308 DISEASES CLASS III. 1. 2, 1. 



know again the blessing to be warm." He complained of cold 

 all the next day, and wore an upper coat, and in a few days 

 another, and in a fortnight took to his bed, always saying no- 

 thing made him warm, he covered himself with very many blank- 

 ets, and had a sieve over his face, as he lay; and from this one 

 insane idea he kept his bed above twenty years for fear of the 

 cold air, till at length he died. 



M. M. As mania arises from pain either of our muscles or 

 organs of sense, the arts of relieving pain must constitute the 

 method of cure. See Sect. XXXIV. 3. 4. Venesection. Vo- 

 mits of from five grains to ten of emetic tartar, repeated every 

 third morning for three or four times; with solution of gum am- 

 moniac, and soluble tartar, so as to purge gently every day. Af- 

 terwards warm bath for two or three hours a day. Opium in 

 large doses. Bark. Steel. 



Dr. Binns gave two scruples (40 grains) of solid opium at a 

 dose, and .twenty grains four hours afterwards; which restored 

 the patient. Dr. Brandreth gave 400 drops of laudanum to a 

 maniac in the greatest possible furor, and in a few hours he be- 

 came calm and rational. Med. Comment, for 1791, p. 384. 



Prognostic. 



THE temporary quick pulse attending some maniacal cases is 

 simply a symptom of debility, and is the consequence of too 

 great exertions; but a permanent quick pulse shews the pre- 

 sence of fever, and is frequently a salutary sign; because, if the 

 life of the patient be safe, when the fever ceases, the insanity 

 generally vanishes along with it, as mentioned above. In this 

 case the kind of fever must direct the method of curing the in- 

 sanity; which must consist of moderate evacuations and diluents, 

 if the pulse be strong; or of nutrientia, bark, and small doses of 

 opium, if the pulse be weak. 



Where the cause is of a temporary nature, as in puerperal 

 insanity, there is reason to hope, that the disease will cease, 

 when the bruises, or other painful sensations attending this state, 

 are removed. In these cases the child should be brought fre- 

 quently to the mother, and applied to her breast, if she will suf- 

 fer it, and this whether she first attends to it or not; as by a few 

 trials it frequently excites the storge, or maternal affection, and 

 removes the insanity, as I have witnessed. 



When the madness is occasioned by pain of the teeth, which 

 I believe is no uncommon case, these must be extracted; and 

 the cure follows the extinction of the pain. There is however 

 some difficulty in detecting the delinquent tooth in this case, as 



