Clinical lectures on the principal forms of insanity : delivered at the Middlesex Lunatic-asylum at Hanwell / by John Conolly.
- John Conolly
- Date:
- 1845
Licence: Public Domain Mark
Credit: Clinical lectures on the principal forms of insanity : delivered at the Middlesex Lunatic-asylum at Hanwell / by John Conolly. Source: Wellcome Collection.
Provider: This material has been provided by King’s College London. The original may be consulted at King’s College London.
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![resiiliKiry lUiiss a im! iiironsi.kTHhlc amount of carbonati' (if noMSS aiiil rviiiiiile of poUissium, lunvins insoUibli.'powiler, fimil.ir lo cliromati' of k'tiii. This powdor contains, bcsiiics an i'lcai.'ii>oiis Unly which iias not yet bi-cn further invc^ti- c;»U'>l. peculiar siih<tanccs. to which Itochledcr has ilS3ii:nc»l the names kA' fn-nziisttUitne atul /u nzcliirie. Ufti:tvlillni' is otitaineil by lioilinir tin' yeUow rcsiiUiary jHittvler wiili alcohol; a few drops ot bydroihloric aciil arc sdiK-l to the alcoholic solution, which acquires, upon this, a lJ'>oil-re>l lint ; this tint disa|ipe;irs ni;;iin after a few iiionient.s, and lK;»:»>ti!b;ne sc[i:irates from the Unid in •imall. white, bril- li;iiit crystals. The composition of benzostilbinL' is expressed by tl'.e formula— Vn II;; I >j yjf.i:.>A>«,- rriuains. after tin-extraction of l« n -n^tilbinc, as a f.ni' li'-'ttt yc-l!o-.v jiowder. wbicli dis<olvc^ in nioiU ratcly heated conccntratt-1 sniphnrie :u'iil, iMip:irlir;x :i inairMiticcnt red colour t.> the solti'ion. I'pon niixii s; this solution i;r;uliuilly •rith s|>irils of wi!\e i'.s colour ch.inircs to |_'rcen, ;iud small crvst.ils of lieiiz.'luK- separate. lier.< ilonc is in^nlulilc in water and aliMhol. Its conipisitiou is expressed by the fornud;i— (-'.,11,0 Nc;t!;erborr/ostiliMnc nor ben/oloue are dcconi posed by the act ion of potass. The proivss of the decomposition of the hyi!roben7amidc. inducol by the ;u tion of l-.yiiratcd potass, :ip|)e;irs to lie this: tho liyilrobeuzamiilc assumes the eleuu nts rif three e<|uivalents of water ami becomes eof.verled into liciizost ilbinc and beu/.o- lotlO which ooiit;un all its ci'rbon. whilst the nitro;_'eu escapes ill the forci »»r amiuonia; — C,, n„ N, + .1 II I) = (',, II,, (I, + (' , II: (I 4- X II, HvdniJtrrt- WaliT. lU-ii/o<tiIliiiic. I'.ui/itlniic. Amiiit'iiia zmiitdi-. Till- other products which ;ippc;ir conjointly with these (llic liydro:_'eii, e.irburetl, I bydrou'eii, c;irlionic ;u'id. ami rv- Riiojren) are the residts oL ,1 more coniplic;ited re-;u t'on wlucli accoiiil>;inies the principid process. l}enzo<tilbinc and benzolone. liowe\er, are, upon the whole, onlv subjects of snbordiu:Ue interest, :niil 1 Inive, therefore, but brioHi- touched upon theiii; but l.nirent has recently clis- coverfd a vere inlercstinL' >nbst;\:ice which is fcnined when livclrolu'n/.miiile is exposed to the ;ielion of he:it. 1 must, however. iMistiione the turtber coi\sider;aiMU of this subject till ncit lecture. Ventii \tio\ or Smmi. ^sn Ciosr I )wi 1 i.in,.s.— For tins |Hir|iosc th'- l :d:vni-cil v;dM'chnnncy stntilati'r, invented liy Dr. Arniitt. whi> h ;dlows the vitiated air to pass into the elunincy, hut prevents the rcCiirn of smoke, may often he applied with ^.Teal ndv;iuta'_'e ; it isclieap. i-ostiiii.' only a few shilliie^s, is mcst simple ill its «|K-ratinn, not lialile to ileiaii_'eiiieiit, ;iiid n i|iinrs little or no rare ; indeed it is so ellii lent, that we Icel as.'ire.I its uni- versal introduction into every sittinu-rooin, draw in).--ro,iiii, iiiid sloepiiiir n|';irtmeiit 111 the kiu'.'ilom, whether of ncli or poor, woiil.l bean ine:dcnliible benefit. 'I'liere are, liou evrr, some diflienl- ties opposed to the ert'ccli-.c ;ic'tioii of this contrivance, the [iriiu 1- pal of which arises from the defeetivi' ro:istructioii of cliinini rs, which arc, aiul cspeci;dly in humble tnen!ents. iniieli too larp-, and thus prevent the ueecssnry dr.iiiL:ht. A lire is idso rccpiisite to produce a full ellcct, but this us ii«ii;illv |,ro\iiled, even in suininer, jiiiion;: the poor for doiiu'<ti, |iiirpos,s. Dr. Arnott has also ilevised a simple and e(l'ei ti\ c plan for ventilatin;.' rooms where m:niv per-oiis arc colleeleil to;:i i!ier, and wliii li iiiinlit he applied adv;intai;eouslv in a vast nunilicr of instances. It is as follows ; the skiriiii'.:-board should be removed from the wall so as 1.. form a sjmcc lor the admission of fresh air ; the spare tlnis ohtRined. is closeil ill at the top by finely jicrlorateil ziii-, ami coimnniiie.Ales with the extermd atmosphere by an opi-niii};, which, l*iie_' provide.I with a valve, retrulates the ipiantity of uir to he nilmitted. The inosi efficient nieaiis f.r supplying; fresh air to lar^je iiuLsses of people is, however, the riir-/<H//iy<, .dso contrived by this distiii;;uislKd and philanthropic rncmher ol our j.rofessioii. The lirst notion of this ajiparatus apjiears to li;i\u been derived from the celebrated l)r. .'Stephen ll.des, vsho proposed a lar^e liellows l,.r the purpose, but whidi wa.s constructed on bin h erroneous principles that the value of the invention was tp'eatly diminished. The air-[inmp of Dr. Arnott drives into the rcjoni or phi' C to 1« veiitii.ited any reipnre.l ipiantity of air with a verT sliL'lit expenditure of fiowcr, ami it ii thus ailmirahly :idapted for Work-rooms, mauulaetories, kIiooIs, churchos ihiiis, &c.—Bnl. and For. J{ev., Oct. CLINICAL LECTURES ON THE PRIXCIPAL FORMS OF INSANITY, DELIVEnKI) IN THE MIHniF.SFX LL NATlC-ASYLl M AT HANWF.I.I.. By JOHN CONOLLY, ^LD., rinsiriAN to the asvli m. T-KCTI KK IV. Tnuttm.il I'f unite iniifuii r.nittitnetl. SiNi 1: the eommenccmcut of this clinical course, the .ipplioa- tion of sedative inedicines. to wbiidi I alluded at the conclusion of the prcecdiuL,' Ici'tnre. has receiveil some illustration in a few cases of recent and aoute mania. Hut to arrive at per- fcctlv siitisfactovy eonelusiotis cimcerninL,' the cflTects of medi- cines of this chiss it is neeessarv to live in an asylum, ami to visit the w iirds tVecpu iitly. and every day. and even in the uiulit. Few reports ol the eireimistances with resiH.'C't to which we reipiire information arc to be depemU'd upon. Full o]i|)ortiiiiitit'S ot observation c:iu be enjoyed by few luediciil men, and the want of them renders the utmost caution iieces- sarv in rci'civim; the contiilent o|iinions bo often |iromiunced and published. F.veu after such opportunities, I feel the im- perfect ion of my exi>criince on this and many other points; ;ind in truth can but consider that clinical observation of them is only eommeneini:. and, acknowlediiiiit; the incompleteness of iliis |i:irt ot ]iraetice. place it before you us a tUdd of investi- Ltation worthy ot your own iinlnstry, and proinisin^' of results. If I can relv upon my own rerolleetiou and notes of tho uiinieroiis c;ises in this ;is\liim. ;ind in iirivatc pr;ictiee, when 1 have taken evi ry precaution to avoid error, I should suy that the ;i]i]ilieation ot sedative im-dieiucs to recent case.s of ni;ini;i is of \ cry limited nsi-fuhu-ss. In the more tdironic tbrnia oi the nialadv tlii'ir i llicacy is u'reater; and in many cases both of chronic iii;iui;i and melancholia they are of the utmost sirvicc. In the case ef .1. S . a 111:111 ailiiiilted in a recent sta^c of mania, and ill the :icnte form, se.hilives were >,'iven after tlio application of leeches; ihev wi ie found InetKcaeious until Kiveii in hirL'e and reiiratcd dosi'S. and their elH.'ct was even Ilii-n iins.itisf:ietory; tlu y scenu-tl even to iiu'rcase his exeito- ineiif, procnrini; only occasional sleep, from vi liich be awoke more violent than before; opiuni in any form .seemed to excite him more—ancHi'ct I have hut loo often noticed; mid the I incturc of henbane was but ti iiiiiorarily u.seful. Ill this case, which terminaled fatally, the brain was inteiif)cly injected; blood w;is etinsed in the arachnoid cavity; the cortical sub- st:ince was scarlet, and mot lied, and the iiK diillary siibstnnce l>ink. \, V , a wonnin tortv. alter two montliH of depression, became excited, and, after beiiif; three weeks acutely maniacal, <Iieil from thi' exhaustion which so often supervenes. Sedatives bail Ltiveii her no relief. I'orlions of the cortical substance were very soft, dark coloured, with uuiuerous red spots; the white snbstauce vascnl.ir; there was efl'iision ill the sac of the arachnoid, .\iiotlicr feniiile patient, A. (J , affed fitty-tliri e ( IM44) died after heiii^'maniacal four luonths; se- datives had in her case been useless; and the whole brain was niiudi injected. The appearances in these cases perhaps ex- plain the ineffleaey of all the iiie:iiis eniploved. lint ill the cases of II. , (lH4'2)iii feiieile ward, No. H; and in .M. A. T.—(1H44) in female ward No. .5, continued ex- eitenniit existeil, resislinj; all treatment, and terniinatin<.c fatally; and in these instances the substance of the brain was very little altered, and the princijial inoi bid elianj;e was eiru- sioti beneath the menibraiies, and in the ventricles. The same ciairse, and the s;iine results, and the s.'ime appearances char- acterized the c.ise of ('. T , ai;ed tliirly-four, in female ward, .\o. n, who died after beliij; acutely inaiiiiu';il alKjut four months. A male p;itienl, .\. T , ai.'ed thirty-six, a coaclinian, was .•iilniitted 111 .\n>;iist. The loss of his situation brounlil on an attack of nninia, in which lie threatened the life of his wife, tried to t'et cut of a window, and said the devil was ill his- room. When adniitttd, about a lbrtni|,'ht after bis attack,, he was thin, pale, restless; always talking incoherently, or sinfiin^r; his ton^tue was white, but it sixin iR'camc dry and coated, and tin n, in a few days, moist. At first he refused food, tlun took itfrwiy; the iKiw^lswere costive; his voice was hoarse; the pulse at first '.t(>, simiii afterward 120, and alwa}s very feeble; be could xive no distinct answers. Hero was a case of recent mania from a moral cause. Leeclie*](https://iiif.wellcomecollection.org/image/b21292140_0031.jp2/full/800%2C/0/default.jpg)
