On the statistics of puerperal insanity as observed in the Royal Edinburgh Asylum, Morningside / [by J. Batty Tuke].

  • Tuke, J. Batty, Sir (John Batty), 1835-1913.
Date:
[1865?]
Catalogue details

Licence: Public Domain Mark

Credit: On the statistics of puerperal insanity as observed in the Royal Edinburgh Asylum, Morningside / [by J. Batty Tuke]. 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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    Although these 155 cases have been spoken of generally as suffer- ing from puerperal insanity, I do not propose to regard them all as such, but rather to divide and arrange them into three groups,—a step, I cannot help thinking, warranted by a variety in symptoms and pathology. In works on Midwifery and Mental Diseases we find the several forms of insanity which occur during pregnancy, follow parturition, and supervene on lactation, all arranged under the common head of Puerperal Mania. This, with regard to the first and third divisions, is of course a misnomer, a contradiction in terms; and it seems rather curious that it should have been so long adhered to, more particularly as it tends to confuse and almost stultify deduc- tions from the few statistics of puerperal mania of which we are possessed. For instance, any comparison drawn between any given number of labours and any given number of so-called puerperal cases, must lead to erroneous conclusions, if the insanity of pregnancy is confounded with pure puerperal mania, or if, as is the case, the anaemic insanity of lactation is confounded with either. To obviate this mistake, I have drawn up a series of tables, in which the particulars of the three forms of insanity are separately tabulated under the heads of— Insanity of Pregnancy. Puerperal Insanity. Insanity of Lactation. That almost all authors on this subject, from Gooch downwards, and more especially Pritchard, have admitted this distinction, I do not deny; but I think I may venture to say, that no series of cases has as yet been recorded in such a way as to bring out prominently the characteristics of each group distinctively. All the cases in which well-marked insanity occurred during pregnancy are placed under the first head. In many of the cases of the second class, or true puerperal insanity, a slight depression of spirits previous to confinement is recorded, but not more than is so frequently observable amongst expectant mothers, and not sufficient to prove the actual existence of insanity. There are, on the other hand, cases in which insanity was fully developed prior to, but became aggravated after confinement. These are all classed under the head of Insanity of Pregnancy, as the cause was, we are entitled to hold, the systematic changes of that period, although the further disturbance set up by childbed may have changed the type of symptoms, and, as occurred in four cases, violent mania supervened on the melancholia of pregnancy. Between the 1st of January 1846 and the 31st of December 1864, there were 2181 female cases of insanity treated m the Royal Edinburgh Asylum. As above stated, 155 were so-called puerperal cases, making a per-centage of 71; but, after careful revision of each case, and acting on the principle of classification just alluded to, the following appears to be the correct subdivision;—