Further report of the Commissioners in Lunacy, to the Lord Chancellor. Presented to both houses of Parliament by command of Her Majesty.
- Date:
- 1847
Licence: Public Domain Mark
Credit: Further report of the Commissioners in Lunacy, to the Lord Chancellor. Presented to both houses of Parliament by command of Her Majesty. Source: Wellcome Collection.
Provider: This material has been provided by the Royal College of Physicians of Edinburgh. The original may be consulted at the Royal College of Physicians of Edinburgh.
416/524 page 402
![Practice pursued in the Cumberland County Asylum (Dunston Lodge) described by Mr. Watson. ]n mania, the result of cerebral congestion and of recent origin. Blood-letting, general or local (a simple incision, four or five inches in length, into the scalp, appears to me to combine the good effects of the two, viz.: rapid detraction of blood and the relief of local congestion). Free purgatives, (one or two drops of croton oil being the most efficacious, and most readily administered, as in beef tea, coffee, &c. Cold to the head, not by cloths, but by frequently holding the head over a tub and pouring cold water over it. The relief thus afforded is great. I often find the patients request its repetition. Having thus relieved the congestion, I exhibit opiates in large doses combined with antimonials. I have been disappointed in the use of other narcotics, as belladonna, hyoscyamus, conium, though used in very large doses. The diet in such cases ought to be low, the room cool and dark. It is of the first importance to distinguish these cases from those which are the result of nervous irritation, and to watch lest the first class should degenerate into the second. The diagnosis is not always easily made, and demands great caution. The treatment is very different—small doses of opium combined with aether frequently repeated—a generous diet, with small quantities of wine or spirits and water—regulation of the digestive organs, by the blue pill, rhubarb, aloes, &c., together with the cold shower bath, or the douche, appear to me to be the principles on which we ought to base our treatment and which I have found most successful. In cases of chronic and intermittent mania with sleeplessness and great excitement, and when opiates had entirely failed, I have found the cold douche produce sleep, followed by great ameliora- tion. In fact, I cannot speak too highly of its good effects in such cases. In recent cases of dementia with pain in the head, stupor, and loss of memory, I have seen the best effects follow the application of the actual cautery to the nape of the neck. Practice pursued in the Suffolk County Asylum, as described by Dr. Kirhnan. Anodynes—Hyoscyamus and camphor, both but particularly the former largely, with intermediate purgatives. Hither and the tincture of hops in large doses. The patients generally seem to be suffering from an exhausting process as coming from pauper life.](https://iiif.wellcomecollection.org/image/b21902756_0416.jp2/full/800%2C/0/default.jpg)
