H. K. a woman, aged thirty, was admitted into the hospital, October 15,
1796. She had then been mad about four months, and her disorder was stated
to have supervened on the birth of a child. From subsequent enquiry it was
ascertained that her mother had been insane, and that her elder sister
had been similarly affected; but from the best information it did not
appear that her brothers (she had two) had ever been visited with this
calamity.
Previously to her admission she had frequently attempted to destroy
herself, and had also endeavoured to take away the life of her husband. In
the hospital she was extremely violent; supposed her neighbours had
conspired to take away her liberty, and became jealous of her husband: she
was often naming some female of her acquaintance who had artfully ensnared
his affections, and whom he had decked out in her best apparel: she
breathed revenge when she should return home, and seemed much delighted
with the idea of destroying these favourites, when they were dressed for
some excursion with her husband.
She had understood that a year was the extent of time that persons were
detained in the hospital, and conceived she should be liberated when it
had elapsed, to put her menaces into execution. Her disorder being of a
dangerous tendency she was retained in the hospital after the period of
probation. When she found the hope of gratifying her revenge frustrated,
by being kept beyond the time of her expectation, she began to pine away,
her appetite diminished, and a cough, with copious expectoration and
hectic fever supervened. During the whole period of her bodily disease,
she would never acknowledge herself to be ill, and the violence of her
mental disorder was unabated. She died of Phthisis Pulmonalis, April 1st,
1798.
The head was opened twenty four hours after her decease. The tunica
arachnoidea was in many places opake; the pia mater was highly inflamed,
and loaded with blood, and a considerable quantity of water was contained
between it and the former membrane. The ventricles were enlarged, but
contained scarcely any fluid. The other parts of the brain were healthy,
and its consistence was natural.
It is a common opinion, that Phthisis Pulmonalis is frequently suspended
by the supervention of mania; medical books abound with such accounts, and
some persons have supposed it difficult, if not impossible, for these
diseases to co-exist. It is not my intention to dispute the accuracy of
such relations, nor to question the power which Mania may possess in
arresting the progress of Phthisis Pulmonalis, but, to state that the
converse does not obtain; and, that whatever obligations may be due from
Phthisis to Mania, the compliment has not been returned. From my own
experience I can affirm, that insane persons are as liable to Phthisis
Pulmonalis as others, that numbers of them die of that disease; and that I
never saw any abatement of the maniacal symptoms through the progress of
consumption.