A system of practical medicine. By American authors. Vol. 5 : $b Diseases of the nervous system
Science
A system of practical medicine. By American authors. Vol. 5 : $b Diseases of the nervous system
Medicine -- Practice
Violence done under the influence of clearly-defined
hallucinations and delusions is most dangerous, because it is executed
with apparent deliberation and volition. Thus, a man laboring under
hallucinations of hearing, fancying himself insulted, may turn in the
street and strike or shoot some one near him, the supposed author of
the insult. An epileptic falls in a partial attack or has epileptic
vertigo; as a part of the seizure there is a dream-like scene of
assault, actual or threatened, upon him, and on rising from the
ground, or after the momentary vertigo the patient, acting in
accordance with the demands of the dream-like scene, makes an
onslaught upon those near him or smashes furniture, etc. Seeing such
acts, without knowing their genesis, one is liable to consider them
normally deliberate and malicious. On recovering consciousness (which
may not be for several hours or days) the epileptic patient appears
utterly oblivious of his actions, and is much astonished to learn what
he has done. In many cases of insanity violent acts are done through a
similar psychic mechanism—_i.e._ through the domination of delusions.
Delusions often give rise to what may be termed negative
violence—resistance to personal care, treatment, giving of food, etc.
This is exemplified in acute melancholia, with overpowering fears of
all kinds and terrorizing hallucinations of sight and hearing. The
patients crowd in corners or sit curled up, and resist with all their
might whatever is done for them, even striking and biting the
attendants.
Therapeutically, the question of physical restraint or non-restraint
in the management of violence might be discussed here, but the
question is one which can be much better considered in connection with
the general treatment of insanity, and the reader is consequently
referred for information to the article on that subject.
Public-domain text, read in full here on John Shaqi.
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