Sunday, March 18, 2007

Morgagni & Mid-18th Century Treatment of the Mad

I recently ran into the English translation of Giovanni Battista Morgagni's [1682-1771] treatise The Seats and Causes of Diseases Investigated by Anatomy. It consists of a series of Letters, the eighth of which is on madness. This letter is a rambling affair, where Morgagni sometimes sticks to his stated task of describing dissections of brains, but often describes clinical cases in some length. I found it an intriguing window into mid 18th century clinical psychiatric practice. Here is one of the shorter cases:

A strong man, by trade a blacksmith, having been liable, from a boy, to the incubus and vertigo, which had been brought on him by a fright, fell down suddenly in the winter-time, and complain'd, in confus'd words, of an internal pain in his breast. Being immediately brought into the hospital, he answer'd scarcely any thing to those who ask'd him questions; but shut his eyes, and cover'd his face with the sheet, like a man out of his senses. He was hot at the same time, and trembl'd' nor had drunkenness, or any other cause of that kind preceded; and a fever likewise attended. On the following day, he began to leap out of bed, to cry out, to threaten, and even to strike, all about him; so that being evidently a maniac, it was necessary that he should be confin'd with bands. He cried out violently and continually; and, at the same time, his whole body was agitated with convulsive motions. Then the physician, having order'd a vein in the foot to be open'd, and a pound of blood to be taken away, also ordered the cataplasm I have told you of [fresh cheese, of the coarser sort, mix'd with oil of violets] to be laid upon his head after being shaved. Do you ask me what was the event? Why by this means, within twelve hours, he was restored to perfect sanity; but whether the cure was accidental, or the effect of blood-letting only, or in some measure owing to the assistance of the external remedy [the cataplasm], I will leave you to determine. Those who foment the heads of insane patients with milk, will readily believe, that the cataplasm contributed thereto.

Giovanni Battista Morgagni, The Seats and Causes of Diseases Investigated by Anatomy, [English edition, 1769, reprinted 1960, original 1761] v1. pp. 149-150.

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