_Patients Who Have Tendencies to Self-Mutilation._--Some patients horribly mutilate themselves. They may gouge out an eye, cut off a hand, pull out their tongue, or even disembowel or dreadfully burn themselves. Some patients persistently beat their heads against the wall or floor, others scratch the skin, making large sores. Such patients frequently think certain passages from the Scriptures apply to them, and they must obey the application and command. They quote in justification of the acts, "An eye for an eye," "And if thy right eye offend thee, pluck it out," "And if thy right hand offend thee, cut it off." Talk of this kind should make an attendant very careful and watchful of the patient. The origin of the ideas that lead to the attempts at self-mutilation is to be found in delusions, and arise in the same way as do ideas of suicide and homicide. These patients are all of the same class and need the same character of care, attention, and watching. _Patients with Tendencies to Setting Things on Fire._--Patients with these tendencies generally desire to commit incendiary acts under the influence of delusions or hallucinations; added to these there are frequently suspicions and feelings of wrong treatment, and the patient takes this way of showing revenge, or, as he may say, of repaying the wrong. Sometimes patients are so feeble in mind that they light a fire because they think it is a pretty sight to see it burn. There are some conditions accompanying epilepsy where patients are liable to commit any of the class of violent acts described in this chapter. The special care demanded by these patients will be fully spoken of hereafter. There are some patients whose minds are so distorted by disease that they seem to take a pleasure in wrong-doing, and are much inclined to do great mischief, and sometimes to commit acts against life or property. The care demanded by patients who are inclined to acts of violence is practically the same for all. The attendant should thoroughly know the habits, peculiarities, and delusions of each person under his care; he should exercise constant watchfulness, and remember that a moment of thoughtless inattention may give the opportunity for a patient to commit some violent act, that will cause him lasting regret. The mind of a faithful attendant will, when upon duty, always be full of anxiety, and there should be in the care of very troublesome patients of this class frequent relief. CHAPTER VIII. THE CARE OF SOME COMMON MENTAL STATES, AND ACCOMPANYING BODILY DISORDERS. _Care of Patients in the Earlier Stages of Insanity._--Patients in the earlier stages of insanity act differently, one from the other, when first brought to the asylum and placed under care and restriction. Sometimes patients accept the situation and fit into asylum life without any friction. They may even come willingly, knowing they need care and treatment, or from confidence in their friends or their physician's advice.