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.

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    dition may not materially improve. If the temperature shows even a slight evening rise, it is an indication that mischief is still going on. For the last three years I have, under these cir- cumstances, used phenazonum (antipyrin) freely. In doses of 15 grains, given every two hours, it very generally soothes and produces sleep, and the general condition improves. We have no evidence before us as to the manner in which this drug acts on nerve cells: its influence in checking metabolism, as shown by its power of arresting the secretion of urea,1 and its vaso- constrictor action in small doses, may be the efficient causes. Although I have frequently given antipyrin to the amount of 60 to 100 grains per diem for a fortnight at a time, I have never noticed any of the ill effects ascribed to it, except occasionally nausea and vomiting. It may be that patients in the condition we are speaking of may be more tolerant of the poison than those in whom temperature runs high. As in all nervous cases, the dosage is at first a matter of experiment ; but it is quite safe to begin with the dose above indicated, raising it somewhat, and administering it more frequently according as the patient's con- dition improves. There is yet another means of bleeding the encephale, which has also an important action on the general systemic nutrition of persons suffering from cortical cell weakness. I allude to the functional hyperemia of muscular activity. Muscular exercise excites the circulation generally, and this should be avoided. Restlessness, under ordinary circumstances, cannot be overcome by an amount of exercise short of fatigue. The sufferer from the incipient symptoms of idiopathic insanity is not in a condition to stand fatigue ; his nervous system is undergoing waste, and to make further demands on it is patho- logically and physiologically illogical. It is not only undergoing waste itself, but it is, as a consequence of its own wasting con- dition, unable to exercise its nourishing functions over the system at large. Fatigue in any sense or in any degree is to be depre- cated. But with the patient in bed we would lose not only the important derivative action of hyperemia incident on muscular action, but the products of muscular waste which, to a certain extent, must accumulate under restful circumstances, would 1 Stockman, Nezu Official Remedies, 1S90.