PSYCHIATRY. 35 



should be firm and fixed to the floor and should have a straw mattress. 

 The attendants should be carefully instructed. "If the sight of other 

 persons irritates them and only in very rare instances, restraint by 

 tying may be employed, but with the greatest precaution, without any 

 unnecessary force, and after carefully protecting all the joints and 

 with especial care to use only restraining apparatus of a soft and deli- 

 cate texture, since means of repression employed without judgment 

 increase and may give rise to furor instead of repressing it." He 

 used fomentation by applying warm moist sponges over the eyelids to 

 relax them and influence the circulation in the membranes of the 

 brain. He advised emollient and astringent applications, the latter 

 made of galls, alum, etc., soothing and invigorating poultices, baths 

 of oil and natural hot baths. He denounced abstinence and ordered a 

 full diet. He spoke against the practice of making the patient in- 

 toxicated, the use of hellebore, of aloes and of venesection. During 

 convalescence he recommended farming, walking, riding, singing and 

 theatrical entertainments. In the latter scenes of a solemn and tragic 

 character were to be enacted to guard against excitement. 



With the passing of Galen and Coelius Aurelianus the sun goes 

 down into the black clouds of ignorance succeeding the fall of the 

 Eoman Empire; and the lunatic is left to drag out a miserable ex- 

 istence, generally neglected and alone throughout the dark centuries 

 following, to and through the middle ages. There is a fitful gleam 

 faintly illuminating the scene momentarily as when Alexander of 

 Tralles (A. D. 560), or Paulus Aegineta (A. D. 630) reiterates the 

 teachings of Aurelianus, but they lay stress more upon the medicinal 

 than the hygienic treatment and are forgetful of his admonitions 

 against chains and imprisonment. The earliest hospital for the insane 

 known was founded in Jerusalem in the fifth century as a refuge for 

 anchorites whose minds became affected through their penances. 



The middle ages are defined by Hallam as dating from the invasion 

 of France by Clovis at the end of the fifth century to the invasion of 

 Naples by Charles VIII. at the end of the fifteenth. During the first 

 half of this period there seems scarcely to have been any intellectual 

 or political development. The whole of Europe was, almost without 

 exception, sunk in the darkest ignorance and the most wretched bar- 

 barism. In some countries the awakening was earlier than in others, 

 but the darkness did not anywhere die out at once. As gradually the 

 clouds began to lift and the signs of returning light were here and 

 there discernible only a fraction of a special class, a limited portion 

 of the clergy, were in any way affected, and the mass remained for long 

 bound down by servility, ignorance and superstition. "The struggle 

 among the races for the possession of the countries that had been 

 loosed from the Eoman yoke," says Sibbald, '"continued for centuries 



