The observations that naturally suggest themselves on this case on the
efficiency of mild treatment, are so obvious, that it would be obtrusive
particularly to state them. I cannot, however, omit adverting to the
fact of the probability of his having lost his toes by exposure to cold,
because it illustrates the remark made in observation V. Patients, in
former times, were kept naked in loose straw; and from their exposure to
cold, mortifications in the extreme parts were common; and then writers
on insanity say, that mortification of the extreme parts and
insensibility to cold, are symptoms of mental derangement!!—See also
observation 12th.
_No._ 19.—_Admitted_ 1800.
Nothing on record. He was a respectable tradesman.
He is constantly muttering and talking to himself, apparently busy in
making calculations, holding in his hand something he calls an almanack,
made by himself, as well as some pieces of money he has polished. He
repeats something, seemingly as a duty imposed upon him, perhaps meant as
a prayer. Though the shrivelled and decayed scraps of mind that remain,
look only like the apparitions of his previous habits of life; yet they
so wholly engross his attention, that he never notices passing and
external objects around him. Sometimes, however, he can with great
difficulty be for a moment diverted from his object, and while roused,
will answer questions with considerable point and shrewdness, but returns
as quickly into the same uniform abstracted state.
He is evidently of a contented and happy disposition. There is something
in his appearance and countenance which seems to say, “I have been a
respectable and good-natured fellow.”