The Universalist. [volume] (Chicago [Ill.]) 1884-1897, 1895-11-23

10 oil luupOuctTdUl0 COf0TluS. w mere
death occurs, as the sequel of insan-
ity, an autopsy, if made, often reveals
large cerebral abscess, involving ex-
tensive tracts of the brain. In other
post-mortem examinations, the lesion
is so minute as not to be discoverable
without the aid of the microscope.
In some instances, not even the mi
croscope reveals the existence of any
lesion, and it is permissible to suppose
that the trouble is functional rather
than organic, though it is not impos-
sible that microscopes of greater
magnifying power would enable us
to see what, without their aid, is be-
yond the range of our imperfect Wis
ion.
Insanity differs in one respect from
all other known diseases. It does
not enter into the sphere of the pa
TENTS personal consciousness. Where
the disease is in any other organ,
telegraphic communication with the
brain through the nerves is at once
established; but when the trouble is
in the brain itself, consciousness goes
no further than the elementary act of
perception; it is incapable of forming
a Judgment. There may be sense
of fullness, of numbness, or of pain;
there may be irritation and alarm at
the sense of inability properly to
govern and direct ones thoughts and
actions; but usually (the exceptions
are 80 few that we may even say uni
versally,) the patient seeks for some
explanation of his condition in pure
ly external causes; he fails to recog-
nize the existence of disease of the
brain, which he often Indignantly
denies. An insane person who
knows himself to be insane is a rare
phenomenon.
The forms which insane manifesto
tions assume correspond to the differ
ent locations of LESSONS in the brain,
and are therefore governed by the
law of statistical averages. Within
definite limits certain percentage
of lunatics will be found to suffer, at
any moment selected for the inquiry,
from mental excitement; another from
mental depression; third will be
dull, apathetic, and more or less i'm
beetle. The pseudo explanations of
their experience given by the patients
themselves will be repeated under
the operation of the same arithmeti-
cal law. OF 10000 insane people, SO
many will imagine themselves to have
been poisoned, so many will claim to
be the victims of conspiracy or perse-
cution, SO many will have committed
the objectionable sin, so many will
be possessed of the devil. In every
thousand patients there will be SO
many who have delusions of exalta-
ton, SO many with strong criminal
impulses-kleptomaniacs, pyro mani
acs, homicides, suicides and so forth.
Elements of Curative Treatment.
The essential elements in the cura-
tive treatment of insanity are few and
simple:
l. The first of them is rest. There
must be as complete cessation as
possible of the use of the portion of
the brain which is directly affected.
2. Rest is impossible without
sleep.
3. Then follows nutrition. The pa
tient must be induced to take all the
food that he can assimilate, and his
appetite tempted by rich and varied
diet.
4. To secure digestion exercise is
essential.
5. During the period of recovery
it is necessary to protect the patients
against drains upon his physical
strength in consequence of other To-
cal complaints; his general health re-
quires close watching and care.
6. 1t is also necessary to protect
him against two mental perils to
which he is inevitably exposed. The
first of these is dependency, the Sec
ond the tendency to become the prey
of fixed ideas. Herein consists the
value of moral" treatment. He must
be cheered and encouraged by genial
conversation, by the assurance OF
loyal, patient sympathy, by the mani
festations of personal affection; but
the sympathy and affection must moi
be in excess. His delusions must be
ignored as far as possible, contradict
ed as often as necessary; but the con,
tradiction, though firm, must always
be gentle and respectful.
z. Both dependency and fixed
ideas usually have their root in an
exaggerated, morbid self-conscious