Strong liquors of every kind ought to be avoided as poison. The most proper drink is water, whey, or very small beer. Tea and coffee are improper. If honey agrees with the patient, it may be eaten freely, or his drink may be sweetened with it. Infusions of balm-leaves, penny-royal, the roots of wild valerian, or the flowers of the lime-tree, may be drank freely, either by themselves, or sweetened with honey, as the patient shall chuse.
The patient ought to take as much exercise in the open air as he can bear. This helps to dissolve the viscid humours, it removes obstructions, promotes the perspiration, and all the other secretions. Every kind of madness is attended with a diminished perspiration; all means ought therefore to be used to promote that necessary and salutary discharge. Nothing can have a more direct tendency to increase the disease than confining the patient to a close apartment. Were he forced to ride or walk a certain number of miles every day, it would tend greatly to alleviate his disorder; but it would have still a better effect, if he were obliged to labour a piece of ground. By digging, hoeing, planting, sowing, &c. both the body and mind would be exercised. A long journey, or a voyage, especially towards a warmer climate, with agreeable companions, has often very happy effects. A plan of this kind, with a strict attention to diet, is a much more rational method of cure, than confining the patient within doors and plying him with medicines.
MEDICINE.——In the cure of this disease particular attention must be paid to the mind. When the patient is in a low state, his mind ought to be soothed and diverted with variety of amusements, as entertaining stories, pastimes, music, &c. This seems to have been the method of curing melancholy among the Jews, as we learn from the story of King Saul; and indeed it is a very rational one. Nothing can remove diseases of the mind so effectually as applications to the mind itself, the most efficacious of which is music. The patient’s company ought likewise to consist of such persons as are agreeable to him. People in this state are apt to conceive unaccountable aversions against particular persons; and the very sight of such persons is sufficient to distract their minds, and throw them into the utmost perturbation.
When the patient is high, evacuations are necessary. In this case he must be bled, and have his body kept open by purging medicines, as manna, rhubarb, cream of tartar, or the soluble tartar. I have seen the last have very happy effects. It may be taken in the dose of half an ounce, dissolved in water-gruel, every day, for sundry weeks, or even for months, if necessary. More or less may be given according as it operates. Vomits have likewise a good effect; but they must be pretty strong, otherwise they will not operate.
Whatever increases the evacuation of urine or promotes perspiration, has a tendency to remove this disease. Both these secretions may be promoted by the use of nitre and vinegar. Half a drachm of purified nitre may be given three or four times a-day in any manner that is most agreeable to the patient; and an ounce and a half of distilled vinegar may be daily mixed with his drink. Dr. Locker seems to think vinegar the best medicine that can be given in this disease.
Camphire and musk have likewise been used in this case with advantage. Ten or twelve grains of camphire may be rubbed in a mortar with half a drachm of nitre, and taken twice a-day, or oftner, if the stomach will bear it. If it will not sit upon the stomach in this form, it may be made into pills with gum asafœtida and Russian castor, and taken in the quantity above directed. If musk is to be administered, a scruple or twenty-five grains of it may be made into a bolus with a little honey or common syrup, and taken twice or thrice a-day. We do not mean that all these medicines should be administered at once; but whichever of them is given, must be duly persisted in, and where one fails another may be tried.
As it is very difficult to induce patients in this disease to take medicines, we shall mention a few outward applications, which sometimes do good; the principal of these are issues, setons, and warm bathing. Issues may be made in any part of the body, but they generally have the best effect near the spine. The discharge from these may be greatly promoted by dressing them with the mild blistering ointment, and keeping what are commonly called the orrice pease in them. The most proper place for a seton is between the shoulder-blades; and it ought to be placed upwards and downwards, or in the direction of the spine.
OF THE PALSY.
The palsy is a loss or diminution of sense or motion, or of both, in one or more parts of the body. Of all the affections called nervous, this is the most suddenly fatal. It is more or less dangerous, according to the importance of the part affected. A palsy of the heart, lungs, or any part necessary to life, is mortal. When it affects the stomach, the intestines, or the bladder, it is highly dangerous. If the face be affected, the case is bad, as it shews that the disease proceeds from the brain. When the part affected feels cold, is insensible, or wastes away, or when the judgment and memory begin to fail, there is small hope of a cure.
CAUSES.——The immediate cause of palsy is any thing that prevents the regular exertion of the nervous power upon any particular muscle or part of the body. The occasional and predisposing causes are various, as drunkenness; wounds of the brain, or spinal marrow; pressure upon the brain or nerves; very cold or damp air; the suppression of customary evacuations; sudden fear; want of exercise; or whatever greatly relaxes the system, as drinking much tea[[147]], or coffee, &c. The palsy may likewise proceed from wounds of the nerves themselves, from the poisonous fumes of metals or minerals, as mercury, lead, arsenic.