DEMENTIA.
For dementia secondary to severe mania, melancholia and other forms of insanity, treatment is practically useless. Though a cure is not to be expected. much con be done by education of the patient in sonic simple employment which tends to prevent further mental deterioration, and the routine of a carefully conducted asylum affords the best means of carrying this out.
If the primary attack of mental disease has been mild or of short dura tion Inn] the symptoms of dementia are in their early stage, much may he done by a complete change of environment and a generous diet ing.
Food should be given in the liquid form, and, practically, in unlimited amount. I ty the India rubber tube of the stomach pump, 6 to 8 pints of peptonised milk may he put into the stomach daily when there is difficulty in getting the patient to cat, and rectal feeding may be resorted to.
\lassage is of much value, hut this should only be attempted when the forced feeding is being freely carried out. Thyroid feeding has occa sionally proved successful by making a profound impression upon the general metabolism, and where the disease arises in the progress of myx (edema this remedy will often give surprising results.
Cod-Liver Oil, Malt Extracts, Iron, Quinine or Bark, with Dilute Nitro Hydrochloric Acid, or other tonics may be given with advantage. Stimu lants may be freely administered at first till the activity of the alimentary canal and the nervous system he roused from its torpor by the increased nutrition. The patient's body should be enveloped in thick flannels, and
artificial warmth is almost always required. The constant current, 20 Leclanche cells, may be applied to different parts of the body for a period of 15 minutes twice daily, and Static Electricity has a powerful influence over the general nutrition.
In the premature type of the primary disease (Dementia Praecox), supposed to be the result of some unknown toxins or of thymic or thyroid deficiency, total change of environment, with complete rest of body and mind and open-air treatment such as the phthisical patient improves under in a sanatorium, will often restore the mental powers speedily. With the feeding, which may have to be forced, massage should be combined and the patient kept in bed. Saline purgatives should be judiciously administered, and the intestinal tract kept in the healthiest possible condition by the use of intestinal antiseptics or lavage of the colon to minimise the forma tion of any toxins, and normal Saline freely administered hypodermically or intravenously and Thyroid or Thymus feeding tried with caution. Nucleinate of Soda has been injected in many cases, but not with convinc ing result.