VESANI7E. 



have advised above with regard to hypochondriasis ; but as in 

 the case of proper melancholia there is commonly a false im- 

 agination or judgment appearing as a partial insanity, it may 

 be further necessary in such cases to employ some artifices for 

 correcting such imagination or judgment. 



MDXCIII. The various remedies for relieving the dyspeptic 

 symptoms which always attend hypochondriasis, will seldom be 

 either requisite or proper in melancholia. 



There is only one of the dyspeptic symptoms, which, though 

 there should be no other, is very constantly present in melan- 

 cholia, and that is costiveness. This it is always proper and 

 even necessary to remove ; and I believe it is upon this account 

 that the use of purgatives has been found so often useful in 

 melancholia. Whether there be any purgatives peculiarly pro- 

 per in this case, I dare not positively determine ; but with 

 respect to the choice of purgatives in melancholia, I am of the 

 same opinion that I delivered above on this same subject with 

 respect to mania. 



MDXCIV. With respect to other remedies, I judge that 

 blood-letting will more seldom be proper in melancholia than 

 in mania ; but how far it may be in any case proper, must be 

 determined by the same considerations as in the case of mania. 



MDXCV. The cold bathing that I judged to be so very 

 useful in several cases of insanity, is, I believe, in melancholia, 

 hardly ever fit to be admitted, at least while this is purely a 

 partial affection, and without any marks of violent excitement. 

 On the contrary, upon account of the general rigidity prevailing 

 in melancholia, it is probable that warm bathing may be often 

 useful. 



MDXCVI. With respect to opiates, which I have supposed 

 might often be useful in cases of mania, I believe they can 

 seldom be properly employed in the partial insanities of the 

 melancholic, except in certain instances of violent excitement, 

 when the melancholia approaches nearly to the state of mania. 



MDXCVII. In such cases of melancholia approaching to a 

 state of mania, a low diet may sometimes be necessary; but as 

 the employing a low diet almost unavoidably leads to the use of 

 vegetable food, and as this in every torpid state of the stomach 

 is ready to produce some dyspeptic symptoms, such vegetable 



