Mental pathology and therapeutics / By W. Griesinger, M.D. ... Translated from the German (second edition) by C. Lockhart Robertson, M.D. ... and James Rutherford, M.D.

  • Griesinger, Wilhelm, 1817-1868.
Date:
1882
Catalogue details

Licence: Public Domain Mark

Credit: Mental pathology and therapeutics / By W. Griesinger, M.D. ... Translated from the German (second edition) by C. Lockhart Robertson, M.D. ... and James Rutherford, M.D. Source: Wellcome Collection.

Provider: This material has been provided by the Francis A. Countway Library of Medicine, through the Medical Heritage Library. The original may be consulted at the Francis A. Countway Library of Medicine, Harvard Medical School.

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    ployed in promoting the healthy sphere of thought (correspondence^ visits, etc.) must be left to the judgment and tact of the physician. § 223. Of moral remedies, proper employment of the patient seems- to us the most important. In healthy work, the innate desire of express- ing and giving vent to its energies finds fullest satisfaction in the objective world ; by constant occupation in forming materials, the thoughts and efforts engross the mind and withdraw it from empty long- ings and illusions of the imaginations; the feeling of^ success again pre- pares the way for expansive sensations, and therewith self-esteem and confidence return. Therefore, a steady employment of the patient, espe- cially when voluntary, is rightly considered a decided indication of improvement, and is frequently the commencement of recovery. Those employments are the best which keep the patient engaged in the open^ air, as all garden and field labor, which prove of great advantage not only to the lower ranks who have been accustomed to daily toil, but also to the educated classes, owing to the peaceful and soothing influences of immediate intercourse with nature. Where this is not practicable, household or mechanical modes of employment, chiefly of a light kind, may be substituted; and very few patients, and these only in alternation, with physical exercise and muscular activity, should_ be engaged in sedentary and mental work. In chronic cases, the learning of a new and agreeable trade will sometimes engage the attention in a most beneficial way. Indigent patients should receive a small remuneration for their work during recovery; this has often proved a seasonable protection, against want: the exertions of the affluent are devoted to the institution and the poorer inmates. Wherever his state of health will admit of it, the patient should work methodically. And while the patients are to be restrained from unsettled trials of all possible employments, every appear- ■ ance of a manufactory, or regard merely to the pecuniary advantage of the institution, is still more to be avoided. Eecovery or improvement of the patient should be the only object of work. Each inmate should be_ re- quired to do only what is suitable to him, and only at the proper period,, and indolence alone is to be strictly prohibited. Work is evidently not adapted to acute states; in the exalted stage of the dis- ease any enforcement to it must prove injurious: recent cerebral irritation de- mands perfect rest. This does not, however, imply that all mental excitement renders vi^ork impossible or injurious. In English asylums, where there is no re- straint, many excited vociferous patients are put to work, for example, at the washing-tub, who, in many German asylums, would be confined in cells; anditis^ remarkable that they become sooner calm by the first method of treatment. But work is decidedly more advantageous in the quieter, especially protracted, states of insanity, in the period of transition to the secondary forms and in these forms themselves, and during convalescence where the desire for work is spontaneous. § 224. Closely related to physical employment stands a healthy en- gagement of the mental powers. In asylums ''the school is a means for this purpose suited to many of the patients. This is not intended to combat the insane ideas of the patient, or to demonstrate by philoso- phy the impracticability of his projects, but to withdraw his atten- tion from the morbid ideas to matters which are interesting and useful. It is a useful means-of awakening the mind and of imparting the elements of mental culture to patients who were previously ignorant. Like all em- ployment which excites the brain, it ought never to be permitted in the acute stages, and in all other cases it should be continued only for a com- paratively short time. The subjects of instruction are regulated according to age, sex, and education, and consist of elementary instruction in music.