaments in people. Temperament is the most general characteristic of each individual person, the most basic characteristic of his nervous system, and this latter puts one or another stamp on the entire activity of each individual. On the question of temperaments, universal human empiricism, led by the brilliant observer of human beings - Hippocrates, seems to have come closest to the truth. This is an ancient classification of temperaments: choleric, melancholic, sanguine and phlegmatic. True, now this classification is being extremely reworked. Some say that there are only two temperaments, some say there are three, some six, etc. However, over the course of two thousand years, a clear majority has leaned towards four types. One might think that this ancient view contains the most truth. To what extent some of the newest authors become confused on this issue, I can give you the example of a Russian psychiatrist. He decided to recognize six temperaments: three normal temperaments and three pathological ones. The normal ones were: cheerful, clear and phlegmatic, and the pathological ones were choleric, melancholic and sanguine. It is strange that the sanguine temperament, for example, belongs to the group of pathological ones only on the basis that all sanguine people are supposedly frivolous. Frivolity, therefore, is a pathological phenomenon. If we look at the ancient classification of the four temperaments, it is impossible not to see the agreement of the results of the experiment on dogs with this classification. Our excitable type is choleric, and our melancholic type is inhibited. The two forms of the playing type would correspond to the phlegmatic and sanguine temperaments. The melancholic temperament is a clearly inhibited type of nervous system. For a melancholic person, obviously, every phenomenon of life becomes an agent inhibiting him, since he does not believe in anything, does not hope for anything, sees and expects only the bad and dangerous in everything. The choleric type is clearly a fighting type, perky, easily and quickly irritated. And in the golden mean there are phlegmatic and sanguine temperaments, balanced, and therefore healthy, stable and truly vital nervous types, no matter how different, even opposite, representatives of these types in appearance. A phlegmatic person is a calm, always even, persistent and persistent worker of life. A sanguine person is an ardent, very productive worker, but only when he has a lot of interesting things to do, that is, there is constant excitement. When there is no such thing, he becomes bored, lethargic, just like our sanguine dogs (that’s what we usually call them), who are extremely animated and businesslike when the situation excites them, and immediately doze and sleep if these excitations No. We allowed ourselves to speculate and think a little further, touching on the clinic of nervous and mental illnesses, although our information about them does not go further than textbooks. It seemed likely to us that in the human environment, the main providers of these clinics are specifically extreme, unstable types or temperaments; both forms of the central type remain more or less untouched amid the unrest and storms of the sea of life. It was thought that for people it would be fair to associate neurasthenia with the excitable choleric type, as a corresponding painful form, and hysteria with the inhibited melancholic type, as a predominantly inhibitory form, an inhibitory disease. And further, when the disease is presented in the form of so-called mental forms, is it not possible to think that both main groups of constitutional endogenous psychoses - circular psychosis and schizophrenia - represent, according to their physiological mechanism, the highest degree of the same diseases?

A neurasthenic, on the one hand, can develop extraordinary work, produce enormous life work. Many big people were neurasthenics. But at the same time, the neurasthenic, along with periods of intense work, certainly experiences a period of deeply weak state.

What about circular? The same. Either he is excited far beyond normal limits, to the point of fits of rage, or he plunges into a deep depressive, melancholic state. On the other hand, our laboratory tantrum dogs apparently have very weak cortical cells, easily slipping into various degrees of chronic inhibition. But the main common feature of human hysteria is also, obviously, weakness of the cortex. Feigning illness, suggestibility and emotiveness (I take this mental characteristic of hysteria from the brochure on “Hysteria and its Pathogenesis” by Prof. L.V. Blumenau) are all vivid manifestations of this weakness. A healthy person will not hide behind an illness, or arouse condescension, sympathy or interest in himself as in a sick person, that is, in a weak person. Suggestibility, of course, is based on the easy transition of cortical cells into an inhibitory state.

And emotivity is a predominance, a riot of the most complex unconditioned reflexes (aggressive, passive-defensive and other reflexes-functions of subcortical centers) with weakened control of the cortex. There are grounds to consider schizophrenia as an extreme weakness of the cortex, as if the highest degree of hysteria.

The main mechanism of suggestibility is the disruption of the normal, more or less unified work of the entire cortex. That is why a certain suggestion is irresistible, because it occurs in the absence of ordinary influences on it from the other parts of the cortex. And if this is so, then schizophrenia will be the highest manifestation of the same mechanism. Let us imagine the general extreme weakness of the cortex, so to speak, its painful, abnormal fragility. Just like our inhibited

In hysterical dogs, by using functional difficulties, it is possible to obtain completely isolated disabled points and foci in the cortex; in schizophrenics, under the influence of more or less strong life impressions, probably due to an organic disease, more and more such powerless points and foci constantly and gradually appear, There is more and more decomposition of the cerebral cortex, a splitting of their normal connected work.

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After all that has been said, it seems to me that it can hardly be disputed that in the thousand-year-old question of laboratory temperaments, thanks to the elementary and

the relative simplicity of its experimental objects has a weighty word.