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rested in the early history of Britain. Mr. Lowe had distinguished himself by a prize essay, entitled (quaintly enough) "On the Ancient History of the Kingdom of the Gaelic, the extent of the country, its laws, population, poetry, and learned.' To this essay the Highland Society of London awarded the premium-and deservedly, since we know of few single volumes of recent date offering such a display of research. Mr. Lowe is, we have been told, one of that laborious and ill-requited class of men who have done so much essential service as well as honour to their country—the parochial schoolmasters of Scotland. In such a situation, command of leisure is rare; access to authorities peculiarly difficult ; and the student works at an expense of time, labour, and too often health, not easily to be appreciated by those more fortunate scholars, whose hours of study are hours of relaxation. It is to be hoped that Mr. Lowe's talents and zeal will raise him from the respectable but hard-working and ill-remunerated class to which he belongs, and place him in a pulpit of The Kirk.
The defect of the book is an aptitude to lean on slight authorities—a slight mixture, in short, of the old sin of the race. Perhaps the author may not have seen the more recent compositions, in which such forgeries as the laws of Kenneth Mac Alpine, for example, have been unanimously rejected by lawyers and historians. The history of the old book termed the Regiam Majestatem,' again, is pretty well understood to have been a ruse-deguerre on the part of Edward I. of England, used for the purpose of riveting the feudal code upon the Scottish nation, as mora favourable to his views, and abolishing the consuetudinary laws and customs of the Scots and Bretts; of the Dalriadic Scots, that is, and the Britons of Strath Clyde. Mr. Lowe also swallows, by wholesale, the belief in Ossian-history, poetry, chronology, and all. These things savour a little of the ancient credulity of the Scottish historians, who could find it in their hearts to deny nothing with which they conceived the honour of their Antiqua Mater to be concerned. The Essay was originally composed for the Highland Society of London, amongst whom some lingering worshippers of the neglected idol are probably to be found ; and this is a circumstance which the candid reader will keep in view. We are extremely sorry that our limits permit us to say nothing further upon the labours of this modest and meritorious young man, and in such a case it would be truly unjust to enlarge on deficiencies.
Art. VI.-An Account of some of the most important Diseases
peculiar to Women. By Robert Gooch, M.D. London. 8vo.
THE work before us, being expressly devoted to medical sub
jects, cannot, as a whole, be appreciated by the non-professional reader. There are points, however, in medicine, forming that debateable land between technical and general knowledge, which few, who have attained to half the years allotted to our sojourn here, have not been forced to make the subjects of anxious thought; and of these the most painfully interesting is insanityto which Dr. Gooch has devoted two essays, distinguished in a very uncommon degree for originality, precision, and vigour of thought.*
The materials which our author has brought together will enable us to examine the validity Of the opinions current in medicine as to the nature and treatment of insanity in general, and puerperal insanity in particular;-Of certain opinions current in society as to insanity;—and, thirdly, of certain notions entertained in law respecting insanity, considered as a subject of legal medicine.
It is well known that some, who are quite sane at all other times, become deranged — sometimes a few days, sometimes several months, after confinement. We may quote the following case:
- A lady, who I was told had had a “ a brain fever" after her former lying.in, came to London to be attended by me in her next confinement. For nine days subsequent to a short and an easy labour, nothing indicated the approach of disease. On the tenth day, however, the shop of a piano-forte maker in Oxford-street caught fire: this occasioned a great bustle in the neighbourhood ; as her sitting-room did not look into the street, it was kept from her knowledge during the day ; but in the evening, while she was standing at her window, which looked into a yard at the back of the house, a piece of burning matter fell within her sight. I saw her about two hours afterwards, at nine in the evening: her manner was agitated. On being questioned as to her feelings, she kept silent for some time, and then answered abruptly: her pulse was quick; her look and manner odd and unnatural. I slept in the house. At four o'clock in the morning the nurse waked me, and said that her mistress had no sleep; that she was sitting up in bed talking to herself, but that instant had expressed a wish to see me. I rose and went to her; there was only a rushlight in a remote part of the chamber. As soon as she saw who I was, she told me to sit down and look at her. I said, " I do." “ What do you sée ? Nothing but yourself.'' « Look at my head.” 4 I do."
* The two essays to which we allude are entitled “ Disorders of the Mind in Lyingin Women;" and "Thoughts on Insanity as an object of Moral Science."
Do you see 'nothing particular there ?" ;Nothing." " Then I was presumptuous : I thought that a glorious light came out of my temples and shone about my head; I thought I was the Virgin Mary," The patient recovered in three weeks.
The practical question to be determined is, what is the state of the body on which the disorder of mind depends ? Our medicinal agents can only “raze out the written troubles of the brain,' through their action on some portion of the organisation. It is of the last importance, therefore, to ascertain that peculiar state of organisation which accompanies insanity; and here Dr. Gooch is opposed not only to popular but to professional prejudices.
There is a strong disposition,' says he, to attribute raving of the mind to inflammation of the brain. Perhaps it originates thus :—that the disorder of the mind, with which we are most familiar, is drunkenness, which is known to be caused by spirits and cured by temperance: - mania is called brain fever; and the sight of a råving patient instantly suggests the thoughts of cupping-glasses, iced caps, low diet, and pargatives.'
Experience, however, according to our author, points to a very different conclusion: it teaches us that disorder of the mind may be connected with very opposite states of the circulation ; 'sometimes with inflammation or active congestion, for which depletion is the shortest remedy; sometimes with an opposite condition of the circulation, which depletion will only aggravate: And, indeed, in order to prove that the excitement of the brain, in puerperal insanity, does not always depend on inflammation, nothing more is necessary than to look over the leading points of the cases Narrated by Dr. Gooch as having fallen within his personal observation.
In one of these, the disease occurred in a pale lady without any heat of skin, or much quickness of pulse, and was not relieved by blood-letting: in another, it occurred in one whose constitution was drained and enfeebled by nursing: a third was habitually hysterical, pale, and from want of sufficient physical power always brought forth dead children: in a fourth, insanity followed immense loss of blood: in a fifth, it occurred in one in whom, for urgent reasons, large bleedings were essential to preserve life: in a sixth, who had lived so low, and was of so irritable a constitution, that she appeared as if at the close of some disease which had been overlooked, mania showed itself, and was relieved not by bleedings or cupping, but by means which trauquillized, soothed, and sustained the patient. In a seventh, the attendant treated the case by moderate depletion, by leeching, cupping, purging, and low diet;-she died, not with the symptoms
of oppressed brain, but with those of exhaustion; and, on examining the body, the whole of the venous system was found extraordinarily empty of blood. In an eighth case, the practitioner, misled by the flushed face, fevered look, hardish pulse, and raving madness, ventured to take away blood; and, on the abstraction of a little more than a tea-cup full, the patient sunk under the stroke of the lancet as if shot. In another, the disease came on after one of those enormous bleedings resorted to for the relief of puerperal convulsion : in both these cases, there was no evidence whatever to be found, after death, of inflammation of the brain. . It is impossible to look at these results, gathered together by a competent observer and a faithful narrator, without coming to the conclusion that puerperal insanity is not necessarily a disease of congestion or inflammation, but is generally one of excitement without power. The insanity occurred, in almost every instance here adduced, in persons previously debilitated; and, when treated under the notion that its cause was inflammation or congestion, the patient either sünk rapidly, or was materially injured, or at best was not relieved. It may, however, be objected that these are cases selected to prove à point, and that they bear a small proportion to others in which the insanity is dependent on an overloaded state of the vessels of the brain. Hos Their very number,' says Dr. Gooch, 'gives a negative to this, sus
picion : ten cases can never form a small proportion of the experience of one individual, however extensive his opportunities of seeing the disease may be; for puerperal insanity is, not like fever, a disease in which an experienced physician counts his cases by hundreds. Dr. William Hunter said that, in the course of his practice, he had met with about twenty or thirty. There can be no mistake, unless, by somo extraordinary accident, all my cases have been exceptions to the genė. ral rule—an incredible supposition. They surely prove that those cases of puerperal mania, which are attended by a very rapid pulse, which Dr. William Hunter said generally die, and which he attributed to paraphrenitis, do not depend on that state of the brain which requires depletion, but on a more exhausting excitation of the nervous system, which requires soothing and sustaining treatment.'
In the latest works written on the subject of insanity, opinions diametrically opposed to these are promulgated; the ancient regime of shaving, cupping, bleeding, is recommended, and opiates discountenanced. From these directions it would be inferred that the generality of cases depended on congestion, and required depletion, which is the reverse of the fact. The real inflammatory pbrensies of puerperal women are rare. Inflammatory head-aches are not uncommon, but their progress is very different from that of puerperal insanity: the delirium, if any, 'is