The connection between tuberculosis and insanity / by T.S. Clouston.
- Thomas Clouston
- Date:
- 1863
Licence: Public Domain Mark
Credit: The connection between tuberculosis and insanity / by T.S. Clouston. 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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![the lungs were partly gangrened and partly tubercular. Gangrene sometimes occurs in those cases in spite of a suilicient quantity of food and stimulants being given. Complete latency of the lung disease, whether it be gangrene or tubercular, is nearly as common in those cases as among general paralytics. There was a distinct history of phthisis preceding the insanity in eight men and six women. Doubtless there were very many more in whom the lungs were diseased, or beginning to be diseased, before they became insane, for in many of those who died a few months after, there were the evidences of old tubercles. In those fourteen persons the phthisical symptoms had been so long continued and pro- minent as to be included in the history of their cases. In three or four of them the insanity had been merely a temporary excitement, soon passing off and leaving the patients almost quite weU, and therefore very much allied to the delirium of fever or starvation. Morel*^ mentions this form of insanity as the chief concomitant of phthisis. He says— From the observation of other writers, as well as from my own experience, I should conclude that if depression usually accom- panies the commencement of tuberculization, maniacal paroxysms usually characterise its latter stages. We can to a certain extent explain these phenomena by ascribing them to the disturbance which imperfect respiration occasions in the circulation and nutrition of the brain. In other cases, doubtless, pathological investigation sufficiently proves that the derangement depends on tubercular meningitis in an insidious fonn. The few cases of this kind compared to the whole number of the tubercular shows how comparatively unimportant they are, and how erroneous an idea MoreFs statement gives of the connection between tuberculosis and insanity, by representing that, owing to a temporary and accidental disturbance of the cerebral circulation in the latter stages of consumption, the mental faculties are affected. Tubercular meningitis we have seen to be as rare as this temporary delirium, and not invariably producing any symp- toms when present. Such being the influence of the tuberculosis on the form of the insanity, how does it influence the prognosis ? Most unfavorably, we answer. There are very few cases indeed who ever recover their soundness of mind if phthisical symptoms have shown themselves or tubercular deposit has taken place to any extent in the chest after the commencement of the insanity. Some of the few cases do recover in whom the insanity has come on after the ])hthisis has become chronic, but scarcely any case of phthisical mania ever recovers. There may be apparent recoveries, but they are mere slight remissions. This almost universal incurability is a strong argument in favour of my view, that in those cases the insanity is the * Murcl, * Trailu des Maladies Mentales.'](https://iiif.wellcomecollection.org/image/b21477085_0025.jp2/full/800%2C/0/default.jpg)
