The prevention of insanity and the early and proper treatment of the insane / by Dr. Putnam Jacobi, Prof. Harris, Dr. Cleaves and others.

  • Jacobi, Mary Putnam, 1842-1906.
Date:
1882
Catalogue details

Licence: Public Domain Mark

Credit: The prevention of insanity and the early and proper treatment of the insane / by Dr. Putnam Jacobi, Prof. Harris, Dr. Cleaves and others. 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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    only of its physical substratum, but of that and of the long series of psychic processes which have been built up on it. It is a fun- damental law of all organized tissues, and most conspicuously illustrated in the brain, that function not only depends upon structure, but ends by modifying it. Hence, morbid modifications of psychic processes may be initiated either in them or in the physical substratum. This is equivalent to the previous assertion that insanity may be determined either by a psychic or a somatic cause, but generally requires the concurrence of both. In the existing professional and popular reaction against the old puer- ilities of the exclusivel} moral theory of insanity, these facts are often overlooked or misunderstood. The question of prophy- laxis has become narrowed clown to the question of prophylaxis in marriage. This is not only much too narrow, and the social difficulties in the way very great, but the rules for practice have been by no means worked out, and many of those which have been suggested are erroneous or superficial. The fact that the previous constitution of the mental conception masses modifies the process of their falsification under the influ- ence of mental disease, should suggest an effort to so build up this constitution that it may be fitted to resist strain. For the forma- tion of the conception masses is far from being a spontaneous or self-directed process. No ideas can enter the forming mind ex- cept from without, from communication with its fellows, or from the transformation of sense impressions. It is therefore largely in our power to determine the nature of the ideas of any child who is thoroughly guarded from his cradle. Again, the will develops in the mould it makes for itself by successive volitions ; these may to a considerable extent be commanded or contrived. It follows that, hand in hand with prophylactic treatment of the physical substratum of the inherited nervous organization, should go stren- uous educational prophylaxis of the psychic processes. But there is needed a far-sighted, comprehensive, minute education, which should begin with the dawn of consciousness, and extend, if pos- sible, through life. It should have a detailed objective or reason for each step, in the elementary lesions of the disease which men- aces the person, or in the elementary defects of his menaced constitution. To assert that moral prophylaxis is useless because insanity is merely a symptom of physical disease, is to contradict the facts of the double nature and double origin of the psychoses which are admitted by the best authorities. Educational prophylaxis could only be expected to contribute one factor toward the solution of the problem ; but it is one, and all the more worth considering, because at present it is so generally neglected. A more plausible objection is that the moral substratum of minds predisposed to in- sanity is peculiarly perverted, so that they are insusceptible of education. That it is precisely this insusceptibility which especially