Two cases of rheumatic insanity : read at a meeting of members of the Medico-Psychological Association, held at the hall of the Faculty of Physicians and Surgeons, Glasgow, April 27th, 1870 / by T. S. Clouston, M.D.

  • Thomas Clouston
Date:
[1870]
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Licence: Public Domain Mark

Credit: Two cases of rheumatic insanity : read at a meeting of members of the Medico-Psychological Association, held at the hall of the Faculty of Physicians and Surgeons, Glasgow, April 27th, 1870 / by T. S. Clouston, M.D. Source: Wellcome Collection.

Provider: This material has been provided by The University of Glasgow Library. The original may be consulted at The University of Glasgow Library.

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    against mj theory of rheumatic inflammation of the connective tissue of the cerebro-spinal centres. He says that no ana- tomical lesions have been found in the most severe cases after death; but both Sir T. Watson and Dr, Fyfe report cases in which severe lesions were found; and, considering- the short time which has elapsed since the very existence of the hinde- gewebe in the nervous centres was discovered, taking into account its small amount and delicate stnicture, and demon- strated oneness with the connective tissue in the rest of thebody, it seems not too great presumption to oppose his strongly expressed opinion in this matter. His opinion was against rheumatic inflammation of the membranes, and he was pro- bably right. The connective tissue of the cord might weU be slightly afiected with a rheumatic inflammation, and yet the membranes be quite intact. He refers to the examples of ordinary chorea, of tetanus, and of hydrophobia, where the utmost interference with all the normal functions of the brain and cord has taken place, and yet no inflammation or other obvious lesion is generally found after death, and asks why, therefore, is it necessary to suppose that such lesions exist in cerebral rheumatism ? The difference is obvious. In those affections there is no increased heat; in the rheumatic in- sanity we have seen this to exist as an essential part of the symptoms, and to be aggravated with any aggravation of the nervous symptoms. It does not appear that Trousseau knew this, or took it into consideration. If there was one point of striking importance and interest in those two cases it was the increased temperature; and I am not aware that attention had been directed to this by anyone before. It affords another example of the immense importance of the use of the ther- mometer. It will have been observed that I used almost no treatment in those two cases, except abundant diet and alcoholic stimu- lants, because in the first place I had never seen such a dis- ease before, and did not know how to treat it, and in the second place I was anxious to let them run their natural course, so that the effects of treatment in future cases may be more certainly known.
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