Some practical notes on the symptoms, treatment, and medico-legal aspects of insanity : a paper read at a meeting of the Chester Medical Society, held on Friday, March 7th, 1890 / by T.N. Brushfield.

  • Brushfield, Thomas Nadauld.
Date:
[1890]
Catalogue details

Licence: Public Domain Mark

Credit: Some practical notes on the symptoms, treatment, and medico-legal aspects of insanity : a paper read at a meeting of the Chester Medical Society, held on Friday, March 7th, 1890 / by T.N. Brushfield. Source: Wellcome Collection.

Provider: This material has been provided by The Royal College of Surgeons of England. The original may be consulted at The Royal College of Surgeons of England.

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    symptoms may be ingravescent without having any acute period. The delusions gradually become more fixed, and in melancholia they more frequently relate to the patient's own condition. Some of the worst cases are those of despair, where from some fancied unpardonable sin, or from being the cause of ruin to others, they feel themselves irretrievably lost; a condition pictured by Goethe in Faust:— My peace is vanished, my heart is sore, I shall find it never, and never more. Hypochondriasis and disease of the abdominal organs are common in melancholia, and influence the character of the delusions. The great principle to recognise in the treatment of the disease is that it is one of debility ; and in every case the following objects have to be kept in view:— ist.—To allay the excitement in mania ; to relieve the depression in melancholia. 2nd.—To promote the secretions. 3rd—To procure sleep. 4th.— To keep up the bodily powers. When a case of acute disease is admitted into an asylum, the very first proceeding is usually to administer a warm bath at 960 to 98°, and if the skin be dense and dirty, as it generally is, to soap the body well. An immersion of five minutes for the first time is sufficient. If there be much heat of scalp, tepid water poured over the head (so done as not to frighten the patient), is often appreciated. If the patient is too weak for this to be effected, then the whole body should be cleansed while in bed, a macintosh sheet being first placed on the latter. While in the bath, or in bed, the abdomen is carefully examined, and in the majority of cases, the bowels, especially the colon, are usually ascertained to be loaded with fceces. If this be not the case to any great extent, an ordinary warm aperient is given. The majority need a good deal more than this: a much stronger aperient, as some Calomel followed by some Salts and Senna ; or, what is better, 1 ounce of Castor Oil, with a drop ofCroton Oil diffused through it, followed 2 hours afterwards by a copious warm Enema, containing plenty of Oil, and injected as far up the rectum as possible. It is surprising to witness, in many cases, the large amount of scybalous matter that comes away, especially if che patient be treated at home for a few days, and the cause is usually not far to seek. The condition of the bowels is apt to receive less attention, than the attempt to allay excitement by drugs, with the common result that constipation is increased, the secretions are more locked up, and the cerebral disturbance is aggravated. The patient is put to bed, or on some mattresses covering