Book review by Dr. MANSOORA. K
NAME OF BOOK : MENTAL DISEASES AND THEIR MODERN TREATMENT
AUTHOR: SELDON HAINES TALCOTT AM, MD, phD
Published By : B. Jain Publishers Pvt. Ltd, New Delhi
Printed In India By JJ Offset Printer, Delhi
Price : Rs 45/-
SELDEN H. TALCOTT (1842-1902) before graduating from the New York Homeopathic Medical College and Hospital in 1872 served in the Civil War with the Fifteenth Regiment of the New York Volunteer Engineers. His homeopathic career predominately dealt with the care of the mentally ill as he stood at the helm of the Middletown Asylum (also known as the Middletown State Homeopathic Hospital) for some 25 years. As superintendent, he created a hospital with a stellar reputation, his accomplishments being lauded as far away as Belgium. He wrote one book, Mental Diseases and Their Modern Treatment, many journal articles, and “as a public speaker had few equals”.
YEAR OF PUBLICATION: 1901
To the class of 1900 of the New York Homoeopathic Medical College And Hospital and to all other earnest students of mental medicine.
During past 25 yrs he has been engaged in practical work of ministering to the needs of insane; which resulted in development of treatment designated as “The hospital idea”. Fact is now generally recognised that the insane man is a sick man and needs for his comfort and cure the application of such means as are ordinarily used for the benefit of the sick in a modern general hospital.
At Middle town state Homoeopathic Hospital: hospital measures and indicated Homoeopathic remedy has been applied with conscientious fidelity in each case.
In his lectures he tried to explain
- the nature of diseases under consideration
- its causes
- its tendencies &
- its conclusions under favourable treatment
This work consists simply of a few “blaze marks” guiding the way through the wilderness of mental disorder & into the sunny shields of health. By author At Middle Town New York on April 1901.
PREFACE TO Ist INDIAN EDITION:
This book embodies, in a series of lectures a long experience in working for the good of those who suffer from mental derangement.
CONTENTS: Ten Lectures along with treatment and index of remedies.
LECTURE I – THE HUMAN BRAIN
About anatomy and physiology of brain, intellectual action of brain.
Also about emotions.
LECTURE II – INSANE DIATHESIS OR ABNORMAL TENDENCIES OF
Grauvogel in “The Text Book Of Homoeopathy” mentions various constitutions of human body
Mental abnormality is always due to
either imperfect/eccentric physical development or effect of inborn or acquired physical diseases or injurious impression either antenatal / postnatal upon that delicate and intricate physical structure known as the human brain.
Some persons more than others when affected by any bodily ailment OR Some physical imperfections or tend to aberrated conditions of mind.
Natural defect and unnatural tendencies applied to in general way to term- insane diathesis.
Conditions leading to unsoundness can be
- inherited (compared to scrofulous)
- Acquired (compared to gouty diathesis)
Hysteria in mother may develop insane diathesis in child; Drunkenness in father may impel epilepsy, or mania, or dementia in son ;Ungoverned passions, from love to hate, hope to fear, when indulged very much by parents -unrestrained madness in children. Approach of medical men by timely warnings may save them for his own treatment instead of sending him to asylum.
Many of the high livers of the present day are developing, rapidly, surely strong tendencies to mental and physical disorders. Methods of life of those who produce children under such circumstancesmental weakness.
Causes developed from parents unclipped imagination or passion of remorse or undue gratification of the appetites or depletion of body system through the overuse, or any perversion of the physical, mental or moral powers etc.,
Can be often the result of peculiar states in which the reproducing pair find at moment of conception, likewise, in the unpleasant emotions induced by surroundings of the mother during pregnancy. Drunkenness, lust, rage, fear mental anxiety..etc., in act of impregnation will each or in combination lead to idiosy, imbecility, eccentricity or absolute insanity.
( eg., Nepoleon-warrior, mother during pregnancy excercised queenly powers. Children born under influence of fear troubled by apprehension insane)
Insane diathesis acquired or inherited By :
- Imperfect nutrition
- Slight and almost imperceptible injuries to the brain- blows or falls.
- Those fears sometimes excited in the minds of young children for the purpose of government.
- Overtaxing the undeveloped physical powers
- Unwise forcing of the mind in its immature or underdeveloped stage
- Premature and unnatural excitement of the sexual organs of the young
- By suppression of the ambitions , and powers, & tastes, and desires, of enthusiastic adolescent.
Insanity is result of diseased condition of the brain, either functional or organicexpression of delusions or hallucinations. Delicate children should be kept much in the open air, and taught to exercise their muscles until they are physically fully developed.
The head of those who are born or bred to insanity are almost always misshapen- One side is fuller than the other, one ear set higher than the other, eyes pear forth in a restless uncertain way from beneath beetling brows, nose slants slightly across the fact, mouth has uneven cut, and lips match each other poorly.
TO AVOID DEVELOPMENT OF INSANE DIATHESIS: avoid debasing passion, shunning all unnecessary anxiety and cares of life, cultivate higher virtues, better tempers etc.,
MEDICINES : Act as stimulus in growth and development of human body .
Remedies are Calc carb, Hepar sulph, Graphites, Phosphorus, Sepia, Silicea, Sulphur.
LECTURE III – SLEEP , SLEEPLESSNESS , AND THE CURE OF INSOMNIA
Sleeplessness is one of the prime & leading indications of approaching insanity. Sleep is the act of closing the doors of the brain against external intrusion while the process of rest & repair is going on within. Health of body and peace of mind are essential to sleep.
Causes Which Prevent Sleep
- Pathological conditions of the brain- derange normal action of the mind- Hyperemia, anemia.
- Protracted overuse of brain- Vasomotor paralysis.
- Worry-undue anxiety over common or little everyday affairs of life.
- Natural temperament of some people is obstacle to acquirement of sleep.
- nervous-rapid action till exhaustion, Irritability
- unfortune temperament
- Localised diseases in some parts of body(Heart, stomach, liver etc.,).
Few Practical Suggestions For Induction Of Satisfactory Sleep
- Take no thought for the morrow.
- Put body in proper condition. Proper exercise, suitable diet, attention to excretory organs, cleanliness..
- Proper nourishment of body. Weak person- hot milk or beef tea, Mildly stimulating broth, soothing gruel – short time before hour of sleep. Sometimes if the stomach & mind is weak- good old wine along with food.
- A warm bath followed by cold douch and brisk rubbing.
- Fresh air.
- Bed- firm texture ,well elevated from floor; head- north, feet- south; light clothing.
- Position of head.
- Induce sleep by massage or muscular manipulation.
Remedies for sleeplessness
Aconite, Bell, Cham, Actea rac, Coffea, Gels, Hyos, Kali brom, Nux vom, Stram,Verat viride.
LECTURE IV – HISTORY & CLASSIFICATION OF INSANITY
Hippocrates first physician who seemed to have a true conception of real nature of insanity- to certain extent insanity was due to physical disturbances.
Mentions about St. Dympna. First Asylum est. – St, Luke’s in London in 1751.
Samuel Hahnemann est. Asylum for insane at Georgenthal in 1791.
Asylum care means close confinement, good food, sufficient clothing and comfortable beds. Human custody of dangerous prisoners. Hospital system recognises fact that lunatic is sick man, and needs nursing & medical treatment in order to effect a cure.
Classification of insanity
- British classification &
- American classification of insanity
- Congenital/Infantile mental deficiency- Idiosy; Imbecility; Cretinism
- With epilepsy
- Without epilepsy
- Epilepsy acquired
- General Paralysis of the Insane
- Apotu, or mania of drunkenness
- Organic ie., from tumors, haemorrhages etc.,
- Delusional insanity (monomania)
- Moral insanity
General practice – 4 general divisions
Melancholia, mania, dementia and general paresis.
1. Ancients believed that insanity was possession of the devil.
2. Believed by some that insanity is a disease of both mind and body or that physical & spiritual forces both degenerated when under the influence of insanity.
3. Modern theory- Insanity is departure from the normal mental status, as a result of diseased conditions of the brain.
Insanity- Insanity is departure from the normal mental status of the individual, and this departure is due to some diseased conditions of the brain or nervous system
Delusion– False belief.
- Delusion made manifest by mental exaltation- incoherency of thought & constant change of ideas, and
- Delusions which grow out of or are the effects of profound depression- fixed contemplation of a single idea.
Produced by external or internal impressions.
Hallucinations – is a sensation without an object.
- Temporary or unimportant diseased condition of the brain- visions & nightmare.
- Indicating profound mental aberration.
Fixed, permanent & intractable in nature- insanity.
Hallucination – affect sensory motor ganglia.
Delusion – affect inhibitory motor ganglia.
LECTURE V – MELANCHOLIA
Term Greek -black, bile
MELANCHOLIA- Disease characterised by mental depression.
- Predisposition :- Unnatural, inborn, inherited tendency to look upon dark side of life; to make the worst of everything etc.,
- Physical disease :- Most common exiting cause of insanity is physical disease at or after the period of maturity. Over zealous struggle, non-limited diseases(feels never recover) depressed.
- Dissipiation :- Excessive drinking or eating or exhaustion of sexual system-by natural or unnatural means melancholia.
- Work & worry :- Worries- useless and injurious.
- Shock from sudden loss of friends or fortune :- Shock upon physical systemdepression.
- Brooding :- who broods over disappointment in life or ambition quietly seeks to keep his trouble to himself melancholia.
- Disorders of faith
1- 6- associated with daily life and present experiences.
7- associated with those intangible subjects concerning present and future existence; mortal & immortal, concerning creator, creation and created.
- Simple melancholia :- Continued depression without formation of concrete delusions. No cause.
- Acute melancholia :- Result of sudden mental shock produced either by loss of friends, reverse of fortune , desertion or seduction, calamities of life etc., They keep quiet, averse to consolation etc., A suicidal feeling common here. Terminate in recovery or mania, or death due to exhaustion.
- Subacute melancholia :- Those which, from a natural predisposition , incline to a survey of life from the dark side. No marked objective symptoms of mental agitation and physical decay, no fixed delusions. Relapses. Should live in mountains & open air.
- Chronic melancholia :- Terminus of all other forms of spirit depression. Due to continued mental shock , worry, brooding, physical decay.
- Melancholia with stupor :- confounded with primary dementia, or stimulate a state of utter mental failure. Without previous mental derangement or occur in course of mania. Terminate in speedy recovery, by absolute dementia or by death.
- Melancholia with agitation :- Person walks, stands, wrings hands, pull out hair etc., Includes religious melancholia.
- Melancholia resistance :- resist very attention or care. Emaciate rapidly
- Acute delirious melancholia :- main in typhoid or of acute mania along with anxiety, unrest, hopelessness & despair. Nourish them. Careful treatment, good care large portion recover.
- Hypochondriacal melancholia :- all thoughts and beliefs centered upon himself. Thinks they have incurable disease.
Prevalence And Prevention
Prophylactic is leading of a regular , natural and healthy life and moderate and reasonable use of all good things earth supplied. Youthful pleasures for wise & noble purposes.
Live patently & regularly.
Passive congestion of cerebral sinuses.
In melancholia with excitement hyperemia of brain seen.
LECTURE VI – MANIA
Term mania derived from a greek word which means a raving or furious madness. Incongruity and unnaturalness of thought, speech and action are its characteristics. Unbalanced mind run a more or less constant series of impulses to work of fury and violence.
- Same as that produce melancholia
- Disease of brain
- Insufficient sleep
- Unusual shock or strain over nervous system, unusual mental excitement.
- Lack of brain strength.
- General forms:- Acute, Subacute , Chronic
- Special forms :- Acute delirious , Recurrent , Periodic and circular
- Peculiar forms :- named from supposed causation ; traumatic, masturbatic , syphilitic, peurperal , hysterical, climacteric, tubercular, metastatic and post febrile manias.
- Disputed forms :- monomania, moral mania
- Class including :- dipsomania, erotomania, nymphomania, satyriasis, kleptomania, pyromania.
SYMPTOMS , COURSES AND CASES
1. Acute Mania :-
Preceded by a period of mental depression brooding
State of excitement for months. Tongue red, lips dark cracked, harder pulse etc., Dirty, lewd , quarrelsome.
Duration from one – six or more months; depends upon age , sex, course, period of incubation, no. of previous attacks, other conditions etc.,
2.Subacute Mania :-
Cunning, self- poised, deceitful, induce in mind that they are not insane. Muscular tremor, hurriedness of speech etc.,
Paranoia :- Usually outgrowth of a high grade of imbecility.
- Paranoia, with delusions of persecution.
- Paranoia, with delusions of ambition or grandeur-
- Religious Paranoia
- Jeolous paronia
3. Chronic mania :- mental disorder continued for a considerable length of time. Terminate by running into dimentia, by death or occasionally by recovery.
- Acute delirious mania: Intensified form of acute mania .Accompanied by delerium, and terminating ordinarily in exhaustion and death. Marked by 2 stages.- Excitement (a mixture of incredulity and maliciousness ; sleeplessness) & Collapse(comes suddenly, recovers when recognised at onset).
- Recurrent mania: invasions repeated at intervals, varying in frequency from one month to two or more years.
- Periodic mania: subdivision of Recurrent mania. Outburst of violence recur uniformly at stated periods( monthly, every summer..)
- Circular mania: is a rythmical alternation of mania with melancholia or between exaltation & depression.
Peculiar forms :-
- Traumatic Mania : Restlessness, incoherence, vivid hallucinations, mistaken identities, muscular weakness ,heat in head etc., Caused by contusion of gray matter caused by a blow or fall.
- Syphilitic Mania : acquired through Indulgence with those who have syphilitic taint.
- Puerperal Mania : Associated with child bearing ( during pregnancy, before childbirth, days after delivery.)
- Hysterical Mania: By exaggeration of some hysterical condition.
Disputed forms :-
Monomania, moral mania, and manias of criminal tendencies. Classed under general head of subacute mania.
Capillary distension hyperemia of cortical substance of the brain.
LECURE VII – DIMENTIA
The term is derived from two Latin words,de, “from”, and mens, “mind”. The expression, therefore, means strictly “out of mind”.
Demented persons are incapable of reasoning because external objects make too feeble an impression upon them, because the organs of transmission have lost a part or all of their energy, or the brain itself has no longer sufficient strength to receive and retain the impression thus transmitted to it. The organ of thought has not energy enough; it has been deprived of that vigor which is necessary for the integrity of its functions.
Idiocy is a congenital absence of both cerebral and mental power. It is amentia, “without mind”. Imbecility means a checked or arrested development.
Dementia may be classified in a general way as primary and secondary. Primary dementia is a disease which comes on independently of any other form of insanity. Secondary dementia follows in the wake of some other form of insanity, chiefly melancholia or mania; and if this condition continues until the case is hopeless, it is then called terminal dementia.
Dementia may be either acute or chronic. That is, it may come on suddenly and with sharp manifestations, or it may gradually develop into a hopeless and long continued aberration.
Primary dementia may be sudden or gradual in its onset. Among the young and the poorly nourished, an attack of dementia is likely to be sudden, and then it is called acute primary dementia. Senile dementia (the dementia of old age) may be primary. That is, it may come on without any previous attack of any form of insanity, or it may come gradually.
Causes and symptoms of acute dementia:
Absence of any neurotic inheritance was favourable to the development of acute dementia when its immediate causes come into play. Acute brought by fright , disappointment, surprise etc., OTHER CAUSES: Poorly fed indifferently housed.
Acute dementia invasion in two ways. Gradually or by attack of excitement. On recovering patients find a great hiatus or vacancy in his memory.
Chronic dementia : After disappearance of acute mania effect of shock are sometimes visible in a certain condition of mental weakness without actual intellectual disorder. This is one end of scale of degeneration . No interest in present, patient leads a vegetative life. Bodily health is good. End is usually death. Occasionally the recovery take place during onset of some acute disease.
Masturbatic dementia : As a result of pervasive and brain- impairing vice familiarly known as self abuse. Such persons can develop mild or acute melancholia or condition resembling subacute mania. But usually terminate in dementia.
Treatment: moral, medical, dietetic & hygienic.
Syphilitic dementia: Have gummy deposits or tumors in brain. Produce loss of memory or sight, paralysis of one or both sides of the body and finally a series of convulsions , in which patient finally dies.
Epilepic dementia: Requires close care, good nursing, light diet and such sympathy as their helpless and deplorable state demands.
Organic dementia: Enfeeblement of mental powers, complicate with or superveining upon paralysis of one or both sides of the body. Frequently follow an attack of apoplexy.
Alcoholic dementia: Produced by protracted use of alcoholic stimulants
Katatonic dementia : Repeat constantly and delibrately the same sentence or phrase.
Senile dimentia: Due to old age or acquired cerebral disease. In acquired cerebral disease patient is clearly conscious of his mental weakness. In senile dimentia first loss of memory particularly for recent events without any serious impairement of reasoning faculties. Second degree loss of reasoning power. Third degree incomprehension. Fourth degree loss of instinctive action.
Blood vessels of bodies of acute dements and especially the capillaries & veins dilated , walls relaxed. Sluggish circulation. Chronic- cerebral chilliness.
LECTURE VIII – GENERAL PARESIS
This is a cosmopolitan type of all modern insanity. Is deep seated. Paresis in Greek means I relax.
- Incipient or irritable stage; stage of worry , anxiety, sleeplessness and melancholy.
- Well defined stage of disease; stage of maniacal excitement and of active delusions of wealth, of power & of grandeur, alternating in some cases with attacks of temporary depression.
- The stage of subsidence, when the patient passes in to a condition of sub-acute or chronic mania, with a general but slow tendency towards decandence.
- Stage of terminal dementia: of physical as well as mental failure & of death.
A physician can see following indications in a person of active paretic in early maniacal stage.
- Pupils are unequally dilated or equally contracted or dilated. Irresponsive to light.
- Unable to control motions of the eye.
- Dropping of one corner of mouth.
- Marked tremulousness of lips & tongue.
- Slight hesitancy in speech
- Tendency to stammering
- Slight unsteadiness of gait.
- Partial obliteration of natural lines of intelligence on face.
- Skin is sallow, wax like.
- Slight exaltation of temperature.
A nervo-sanguine temperament, great physical activity, vaulting ambition, imperfect education, desire to attain & enjoy all good things in life, coupled with anxiety and worry are conditions over which paresis develops. Another cause is Imperfect education.
Inflammation of cerebral membranes covering frontal & parietal lobes. Occasionally tumors of gummatous nature ; Atrophy & sclerosis of cerebral mass are found.
DIAGNOSIS, PROGNOSIS & TREATMENT
Paresis can be found confounded with locomotor ataxia, progressive muscular atrophy , and senile dimentia.
Unfavourable, patient dies within one – eight or ten years after inception of the disease. By means of rest in bed & a suitable diet , and proper care, the paretic may live for several years. During remissions they can exercise very gently. Beds should be soft, elastic and comfortable to avoid bed sores.
Prevention of causes.
LECTURE IX – TREATMENT
Physician should decide whether a patient shall remain at home or go to a private sanitarium, or committed to a state hospital for the insane.
1. Patients who are wealthy can put in trained nurses and experienced physician.
2. Quiet & harmless insane patients- in whom suicidal disposition has subsided, those with c/c dimentia or of imbecility or senile dimentia cared in pvt homes or cottages.
- Kindness & gentle discipline
- Rest as a means of physical & mental recuperation
- Bathing & massage : Simple towel / soap bath, spray bath (who are strong enough to sit up) , old fashioned tub bath( who desire it. warm- cold water plus brisk rubbing ) Massage by Hypericum , Arnica, old bruises with Hamamelis & oil.
- Enforced protection- Body bandage, If patient is inclined to hurt others, or suicidal padded mittens used.
- Artificial feeding: Administration of sufficient quantities of food; food that promote rebuilding of those shattered portions of human temple, selected foods (easy and rapidly digesting)
- Dietetics: hot liquid foods, principally of milk. Beaf tea, bean broth, & chicken, clam, oyster & other soups suggested. Aged- butter milk. Fat flbby- skimmed milk. Rich stimulating red meat for melancholia, but avoided in mania & general paresis. Fruit during convalescence. Stimulants rarely need.
- Exercise, amusement & occupation
- Moral hygeine
OPERATION : For relief of epilepsy and traumatic injuries.
LECTURE X – MEDICAL TREATMENT
In prescribing a remedy physician should consider
- Pathological condition existing in physical structure,
- Mental aberrations which follow physical disturbance
- Totality of symptoms
When called on to treat a case of mental disease make careful examination
- As to condition of entire system
- All abnormal states of body which may lead to disturbance of mind
- Departures from normal mental status
- Note of all symptoms gathered
- Suicidal melancholia – Aurum
- Suicidal melancholia, restless, resistive, agitated- Arsenicum
- Acute melancholia, profound grief- Ignatia
- Overamastering effects of good news leads to hysterical state- Coffea
- Brooding- Natrum mur
- Cry babies- Puls, Nux mosch, Cactus.
- Loss of memory & stupid condition – Ana, Op, Phosp acid
- Melancholia with stupor- Digitalis
- Melancholia with fever., dullness- Gels
- Chronic melancholia – Opium
- Melancholia with physical prostration- Verat alb
- Melancholia with- ovarian / uterine troubles- Actea, Lil, Sepia
- Big Four – Old guards- Bell, Hyos, Stram , Verat alb
- Subacute mania- Nux vom
- Bry, Lachesis
- Acute mania- Rhus tox
- Sulphur- intercurrent remedy in mania, fantastic mania.
- Sexual excitement in mania- Cantharis
- Anac, Apis , Calc carb, Calc phos, Phos acid.
- Masturbatic dementia- Agnus, Caust, Canth ,Damiana, Pic acid, Phos, Phos acid, Staph. Nux vom , Opium.
- Epileptic dementia- Bell, Cup acet, Lauro,Oenanthe crocata, Solanum carolinense.
- Health development in epilepsy – Silicea.
- Mercury in its various forms, Nit acid, Iodide of Potash;
- Syphilis suspected- Sulphur, Aurum
- Epileptiform seizures- Verat, Actea, Cup met, Laur
- Intense restlessness anxiety- Acon, Ars, Bell
HOSPITAL CONSTRUCTION: Consider
- Suitable site for proposal of hospital
- Economical and durable construction
- Ventilation, heating, lighting
- Protection against fire
- Furnishing & decorations
- Congregate and ward ding rooms
- Kitchen & bakery building
- Boiler- house, dynamo plant, & laundry
- Cold storage building for general supplies
- Outbuildings for stock of various kinds
We present herewith, alphabetically, a list of remedies for mental disorders, with characteristic mental and allied symptoms.
Aconit napel * Agaricus muscarius * Alumina * Anacardium orientale * Antimonium crudum * Antimonium tartaricum * Apis mellifica * Argentum nitricum * Arnica montana *Arsenicum album * Aurum metallicum * Baptisia * Belladonna * Bryonia alba * Cactus grandiflorus * Calcarea carbonica * Calcarea phosphorica * Camphora * Cannabis indica *Cantharis * Causticum * Chamomilla * China * Cicuta virosa * Cimicifuga * Cocculus * Coffea cruda * Colchicum * Colocynthis * Conium maculatum * Cuprum metallicum * Digitalis *Ferrum metallicum * Gelsemium * Glonoin * Helleborus niger * Hepar sulphur * Hyoscyamus * Hypericum * Ignatia * Iodum * Lachesis * Lilium tigrinum * Lycopodium * Mercurius *Natrum muriaticum * Nitricum acidum * Nux vomica * Opium * Phosphoricum acidum * Phosphorus * Platina * Podophyllum * Pulsatilla * Rhus toxicodendron * Secale cornutum *Sepia * Silicea * Spongia * Stramonium * Staphysagria * Sulphur * Thuya * Veratrum album * Veratrum viride * Zincum metallicum
- MENTAL DISEASE AND THEIR MODERN TREATMENT- S. H TALCOTT