CONTENTS. Indispensables in the Cure of the Insane, T. L. BROWN, M.D. On the Relations of Pulmonary Phthisis to Insanity, S. LILIENTHAL, M.D. Discussion. INDISPENSABLES IN THE CURE BY T. L. BROWN, M.D. We are losing or gaining, bodily and mentally, as we move on toward dissolution. There are moments when we are mad, insane, unfit to do the right as rational beings. We become possessed of unpleasant thoughts, which compel us to irrational and improper deeds. All persons are wandering mentally, at times, into the realm of the impossible, especially when the actual is not controlling our consciousness. Every organic change toward disorganization brings us unsound mental action. If there is one fact as good as another it is the one we are taught, that the soundest mind is the result of the healthiest organized body. Necessary to correct thought is a sound organization. Before insanity, we have disorganization and destruction of blood, and consequent change in brain tissue. The brain of man is the result of contact and combination of the elementary substances, under certain uniform relations. The necessary growth or repair of the brain, depends upon the atomic and molecular motions of the elementary forms entering into the composition of its tissues. The most completely organized brain is the best known locality of sane thought. Regularity in periods of motion and rest are indispensable in the organization as well as the preservation of the brain and its sound mental action. The best evidence of sanity, in any person, is the order and regularity that person manifests in word and deed. Such a person has nerve, bravery and character. He knows more than he fears or raves. He has labored and rested at regular intervals. Physiological order can be traced historically back to his ancestry, as one of the trade marks of the generations from which he had his being. Brain repair cannot be healthfully accomplished without order and suitable quality of material, essential in organizing brain forms. Only those elementary substances known to combine in natural proportions can be used to repair or reorganize a diseased brain. When the insane treat the insane, they generally depend alone upon drug remedies. We once knew an insane man who consulted four doctors in one day, and attempted to follow their advice and take their drug prescriptions, for his imagined diseases. Disorder and irregularity of thought and action was quite well manifested in his case. He was, however, sharp enough to keep each physician ignorant of the others' prescriptions. He only showed order and sanity in his reserve. We knew him before, when order and regularity in all the then known hygiene of life was his, making him sane and useful. To practice the physiological cure is to secure what remedies can not produce. Healthy persons should be the only attendants in charge of the insane. Always those who practice what they teach. Physicians who know and fully appreciate the laws of physiology, and will put them in practice, can do what remedies cannot. In the treatment of insanity there can be no substitution for the elementary combinations so absolute and indispensable during organization or reorganization. Air, food, water, exercise, rest, sleep and objective mental impressions, are absolute in their curative action in the treatment of the insane. We do not understand how a cure can be produced without such sanitary means. Pure air, day and night, sufficient to supply the blood with all needed oxygen. Food in proper quantity adapted to the patient's wasted condition and ability to digest. Water free from all disease producing properties. Rest at such regular intervals as would make exercise both necessary and restorative. Sleep, the most important of all the physiological restoratives, is the periodical state securing permanent recovery. Removal of all objects which helped to produce the mental alienation, and getting a supply of other and more pleasing influences, will aid recovery as no other means can. Taking the patient where nothing can be seen or heard to suggest any of the former perplexities, is indispensable, and will soonest cure the patient. The incurables are those who have reached that stage of organic destruction which is beyond hygienic or sanitary influences. Then remedies may do what other means have failed to accomplish. By the timely use of our well chosen remedies many a shattered brain has been restored to correct mental action. Good cures depend most upon not failing to use, at the time needed, every well tested means known to the educated profession. Many of the most important indispensables are often forgotten, hence the failures so often recorded, where cures could have taken their places. ON THE RELATIONS OF PULMONARY PHTHISIS TO INSANITY. BY S. LILIENTHAL, M.D. Prof. Loomis, in his classical work on the "Diseases of the Respiratory Organs," when speaking of hereditary disposition, says: "If we take the position that it is not the phthisis that is transmitted from parent to offspring, but a feebleness or vice of constitution which so affects the individual that he is liable to phthisical developments when certain local causes are brought into operation, then hereditary influences, as a cause of phthisis, are better understood and more fully appreciated; especially is this evident when it can be shown that this vice of constitution may be inherited by the children of the aged, of drunkards, of those enervated by excesses of any kind, or of those who, at the time of the birth of their children, were suffering from some form of constitutional disease, such as cancer, syphilis, rheumatism, &c. So long as poverty and destitution shall exist on the one hand, and dissipation and enervating luxury on the other, anti-hygienic influences must be regarded as important general causes of pulmonary phthisis: ranking only second in importance to hereditary influences. Impure air, improper quality and insufficient quantity of readily assimilated food, are among the most prolific of this class of causes. If to these are added insufficient clothing, damp, badly ventilated apartments, intemperance in the use of alcoholic stimulants, venereal excesses, prolonged lactation, repeated miscarriages, want of cleanliness, and all those influences which arrest or diminish cutaneous function, we have a most formidable array of predisposing causes." Woodman & Tidy, in their Forensic Medicine, p. 737, mention as predisposing causes of insanity: heredity, i. e., defects or instability handed down from ancestors, and as proximate causes, the same mentioned by Loomis. Krafft-Ebbing, in his Psychiatry, I, p. 153, remarks: "Next to |