The Rock Island Argus., 1878-01-24


desperation or disease, sanity or insanity,
which leads an individual to the commits
sion of self-murder is one which most
assuredly calls for the careful considera-
ton, not only of the medical jurist, the
moralist, and psychologist, but the general
practitioner of medicine, under whose
observation, if before it is too late these
cases come under any useful observation
at all, they are the most apt first to fall.
No class of patients are more embar-
RAISING to the general practitioner than
these cases of mild incipient melancholia
with depressing delusions and suicidal
tendencies. Even in an institution where
every means Of guarding and observing
them is had, they give more trouble and
are a greater source of anxiety than any
other. They can never he trusted, their
mental acuteness, their cunning, and, to
the superficial observer, their apparent
sanity, serve to put the physician, as well
as attendants and friends, off guard; and
their faithful promises of self.control are
apt to be relied upon, till some fine morn
ing or calm evening case of cut throat,
drowning, pistol-shot, poisoning, or stran-
gulation is presented to our horrifed gaze,
a family is thrown into deep distress, a
whole community, profoundly shocked,
sympathizes with them, and, as rule,
blindly blames the doctor.
One of the most serious difficulties the
general practitioner has to contend with
in all these cases in their incipiency, is the
concealment os grave symptoms by the
family. People have yet to be educated
up to the thought of looking at these
symptoms Of unusual depression, which
lead to such untoward results, as they
would upon any other symptoms of disease.
Sleeplessness, loss of appetite, and gen
eral naaldiSe they are ready to meet, but
as soon as the patient passes into the next
stage of his malady and ventilates delu-
sions of dangerous character-such as
the fear Of poverty, disgrace, eternal dam
nation, etc., and shows disposition to act
on them to the great danger of himself or
members Of his family, all is concealment,
and these things are scarcely mentioned,
even to the physician, for fear of publicity
aud disgrace; while, at the same time,
they hold him responsible for the safety
and treatment of their friends. No one
knows better than a physician placed iu
such circumstances how strong is thl;
feeling, and how even physicians are some
times troubled to get at all the facts of the
case.
Until the public can be taught to fact
all these grave mental symptoms and lay
them before their medical advisers as fully
as they would any physical symptoms il
other diseases, they must be prepared t
take the consequences of Withholding
them; for the physician cannot be mad
the scapegoat In all cases, though perhap
In some he is led to yield feebly to the pre-
JUDGES OF his patrons, or as | have known
to motives of baser character, until cul
pability follows from the neglect of a grav
responsibility.
So unwilling are friends to act ef6cientl
upon the earlier symptoms of this grav
malady lfOr it as a grGUe malady, even
the sense in which the term is used /
Mercutio when tie hole through his bod
though not as large as a church-door, Wi
sufficient to make him a Craze man) tn
the earliest evidences are inot apt to con
under the observation of physicians in II
position; sometimes, creditably to the i
telligence lof friends, and generally fo
tunate tor the patients, L may say, witho
either arrogance or egotism, they do cor
before US promptly,
These early symptoms are the ones
which l desire especially to direct the
tentiOn at this stime-symptoms which q
often neglected too long, sometimes
years, without any untoward results, |
in the end often most unhappy in tn
termination. As penned this paragra
l took up the morning paper, and aim
the first line which met my view illustra
this remark:
"Mrs, Daniel Kunziman cut her throat fata
early yesterday morning, with a razor. Since
death Of her two children, tJ0O years SINCE she
been mentally depressed
Scarcely paper can be opened Il
does not contain some similar announ
ment. Here the symptoms had lasted
two years, and no notice appears to hi
been taken of them.
The NeiC York Herald OF the 7th inst rep
thirteen suicides and nine cases OF drowni
termed accidental as occurring in the month
May last. This equal to the palmiest day,
suicidal Paris, when bodies were fished out of
Seine, or picked up at the foot Of the Column '
dome, every morning. Many Of these suic
were, no doubt, the direct offspring OF want
desperation; others, probably, from estabis
melancholia resulting from the same. In ell
case, whether the cause was direct or indirect
mote or immediate, the result was equally sad
Now another great difficulty to the g
eral practitioner lies in the fact that tn
earlier symptoms are not apparently
grave as to call for any special attenti
the deluslons, if developed, are carefl
concealed by the patient. and there
nothing TO the superficial observer on VIII
insanity can be so certainly predcated
to call Tor treatment, much less for
cIuslon or restraint. Still, as in all q
eases, there are premonitory sympto
which should be carefully watched
met, and these [ now proceed to point
Frequently the patient himself is c
conscious that there is something wr
with him, and sometimes he will III
ton symptoms OF a change in charac
conduct, disposltiOn,o or feeling, which e,
his friends, If they observe them are
willing to point out, or feel delicac
doing so. lie sleeps badly, has disturb
dreams, perhaps, and is up wander
about his room. His digestion is
breath foul, and bowels constipated.
usual scapegoats Tor all phsical and me
evils, the stomach and liver .Eare char
with not doing their duty, or doing il
perfectly; there is great listlessness. 10
OF the functions of the brain and ner,
system, thought and feeling, which to
may be followed in time by exaltatior
the same taculties-periods of'depres
alternating with periods of exaltation.
Now 1t is in this state that me,
treatment is demanded and in whic
tells best, and if it is neglected, the h
ache usually present becomes
aggravated, the sleep more and more
turbed, and the patient goes on frou
to worse, till he passes into the ne
deusional staee.
In this first stage, though he may
made neither threats nor attempt
suicide he is very uncertain and shoul