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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    ■weeks, or more frequently earlier, the mania gradually subsides, and is replaced by a state of dementia, generally accompanied by delu- sions, which almost invariably assume the form of mistaken identity. These gradually disappear, leaving a haziness of apprehension and a state suggesting the idea of waking from a dream. The patient can now generally be induced to work, and otherwise employ herself. From that moment you may look with almost certainty to ultimate recovery. I have inquired of several convalescent patients how much they recollect of the incidents of the last few months or weeks. The account usually given was, that memory was lost for a time, — the period of the maniacal paroxysm,— but they have always given a wonderfully accurate account of proceeding subsequent to its disappearance. The delusions are very vividly impressed on the recollection, and I have been told by convalescents that it was a long time before they could argue themselves out of them. It is intensely interesting to watch the gradual re-assertion of reason; to me it is difficult to conceive a greater amount of satisfaction to be derived from the successful treatment of any other disease. In the four patients who recovered after a period longer than nine months the delusions were peculiarly persistent, but ultimately disappeared. Three of them were cases of melancholia. I may here mention that this symptom is much less amenable to treatment than acute mania, and more frequently degenerates into dementia. Puerperal melan- cholia amongst the cases now under consideration appeared far on in the month succeeding labour, and was not, except in two instances, accompanied by a suicidal tendency, the majority of the patients being weak anasmic women with a tendency to phthisis. The train of symptoms was eminently asthenic, and the proportion of recoveries much lower than where mania was the leading symp- tom. Within the last two months, and since this report was com- menced, 2 cases of puerperal insanity have been admitted into the asylum, both of which give me the impression of being subjects of a degree of congenital imbecility. One is maniacal, the other de- mented, and both are, I fear, incurable. They have small badly- shaped heads, and bear the stamp of a low type of organization. Puerperal insanity in cases like these is most hopeless, and renders the subject of it the inmate of an asylum for life. Moral causes are frequently assigned for the attack : fright and sudden shocks being the most common. In two instances where this is reported the lochial discharge was said to have been arrested, and mania to have set in shortly afterwards. Cold, chills, the taking of spirits shortly after confmment, are also reasons given foi the appearance of insanity. Of itself, puerperal insanity has been by no means fatal in the practice of the Royal Edinburgh Asylum, only 2 deaths being clearly traceable to it, both of which took place within a week of admission. They both presented the unpromising symptoms of quick
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