128 INSANITY. 
M. Pinel then relates his own experience of the ber.e- the fpeedy fconvalefcence, after fuch evacuation, is ftill 
fit of this mode of treatment, in which we fully concur more remarkable. 
/with him.—“ Convalefcent maniacs, when, amidit the There are fome circumftances, however, unconnected 
languors of an inactive life, a ftimulus is offered to their with difeafe of mind, which might difpofe infane perfons 
.natural propenfity to motion and exercife, are aftive, di- to coftivenefs. When they are mifchievoufly difpof'ed 
ligent, and methodical. Laborious or amufmgoccupations they require a greater degree of reftraint, and are confe- 
arreft their delirious wanderings, prevent the determina- quently deprived of that air and exercife which fo much 
tion of blood to the head by rendering the circulation contribute to regularity of bowels. It is well known 
more uniform, and induce tranquil and refrefhing fleep. that thofe who have been in the habits of free-living, and 
I was one day deafened by the tumultuous cries and ri- who come fuddenly to a more temperate diet, are very 
otous behaviour of a maniac; employment of a rural ha- much difpofed to coftivenefs. But to adduce the faireft 
ture, fuch as I knew would meet his tafte, was procured proof of what has been advanced, I can truly Bate, fays 
.for him ; from that time I never obferved any confufion Mr. Haflam, “ that incurable patients, who have for many 
.nor extravagance in his ideas. It was pleafing to obferve years been confined in the hofpital, are fubjeCt to no in- 
.the filence and tranquillity which prevailed in the Bicetre, conveniencies from conftipation.” Many patients arc 
■when nearly all the patients were fupplied by the tradef- averfe to food ; and, where little is taken in, the egefta 
.men of Paris with employments which fixed their atten- mult be inconsiderable. 
tion, and allured them to exertion by the profpedt of a Every praftitioner agrees, that cathartic medicines arc 
trifling gain. To perpetuate thofe advantages, and to of the greateft fervice, and ought to be confidered as in- 
ameliorate the condition of the patients, I made at that difpenfable in cafes of infanity. Senna and jalap are the 
time every exertion in my power to obtain from the go- drugs now in ufe for this purpofe. The ancients ufed 
vernment an adjacent piece of ground, the cultivation of hellebore, but.they diminiflied its attivity by their mode 
which might employ the convalefcent maniacs, and con- of preparing it; and we do not find that it polfelfed pe- 
duce to the re-eftablifhment of their health. The diftur- culiar powers ; though, if the plant they ufed be, as we 
.bances which agitated the country in the fecond and third have reafon to fufpeft, a fpecies of adonis, it probably 
.years of the republic prevented the accomplifhment of combined the qualities of an anodyne with thole of a ca- 
my wifhes; and I was obliged to content myfelf with the thartic. 
.fubfidiary means which had been previously adopted by Dr. Monro allures us, that the evacuation by vomiting 
the governor, that of choofing the fervants from among is infinitely preferable to any other. The prodigious 
the convalefcents. The fame method is ltill continued at quantity of phlegm with which the patients in this difeafe 
the madhoufe at Amfterdam. The accomplifhment of abound, he fays, is not to be overcome but by repeated 
this fcheme would be molt effectually obtained by com- emetics ; and he obferves, that the purges have not their 
bining with every lunatic afylum the advantages of an right effect, or do not operate to fo good purpofe, until the 
extenfive enclofure, to be converted into a fort of farm, phlegm be broken and attenuated by frequent emetics, 
which might be cultivated by the labour of the patients, He mentions the cafe of a gentleman who had laboured 
and the profits of which might be devoted to their fup- under a melancholy for three years, from w’hich he was 
.port. Even the natural indolence and limpidity of idiots relieved entirely by the ufe of vomits and a proper regi- 
might in fome degree be obviated, by engaging them in men. 
.manual occupations, fuitable to their refpeflive capacities. Mr. Haflam is no advocate for this remedy: “However 
With an able aftive man at their head, idiots are capable ftrongly this practice may have been recommended, and how 
of being drilled into any fort of fervice where bodily much f'oever it may at prefent prevail, I am forry that it 
ftrength alone is requiilte. The new plantation at Bice- is not in my power to fpeak of it-favourably. In many 
tre was made almoft- altogether by their exertions. inflances, and fome where blood-letting had been previ- 
The medical treatment, as ufed in conjunction with what oufly employed, paralytic affections have within a few 
Dr. Pinel calls the mental regimen, or moral treatment, hours fupervened on the exhibition of an emetic, more 
inuit not be palled over.—Where the patient is Strong, efpecially where the patient has been of a full habit, and 
and of a plethoric habit, and where the diforder has not has had the appearance of an increafed determination to the 
.been of any long continuance, bleeding has been found of head. It has been for many years the practice of Beth- 
confiderable advantage; and Mr. Haflam regards it as lem-hofpital to adminiftef to the curable patients four or 
“ the mold beneficial remedy that has been employed.” five emetics in the fpring of the year; but, on confulting 
The melancholic cafes have been equally relieved with my book of cafes, I have not found that fuch patients 
the maniacal by this mode of treatment. Venefection by have been particularly benefited by the ufe of this remedy, 
the arm is, however, inferior- in its good effeCts to blood From one grain and a half to two grains of tartarized an- 
taken from the head by cupping; having the head previ- timony has been the ufual dofe, which has hardly ever 
oufly fhaved, and fix or eight cupping-glades applied on failed of procuring full vomiting. In the few inftances 
the fcalp. By thefe means any quantity of blood may be where the plan of exhibiting this medicine in naufeating 
taken, and in as fhort a time as by an orifice made in a dofes was purfued for a confiderable time, it by no means 
vein by the lancet. The quantity to be taken, mu ft be anfwered the expectations which had been railed in its 
left todhe discretion of the practitioner ; from eight to favour by very high authority. Where the tartarized an- 
fixteen ounces may be drawn, and the operation occafion- timony, given with this intention, operated as a purgative, 
ally repeated, as circumftances may require. it generally produced beneficial effeCls.” As Mr. Haf- 
An opinion has long prevailed, continues Mr. Haflam, lam’s opinion on this point has been much oppofed by 
that mad people are particularly conftipated, and lilcewife Dr. Cox and others, he thus replies in his fecond edition : 
extremely difficult to be purged. From ail the obferva- “Ten years have elapfed fince the former edition of this 
tion I have been able to make, infane patients, on the work appeared ; but this length of time, and fubfequent 
contrary, are of very .delicate and irritable bowels, and observation, have not enabled me to place any greater 
are well and copibufly purged by a common cathartic confidence in the operation of emetics, as a cure for infa- 
draught. In confirmation of this, it may be mentioned, nity. It was never my intention to deny, that, in a dif- 
that the ordinary complaints, with which they are affeCt- ordered ftate of the ftomach, the madman would be 
ed are ciiarrhcea and dyfentery; thefe are often very equally benefited with one in his fenfes by the operation 
violent and obftinate. But diarrhoea very often proves a of a vomit; but I have aflerted, that, after the adminif- 
jiatural cure of infanity; at leaft, there is fufficient reafon tration of many thoufand emetics to perfons who were in¬ 
to luppofe, that fuch evacuation has very .much contri- fane, but otherwife in good health, I never faw any 
bated to it. The number of cafes, which might be ad- benefit derived from their ufe. In St. Luke’s hofpital, 
$ueed in confirmation of this remark, is confiderable j and the large!! public receptacle for infane perfons, where the 
medical 
