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THE POPULAR SCIENCE MONTHLY.— SUPPLEMENT. 



dreamy thoughts which naturally crowd into the 

 mind 'twixt sleep and waking again arouse de- 

 lusions and hallucinations. The patient can- 

 not control his terror or analyze his sensations, 

 and he tries to escape from imaginary foes. 

 If in a single room he may attempt, and some- 

 times with success, to pass through an iron-guard- 

 ed ventilator, the aperture of which would seem 

 to the inexperienced to be altogether incapable 

 of allowing the passage of a human body. If in 

 a padded room, he knocks himself about in wild 

 confusion ; and, if in a dormitory, he generally 

 makes a sudden dart from bed, and rushes wildly 

 forward in search of some place of safety. But 

 even in such a case the prognosis is rarely un- 

 favorable, and after several sudden outbursts of 

 excitement the maniac — strengthened by the 

 regular administration of digestible and highly- 

 nourishing food, relieved by elimination from the 

 irritating effects of alcohol on the nervous tis- 

 sues, and soothed by kindly treatment and by 

 such remedies as opium or digitalis — usually re- 

 gains the use of his reason without showing the 

 slightest trace of dementia ; and, after a period 

 of convalescence, is discharged recovered — to re- 

 sume his ordinary employment, and unfortunate- 

 ly, in too many cases, to resume also the indul- 

 gence which compelled him to pass through so 

 trying an ordeal. Though it is evident that in 

 such cases Nature herself performs the greater 

 part of the cure, yet there can be little doubt that 

 some benefit can be obtained by judicious modi- 

 fications of diet and by the administration of 

 medicines. In the West Riding Asylum I have 

 both in this and other forms of severe mania seen 

 marvelous results produced by the use of a very 

 highly-concentrated essence of fresh meat. This 

 essence is made by placing in a porous covered 

 jar three pounds of fresh meat, free from bone, 

 cut small and without fluid. The jar is placed in 

 the steam-cooking chamber and allowed to re- 

 main till the meat is seen to have yielded about 

 a pint of essence. It is salted and simply sea- 

 soned with pepper, unless otherwise ordered. 

 With regard to the medical treatment of such 

 cases, I have always placed most reliance on the 

 administration of moderate doses of opium com- 

 bine 1 with one-drachm or even two-drachm doses 

 of liq. bismuthi. Dr. Magnan, in speaking of 

 such cases as those to which I have just been refer- 

 ring, says that it is rare in alcoholic mania to have 

 exalted delusions. I have met only one case of 

 pure mania apotu in which there were delusions of 

 exaltation. Dr. Major, of the West Riding Asy- 

 lum, has kindly permitted me to peruse this case 



for the purpose of making a few comments upon 

 it. The patient had had several attacks of mania, 

 all occurring during or after bouts of drinking, 

 and the attack which led to his being brought to 

 the asylum seems to have been one of the worst. 

 Before his arrest he had been collating crowds 

 in the street, making remarks to them about his 

 great ability, and, in gratitude for their patience 

 in listening to him, had been in the habit of sup- 

 plying them with drink. When taken before the 

 magistrates, he made a witty defense, which oc- 

 cupied about forty minutes. He talked a great 

 deal about his accomplishments, the colleges he 

 had attended, and his numerous dealings with the 

 aristocracy. Both before and after his admission 

 to the asylum his actions and conversation were 

 characterized by considerable wit and humor. 

 In the prison he constructed an effigy of himself, 

 suspended it by the throat from a fastening, and 

 made signs of distress to attract the attention of 

 the warders, who rushed in after he had hidden 

 himself for the purpose of enjoying their conster- 

 nation at witnessing the apparent suicide of their 

 prisoner. When on the way to the asylum, he 

 asked to be allowed to look at the certificate, in- 

 tending to secure it, so as to be able to act the 

 part of a relieving-officer and hand over the 

 warder who was conveying him to the asylum. 

 On admission he was very talkative and witty, and 

 tried to get a reputation for knowledge of lan- 

 guages. He spoke in Latin, but when answered in 

 the same tongue was unable to maintain the con- 

 versation. He represented himself to have been 

 a captain in the Engineers, and to have bought a 

 public-house for £5,000. This patient made a 

 good recovery, and was discharged in about two 

 months. 



This is, no doubt, a somewhat uncommon 

 form of alcoholic insanity, inasmuch as in this 

 instance alcoholism seems to have been an excit- 

 ing cause acting upon a predisposition to well-de- 

 fined recurrent attacks which were but slightly 

 tinged with the particular influence of the excit- 

 ing cause. The only delusions of suspicion which 

 he had were against the police-officers who had 

 arrested him. Two points connected with these 

 attacks of mania a potu seem worthy of passing 

 notice. The first is, that one frequently meets 

 with cases in which within a comparatively short 

 space of time six or eight, or even more, attacks 

 have occurred in the same individual, from all of 

 which he has recovered without the least trace 

 of consecutive dementia. It appears that, if the 

 vessels remain moderately healthy, the mania is 

 due to the actual saturation of the tissues with 



