The cyclopaedia of practical medicine: comprising treatises on the nature and treatment of diseases, materia medica and therapeutics, medical jurisprudence, etc., etc (Volume 3).

Date:
1845
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Licence: Public Domain Mark

Credit: The cyclopaedia of practical medicine: comprising treatises on the nature and treatment of diseases, materia medica and therapeutics, medical jurisprudence, etc., etc (Volume 3). Source: Wellcome Collection.

Provider: This material has been provided by the National Library of Medicine (U.S.), through the Medical Heritage Library. The original may be consulted at the National Library of Medicine (U.S.)

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    diately succeeded it in that city, (Opus cit.); and botii he and Dr. Reynolds remariied that in 1775 diarrhoea sometimes followed the attack of influ- enza. (Mem. of Fothergill, supra cit.) Dr. Hamilton states that in the neighbourhood of Newcastle-upon-Tyne, the influenza of 1782 was accompanied with colic pains and cramps in the region of the abdomen and stomach, and some had purging. (Mem. of Med. iSoc. vol. ii. p. 435.) In France, in the influenza of 1803, gastric ir- ritation was one of the most frequent complica- tions of the disorder, and appeared in some mea- sure to constitute an essential part of it. (Diet, des Sc. Med. Art. Grippe, p. 362.) Dr. Bertram of Hull remarked that some of the attacks of influenza in 1803 nearly resembled cho- lera-morbus, others cynanche tonsillaris; and he goes so far as to express a firm conviction of the three diseases being different types of the same disorder, and occasioned by the same cause.— (Mem. of Med. Soc. vol. vi. p. 332.) Diarrhcea seems to have preceded, as an epi- demic, the influenza of 1803, at Plymouth Dock, as in 1743 and 1788; for Dr. May says that early in the year diarrhoea and cholera were very prevalent; so nearly similar to that preceding the influenza of 1788, that to many of his friends he hazarded a pretty confident opinion of an expected return ; and in this he was not deceived. (Med. and Phys. Journ. x. p. 291.) It must be fresh in the recollection of most that the epidemic cholera which in a milder character appeared in many parts of Great Britain last year (1831), and is now running so fatal a career in its malignant type, was preceded by the influenza; and we know that the same herald of that formida- ble epidemic was seen also at Warsaw, Paris, and other places ; and was lately announced even in the United States of America a short time before the cholera made its appearance in the transatlan- tic cities. These facts are collected to show that there is a closer connection between some epidemic dis- eases, both as to their affinity and their causes, than we commonly imagine; and that it is only by a very enlarged view of their phenomena in different countries that we can hope to improve our knowledge in this obscure branch of science. Thomas Hancock. INSANITY. —Sect. 1.-Remarks on at- tempted definitions of Insanity.—Different -varieties of the Disease referred to three principal Forms. Writers on insanity are generally agreed as to the difficulty of inventing a satisfactory definition of that disease. It is perhaps impossible to com- prise in a few words a characteristic description of mental derangement which may prove to be of practical use; and it is not an easy matter to discover one that even includes all the essential features of the object which it is proposed to defirie. The latter of these requisites will be obtained if we describe insanity as consistino- in a disordered state of the functions of the brain, which gives rise to disturbances in the operations of the mind. This definition may correctly be applied to madness, but it also includes a variety of other diseases; and hence it becomes neces- sary to render the description more particular by- exclusions and restrictions. It must be added for example, that the disturbance in the mental operations ensuing from the morbid cause in the brain is not allied to coma or to loss of conscious- ness and sensibility, in order to exclude from the definition apoplexy and disorders of the same class. For a similar reason it has been common to observe that madness is a species of delirium distinct from that which is symptomatic of typhus and other febrile diseases. There are some other morbid states of the brain and of the faculties dependent for their exercise on the functions of that organ, which must in like manner be ex- cluded by express limitations. Such are congen- ital idiotism, and the imbecility of old age. Now it is obvious that a definition loses all its utility when it is found necessary to encumber it with so many particular restrictions, and it is therefore better to give up the attempt to define insanity in general terms. But the practical purpose of a definition, which is to give a clear and distinct conception of the thing to be described, will be secured if we can determine and classify the various disturbances which the mental operations undergo. These disturbances, however, present very different phe- nomena in different instances of the disease, and we cannot attempt to draw up a concise account of them until we have briefly noted their principal varieties. It is generally supposed that the intellect or the reasoning faculty is principally disordered in per- sons labouring under mental derangement. Mr. Locke made a remark, that madmen do not appear to have lost the faculty of reasoning; but having joined together some ideas very wrongly, they mistake them for truths, and they err as men do that argue right from wrong principles. From Mr. Lock's time it has been customary to observe that insane persons reason correctly from erroneous premises ; and some instances of hallu- cination, or some particular erroneous impression, have been looked for as the characteristic of the disease, or an essential circumstance in it. Dr. Cullen seems to have had Mr. Locke's observation in his mind when he laid down the definition of madness which occurs in his First Lines. He describes this disease to be in a person awake a false or mistaken judgment of those relations of things which, as occurring most frequently in life, are those about which the generalitv of men form the same judgment; and particularly when the judgment is very different from whai the person himself had before usually formed. Cullen at- tempted to draw even this description within nar- rower limits, by observing that there is generally some false perception of external objects, and that such false perception necessarily occasions a dehrmm or erroneous Judgment, which is to be considered as the &ea.se. That this is by far too limited an account of mad ness, and only com- prises one, and that by no means the most fre quent form of mental derangement, everv nH, every person ex- must be aware who has had opportunities of tensive observation. Of those lunatics whose intellectual UrnHic. are manifestly disordered, there is always a JlT-