Cerebral and mental symptoms in relation to somatic disease, anæsthetics and toxic agents, traumata and surgical procedures : with a review of the treatment of some cerebral and mental symptoms by operation / by James Christian Simpson.

  • Simpson, James Christian.
Date:
1898
Catalogue details

Licence: Public Domain Mark

Credit: Cerebral and mental symptoms in relation to somatic disease, anæsthetics and toxic agents, traumata and surgical procedures : with a review of the treatment of some cerebral and mental symptoms by operation / by James Christian Simpson. Source: Wellcome Collection.

Provider: This material has been provided by King’s College London. The original may be consulted at King’s College London.

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    system, Mays says that phthisis is three times more common in the insane, and is more apt to occur in subjects of melan- cholia, diabetes, myxoedema, and idiocy. Phthisis and insanity usually occur between the years of 20 and 30, whereas tubercular meningitis reaches its maximum at 1 year, and its minimum after 3 years. Hysteria, chorea, and epilepsy often co-exist with phthisis. Phthisis is from eight to ten times more frequent in idiotic families, and idiots die of phthisis about ten years earlier than the average. In fact, Mays considers phthisis and insanity as one family group, the former being a vagus lesion. Clouston found a hereditary predisposition to insanity in 7 per cent more of the insane who were tubercular than of the insane generally, and that the last of the family is either insane or tubercular. There is a strong relation between the phthisical and the insane predisposition; and when phthisis and insanity contempo- raneously develop, a special type of insanity may be made out in about one-fourth of the cases. Dr. M'Callum has shown that the deaths from phthisis in Scottish asylums during the period of eighteen years from 1871 to 1889 have materially decreased; and in dividing this period into three sub-periods of six years each, he arrived at this result: that while the percentage of male deaths from phthisis on the total number of male deaths fell from 13-3 to 12-5, the percentage of female deaths from phthisis on the total number of female deaths fell from 19 to 15-1. Taking the total phthisis death percentage, there is a fall from 16 to 13-8, the greater part of this improvement being due to the great decrease in the number of women dying of phthisis^ A similar inquiry was made in seven English asylums chosen at hap-hazard. The available period was from 1880 to 1889 subdivided into two periods of five years. This show^ed that m these seven asylums the death-rate from phthisis as compared with the total death-rate, is higher in the second period than in the first, and this increase is due entirely to the higher phthisical death-rate in women, which rose from 17-3 to 20-6. Northumberland Asylum actually showed an increase of 12 per cent; and when this is analysed, it is really an increase of 20-1 in the female death-rate from phthisis In commenting on this, Dr. MacDowell said, in 1885 that the ventilation was at fault, the gauge covering the opening into the venti ators being choked with dirt, and some of the shafts opening directly outside having birds' nests in them. These detects were remedied and next year there was an appreciable decrease in the phthisical death-rate ; but Clouston has shown