340 THE TREATMENT OF DISEASES. 



A case of hydrophobia has been published in which recovery was attributed to 

 hypodermic injections of morphia frequently repeated. 



Of late years the use of the vapour bath has been strongly recommended, not 

 only as a preventive of hydrophobia, but as a means of curing the disease when fully 

 developed. It is not at all improbable that it may be instrumental in eliminating 

 a virus which lurks so long in the system. The bath is recommended to be taken, 

 ct la liusse, on several successive days, at a temperature of from 57 U to 63. Benefit 

 might possibly be derived from the use of the Turkish bath. 



In addition to the specific treatment, sve should try to soothe and comfort the 

 unfortunate patient by every means in our power, and should be especially careful 

 to prevent all noises, draughts, and other sources of excitement which are so liable 

 to excite the painful spasm of the throat. It has been suggested, and apparently 

 with good reason, that large fluid injections might with advantage be administered 

 by the bowel. By checking the agonising thirst, they would in all probability greatly 

 lessen the sufferings of the patient. 



HYPOCHONDRIASIS. 



Hypochondriasis may be said to consist essentially of an exaggerated egotism. Its 

 principal feature is mental depression occurring without adequate cause, and taking 

 the shape of a conviction in the patient's mind that he is the victim of some serious 

 bodily disease. It is a complaint that has been recognised from the earliest times, 

 and has always been known as hypochondriasis or the hypochondriac disorder, and 

 sometimes as the "spleen." It might aptly be described by the term "misery." It 

 is not pain ; bodily pain is not misery, for you often see patients cheerful and even 

 jocose, though daily racked with pains which might almost bring tears into your eyes 

 to witness. Misery is worse than pain ; it is a terrible infliction, as those who have 

 experienced it know well. 



In this case there is no perversion of the understanding such as frees the insane 

 from the responsibility of moral agency. Indeed, the average intellectual capacity 

 in hypochondriacs is not below but rather above the general standard. Without 

 any sufficient reason for such conduct, and without any signs of intellectual impair- 

 ment, the patient concentrates his attention on some particular organ of the body 

 and imagines that it is seriously diseased. He is constantly tormenting himself 

 and others too, for the matter of that by dwelling upon his miserable condition, 

 and suffers from the incessant dread of the existence of some serious malady, with 

 perhaps a fear of impending death or insanity. He may fulfil his ordinary duties 

 creditably, but, as a rule, is preoccupied with his own condition, to the exclusion of 

 all other interests and affections, and is ever writhing under the petty despotism of 

 an imaginary evil. Many a hypochondriac might exclaim with Hamlet : " I have 

 of late (but wherefore I know not) lost all my mirth, foregone all custom of exercises ; 

 and, indeed, it goes so heavily with my disposition, that this goodly frame, the earth, 

 seems to me a sterile promontory ; this most excellent canopy, the air, look you this 

 brave o'erhanging firmament, this majestic roof fretted with golden fire why, it 

 appears no other thing to me than a foul and pestilent congregation of vapours." 



Hypochondriacs generally present a healthy appearance, and sleep and perform 



