| Description Of Item | From the collection of Thomas Laycock. Article is titled ‘On Prolonged Fasting, with reference to a particular Class of Insane Persons’ by John Manley M.D., Medical Superintendent of the Hants County Asylum, late Assistant Medical Officer of the Devon County Asylum. Published in The Asylum Journal, Volume 1, Issue 10, January 1855, pp. 150 – 154 included. Written in pencil at the top is the word ‘sitophobia’ – meaning the fear of eating food. The article presents the effects of ‘long-continued fasting’, describing how cases of food deprivation due to ‘accidental circumstances’ such as natural disaster, can be studied to assist the treatment of asylum patients who might be unable to eat because of ‘physical incapacity’ or because of ‘a peculiar condition of the mind’ that induces a ‘disregard or disinclination for food.’
Manley describes examples of people deprived of food such as shipwrecked sailors and survivors of earthquakes. He describes the effects of such periods of fasting on the body as causing ‘loss of strength, wasting of the tissues […], derangement of the digestive apparatus, so that the system is not nourished by food subsequently taken which food is often soon vomited, or passed off indigested by diarrhoea, a[…] foetid state of breath, dry harsh skin, a tendency to bruise […]’ and low body temperature. Manley notes that mental faculties are not at first affected, but changes in mood can follow. Manley notes that because pain occurs in the digestive organs when a person tries to eat after a long period of fasting, which ‘may lead to obstinate refusal of food.’
Manley then describes situations in which people have subsisted on very small quantities of food, such as women stranded by an avalanche who survived for thirty-seven days with only goat’s milk and hay to consume – when rescued they were described as being in ‘perfect health.’ Manley also describes a case from 1786 in which a man having religious delusions lived on ‘one half pint of water and the juice of two oranges daily for sixty days.’ A Dr Willan attended him at this point, describing the patient as exhibiting ‘the appearance of a skeleton.’ Once the doctor prescribed a ‘proper regimen’ the patient became able to walk across the room again and his delusions vanished – however the patient died seven days later.
Manley then describes six cases from the Devon County Asylum, describing the circumstances in which patients who were refusing to eat arrived at the facility. He describes the causes of their distress – including suicidal ideation and typhoid fever – then the treatment administered, and finally the notes taken during the autopsy of each case.
Considering the cases of people who endure long periods of fasting due to accidental circumstances, compared to the patients from the asylum, Manley makes the statement that ‘as a general rule, the sane are capable of enduring a more prolonged period of fasting than the insane.’
Another article follows this main one, titled: ‘On the Non-Restraint System’ by Robert Gardiner Hill from Eastgate House, Lincoln. The article discusses how non mechanical restraint of patients is the favoured approach in in the ‘English County Asylums, (Yorkshire excepted) and in the Scotch Asylums.’ The author cautions for use of restraint only in the most extreme cases when it is necessary for the safety of the patient. |