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How to Care for the Insane
A Manual for Nurses

written by "Granger, William D."
...erly classed with those inclined to commit acts of violence, because they are frequently fully under the control of delusions, which make them dangerous and difficult to manage. Many patients have ideas that make them suspicious of those about them; these may relate to the patients, but more frequently to the attendants and physicians, and they may arise from delusions, hallucinations or illusions. This class of patients is apt to be morose, cross, and irritable; they sit brooding over their fancied wrongs; repulse advances and friendly intercourse; they refuse to employ themselves, and do not respond willingly to the requirements of the attendants. Our most trifling and unmeaning acts may give rise to the most intense suspicions and hatred. A look, a shrug of the shoulder, the manner of shaking the head, a cough, the squeaking of our boots, are frequently enough to arouse, these feelings. Suspicious patients often think they are the subjects of ridicule; that their thoughts are read and proclaimed to the ward; that their virtue, truth, or honor is called[Pg 54] in question, and the accusations openly told to others, or that they are called vile and insulting names. They often have delusions of conspiracy to do them or their families harm, and connect the attendants and physicians with them, thinking, as they keep them locked in the asylum, they are associated in the conspiracy. Sometimes these patients think themselves some great persons, perhaps that they are a member of the Deity, or a ruler, or prophet, or that they have some great mission to perform, and that they are deprived of their rights, or their work interfered with, by being kept in the asylum, and that those in authority are imprisoning and persecuting them. Such persons may be, on account of their fancied wrongs, very suspicious, and even violent towards those who care for them. Other patients have suspicions and fears of bodily harm. They may think they are to be...

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