Fat and Blood: An Essay on the Treatment of Certain Forms of Neurasthenia and HysteriaMitchell, S. Weir (Silas Weir)
Science
Fat and Blood: An Essay on the Treatment of Certain Forms of Neurasthenia and Hysteria
Mitchell, S. Weir (Silas Weir)
Hysteria; Neurasthenia; Rest
Let us now suppose that we have to deal with a person of another and
different type,--one of the larger class of feeble, thin-blooded,
neurasthenic or hysterical women. Let us presume that every ordinary and
easily attainable means of relief has been utterly exhausted, for not
otherwise do I consider it reasonable to use so extreme a treatment as
the one we are now to consider. Inevitably, if it be a woman long ill
and long treated, we shall have to settle the question of uterine
therapeutics. A careful examination is made, and we learn that there is
decided displacement. In this case it is well to correct it at once and
to let the uterine treatment go on with the general treatment. If there
be bad lacerations of the womb or perineum, their surgical relief may
await a change in the general status of health,--say at the fourth or
fifth week. If there be only congestive or other morbid states of the
womb or ovaries, they are best left to be aided by the general gain in
health; but in this as in every other stage of this treatment it is
unwise, and undesirable therefore, to lay down too absolute laws. Having
satisfied ourselves as to these points, and that rest, etc., is needful,
we begin treatment, if possible, at the close of a menstrual period,
because usually the monthly flow is a time at which there is little or
no gain, and by starting our treatment when it is just over we save a
week of time in bed.
The next step is, usually, to get her by degrees on a milk diet, which
has two advantages. It enables us to know precisely the amount of food
taken, and to regulate it easily; and it nearly always dismisses, as by
magic, all the dyspeptic conditions. If the case be an old one, I rarely
omit the milk; but, although I begin with three or four ounces every two
hours, I increase it in a few days up to two quarts, given in divided
doses every three hours. If a cup of coffee given without sugar on
awaking does not regulate the bowels, I add a small amount of watery
extract of aloes at bedtime; or if the constipation be obstinate, I give
thrice a day one-quarter of a grain of watery extract of aloes with two
grains of dried ox-gall. I find the simple milk diet a great aid
towards getting rid of chloral, bromides, and morphia, all of which I
usually am able to lay aside during the first week of treatment.[27] Nor
is it less easy with the same means to enable the patient to give up
stimulus; and I may add that in the treatment of the congested stomach
of the habitual hard drinker the milk treatment is of admirable
efficacy. As I have spoken over and over of the use of stimulus by
nervous women, I should be careful to explain that anything like great
excess on the part of women of the upper classes, in this country at
least, is, in my opinion, extremely rare, and that when I speak of the
habit of stimulation I mean only that nervous women are apt to be taught
to take wine or whiskey daily, to an extent that does not affect visibly
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