308

MELANCHOLY.

one. Nothing can remove diseases of the mind so effectually asapplications to the mind itself, the most efficacious of which ismusic. The patient's company ought likewise to consist of suchpersons as are agreeable to him. People in this state are apt to con-ceive unaccountable aversions against particular persons ; and thevery sight of such persons is sufficient to distract their minds, andthrow them into the utmost perturbation. In all kinds of mad-ness, it is better to soothe and calm the mind, than to ruffle it bycontradiction.

When the patient is high, evacuations are necessary. In thiscase he must be bled, and have his body kept open by purgingmedicines, as manna, rhubarb, cream of tartar, or the soluble tar-tar. I have seen the last have very happy effects. It may betaken in the dose of half an ounce, dissolved in water-gruel, everyday, for several weeks, or even for months, if necessary. More orless may be given according as it operates. Vomits have likewisea good effect ; but they must be pretty strong, otherwise they willnot operate.

Whatever increases the secretion of urine or prometes perspi-ration, has a tendency to remove this disease. Both these secre-tions may be promoted by the use of nitre and vinegar. Half adrachm of purified nitre may be given three or four times a-day inany manner that is most agreeable to the patient ; and an ounceand a half of distilled vinegar may be daily mixed with his drink.Dr. Locker seems to think vinegar the best medicine that can begiven in this disease.

Camphor and musk have likewise been used in this case withadvantage. Ten or twelve grains of camphor may be rubbed ina mortar with half a drachm of nitre, and taken twice a-day, 07oftener, if the stomach will bear it. If it will not sit upon the stom-ach in this form, it may be made into pills with gum assafcetidaand Russian castor, and taken in the quantity above directed. Ifmusk is to be administered, a scruple or twenty-five grains of itmay be made into a bolus with a little honey or common syrup,and taken twice or thrice a-day. The antimonial wine is by someextolled for the cure of madness; it maybe taken in a dose of for-ty or fifty drops twice or thrice a-day in a cup of tea. We do notmean that all these medicines should be administered at once ; butwhichever of them is given, must be duly persisted in, and whereone fails another may be tried.

As it is very difficult to induce patients in this disease to takemedicines, we shall mention a few outward applications whichsometimes do good ; the principal of these are issues, setons, andwarm bathing. Issues may be made in any part of the body, butthey generally have the best effect near the spine. The dischargefrom these may be greatly promoted by dressing them with themild blistering ointment, and keeping what are commonly calledthe orrice peas in them. The most proper place for a seton is be-tween the shoulder blades ; and it ought to be placed upwards anddownwards, or in the direction of the spine.

Madness or delirium, which proceeds from mere weakness, re-quires a different treatment. This must be removed by nourish-ing diet, exercise proportioned to the patient's strength, and cor-