|
Main
- books.jibble.org
My Books
- IRC Hacks
Misc. Articles
- Meaning of Jibble
- M4 Su Doku
- Computer Scrapbooking
- Setting up Java
- Bootable Java
- Cookies in Java
- Dynamic Graphs
- Social Shakespeare
External Links
- Paul Mutton
- Jibble Photo Gallery
- Jibble Forums
- Google Landmarks
- Jibble Shop
- Free Books
- Intershot Ltd
|
books.jibble.org
Previous Page
| Next Page
Page 10
In former editions I have advised against any attempt to treat the true
melancholias, which are not mere depression of spirits from loss of all
hope of relief, by this method, but wider experience has convinced me
that rest and seclusion may often be successfully prescribed to a
certain extent and in certain cases.
Those in which the most good has been done have been the cases of
agitated melancholia with attacks, more or less clearly periodic, of
excitement, during which their delusions take acuter hold of them and
drive them to wild extravagance of noisy talk and bodily restlessness.
Whether such patients must be put to bed or not one must judge in each
instance, taking into account the general nutrition. In my own practice
I certainly do put them to bed now much oftener than formerly. It is not
desirable to keep them there for the six or eight weeks which full
treatment would demand. Usually it will be of advantage to order, say,
two weeks of "absolute rest," observing the usual precautions about
getting the patient up, prescribing bed again when the early signs of an
attack of agitation appear, and keeping him there for a couple of days
on each occasion, during which the full schedule of treatment is to be
minutely carried out.
Goodell and, more recently, Playfair have pointed out the fact that some
cases of disease of the uterine appendages such as would ordinarily be
considered hopeless, except for surgical treatment, have in their hands
recovered to all appearances entirely; and my own list of patients
condemned to the removal of the ovaries but recovering and remaining
well has now grown to a formidable length. Playfair observes also that
he believes it possible that in even very severe and extensive disease
the health of the patient may be sufficiently improved to render
operation unnecessary.[14]
In cases of floating kidney some very satisfactory results have been
reached by long rest; and although it may be necessary to keep the
patient supine for three months or more, the reasonable probability of
permanent replacement of the organ is much greater than from operative
attempts at fixation, apart from the danger and pain of surgical
procedures. Persons with floating kidney are nearly always thin, often
giving a history of rapid loss of weight, have usually various symptoms
of gastric and intestinal disturbance, and present therefore subjects in
all ways suitable for a fattening and blood-making _r�gime_ which shall
furnish padding to hold the kidney firmly in its normal place.
The treatment of locomotor ataxia and some allied states by this method,
with certain modifications, has yielded such good results that I now
undertake with reasonable confidence the charge of such patients; and
the subject is so important and has as yet influenced so little the
futile drugging treatment of these wretched cases that it seems worth
while to devote a special chapter to it, although the affections named
can scarcely be said to be included under the head of neurasthenic
disease.
In the following chapters I shall treat of the means which I have
employed, and shall not hesitate to give such minute details as shall
enable others to profit by my failures and successes. In describing the
remedies used, and the mode of using them in combination, I shall relate
a sufficient number of cases to illustrate both the happier results and
the causes of occasional failure.
The treatment I am about to describe consists in seclusion, certain
forms of diet, rest in bed, massage (or manipulation), and electricity;
and I desire to insist anew on the fact that in most cases it is the
combined use of these means that is wanted. How far they may be modified
or used separately in some instances, I shall have occasion to point out
as I discuss the various agencies alluded to.
CHAPTER IV.
SECLUSION.
It is rare to find any of the class of patients I have described so free
from the influence of their habitual surroundings as to make it easy to
treat them in their own homes. It is needful to disentangle them from
the meshes of old habits and to remove them from contact with those who
have been the willing slaves of their caprices. I have often made the
effort to treat them where they have lived and to isolate them there,
but I have rarely done so without promising myself that I would not
again complicate my treatment by any such embarrassments. Once separate
the patient from the moral and physical surroundings which have become
part of her life of sickness, and you will have made a change which will
be in itself beneficial and will enormously aid in the treatment which
is to follow. Of course this step is not essential in such cases as are
merely an�mic, feeble, and thin, owing to distinct causes, like the
exhaustion of overwork, blood-losses, dyspepsia, low fevers, or nursing.
There are but too many women who have broken down under such causes and
failed to climb again to the level of health, despite all that could be
done for them; and when such persons are free from emotional excitement
or hysterical complications there is no reason why the seclusion needful
to secure them repose of mind should not be pleasantly modified in
accordance with the dictates of common sense. Very often a little
experimentation as to what they will profitably bear in the way of
visits and the like will inform us, as their treatment progresses, how
far such indulgence is of use or free from hurtful influences. Cases of
extreme neurasthenia in men accompanied with nutritive failures require
as to this matter cautious handling, because, for some reason, the ennui
of rest and seclusion is far better borne by women than by the other
sex.
Previous Page
| Next Page
|
|