CLASS III. 1. 2. OF VOLITION. 301 



tends insane people, which is nevertheless generally only a symp- 

 tom of the debilit) owing to the too great expenditure of senso- 

 rial power; or of the paucity of its production, as an irritative, 

 or insensitive in irritated fever. See Class III. 1.1. 



But nevertheless where the quick pulse is permanent, it shews 

 the presence of fever; and as the madness then generally arises 

 from the disagreeable sensations attending the fever, it is so far 

 a good symptom; because when the fever is cured, or ceases 

 spontaneously, the insanity most frequently vanishes at the same 

 time. 



The stimulus of so much volition supports insane people un- 

 der variety of hardships, and contributes to the cure of diseases 

 from debility, as sometimes occurs towards the end of fevers. 

 See Sect. XXXIV. 2. 5. And, on the same account, they bear 

 large doses of medicines to procure any operation on them; as 

 emetics, and cathartics, which, before they produce their effect 

 in inverting the motions of the stomach in vomiting, or of the 

 absorbents of the bowels in purging, must first weaken the na- 

 tural actions of those organs, as shewn in Sect. XXXV. 1.13. 



From these considerations it appears, that the indications of 

 cure must consist in removing the cause of the pain, whether it 

 arises from a delirious idea, or from a real fact, or from bodily 

 disease ; or secondly, if this cannot be done, by relieving the 

 pain in consequence of such idea or disease. The first is some- 

 times effected by presenting frequently in a day contrary ideas 

 to shew the fallacy, or the too great estimation, of the painful 

 ideas. 2dly. By change of place, and thus presenting the sti- 

 mulus of new objects, as a long journey. 3dly. By producing 

 fbrgetfulness of the idea or object, which causes their pain; by 

 removing all things which recall it to their minds; and avoiding 

 all conversation on similar subjects, For I suppose no disease 

 of the mind is so perfectly cured by other means as by forget- 

 fulness. 



Secondly, the pain in consequence of the ideas or bodily dis- 

 eases above described is to be removed, first, by evacuations, as 

 venesection, emetics, and cathartics; and then by large doses 

 of opium, or by the vertigo occasioned by a circulating swing, or 

 by a sea-voyage, which, as they affect the organs of sense as well 

 as evacuate the stomach, may contribute to answer both indica- 

 tions of cure. 



Where maniacs are outrageous, there can be no doubt but co- 

 ersion is necessary; which may be done by means of a strait 

 waistcoat; which disarms them without hurting them; and by 

 tieing a handkerchief round their ankles to prevent their escape. 

 In others there can be no doubt, but that confinement retards 



