Insanity : its classification, diagnosis, and treatment; a manual for students and practitioners of medicine / by E. C. Spitzka.

  • Spitzka, E. C. (Edward Charles), 1852-1914.
Date:
1887
Catalogue details

Licence: Public Domain Mark

Credit: Insanity : its classification, diagnosis, and treatment; a manual for students and practitioners of medicine / by E. C. Spitzka. Source: Wellcome Collection.

Provider: This material has been provided by the Harvey Cushing/John Hay Whitney Medical Library at Yale University, through the Medical Heritage Library. The original may be consulted at the Harvey Cushing/John Hay Whitney Medical Library at Yale University.

    403/424 (page 409)
    unlike the one used by the author. He says that even in hys- terical disorders, oophorectomy is no more justifiable than would be the extraction of a tooth is true neuralgia of the Fifth Pair. I am aware that Goodell and Flechsig claim re- medial results from oophorectomy, particularly in hysterical derangement. But none of their cases seem to have been observed a sufficiently long time to justify very positive state- ments. Indeed Israel has furnished a singular and suggestive observation calculated to throw discredit on the claims of oophorectomists by performing a sham operation followed by radical recovery for the time being, in a case of hystero-epilepsy. Claus* has also made a protest against what may be termed gyn- ecological psychiatry which was provoked by the assertion of Frank that neuroses in women are naught but genital symptoms, even in cases where gynaecologists are unable to detect disease of the female organs ! Bondurantf reports two cases, one of hysteria with periodical excitement, and one of folie raissonante with exacerbations at the time of the menses, in both of which oophorectomy was performed without any lasting improvement; both patients were mentally as abnormal after the expiration of a year as they had been prior to the operation. I am aware of the fact, and it has been corroborated to me by experienced practioners, that at present the operation of oophorectomy is performed in a large number of cases, without any justifying indications. Healthy ovaries have been re- moved by the dozen in New York City alone, in cases where almost any surgical procedure, or potent moral impression would have been as effective. This protest against oophorec- tomy and the abuse of gynaecological procedures in psychiatry has, as Tuke correctly pointed out in the discussion referred to, been misunderstood, owing to the failure of one of the speakers to cite the context. As the passage read in the first edition, standing by itself, it was susceptible of being so misunderstood. The author's intention was to utilize the non-existence of in- sanity in some of the gravest cases of uterine and ovarian dis- ease as an argument against an intrinsic relationship between ordinary affections of the female pelvic viscera and insanity. The grave and disastrous error which is almost daily committed by those who would cure insanity by gynaecological operations and methods, is the neglect to select proper cases. Certainly those forms of insanity which, like primary paranoia and moral * Irrenfreund, 1882, No. 6. \ American Journal of Insanity, January, 1SS6.