and blasphemous thoughts, which would force themselves into my mind when I fancied myself most ardently struggling with God in prayer. To such a degree was I under the influence of these terrible suggestions, that when they made an effort to rush to my lips I was obliged to put my hand to my mouth to prevent myself giving utterance to them. So greatly afflicted was I in this manner, that I consulted a venerable Christian friend respecting these wicked thoughts. He asked me whether they came into my mind in any consecutive form, or only by fits and starts. I replied that they came quite suddenly, and had nothing consecutive about them. 'Oh, then,' said my Christian friend, care nothing for these thoughts, I know where they come from; treat them as in Old England we used to treat vagrants, flog them well at the cart's tail, and send them home to their parish. These thoughts are suggested to your mind by Satan, who says to himself, "I am likely to lose this man, and I will make a desperate effort to keep him within my power." Flog them, I repeat, well, and send them home.' I did," continues Mr. Spurgeon, "what my dear Christian counsellor advised, and conquered the enemy."

The power of self-control is, in many instances, weakened, or altogether lost, by a voluntary and criminal indulgence in a train of thought which it was the duty of the individual, in the first instance, to resolutely battle with, control, and subdue. Nervous disorders as well as insane delusive thoughts are thus often self-created. It may not be an easy task to subdue morbid sugges tions, obtain a mastery over unhappy feelings, crush unnatural inclinations, destroy in their infancy the tyranny of unhealthy impulses, keep in subjection wicked, vicious, and criminal tendencies. The difficulty of obtaining such a dominion over the perturbed mind may be apparently insurmountable, nevertheless, a resolute and

persevering exercise of the volitional power will, in many cases, effectually enable the patient to accomplish it.

"Nemo adeo ferus est, ut non mitescere possit,

Si modo culturæ patientem commodet aurem."-HOR.

Directly the will ceases to exercise controlling influence over the understanding and emotions, the intellect loses its healthy balancing power. A man indulges in a depraved course of conduct, harbours and encourages vicious ideas, his actions often corresponding with the unfortunate condition of his mind and feelings, until all power of volition becomes suspended, and he is actually reduced to a state of quasi lunacy. A person, perhaps for some real cause, feels a degree of animosity towards a particular individual who has injured him. Instead of making an effort to conquer this feeling, he allows—in fact, forces his mind to dwell upon it; the idea pursues him in all his walks, haunts him in his waking thoughts, and exercises a fearful ascendancy over him during the darkness of the night. The mind eventually becomes so absorbed in the idea, that the bitter, angry feeling which, at the first onset, was insignificant and amenable to control, seizes hold of the mind, and influences and distorts every idea and action. The morbid soon becomes a deranged mind, the insanity manifesting itself in an exaggerated, extravagant, and perverted conception of a notion which had originally some semblance of truth for its foundation. The self-created delusive idea may thus obtain a fearful influence over the mind, and eventually lead to the commission of criminal acts.

If self-control is to be exercised with any great advantage, it must be practised in the incipient stages of disordered mind. At this period it is possible, even when insanity has begun to throw a dark shadow over the intellect, to subdue the morbid thoughts and perverted feelings, by a resolute and determined effort of the will.

"Our remedies oft in ourselves do lie,

Which we ascribe to Heaven; the fated sky
Gives us free scope; only doth backward pull
Our slow designs, when we ourselves are dull."

In many of these quasi morbid states of thought, or early scintillations of insanity, much benefit is often derived from the adoption of a course of remedial medical treatment. Happily we possess the means of invigorating the functions of the brain and nervous system, and thereby giving tone to the flagging and enfeebled efforts of the will. It would be most unwise, while struggling to keep in check unhealthy thoughts, to neglect a careful consideration of the state of the bodily health.

It will be impossible for me to enter, except in general terms, into a consideration of the treatment of incipient paralysis, apoplexy, softening of the brain, and other organic cerebral diseases, without anticipating what I shall have to advance in reference to this important subject in the succeeding work.

I am convinced from the number of cases of incipient organic disease of the brain which have come under my observation, that much may be effected by means of treatment in arresting the progress of these encephalic affections, provided they are brought at an early period of their development within the range of remedial treatment.

The abstraction of a small quantity of blood from the head, the administration of mercurial alteratives, a careful attention to the state of the secretions, skin, and renal functions, combined with counter-irritation and an abstinence from all mental agitation and anxiety, will often be found of essential benefit in the incipient stages of apoplexy and paralysis. In a certain type of case connected with organic or functional disease of the heart, I have, after relieving the local head symptoms by means of

TREATMENT OF INCIPIENT SOFTENING, PARALYSIS, ETC. 669

cupping (wet and dry), leeches and blisters, found great benefit from a combined use of opium, digitalis, and iodide of potassium. Where there is laborious action of the heart consequent upon hypertrophy or valvular disease, the preceding formula almost invariably alleviates the cardiac as well as the head symptoms.

There are other types of incipient apoplexy and paralysis only to be successfully treated by means of tonics and stimulants. I have observed well-marked symptoms of apparently acute attacks of cerebral hemorrhage and paraplegia yield speedily to the administration of iron, quinine, and various preparations of zinc and copper. In this anæmic class of case wine and good nourishment will also be indispensable. The pulse is generally weak, action of the heart feeble, and the blood deficient in red globules. This is indicated by the pallor of the countenance and general state of anæmia. The patient complains of great muscular debility and nervous depression. Associated with the preceding symptoms, I have often observed signs of what was considered at the time. to be threatening indications of apoplexy and paralysis.

In incipient general paralysis, I am of opinion that much benefit is to be derived from a persevering and continuous course of tonic treatment. In this affection it will often be found necessary, whilst building up the patient, and conserving his powers of life by means of iron, quinine, zinc, cod-liver oil, &c., to apply a seton or issue to the arm or nape of the neck.

In cases of this disease we occasionally observe symptoms of temporary congestion of the brain. For the relief of this complication I have generally applied one or two leeches to the schneiderian membrane with marked benefit. In some instances I have exhibited the various preparations of arsenic and copper with apparent advantage. In depressed conditions of the cerebral force,

phosphorus, combined with minute doses of strychnine and cod-liver oil, may be administered.

In the treatment of incipient softening of the brain, it will be necessary, in the majority of cases, to give tonics and stimulants. I am satisfied of the possibility of arresting, in the early stages of softening, the progress of the cerebral disorganization by means of the treatment previously suggested. Much, however, will depend upon the characteristics of each individual case. In some patients it will be necessary to apply, even at the first onset of the disease, if the physician be fortunate enough to see the case in this early stage, counter-irritation to the neck, as well as to use dry-cupping. In particular formations of the cranium, states of the heart and cerebral vessels, it will be necessary, whilst sustaining the powers of life by the therapeutic agents specified, to cautiously relieve local head symptoms by means of leeches. antiphlogistic treatment will rarely be found necessary. I need not, whilst advising a course of tonic treatment, associated with generous diet, and a liberal use of wine, &c., in cases of incipient softening of the brain, suggest the importance of carefully protecting the patient from mental labour, irritation, and anxiety. It will be useless to grapple by means of medicine with this serious cerebral disease, unless the mind is most scrupulously preserved from an undue exercise or strain of its powers.

But

It will often be found desirable to send the patient abroad, or to a remote part of the country, with the view of removing him from all temptation to work, or to advise a sea voyage after his state of general, mental, and cerebral health has been well analysed and remedially treated.

I have on record the particulars of a number of cases of incipient softening of the brain which have been successfully cured by an adoption of these remedial