On insanity, with special reference to heredity and prognosis / by A.R. Urquhart.

  • Urquhart, Alexander Reid, 1852-1917.
Date:
[1907]
Catalogue details

Licence: In copyright

Credit: On insanity, with special reference to heredity and prognosis / by A.R. Urquhart. Source: Wellcome Collection.

Provider: This material has been provided by The Royal College of Surgeons of England. The original may be consulted at The Royal College of Surgeons of England.

    38/92 page 36
    manifestations : but the feeling of bien Hre is never a. prodrome— it is a symptom of declared insanity. I regard the inception of the attack as the period when these vague prodromata culminate in indubitable insanity—that is to say, when it evolves as insanity from the medical point of view, altogether apart from the question of certification for legal purposes. It has been found possible to determine this date in 913 cases with sufficient precision. Many years ago Sir Arthur Mitchell constructed a most interesting chart relative to deaths regis- tered under various diseases, showing the seasonal incidence of deaths. Unfortunately, I can only refer to it from memory, but it was impressed upon me as showing the maximum inci- dence for respiratory diseases in spring, for nervous diseases in summer, and for abdominal diseases in autumn. That was in consonance with the undoubted high prevalence of suicide in July and the low rate for November. The chart which I now submit is more in consonance with still older observations. Dr. Edward Smith {Health and Disease, 1861) says that “ brain diseases prevail in the cold season,” and he found that writers of the seventeenth century placed diseases of the head and , nerves under the sign Aries—that is, April—when, according to ancient writers, diseases began in the head, descending to the throat in May, to the stomach in July, and so on. If we consider the total incidence in three-monthly periods, beginning with December, the inset in the chart shows a culmi- nating rise till May, when the fall is continuous until November. My impression as to asylum excitement has been that it does not so much depend upon the season as a change in the type of weather—the more rapid and complete the alteration the more marked the effect. But although we have kept charted records of the barometer and thermometer for many years and have attempted to correlate them with the varying conditions of patients, no order has been evolved from the complicated series of facts so dealt with. To return to Chart IX, it is evident that the points marked are at maximal elevations for April, June, and December, showing a singular abrupt fall in May and a more prolonged fall towards the autumnal months. These 913 cases have, of course, been spread over a period of twenty-five years, and there does not seem to be reason to regard the results as
    digitised image 1
    digitised image 2
    digitised image 3