526 PRACTICE OF PHYSIC. 



MDLXVII. For the same purpose of taking off the fulness 

 and tension of these vessels of the brain, purging may be em- 

 ployed ; and I can in no other view understand the celebrated 

 use of hellebore among the ancients. I cannot, however, sup- 

 pose any specific power in hellebore ; and can by no means 

 find, that at least the black hellebore, is so efficacious with us 

 as it is said to have been at Anticyra. As costiveness, how- 

 ever, is commonly a very constant and hurtful attendant of 

 mania, purgatives come to be sometimes very necessary : and I 

 have known some benefit obtained from the frequent use of 

 pretty drastic purgatives. In this, however, I have been fre- 

 quently disappointed ; and I have found more advantage from 

 the frequent use of cooling purgatives, particularly the soluble 

 tartar, than from more drastic medicines. 



MDLXVIII. Vomiting has also been frequently employed 

 in mania; and by determining powerfully to the surface of the 

 body, it may possibly diminish the fulness and tension of the 

 vessels, and thereby the excitement of the brain ; but I have 

 never carried the use of this remedy so far as might enable me 

 to judge properly of its effects. Whether it may do harm, by 

 impelling the blood too forcibly into the vessels of the brain, or 

 whether, by its general agitation of the whole system, it may 

 remove that inequality of excitement which prevails in mania, I 

 have not had experience enough to determine. 



MDLXIX. Frequent shaving of the head has been found of 

 service in mania ; and by promoting perspiration, it probably 

 takes off from the excitement of the internal parts. This, how- 

 ever, it is likely, may be more effectually done by blistering, 

 which more certainly takes off the excitement of subjacent parts. 

 In recent cases it has been found useful by inducing sleep ; and 

 when it has that effect, the repetition of it may be proper : but 

 in maniacal cases that have lasted for some time, blistering has 

 not appeared to me to be of any service ; and in such cases also 

 I have not found perpetual blisters, or any other form of issue, 

 prove useful. 



MDLXX. As heat is the principal means of first exciting 

 the nervous system, and establishing the nervous power and 

 vital principle in animals, so, in cases of preternatural excite- 

 ment, the application of cold might be supposed a proper rem- 



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