E. L. was a man, about seventy-eight years of age; had been admitted on
the incurable establishment, January 3, 1767. By report, I have understood
that he was formerly in the navy, and that his insanity was caused by a
disappointment of some promotion which he expected. It was also said, that
he was troublesome to some persons high in office, which rendered it
necessary that he should be confined. At one time he imagined himself to
be the king, and insisted on his crown. During the time I had an
opportunity of knowing him, he conducted himself in a very gentlemanly
manner. His disposition was remarkably placid, and I never remember him to
have uttered an unkind or hasty expression. With the other patients he
seldom held any conversation. His chief amusement was reading, and writing
letters to the people of the house. Of his books he was by no means
choice; he appeared to derive as much amusement from an old catalogue as
from the most entertaining performance. His writings always contained
directions for his release from confinement; and he never omitted his high
titles of God's King, Holy Ghost, Admiral, and Physician. He died June 13,
1797, worn out with age. He was opened two days after death. The scull was
thick and porous. There was a large quantity of water between the
different membranes. The tunica arachnoidea was particularly opake: the
veins seemed to contain air: in the medullary substance the vessels were
very copious and much enlarged: the lateral ventricles contained two
ounces of pellucid water: the consistence of the brain was natural.
It has been stated, by a gentleman of great accuracy, and whose situation
affords him abundant opportunity of acquiring a knowledge of diseased
appearances, that the fluid of hydrocephalus appears to be of the same
nature with the water which is found in dropsy of the thorax and
abdomen.[10] That this is generally the case, there can be no doubt, from
the respectable testimony of the author of the Morbid Anatomy: but in
three instances, where I submitted this fluid to experiment, it was
incoagulable by acids and by heat; in all of them its consistence was not
altered even by boiling. There was, however, a cloudiness produced; and,
after the liquor had stood some time, a slight deposition of animal
matter took place, which, prior to the application of heat or mineral
acids, had been dissolved in the fluid. This liquor tinged green the
vegetable blues; produced a copious deposition with nitrat of silver; and,
on evaporation, afforded cubic crystals (nitrat of soda). From this
examination it was inferred, that the water of the brain, collected in
maniacal cases, contained a quantity of uncombined alkali and some common
salt. What other substances may enter into its composition, from want of
sufficient opportunity, I have not been enabled to determine.