Clinical reports on insanity |
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Abdominal section abnormal acute mania adherent adhesions admission admitted alienists amiable asepsis Assistant Physician attack attendants became bone brain Bright's disease cavity Clinical Assistant congested convulsions cystic delirious delusions depression discharged doses drachm eighth day enlarged epilepsy epileptic Epsom salts excitement family denied Family history frontal bone given hallucinations hyoscine hyoscyamine hypnotic hystero-epilepsy improved inch incision insane hospital iodoform irritable kidney disease Left ovary lesions mania married Maryland Hospital Medical melancholia menstrual periods ment months obscene operation organs ovaries and tubes paraldehyde Patient recovered pelvic disease PERCY WADE perineum physical condition psychical puerperal infection Puerperal insanity occurs pulse quiet recovery reported restless Right ovary Rohé septic seventh day sexual simple mania sleep slept suicidal tendencies sulfonal sutures sutures were removed talk temperature tion toxic symptoms treatment trephining urine usual aseptic precautions uterine appendages uterus vaginal examination ward washed weeks wound had united
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Page 22 - Without rejecting the influence of other factors, such as heredity, anemia, exhaustion, mental shock and distress, careful observation will show that few cases of puerperal insanity occur without preceding or coincident puerperal infection. " The reasons for this opinion may be briefly summed up as follows:
Page 23 - Post mortem examinations, though apparently infrequent in these cases, have shown grave involvement of the pelvic viscera. 6. Examinations of the pelvic organs during life show lacerations of the perineum and cervix uteri (facile channels of infection in the puerperal woman.) As secondary conditions are found intrapelvic (peritoneal) inflammations, and consequent abnormal locations, fixations, and congestions of the uterus, tubes, and ovaries. 7. The results of operations seem to show that removal...
Page 39 - The facts recorded demonstrate, first, that there is a fruitful field for gynecological work among insane women ; second, that this work is as practicable and can be pursued with as much success in an insane hospital as elsewhere ; and third, that the results obtained not only encourage us to continue in the work, but require us, in the name of science and humanity to give to an insane woman the same chance of relief from disease of the ovaries and uterus that a sane woman has.
Page 59 - Three of our cases, two being acute mania and one epileptic mania, furnish evidence of the value of sulfonal as a prompt and reliable hypnotic, when given in sufficiently large doses. In the first two cases, both patients had been given morphine injections and other hypnotics by their family physicians, with no appreciable effect. In both cases sulfonal acted promptly. In the third case, sulfonal was found to act much more promptly than bromidia, paraldehyde or morphia, all of which had been previously...
Page 22 - The death rate is much higher than in simple mania. Death occurs from exhaustion, usually with high temperature and rapid pulse. "5. Post-mortem examinations, though apparently infrequent in these cases, have shown grave involvement of the pelvic viscera. " 6. Examinations of the pelvic organs during life show lacerations of the perineum and cervix uteri (facile channels of infection in the puerperal woman). As secondary conditions are found intrapelvic (peritoneal) inflammations, and consequent...
Page 22 - The reasons for this opinion may be briefly summed up as follows: " 1. Puerperal insanity occurs in the great majority of cases within the first ten days after delivery — about one-half in the first five days — the same period during which puerperal infection usually occurs. "2. It is usually accompanied by elevation of temperature and other evidences of febrile disturbance.
Page 22 - ... insanity occurs in the great majority of cases within the first ten days after delivery — about one-half in the first five days — the same period during which puerperal infection usually occurs. "2. It is usually accompanied by elevation of temperature and other evidences of febrile disturbance. " 3. The clinical form in which puerperal insanity manifests itself is, in the majority of cases, that of acute, delirious, or confusional mania. Depressive states are rare except as secondary forms.
Page 58 - ... very lives demand it, sulfonal has not failed in any case in which it has been used. Given in drachm doses, preferably in whisky. Not only has it secured from six to eight hours of sound sleep, but it has produced quite a decided amount of motor sedation, lasting from eight to twelve hours after waking. In each case sleep was obtained within one hour after administration, and in none was any bad after-effects noticed.
Page 51 - I take the liberty of here quoting the conclusions of that report : " 1. Puerperal insanity is, in at least the large majority of cases, an infection psychosis. " 2. Without rejecting the influence of other factors, such as heredity...