Cases illustrative of the insanity of pregnancy, puerperal mania, and insanity of lactation / by John B. Tuke, Esq.

  • Tuke, J. Batty, Sir (John Batty), 1835-1913.
Date:
1867
Catalogue details

Licence: Public Domain Mark

Credit: Cases illustrative of the insanity of pregnancy, puerperal mania, and insanity of lactation / by John B. Tuke, Esq. Source: Wellcome Collection.

Provider: This material has been provided by The University of Glasgow Library. The original may be consulted at The University of Glasgow Library.

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    several diseases are evidenced by well-marked, peculiar, and per- sistent indications. On glancing over the tables (pp. 1025-1028, vol. x.), it v^ill be . seen that there is a marked preponderance of certain mental symp- toms in the aggregate of each class. Thus, in insanity of pregnancy 20 are reported as cases of melancholia, 6 as moral perversion and dipsomania; in puerperal insanity proper 53 as cases of acute mania, 15 melancholia; in insanity of lactation, melancholia 39, acute mania 10. The balance of exceptional cases, dementia and epileptic insanity, seemed so slight as to lead to the suggestion that they were not exceptional, but that circumstances connected with them had not been ascertained, or that material symptoms had been overlooked in the report. In many instances this proved to be true, in others the lapse of time was so great as to make inquiry impossible. To a certain extent there always exists a soiu-ce of fallacy in observations based on the case-books of a public hospital. This depends on the imperfect, at times false, information obtained with the patient. This remark extends to all classes of the insane, rich or poor, as regards the obtaining of a history of previous attacks, . hereditary predisposition, and even the earlier symptoms of the disease. I reiterate this common complaint of all asylum physicians, partly in order to excuse us from a not unfrequent acciisation, that of not inquiring into the previous history of patients, and of ignorance of very important facts tending to an accurate diagnosis of cases placed under our charge. The fault seldom lies with us. Ataongst the higher classes relatives suppress the trath, or even pervert it. In the case of paupers, inspectors of poor frequently, from negli- gence, ignorance, or carelessness, do not furnish the information demanded in the statutory statement, which is in itself insufficient. It is careful in its inquiries as to the age, sex, and religious deno- mination of the patient, but does not insist on important pomts, such as previous habits, state of health, disposition, and character. This statement not only does no good, but often misleads, but could be rendered of great benefit if, more particularly in the case of paupers, the parochial surgeon were required to furnish such information instead of the inspector of poor. In certain cases this is impossible ; but in a large number, the medical man of the parish is acquainted with the whole history of the patient, but has no opportunity of notifying to the asylum physician facts material to the proper treat- ment of the case. In a disease dependent upon actual stnictui-al derangement, but which is often only characterized by mental alienation, too clo^e inquiry is impossible; and were we furnished in every case with a full and particular report, there can be little doubt that a larger proportion of recoveries would ensue. It must consist with the experience of every alienist that where an accurate history of the bodily ailments has been furnished, the patient has soonest recovered mental health, or if such was not the happy result the minds of friends have been satisfied by a distinct prognosis.