—Insanity, like cancer, is increasing. Like both cancer and tuberculosis, hope lies in prevention and early treatment; and like them both, in its early symptoms it is too often unrecognized or neglected.
Many people are surprised to learn that known, avoidable causes are responsible for the condition of about 50% of the insane patients now under treatment. Chief among these known causes is a communicable germ disease called syphilis, to which is due the disease called paresis, or "softening of the brain." About 25% of patients admitted to hospitals for the insane are there from the effects of habitual use of alcohol, even in "moderate" quantities. Other cases of insanity result from diseases of the heart, arteries, and kidneys, and still others have been traced to the poisons of tuberculosis, typhoid, diphtheria, and other communicable diseases. Prevention of insanity caused by these diseases depends upon prevention or complete cure of the diseases themselves.
Still other causes of insanity are known. Hereditary nervous weakness may predispose to insanity,
and for such persons, those whose nervous resistance is naturally not very great, the stress of living may prove too much. Mental breakdowns are rarely caused by overwork unless accompanied by worry or bad hygienic conditions, but they result not infrequently from bad mental habits.
"The average person, little realizes the danger of brooding over slights, injuries, disappointments, or misfortunes, or of an unnatural attitude towards his fellowmen, shown by unusual sensitiveness or marked suspicion. Yet all these unwholesome and painful trains of thought, may if persisted in and unrelieved by healthy interests and activities, tend towards insanity. Wholesome work relieved by periods of rest and simple pleasures and an interest in the affairs of others, are important preventives of unwholesome ways of thinking. We should train ourselves not to brood, but to honestly face personal difficulties."—(Why Should Anyone Go Insane?, by Folks and Ellwood.)
Prevention of insanity consequently depends chiefly upon avoiding alcohol and communicable diseases, especially syphilis; upon good hygiene, self-control, and avoidance of bad mental habits; and upon adopting a program of living and working that will not overtax one's nervous strength. Sleeplessness, unusual nervous fatigue following slight exertion, and diminished power to control the emotions, are among the danger signals. And
when a person becomes unusually depressed or morose, excited or irritable, suspicious, unreasonable, or "queer," it is probable that expert medical advice should be obtained as quickly as possible.
EXERCISES
- What is a symptom? Why are early symptoms especially important?
- Distinguish between objective and subjective symptoms.
- Tell all you can about normal and abnormal variations in the body temperature. What symptoms would lead you to take a person's temperature?
- Describe the method of taking temperatures.
- How should you cleanse a clinical thermometer? What are the dangers of neglecting to cleanse it properly?
- Describe both normal and abnormal pulse and respiration.
- Discuss the significance and importance of pain.
- Describe early symptoms of tuberculosis, cancer, and mental illness. What is the first step to be taken when any one of these symptoms appears?
- What symptoms of all those mentioned in this chapter did you notice in the last sick person with whom you had anything to do?
- What are the essentials of a good daily record? The following is an account that a mother gave of the first twenty-four hours of a child's illness. Make a chart for the patient, and include in it all the information the mother gave. Which do you consider more useful, your chart or the narrative?
- "Yesterday, October 10th, Johnny came home from school about half past three, and said he was too cold to play outdoors. He lay down and slept till about five, when he vomited a large amount of undigested food. I took his temperature and found that it was 103.8°, pulse 126, and respiration 28. At 10 that night his temperature was 102.5°, pulse 116, and respiration the same as before. The next morning at 8 he had a temperature of 100.6°, pulse 114, respiration 24. At noon his temperature was 101°, pulse 118, respiration 24; and at 4 o'clock his temperature was 100.6°, pulse 122, respiration 22. The doctor came at 6 o'clock yesterday afternoon; according to his orders I put Johnny to bed, gave him half a tablespoonful of castor oil at 6.30, and a special gargle. His throat was red and sore and he seemed to feel very miserable. The doctor took a culture from the child's throat. At 8.15 and again at 8.50 he had fluid bowel movements. At 9.30 he had a glass of milk, after which he slept until 6 a.m. when his bowels moved again and urine was passed. He passed eight ounces of urine at noon and four ounces at 3.30. He drank a glass of water at 6 this morning, and at 6.30 I gave him a cup of hot broth. At 8 he had a glass of milk, but at 10 he refused everything but a glass of water. At 1.30 he had a large dish of ice cream. He had a cool sponge bath last night at 9, and a cleansing bath this morning at 8.45. This morning his throat was still sore but not so red, and I saw that he gargled every half hour when he was awake. This afternoon he seems brighter and asked for his harmonica, so his throat is probably more comfortable."