VESANIjE. 



523 



quence of a melancholia which had previously long subsisted ; 

 whether we consider that melancholia as a partial insanity, or as 

 a long persisting attachment to one train of thinking, it will be 

 readily perceived, that in either case such an increase of excite- 

 ment may take place in so considerable a degree, and in so 

 large a portion of the brain, as may give occasion to a complete 

 mania. 



MDLXI. These considerations with regard to the remote causes 

 appear to me to confirm sufficiently our general doctrine of in- 

 creased and unequal excitement in the mania, which I have de- 

 scribed above ; but I must own, that I have not exhausted the 

 subject, and that there are cases of mania of which I cannot 

 assign the remote causes : but although I cannot in all cases 

 explain in what manner the mania is produced, I presume, from 

 the explanation given, and especially from the symptoms en- 

 umerated above, to conclude, that the disease described above 

 depends upon an increased excitement of the brain ; an opinion 

 in which I am the more confirmed, as I think it will point out 

 the proper method of cure. At least I think it will most clear- 

 ly explain the operation of those remedies, which, so far as I 

 can learn from my own experience, and that of others, have 

 proved the most successful in this disease ; and to illustrate this, 

 I now enter upon the consideration of these remedies ; and to 

 make some remarks upon the proper manner of employing 

 them. 



MDLXII. Restraining the anger and violence of madmen 

 is always necessary for preventing their hurting themselves or 

 others : but this restraint is also to be considered as a remedy. 

 Angry passions are always rendered more violent by the indul- 

 gence of the impetuous motions they produce ; and even in mad- 

 men, the feeling of restraint will sometimes prevent the efforts 

 which their passion would otherwise occasion. Restraint, there- 

 fore, is useful, and ought to be complete ; but it should be exe- 

 cuted in the easiest manner possible for the patient, and the strait' 

 waistcoat answers every purpose better than any other that has 

 yet been thought of. The restraining madmen by the force of 

 other men, as occasioning a constant struggle and violent agita- 

 tion, is often hurtful. Although, on many occasions, it may not 

 be safe to allow maniacs to be upon their legs, or to walk about, 





