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 in 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 membrana 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[3]. 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 took place of
animal matter, 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.