42

ELEMENTS ÜF MATERIA MEDICA.

Their employment as therapeutical agents is necessarily limited; on account ofthe difficulty experienced in producing, regulating, and Controlling them. Yetthey are by no means unimportant, or to be negleoted.

They may be conveniently divided into two sets or classes,—the one includingthose affections which immediatoly result from the presence of objccts externa}to the mind, and which may be denominated external affections; —the other corn-prising those affections which arise in consequence of certain preceding affec-tions of the mind itself, and which may be termed internal affections. 1

Class l. External Affections of the Mind.—To this division belong those

phenomena or states of the mind commonly termed sensations, and which mayarise either from influences external to the body [external sensations,) or fromorganic causes existing within the body [internal sensations.) They suggest,by the association of ideas, other affections, which, as they arise from precedingstates of the mind, are truly internal. But, in considering external affections asremedial agents, it is scarcely possible to estimate their influence independent ofthe internal affections which immediately arise from them. Indeed, the greatremedial value of some external affections depends on the internal affections whichthey suggest; as in the case of Music, the therapeutical effects of which are refer-rible, not to the mere pereeption of the sounds, but to the resulting emotions.

The mental affections of this class, which will require a brief notice, are theexternal sensations; viz., those ascribed. to the Organs of smell, taste, hearing,vision, and touch.

1 & 2. Smell and Taste.—«. An important objeet in the art of prescribing is to cover theunpleasant taste and smell of inedicines by other substances possessed of an agreeable fiavourand odour.

ß. In some nervous affections we endeavour to increase the faith of our patients in the pow-erful agency of the remedies employed, by augmenting the odorons and sapid qualities of thesubstances used.

3. Hearing.- —*. Monotonous noises favour sleep ; as the humming of bees, the ticking of aclock, the murimir of a rivulet, a dull diseoui'se, &c. We avail ourselves of this fact in the-rapeutics, and combat vvant of sleep by directing an attendant to read aloud to our patient.

ß. Silence frequently disposes to sleep. Under some circumstances, however, it " maybecome a Stimulus, while sound ccases to be so. Tlius, a milier being very ill, bis uiill wasEtopped, that he might not be distarbed by its noise; but this, so far from inducing sleep, pre-vented it altogether; and it did not take place tili the miil was set a-going again." (Dr.Robert Maenish's Philosophy of Sleep, p. 32. Glasg. 1830.)

y. Music has been employed in the treatment of diseases (espceially those of the mind) fromvery remote times (F. A. Steinbeck, Diss. Inaug. De Musices algue Poesos, Berol, 182G.)The most ancient notice of its remedial use oecurs in the ßiblc, (Samuel, xvi. 15—23,) wherethe Sacred Historian teils us that David cured the melancholy of Saul by music. This hap-pencd more than a thousand years before Christ. The ancient Greeks also had recourse tomusic in medicine, though Hippoeratcs makes no mention of it. It would appear to be prin-cipally adapted fbr the relief of the melancboüe form of insanity; but its bcnefictal effects arevery transitory, and have been greatly exaggerated. Esquirol (Des Maladies Mentales, tom.ii. p. 538 Paris, 1838) tried it at Charenton in every way, and under the most favourablecircumstances, but with little sueeess. "Sometimes," he reports, " it rendered the patientsfurious, often it appeared to divert them, but I caunot affirm that it contributed to their reco-very. To the convalescent, however, it proved advantageous." A more reeent writer (Dr.Conolly) also observes, 2 that " little regard is probably due to music as a remedial means, itseffects being usually only temporary. Violent patients ölten becoine silent, and then movedto weeping, when the piano is played to them."—As, in the therapeutical employment ofmusie in insanity, our objeet is to create agreeable emotions, by reealüng the happy eventsof by-gonc times, and by restoring old associations and trains of thought, particular attentionshould be paid to adapt the character of the music to the peculiarities of each case; for it isobvious that what may prove beneficial to one patient, may be injurious to another.

4. Vision. —*. Sleep is promoted by "the sight of any tiiing waving; as of a field of Stand-ing com, or of the band drawn up and down before the face by a mesrnerisor, attraclingattention mueh more than an objeet at rest." (Dr. Elliotson's Human Physiology, p. 608,5th ed. 1840.)

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• Consult Dr. Thomas Brown's Lectures an the Philosophy of the. Human Mind, vol. i. p. 341., 2d ed. 1824.■> The Report of the Resident. Physician of the Hanwell Lunatic Asylum, prcscnteU to the Court of QiLarter Ses-sionsfor Middlescz, at the Mtddlesex Sessi^ns, 1840.