The cyclopaedia of practical medicine: comprising treatises on the nature and treatment of diseases, materia medica and therapeutics, medical jurisprudence, etc., etc (Volume 3).

Date:
1845
Catalogue details

Licence: Public Domain Mark

Credit: The cyclopaedia of practical medicine: comprising treatises on the nature and treatment of diseases, materia medica and therapeutics, medical jurisprudence, etc., etc (Volume 3). Source: Wellcome Collection.

Provider: This material has been provided by the National Library of Medicine (U.S.), through the Medical Heritage Library. The original may be consulted at the National Library of Medicine (U.S.)

    44/780
    Intestinal worms arc one of the results of con- stipation. Madness produced by the last men- tioned cause is probahly of very rare occurrence. .M. E>-quirol has, however, mentioned a remarkable instance of maniacal disease, affecting a young man, who was cured at two different periods by the expulsion of a large quantity of worms firom the intestinal canal. 4. Causes depending on Stales of the Uterine System.—States of the general system connected with irregularity of the uterine functions are well known to coexist with or to display themselves in various affections of the brain. Among them madness is one. Maniacal affections of this class may be mentioi.ed under three heads. a. Dysmenorrhmal Affections.—Some females at the period of the catamenia undergo a consi- derable degree of nervous excitement : morbid dis- positions of mind are displayed by them at these times, a wayward and capricious temper, excita- bility in the feelings, moroseness in disposition, a proneness to quarrel with their dearest relatives, and sometimes a dejection of mind approaching to melancholia. These are distinct from the cases of hysterical affection connected with the same periodical causes of excitement. The former are sometimes the preludes of a far more permanent disease. b. Suppressions of the Catamenia. — Sudden suppressions of the catamenia are frequently fol- lowed by diseases of the nervous system of vari- ous kinds. Females exposed to cold, undergoing powerful excitements, sustain a suppression of the catamenia, followed in some instances immedi- ately by fits of epilepsy or hysteria, the attacks of which are so sudden as to illustrate the connec- tion of cause and effect. In attacks of madness the catamenia are for the most part wholly or par- tially suppressed during the early periods, and in many cases it is not easy to say whether the sup- pression is the effect or the cause of the disease. There are instances, however, in which the cir- cumstances sufficiently indicate the order of con- nection. Dr. Burrows has detailed a case in which suppression brought on by manifest causes was followed by mania. We have already alluded to the case of a young female mentioned by M. Esquirol, who suddenly exclaimed that she was cured of her disorder; her catamenia had flowed .spontaneously, and her restoration to sanity was the immediate consequence. Facts so decisive in their bearings on pathology are not of very fre- quent occurrence, but their evidence reaches far- ther than the individual cases recorded. It often happens that after some weeks or months in the dur^ition of madness, the catamenia, though previously deficient, become restored nearly to their usual state. This, like the other indications of improvement in merely physical health, is only a favourable sign when it is accompanied by some amendment in the state of the mental faculties. V/ithout any such change, it rather gives reason to apprehend that the disorder is becoming inve- terate, and perhaps already making its transition from mania into an incipient stage of fatuity. c. Puerperal madness is another modification of the disease connected with the state of the uterine functions. As this form of insanity is a most im- portant subject, and in circumstances very pecu- liar we shall allot a distinct section towards the conclusion of this treatise to the consideration of its history and pathology. 4*. fExcessive venery has been regarded hy many as a cause of insanity, and especially of dementia. In the annual reports of several of our insane institutions and penitentiaries, many cases are referred to masturbation; yet its influen« would certainly seem to be exaggerated by some observers. It is a common vice everywhere, and is very likely to be practised to a greater extent in such institutions ; but it cannot be considered as by any means proved, that masturbation was the cause of the insanity in many of the reported cases. Often, doubtless, it is the effect. A table of the causes assigned for insanity in dif. ferent insane institutions of Great Britain and this country is given by Dr. Woodward, in the Ek- vcnth Report of the State Lunatic Hospital at Worcester, Mas.s., Boston, 1844.] 5. Metastasis.—The pathological fact, that dis- eases of the brain, and among others that from which madness results, supervene on the cessa- tion of various discharges, on the healing of old ulcers, on the disappearance of cutaneous erup- tions, on the cessation of inflammatory disease in membranous and other structures, on the removal of tumours, has been observed with greater or less attention by practical writers on medicine from the time of Hippocrates. Many cases illustrative of this fact are to be found in the works of Hildanus, Tulpius, and Hoffmann ; and Sauvages, among the forms of madness, has reckoned one which he terms metastatic. M. Esquirol says that even a cessation of the usual discharge from the nostrils, of leucorrhoea, of blennorrhagia, as well as the disappearance of scabies, of herpes, of gout and rheumatism, has produced madness. In general it may be observed that the suppression of acute eruptions, whether pustular, exanlhematic, or ery- sipelatous, is followed by acute inflammatory affec- tions of the internal organs; in such cases the brain or its membranes are attacked by phrenitis or meningitis ; while the disappearance of chronic disorder of the same class is the precursor of mental aberration. The suppression of more copi- ous discharges, the removal of large tumours, the disappearance in dropsical cases by rapid absorp- tion of deposited fluids without increased excre- tion, has been followed by determinations of blood to the head, giving rise to fatal apoplexy or severe convulsions. 6. Moral Causes of Insanity. — Among the moral causes of insanity we must reckon all the circumstances which are calculated to give rise to strong emotions, or to excite the passions. Strong emotions, by their operation on the nervous sys- tem, produce injurious effects on the brain, and give rise to disturbed actions in that organ, whence arises mental derangement. The passions and emotions are indeed the principal and most fre- quently productive causes of madness. In barbarous nations, among whom the mind is uncultivated, the passions are proportionally im- petuous, but their sphere is limited, and the intel- lectual and moral faculties are very imperfectly developed. Madness is comparatively rare among such nations. According to Von Humboldt there are very few lunatics among the native Ameri-
    digitised image 1
    digitised image 2
    digitised image 3