Essay on the Classification of the InsaneAllen, M. (Physician)
Science
Essay on the Classification of the Insane
Allen, M. (Physician)
Mental illness
It is a case, where little insanity is observable in his conversation,
but appears almost altogether in this constant propensity to indulge in
destructiveness—breaking windows, tearing his clothes, &c. The more
costly the articles he destroys, the more pleasure he seems to have in
the indulgence of this propensity for mischief and evil. By over-much
confinement and coercion, this patient would soon have become a settled
case of furious and destructive mania; but by great liberality, and using
restraint occasionally, the habit is much lessened: still, however, the
propensity exists, and might be easily aggravated. A week of the usual
coercive measures, would make this case degenerate into one equally
malignant and murderous as that of Walsh, whose character is given in the
Sketches of Bedlam.
* * * * *
A great number of cases might be adduced in support of these views; but I
trust these may suffice to enforce the argument in favour of the system,
which some have blamed, as being too liberal and indulgent. I have
therefore quoted a few such cases, both as an illustration of my views
and motives, and also as the best apology and vindication I can give in
my own defence.
In all violent cases, there is one remark that must not be forgotten—that
when it is possible, good may often be expected from violent exercise,
always taking care that the patient is in a state to bear the fatigue,
and still more so if he undertakes any sort of exercise with voluntary
pleasure. In cases, however, sinking into marasmus,—cases which I class
under those of gradual decay of mind—exercise must be undertaken at
suitable seasons, and when in a proper state, and must always be gentle
and moderate. Besides, though the greatest good may be expected in
almost all cases from labour and exercise, properly regulated, and
willingly undertaken, it is to be remarked, that while, with a great
proportion of a pauper class of patients, various kinds of labour and
exercise are, from their previous habits, easily adopted, and soon, by
vigilant management, reduced to a regular system, and such system is of
paramount importance to their health and mental restoration; yet with a
higher class of patients, who had not acquired at an early period of life
regular habits of industry, even the attempt to do the same thing might
be altogether as difficult and injurious; and therefore though exercise
is of very great importance, this should not make us overlook the
necessity of not urging and compelling them to it in a way to cause
irritation, unless indeed, in some extreme perverse cases, who must be
forced to walk or ride rather than their health suffer from deficiency of
air and exercise. What I mean is, that we must avoid doing a positive
evil where the good is only probable. For though exercise is one of the
most powerful means of withdrawing the determination of the nervous
energy and blood from the head, and distributing them properly through
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