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
A man with delusions by virtue of which he thinks that some one is
{134} plotting to ruin or kill him is apt to commit murder; a mother
who believes that the world is going to ruin and her children to
torture may be expected to put herself and them out of misery; a
demented woman chops off her infant's head because its cries disturb
her; and the maniac's delirium or epileptic's fury drives him into any
horrible act. Such people need to be watched always by some person or
persons fully able to prevent their doing harm, which in many cases
can only be done, with any reasonable degree of liberty to the
patient, in a hospital for the insane. If the danger is obviated by
removal of certain persons—children, for instance—or if watching by
nurses serves the purpose, and there are no Other objections to such a
course, there are cases in which the chances of cure are more if the
patient remains at home whenever the disease pursues an acute course.
Most of the insane, however, have passed the curable stage; the
majority need the moral support and freedom from responsibility or the
regular life and regimen of a hospital; and a large proportion of the
cases following a subacute or chronic course must be removed from
home. The expense attendant upon the safe treatment of mental disease
in a private house is entirely beyond the means of most families, just
as they cannot send their consumptives to Colorado or France, and so
the hospital becomes a necessity. Except in dangerous cases, however,
the hospital should never be hastily decided upon. A little delay does
not diminish the patient's chances of recovery, and may show that the
attack is only transient, whereas removal to a strange place might
aggravate the disease and increase its duration. It is particularly
important not to choose an unfavorable time to commit an insane person
to an asylum, and thereby add to discouraging conditions already
existing an additional source of despair at a time when every
influence should be as elevating and cheering as possible. In most
cases, especially if there is a suicidal or homicidal tendency, it is
best, when removal to an asylum has been decided to be necessary, not
to argue the question with the patient, but to explain why it must be
done, and then do it without delay.
The law provides the methods of commitment to asylums. They are so
different in the different States that they cannot be discussed
here.[11] The one rule holds good everywhere, however—that it is far
better to use force than deception in sending the insane from home to
asylums, and that the cases are very few in treating the insane in or
out of asylums where deception is either justifiable or wise. A second
safe rule is that a person of unsound mind is always a source,
immediate or remote, of more or less danger.
[Footnote 11: An abstract of the various laws may be found in the
appendix to the American edition of Clouston's _Clinical Lectures on
Mental Diseases_.]
Public-domain text, read in full here on John Shaqi.
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