The insane should be regarded simply as sick persons; they should be removed to hospitals, or detained there in the same manner as cases of infectious dis ease are taken in charge and isolated by the health authorities. Stephen Smith (Amer. Jour. of Insanity, Jan., '94).
In a great number of eases of fully developed mental disease of some stand ing, with fits of alarm, hallucinations, maniacal excitement, etc., the symptoms yield to rest of one or two weeks in bed, whereas in other circumstances a much longer time would certainly be required. L. Meyer (Jour. Mental Sci., Apr., '96).
Twenty-eight male patients, including S general paralytics, 6 cases of dementia, 5 of melancholia, 4 of paranoia, and 1 each of catatonia, psychosis, hysterics, senile dementia, and cerebral syphilis treated with complete rest in bed. The weight of the patient usually fell at first, but increased again after some weeks. As regards the duration or cure of the disease, bed-treatment has no influence. Trapesnikow (Neurol. Cent., p. 142, '9S).
Series of female patients treated by rest in bed, including 3 cases of secondary dementia, 1 of chronic paranoia, 2 with chronic hallucinations, 2 with amentia, and 1 each with maniacal exaltation, melancholia, circular insanity, periodic insanity, and organic cerebral dementia. In some patients good results were ob tained, but not in all. Weight was often lost, and sleep, appetite, and the action of the bowels were all prejudicially in terfered with, and hypnotics had to be used just as frequently. Bed-treatment is only useful for individual eases.
Ossipow (Neurol. Centralb., p. 142, '98).
Travel may be good in one stage, and bad in another, of the same disease. Neurasthenic, hysterical conditions re quire rest, though the patient may seem strong. Certain self-centred patients gain no benefit from travel. In delusions of persecution, suicidal or homicidal tend encies, and active and changing mental conditions travel is contra-indicated. Richard Dewey (Jour. of Amer. Med. Assoc., Aug. 18, 1900).
Rest in bed is important in acute men tal disease. The horizontal position favors the circulation in the brain and aids in overcoming cerebral and consti tutional exhaustion, which is present in a large proportion of cases. S6rieux and Farnurier (Med. News, Sept. 15, 1900).
Mechanical restraint and seclusion in a dark or barred room are not necessary in the treatment of insanity in any of its forms and should never be employed.
There is a class of cases in which the use of mechanical restraint is beneficial, but it should never be used except for the protection of the patient; and not for cases of violence or destructiveness. P. Maury Deas (Jour. of Mental Science, Jan., '96).
Emphatic condemnation of the custom of using dark cells for the purposes of punishment in prisons, the main cause of insanity among long-term prisoners. Twenty-three per cent. of the life-men in the prisons of the State of New York are inmates of the Matteawan State Hos pital to-day. Most of them are hope lessly insane. H. E. Allison (Albany Med. Annals, Dec., '97).
Special Forms of Insanity.