An expiscation of acute delirium / by H.C. Wood.

  • Wood, Horatio Curtis, 1841-1920.
Date:
1895
Catalogue details

Licence: Public Domain Mark

Credit: An expiscation of acute delirium / by H.C. Wood. Source: Wellcome Collection.

Provider: This material has been provided by The Royal College of Surgeons of England. The original may be consulted at The Royal College of Surgeons of England.

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    Extracted from The American Journal of the Medical Sciences, April, 1895. 1 AN EXPISCATION dF ACUTE DELIRIUM. By H. 0* Wood, ]|,Dy^L.D. (Yale). There is probably no department of medicine in which the scientific study of disease affords so little of mental satisfaction as in that which treats of insanity. The reason of this is not far to seek; as I have formerly insisted upon, the various insanities to which names have been given by authors, as though they were distinct diseases, are in great part nothing more than symptom-groups, one of these groups often containing two or more diseases, and one disease reappearing in two or more groups. As in the former time, physicians talked about dropsy as a disease, and now this alleged disease is resolved into heart, renal, and kidney affec- tions, so at present we speak of manias and melancholias, which in the aftertime will, we hope, be resolved into various organic affections. Our knowledge of cerebral pathology in its relation to cerebral action is so imperfect that it seems almost impossible for the alienist to get much firm ground under his feet; indeed, it still remains doubtful whether it will ever be possible to get a complete pathological basis for our study of insanity, unless, indeed, some great genius shall arise and invent new methods of investigation. The matter is made more diffi- cult and the value of our present knowledge more problematic by the fact that we have no definite, positive proof at present that correspond- ing lesions produce in different individual brains the same symptoms; whilst we do know that different lesions will produce closely similar symptoms. Nevertheless, by splitting off here and there a group of cases whose pathology has been made out, we may hope little by little to obtain more and more definitude of knowledge, and continually reduce in number and importance the symptomatic disease-groups of unknown pathology. In chronic insanity such a long time usually elapses between the com- mencement of the process and the death of the individual that secondary brain-alteration must continually obscure any original structural devia- tions ; pathological study in chronic insanities is therefore more hopeless than in the active disorders. It is plain that in an attempted elucidation of the essential nature of insanity very little value attaches to reports of cases in which recovery has occurred, and in which, therefore, no patho- logical study has been possible. The literature of medicine teems with the reports of such cases; indeed, there has been such au accumulation that it is hardly probable that our knowledge can be advanced by further