The book of health; a compendium of domestic medicine / deduced from the experience of the most eminent modern practitioners. [Anon].

Date:
1840
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Licence: Public Domain Mark

Credit: The book of health; a compendium of domestic medicine / deduced from the experience of the most eminent modern practitioners. [Anon]. Source: Wellcome Collection.

    73/124 (page 73)
    NERVOUSNESS. mental disorder. If there should be discovered an hereditary tendency to the disease, and this tendency should be marked by any malformation of skull, it will much diminish the chance of re- covery ; the more frequently, also, the disease has recurred, the less likely will it be to go off again. Upon the whole, it may be observed, that where the disease occurs for the first time, and when it is not hereditary, but produced by causes of a temporary nature, which may be easily avoided, (such as the use of intoxicating drinks, and mental emotion or exertion,) a re- covery may be expected to take place in a great majority of cases. When recovery takes place, it is almost always slow and gradual, requiring many months for its completion. Melancholy is considered as a partial kind of insanity, attended with depression of spirits, and leading often to self-destruction. It fre- quently arises from some supposed impending evil; but, sometimes it takes place without any such error of judgment, and is altogether unac- countable. “ As far as I have seen, (says Dr. Clutterbuck,) this depression of spirits is no- wise essentially connected with, far less depen- dent upon, bodily weakness as its cause; on the contrary, you will often find such patients to be of full habit, and complaining of throbbing head- ach, with flushing of the face, a full and strong pulse, though sometimes the pulse is preterna- turally slow : the tongue is often white and dry, as in inflammation in general. These symptoms, considered in themselves, would call for active measures, such as bleeding and purging; and these are not at all the less necessary, because the patient is in a low and desponding state of mind.” Treatmev t of Insanity in general.—^^The treat- ment of insanity (continues Dr. Clutterbuck) is more simple, than it is perhaps successful. You must not bleed profusely, merely because the delirium is of a furious kind; nor, on the other hand, should you stimulate, because the patient is in a desponding and melancholy frame of mind ; but this is to be determined by the state of the pulse, and the various other circumstances by which we are accustomed to judge of the ac- tivity of the disease, and the strength or weak- ness of the system altogether. The empirical practice of pouring cold water upon the head, while the feet or body is immersed in warm water, operates probaWy upon the principle of terror, and seems quite as likely to do harm as good. Yet, a few years ago, the success of this practice was vouched for by many persons of rank and intelligence ; but the practice, never- thele^, has pretty well gone into oblivion.”* Dr. Clutterbuck decidedly objects to the administer- ing of opium, or any other analogous drug, in order to procure sleep, as he considers it to be highly injurious, and tending to aggravate the in- * See the article “ Brain Fever,” p. 44. 73 flammatory state of the brain. Every thing that is calculated to excite much action of the brain, must be carefully avoided, viz. intoxicating drinks and narcotics in general; too powerful impressions of the different organs of sense; great voluntary exertion ; and above all, mental emotion and excessive application of the mind to any subject. Music and dancing have been sometimes permitted in favourable cases, and with apparent advantage: travelling has been recommended in many cases, where the circum- stances of the patient would admit. “ Harsh treatment, no less than excessive indulgence, is injurious; but, firmness and decision are in- dispensable. A command over maniacs is easily obtained and preserved; for coercion should never be carried further than safety requires.”* NERVOUSNESS. “I THINK (says Dr. Armstrongf) that there is such a condition as general nervousness, without its being referable to the existence of any par- ticular local affection of the nervous system ; J but as nervous sensations are frequently mixed up M'ith serious affections of the brain, heart, stomach, liver, or intestines, the greatest care ought to be taken that these affections are not overlooked.”—Whatever tends to enervate the general system, may be considered as the pri- mary cause of nervous debility; viz. costiveness, anxiety, sedentary or luxurious mode of living, the excessive use of mercury, disorder of the di- gestive organs, close application to business or literary pursuits. The symptoms of this malady are pretty well known; they mostly consist of general irritability, pain in the head, spasmodic pains in the different parts of the body, sleep- less nights, and great debility. Treatment.—Bleeding, leeching, or any other mode of abstracting blood, is by no means to be employed in nervous affections. The use of daily fi'iction by the patient, is to be strongly recom- mended ; and early rising and daily exercise must form a part of the general treatment. In order to improve the condition of the system. Sir A. Cooper advises the following, with the other means just mentioned :— Take of carbonate of ammonia, half a drachm j spearmint water, five ounces and a half; com- pound tincture of cardamoms, half an ounce :— mix, and take three table-spoonsful, two or three times a day. Costiveness must be particularly guarded against; for which purpose a mild purgative maybe taken. * Dr. Armstrong. t ” Principles and Practice of Physic.” t On nervous affections, ' Mr. Abernethy observes, “ I do not believe any one system in particular is af- fected, but that every system of the part suflFers ; for when the nerves are affected locally, it most frequently depends on general disturbance of the whole nervous system.”—“We often hear (says Dr. Clutterbuck) of nervous head-ach and nervous irritation ; now, as far as any thing intelligible can be collected from them, tliey seem to be intended to signify that such affections are difierent from inflammation.” K