= 
1805. ] Obfervations on the 
ny maniacs have been expofed, for a great 
length ef time, to a confiderable degree of 
cold, without having their fymptoms at all 
relieved; and even {hould it be admitted 
that fome patients have done well under. 
fuch treatment, it would by no means juf- 
tify its indifcriminate adoption. It would, 
furely, therefore, not only be humanity, 
but good medical praétice, to fubjeét fuch 
patients only, as the phyfician may direé&t, 
to this fevere remedy, and to make the 
wards, in general, of a comfortable and 
moderate temperature. The affertion, 
that maniacs do not fuffer from cold, can- 
not be admitted as an objection to a hu. 
mane attention to this point, as that can’ 
only be underfteod of thofe who labour 
under a total alienation of mind. : 
Another queftion, well worthy cf the 
confideration of perfons concerned in fuch 
an erection, is, “* how far the indifcrimi- 
nite mixiure of cafes, and freedom of 
communication between the patients, is 
ferviceable or detrimental?” The prefent 
practice of the hofpital in queftien adimirs 
of this intercourfe, in its fullelt extent ; 
and it is afferced that the patients mutually 
laugh each other out of their abfurdities. 
This I can, by no means, believe to be 
the cafe: on the contrary, it cannot fail, 
in.an high degree, to retard their cure, if 
not entirely to prevent it. Itisiaid down 
as a general principle, that the place of 
“confinement fhould prefent as few objects 
of fight and hearing as poffible. But 
where this communication amongtt the pa- 
tients is allowed, they are in the midft of 
a perpetually changing fcene, and, at every 
inftant, ideas are prefented to their dif. 
tracted imagination, fufficiently in them- 
felves perplexed to derange the moft fixed 
and fedate mind. ‘Phe violence of the 
Faging maniac is, of courfe, rettrained ; 
but this prevents him not from venting 
his paflion, in oaths and angry words, up- 
on his fellow-fufferers, who furround him. 
To fay nothing of the injury he himfelf fut 
‘tains by this, what cffeét mutt fuch a f{cene 
of noifé and violence have upon the minds 
of ttofe expofedto it? Little or nothing is 
done-towards the cure of thefe difeafes by 
médicine, in any of our lunatic hofpitals 
{oecational bleeding and purgatives, or 
yimall dofes of gentian, are. the principal 
meas tried in any of them). If, then, 
any advantage is to be obtained, it muft 
be by applications to the mind ; snd how 
can recourfe be had to them where the pa- 
tients are indifcriminately confined toge- 
ther? If, however, this muft be the cafe, 
fome good might, perhaps, be done by 
Claffing them, and putting fuch only togé- 
MontTuty Mac, No. 126. 
Treatment of Lunacy, 138 
ther as may be fuppofed to corres each 
other. For this purpofe, tae wards should 
be fmall aod numerous, and fhould have 
apartments adjoining them, in which the 
patients fhould, at lea&, fl-ep alone, aud 
to which they may, upon bad behaviour, 
be confined, The raging infuriate mad. 
man fhould, by no means, be brought in- 
to the fight of the other patients, but be 
excluded from light, noife, and every cir- 
cumfiance that can, in any way; excite 
emetion or paffion in his mind. Again, 
it is a queflion, whether or no fome labour 
fhould not be enjoined in eftablifhments of 
this fort. It 1s reafonably concluded, 
‘that the indolence in which perfens in 
confinement pafs their time, muft help to 
fix, by repetition, the abfurd ideas and 
falie combinations which conftitute the 
_diteafe, and thus, in a great degree, ren- 
der their infanity permanent. It is, on 
the other hand, objected, that fuch Jabour 
neceilarily requires tools, which would afz 
ford the maniac méans of bis own or his 
companions’ deftrugétion. Some plan, how- 
ever, might, furely, be adopted, by which, 
with ftrict vigilance, fuch-an objection 
might be obviated. Under this head may 
be mentioned books: thefe might ufefuliy 
be employed, efpecially in fixing the ats 
tention of thofe perfons who are, in popu- 
lar language, termed flighty. To this 
end, a regular tafk fhould be fet: arith- 
me:ie, agd dry heavy fubje&ts, with fome 
clofenefs of reafoning, fhould be chofen, 
and the patient be compelled to give an 
account of what he is reading, “Io the 
victim of melancholy, poetry, comedies, 
andenlivenmng piétures of nature, fhould 
be given, and his mind conftantly be di- 
rected to the brighteft fide of humanity, 
particular care being taken to avoid the 
fubjeé&t of his hallucinations. The fe- 
males might be employed upon needle- 
work ; and when tne diforder is flight, 
they might, perhaps, be entruted with 
fome of the domeltic duties of the place. 
Regulations like thefe would; no doubt, 
require many attendants, and would fome. 
what increafe the expence ef« the efabliihe 
ment. “Fo many they may. appear too 
minute, and unworthy the attention of 
the philofopher or the phyfician: in fuch 
an opinion [can by nomeans join. Little 
has hitherto been done towards the cure of 
madnefs ; and, in our prefent ignorance, 
nothing fhould be left untried that is likely 
to be of the fmalleft ufe: many more par- 
ticulars might, mdeed, be enumerated; 
but Dhave, perhaps, already tréipailed tea 
long on your readers’ attention, and fhail 
anly add, that, as in thete dittafes, efpes 
Pie ai oaky 
