PUERPERAL MANIA.
As many cases of puerperal mania are due to sepsis, a careful search should be made in each case for such a cause, and the appropriate treat ment instituted (see under Puerperal Fever). As regards the mental condition, there is no doubt that the best chance of the patient's complete recovery is given by removal to a special institution. The relations not unnaturally are often opposed to such a course, owing to the stigma attaching to one who has been an inmate in an asylum, and it is a matter for great regret that we have no properly equipped mental hospitals for the reception of acute mental cases with fair prospects of speedy and complete recovery such as these. The practitioner should use his best endeavours to overcome the reluctance of the relatives in the patient's own interests.
The care of a case of mania resolves itself into nursing and feeding.
The patient must never be left alone even for a few minutes, as homicidal or suicidal tendencies may show themselves at any moment. Her own child is specially in danger from her, and should be removed entirely from her presence. Overfeeding must he carried out, if necessary through a nasal tube, and if firmness is shown at first the patient usually becomes quite docile and takes what she is given. Milk, eggs, soups and jellies may be given at first, and may be supplemented after a few days with more solid food.
No drug is of any avail in influencing the disease itself, but if sleep lessness is marked Sulphonal may be given in 20 to 4o gr. doses, or— R. Paraldehvdi 5j.
Pot. Brom. 5j.
Aquce Chlorol. ad 5ij. Misce.
Fiat haustus, flora somni sumendus.
An aperient is usually required at regular intervals.--R. J. J.