Observations on Madness and Melancholy: Including Practical Remarks on those Diseases together with Cases and an Account of the Morbid Appearances on DissectionHaslam, John
Science
Observations on Madness and Melancholy: Including Practical Remarks on those Diseases together with Cases and an Account of the Morbid Appearances on Dissection
Haslam, John
Depression, Mental; Melancholy; Psychiatry -- Early works to 1900; Psychology, Pathological
If the patient be so far deprived of understanding, as to be insensible
why he is punished, such correction, setting aside its cruelty, is
manifestly absurd: and, if his state be such, as to be conscious of the
impropriety of his conduct, there are other methods more mild and
effectual. Would any rational practitioner, in a case of phrenitis, or in
the delirium of fever, order his patient to be scourged? he would rather
suppose, that the brain, or its membranes, were inflamed, and that the
incoherence of discourse and violence of action were produced by such
local disease. It has been shewn by the preceding dissections, that the
contents of the cranium, in all the instances that have occurred to me,
have been in a morbid state. It should, therefore, be the object of the
practitioner, to remove such disease, rather than irritate and torment the
sufferer.--Coercion should only be considered as a protecting and salutary
restraint.
In the most violent state of the disease, the patient should be kept
alone in a dark and quiet room, so that he may not be affected by the
stimuli of light or sound, such abstraction more readily disposing to
sleep. As in this violent state there is a strong propensity to associate
ideas, it is particularly important to prevent the accession of such as
might be transmitted through the medium of the senses. The hands should be
properly secured, and the patient should also be confined by one leg; this
will prevent him from committing any violence. The more effectual and
convenient mode of confining the hands is by metallic manacles; for,
should the patient, as frequently occurs, be constantly endeavouring to
liberate himself, the friction of the skin against a polished metallic
body may be long sustained without injury; whereas excoriation shortly
takes place when the surface is rubbed with linen or cotton. Ligatures
should on all occasions be avoided. The straight waistcoat is admirably
calculated to prevent patients from doing mischief to themselves; but in
the furious state, and particularly in warm weather, it irritates, and
increases that restlessness which patients of this description usually
labour under. They then disdain the incumbrance of clothing, and seem to
delight in exposing their bodies to the atmosphere. Where the patient is
in a condition to be sensible of restraint, he may be punished for
improper behaviour, by confining him to his room, by degrading him, and
not allowing him to associate with the convalescents, and by withholding
certain indulgences, he had been accustomed to enjoy.
Public-domain text, read in full here on John Shaqi.
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