A manual of clinical medicine and physical diagnosis / by Thomas Hawkes Tanner.

  • Tanner, Thomas Hawkes, 1824-1871.
Date:
1876
Catalogue details

Licence: Public Domain Mark

Credit: A manual of clinical medicine and physical diagnosis / by Thomas Hawkes Tanner. Source: Wellcome Collection.

    30/346 (page 12)
    The various gestures and actions of tlie insane, however, from the happy easy movements of the man who believes himself a monarch, or the excited violent ravings of one suffering from acute mania, to the sad torpid listlessness of the incurably demented, require to be drawn in stronger colours than we have the art of employing, in order to produce truthful portraits. The Conversation of tlie Insane.—In endeavouring to gain information from this source, we must first seek to obtain, by kindness and a sympathizing manner, the confidence of the patient; for since it will frequently be necessary to ascertain his thoughts on the most varied subjects, so—unless we do so—and succeed in interesting him, he will often become suspicious of our motives, sullen, and uncommunicative. Lord Erskine, in his defence of Hadfield, referred to the case of a lunatic from whom he could draw no indication of insanity in the course of an examination in a court of law, until Dr. Sims entered, when the man addressed him as the Lord and Saviour of mankind. In many cases of madness, the reasoning faculties not being wholly lost, we are not surprised at finding that the patient can discuss correctly on many- topics, until some accidental observation leads him to break out into the most imbecile extravagance, or makes him confide to us plans of revenge, or proposals for per- forming the most impracticable achievements. Tlie Memory of the Insane.—Evidence may generally be obtained more easily upon this point than upon most others. A few quiet questions addressed to the patient as to his name, age, and address, the members of his family, the nature of his occupation, the day of the week, the name of the reigning monarch, &c., will often suffice ; or where there is evidently mental weakness, we may ask him to shut his left eye, give his left hand, put out his tongue, show his right leg, and so on. An examination of the letters written by such an one will often also give us information upon this head, while they at the same time teach us his intimate thoughts. These letters are often rambling and incoherent, and a very frequent cha- racteristic of them is that they are full of wants.