It has been said, by the late Dr. Jenner, and some others, that cutaneous
disorders are common to the insane. I should think they are not very
common. {153} This is the only case that I have seen, where the two have
continued to exist together. Whether it was the original cause of his
mental malady, I have not been able to ascertain, but it is certain, it
aggravated it. That mania, in some instances, follows the disappearance
of eruptions, ulcers, and other local diseases, particularly with
females, is satisfactorily established; but in many instances, other
causes co-operate.
In cases of dementia, arising apparently from continued pressure on the
brain, the surface, from the general bad habit of the system, is liable
to sores, boils, and ulcerations. This cannot be called a cutaneous
disease; it is rather a symptom of the diseased state of the brain, than
itself the cause of insanity. Glandular swellings, however, seem to have
a more direct connection; but still they appear rather before, than after
the alienation has taken place. In a few cases, I have noticed slight
eruptions during recent paroxysms, and in two or three, immediately
previous to their convalescent state. Had such appearances occurred more
frequently, I should gladly have regarded them as favourable prognostics;
but they might arise from strong medicines, their state of confinement,
or they might be mere accidental coincidences. There are many instances
of cures by accidental injuries, {154a} as well as by the accession of
consumption and other physical diseases.
Here I leave the question for the present, till I come to some cases,
where, according to the theory of such a connection subsisting, (which I
believe is the case in a few instances,) the tartarized antimonial
ointment has been applied; {154b} but I confess, that there is no part of
my experience in which my sanguine expectations of cure, after a certain
duration of the disease, on this principle of counteraction, have been
more disappointed. In the early stages of insanity, it is decidedly the
most valuable principle in our practice.
_No._ 9.—_Admitted_ 1793.
No statement on record, that gives any satisfactory information. She was
a respectable farmer’s wife, and her insanity was occasioned by her
husband’s heavy losses of cattle. Her first symptom was throwing her
little infant at the feet of the parish officers, saying, “there, take
it.” {155} She often repeats, with a very moaning sound, and tears, “God
rest thy soul, poor old mare.” She will be easily known, when I say, she
is a poor, moaning, miserable looking imbecile, constantly sitting
cowering in a corner, always crying for tobacco. She was one of those
who were kept naked in loose straw, and hence her inclination to undress
herself, her dirty habits, and her peculiar mode of sitting: indeed,
formerly, throughout the house, the lowest and worst patients had no
seats allowed them.
_No._ 10.—_Admitted_ 1793.
Nothing recorded of this case. It is said, that when young, he was
severely kicked by a horse. There is now a considerable indentation just
above his left ear.
His mind, though extremely childish, is altogether in a torpid state, for
the most part quiet and good-natured; but sometimes, when more excited,
he exhibits a love of mischief, generally very childishly, but sometimes
more seriously so. {156a} His temperament is phlegmatic, and he has a
heavy, dull look. He has been for years employed in the garden.
_No._ 11.—_Admitted_ 1793.
Nothing on record. I have been informed, that he was a well-sinker, and
that his insanity was the consequence of a rheumatic fever. No one,
except a complete idiot, can be in a more stupidly stagnant state of
mind; he scarcely notices any thing, and never speaks unless spoken to,
and then his answers are merely monosyllables. About once in twelve
months, a slight exhibition of excitement shows itself in a sort of
ill-tempered obstinate fit, {156b} but which soon subsides, especially
with the aid of sulphate of magnesia. He is, together with No. 10,
constantly employed in the garden.