Joseph Mason Cox
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Joseph Mason Cox (1763–1818) was an early nineteenth century English physician whose entire professional career was devoted to care and treatment of mentally ill people. Born in
Bristol Bristol () is a city, ceremonial county and unitary authority in England. Situated on the River Avon, it is bordered by the ceremonial counties of Gloucestershire to the north and Somerset to the south. Bristol is the most populous city in ...
, the son of John Cox, he was apprenticed to a surgeon-apothecary around 1778. In 1783, he became an apprentice to James Padmore Noble, a surgeon to the Bristol Infirmary. The next year, he began to study medicine in
London London is the capital and largest city of England and the United Kingdom, with a population of just under 9 million. It stands on the River Thames in south-east England at the head of a estuary down to the North Sea, and has been a majo ...
, followed by studies in
Edinburgh, Scotland Edinburgh ( ; gd, Dùn Èideann ) is the capital city of Scotland and one of its 32 Council areas of Scotland, council areas. Historically part of the county of Midlothian (interchangeably Edinburghshire before 1921), it is located in Lothian ...
; in
Paris, France Paris () is the Capital city, capital and List of communes in France with over 20,000 inhabitants, most populous city of France, with an estimated population of 2,165,423 residents in 2019 in an area of more than 105 km² (41 sq mi), ma ...
; and in
Leiden, Netherlands Leiden (; in English and archaic Dutch also Leyden) is a city and municipality in the province of South Holland, Netherlands. The municipality of Leiden has a population of 119,713, but the city forms one densely connected agglomeration with ...
, where he received his medical degree in 1787. His thesis was titled “De Mania.” Cox’s maternal grandfather owned Fishponds, a
lunatic asylum The lunatic asylum (or insane asylum) was an early precursor of the modern psychiatric hospital. The fall of the lunatic asylum and its eventual replacement by modern psychiatric hospitals explains the rise of organized, institutional psychiatry ...
near Bristol. The asylum had been established about 1738 and came to the elder Cox’s ownership about 1760. The elder Cox maintained the asylum until his death in 1779. His two daughters succeeded him as owners, and when one daughter died, John Cox and the surviving daughter became the owners. When John died in 1788, Joseph took over the asylum and managed it until his death in 1818. Fishponds continued to serve as an asylum until 1859.


Physician

Joseph Cox published a book in 1804 which described his experiences in treating mental patients as both a madhouse keeper and a psychiatric consultant. The title page of the book reads ''Practical Observations on Insanity in which some suggestions are offered towards an Improved Mode of Treating Diseases of the Mind, and Some Rules Proposed which it is hoped may lead to a more Humane and successful Method of Cure. To which are subjoined, Remarks on Medical Jurisprudence as connected with Disease Intellect''. The book had subsequent editions in 1806, 1811 and 1813, and was published in France, Germany and the United States. The book begins with a description of a maniacal attack, which set forth Cox’s ideas as to the possible causes of
insanity Insanity, madness, lunacy, and craziness are behaviors performed by certain abnormal mental or behavioral patterns. Insanity can be manifest as violations of societal norms, including a person or persons becoming a danger to themselves or to ...
. Cox believed that kind and gentle management of lunatics was important but he did not eschew coercive measures such as using the
straitjacket A straitjacket is a garment shaped like a jacket with long sleeves that surpass the tips of the wearer's fingers. Its most typical use is restraining people who may cause harm to themselves or others. Once the wearer slides their arms into the ...
when necessary. He concluded that patient history taking and patient treatment should be individualized. He described the uses of
hydrotherapy Hydrotherapy, formerly called hydropathy and also called water cure, is a branch of alternative medicine (particularly naturopathy), occupational therapy, and physiotherapy, that involves the use of water for pain relief and treatment. The term ...
in both
mania Mania, also known as manic syndrome, is a mental and behavioral disorder defined as a state of abnormally elevated arousal, affect, and energy level, or "a state of heightened overall activation with enhanced affective expression together wit ...
and
melancholia Melancholia or melancholy (from el, µέλαινα χολή ',Burton, Bk. I, p. 147 meaning black bile) is a concept found throughout ancient, medieval and premodern medicine in Europe that describes a condition characterized by markedly dep ...
, which he believed to be manifestations of the same illness. He warned of the dangers of patients harming themselves. He provided detailed descriptions of the various medications used, especially
digitalis ''Digitalis'' ( or ) is a genus of about 20 species of herbaceous perennial plants, shrubs, and biennials, commonly called foxgloves. ''Digitalis'' is native to Europe, western Asia, and northwestern Africa. The flowers are tubular in sha ...
as an anti-maniacal remedy. Cox conveyed his ideas about protecting people from coercion into asylums and described how a physician must examine an individual before issuing a certificate of lunacy. His ideas on patients’ treatment were in keeping with other physicians at the time. Cox introduced a new treatment called swinging to effect change in blood flow in the head and body, a practice that had been advocated by
Erasmus Darwin Erasmus Robert Darwin (12 December 173118 April 1802) was an English physician. One of the key thinkers of the Midlands Enlightenment, he was also a natural philosopher, physiologist, slave-trade abolitionist, inventor, and poet. His poems ...
(1731-1802), a physician and naturalist. The patient was suspended in a chair or bed and swung in an oscillatory or circular manner at varying tempos. Nausea, vomiting, and convulsions were produced but often refreshing sleep followed.


Works

*Cox, Joseph Mason. ''Dissertatio medica inauguralis quaedam de mania complectens ...'' Leyden, 1787. *Cox, Joseph Mason. ''Practical observations on insanity: in which some suggestions are offered towards an improved mode of treating diseases of the mind, and some rules proposed which it is hoped may lead to a more humane and successful method of cure ; to which are subjoined remarks on medical jurisprudence as connected with diseased intellect''. London, Baldwin, 1804. http://resource.nlm.nih.gov/2547017R


References

*Andrews, Jonathan, et al. ''The History of Bethlem''. London; New York: Routledge, 1997. *Hunter, Richard A., and Ida Macalpine. ''Three Hundred Years of Psychiatry, 1535-1860: A History Presented in Selected English Texts''. London: Oxford Univ. Press, 1963. *Parry-Jones, William LI. ''The Trade in Lunacy: A Study of Private Madhouses in England in the Eighteenth and Nineteenth Centuries''. London: Routledge & Kegan Paul, 1972. *Porter, Roy. ''Madness: A Brief History''. Oxford; New York: Oxford Univ. Press, 2002. *Scull, Andrew T. ''The Most Solitary of Afflictions: Madness and Society in Britain, 1700-1900''. New Haven: Yale Univ. Press, 1993. {{DEFAULTSORT:Cox, Joseph Mason 1763 births 1818 deaths British psychiatrists Medical doctors from Bristol