The insanity of over-exertion of the brain : being the Morison lectures delivered before the Royal College of Physicians of Edinburgh, session 1894 / by J. Batty Tuke.

  • Tuke, J. Batty (John Batty), Sir, 1835-1913.
Date:
1894
Catalogue details

Licence: Public Domain Mark

Credit: The insanity of over-exertion of the brain : being the Morison lectures delivered before the Royal College of Physicians of Edinburgh, session 1894 / by J. Batty Tuke. Source: Wellcome Collection.

Provider: This material has been provided by the Gerstein Science Information Centre at the University of Toronto, through the Medical Heritage Library. The original may be consulted at the Gerstein Science Information Centre, University of Toronto.

    77/88 (page 59)
    beneficial. I have found it so in the class of cases we are now considering. It is my custom to apply mustard on the upper part of the chest and of the back for long-continued periods, placing such a poultice on the front one night and on the back the next, alternating the application so long as the skin will bear it without vesication. It is a matter of indifference what rubefacient is employed, but mustard leaves are the most con- venient. Uneasy feelings in the head are soon relieved by this process, and it not unfrequently happens that sleep for shorter or longer periods follows. Blistering is an unnecessarily severe measure. Warmth maintained by bottles applied to the feet and back, and by warm compresses over the abdomen, is often useful. Very gentle shampooing or massage applied to the head and neck four or five times a day for a few minutes at a time is generally soothing. This should be done by the spread-out fingers, starting from the sides and back of the head, and being carried gently down to the clavicles and the root of the neck all round. Pressure should be slight. It is possible that this pro- cess may relieve the veins and lymphatics of the neck, and consequently those of the brain. Food should be given in small quantities, and often,—every two or three hours, the largest meal being at night. As I am speaking now of food only as a sleep-producer, the general question of diet may lie over for a time. The best method of bleeding a man's brain is to draw the blood into the vessels of the abdomen by means of food ; and therefore frequency of meals is called for, and the night meal should be the most plentiful. Of drugs, digitalis is the most useful, given in fairly large doses, and pretty frequently,— TTL 15 doses every two or three hours. In this disease there is considerable toleration of this and other drugs. Digitalis has no direct action on the nervous system ; in cases of poisoning the intellect is in no way affected. Its action on the cells is through the vascular system, by producing contraction of the terminal vessels. When sleep follows rapidly on its administra- tion in conjunction with the other measures just alluded to, the prospect is very hopeful, for it indicates that convolutional con- gestion is being relieved. That this drug acts on the terminal vessels is opposed to the views of Schmiedeberg ; it is, however, in accordance with the teaching of Lauder Brunton, and my