A blow on the head has been known to develope this feeling. The affection of the sentient organ may remain latent for many years, and then suddenly manifest itself. A man had received, when young, a kick from a horse, which produced at the time no very urgent symptoms. Six years after the accident, he, without giving any indications of previous derangement of mind, cut his throat. Upon examining the brain, it was found extensively diseased.
A man, feeling the suicidal disposition, bled himself from the arm, and recovered.
It will not be proper in all cases to abstract blood; for the destructive propensity has been known to exist where there has been a deficiency of blood in the brain. The practitioner should examine the condition of the patient thoroughly before he recommends active depletion. Sixty per cent. of the cases of suicide will, however, be found with cerebral disease either of a primary or secondary nature; and to that organ the medical man’s attention should be particularly directed.
The following case happily illustrates the benefits which are sometimes derived from the local abstraction of blood in certain cases of temporary insanity, accompanied with a disposition to commit suicide. “A gentleman,” says Dr. Burrows, “of a very irascible and impetuous disposition, with whom I was intimate, experienced in a public meeting a rebuke which exceedingly mortified him, and made so deep an impression upon his mind, that he was quite miserable. At night, instead of going to bed, he roamed abroad; and at length, early in the morning, without knowing whither he went, he found himself near a sheet of water. The view of it at once determined him to drown himself, and he accordingly plunged in. The action was perceived, and he was rescued from the water, insensible, and immediately conveyed to a place where means of resuscitation were adopted. As his address was found in his pocket, a communication was directly made to his family, and Dr. Burrows was called in to see the patient. He found him in a state of insensibility. As soon as consciousness returned, he was dressed, put into a coach, and Dr. B. accompanied him to his residence. As yet, he had not spoken, neither did he appear to observe anything. The motion of the carriage on the stones seemed to rouse him, and he looked about. He took no notice of those who were in the carriage with him. He soon became violent; his eyes were wild, and rolled in their sockets; his face became flushed; the vessels of the forehead were excessively distended, and all the symptoms of genuine delirium came on.[57] Dr. Burrows ascribed the symptoms to a violent reaction in the vascular system from the state of collapse it had sustained, and ordered the oppressed vessels of the head to be relieved by the application of cupping glasses, and the abstraction of sixteen ounces of blood; the head to be kept cool, and enemata to be administered until the bowels were well cleansed out. After these operations, he soon became passive and disposed to sleep. He slept six hours, and awoke tolerably composed, but not quite coherent. He took light nourishment, and at night awoke perfectly collected, but exceedingly low. The next day he was well, but languid. An explanation was given him, which removed the impression that the offensive part of the speech had given him, and he by degrees recovered his usual state of mind.”