On the symptoms, causes, and treatment of puerperal insanity / by James Reid.

  • Reid, James
Date:
[1848]
Catalogue details

Licence: Public Domain Mark

Credit: On the symptoms, causes, and treatment of puerperal insanity / by James Reid. Source: Wellcome Collection.

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    cases which have fallen under my own notice in private practice or in consultation, the patients had all been previously remarkable for their excitable temperament or eccentricity of manner. Taking cold soon after confinement is another cause, acting, as it does often, in arresting the secretion of milk and the locliial discharge, and producing the consequent fever; the re-establishment of these secretions in a regular healthy con¬ dition is often the commencement of the recovery. Morbid irritation of the gastric and hepatic organs will likewise be intimately connected with the appearance of this complaint, whether as cause or effect is I think doubtful, but it is quite certain that on a copious evacuation of dark vitiated secretions from the bowels, in some cases, an immediate amendment has been observable. The sympathy between the healthy and disordered function of the liver, and the condition of the cerebral organs, is too well known to all practitioners to require com¬ ment. That moral causes have a most powerful influence in the production of puerperal mania, is a fact believed by most authors; and it may be further asserted, that it is a much more frequent cause of bringing out the symptoms of it, in constitutions already predisposed, than the phy¬ sical. This is perhaps shown by the much larger number of cases which occur in unmarried women than in the married, as is also the case in general insanity. Thus, in the Han well report of cases, of 415 females there were 122 married, 263 unmarried, and 30 widows. In Sal- petriere, of 1726 cases admitted, 397 were married, 980 unmarried, and 291 widows. In the German reports, the proportion was still larger, according to Dr. Jacobi in his Statistik—viz., in 835 females 599 were unmarried, 80 widows, and only 156 married. As a further proof that the same fact holds good as to puerperal mania, I may instance the statistical returns of those large lying-in in¬ stitutions of London which have been given in these pages. In the Queen Charlotte’s Hospital, the proportion of insane cases is much larger than in the other two alluded to, and this return is very justly supposed to depend on the fact, that one half of the patients there admitted are single women. Of the eleven cases, three were married, and eight unmarried. It not unfrequently happens that young females of a superior class, who are deserted by their friends, are obliged to apply for admission into such an institution, to hide their shame, and for want of means; and of five fatal cases out of the eleven, one only was married. Two were of the class just described, highly educated, of sensitive dispositions, and compelled by the cruel desertion of their seducers, and neglect of their friends, to seek for admission into a public hospital. It was supposed formerly that all puerperal diseases were the effect of the suppressed secretion and metastasis of the milk: thus, there was the milk abscess, the oedema lactea, the mania lactea, &c. Levret, in fact, asserted, that after the latter disease proving fatal, he had found milk within the cranium; but this was no doubt simply an albuminous effusion.