A treatise on mental diseases : based upon the lecture course at the Johns Hopkins University, 1899, and designed for the use of practitioners and students of medicine / by Henry J. Berkley.

  • Berkley, Henry J. (Henry Johns), 1860-1940.
Date:
1901
Catalogue details

Licence: In copyright

Credit: A treatise on mental diseases : based upon the lecture course at the Johns Hopkins University, 1899, and designed for the use of practitioners and students of medicine / by Henry J. Berkley. 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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    hyoscine to a patient with a weak heart. It is a moderate depress- ant of vohmtarj motion, and acts without producing much mental confusion. The ease with which it may be given by hypodermic injection often causes it to be chosen, but with many patients it is not a safe drug. The hypnotics are not only admissible, but frequently prove most serviceable in attempting to abort an incipient attack of mel- ancholia or mania. When employed with judgment they may induce a patient to resume the broken habit of sleep, and tempo- rarily quiet violent cases so that they are saved from the severe effects of prolonged frenzy, and, if necessary, are rendered torpid for a certain length of time, during which it is possible to remove them from their homes to a pi'oper place for treatment. Never use hypnotics longer than is absolutely necessary; the after-effects are not readily controlled. We are not infrequently confronted by the question. Will the patient stand a better chance of recovery at home, or in an asylum for the insane ? Cases from the lower walks of life are always bet- ter oft in an institution where they can be properly cared for, but the same rule does not generally apply to the wealthier classes. If from previous experience we expect the duration of tlie attack to be short, and the individual can have proper nursing and food at home, it is better for him to stay there, in order to avoid the stigma of the mad-house which might remain attached to him or her forever afterward. Extremely violent cases have to be removed at once to a suitable institution. Mild manias, melancholias, or the confu- sional forms of insanity, do equally well or better at home than in an institution. Often one of the chief considerations is whether the patient be suicidal or not. If he has shown any such tendency, and there is any question about the reliability and watchfulness of the attendants, it is wise to have him removed. If he is homicidal the same holds good. As a general rule, it may be said that only the milder cases of the acute and chronic forms of insanity should be treated at their own homes.