A manual of psychological medicine : containing the history, nosology, description, statistics, diagnosis, pathology, and treatment of insanity, with an appendix of cases / by John Charles Bucknill and by Daniel H. Tuke.

  • Bucknill, John Charles, 1817-1897.
Date:
1858
Catalogue details

Licence: Public Domain Mark

Credit: A manual of psychological medicine : containing the history, nosology, description, statistics, diagnosis, pathology, and treatment of insanity, with an appendix of cases / by John Charles Bucknill and by Daniel H. Tuke. Source: Wellcome Collection.

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    The effects prothiced by the combined bath are so great, that the length of time it is prescribed by M. Brierre de Boismont is to us unaccountable. We have known patients faint after the use of the warm bath, with a cold shower on the scalp, of no great force, con- tinued for less than an hour. Once only we have used it for two hours ; and an experience of some years has convinced us that it is a most important and valuable remedy, but one by no means free from danger, and the use of which, for any period approaching ten, twelve, or fifteen hours, would be fraught with peril. We have known a single application, for one hour, of the warm bath with cold to the head, effect the best part of a cure in a mania- cal patient; and in many instances of recent mania, with hot head, full pulse, and violent delirium, we have seen the symptoms take a favorable • turn from the first application of this powerful remedy. But we have known one patient, affected with syncope, die on re- moval from the bath after being in it only twenty minutes ; and in several cases we have observed so decided a tendency to syncope, that we have been convinced that it is not safe practice, in all cases,' to repel the blood from a hypersemic brain in the sudden and de- cided manner which the combined bath places at the disposal of the physician. Urgent cases, of course, need energetic measures; but, in the majority of cases of mania with cerebral hyperemia, a warn! bath at ninety-two or ninety-si\ degrees, with pledgets of wet linen constantly renewed to the shaven scalp, or kept cool by a small shower of cold water poured from time to time from the nose of a small common watering-pot, and used after leeches to the temples, is sufficiently energetic and successful and far safer than the practice recommended by the eminent author above quoted. It will be useful to give a brief resuvie of the principles upon which the active remedies should be prescribed whose employment in mental disease has been here treated upon. In the first place, it is a question of the utmost importance to decide when active remedies are needful. In the chronic stages of insanity active remedies are rarely admissible, except to obviate°sorae intercurrent condition, which produces too much disturbance and danger to be permitted to run a natural course, and wear itself out In recent insanity, with symptoms of physical disturbance of little violence and urgency, active medicinal treatment may oftentimes be dispensed with. The removal, or the cessation, of the causes of the disease, and the influences of mental and physical regimen, often 31