Observations on Insanity: With Practical Remarks on the Disease and an Account of the Morbid Appearances on DissectionHaslam, John
Science
Observations on Insanity: With Practical Remarks on the Disease and an Account of the Morbid Appearances on Dissection
Haslam, John
Mental illness
In our own climate women are more frequently affected with insanity than
men. Several persons who superintend private mad-houses have assured me,
that the number of females brought in annually considerably exceeds that
of the males. From the year 1748, to 1794, comprizing a period of
forty-six years, there have been admitted into Bethlem Hospital 4832
women, and 4042 men. The natural processes which women undergo, of
menstruation, parturition, and of preparing nutriment for the infant,
together with the diseases to which they are subject at these periods, and
which are frequently remote causes of insanity, may, perhaps, serve to
explain their greater disposition to this malady. As to the proportion in
which they recover, compared with males, it may be stated, that of 4832
women affected, 1402 were discharged cured; and that of the 4042 men, 1155
recovered. It is proper here to mention that in general we know but little
of what becomes of those who are discharged, a certain number of those
cured occasionally relapse; and some of those who are discharged uncured
afterwards recover: perhaps in the majority of instances, where they
relapse, they are sent back to Bethlem. To give some idea of the number so
readmitted, it may be mentioned, that, during the last two years, there
have been admitted 389 patients, 53 of whom had at some former time been
in the house. There are such a variety of circumstances, which, supposing
they did relapse, might prevent them from returning, that it can only be
stated, with confidence, that within twelve months (the time allowed as a
trial of cure) so many have been discharged perfectly well.
To shew how frequently insanity supervenes on parturition, it may be
remarked, that, from the year 1784 to 1794 inclusive, 80 patients have
been admitted, whose disorder shortly followed the puerperal state. Women
affected from this cause recover in a larger proportion than patients of
any other description of the same age. Of these 80, 50 have perfectly
recovered. The first symptom of the approach of this disease, after
delivery, is want of sleep; the milk is afterwards secreted in less
quantity, and, when the mind becomes more violently disordered, it is
totally suppressed.
From whatever cause this disease may be produced in women, it is
considered as very unfavourable to recovery, if they are worse at the
period of menstruation, or have their catamenia in very small or
immoderate quantities.
At the first attack of the disease, and for some months afterwards, during
its continuance, females most commonly labour under amenorrhoea. The
natural and healthy return of this discharge generally precedes
convalescence.
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