Carolina in whom that disease was induced by feveral difficult. labours followed by the birth of dead children. My remedies for madness in its first stage, or rather in all its ftates of high excitement, are bleeding, purging, and extremely low diet. In the use of the lancet, I am more influenced by the high temper, and extravagant conduct of the patient-by the fiercenefs of the eyes-by the abfence of fleep,' and by cold feet with the above symptoms, than by the state of the pulfe. In all diseases of the brain Mr. Hunter has well obferved the pulfe now and then refuses to impart any knowledge of their force, feat, or danger. Where the strength of the disease is concentrated in the brain, and other parts of the fyftem are languid, I have substituted cups and leeches to venesection. Perhaps it is not too late yet to use one of those modes of bleeding in Mrs. B's cafe. If it be, purges of calomel and jalap should be given. The liver, fpleen and bowels all require, from the congestions induced in them before and after madness, the occafional use of this clafs of medicines. Blisters to the ankles I have found more useful than to the head and neck before the excitement of the brain is in part reduced. I learned this practice from Dr. Willis foon after he cured the king of Great Britain. If all the above remedies fail, recourse must be had to a falivation. There is no general disease in which its effects are more uniformly beneficial. I have known order to be eftablished in the operations of the mind in a few hours after the patient complained of a fore mouth. But a much longer time is generally neceffary for it to cure. The cold bath fhould follow the falivation, if any part of her disease should remain unfubdued, alfo cordial diet and medicines. Great attention fhould be paid to the state of her mind. Every thing affociated with the cause of her disease, fhould be removed, and objects calculated to revive pleasant and healthy affociations of ideas fhould be fought for in company-in the haunts of her youth-or in any other place or fituation in which she has been happy.-When her temper, or wrong ideas are highly extravagant her mind should be foothed or diverted, as if by accident, to other fubjects.-When her alienations of mind become more feeble, they may be oppofed by reason-by amusements-by conversation-and even by ridicule,-each of which I have known fuddenly or gradually to restore order to the actions of the mind. Gentle exercife, when practicable, muft not be neglected. I was much pleased to read your account of the good effects of copious bleeding in facilitating Mrs. B's. delivery. It will give me pleasure to hear of the iffue of Mrs. B's. cafe. I more than hope ;-from the prefent fymptoms, and prognofis of her disease-I expect her recovery. Madness, fucceeding hyfteria, and attended with good humour, is much lefs difficult to cure than when it originates in hypochondriafis, and is attended with filence, and depreffion. From, dear Sir, yours, DR. SPENCE. BENJAMIN RUSH. No III. N the following table the firft column fhews the month IN the fecond the day of the month-the third, the number of grains of calomel given each day, and the fourth, the number of ftools in 24 hours. Salivation increased remarkably after leaving off the mercury, mouth and throat became very fore, breath offensive, bowels fince the fame period have been kept open by stewed fruits, or molaffes and water. Has rode out feveral times in a carriage; though often filent, never gloomy or melancholy. In the foregoing table the number of grains of calomel given each day is stated; but this quantity was always exhibited in divided dofes. The dofes were carefully weighed by her husband and given to her by his own hand. The cafk containing the shower bath was elevated nine feet, and held ten gallons of water. No. IV. Dumfries, October 30, 1806. DEAR SIR, THE HE above is a journal of our patients' cafe by her husband, which I defired him to keep, as my engagements during the fickly feafon prevented me from attending to her minutely. In a medical point of view this journal is imperfect, but I deem it valuable and therefore, although rather prolix, I think it proper to fend you an exact copy. You will fee by it that I commenced a mercurial course as foon as your inftructions came to hand. You will obferve also that the calomel foon after it was administered operated powerfully as a cathartic thereby answering one great object you had in view, |