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
BLEEDING.--Where the patient is strong and of a plethoric habit, and where
the disorder has not been of any long continuance, bleeding has been found
of considerable advantage, and, as far as I have yet observed, is the
most beneficial remedy that has been employed. The melancholic cases have
been equally relieved with the maniacal by this mode of treatment.
Venesection by the arm is, however, inferior in its goods effects to blood
taken from the head by cupping. This operation, performed in the manner to
which I have been accustomed, consists in having the head previously
shaven, and six or eight cupping glasses applied on the scalp; By these
means any quantity of blood may be taken, and in as short a time, as by an
orifice made in a vein by the lancet. When the raving paroxysm has
continued for a considerable time, and the scalp has become unusually
flaccid; or where a stupid state has succeeded to violence of considerable
duration, no benefit has been derived from bleeding; indeed these states
are generally attended by a degree of bodily weakness, sufficient to
prohibit such practice independently of other considerations.
The quantity of blood to be taken, must be left to the discretion of the
practitioner: from eight to sixteen ounces may be drawn, and the operation
occasionally repeated, as circumstances may require.
In the few cases where blood was drawn at the commencement of the disease
from the arm, and from patients who were extremely furious and
ungovernable, it was covered with a buffy coat; but in other cases it has
seldom or never such an appearance. In more than two hundred patients,
male and female, who were let blood by venesection, there were only six,
whose blood could be termed sizy.
In some few instances hemoptysis has preceded convalescence, as has also
a bleeding from, the hemorrhoidal veins. Epistaxis has not, to my
knowledge, ever occurred.
PURGING.--An opinion has long prevailed, that mad people are particularly
constipated, and likewise extremely difficult to be purged. From all the
observations I have been able to make, insane patients, on the contrary,
are of very delicate and irritable bowels, and are well and copiously
purged by a common cathartic draught. That which is commonly employed in
the hospital is prepared agreeably to the following formula.
[Prescription]. Infusi sennæ [ounce] iss ad [ounce] ij.
Tincturæ sennæ [dram] i ad [dram] ij.
Syrupi spinæ cervinæ [dram] i ad [dram] ij.
This seldom fails of procuring four or five stools, and frequently a
greater number.
In confirmation of what I have advanced respecting the irritable state of
intestines in mad people, it may be mentioned, that the ordinary
complaints with which they are affected, are diarrhoea and dysentery:
these are sometimes very violent and obstinate.
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