Chapter 5 - Diseases of the Brain and Nerves
A Picture of Perfect Health - Diagram
Muscles of the Neck and Face - Diagram 1
Muscles of the Neck and Face - Diagram 2
Internal View of Base of Cranium - Diagram
Cross-section of Head - Diagram
Base of the Brain - Diagram
Cross-section of Head - Diagram
View of Skull - Diagram
Introduction to Diseases of the Brain and Nerves
Inflammation of the Dura Mater
Inflammation of the Arachnoid and Pia Mater
Brain Fever
Softening of the Brain
Abscess of the Brain
Induration of the Brain
Tumors of the Brain
Delirium Tremens
Effects of Alcohol on Stomach and Kidneys - Diagram
Effects of Alcohol on Stomach and Kidneys
Enlargement of the Brain
Shrinking of the Brain
Water in the Head
Dropsy of the Brain
CerebroSpinal Fever
Diseases of the Spinal Cord
Inflammation of the Spinal Cord
Paralysis of One Side of the Body
Paralysis of Lower Part of the Body
Local Palsy
Shaking Palsy
Lead Palsy
Muscular and Nervous Derangements from Wounds
Locked Jaw
St. Vitus' Dance
Chronic Chorea
Pains of Nerves
Tic Douloureux
Dizziness of the Head
Locomotor Ataxia

5.53 Idiocy


Idiocy is in the condition in which the intellectual faculties have never been manifested. We are not to infer disease from it, any more than we infer it in the lower animals from the absence of intellect.
In idiocy there is no mind, because the brain is not large enough to be the organ of intelligence. It always dates back, therefore, to the beginning of life. Everything about the idiot betrays a defective organization. The demented person, the monomaniac, etc., once had intelligence; the idiot, never. They, in many cases, may be cured; he is hopelessly incurable. They had blessings which have been taken from them; to him, none were ever given. They were once the pride and hope of their friends; he, from his birth, was the smitten and blasted one of his family. He never reaches an advanced age, rarely living beyond thirty years.
These remarks are sufficient to show the difference between idiocy and other forms of mental derangement. In the other forms of insanity there are brains enough, but they are diseased; in this there is no disease; the smallness of the brain is the primal and fatal defect.
This form of mental derangement is caused by a defective development of the brain. That the other forms are produced by disease of the brain, there can be no doubt.
Some have supposed insanity to be a mental disorder merely, having nothing to do with the body. They might as well suppose the delirium of fever to be a disease of the mind only.
Insanity is an unsoundness of the brain and nerves which proceed from it, in every instance. At first it is probably only excitement of the brain; but this, long continued, becomes a chronic inflammation. The brain and nerves of an insane person are undoubtedly sore, and hence the painful thoughts and feelings which afflict them. When the soreness is much increased, they are violent and furious; when it subsides, they ar6 calm. In consequence of this inflammation and soreness of the brain, an insane person can no more think, or reason, or will, or feel correctly, than a person with an inflamed stomach can digest food well, or than one with inflamed eyes can see well.

Causes of Insanity. Hereditary predisposition; painful subjects of thought or feeling long revolved in the mind; injured feelings which cannot be resented, mortified pride, perplexity in business; disappointed affection or ambition; great political, religious, or social excitements; sudden and heavy strokes of misfortune in the loss of property and friends; and in general, whatever worries the mind for a long time, and creates a deep distress, may be a cause of insanity.
But one of the most prolific causes, and worthy of special mention, is masturbation, or self pollution, a vice contracted by thousands of young people, both male and female.
Besides the above, I may mention several physical causes, as convulsions of the mother during gestation, epilepsy, monthly disorders of women, blows upon the head, fevers, loss of sleep, syphilis, excessive use of mercury, worms in the bowels, and apoplexy.

Chances of Cure. Idiotism is never cured.
Melancholy and monomania are cured when recent, and do not depend upon organic disease.
Dementia is sometimes, though seldom, cured.
Chronic insanity, of long standing, is not easily cured.
Insanity which has been produced by moral causes, acting suddenly, is generally curable; if the causes have acted slowly and long, the cure is more doubtful.
Excessive study causes insanity which is hard to cure.
If caused or continued by religious ideas, or by pride,' it is not often cured.
Insanity caused and maintained by masturbation is cured with great difficulty.

Treatment. The treatment of the insane is now almost confined, as it should be, to public hospitals. In these institutions, all the means are provided which humanity has been able to devise, to lift from these unfortunate beings the terrible shadow which is upon them. Here they have safety, comfort, recreation, friendly guardians, rest, and medicine.
They have safety from the annoyances which well meaning but mistaken friends at home almost always commit in contradicting, and reasoning with, persuading, and threatening them; for only in these humane institutions has it been well learned that to do so is no wiser than to persuade, scold, or threaten a neuralgic pain in the face, an inflammation in the stomach, or a felon upon the finger. They are safe, too, from the impertinent scrutiny of neighbors, the hootings of unthinking boys in the streets, and especially from the causes, whatever they are, which have produced the disease. And so far, this is just the treatment they want, no contradiction, no impertinent scrutiny from neighbors, no abuse in the streets, and a withdrawal of the causes which have produced the disease.
In these institutions, too, they have comforts. They have clean rooms, galleries, lodges, bathing ;rooms, yards and gardens for exercise and walking, safe, quiet, well aired bed rooms, and clean and comfortable beds ; cheerful dining rooms, and plain, wholesome, and nutritious food. And this, likewise, is the treatment they require.
They have recreation, dances, cards, back gammon, checkers, chess, billiards, nine pins, walking parties, riding parties, gardening, and an indulgence in those arts of painting, music, drawing and architecture for which they may have a taste. And such recreations are powerful instruments in the cure of all disorders of the nervous system.
Here, too, they have friendly guardians, who have long studied their complaints, and have imbued their souls with a sympathy which goes down into the depths of their sufferings, and allies itself with all their sorrows; men and women who are willing to act the part of guardian angels; to be their friends; who know how to gain their confidence; and who use the influence acquired by love, in leading them back towards health and happiness. And this, too, in curing the insane, is of great consequence, for none can do them good till they have their confidence, and this can be gained only by love and wisdom.
In these insane asylum, they find rest. When the brain is hot from inflammation, and they are raving from delirium, they are here withdrawn from the noisy crowd, and shielded from the rude shocks of the world. If need be, they are placed in solitary rooms, where silence spreads its soothing stillness through their excited brains. And it is of the greatest importance that the sore and torn feelings should rest; for rest allays excitement, and brings sleep; and without a proper amount of sleep recovery is not possible.
Finally, in these ;.institutions, they receive the best medical treatment. They have warm and cold bathing, judiciously administered; they have simple cathartics when the bowels are bound, as salts, castor oil, and magnesia; tonics for debility, such as quinine, iron, casĀr3ia, columbo, chamomile; and quieting medicines for their excitement, such as opium, morphine, cicuta, hyoscyamus, belladonna, stramonium, scullcap, and valerian. Prescription 74 is a combination much used. Here, too, broth, gruel, and milk, are administered by the forcing pump to such as take a fancy not to eat, an expedient which has saved many lives. Fruits of all kinds, as strawberries, cherries, currants, plums, apples, peaches, and grapes, are allowed freely. Cold water, sweetened or otherwise, is the drink. To these things are added lively conversation, and whatever will divert the mind from reflection, and internal imaginings and revery.
Thus I have indicated, very briefly, the treatment which the insane receive in public institutions. That the chances of recovery in these humane retreats is much greater than at home, does not admit of a doubt. When it is not convenient to send an insane person to a hospital, the treatment should be as near like the one here sketched as circumstances will permit.

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