Insanity : its classification, diagnosis, and treatment; a manual for students and practitioners of medicine / by E. C. Spitzka.

  • Spitzka, E. C. (Edward Charles), 1852-1914.
Date:
1887
Catalogue details

Licence: Public Domain Mark

Credit: Insanity : its classification, diagnosis, and treatment; a manual for students and practitioners of medicine / by E. C. Spitzka. Source: Wellcome Collection.

Provider: This material has been provided by the Harvey Cushing/John Hay Whitney Medical Library at Yale University, through the Medical Heritage Library. The original may be consulted at the Harvey Cushing/John Hay Whitney Medical Library at Yale University.

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    one ward to another of an asylum, will imitate the different forms of insanity he sees there. He may appear melan- choly or demented one week, hilarious and destructive the next, and cases have been observed where simulators on being placed in the filthy ward of an asylum, with the idea that its disgusting and frightful scenes would induce them to abandon simulation—which sometimes is the case—de- voured their own excrement, acting to the best of their ability as the other inmates did. Imitation may occur in real insanity, but it is limited to delusive conceptions which are accepted by weak-minded lunatics from more intelli- gent ones, in what the French call folie communique and folie d deux. A simulator whose signs indicate, say, dementia, monomania, melancholia, or mania, on being placed in a ward with paretic dements or epileptics, allowing him to overhear the statement that he must be either a paretic de- ment or an epileptic, and that he cannot possibly belong to any other form of insanity, will have delusions of grandeur and paralysis in the former and convulsions in the latter ward. Numerous suggestions may be made of symptoms out of harmony with the assumed mental dis- order, and their adoption serves to expose the fraud. Thus the writer suggested ptyalism in a simulated monomania, and oscillatory movements of the head in simulated sui- cidal monomania, with this result. It may be feasible to relate cases in the hearing of well-posted simulators, where the insane had miraculous beliefs, or spouted poetry all day, and thus to prompt the adoption of inconsistent and convicting symptoms. Of the various tests thus far enumerated, the device of charging simulation point blank should not be made until all other, means have been exhausted. The simulator should not know that he is suspected until the last mo- ment. Various medicinal tests have been suggested for the pur- pose of exposing simulation, but they are of no value ; perhaps the best is ether, but comparative lucidity may occur after its use in the really insane, and both in sane and in insane persons false assertions, self accusations, and accusations against others are made in ether and chloro- regard as a deliberate insult. This ignorance is heir to the same feeling which fifty years ago treated the insane as wild beasts, and to-day treats them like paupers and jail-birds.