Contributions to the study of insanity and its treatment, &c., &c.

  • Clouston, T. S. (Thomas Smith), 1840-1915.
Date:
1863-[1870]
Catalogue details

Licence: Public Domain Mark

Credit: Contributions to the study of insanity and its treatment, &c., &c. 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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    the excitement still remains as acute as ever if the medicine is stopped. If good effects are not manifested within a fortnight of treatment in a curable case of acute mania, my own opinion is that then the case should be left for a time at least to nature, with appetizing tonics and nourishment alone. In all the cases of acute mania where I say that the medicine did good, I mean that its effects were distinctly in the direction of health, and not merely that the symptoms were re- lieved. In some of those cases in which the best effects resulted from the use of the drug, I think that if it had been given at first the patients need never have been sent to an asylum at all. If my anticipations in regard to it are realised, this will unquestionably be one of the most important effects of the remedy. To be able to treat many cases of insanity, especially if attended with excitement, at home has been impossible just because we had no remedy that could safely be given to allay the excitement without the. risk of in- terfering with the recovery of the patient. In the case of senile mania to which I referred, the patient was treated quite well at home. Some cases of maniacal excitement of short duration which now have to be sent to asylums will, I think, be saved from this by the use of the bromide and Indian hemp combined. There are few risks attending its use, and its good effects, if there are to be good effects, are so very soon seen and follow its use so manifestly, that there generally can be but little question of mere coincidence. In these forms of maniacal excitement which have hitherto been found to be incurable, the bromide of potassium and its combina- tions are no more powerful than other drugs have been found to be in effecting cures. But in many of those cases its effect is to modify the symptoms of the disease so much that the lives of the patients become far more tolerable to themselves and others. In chronic and periodic mania, I have given the bromide combined with Indian hemp in eighteen cases, and it produced good effects in thirteen of these. In four cases of periodic mauia to whom I gave it, the effects were, perhaps, more wonderful than in any others, because the patients had all confirmed excitement of a severe character; the his- tory of their previous attacks was known, and could be contrasted with their attacks when getting the drug. In three cases the effect of the drug was to cut short an attack when it was coming on in its ordinary course as it had come on before. In two of the latter the attack was only postponed, as it were, but in the third case the patient remained well, was discharged from the asylum, and has kept well for twelve months—a far longer period than she has ever been free from excitement before for five years. I shall relate the case more fully afterwards. The other two were not so striking, but still are curious. One was a woman who had in her youth taken epileptic fits. After these ceased she became subject to severe attacks of excitement, which came on about every two months, and