A report on the recent progress of psychological medicine and mental pathology / by C. Lockhart Robertson.

Date:: 1848

Credit: A report on the recent progress of psychological medicine and mental pathology / by C. Lockhart Robertson. 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.

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$KEPomT o\ rsrcaoLOtnciU. me motor. 23 observation ; I consider it one of the most valuable indications we possess of approaching insanity; it has never yet deceived me. Whenever 1 see this state of watchfulness by night, and restlessness by day, 1 fed that not another moment is to be lost. Tlic /mUe is tlte pulse of excitement; it is sometimes quick, aud then the reverse. In incipient insanity it is an uncertain sign.” § VIII.—Pathology. I. SfOBltlD ANATOMY. 30. The idea that the pathological cause of all cases of mental derangement, or even of the majority, consists iu morbid alteration of the structure of the hrian, and in the presence in the same of some one of the products of inflammation, is lieginning to he doubled by those best qualified to judge in thr matter, and insanity is being regarded more as a functional titan an organic disease. In- deed, It may be asserted, without fear of contradiction, that no pathologist could in nine tenths of the cases of mental derangement* which prove fatal, take upon himself to say, from an examination of the brain, whether tlte per- son hail during life tteen of sound mind or not. Dr. Seymour has well (minted out the unsatisfactory relations in which morbid anatomy anti mental derangement at present stand. ** 1 go on,” he says, ** to sjieak of the little advantage hitherto which morbid anatomy has contributed to our improvement in the understanding of cases of mental derangement, and hence in tlie art of curbs?—the first great object of every physician's inquiries. “ Sir Benjamin Broshe told me that he h*d examined very accurately with Mr. Tatum, surgeon to St. George's Hospital, the brain of a gentleman wito had been confined for many year*, nor could he ascertain any apparent altera- turn from ordinary structure. Many, man? caves of a similar nature have occurred, but, above ail. the numerous and permanent cures which have arisen from allaying functional disturbance, prove that mental derangement dor* r ot necessarily depend on organic disease of the brain. If a lunatic advanced in life dies of apoplexy, the effusion of blood or fluid into one of tbe ventricles of the brain, or, at least, the condition of the arteries which produced it, i« considered quite enough to explain the preceding malady. In soother case the blame is laid to the vesicles fount] in the choroid plexus; the observer forgetting that such cave* occur in very large numbers, without any degree of mental aberration ever having been observed. At another time, adhesion of the membrane* dependent on age, or complete ossification aud obliteration of the sutures, have licen quite enough to satisfy the observer, even though he find* the sane- appearance next day in a patient who has died of carcinoma of the rectum, or stricture of the bowel. And this was still more the case, when all disease was considered to be the result of inflammation, acute or chronic; any appearance of thickeniug or increased vascularity, however old the former or recent tlte latter, accounted, in default of other appearance*, for the mental alternation of the (tatient. For example, several rases of post- mortem examination are related in the early part of the work of the late Sir W. Ellis. Now 1 fee! satisfied that iu no one of these cases arc there any appearances which I have not seen in patients who have died of disease wholly unconnected with disordered mind.” I nder this category must be included the recent investigations of Dr. » We her* us* the word nutntni 4mr/crm*»t, n including atl departure from the healthy wantfieMatioa* of mini!, and a* uppmed to ft tup y and (laistyiis, where the mlud it not mi math deranged a* destroyed, and (U raamf«*taiton» entirely rurpended. In there Utter irotBscei .Uetatma of the brai. to generally PreW$

A report on the recent progress of psychological medicine and mental pathology / by C. Lockhart Robertson.

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