,,h[ ,,to ,,c>e ,,= ,,! ,,insane ,a ,,manual ,,= ,,nurses ,,by ,,william ,d4 ,,grang]1 ,m4,d4 ,,proprietor-,,physician1 ,,v]non ,,h\se1 ,,mt4 ,,v]non1 ,n4 ,y4 ,,=m]ly ,,fir/ ,,assi/ant ,,physician ,,buffalo ,,/ate ,,hospital1 ,,buffalo1 ,n4 ,y4 ,,memb] ,,am]ican ,,association ,,( ,,sup]9t5d5ts ,,( ,,hospitals ,,= ,,! ,,insane4 ,,memb] ,,new ,,york ,,neurological ,,society4 ,,second ,,edition4 ,,revis$4 ,g4 ,p4 ,,putnam',s ,,sons ,,new ,,york #bg ,,we/ ,,tw5ty-,,?ird ,,/4 ,,london #bg ,,k+ ,,william ,,/41 ,,/r& ,! ,knick]bock] ,press #ahia ,,copyright ,g4 ,p4 ,,putnam',s ,,sons #ahhf ,press ( ,g4 ,p4 ,,putnam',s ,,sons ,new ,york ,,note ,,to ,,second ,,edition4 ,at ! "t ( />t+ a tra9+ s*ool1 9 #ahhc1 ! au?or 0 unaw>e t l "w 0 comm5c+ at ! ,mc,lean ,asylum1 ,som]ville1 ,mass41 by ,dr4 ,campbell ,cl>k & o!rs 9 ,scotl&1 & 9 ,new ,s\? ,wales4 ,ea* 0 indep5d5t1 & ea* work$ out ! problem indep5d5tly4 ,?us1 f> sep>at$ ef=ts %[$ ! "t _h come :5 att5dants mu/ be evolv$ into tra9$ nurses4 ,! mo/ gratify+ feature has be5 ! unanim\s approval by ,am]ican sup]9t5d5ts & ! e/abli%m5t ( tra9+ s*ools 9 almo/ e asylum 9 ! l&1 (t5 "u ! mo/ difficult conditions & at a great sacrifice ( ! preci\s "t & /r5g? ( ! m$ical /aff4 ,! increas+ numb] ( ^! s*ools & pupils dem&s a second edition ( ?is little manual4 ,,v]non ,,h\se1 ,,mt4 ,,v]non1 ,n4 ,y41 ,m>* #ba1 #ahia4 ,,introduction4 ,! writ] began 9 ,octob]1 #ahhc1 at ! ,buffalo ,/ate ,asylum = ! ,insane1 a c\rse ( in/ruction to ! wom5 att5dants ^u _! duties & h[ be/ to c>e = _! pati5ts4 ,?is has be5 regul>ly cont9u$ till x has become a fix$ "p ( ! asylum life1 & has develop$ into a sy/em ( tra9+1 & n[ a class ( att5dants has ne>ly complet$ its /udies4 ,s9ce ,july1 #ahhe1 in/ruction has be5 giv5 to m5 att5dants4 ,9 ,april1 #ahhe1 ! ,sup]9t5d5t1 ,dr4 ,j4 ,b4 ,&rews1 :o _h enc\rag$ ! s*ool f its conception1 ask$ ! ,bo>d ( ,manag]s to (ficially recognize x4 ,!y adopt$ ! recomm5dation & fix$ ! qualifications = admission1 ! pay & privileges ( its memb]s1 & provid$ = a c]tificate z a tra9$ nurse & an att5dant ^u ! insane1 to be giv5 to all1 :o at ! end ( two ye>s successfully f9i%$ ! full c\rse ( in/ruction4 ,! writ] believes t all att5dants %\ld be regul>ly in/ruct$ 9 _! duties1 & ! highe/ /&>d ( c>e c be rea*$ only :5 ?is is done4 ,he also believes t e p]son :o is all[$ to c>e = ! insane w be greatly b5efit$ by su* in/ruction1 & w be able to le>n e ?+ taught1 if ! tea*] uses simple me?ods & is pati5t to in/ruct4 ,z a rule !y ent] ^u ! /udy ) int]e/1 & soon a skill$ corps is =m$1 :o are compet5t to fill ! responsible positions1 & control ! un/able class t drift 9 & out ( an asylum4 ,ev5 ! dulle/ are awak5$ to new zeal1 & are advanc$ to positions ( tru/ !y c\ld n o!rwise h fill$4 ,a brief outl9e ( ! c\rse ( in/ruction ( ! s*ool may be ( int]e/4 ,! fir/ ye> is sp5t 9 le>n+ ! r\t9e ( w>d "w & fill+ m9or positions4 ,! att5dants are *ang$ f w>d to w>d1 & h ! c>e ( all classes ( ! insane4 ,!y fir/ receive in/ruction 9 ! pr9t$ rules ( ! asylum4 ,e rule relat+ to ! duties ( att5dants is read & expla9$1 & special att5tion is call$ to ! p]=mance ( ! foll[+ duties3 a4 ,duties to (fic]s4 b4 ,duties to ea* o!r4 c4 ,duties to pati5ts4 d4 ,duties to ! in/itution4 ,?us ! new att5dants e>ly get an outl9e ( _! duties 9 ! special c>e ( ! insane4 ,aft] ?is comes in/ruction 9 elem5t>y anatomy & physiology4 ,!y are taught ( ! bones1 jo9ts1 muscles1 & organs ( ! body1 food & dige/ion1 ! circulation & respiration1 wa/e & repair1 animal heat1 & ! n]v\s sy/em4 ,9 ord] to be ready = advanc$ in/ruction ! elem5ts ( physiology mu/ be ?or\ghly le>n$4 ,! tea*+ mu/ be adapt$ to ! ability & wants ( ^? in/ruct$4 ,hav+ fix$ ! limit ( duties requir$ ( an att5dant1 x is easy to fix ! limit ( in/ruction4 ,x is an error to tea* too mu* m$ic9e1 = !n we beg9 to make physicians4 ,all t is ne$$ is att5dants :o are able to d _! "w intellig5tly1 &1 keep+ ?is object 9 m9d1 lectures by a physician1 devoid ( too mu* detail1 b simple1 direct1 & pla91 are bett] ?an in/ruction f any ( ! text-books4 ,) notes ( ! lectures furni%$1 & ) repeat$ recitations1 any lesson is readily le>n$4 ,?is way ( in/ruct+1 by lectures1 notes1 & recitations1 is cont9u$ ?r\gh\t ! entire two ye>s4 ,a c\rse 9 hygi5e foll[s ! lectures 9 physiology4 ,in/ruction 9 ^! ?ree /udies occupies ! fir/ ye>4 ,an att5dant :o1 at ! end ( ?is "t1 successfully passes an exam9ation 9 !m1 & :o has be5 fai?ful 9 8 duties1 is ready to receive ! advanc$ in/ruction ( ! second ye>4 ,?is includes ! nurs+ ( ! sick1 ! managem5t ( em]g5cies1 & f9ally ! special "w ( c>+ = ! insane4 ,! wits ( an att5dant ^u ! insane h to be %>p5$ 9 _m directions n requir$ ( a g5]al nurse4 ,! text-books on nurs+ may prop]ly be foll[$ by ano!r1 :i* %all aid "o skill$ z a nurse to p]=m ! v>i$ & difficult duties incid5t to ! c>e ( ! insane & ! w>ds ( an asylum4 ,to furni% ?is is ! object ( ?is manual4 ,a brief review ( ! physiology ( ! n]v\s sy/em is introduc$ = ! aid ( /ud5ts1 9 read+ ! *apt]s on ! m9d & insanity4 ,to tea* any ?+ metaphysical or pa?ological may seem que/ionable4 ,! class1 h[ev]1 has n only be5 int]e/$ 9 ! simple /udy ( ! ph5om5a ( ! m9d1 b has be5 able to compreh5d & pr(it by ! lectures on ?is subject4 ,! lectures on ! c>e ( ! insane 7 giv5 to ! class almo/ z !y appe> 9 ^! pages4 ,! sugge/ion 0 made t if !y 7 pr9t$ !y w\ld f9d a place 9 ! h&s ( att5dants 9 o!r asylums4 ,?is is ! reason ( _! publication4 ,to my colleague1 ,dr4 ,a4 ,w4 ,hurd1 ,i wi% to t5d] my ?anks = ! valuable assi/ance he has giv5 me 9 ! prep>ation ( ?is manual4 ,i am greatly indebt$ to ,dr4 ,&rews = 8 ev] k9d b critical advice4 ,b = 8 enc\ragem5t & help nei!r ! "w ( in/ruction nor ! prep>ation ( ^! pages w\ld h be5 begun1 nor success1 if success be ga9$1 a*iev$4 ,,cont5ts4 ,,page ,,introduction v ,,*apt] ,i4 ,,! ,,n]v\s ,,sy/em ,,& ,,"s ,,( ,,its ,,m ,,important ,,functions #a ,n]ve ,c5tres4--,bra9 & ,sp9al ,cord4--,! ,n]ves4--,n]ve ,cells & ,fibres4--,motor & ,s5sory ,n]ves4--,! ,five ,organs ( ,special ,s5se4--,n]ve ,impulses4--,! ,bra9 & ,n]v\s ,sy/em ,always ,busy4--,ne$ ( ,re/4 ,,*apt] ,,ii4 ,,! ,,m9d ,,& ,,"s ,,( ,,its ,,faculties #g ,m9d & ,matt]4--,life4--,relation ( ,m9d & ,bra94-- ,faculties ( ! ,m9d4--,intellectual ,faculties4--,w4-- ,emotions4--,in/9cts4--,moral ,faculties4 ,,*apt] ,,iii4 ,,insanity2 ,,or1 ,,disease ,,( ,,! ,,m9d #ac ,insanity a ,*ange4--,involves ,disease ( ! ,bra94-- ,delusions4--,halluc9ations4--,illusions 4--,incoh]5ce4-- ,m5tal ,/ates4--,mania4--,melan*olia4--,dem5tia 4-- ,monomania4--,emotional ,insanity4--,dipsomania4--,moral ,insanity4 ,,*apt] ,,iv4 ,,! ,,duties ,,( ,,an ,,att5dant #bb ,:at an ,att5dant ,%\ld ,fir/ ,le>n4--,! ,relation ( ,att5dants to ,pati5ts4--,! ,"* ( an ,att5dant4-- ,relation to ! ,in/itution4--,h[ & ,:at to ,obs]ve4-- ,sy/ematiz$ ,plan ( ,obs]vation4--,control & ,influ5ce ( ,att5dants ov] ,pati5ts4--,c>e & ,/udy ( ! ,individual4--,lib]ty to be ,all[$ ,pati5ts4--,self-,control ( ,pati5ts to be ,enc\rag$4 ,,*apt] ,v4 ,,g5]al ,,c>e ,,( ,,! ,,insane #cc ,reception ( ,new ,pati5ts4--,"w & ,employm5t4--,pati5ts' ,c>e ( ,!mselves4--,walk+4--,clo?+4--,ba?+4--,s ]v+ ( ,food4--,b$ & ,ris+ ,"t4--,night ,c>e4 ,,*apt] ,,vi4 ,,c>e ,,( ,,! ,,viol5t ,,insane #de ,ne$ ( ,/udy+ ,ea* ,case4--,con/ant ,att5tion & ,ov]sight4--,value ( ,employm5t & ,out-,door ,ex]cise4-- ,re/riction & ,idl5ess4--,p>oxysms ( ,viol5ce2 ,h[ ,c>$ ,=4--,h[ to ,hold or ,c>ry a ,pati5t4--,dang] ( ,injury4-- ,/ruggles to be ,avoid$4--,c>e ( ,de/ructive ,pati5ts4-- ,use ( ,re/ra9t1 ,seclusion1 & ,cov]$ ,b$4 ,,*apt] ,,vii4 ,,c>e ,,( ,,! ,,homicidal ,,& ,,suicidal ,,insane1 ,,& ,,( ,,^? ,,incl9$ ,,to ,,acts ,,( ,,viol5ce #ec ,delusions ( ,suspicion4--,homicidal ,pati5ts4--,suicidal ,pati5ts4--,self-,mutilation4--,inc5di>y ,pati5ts4 ,,*apt] ,,viii4 ,,c>e ,,( ,,"s ,,( ,,! ,,common ,,m5tal ,,/ates ,,& ,,! ,,accompany+ ,,bodily ,,conditions #fj ,c>e 9 ! ,e>li] ,/ages4--,insanity ) ,exhau/ion4-- ,symptoms ( ,dang]4--,c>e ( ,dem5tia1 ,e>ly ,dem5tia1 ,*ronic or ,t]m9al ,dem5tia4--,convalesc5ce4--,relapse4-- ,epilepsy4--,p>esis4--,c>e ( ,p>alytics1 ! ,helpless1 ! ,b$-ridd54--,b$-,sores4 ,,*apt] ,,ix4 ,,"s ,,( ,,! ,,common ,,accid5ts ,,among ,,! ,,insane1 ,,& ,,! ,,treatm5t ,,( ,,em]g5cies #ga ,c]ta9 ,classes ( ,insane ,liable to ,injury4--,fractures4-- ,w\nds4--,bites4--,bl[s on ! ,head--,cut ,?roat4--,w\nds ( ! ,extremities ) ,hemorrhage4--,spra9s4--,*ok+4-- ,artificial ,respiration4--,burns4--,fro/-bites4--,/ ates ( ,unconsci\sness4--,apoplexy4--,sun/roke4 --,poison+4--,eat+ ,glass4--,injury ) ,ne$les4 ,,*apt] ,x4 ,,"s ,,s]vices ,,frequ5tly ,,dem&$ ,,( ,,att5dants ,,& ,,h[ ,,to ,,d ,,!m #he ,adm9i/ration & ,effects ( ,m$ic9e4--,opium1 ,*loral1 ,hyosc9e1 & ,hyoscyam9e2 ,doses1 ,effects1 ,poison+1 ,treatm5t4--,/imulants4--,applications ( ,heat & ,cold4-- ,ba?s & ,wet ,pack+4--,hypod]mic ,injections4--,=cible ,fe$+ ) ,/oma*-,tube4--,nutritive ,enemata4 ,,h[ ,,to ,,c>e ,,= ,,! ,,insane4 ,,*apt] ,i4 ,,! ,,n]v\s ,,sy/em ,,& ,,"s ,,( ,,its ,,m ,,important ,,functions4 ,! n]v\s sy/em is made up ( a n]ve c5tre & n]ves4 ,! great n]ve c5tre is ! ,bra9 & ,sp9al ,cord4 ,! bra9 is a body weigh+ ab\t =ty ounces1 & fills a cavity 9 ! upp] "p ( ! skull4 ,! sp9al cord1 commonly call$ sp9al m>r[1 is directly connect$ ) ! bra94 ,! skull re/s ^u ! sp9al column1 or backbone1 & !re is a cavity inside ! :ole l5g? ( ?is column1 :i* conta9s ! cord4 ,!re is an op5+ ?r\gh ! base ( ! skull :]e x re/s ^u ! sp9al column1 & x is ?r\gh ?is op5+ t ! fibres ( ! cord g1 to pass into & become a "p ( ! bra94 ,^! mo/ important p>ts are c>efully protect$ by a /rong bony cov]+4 ,_m n]ves are giv5 (f f ! bra9 & cord & g practically ev]y:]e1 s t e "p ( ! body is suppli$ ) !m4 ,^! n]ves are :ite cords ( diff]5t sizes2 ! l>ge/ n]ve ( ! body1 ! "o t goes to ! leg1 call$ ! sciatic1 is z l>ge z ! little f+]4 ,!re are really two bra9s & two cords1 z along ! c5tral l9e ( ! body !re is a division ( ! bra9 & cord1 mak+ two halves exactly alike4 ,^! halves are connect$ toge!r1 ! division n be+ complete4 ,n]ves are giv5 (f 9 pairs2 = example1 f ei!r side ( ! bra9 arises a n]ve t goes to ea* eye4 ,s two n]ves exactly alike spr+ f ! two sides ( ! sp9al cord1 go+ to ea* arm4 ,a n]ve is compos$ ( a bundle ( fibres1 microscopic 9 size4 ,z a n]ve passes to ! extremities x divides by bran*+ mu* z does an art]y1 & ?us a bundle ( fibres is di/ribut$ to a muscle1 or a "p ( ! sk91 or to an organ1 & e "p ( ! body has a direct n]ve supply1 mu* z y saw 9 ! microscope x 0 suppli$ ) blood by means ( ! capill>ies4 ,we _c prick our f+] ) ! f9e/ ne$le b n]ve1 fibres are irritat$1 & we feel x1 & capill>ies are injur$ & we get a drop ( blood4 ,mo/ ( ! n]ves t g to ! arms1 legs1 & organs ( ! *e/ & abdom51 arise 9 & proce$ f ! sp9al cord1 b "s ( ! fibres beg9 9 ! bra9 & are cont9u$ d[n ! cord1 :]e1 jo9+ ) fibres t orig9ate 9 ! cord itself1 bo? g to make up ! n]ve1 ?us connect+ all p>ts ( ! body ) ! great c5tre4 ,! bra9 & cord are made up ( blood-vessels1 n]ve cells1 n]ve fibres1 &1 hold+ !m all toge!r1 connective tissue4 ,! cells are v small1 be+ microscopic 9 size2 !re are an imm5se numb] ( !m1 & !y make up mo/ ( ! gray matt] or outside ( ! bra91 b 9 ! sp9al cord ! gray matt] is 9 ! c5tre4 ,! fibres t g to make up ! n]ves beg9 & spr+ f ! cells1 & !y also unite !m toge!r4 ,! cells are ga!r$ into gr\ps1 :i* h ea* a sep>ate function to p]=m4 ,!re is a gr\p f :i* ! n]ve ( ! eye proce$s2 ano!r = ! n]ve t goes to ! e>2 ano!r = ! n]ve t goes to ! arm2 & ano!r = ! n]ve ( ! he>t4 ,!re is a gr\p t presides ov] spee*1 & o!r gr\ps t preside ov] m5tal action1 :ile all ( ^! are connect$ toge!r by fibres4 ,?us x appe>s t ! bra9 is a true c5tre1 & ! n]ves b ! means ( connection betwe5 diff]5t p>ts ( ! body & ! bra91 & also betwe5 diff]5t p>ts ( ! bra94 ,n]ves h two special functions3 "o to c>ry impressions made ^u ! fibres1 t end 9 ! diff]5t p>ts & organs ( ! body1 to ! bra92 ano!r to c>ry f ! n]ve cells s-call$ n]ve impulses1 to ! diff]5t p>ts & organs ( ! body4 ,"s n]ves h 9 !mselves ^! two functions1 z ! n]ves t g to ! arm or leg2 o!rs h b "o1 z ! optic or eye n]ve1 :i* c only c>ry ! s5sation ( sight f ! eye to ! bra94 ,! n]ves t c>ry s5sations to ! bra9 are call$ ,s5sory ,n]ves4 ,! n]ves t c>ry motor impulses f ! bra9 are call$ ,motor ,n]ves4 ,!re are five special organs ( s5se1 ea* receiv+ diff]5t impressions1 & s5d+ by its s5sory n]ve or n]ves a diff]5t "* ( s5sation to ! bra91 namely3 ,! eye1 giv+ s5sations ( light & color4 ,! e>1 giv+ s5sations ( s\nd4 ,! nose1 giv+ s5sations ( smell4 ,! m\?1 giv+ s5sations ( ta/e4 ,! sk91 giv+ s5sations ( t\*1 ) ideas ( r\ghness1 smoo?ness1 h>dness1 s(tness1 heat1 & cold4 ,!re mu/ be1 9 e case1 a direct n]ve connection f ! organ ( special s5se to ! special gr\p ( cells 9 ! bra9 to :i* ! n]ve goes4 ,if ! connection is brok5 at any po9t1 ! impression made ^u ! fibres 9 ! organ ( s5se _c rea* ! bra94 ,only aft] ! impression rea*es ! bra9 & ! cells are affect$1 d we become consci\s ( a s5sation4 ,we !n say1 z ! case may be1 ,i see1 or he>1 or smell1 or ta/e1 or feel some?+4 ,x ?us appe>s t ^! organs ( s5se simply receive ! impressions made ^u !m to transmit to ! bra91 & x is really ! bra9 t sees1 he>s1 smells1 ta/es1 & feels4 ,by ! action ( ! organs & n]ves ( special s5se we get all our k ( ! ext]nal _w1 &1 probably1 if we _h no organs ( s5se1 we w\ld h no consci\sness ( our exi/5ce4 ,pa9 is due to abnormal action ( s5sory n]ves1 caus$ by disease1 injury1 or pressure1 & ! irritation made1 be+ c>ri$ to ! bra9 makes u consci\s ( ! peculi> s5sation we call pa94 ,s ! want ( food or wat] makes an impression ^u n]ves1 :i* be+ c>ri$ to ! bra9 causes a peculi> s5sation1 & we say we feel hungry or ?ir/y4 ,! ,motor ,n]ves arise 9 ! cells ( ! bra9 & cord4 ,^? :i* g to ! volunt>y muscles cause !m to contract1 & are "u ! control ( ! w4 ,if ! cells are diseas$1 if !y d n get en\gh art]ial blood1 or are poison$ by c>bonic acid1 or if ! n]ves are diseas$1 injur$1 or cut1 s t n]ve impulses _c be s5t f ! bra9 to ! muscles1 we h p>alysis ( a muscle or a gr\p ( muscles1 accord+ to ! ext5t ( ! injury4 ,n[ we c appreciate ! =ce ( ?is tea*+ 9 ! physiology ( ! muscul> sy/em1 t p>alysis is a loss ( p[]1 ei!r p>tial or complete1 to contract muscles1 due to disease ( ! n]ves4 ,by ! ready action ( our m9d1 ! quick work+ ( our w1 we direct & control ! action ( our muscles1 s z to p]=m ) ! utmo/ skill & ease ! v>i$ & innum]able movem5ts ( our body4 ,x seems v easy to d ?is1 b wat* a *ild le>n+ to walk2 x is educat+ its m9d & w to control ! muscles1 & x is a sl[ & difficult education4 ,b all motor impulses & bodily activities are n "u ! control ( ! w4 ,! he>t is suppli$ ) motor n]ves1 b we _c by our w /op its beat+ or control its action4 ,! tak+ ( food makes a m5tal impression1 & )\t ! w be+ involv$1 impulses are s5t to ! gl&s ( ! m\?1 sett+ !m actively at "w1 & saliva fl[s4 ,s ! /oma* beg9s to *urn food :5 x is introduc$1 & ! liv] is kept at "w mak+ bile & sug>1 & we brea! :5 we are asleep4 ,all ! organs ( ! body are suppli$ ) motor n]ves1 t regulate _! action & give !m ! p[] to d _! function or "w1 b ) ! exception ( ! muscles1 ?is p[] is s5t )\t ! action ( ! w4 ,our bra9s are v busy4 ,:ile we are awake we are con/antly receiv+ s5sations1 we are ?9k+1 rememb]+1 will+1 & s5d+ _m messages e m9ute1 & direct+ p[] to all p>ts ( ! body4 ,! bra9 works & gets tir$1 j z ! re/ ( ! body gets tir$1 &1 if abus$1 injur$1 or ov]work$1 may become diseas$ z may any "p4 ,its tissues we> out1 are burn$ up1 & require ! same supply ( mat]ial to repair !m t any o!r "p ( ! body requires4 ,x ne$s !n re/1 good food1 good blood1 & pl5ty ( oxyg54 ,no wond] "s bra9s give out1 & fail to d _! "w prop]ly1 & s cause insanity4 ,,*apt] ,,ii4 ,,! ,,m9d ,,& ,,"s ,,( ,,its ,,faculties4 ,we "k !re is some?+ we call m9d1 because we "k some?+ ( its way ( work+1 or its faculties4 ,:at m9d is we d n "k1 b we "k x is n matt]1 because matt] is some?+ t occupies space1 & has qualities t d n belong to m9d4 ,we say ( m9d1 x reasons1 rememb]s1 or wills2 ( matt]1 t x is h>d or s(t1 or cold or ela/ic1 or t x has color2 speak+ always ( ! faculties ( m9d or :at x does1 & ( ! qualities ( matt]1 or :at x is4 ,we d n "k :at matt] is1 only h[ x appe>s to u2 we "k x is n m9d because m9d is some?+ spiritual1 & possess$ ( faculties or p[]s t d n belong to matt]4 ,m9d & ,matt] are ! only =ms ( exi/5ce ( :i* we h any k4 ,we speak ( matt] z inorganic--t is1 )\t life1 z iron1 wat]1 oxyg52 & z organic1 or matt] plus some?+ we call life4 ,life appe>s 9 two =ms1 namely1 vegetable & animal4 ,! l[e/ =ms ( animal life h no n]v\s sy/em1 b z we asc5d 9 ! scale ! n]v\s sy/em appe>s1 & becomes m & m complete4 ,man possesses ! mo/ p]fect n]v\s sy/em1 has ! mo/ p]fect bra91 & also an intellig5ce f> above t ( any o!r animal1 & is end[$ ) "s m5tal faculties t belong to him alone4 ,! bra9 may be said to be ! organ ( ! m9d1 b we d n "k :at is ! true relation betwe5 !m2 t is1 h[ ! bra9 is act$ ^u by ! m9d1 or h[ ! action ( ! m9d affects ! bra94 ,bra9 is matt]1 & v solid matt] z well1 m9d is immat]ial1 or spiritual1 & ! exact connection betwe5 some?+ mat]ial & some?+ spiritual has nev] be5 made out & nev] w be4 ,"s say ! bra9 makes m9d a good deal z liv] makes bile1 or ! gl&s ( ! m\? make saliva1 or ! cells ( ! bra9 make motor impulses1 & if ! bra9 does n act !re is no m9d made2 s mu* cell action1 s mu* memory1 reason1 or w produc$4 ,b h[1 x is imm$iately ask$1 is some?+ mat]ial to make some?+ immat]ial8 ,o!rs say t m9d is some?+1 & has an exi/5ce ( its own1 &1 ?\gh spiritual1 acts ^u its organ1 ! bra91 & by s do+1 we are consci\s t we see1 reason1 rememb]1 & w4 ,b h[1 x is imm$iately ask$1 does some?+ immat]ial act ^u some?+ mat]ial8 ,we d n "k1 & we probably nev] %all "k4 ,?is intimate connection betwe5 m9d & matt] exi/s dur+ life only2 x beg9s ) life & ends ) life4 ,we mu/ !n come back to ! />t+-po9t--!re are two =ms ( exi/5ce1 m9d & matt]4 ,we d n "k :at ei!r really is1 b only ! faculties or work+ ( our m9ds1 & ! qualities or appe>ance ( matt]4 ,m9d ?9ks or rememb]s1 reasons or wills1 b ^! are faculties ( ! m9d2 x is :at ! m9d does1 n m9d itself4 ,gold is yell[1 b yell[ is n gold2 gold is h>d1 b h>dness is n gold2 ^! are qualities ( gold1 & n gold itself4 ,9 ! /udy ( physiology y f\nd ! body divid$ into _m p>ts1 & t ^! p>ts _h ea* a sep>ate function or duty to p]=m4 ,9 ! /udy ( ! m9d1 we f9d x has _m diff]5t faculties or ways ( work+4 ,we did n /udy all ! functions ( ! body1 s we w n /udy all ! faculties ( ! m9d4 ,! m9d is v complicat$ 9 its action1 & difficult to und]/&4 ,m5 /udy x all _! lives & are n agre$ ab\t "s ( its simple manife/ations1 & argue & ev5 cont5d ab\t _! diff]5ces4 ,!re are1 h[ev]1 "s seem+ly natural divisions ( ! faculties ( ! m9d1 & a k ( ^! is suffici5t = our purposes4 ,we may say ( ! m9d t x possesses3 a4 ,intellectual faculties4 b4 ,w4 c4 ,emotions or feel+s4 d4 ,in/9cts4 e4 ,moral faculties or consci5ce4 ,! fir/ ?ree are commonly giv5 z divisions ( ! m9d2 ! la/ two are includ$ = conv5i5ce ( tea*+4 ,! ,intellectual ,faculties include ^? p[]s :i* 9 common language are call$ m9d4 ,a few only w be consid]$--namely1 ! p]ceptive faculty1 consci\sness1 memory1 & reason4 ,! ,p]ceptive ,faculty is ! p[] ( ! m9d to p]ceive or "k ! s5sations br\ght to ! bra9 by ! s5sory n]ves1 f ! organs ( s5se1 & ! action ( ?is faculty gives u a k ( ! exi/5ce & qualities ( matt]4 ,consci\sness is t faculty by :i* we "k we p]ceive1 reason1 rememb]1 w1 or possess emotions4 ,by its op]ation we "k t we exi/1 h a m9d1 & :at t m9d does4 ,memory is t faculty by :i* we are able to recall to consci\sness ! k we possess ( pa/ ev5ts4 ,reason is t faculty by :i* we are able to make use ( :at we "k & to acquire new k4 ,= in/ance1 ,i "k ! di/ance betwe5 two places is sixty miles1 & ,i "k t ! c>s1 go+ betwe5 ! places1 travel at ! rate ( tw5ty miles an h\r1 & t !y leave at f\r o'clock4 ,)\t reason1 ,i c\ld nev] ( myself1 "k ! two new facts1 t x w\ld require ?ree h\rs to make ! j\rney1 & t ! arrival w be at sev5 o'clock4 ,! faculty ( reason is "o ( ! mo/ di/9ctive ( ! human m9d4 ,! ,w4--,9 consequ5ce ( our p]ceptions1 our consci\sness1 our memory1 our reason1 we are 9 a condition to "k a good deal ( :at is ab\t u1 & ( ourselves1 & we desire to br+ ourselves into relation ) ! outside _w1 & !re=e we act4 ,!re is a faculty ( m9d t all[s u to *oose h[ to act1 & ?is is call$ ! w1 or t faculty ( ! m9d by :i* we are capable ( *oos+4 ,by ! action ( ! w1 we direct & control ! volunt>y muscles & motions ( ! body1 :ile ! action ( ! m9d is also l>gely "u its control4 ,x may truly be said t unless we are "u ! compulsion ( "s physical =ce1 we always *oose to d :atev] we mo/ wi% to d4 ,?is lib]ty ( *oos+ is call$ fre$om ( ! w1 & because we are free to *oose1 we are responsible = ! consequ5ces ( our *oice4 ,we say1 9 common language1 a p]son is responsible = :at he does1 & bo? human & div9e law holds ea* to a /rict acc\ntability = 8 conduct1 because all are free to *oose h[ !y w conduct !mselves4 ,! ,emotions or ,feel+s4--,! emotions are joy1 love1 grief1 hatr$1 ang]1 jeal\sy1 & o!r l conditions1 & we speak ( !m z natural1 because !y appe> )\t ! op]ation ( our intellect or w1 & ! capacity = !m seems to be a "p ( our exi/5ce4 ,!y %\ld1 h[ev]1 be "u ! control ( reason & w1 & a p]son :o gives way to 8 feel+s1 z ( jeal\sy1 & murd]s1 is held responsible by human & div9e law4 ,b ?\gh we control !m1 we _c prev5t _! action1 & we mu/1 z long z we live1 feel love & joy1 be affect$ by grief1 suff] f ang]1 or be jeal\s4 ,in/9cts4--,^! belong l>gely to our animal nature2 our appetites & desires are in/9cts1 & we speak ( !m z natural4 ,*ildr5 want food & dr9k be=e !y "k :at x is !y want1 & birds 9 ! ne/1 op5 _! little m\?s = ! worm _! "m br+s !m4 ,appetites indulg$ 9 become /rong1 & are (t5 uncontroll$ by ! reason & w2 z ! indulg$ appetite = liquor4 ,a /rong & heal?y m9d %\ld control ! appetites1 z we h le>n$ x %\ld control ! emotions1 & we are ju/ly held responsible = ! consequ5ces ( an indulg$ appetite4 ,moral ,faculties4--,!re exi/s 9 ! m9d ( man a k ( "r & wrong1 & a feel+ ( obligation to respect ! rights ( o!rs4 ,we c h>dly conceive ( a man 9 8 "r m9d :o does n "k x is wrong to lie1 or /eal1 or murd]4 ,! capacity to "k "r f wrong is call$ consci5ce4 ,mo/ p1 p]haps all1 h a feel+ ( relation & obligation to a high] moral be+ ?an man4 ,! feel+ to d "r because x is pleas+ to a ,god to :om we are directly responsible1 is ! f\ndation ( our religi\s convictions4 ,! m9d is a mo/ complex affair1 x is always active1 nor is "o faculty at "w & ! re/ idle1 b _m p>ts are at "w at ! same "t1 & act & react ^u ea* o!r4 ,we may ex]cise our p]ceptive faculty1 or reason1 memory1 & w1 & be affect$ by our feel+s at ! same "t4 ,!re is ) x all a regulat+ p[] t coord9ates or br+s ^! diff]5t actions into h>mony1 & we get ! work+ ( a heal?y m9d4 ,,*apt] ,,iii4 ,,insanity2 ,,or1 ,,disease ,,( ,,! ,,m9d4 ,9 common language we speak ( ! m9d diseas$4 ,?is is n /rictly true1 z x is ! bra9 t is diseas$ &1 9 consequ5ce1 we get di/urb$ m5tal action4 ,e p]son has individual *>act]i/ics4 ,z no two faces are alike1 s ! m9d1 "*1 & mann] ( no two are alike1 & x is by ! manife/ation ( ^!1 t ea* is kn[n4 ,:5 a p]son becomes insane !re is always a *ange f 8 natural way ( ?9k+1 feel+1 & act+1 due to disease ( ! bra94 ,sometimes ! *ange is slight1 or conceal$ by ! pati5t1 & is app>5t only to ne> fri5ds1 or aft] a c>eful exam9ation4 ,sometimes x is s great z to attract imm$iate att5tion1 :5 x may pres5t ! features ( rav+ madness1 or ( ! mo/ abject melan*oly4 ,to illu/rate ?is *ange1 we may suppose bo? a k+ & a paup] to become insane3 !re is1 ( c\rse1 a va/ diff]5ce betwe5 !m1 b ! k+ may be s *ang$ by ! disease z to believe t he is a paup]1 & himself & 8 family />v+1 & he may also wi% & ev5 try to "w & dig l a labor] to support !m2 or a paup] may ?9k himself a k+1 & try to act l "o4 ,su* conditions %[ a m>k$ *ange 9 ! mann] ( ?9k+1 feel+1 & act+1 :i* involves diseas$ action ( ! intellect1 ! emotions1 & ! w4 ,sometimes ! appetites are also *ang$1 or control ov] !m is lo/1 & sometimes ! moral nature is affect$ z well1 sometimes a s+le faculty ( ! m9d appe>s m di/urb$ ?an d o!rs2 x is1 h[ev]1 d\btful1 or at lea/ d5i$1 t "o faculty c %[ su* di/urb$ m5tal action z to indicate insanity1 & ! re/ ( ! m9d appe> p]fectly heal?y & normal4 ,) ! *anges t h be5 spok5 (1 !re is g5]ally di/urbances ( ! physical heal?1 & (t5 ( a m>k$ "*4 ,x mu/ be rememb]$ t m]e oddity ( appe>ance or ecc5tricity ( conduct1 h[ev] m>k$1 if natural1 d n ( !mselves con/itute signs ( insanity4 ,"s ,m5tal ,symptoms ( ,insanity4--,!re are "s important m5tal symptoms :i* q g5]ally accompany insanity1 & are f\nd ei!r alone or comb9$ 9 ! individual case4 ,^! are3 a4 ,delusions4 b4 ,halluc9ations4 c4 ,illusions4 d4 ,incoh]5ce ( spee*4 ,delusions are false beliefs4 ,we ?9k a belief 9 ! religion ( ,mahomet is a delusion1 b n an insane "o4 ,insane delusions arise f disease ( ! bra91 & are a "p ( ^? m5tal *anges t appe> dur+ its progress4 ,! k+1 :o1 "u ! influ5ce ( disease1 ?9ks himself a paup] & t he & 8 family are />v+1 & ! paup]1 :o ?9ks himself a k+1 ) all ! weal? & p[] ( "o1 h ea* insane delusions4 ,"s delusions are fleet+ & *angeable1 la/+ a few days1 weeks1 or mon?s1 :ile o!rs are fix$1 la/+ a lifetime2 "s are impossible & beyond rational belief1 z :5 a man ?9ks himself ,que5 ,victoria1 or t 8 head is made ( brass1 or t he is dead1 & yet sleeps & eats & talks2 o!r delusions are possible1 z :5 a k+ ?9ks himself a paup]1 because su* a ?+ may & ev5 has happ5$1 or :5 a paup] ?9ks himself a k+1 because p ( v l[ degree h ris5 to su* a /ation1 b !y are v improbable1 & we d n expect su* ?+s among ,am]icans1 mu* less among our pati5ts4 ,o!r delusions are n only possible1 b relate to ?+s t may or d happ51 or are )9 ! b\nds ( a rational belief1 z t ( a p]son :o insi/s he has a canc]1 or t he has committ$ ! unp>donable s91 or t pov]ty is imp5d+ & ! poorh\se n f> (f2 or t ( a woman t %e has be5 violat$1 or t1 :5 h] *ild 0 sick %e s neglect$ x1 t x di$4 ,su* beliefs z ^! are delusions1 :5 !y h no o!r reason = _! exi/5ce ?an t !y are caus$ by disease4 ,"s delusions are call$ homicidal1 suicidal1 or dang]\s1 because !y cause a pati5t to d1 or want to d1 acts t are dang]\s to himself or o!rs1 or prop]ty4 ,halluc9ations4--,:5 a pati5t has halluc9ations1 he ?9ks he sees1 he>s1 smells1 ta/es1 or feels some?+1 :5 !re is really no?+ to cause ! s5sations or ideas except diseas$ action ( ! bra92 no?+ be+ s5t to ! bra9 f any special organ ( s5se1 he really sees1 he>s1 smells1 ta/es1 or feels no?+1 x is all imag9ation1 ?\gh seem+ly v real4 ,= in/ance1 a p]son ?9ks he he>s a voice1 p]haps t ( ,god1 or ( "s "o :o is dead1 or ( an abs5t fri5d1 or ?9ks he sees ^! p]sons1 :5 !re is no?+ ext]nal to ! bra9 to excite ! s5sation or give ! idea4 ,illusions4--,:5 illusions are pres5t1 ! m9d fails to p]ceive correctly :at ! eye sees1 or ! e> he>s1 or ! impressions t are br\ght to ! bra9 f any ( ! organs ( s5se4 ,= in/ance1 a p]son looks at a r[ ( trees1 & !y appe> to him to be a r[ ( soldi]s2 or ! :i/le ( a locomotive may be s *ang$ z to seem to be ! voice ( ,god2 or ! odor ( a rose1 burn+ sulphur2 food may ta/e l poison1 or ! h& ( a fri5d feel l a piece ( ice or a r$-hot iron1 & is s believ$ to be4 ,^! are deceptions ( ! s5ses4 ,9 insanity1 ! tru? & exi/5ce ( delusions1 halluc9ations1 & illusions are fully believ$ 91 & ! pati5t _c be argu$ out ( ! belief1 h[ev] absurd or unreal x may be4 ,incoh]5ce ( ,spee*4--,:5 a p]son is incoh]5t1 he rambles 9 talk2 !re is little connection betwe5 diff]5t s5t5ces1 or ! s5t5ce itself is mean+less1 be+ a m]e jumble ( words2 sometimes ideas come too rapidly into ! m9d1 & "s new subject is begun & talk$ ab\t be=e ! fir/ is f9i%$2 sometimes ! m9d is sl[1 & memory =gets :at is be+ talk$ ab\t4 ,g5]al ,/ates ( ,insanity4--,!re are a few g5]al m5tal /ates 9 insanity1 "o ( :i* be+ pres5t gives ! "* & "n to ! disease4 ,^! are3 a4 ,a /ate ( exaltation ( m9d1 or mania4 b4 ,a /ate ( depression ( m9d1 or melan*olia4 c4 ,a /ate ( enfeeblem5t ( m9d1 or dem5tia4 ,b "o ( ^! fir/ two /ates ( feel+ c be pres5t at ! same "t1 = a p]son _c at any "o mom5t be bo? exalt$ & depress$1 ?\gh he h mania to day1 & aft]w>d be s *ang$ 9 8 feel+ z to h melan*olia to-morr[1 or next week1 or next mon?4 ,9 a g5]al way all disease is divid$ into acute & *ronic =ms4 ,an acute disease is "o ( rec5t orig91 & f :i* recov]y is to be hop$ =2 a *ronic disease is prolong$ & does n t5d to recov]y2 an acute disease may become *ronic4 ,mania & melan*olia are at fir/ consid]$ acute & curable1 b1 if recov]y does n take place1 !y pass into ei!r *ronic mania or *ronic melan*olia1 or1 if ! m9d is mu* enfeebl$1 into a condition ( dem5tia4 ,mania4--,9 mania ! m9d is g5]ally v active1 ?\gh lack+ 9 control1 & is irregul> & illogical 9 its action2 ! pati5t talks rapidly1 & ^u _m subjects1 & is (t5 incoh]5t1 or he laughs1 s+s1 dances1 or cries1 p]haps 9 turn2 he is (t5 irritable & unreasonable1 & p]haps ?reat5+1 & becomes m viol5t if int]f]$ )4 ,accompany+ ?is m5tal excitem5t !re is frequ5tly p]si/5t loss ( sleep1 con/ant re/lessness1 & great bodily activity1 & indiff]5ce to or refusal ( food4 ,sometimes ! bra9 excitem5t is s great t all self-control is lo/1 & ! pati5t becomes a rav+ maniac4 ,! delusions ( mania are l>gely ( gr&eur & self-exaltation2 ! pati5t ?9ks himself 9 ! be/ ( heal?1 & v /rong1 or ( a sup]ior m9d1 or1 t he is a great s+]1 poet1 actor1 or prea*]2 p]haps1 tak+ a high] flight1 he ?9ks himself possess$ ( ! weal? ( ,v&]bilt1 or t he is ! ,pope1 or ! ,presid5t1 or ev5 ,god himself4 ,sometimes ! excitem5t comes on 9 p>oxysms1 la/+ a few days or weeks1 ) p]iods1 m or less prolong$1 ( comp>ative m5tal quiet4 ,melan*olia4--,9 melan*olia ! expression ( ! face (t5 tells ! "* ( ! disease2 ! eyes are d[nca/1 ! l9es ( ! face are l5g!n$1 & ! :ole appe>ance is t ( unhapp9ess4 ,9 ?is =m ( insanity ! pati5t may refuse to speak or int]e/ himself 9 any ?+1 or he may moan1 groan & cry1 & walk back & =? wr++ 8 h&s2 :5 he is quiet1 ! m9d1 h[ev]1 may be v active & full ( delusions1 :i* occupy x to ! exclusion ( e ?+1 driv+ away sleep1 & mak+ him indiff]5t to ! tak+ ( food or att5d+ to 8 mo/ necess>y wants2 sometimes ! pati5t talks a great deal1 b always ab\t 8 delusions1 :i* are g5]ally connect$ ) himself1 8 family1 or 8 affairs4 ,melan*oliacs are (t5 tortur$ by fe>s1 &1 !re=e1 become fr5zi$ & z wild & viol5t z 9 mania2 or !y may be v suspici\s1 ?9k+ t "s "o is p]secut+ !m1 or poison+ _! food1 or foll[+ to kill !m4 ,on acc\nt ( _! delusions !y frequ5tly refuse food1 !y g5]ally sleep poorly1 & are (t5 v suicidal4 ,dem5tia4--,?is =m ( insanity is mo/ frequ5tly ! result ( acute mania or melan*olia1 & comes aft] ! =ce & int5sity ( ! disease has sp5t itself1 leav+ ! m9d crippl$ & weak5$4 ,! p]ceptions are blunt$ & di/ort$1 memory fails1 ! reason+ p[]s are weak5$1 ! w has ceas$ to control1 ! emotions & appetites are dormant or *ang$1 & ! m9d may become almo/ a blank1 ?\gh 9 ! n>r[ circle ( ?\ght !re is left rema9s ( delusions1 illusions1 & halluc9ations4 ,! pati5t is frequ5tly c>eless ( ! ord9>y necessities & dec5cies ( life1 & requires con/ant c>e4 ,!re are degrees ( dem5tia3 x may be slight1 p>tial1 or ne>ly complete4 ,dur+ ! fir/ few mon?s or ye>s dem5tia (t5 ends 9 recov]y1 b1 z x cont9ues1 ! case becomes m & m hopeless4 ,monomania4--,?is is a t]m belong+ to common spee*1 b !re is n an agreem5t ( op9ion z to ! exi/5ce ( su* a special =m ( insanity1 nor among ^? :o believe 9 x1 z to :at x is & :at are its symptoms4 ,monomania really means an insanity ) b "o1 or1 at mo/1 a small class ( delusions ( ! same "*1 ! re/ ( ! m9d %[+ no disease4 ,h>dly any "o believes 9 ! exi/5ce ( su* a n>r[ limit to insanity1 &1 gett+ beyond ?is po9t1 !re is no agreem5t :]e ! limit %\ld be set up to m>k & b\nd x4 ,"s ?9k !re is a special insanity ( ! emotions only1 & call x emotional insanity4 ,!re is n an agreem5t ( op9ion z to :at emotional insanity is2 ! idea seems to be t ! emotions1 or "o ( !m1 s ov]p[] reason & w z to make ! p]son irresponsible4 ,?is condition is suppos$ to exi/ )\t di/urbances ( ! intellectual faculties1 & to be unaccompani$ by delusions1 halluc9ations1 or illusions4 ,o!rs see 9 ^! cases no evid5ce ( insanity2 no?+ b ov]-indulg5ce ( ! emotions1 or a want ( ex]cise ( self-control1 or an excuse = crime4 ,"s p]sons believe t ! appetites ov]-indulg$ become morbid & produce disease ( ! n]v\s sy/em1 & z a consequ5ce ! reason & w are weak5$ 9 relation to ?is indulg$ appetite1 & ! op9ion is rea*$ t x is a =m ( insanity4 ,an indulg$ appetite = dr9k is call$ dipsomania4 ,o!rs believe t unless !re are pres5t ! usual symptoms1 associat$ z !y g5]ally appe> 9 insanity1 ^! cases are no?+ b unbridl$ appetites or vices4 ,moral ,insanity4--,!re are ^? :o claim t ! moral nature alone may be diseas$1 & ! p]sons 9 :om ?is occurs are said to lose ! appreciation ( "r & wrong1 or h an uncontrollable prop5sity to d "s wrong act1 & take a peculi> pleasure 9 s do+4 ,special names are giv5 to ^! acts1 accord+ to _! "*1 z kleptomania1 an impulse t prompts to /eal2 or pyromania1 love ( sett+ ?+s on fire2 or homicidal mania1 an int5se desire to kill4 ,o!r p]sons consid]+ ^! cases & f9d+ no delusions1 or intellectual di/urbances1 or *ange 9 feel+1 ?9k+1 or act+ due to disease1 call ! condition "o ( crime only4 ,^! are difficult matt]s to und]/&1 & ^? :o make a life-/udy ( insanity d n fully und]/& !m1 or agree toge!r z to :at !y "k4 ,!y are1 h[ev]1 t]ms ( common spee*1 & x is well to h "s idea ( !m1 z x w add int]e/ to ! /udy ( ! pati5ts "u c>e & *>ge4 ,,*apt] ,,iv4 ,,! ,,duties ,,( ,,an ,,att5dant4 ,:at an ,att5dant ,%\ld ,fir/ ,le>n4--,! duties ( an att5dant ^u ! insane are v>i$1 ardu\s1 & exact+2 !y are associat$ ) irritations1 p]plexities1 & anxieties1 br+ grave responsibilities1 & call = ! ex]cise ( tact1 judgm5t1 & self-control4 ,^! _m duties are n quickly nor easily le>n$1 & ! new att5dant mu/ be will+ to fill1 at fir/1 a m9or position1 to beg9 at ! beg9n+ & le>n gradually all ! details ( w>d "w2 he mu/ acquire habits ( caution & wat*fulness1 & le>n 9 a g5]al way ! c>e ( ! insane1 be=e he c assume a position ( au?ority ov] o!r att5dants1 ! control ( a w>d1 & ! responsibility ( ! direct c>e ( pati5ts4 ,?is la/ duty is ! mo/ difficult ( all1 because x br+s ! att5dant into intimate relations ) a class ( p]sons1 ^: true appreciation ( !mselves1 ( _! conditions & surr\nd+s1 is *ang$1 ^: ?\ghts & desires are unreasonable1 ^: conduct is unnatural1 & :o are l>gely controll$ by insane delusions1 halluc9ations1 & illusions4 ,x requires an intimate association ) ! insane1 & a c>eful /udy ( _! mann] ( ?\ght & conduct1 to be able to successfully guide1 direct1 & control !m4 ,! ,relation ( ,att5dants to ,pati5ts4--,! position ( att5dants is (t5 a try+ "o2 !y are liable to misrepres5tation :5 !y h fai?fully done _! duty2 !y mu/ le>n to receive ) calmness a bl[ or an insult1 or ev5 s great an indignity z be+ spit ^u2 !y mu/ be> ) provocations t come day aft] day1 & are seem+ly z malici\s z !y are +5i\s & design+2 !y mu/ wat* ov] ! suicidal ) tireless vigilance1 control ! viol5t1 & keep ! unclean clean4 ,to d all ?is requires ! ex]cise ( self-control & k9dness2 ! putt+ a curb ^u ! temp]2 ! education ( judgm5t & tact2 fai?fulness 9 ! p]=mance ( duty1 & a k ( :at to d & :at to avoid4 ,^! trials are1 h[ev]1 b a "p ( ! exp]i5ce ( an att5dant 9 c>+ = ! insane1 = !re is associat$ 9 ?is c>e mu* t is satisfactory & pleasurable4 ,x is a satisfaction to "k t duty has be5 well done2 to be able to c>e = ! sick2 to d some?+ to alleviate suff]+2 to t5d]ly wat* ov] & soo! ! dy+2 x is a pleasure to see a pati5t improv+1 go+ on to recov]y1 & f9ally able to return home cur$4 ,_m delightful fri5d%ips are =m$ betwe5 att5dants & pati5ts1 "s la/+ = ye>s )9 ! asylum1 & "s = a lifetime1 ) ^? :o h recov]$4 ,mo/ ( ! insane appreciate ! s]vices r5d]$ !m1 & h a feel+ ( gratitude = ^? :o c>e = !m4 ,att5dants %\ld always treat pati5ts ) polit5ess & respect2 x is some?+ t is nev] ?r[n away1 & ex]ts a good influ5ce1 h[ev] rude & disrespectful a pati5t may behave4 ,pati5ts %\ld n be ridicul$1 _! m5tal weakness & peculi>ities made light (1 nor %\ld !y be made a %[ to inquisitive visitors4 ,x is useless = att5dants to try to argue pati5ts out ( a belief 9 _! delusions1 & to d s (t5 results 9 fix+ !m m firmly 9 ! m9d4 ,we %\ld n h[ev] pret5d to believe !m1 nor humor _! belief1 nor all[ !m to c>ry out _! delusions 9 _! dress1 conduct1 & g5]al behavior4 ,! ,"* ( an ,att5dant4--,! insane %\ld always be treat$ ) k9dness1 & n[h]e is ! gold5 rule ?\ %alt love ?y neighbor z ?yself m necess>y ( application ?an 9 c>+ = !m2 & x is well = att5dants1 :5 tempt$1 to /op & ?9k h[1 "u l circum/ances1 !y w\ld want _! "m or si/] or bro!r treat$4 ,keep+ ?is noble tea*+ & ?is high motive = "r-do+ ev] 9 m9d1 an att5dant _c g f> a/ray4 ,x is a developm5t ( "* to c>e = ! insane1 & in/ead ( be+ brutaliz+1 z "s ignorant p say1 x is elevat+ & humaniz+4 ,att5dants %\ld nev] gossip1 ei!r among or ab\t !mselves1 or ( _! pati5ts4 ,x is a mean & degrad+ habit to indulge 92 x w und]m9e a good "*1 & (t5 become ov]p[]+ & malici\s4 ,on ! o!r h&1 nev] be afraid to speak ! tru?1 & nev] let a lie1 or ! semblance ( a lie1 pass y\r lips1 or rema9 = a mom5t 9 y\r he>t4 ,( all ?+s be tru?ful4 ,att5dants mu/ acquire a _s ( will+ ob$i5ce1 ( *e]ful execution ( all comm&s & directions1 & ( fai?ful p]=mance ( e duty t devolves ^u !m4 ,unless !y h ?is _s1 !y w be unable to successfully assume positions :]e ob$i5ce is to be exact$ f o!rs4 ,!y %\ld pres]ve _! own self-respect2 9 all ?+s set a good example2 be neat & tidy 9 _! dress1 g5tlemanly or ladylike 9 _! conduct2 consid]ate ( ! wants & feel+s ( o!r att5dants2 !y %\ld *]i% a high s5se ( moral obligation2 cultivate an humble1 self-d5y+ _s2 seek to be useful2 & ma9ta9 at all haz>ds _! purity1 tru?fulness1 economy1 fai?fulness1 & hone/y 7,utica ,asylum ,rules & ,regulations74 ,9 _! relation to ! in/itution1 att5dants %\ld fulfil all _! engagem5ts ) ! same s5se ( "r1 t !y expect w be obs]v$ t[>ds !m by ^? :o employ !m4 ,x is a bus9ess contract t is assum$1 & br+s ) x mutual legal responsibilities1 rights1 & obligations4 ,att5dants %\ld /rive to s conduct !mselves1 t :5 !y leave _! employm5t !y c g away ) ! respect ( e "o1 & be> ) !m ! reputation ( a good "* & ( "w well done4 ,h[ & ,:at to ,obs]ve 9 ! ,c>e ( ,pati5ts4--,x is important t att5dants %\ld e>ly le>n habits ( close obs]vation4 ,! ex]cise ( ! habit increases ! ability to obs]ve1 & "o soon comes to see & "k ?+s he nev] saw1 or ?\ght ( be=e4 ,x is necess>y to le>n fir/ ! physical condition1 m5tal symptoms1 & habits ( a pati5t1 be=e we are able to obs]ve & appreciate any *ange4 ,obs]vation1 to be ( value1 %\ld be sy/ematically made1 & only "o ?+ at a "t c be notic$1 :i* mu/ be und]/ood be=e pass+ to ano!r1 o!rwise e ?+ is confus$4 ,! condition & appe>ance ( a s+le "p %\ld be look$ at to see :at is natural1 & :at is evid5ce ( disease4 ,9 practice1 writt5 notes tak5 at ! "t1 are extremely valuable 9 tea*+ close & accurate obs]vation1 & cultivat+ an ability to cle>ly express to o!rs ! result4 ,= ! purpose ( sugge/ion & guidance1 ! foll[+ sy/em = obs]vation is giv53 ,obs]ve ! effect ( m$ic9e4 ,! face4--,obs]ve if x is pale1 & if ! pallor is sudd51 tempor>y or p]man5t2 if flu%$1 if conge/$1 if blue ) v5\s blood1 if !re are any eruptions1 bruises1 or sc>s4 ,obs]ve ! expression ( ! face4 ,! tongue4--,obs]ve if x is coat$1 & if s1 if :ite1 br[n1 r$1 black1 glaz$1 dry1 or crack$2 if x is tremul\s1 or drawn to "o side1 or protrud$ ) difficulty4 ,! lips4--,obs]ve if pale1 blue1 dry & crack$1 if !re is tremul\sness ab\t ! corn]s ( ! m\?2 ! tee?1 if cov]$ ) sordes2 ! gums1 if ble$+4 ,! brea?4--,obs]ve if sweet1 s\r1 f\l1 or (f5sive4 ,! respiration4--,obs]ve if sl[ or fa/1 quiet & natural1 or l\d1 labor$1 & difficult1 if puff+1 :eez+1 %all[1 or irregul>4 ,! eyes4--,obs]ve if conge/$1 ! color1 if any bl9dness2 ! pupils1 if contract$1 dilat$1 irregul>1 unequal1 or if !y respond readily to light4 ,if !re is c\gh1 obs]ve if moi/ or dry1 if cr\py1 if ) pa91 or if prolong$4 ,if any expectoration1 obs]ve if x is bloody or /reak$ ) blood1 if ?9 & fro?y1 ?ick & purul5t1 or if x /icks to ! cup4 ,! pulse4--,obs]ve if x is sl[ or rapid1 full1 weak & ?91 if irregul> or int]mitt+4 ,c\nt x4 ,! temp]ature4--,obs]ve by ! h& or !rmomet]4 ,! body4--,obs]ve = eruptions ( ! sk91 = sores1 bruises1 or de=mities1 or if !re is any p>alysis4 ,! appetite4--,obs]ve if x is poor1 *angeable1 if food is reli%$ or dislik$2 if refus$1 if x is con/antly or occasionally1 & if f delusions or indiff]5ce2 if !re is ov]eat+ & gluttony1 if food is bolt$1 or *ew$1 or if ! pati5t has tee? to eat )4 ,! dige/ion4--,obs]ve if natural1 or pa9ful1 & if s1 :e!r ^u tak+ food1 or if ! pa9 is delay$2 if gas is dis*>g$ f ! m\?1 if ! /oma* is s\r1 if ! food is heavy & di/ress+2 also obs]ve :at k9ds ( food give dyspepsia1 & :at seem to be well borne4 ,( vomit+4--,obs]ve if occasional or con/ant1 if imm$iately aft] food1 or delay$1 if s\r or bitt]1 if prec$$ by pa9 or nausea1 if x conta9s any undige/$ food4 ,( di>rhoea4--,obs]ve h[ frequ5t ! dis*>ges1 if ) pa91 & :]e x is situat$1 ! color1 ! consi/5cy1 if !re is any blood or mucus1 if x alt]nates ) con/ipation4 ,( con/ipation4--,obs]ve if alt]nat+ ) di>rhoea1 if habitual1 ! effect ( m$ic9e & food2 if !re are any piles4 ,! m5ses4--,! quantity1 if !re is any pa91 its cessation & reappe>ance1 if any effect ^u ! m5tal condition4 ,( pa94--,obs]ve ! "* & sev]ity1 its location1 & any evid5ce ( a cause4 ,( dropsy4--,obs]ve if x is g5]al or local1 if 9 ! *e/1 face1 abdom51 arms1 or legs2 if !re are any v>icose ve9s4 ,( sleep4--,obs]ve ! l5g? ( "t1 if quiet & natural1 if re/less1 if deep or light1 if !re is great dr[s9ess or cont9u$ wakefulness1 & ! effects ( m$ic9e4 ,( unconsci\sness4--,obs]ve if x comes on sl[ly or sudd5ly1 if p>tial or complete1 if ! pati5t c be ar\s$4 ,( convulsions4--,obs]ve if slight or sev]e1 if ( %ort or long duration1 if cont9u$ or int]rupt$1 if g5]al or ( "o side1 or ( an arm or a leg1 or ! face1 or ( a few muscles only4 ,( ! m5tal condition4--,obs]ve if fix$ or *angeable1 ! nature ( delusions1 illusions1 or halluc9ations2 dang]\s attempts or ?reats t[>d himself or o!rs2 any *ange 9 ! m5tal /ate4 ,( habits4--,obs]ve if fix$ or *angeable1 h[ =m$ or h[ correct$4 ,( ! g5]al conduct4--,obs]ve ! dress1 if neat & tidy1 or o!rwise1 private habits1 c>e ( p]sonal wants1 improvem5t 9 conduct1 ! influ5ce ( att5dants & o!r pati5ts1 or ! influ5ce ! pati5t himself ex]ts on o!rs4 ,?is by no means includes all t x is necess>y to obs]ve1 b x conta9s mu* t is important1 & ! sy/em1 if /udi$ & us$ practically1 w sugge/ to ! obs]v] :atev] may require att5tion4 ,! ,control & ,influ5ce ( ,att5dants ov] ,pati5ts4--,by a sm>t att5dant is meant "o :o sees little to d beyond hav+ a control ( ! w>d by a rule t is close & exact+1 :o ma9ta9s a /rict discipl9e1 & :o has a love = cleanl9ess1 ord]1 "w1 & scrubb+4 ,b a useful att5dant is "o :o temp]s ^! m5tion$ traits1 by /riv+ to ga9 ! confid5ce ( 8 pati5ts1 by ex]t+ ov] !m a b5eficial influ5ce1 :o is able to br+ ! individual pati5t into accord ) 8 surr\nd+s 9 ! asylum1 s z to help 8 improvem5t or recov]y1 meet 8 wants1 & increase 8 com=t & enjoym5t4 ,9 ord] to d ?is x is necess>y t ! att5dant %\ld give c>eful /udy & att5tion to ea* pati5t4 ,su* a /udy w soon demon/rate to1 & tea* ! att5dant ! fact1 t ! insane are v individual 9 _! habits1 & :ile no two are alike1 !re are resemblances t 9 an asylum are made ! basis ( classification by w>ds3 !re is ! convalesc5t1 ! suicidal1 ! dem5t$1 ! sick & feeble1 & ! noisy or viol5t w>ds4 ,att5dants mu/ fir/ le>n t pati5ts are n to be treat$ m]ely z a w>d full ( p to be kept 9 ord]1 to be clo!d1 f$1 & put to b$1 b t ! peculi>ities ( ea* pati5t are to be /udi$1 & t x is _! duty to "k ?or\ghly ! wants1 & condition ( ea* case1 & h[ be/ to c>e = & control x4 ,! bett] k an att5dant has ( ! individual1 ! bett] he c c>e = a w>d full ( individuals4 ,! p]sons :o are "u our c>e are always to be consid]$ z pati5ts1 & x mu/ be rememb]$ t ^! sick p are s5t away f _! homes & giv5 ov] to u1 ?\gh /rang]s1 because x is suppos$ t we c d bett] by !m ?an _! fri5ds are able to d4 ,_! position is "o ( helplessness & dep5d5ce ^u ^? :o are plac$ 9 *>ge1 & we are prop]ly held responsible by ! fri5ds & ! public1 = a judici\s ex]cise ( ! p[] & influ5ce we possess ov] !m4 ,pati5ts are n rightly influ5c$ by ! m]e ex]cise ( au?ority or by dictation or comm&2 ^! !y fe> & obey1 or res5t & resi/2 b we %\ld always appeal to ! highe/ motives = ob$i5ce & correct conduct1 & we %\ld lead our pati5ts to tru/ & n to fe> u4 ,9 our deal+s ) !m we %\ld be tru?ful1 /raight=w>d1 & /rictly upright1 & ex]cise ov] ourselves pati5ce & self-control4 ,we c g5]ally control our pati5ts by ! ex]cise ( sympa?y1 k9dness1 & tact1 jo9$ ) a reason = :at is requir$1 & :]e m is ne$$1 a firm1 k9d au?ority & comm& w suffice4 ,! use ( au?ority1 re/riction1 & re/ra9t is to be avoid$1 :ile on ! o!r h& pati5ts are to be all[$ all ! lib]ty & fre$om !y c safely enjoy1 & taught to ex]cise all ! self-control !y are capable (4 ,! grant+ ( m fre$om & lib]ty ( action ?an 0 =m]ly accord$ ! insane1 does n imply a *ange 9 ! "* ( ! disease1 b improv$ me?ods ( c>e1 & places m responsibility ^u ! att5dants4 ,! degree ( lib]ty to be all[$ mu/1 9 ea* case1 be decid$ by ! physician1 & ! att5dants %\ld closely obs]ve ! pati5t1 & report any symptoms :i* makes ! enl>g$ fre$om dang]\s to ! pati5t or to o!rs4 ,pati5ts be+ sick1 are s5t to ! asylum t !y may be k9dly & judici\sly c>$ =1 &1 if possible1 cur$4 ,z _m pati5ts :o may nev] fully recov] may s improve z to be able to return to _! homes1 &1 z x is impossible to say t any giv5 pati5t w n recov]1 ea* case des]ves & %\ld receive our be/ c>e & ef=ts to ?is end4 ,because our pati5ts are sick !y mu/ be nurs$1 & nurs+ means t5d] c>e4 ,& x is a nurse's duty to d all 9 8 p[] to alleviate pa9 & promote bodily com=t4 ,! insane are subject to all ! ills t fle% is heir to1 & !re is always among our pati5ts mu* sickness & bodily suff]+4 ,_m pati5ts _c tell :5 !y are sick1 nor :5 !y suff] pa91 b !y %[ sickness & pa91 & (t5 appeal by _! mann] = t c>e & sympa?y1 we all feel 9 ne$ ( at su* times4 ,^! sil5t symptoms %\ld be obs]v$ by ! att5dants1 :o %\ld always see & "k :5 _! pati5ts are sick4 ,"s ( ^! symptoms are1 cry+1 moan+1 weakness1 go+ to b$1 or ly+ d[n1 c\gh1 *anges 9 respiration1 signs ( fev]1 a flu%$ face1 quick pulse1 or *ills1 a pale face1 vomit+1 or di>rhoea1 & loss ( appetite4 ,mu* insanity is associat$ ) great physical di/urbances :i* require c>eful nurs+4 ,! old & feeble1 ! p>alytic & b$ridd5 also require special att5tion & c>e4 ,f ?is x appe>s t ! c>e ( ! insane calls = ! ex]cise ( self-control1 habits ( close obs]vation1 ! us+ ( good judgm5t1 ! putt+ =? ( ennobl+ influ5ces1 & ! t5d] c>e ( ! nurse4 ,,*apt] ,v4 ,,! ,,g5]al ,,c>e ,,( ,,! ,,insane4 ,! ,reception ( ,new ,pati5ts4--,att5dants mu/ at once /udy ! peculi>ities1 ! physical condition1 & ! m5tal symptoms ( a new pati5t1 s z to "k ! case ?or\ghly4 ,new pati5ts %\ld receive special att5tion2 _! fe>s quiet$2 !y %\ld1 if 9 a prop] condition1 be introduc$ to ! o!r pati5ts2 ! effect ( be+ 9 s l>ge & /range a place1 :]e ! doors are lock$ & ! w9d[s gu>d$ %\ld be notic$1 & unpleasant impressions ov]come2 !y mu/ be told !y h come among fri5ds & w be k9dly treat$4 ,! necess>y rules ( ! w>d %\ld be expla9$2 !y %\ld be invit$ to _! meals1 %[n to _! rooms & told at b$time ! night wat* w visit !m1 & !y mu/ be assur$ t no h>m w come to !m4 ,! fir/ impressions a new pati5t receives may be ! la/+ ones1 & influ5ce _! :ole conduct 9 ! asylum4 ,if !y resi/ :at is necess>y to d = !m1 d n /ruggle & cont5d ) !m1 & =ce !m to b$1 or to ! ba?1 b fir/ seek advice f ! sup]visor1 or ! physician4 ,always se>* new pati5ts1 unless o!rwise ord]$1 = money1 jewelry1 weapons1 m$ic9e1 & o!r l articles1 or if 9 d\bt :at to d ask = directions4 ,! head1 body1 & clo?+ %\ld be exam9$ = v]m91 & ! body = injuries & bruises4 ,if :at is wi%$ to be done 9 ?is p>ticul> is expla9$1 pati5ts w g5]ally quietly all[ x4 ,"w1 ,employm5t1 & ,occupation4--,by ?is is meant :atev] occupies ! pati5t's "t & m9d1 9 useful & pleasant ways4 ,( all ?+s idl5ess & loaf+ are ! wor/2 ev5 games1 su* z billi>ds & c>ds1 if indulg$ 9 to ! exclusion ( useful employm5t1 w deg5]ate a pati5t4 ,"s will+ pati5ts are kept 9 a tread-mill ( daily "w1 _! monoton\s life nev] brok5 by a div]sion1 an enjoym5t1 or a hope4 ,x is v que/ionable if x is b5eficial to make a pati5t drudge ?r\gh su* a daily r\t9e4 ,asylum life %\ld be made z home-l1 pleasant1 & natural z possible2 z a rule e pati5t :o is able %\ld d "s useful "w e day1 & to ?is %\ld be add$ ! div]sion1 t comes f amusem5ts & ! enjoym5t ( innoc5t pleasures4 ,occupation !n means a great deal m ?an "w2 x is ! way a pati5t sp5ds 8 "t4 ,unless enc\rag$ & direct$1 pati5ts may occupy !mselves 9 ?9k+ ( _! delusions1 9 noise1 viol5ce1 or de/ructiv5ess1 9 idly walk+ up & d[n ! w>ds1 9 ! indulg5ce ( secret vices1 9 gossip1 9 spread+ discont5t1 9 pray]1 or 9 con/ant ,bible read+4 ,"s pati5ts really "w h>d try+ to d no?+1 & h no m ambition ?an to sit ar\nd on ! w>d1 & *ew tobacco1 & indulge 9 idl5ess4 ,pati5ts %\ld be enc\rag$ to d some?+ = !mselves1 ! wom5 to make & m5d _! own clo!s1 to keep _! rooms 9 good ord]1 & assi/ ab\t ! w>d4 ,!y %\ld be made to feel t !y c add to _! own com=table surr\nd+s by _! own ef=ts4 ,= ! m51 w>d "w is n s natural or ta/eful1 b !y w d ) int]e/ mu* ( ?is k9d ( "w2 to ?is may be add$ employm5t 9 decorat+ _! own rooms or ! w>d1 & 9 c>+ = plants & fl[]s4 ,! wom5 c add to w>d "w1 sew+1 knitt+1 m5d+1 embroid]y1 artificial fl[] mak+1 quilt+1 c>e ( fl[]s 9 ! w>d1 & x is (t5 a real enjoym5t = pati5ts to make "s little pres5t = _! outside fri5ds4 ,! laundry (f]s an invit+ field = "s pati5ts1 b x is (t5 too h>d "w1 especially :5 !y are s5t twice a day to ! wa%-tub1 or kept 9 ! hot iron+ room4 ,a half day is en\gh = mo/ pati5ts1 & _m are n /rong en\gh to g !re4 ,out-(-door "w is well suit$ = ! m54 ,! f>m1 g>d51 lawn1 b>ns1 & ma*9e-%ops (f] mu* t c be made useful = ! pati5ts' employm5t2 ! diff]5t me*anics & artisans ab\t ! asylum %\ld h pati5ts work+ ) !m4 ,?us x appe>s !re are _m directions = pati5ts to "w1 & x is also true t all pati5ts are n suit$ to d ! same "w nor ! same am\nt ( "w4 ,:atev] !y d %\ld be = _! b5efit alone1 o!rwise we might take a contract = a giv5 numb] ( pati5ts to "w a giv5 numb] ( h\rs e day1 a good deal z has be5 done 9 prisons & re=matories1 b no "o w\ld believe su* a c\rse = ! int]e/1 improvem5t1 or recov]y ( ! pati5ts4 ,! only rule to g by is1 t ! "w & occupation %all be = _! own good1 &1 t !y %all n be made or enc\rag$ to "w = any o!r purpose4 ,z a rule1 pati5ts %\ld be all[$ to employ !mselves 9 ways t mo/ int]e/ !m1 provid$ x is useful & seems to be b5eficial4 ,ov]-"w is z bad z idl5ess2 too mu* sew+ w (t5 give a sleepless night4 ,g5]ally all pati5ts may be all[$ to engage 9 light "w1 )\t special directions2 new pati5ts1 h[ev]1 %\ld n be s5t (f ! w>d1 or giv5 tools t may become weapons1 unless by ord] ( a physician4 ,x is a bad habit = att5dants to sit idly by1 or /& ar\nd ) _! h&s 9 _! pockets1 & h pati5ts d all ! "w4 ,x may be s necess>y to wat* ! pati5ts t ! att5dant _c "w /eadily1 b he %\ld h ! appe>ance ( do+ some?+1 & if possible jo9 ) !m 9 "w4 ,a p>ty ( wom5 sew+1 %\ld be laugh+1 talk+1 tell+ /ories1 p]haps s++2 !y %\ld be made to enjoy ! "t1 & n to look ^u x z some?+ irksome4 ,"s pati5ts are too feeble 9 m9d1 & "s too feeble 9 body to "w2 _m ne$ re/1 quiet1 & nurs+1 & directions = ! c>e & occupation ( su* pati5ts %\ld come f ! physician4 ,_m ( ^! pati5ts w d a little1 o!rs c be amus$1 or read to1 & _! m9ds ?us div]t$ f _! tr\bles1 & turn$ into pleasant & *e]ful directions ( ?\ght4 ,x has be5 %[n t "w is n ! only useful way t pati5ts may occupy _! "t1 t no?+ b "w is z bad z no "w1 & t !y %\ld h div]sion1 enjoym5t1 & ent]ta9m5t4 ,= ! ent]ta9m5t & occupation ( pati5ts1 !re are furni%$1 dances1 conc]ts1 !atricals1 billi>ds1 c>ds1 pianos1 books & pap]s1 s*ools1 *apel s]vices1 walks1 rides1 & excursions1 & !y also receive visits f fri5ds1 & write & receive lett]s4 ,pati5ts %\ld be enc\rag$ & sometimes made to take "p 9 ^! natural & pleasant amusem5ts2 ( c\rse e pati5t _c play ! piano1 or billi>ds1 b among ^! _m =ms ( recreation1 all pati5ts c f9d ways ( div]sion & means ( enjoym5t4 ,?us e>ly 9 ! /udy ( ! c>e ( ! insane1 x is le>n$ t ! life ( pati5ts is to be /ripp$1 z mu* z possible1 ( re/riction & re/ra9t2 t self-control is to be taught2 t useful "w is to be enc\rag$2 t amusem5ts & innoc5t pleasures are to be enjoy$2 9 a ^w1 att5dants are to le>n1 t ! *>act]i/ics ( in/itutional life are to be less5$1 & ^? ( a home life made prom95t4 ,! ,pati5ts' ,c>e ( ,!mselves4--,! g5]al t5d5cy ( ! insane is to m5tal enfeeblem5t1 to neglect ( p]son1 & to slov5ly habits4 ,pati5ts %\ld be enc\rag$ z mu* z possible to c>e = !mselves2 to be helpful t[>ds o!rs2 to d su* "w z !y are able2 to seek amusem5ts1 & to live z mu* z possible su* a life z we ord9>ily are accu/om$ to outside ! asylum4 ,pati5ts %\ld be enc\rag$ to keep !mselves tidy1 & nicely dress$1 to h ! c>e ( _! clo?+2 if possible1 !y %\ld be giv5 a room ( _! own1 :i* !y %\ld take a pride 9 keep+ 9 ord]1 & ornam5t+ ) pictures & fl[]s2 & %\ld be all[$ to d :atev] w help ma9ta9 _! self-respect1 self-c>e1 & a feel+ ( individuality4 ,!re is great diff]5ce 9 pati5ts z %[n 9 _! capacity = self-help4 ,"s seem to be able to d no?+1 "s ev]y?+4 ,no?+ c light5 ! burd5s ( att5dants s mu* z to make ! helpless self-helpful4 ,no?+ b5efits ! pati5ts m4 ,d n ab&on ef=t = any pati5t4 ,unexpect$ & gratify+ results are ! rew>ds ( e>ne/ ef=ts4 ,out ( ,door ,ex]cise--,walk+4--,if possible1 pati5ts %\ld be out ( doors e day4 ,9 ! summ] mu* "t c be sp5t 9 ! fields1 on ! lawn1 ei!r walk+ or sitt+ "u ! trees2 9 ! w9t] "t %ort] walks only c be tak51 b on pleasant days1 (t5 an h\r may be sp5t out ( doors4 ,w>m clo?+ & good %oes mu/ nev] be neglect$1 & ! p]son mu/ be ?or\ghly protect$1 because ! insane are frequ5tly cold-blood$1 t is1 ! circulation is poor1 ! h&s & feet conge/$1 blue1 & cold1 !y make animal w>m? sl[ly & ) difficulty1 & easily suff] f ! cold4 ,_m pati5ts g out to walk on p>ole4 ,^? :o are all[$ ?is lib]ty w be designat$ by ! physicians2 any *ange 9 ! pati5t t makes su* lib]ty dang]\s %\ld at once be report$4 ,o!rs g out 9 l>ge p>ties1 ) few att5dants to c>e = !m1 :ile ! old1 sick1 & feeble1 ! homicidal & suicidal1 ! noisy & viol5t1 require special c>e & att5tion 9 _! ex]cise & walks4 ,clo?+ ( ,pati5ts4--,9 _m asylums ea* pati5t has 8 own clo?+4 ,e article %\ld be pla9ly m>k$ ) 8 own "n1 & %\ld be us$ only by ! pati5t to :om x belongs1 & nev] giv5 to any "o else to we>4 ,all clo?+ %\ld be kept clean & well m5d$1 & %\ld be prop]ly put on & kept on dur+ ! day4 ,!re %\ld always be en\gh to keep ! pati5t w>m1 & *ang$ ) ! *anges 9 ! wea!r1 or ! temp]ature ( ! w>d1 or ! ne$s ( ! pati5t4 ,! sick1 feeble1 & old always ne$ extra clo?+2 t worn next ! sk9 %\ld be *ang$ at lea/ once a week1 & all clo?+ %\ld be *ang$ z (t5 z soil$4 ,ba?+ ( ,pati5ts4--,e pati5t %\ld be ba!d once a week & z mu* (t5] z is necess>y4 ,! tub %\ld be clean$ & ! wat] *ang$ = ea* pati5t2 ! temp]ature %\ld be ab\t n9ety-five degrees1 or n hot to ! h&1 & ! tub %\ld be ab\t two-?irds full4 ,! head1 neck1 & body %\ld be wa%$ ) soap2 ea* pati5t %\ld h a clean t[el1 be wip$ dry1 & giv5 a *ange ( clean clo?+4 ,"s pati5ts object to ba?+2 !y fe> ! tub1 b w wa% ) wat] & a sponge1 & !y %\ld be all[$ to d s4 ,o!rs want to ba! fir/2 let !m1 if possible4 ,o!rs w n ba! ! day ! re/ d2 x is sometimes be/ to humor !m4 ,"s pati5ts h to be =cibly ba!d4 ,9 su* cases always wait1 use e art to induce !m to ba!1 & be=e act+ s5d = advice4 ,att5dants are too prone to ?9k t e ?+ %\ld be done by rule1 & t all mu/ be =c$ to obey ! rule4 ,mo/ w obs]ve x )\t tr\ble1 & ! object s\ght c g5]ally be ga9$ by pati5ce1 tact1 & k9dness4 ,s]v+ ( ,food4--,! d9+-tables %\ld be neatly set & made attractive2 ! food %\ld be promptly s]v$1 & :ile hot2 all pati5ts %\ld be at meals1 unless excus$ by ! physicians4 ,economy %\ld be practis$1 & e ?+ %\ld be us$ or sav$4 ,ea* p]son %\ld h en\gh1 b no "o %\ld be all[$ to make a meal ( a delicacy1 or take all ( ! be/ ( a di%4 ,"s pati5ts w\ld wa/e a p\nd ( butt] or sug> at ea* meal2 en\gh is suffici5t = anybody4 ,! old & feeble %\ld be s]v$ by att5dants2 ^? )\t tee? %\ld h _! food prep>$1 & ! meat %\ld be cut v f9e4 ,^? :o w n eat mu/ be kept 9 ! d9+-room & f$2 ! att5dants may use =ce by hold+ ! h&s1 & plac+ food 9 or to ! m\?2 b x is dang]\s to d m1 & hold+ ! nose is some?+ t is nev] all[able4 ,if ^! ef=ts to get !m to take food d n succe$1 report to ! physician4 ,"s pati5ts f delusions w eat c]ta9 k9ds ( food1 & ei!r n get en\gh or n a suffici5t v>iety4 ,a mix$ diet is ! be/1 & pati5ts %\ld if possible be made to eat bread1 butt]1 meat1 vegetables1 & dr9k milk & pl5ty ( wat]4 ,no pati5t %\ld be all[$ to lose 9 fle% & /r5g? on acc\nt ( failure to take suffici5t1 or prop] food2 be=e ^! ?+s happ5 x %\ld be report$ to ! physician4 ,"s pati5ts w only eat en\gh if !y are all[$ to eat x 9 _! own way2 !y w eat x p]haps /&+1 or aft] ! o!rs h f9i%$1 or alone1 or 9 _! room1 or !y may /eal x1 if giv5 ! opportunity4 ,su* peculi>ities (t5 h to be indulg$4 ,"s pati5ts w take no?+ b milk1 !n ab\t ?ree qu>ts a day are ne$$2 eggs may be add$ & are (t5 readily tak51 & "s may be got to eat bread & milk1 :i* is a v nutriti\s diet4 ,! food ( ! sick %\ld be nicely & invit+ly s]v$1 & ef=ts %\ld be made to meet _! :ims & fancies4 ,pati5ts :o are s pr(ane1 viol5t1 or noisy1 t !y are n all[$ to come to ! d9+-room1 mu/ always be f$ by1 & 9 ! pres5ce ( an att5dant1 & meals %\ld n be pass$ into a pati5t's room & left !re4 ,knives & =ks %\ld always be c\nt$ by an att5dant be=e & aft] ea* meal2 c>e %\ld be us$ t !y are n lo/1 secret$1 or c>ri$ out ( ! d9+-room by pati5ts4 ,no "o b an att5dant %\ld ev] h&le ! c>v+ knife & =k1 or ! bread knife4 ,c>e ( ,pati5ts :5 ,go+ to ,b$1 or ,ris+4--,! b$s %\ld be daily air$1 & always clean & nicely made up2 = a fil?y pati5t a /raw b$1 t c be *ang$1 alone is clean4 ,all pati5ts d n ne$ to g to b$ at ! same "t1 & :ile "s are able to c>e = !mselves1 mo/ ne$ c>e1 att5tion1 & wat*+4 ,! helpless %\ld be dress$ & undress$1 & put to b$ fir/3 ! viol5t & homicidal ne$ to be wat*$1 & %\ld be put to b$ e>ly1 :ile ! suicidal %\ld be kept "u sup]vision1 & put to b$ at ! mo/ conv5i5t "t4 ,aft] a pati5t is 9 b$1 an att5dant %\ld g into ! room1 ) a lant]n1 s z to see t e ?+ is 9 ord] & safe1 &1 ) a *e]ful good-night close ! door4 ,pati5ts :o ne$ c>e %\ld be visit$ dur+ ! ev5+1 & left clean & 9 good condition to be c>$ = by ! night wat*4 ,9 ! morn+ pati5ts ne$ att5tion be=e any ?+ else is done4 ,fir/1 ! suicidal1 sick & feeble1 ! viol5t1 & ^? likely to be fil?y %\ld be visit$1 & e pati5t %\ld be wa%$ & dress$ be=e breakfa/2 or1 if = any reason !y d n come to ?is meal1 _! faces & h&s %\ld be wa%$1 ! b$ put 9 ord]1 & ! room made clean & air$4 ,aft] ^! ?+s h be5 att5d$ to1 ! w>d "w %\ld be done1 ?\gh g5]ally ! two c g on toge!r4 ,c>e ( ,pati5ts dur+ ! ,night4--,aft] ! pati5ts h gone to b$ ! w>d %\ld be quiet1 doors %\ld be quietly clos$1 voices l[]$1 & l\d calls & laught] n indulg$ 91 squeak+ boots %\ld n be worn1 & heavy walk+ avoid$4 ,_m pati5ts g to sleep e>ly1 b are easily awak5$1 & may rema9 sleepless till morn+1 or at lea/ a "p ( ! night4 ,! night wat*]s h responsible1 ardu\s1 & try+ duties4 ,att5dants %\ld always1 dur+ ! night1 quickly respond :5ev] a dem& is made ^u !m = assi/ance1 ?\gh an unnecess>y call %\ld nev] be made4 ,! night wat*]s %\ld be in=m$ ( any *anges t h occurr$ dur+ ! day1 t w require _! att5tion dur+ ! night2 !y %\ld see new pati5ts & be made acqua9t$ ) _! peculi>ities2 !y %\ld visit ! w>ds dur+ ! ev5+ be=e !y come to ! m$ical (fice to receive in/ructions f ! physicians4 ,x is ! duty ( a night wat* to visit regul>ly all ! w>ds "u 8 *>ge2 to see & "k ! condition ( ! sick1 ! helpless1 feeble1 ! suicidal1 & ! epileptic2 to att5d to1 by tak+ up1 ^? :o are incl9$ to be fil?y1 & wa% ^? :o ne$ x1 & make !m1 _! b$s1 & rooms p]fectly clean4 ,he %\ld obs]ve ! conduct ( new pati5ts1 be wat*ful ( ! viol5t1 "k h[ mu* wakeful pati5ts sleep1 visit all associat$ dormitories1 wait ^u all ^? :o ne$ att5tion1 & gu>d aga9/ fire & accid5t4 ,! night wat* %\ld place ea* day on ! m$ical (fice table1 a detail$ acc\nt ( e pati5t t ne$$ c>e or att5tion1 :o 0 di/urb$1 or did n sleep dur+ ! previ\s night4 ,pati5ts %\ld be left clean = ! night wat*1 :o %\ld leave !m 9 z good condition 9 ! morn+1 = ! day att5dants1 & any neglect 9 ^! directions %\ld be report$ by ei!r p>ty4 ,sick pati5ts frequ5tly h to receive special night s]vice1 to be wat*$1 & giv5 food & m$ic9e4 ,:5 ?is _c be done by ! night wat*1 x devolves ^u ! day att5dants1 & is a duty t %\ld be *e]fully r5d]$4 ,dur+ ! night1 any accid5t1 attempt at suicide or to escape1 or unusual viol5ce1 p]si/5t sleeplessness1 or be+ out ( b$1 a s]i\s sickness or *ange = ! worse1 or ! approa* ( dea?1 %\ld be report$ to ! physician4 ,x is1 9 _m in/itutions1 ! duty ( ! night wat* to report any neglect or misconduct on ! "p ( an att5dant or employe1 & x is some?+ t %\ld be fai?fully & imp>tially done4 ,hav+ briefly sket*$ ! g5]al duties ( an att5dant1 x seems be/ to aga9 rem9d !m1 t an asylum is built & ma9ta9$ = no o!r purpose ?an = c>+ = ! insane2 t ea* pati5t is entitl$ to ! be/ our means c af=d2 t :ile ! att5dants are n responsible = ! m$ical treatm5t1 !y are = t k9d & intellig5t c>e x is )9 _! prov9ce to give2 & !y are also rem9d$ t1 s f> z x c be done1 su* p]sonal att5tion is to be giv5 to ea* pati5t z w assi/ 9 recov]y or improvem5t1 or promote 8 well-be+4 ,,*apt] ,,vi4 ,,! ,,c>e ,,( ,,! ,,viol5t ,,insane4 ,a c>eful /udy ( ea* viol5t pati5t1 ( 8 habits1 delusions1 & halluc9ations1 ( 8 peculi> mann] ( %[+ viol5ce1 & a k ( :at is likely to provoke outbur/s is necess>y to prop]ly c>e = him4 ,an att5dant's ability to successfully manage a w>d full ( pati5ts w dep5d l>gely ^u ! /udy giv5 to1 & ! ?or\gh und]/&+ (1 ea* case4 ,su* /udy w soon tea* him t e viol5t pati5t has peculi> & pretty con/ant ways ( %[+ & ex]cis+ viol5ce1 & t ! same rule ( individuality holds good among ?is1 z x does among o!r classes ( ! insane4 ,hav+ le>n$ :at w cause viol5ce1 x c (t5 be avoid$ by remov+ ! cause2 hav+ le>n$ ! symptoms t prec$e a pati5t's outbur/s ( viol5ce1 !y c sometimes be av]t$1 or prep>ations made to control !m2 hav+ le>n$ 9 :at direction viol5ce is %[n1 h[ sudd51 bl9d1 or furi\s x may be1 or h[ sl[1 delib]ate1 & plann$1 ! att5dant is bett] able to meet1 manage1 & control x4 ,few pati5ts are s cont9u\sly & furi\sly viol5t z to ne$ con/ant repression1 & ! directions h[ to c>e = su* pati5ts c always be giv5 by ! physician4 ,mo/ viol5t pati5ts are subject to ! firm1 k9d control ( att5dants1 & c be kept suffici5tly quiet & ord]ly2 !y %\ld nev] be left alone1 & mops1 pails1 brooms1 *amb]s1 & all o!r articles1 t may become weapons %\ld n be left )9 rea*4 ,/rong com=table clo?+ c g5]ally be kept on ! mo/ viol5t & de/ructive1 ) c>e & att5tion f att5dants1 b n )\t4 ,_m viol5t pati5ts w employ !mselves & be ! quiet] = s do+4 ,light out-(-door "w is ! be/ employm5t = ?is class1 & out-(-door walk+ & ex]cise %\ld nev] be neglect$4 ,on ! woman's w>d knitt+1 sew+1 m5d+1 & w>d "w are suitable = _m1 :ile "s w "w at ! laundry1 & o!rs w g quietly to *ur* & ent]ta9m5t2 books & illu/rat$ pap]s %\ld be furni%$ & w be mu* read & enjoy$4 ,z a rule ! m viol5t pati5ts are re/rict$1 kept cont9u\sly on ! w>d1 or 9 a small room1 & giv5 no "w1 amusem5ts1 walks1 & ex]cise1 ! m noisy & viol5t d !y become4 ,att5dants mu/ le>n t m]e noise1 & mu* ( maniacal activity1 su* z runn+ ab\t1 jump+1 or p\nd+1 is n 9 itself h>mful1 & t unless su* pati5ts are do+ !mselves injury1 or s di/urb+ ! w>d & o!r pati5ts z to require int]f]5ce1 x is bett] to control ?an to repress & re/rict !m4 ,_m viol5t pati5ts are subject to su* p>oxysms ( great viol5ce z to require imm$iate c>e & (t5 tempor>y control at ! h&s ( att5dants4 ,g5]ally ^! p>oxysms sp5d !mselves aft] a %ort "t1 b if !y d n1 advice & help c be call$ =4 ,by c>eful wat*+1 ! approa* ( ^! p>oxysms c be kn[n & (t5 avoid$4 ,?is may be done by remov+ ! cause1 :i* is (t5 ! irritation ( ano!r pati5t or an att5dant1 by a ^w1 a joke1 by simply lett+ ! pati5t alone1 or by a firm %[ ( au?ority1 or by any o!r means exp]i5ce has taught to be useful 9 ! p>ticul> case4 ,if necess>y to hold a pati5t1 ?ree p]sons %\ld be able to c>e = ! mo/ viol5t4 ,?is c be done by grasp+ ea* arm at ! wri/ & elb[1 & hold+ x out /raight1 ! att5dants /&+ beh9d :ile ano!r passes ! arm ab\t ! neck & holds ! *91 to prev5t bit+ & spitt+2 ! pati5t may !n be walk$ backw>d & seat$ 9 a *air4 ,aft] ! viol5ce has subsid$1 ?\gh ! pati5t %\ld cont9ue to scold1 swe>1 ?reat51 or cry1 he %\ld1 z soon z possible1 be left alone1 ! att5dants walk+ away1 b rema9+ wat*ful4 ,d n1 unless x is necess>y1 int]f]e to /op ! noise1 = x is (t5 a sub/itute = ! viol5ce1 & ! attack we>s itself out 9 ?is way4 ,if necess>y to c>ry a viol5t pati5t1 x c be done by f\r or six att5dants4 ,! face %\ld be turn$ d[nw>d1 !reby less5+ ! p[] to resi/1 &1 to prev5t dislocat+ ! arms1 ! pati5t %\ld be c>ri$ by ! %\ld]s & *e/2 ! b&s ab\t ! neck %\ld be loos5$4 ,9 us+ =ce 9 ! c>e ( viol5t pati5ts1 x %\ld always be done z g5tly z possible1 & /ruggl+ %\ld be avoid$2 he %\ld nev] be *ok$ or kick$1 receive a bl[1 or be knock$ d[n2 ! arms %\ld nev] be twi/$1 nor a t[el held ov] ! m\?1 b if ! pati5t p]si/s 9 spitt+ x may be held 9 front ( ! face4 ,c>e mu/ always be us$ n to injure a pati5t :ile ex]cis+ necess>y control4 ,9 ! viol5ce ( a pati5t innoc5t injuries are sometimes receiv$4 ,! att5dant is excusable if he c %[ t he us$ necess>y =ce only1 )\t malice4 ,a viol5t pati5t %\ld nev] be /ruggl$ ) alone1 & on a well-manag$ w>d help w always be )9 call4 ,x may be necess>y1 h[ev]1 to break ?is rule 9 ord] to prev5t homicide or suicide1 or s]i\s injury to ano!r pati5t1 or sett+ ! h\se on fire4 ,x is bett] n to visit ! room ( a viol5t pati5t alone1 & if an attack is fe>$1 especially ) a weapon1 ! door %\ld be sl[ly op5$1 & held s x c be quickly clos$4 ,! pati5t usually makes an imm$iate attack1 &1 be=e he has recov]$ = a second1 c g5]ally be dis>m$ & controll$4 ,viol5ce usually consi/s ( noise1 te>+ ! clo?+1 break+ glass or furniture1 bit+1 scrat*+1 /rik+1 hair pull+1 kick+1 or attack+ o!rs ) weapons4 ,x is sometimes secretly & delib]ately plann$ & skilfully execut$1 ?\gh g5]ally )\t reason+ or direction1 b bl9d & fi]ce4 ,! c>e ( ! viol5t insane involves ! c>eful /udy ( ea* case1 ) con/ant wat*fulness1 & ! ex]cise ( a control t is k9d1 b firm & unyield+1 t does n repress except :5 necess>y1 nor re/rict )\t reason1 t indulges :5ev] possible1 t nev] drives1 scolds1 or ?reat5s1 b influ5ces1 guides1 & directs4 ,! greate/ lib]ty possible %\ld be all[$1 & self-control enc\rag$1 & "w1 occupation1 & amusem5t %\ld be furni%$4 ,an att5dant mu/ always rememb] t fe> is ! l[e/ motive to gov]n by1 & t k9dness w (t5 be appreciat$ & return$4 ,c>e ( ! ,de/ructive ,pati5ts4--,besides ! viol5tly de/ructive pati5ts1 !re are "s :o are malici\sly de/ructive1 & :o ex]cise all _! +5uity to escape ! wat*fulness ( ! att5dants2 :o glory 9 _! wrong-do+2 :o op5ly say !y _c be puni%$1 & exultantly tell ! physician h[ !y h outwitt$ ! att5dant1 or proclaim be=e him 8 %ortcom+s & neglect4 ,su* pati5ts w de/roy _! own or o!rs clo?+1 !y w /eal & hide1 or ?r[ x out ! w9d[ or d[n ! wat]-closet1 or erase ! "n by :i* x is m>k$4 ,!y w de/roy b$d+1 w9d[s1 crock]y1 pictures1 or furniture4 ,) a p91 a nail1 or a bit ( glass or wood1 !y w m> & deface _! room or ! w>d1 & (t5 d damage t _c be repair$4 ,! only way to meet su* cases is by wat*fulness4 ,!y %\ld be kept1 if possible1 at "w1 or at lea/ ) a company ( work]s1 & !re=e "u con/ant obs]vation4 ,:5 put to b$ _! clo?+1 m\?1 hair1 & p]son %\ld be ?or\ghly se>*$4 ,k9dness (t5 has b little effect1 b a ?reat is apt to make !m m det]m9$ to de/roy4 ,! ,c>e ( ,pati5ts by ,me*anical ,re/ra9t & ,seclusion4--,all ! re/riction ( an asylum is re/ra9t4 ,! lock+ ( b$room doors at night is v re/rict$ re/ra9t4 ,mo/ pati5ts 9 an asylum h a feel+ t !y are "u great compulsion & re/ra9t1 9 be+ depriv$ ( _! lib]ty4 ,x has already be5 taught t pati5ts are to be giv5 all ! lib]ty possible1 t re/ra9t ov] _! fre$om is to be ex]cis$ no m ?an is absolutely necess>y1 & t ! greate/ good ( ! pati5ts alone is to be ?\ght (4 ,^! tea*+s are equally true ( special =ms ( re/ra9t4 ,if us$ at all !y are to be us$ = ! good ( ! pati5t alone1 & an att5dant %\ld be able to c>e = any case )\t re/ra9t4 ,re/ra9+ app>atus %\ld nev] be kept on ! w>d4 ,an att5dant %\ld nev] ask t x be us$1 nor say he _c get along )\t x4 ,if ord]$ by ! physician x is ! att5dant's duty to see t x is s appli$ z to d no injury1 t x does n b9d or tie ! pati5t d[n1 t x does n irritate & make ! sk9 sore1 nor re/rict ! free movem5t ( ! limbs4 ,pati5ts :o are re/ra9$ are n to be fur!r conf9$ to a *air )\t specific ord]4 ,re/ra9t us$ dur+ ! day is n1 unless s ord]$1 to be cont9u$ at night nor reappli$ ! next day4 ,pati5ts are to be tak5 frequ5tly to ! closet4 ,re/ra9t %\ld be tak5 (f sev]al times a day1 & kept (f long en\gh to give relief to any feel+ ( discom=t1 & free movem5t %\ld be all[$4 ,:5 pati5ts are re/ra9$ !y ne$ unusual c>e & wat*+1 & %\ld nev] be left alone4 ,! att5dant %\ld be in=m$ :y re/ra9t is us$1 & :at is hop$ to be ga9$ by its use4 ,he %\ld closely obs]ve ! effect ^u ! pati5t & comp>e 8 condition ) :at x is :5 n re/ra9$4 ,! result ( ^! obs]vations %\ld be report$4 ,?us us$1 an att5dant w soon le>n t x is n ! easie/ way to c>e = a pati5t1 t its use involves increas$ wat*fulness & c>e1 & great] discretion1 & t x is /rictly a =m ( m$ical treatm5t4 ,x is a h>% rem$y at its be/1 & ne$s to be us$ ) k9dness1 intellig5ce1 & judgm5t1 & x is to be appli$ b = "o purpose1 namely1 t ! pati5t may be b5efit$4 ,! ,use ( ! ,cov]$ ,b$4--,l re/ra9t x is nev] to be us$ except by ! ord]s ( a physician1 nor is its use to be repeat$ )\t special ord]s2 x is always to be consid]$ a me?od ( treatm5t & some?+ ! att5dant has no int]e/ 91 except to "k h[ be/ to use x :5 ord]$ to d s4 ,:5 9 a cov]$ b$ ! pati5t %\ld be frequ5tly visit$2 he %\ld be tak5 up at lea/ once 9 ?ree h\rs1 unless asleep2 ! b$ & ! pati5t %\ld be kept p]fectly clean4 ,if us$ 9 ! daytime an att5dant %\ld sit beside ! pati5t = "s h\rs & try to keep him quietly 9 b$1 & ! same %\ld be done 9 ! ev5+ :5 ! pati5t is put to b$4 ,an att5dant %\ld be able to report h[ mu* ! pati5t sleeps1 h[ mu* quiet & re/ is obta9$1 ! effect ( ! treatm5t1 & comp>e ! condition ( ! pati5t :5 9 ! b$ ) :at x is :5 n us$4 ,! ,use ( ,seclusion4--,seclusion is %utt+ a pati5t alone 9 a room 9 ! daytime4 ,if all[$ to be done )\t ord]s f ! physician x %\ld be imm$iately report$4 ,if ord]$ to be cont9u$ ! pati5t %\ld be se5 at lea/ once 9 fifte5 m9utes1 :ile _m ne$ to be se5 once 9 five m9utes1 & an att5dant %\ld nev] be f> f ! door4 ,! pati5t %\ld be frequ5tly tak5 to ! closet4 ,! effect & result ( seclusion %\ld be obs]v$ & report$4 ,_m physicians nev] use any =m ( re/ra9t1 :ile o!rs make consid]able use ( x z a means ( treatm5t4 ,an att5dant %\ld be able to successfully c>e = any case1 s z to meet ! wi%es & directions ( ! physician1 & only z he is able to d ?is c he give ! pati5t ! highe/ /&>d ( att5tion1 c>e1 & nurs+4 ,,*apt] ,,vii4 ,,! ,,c>e ,,( ,,! ,,homicidal1 ,,suicidal1 ,,& ,,^? ,,incl9$ ,,to ,,acts ,,( ,,viol5ce4 ,pati5ts ) ,delusions ( ,suspicion dem& special c>e1 & are prop]ly class$ ) ^? incl9$ to commit acts ( viol5ce1 because !y are frequ5tly fully "u ! control ( delusions1 :i* make !m dang]\s & difficult to manage4 ,_m pati5ts h ideas t make !m suspici\s ( ^? ab\t !m2 ^! may relate to ! pati5ts1 b m frequ5tly to ! att5dants & physicians1 & !y may arise f delusions1 halluc9ations or illusions4 ,?is class ( pati5ts is apt to be morose1 cross1 & irritable2 !y sit brood+ ov] _! fanci$ wrongs2 repulse advances & fri5dly int]c\rse2 !y refuse to employ !mselves1 & d n respond will+ly to ! requirem5ts ( ! att5dants4 ,our mo/ trifl+ & unmean+ acts may give rise to ! mo/ int5se suspicions & hatr$4 ,a look1 a %rug ( ! %\ld]1 ! mann] ( %ak+ ! head1 a c\gh1 ! squeak+ ( our boots1 are frequ5tly en\gh to ar\se1 ^! feel+s4 ,suspici\s pati5ts (t5 ?9k !y are ! subjects ( ridicule2 t _! ?\ghts are read & proclaim$ to ! w>d2 t _! virtue1 tru?1 or honor is call$ 9 "q1 & ! accusations op5ly told to o!rs1 or t !y are call$ vile & insult+ names4 ,!y (t5 h delusions ( conspiracy to d !m or _! families h>m1 & connect ! att5dants & physicians ) !m1 ?9k+1 z !y keep !m lock$ 9 ! asylum1 !y are associat$ 9 ! conspiracy4 ,sometimes ^! pati5ts ?9k !mselves "s great p]sons1 p]haps t !y are a memb] ( ! ,deity1 or a rul]1 or prophet1 or t !y h "s great mission to p]=m1 & t !y are depriv$ ( _! rights1 or _! "w int]f]$ )1 by be+ kept 9 ! asylum1 & t ^? 9 au?ority are imprison+ & p]secut+ !m4 ,su* p]sons may be1 on acc\nt ( _! fanci$ wrongs1 v suspici\s1 & ev5 viol5t t[>ds ^? :o c>e = !m4 ,o!r pati5ts h suspicions & fe>s ( bodily h>m4 ,!y may ?9k !y are to be tortur$1 t !y are to be burn$ alive1 or t "s "o is try+ to kill !m4 ,to-day1 z ,i wrote ^! l9es1 a pati5t told me %e did n sleep la/ night = fe> ! night-wat* w\ld kill h]--say+ t ,god told h] ! wat* 0 arm$ ) a knife = t purpose1 & %e ?reat5$ homicidal viol5ce 9 def5d+ h]self4 ,_m pati5ts mi/ake ord9>y s5sations ( pa9 & bodily discom=t1 & h delusions t !y are be+ injur$4 ,! feel+s ( dyspepsia may make pati5ts ?9k !y h be5 poison$2 ord9>y pa9s or a*es1 t !y h be5 %ot1 /abb$1 or p\nd$2 wom5 may1 = "s su* causes1 ?9k !y h be5 violat$ or are pregnant4 ,peculi> s5sations ( v>i\s k9ds may make pati5ts ?9k "s "o is affect+ !m by electricity or mesm]iz+ !m4 ,x is v easy to trace f su* ideas ( p]secution & suspicion1 ! orig9 ( homicidal1 suicidal1 inc5di>y & o!r viol5t t5d5cies & acts4 ,homicidal ,pati5ts4--,pati5ts are sometimes bo? homicidal & suicidal1 & sometimes !y are incl9$ to only "o ( ^! =ms ( viol5ce4 ,homicides are n ( frequ5t occurr5ce 9 an asylum4 ,! bett] ! c>e ! less is ! liability to homicide4 ,b !re are always a great _m homicidal pati5ts1 & _m m :o h delusions & ideas t may cause su* t5d5cies to arise4 ,_m pati5ts are homicidal m]ely f viol5ce & fr5zy1 & )\t any settl$ plan1 any fix$ delusion1 or int5se suspicion4 ,!y may attack o!rs sudd5ly & furi\sly2 !y may commit ! act :ile try+ to escape1 or x may be ! result ( ! viol5ce ( acute mania4 ,o!r pati5ts become homicidal "u ! desire to protect !mselves f suppos$ assaults4 ,!y may ?9k a p]son :o is approa*+ !m is com+ to kill or torture !m4 ,o!rs are homicidal f any ( ! ideas ( p]secution & suspicion t h j be5 spok5 (4 ,sometimes pati5ts he> voices tell+ !m to commit ! act1 p]haps x is ,god's voice comm&+ a fa!r to (f] up 8 only son z a sacrifice1 or a "m to kill h] little *ildr5 to save _! s\ls1 or keep !m f "s mis]y or crime t awaits !m4 ,pati5ts may ?9k !mselves ,god1 or a k+1 or rul]1 & !re=e h a "r to take life4 ,homicidal pati5ts are (t5 among ! quiete/1 & are f\nd 9 ! quiet w>ds4 ,!y frequ5tly lay c>eful plans1 are secretive1 & only try to commit ! act :5 !y feel sure x w succe$4 ,pati5ts :o are homicidal %\ld be especially wat*$4 ,!y %\ld1 if possible1 be kept employ$1 b nev] giv5 tools t may become weapons4 ,!y %\ld sleep 9 a room by !mselves4 ,all p]sons aga9/ :om !y h delusions %\ld be w>n$4 ,pati5ts aga9/ :om !y h>bor suspici\s or homicidal ideas %\ld be sep>at$ f !m4 ,att5dants %\ld rememb] t a mop1 a pail1 or a *air1 may become a dang]\s weapon1 or t a knife1 scissors1 or a %>p5$ piece ( iron or t91 may make a fatal w\nd4 ,suicidal ,pati5ts4--,pati5ts ) ?is t5d5cy w g5]ally talk freely ( _! suicidal ideas1 tell :y !y wi% to commit x1 :at provokes ! idea1 & h[ !y w\ld d ! act4 ,!y are frequ5tly grateful = ! c>e be/[$ to help !m resi/ ! impulse1 & w sometimes tell ! att5dants :5 !y feel ! suicidal ideas com+ on1 t !y may be ! m surely wat*$4 ,melan*olic pati5ts are mo/ incl9$ to suicide1 b any insane p]son1 :atev] ! m5tal /ate1 may commit ! act4 ,delusions ( depression g5]ally cause ! suicidal ideas1 b halluc9ations sometimes play an important "p4 ,"s p]sons are simply tir$ ( life1 & see no hope 9 liv+2 "s ?9k !y are a burd5 to _! fri5ds1 & t !y are tak+ food away f _! *ildr52 o!rs wi% to die to escape f _! mis]y1 :i* is g5]ally a m5tal1 & n a physical suff]+2 o!rs t by s do+ !y may get =giv5ess ( _! s9s2 o!rs because !y ?9k !y w save _! *ildr5 f a fate l !irs2 sometimes x is ! result ( halluc9ation1 z a direct comm& f ,god1 tell+ !m to commit ! act4 ,b few pati5ts are con/antly det]m9$ to commit suicide4 ,! opportunity (f]$1 z a ba?-room door left op51 a rope1 a knife1 (t5 prompts ! desire & all[s ! accompli%m5t ( ! de$4 ,att5dants mu/ rememb] t x takes b a few m9utes to commit suicide1 by dr[n+ or hang+--b a mom5t to cut ! ?roat2 t p]sons c dr[n !mselves 9 a pail ( wat]1 hang !mselves by ! hem ( ! %eets1 cut _! ?roat ) a piece ( glass or t94 ,sometimes pati5ts slyly save _! m$ic9e until !y get en\gh to poison !mselves4 ,ab\t dusk 9 ! ev5+1 or at e>ly morn+1 is ! "t :5 pati5ts are mo/ incl9$ to commit suicide4 ,:5 pati5ts are ris+1 go+ to b$1 or to _! meals1 :5 go+ to *apel1 amusem5ts1 or to walk1 :5 all is busy & a/ir on ! w>d1 are ! times t (f] ! mo/ favorable opportunities = ! act4 ,(t5 pati5ts h a c]ta9 way by :i* !y w commit suicide1 & !y w d x 9 no o!r2 "o wi%es to dr[n himself1 ano!r to hang1 & ano!r to take poison4 ,sometimes pati5ts w appe> *e]ful to avoid suspicion & s f9d _! opportunity1 :ile o!rs may sudd5ly & :ile convalesc5t commit ! act4 ,! only way to c>e = pati5ts :o are suicidal1 is by con/ant wat*fulness day & night4 ,dur+ ! day !y %\ld be employ$ & kept ) o!r pati5ts1 !y %\ld be especially look$ aft] at ^? times :5 opportunities = suicide are increas$4 ,at night x is bett] to h !m sleep 9 an associat$ dormitory ) "s "o to wat* !m4 ,if a pati5t is f\nd hang+ he %\ld at once be cut d[n1 all re/riction ab\t ! neck remov$ & artificial respiration set up1 or if dr[n+1 ! m\? & lungs %\ld be fir/ empti$ ( wat]2 if !re is hemorrhage compression %\ld be made ^u ! art]y1 or if ?is is n possible1 !n directly ^u ! w\nd4 ,h[ to control hemorrhage & d artificial respiration w be describ$ 9 ! *apt] on em]g5cies4 ,pati5ts ,:o ,h ,t5d5cies to ,self-,mutilation4--,"s pati5ts horribly mutilate !mselves4 ,!y may g\ge out an eye1 cut (f a h&1 pull out _! tongue1 or ev5 disemb[el or dreadfully burn !mselves4 ,"s pati5ts p]si/5tly beat _! heads aga9/ ! wall or floor1 o!rs scrat* ! sk91 mak+ l>ge sores4 ,su* pati5ts frequ5tly ?9k c]ta9 passages f ! ,scriptures apply to !m1 & !y mu/ obey ! application & comm&4 ,!y quote 9 ju/ification ( ! acts1 ,an eye = an eye1 ,& if ?y "r eye (f5d !e1 pluck x out1 ,& if ?y "r h& (f5d !e1 cut x (f4 ,talk ( ?is k9d %\ld make an att5dant v c>eful & wat*ful ( ! pati5t4 ,! orig9 ( ! ideas t lead to ! attempts at self-mutilation is to be f\nd 9 delusions1 & arise 9 ! same way z d ideas ( suicide & homicide4 ,^! pati5ts are all ( ! same class & ne$ ! same "* ( c>e1 att5tion1 & wat*+4 ,pati5ts ) ,t5d5cies to ,sett+ ,?+s on ,fire4--,pati5ts ) ^! t5d5cies g5]ally desire to commit inc5di>y acts "u ! influ5ce ( delusions or halluc9ations2 add$ to ^! !re are frequ5tly suspicions & feel+s ( wrong treatm5t1 & ! pati5t takes ?is way ( %[+ rev5ge1 or1 z he may say1 ( repay+ ! wrong4 ,sometimes pati5ts are s feeble 9 m9d t !y light a fire because !y ?9k x is a pretty sight to see x burn4 ,!re are "s conditions accompany+ epilepsy :]e pati5ts are liable to commit any ( ! class ( viol5t acts describ$ 9 ?is *apt]4 ,! special c>e dem&$ by ^! pati5ts w be fully spok5 ( h]eaft]4 ,!re are "s pati5ts ^: m9ds are s di/ort$ by disease t !y seem to take a pleasure 9 wrong-do+1 & are mu* incl9$ to d great mis*ief1 & sometimes to commit acts aga9/ life or prop]ty4 ,! c>e dem&$ by pati5ts :o are incl9$ to acts ( viol5ce is practically ! same = all4 ,! att5dant %\ld ?or\ghly "k ! habits1 peculi>ities1 & delusions ( ea* p]son "u 8 c>e2 he %\ld ex]cise con/ant wat*fulness1 & rememb] t a mom5t ( ?\ghtless inatt5tion may give ! opportunity = a pati5t to commit "s viol5t act1 t w cause him la/+ regret4 ,! m9d ( a fai?ful att5dant w1 :5 ^u duty1 always be full ( anxiety1 & !re %\ld be 9 ! c>e ( v tr\blesome pati5ts ( ?is class frequ5t relief4 ,,*apt] ,,viii4 ,,! ,,c>e ,,( ,,"s ,,common ,,m5tal ,,/ates1 ,,& ,,accompany+ ,,bodily ,,disord]s4 ,c>e ( ,pati5ts 9 ! ,e>li] ,/ages ( ,insanity4--,pati5ts 9 ! e>li] /ages ( insanity act diff]5tly1 "o f ! o!r1 :5 fir/ br\ght to ! asylum & plac$ "u c>e & re/riction4 ,sometimes pati5ts accept ! situation & fit into asylum life )\t any friction4 ,!y may ev5 come will+ly1 kn[+ !y ne$ c>e & treatm5t1 or f confid5ce 9 _! fri5ds or _! physician's advice4 ,to "s pati5ts ! re/rictions ( an asylum are irksome & misund]/ood2 ! quiet1 regul>ity1 & r\t9e ( ! life on ! w>d does n at fir/ affect !m2 !y may1 & (t5 d1 become fretful1 are irritat$ by _! conf9em5t1 sleep poorly1 eat little1 & may make viol5t ef=ts to escape4 ,^! conditions1 if no?+ is done to occupy ! pati5t's "t & m9d1 & s relieve !m1 w (t5 be suffici5t to provoke viol5ce4 ,^! pati5ts %\ld be c>efully wat*$ & _! condition /udi$2 !y %\ld be br\ght "u ! k9d control & influ5ce ( att5dants1 induc$ to take "p 9 ! regul> ord] ( ! w>d1 &1 if /rong en\gh1 %\ld be furni%$ ) prop] "w & occupation4 ,pati5ts1 :5 fir/ br\ght to ! asylum1 frequ5tly h mu* anxiety ab\t _! homes1 _! families1 or _! bus9ess affairs4 ,?is is p>ticul>ly true 9 rec5t cases ( insanity1 because su* pati5ts (t5 h c>es & responsibilities1 or !y h tri$ to cont9ue to assume !m1 up to ! "t ( com+ to ! asylum4 ,special c>e %\ld be tak5 to quiet fe>s 9 ^! directions2 !y %\ld be assur$ t !y are gr\ndless1 told !y w be all[$ to communicate ) _! fri5ds1 t !y w be visit$ by _! family1 & t all _! int]e/s w be c>$ =4 ,x is impossible to speak ( ! v>i$ causes ( insanity1 or ( ! equally v>i$ manife/ations ( ! disease & conduct ( ! pati5t at its onset1 b !re are a few conditions :i*1 be+ pres5t1 give a "* to a p>ticul> case1 & sugge/ ! c>e requir$4 ,sometimes1 z has be5 said1 ! pati5t p>tly realizes 8 condition1 & is will+ to come to ! asylum1 & 9 e way to conduct himself 9 accordance ) ! rules & requirem5ts4 ,sometimes ! onset is sl[ & ! symptoms s obscure z to attract little att5tion4 ,foll[+ ?is1 m decid$ symptoms may appe>2 ! pati5t may become viol5t1 noisy1 de/ructive1 or sleepless1 or he may try to commit suicide or homicide1 or d "s o!r act ( viol5ce2 or ! great re/lessness1 moan+1 cry+1 & sleeplessness ( melan*olia may come on1 or ! pati5t may refuse1 = sev]al days1 all food4 ,! reason = br++ su* pati5ts to ! asylum is t !y c no long] be kept at home4 ,foll[+ ! treatm5t t has be5 describ$1 ^! pati5ts w frequ5tly 9 a %ort "t become m quiet1 self-controll$1 & m easily influ5c$ & c>$ =4 ,! e>li] /ages ( insanity are frequ5tly accompani$ by consid]able di/urbance ( bodily heal?4 ,! appetite is poor1 ! dige/ion disord]$1 ! b[els con/ipat$1 ! brea? f\l1 ! secretions ( ! sk9 *ang$ & (t5 (f5sive1 ! temp]ature a little elevat$1 ! pulse rapid1 & ! he>t weak4 ,sometimes1 on ! o!r h&1 ! temp]ature is normal1 or a little bel[1 :ile ! h&s are cold & clammy4 ,9 addition1 nutrition is frequ5tly impair$1 s t ! food tak5 by pati5ts does n seem to prop]ly n\ri% & /r5g!n4 ,all ( ^! symptoms are n pres5t 9 a giv5 case2 sometimes mo/ ( !m may be1 & aga9 b few are to be notic$4 ,! important lesson to le>n 9 ! c>e ( ^! cases is t su* pati5ts may rapidly pass into a m s]i\s condition1 9 :i* !re is great exhau/ion1 :i* is always al>m+1 & may ev5 result fatally4 ,rec5t cases1 su* z h be5 spok5 (1 ne$ our be/ c>e1 close/ att5tion1 & k9de/ nurs+4 ,! pati5t %\ld daily take suffici5t food1 :i*1 if necess>y1 %\ld be en=c$1 & ! opportunity = sleep promot$4 ,a few days1 or a day1 )\t food & sleep may br+ on al>m+ symptoms4 ,= ^! pati5ts1 milk is ! be/ article ( diet2 x is mo/ easily giv5 & readily tak52 x %\ld be giv5 by ! glassful1 or if n able to d ?is by ! spoonful4 ,"s pati5ts1 = reasons n always kn[n1 w refuse food "o h\r & take x freely ! next2 x %\ld1 !re=e1 be frequ5tly (f]$4 ,) milk z a basis1 we may add to x1 z we are able4 ,raw egg1 gruel1 boil$ rice1 oatmeal1 cu/>d1 & bread are adjuncts t are nutriti\s & easily giv54 ,x makes b little diff]5ce :y pati5ts refuse food1 except t a k ( ! reasons may enable u to ov]come _! dis9cl9ations4 ,! ?+ to rememb] is t !y mu/ 9 "s way be made to get en\gh4 ,c>e ( ,pati5ts ) ,insanity1 ,accompani$ by ,exhau/ion4--,!re is a condition associat$ ) acute mania or melan*olia--?\gh x is sometimes se5 9 connection ) ! m *ronic =ms ( insanity1--( exhau/ion s ov]p[]+1 t x may be rightly comp>$ ) ! exhau/ion ( typhoid fev]4 ,x may la/ a few days or a mon?1 or m1 if x does n soon] t]m9ate fatally4 ,in/ead ( ! quiet delirium ( typhoid fev] !re is g5]ally viol5t mania or fr5zy4 ,nei!r m9d nor body is quiet2 sleep seems to h fl$4 ,! pati5t may be de/ructive1 con/antly out ( b$1 fight+ c>e1 refus+ food1 & wett+ & dirty+ himself4 ,) ^! un=tunate conditions !re g5]ally is fev]1 (t5 to a consid]able degree1 ! he>t is feeble1 ! pulse rapid1 ! tongue & lips dry & crack$1 ! tee? cov]$ ) sordes1 & ! body emaciat$4 ,e case does n pres5t all ^! symptoms1 nor %[ su* al>m+ exhau/ion4 ,!re are _m degrees ( sev]ity 9 ?is sickness4 ,su* pati5ts mu/ nev] be left alone & ne$ con/ant nurs+ day & night4 ,!y mu/ h food1 ev5 if x is giv5 =cibly4 ,!y mu/1 if possible1 be kept 9 b$1 & cov]$ ) clo?+1 & !y mu/ be kept clean4 ,if wakeful1 food mu/ be adm9i/]$ dur+ ! night1 & especially t[>ds morn+1 :i* is ! "t ( greate/ weakness & physical depression4 ,hot ba?s may be ord]$ = ^! pati5ts1 & /imulants & m$ic9e to produce sleep left 9 ! c>e ( att5dants4 ,h[ to give ! ba?s & m$ic9e1 :at results are to be expect$1 & :at dang]s are to be fe>$1 w be describ$ lat]1 9 ! *apt] on ! adm9i/ration ( m$ic9e4 ,!re are c]ta9 symptoms :i* %\ld w>n ! att5dant ( dang]1 & :i* (t5 prec$e dea?4 ,:5 any ( ^! are pres5t !y %\ld be report$ to ! physician4 ,!y are3 p>tial or complete unconsci\sness1 sl[ & labor$1 rapid1 %all[1 or irregul> brea?+1 increas$ weakness & rapidity ( he>t or pulse1 cold h&s & feet4 ,pick+ at ! b$clo!s1 or at imag9>y objects 9 ! air1 or vacant />+1 are bad symptoms4 ,! ,c>e ( ,pati5ts 9 a ,condition ( ,dem5tia4--,x is to be rememb]$ t dem5tia may be ei!r1 a condition ( *ronic insanity )\t recov]y1 or a less p]man5t /ate ( m5tal enfeeblem5t foll[+ ! acute attack1 & f :i* recov]y may be hop$4 ,9 ! fir/ ( ^! conditions !re is little to be done except to c>e = ! pati5t4 ,_m are able to d "s "w1 & %\ld be all[$1 enc\rag$1 & taught to d x4 ,o!rs d n "k en\gh to dress1 fe$1 or c>e = !mselves4 ,^! mu/ be kept neatly dress$1 tak5 to ! table & _! food prep>$1 tak5 to ! ba? & closet1 tak5 to walk1 & put to b$4 ,if n s att5d$ to1 !y w deg5]ate into a ragg$1 dirty1 & ev5 fil?y /ate1 & ! w>d ^u :i* !y live w be (f5sive to ! smell4 ,!y %\ld be frequ5tly exam9$ = body v]m91 z ^! pe/s are liable to bre$ & fl\ri% among ^! pati5ts4 ,! condition ( ! dem5t$ af=ds ! be/ evid5ce ( ! c>e giv5 to ! pati5ts 9 an in/itution4 ,att5dants w (t5 be gratifi$ to see "s ( ^! app>5tly hopeless cases greatly improve & sometimes recov]4 ,if att5dants w wat* _! pati5ts z !y come out ( acute mania or melan*olia & become quiet1 !y w (t5 notice t !y ga9 9 fle% & become dem5t$4 ,! dem5tia may be b p>tial1 or s v complete t ! pati5t kn[s no?+4 ,f ?is !y may gradually g on to improvem5t1 or ev5 recov]y4 ,!y ne$ all ! c>e dem&$ by ! confirm$ dem5t1 &1 9 addition1 advantage mu/ be tak5 ( e means to promote recov]y4 ,!y mu/ be well f$1 regul>ly tak5 out = ex]cise1 &1 z !y are able1 enc\rag$ to employ !mselves4 ,any symptoms ( a return ( _! m viol5t condition1 any failure to sleep1 or *ange notic$ 9 ! heal? ( ! pati5t1 %\ld be at once report$4 ,c>e ( ! ,convalesc5t ,pati5ts4--,?is is ! p]iod t prec$es recov]y f disease4 ,) ! insane x is (t5 a critical "t1 & if n prop]ly c>$ = !y may fail to get well1 & become *ronic lunatics4 ,! pati5ts1 & frequ5tly _! fri5ds1 ?9k !y are well & %\ld be at home4 ,x is ! att5dant's duty to enc\rage ! pati5t1 & to promote 8 confid5ce 9 ! physician4 ,!y %\ld n be told ( _! pa/ conditions1 or ! disagreeable features ( _! sickness call$ to m9d1 & _! la/1 z well z _! fir/ impressions ( ! asylum %\ld be made pleasant4 ,sometimes !re is a slight return ( depression or mania1 & ! pati5t may sudd5ly beg9 to lose sleep4 ,^! conditions mu/ be obs]v$ & report$1 = x is v easy = pati5ts :o are recov]+ to become z di/urb$ z :5 !y 7 fir/ insane1 & to suff] a relapse f :i* !y may nev] recov]4 ,x is h>dly necess>y to rem9d ! att5dant t employm5t1 amusem5t1 & all ! heal?ful means ( occupation af=d$ by ! asylum1 %\ld be judici\sly all[$ ^! pati5ts4 ,sometimes pati5ts feel too well4 ,!y are too cont5t$1 happy1 & indiff]5t1 & are v active 9 body & m9d4 ,!y want to "w all day1 f e>ly 9 ! morn+ until late at night4 ,!y s+ z !y "w1 & talk r l\d & fa/4 ,^! pati5ts ne$ re/riction2 !y %\ld n be all[$ to "w too mu*1 s z to ov]tax _! /r5g?4 ,s long1 h[ev]1 z !y cont9ue to ga91 & sleep well1 little is to be fe>$1 & !y g5]ally become quiet] & recov]4 ,! ,c>e ( ! ,epileptic ,insane4--,n all epileptics are insane1 b !y are all liable to insanity4 ,g5]ally ! mo/ hopeless & difficult to be c>$ = are br\ght to ! asylum4 ,epileptics are liable to h fits at any "t1 b "s pati5ts h !m at night only4 ,! attack is g5]ally sudd51 ?\gh sometimes pati5ts h feel+s t w>n !m ( _! approa*4 ,?is may prec$e ! fit = a v %ort "t1 or ! pati5t may "k dur+ ! day t he w h a fit dur+ ! night4 ,epileptic fits are accompani$ by convulsions & unconsci\sness1 & are ! type ( all convulsions4 ,! unconsci\sness may be b mom5t>y1 or la/ an h\r or long]1 & ev5 prolong$ sev]al days2 ! convulsions may be b ! twit*+ ( a few muscles1 z ( ! face1 or may consi/ ( ! mo/ t]rible wri?+s1 & la/ = sev]al m9utes1 & be (t5 repeat$4 ,sometimes ! fits are u%]$ 9 by a scream4 ,! fit itself is n dang]\s to life1 b pati5ts may at night turn _! face d[nw>d & s smo!r2 !y may fall f high places1 or d[n /airs1 or into ! wat]1 or into ! fire1 & s injure !mselves4 ,!re is little to d dur+ an epileptic attack4 ,pati5ts %\ld n be held to prev5t ! convulsions1 b s t !y %all n injure !mselves4 ,a pill[ %\ld be plac$ "u ! head & ! b&s ab\t ! neck loos5$4 ,! nurse is sometimes giv5 rem$ies :i*1 if prop]ly adm9i/]$ :5 ! attack is felt to be com+ on1 may w>d (f ! fit4 ,nitrite ( amyl 9 small glass pe>ls is a common rem$y4 ,x is to be brok5 9 a h&k]*ief & sev]al /rong brea?fuls tak54 ,at _! be/1 epileptics are cross1 irritable1 quick-temp]$1 unreasonable1 & qu>relsome1 & !y w (t5 give a bl[ at slight1 or ev5 = no provocation4 ,aft] a fit !y are frequ5tly dang]\s & always require gu>d$ c>e & wat*+4 ,z has be5 said1 !y may soon recov] _! natural condition1 or rema9 9 a m or less prolong$ /ate ( unconsci\sness1 or !y may pass into a condition t appe>s natural1 b 9 :i* !y h b little or no appreciation ( _! situation or surr\nd+s1 or rememb] aft]w>ds :at !y d4 ,9 ^! /ates !y may1 )\t w>n+1 make viol5t assaults1 commit murd] or suicide1 or set ?+s on fire4 ,sometimes !y d outrage\s acts1 su* z beat+ _! own *ildr5 to dea? aga9/ ! wall1 or mutilat+ !m1 or roa/+ !m to dea? on ! /ove4 ,_m (t5 suff] f halluc9ations or illusions ( sight or he>+1 & h delusions ( imp5d+ h>m or assaults1 & ?9k !y mu/ def5d !mselves4 ,c>e ( ,pati5ts ) ,p>esis4--,?is is a =m ( insanity *>act]iz$ by progressive dem5tia & increas+ bodily enfeeblem5t & p>alysis4 ,! p>alysis is p>tial1 n complete2 ! pati5t's walk is feeble1 un/eady1 & %uffl+2 ! h&s are tremul\s1 lose _! f95ess ( t\* & ability to d "w & write2 !re is twit*+ 9 ! muscles ( ! tongue & ab\t ! m\?1 & ! spee* is ?ick & indi/9ct4 ,z ! disease progresses ! pati5t becomes helpless1 b$ridd51 wet1 & fil?y4 ,! result is always dea?4 ,convulsions l ^? ( epilepsy are liable to occur1 f :i* ! pati5ts may rally1 or 9 :i* !y may die or l+] a few days4 ,9 ! e>li] /ages ! pati5ts are (t5 /rong1 & controll$ by delusions & halluc9ations t make !m viol5t4 ,sometimes !y are simply good-natur$ & easily manag$4 ,!y g5]ally h v exalt$ & extravagant delusions1 & are )\t appreciation ( _! condition or surr\nd+s1 & are irritat$ at ! control ( ! asylum1 & on acc\nt ( _! unreasonabl5ess !y c r>ely be all[$ ! lib]ty o!rs enjoy4 ,p>etics (t5 eat rav5\sly & rapidly1 !y /uff _! m\?s full ( food & s *oke !mselves4 ,_! condition ( p>alysis may r5d] !m unconsci\s ( dang] & p[]less to help !mselves4 ,! c>e ne$$ by b$ridd51 fil?y p>etics is practically ! same dem&$ by helpless p>alytics1 ! old1 feeble1 or dem5t$ class1 & all o!rs :o _c c>e = !mselves4 ,c>e ( ! ,p>alytic1 ,helpless1 ,b$ridd51 & ,fil?y ,pati5ts4--,!re are _m pati5ts 9 an asylum :o are indiff]5t to all ! wants ( nature1 :o wet & dirty !mselves4 ,"s ( ^! pati5ts are b$ridd52 "s are ab\t ! w>d1 b dem5t$2 "s are viol5t & maniacal1 & "s f delusions make _! p]sons & rooms z fil?y z possible4 ,mu* c be done ) _m ( ^! pati5ts by regul>ly tak+ !m to ! closet1 & _! bad habits may 9 ?is way be brok5 up4 ,pati5ts ( ?is class %\ld be visit$ dur+ ! ev5+1 att5d$ to frequ5tly by ! night wat*1 & se5 ! fir/ ?+ 9 ! morn+4 ,pati5ts1 :5 dirty1 %\ld be ?or\ghly wa%$ & c>efully dri$4 ,_! b$s %\ld be clean$ & *ang$1 & dur+ ! day clean clo?+ %\ld be giv5 !m z (t5 z requir$4 ,! greate/ dang] t comes f n keep+ pati5ts clean is ! =mation ( b$-sores4 ,b$-,sores4--,b$-sores occur 9 pati5ts long conf9$ to b$1 & :o suff] f exhau/ive diseases4 ,p>alytics & p>etics are p>ticul>ly liable to !m1 ! diseas$ condition ( ! n]ves all[+ ! tissues to break d[n easily4 ,sometimes ! f+]s or toes ( a p>etic become gangr5\s or l>ge surfaces ( ! sk9 die1 & sometimes deep] tissues sl\gh away rapidly4 ,^! conditions may come on 9 a day or a night4 ,pati5ts :o are wet & dirty are m liable to h b$-sores4 ,!y w always appe> 9 a b$ridd5 p>etic 9 a few days if n kept p]fectly clean4 ,!y mo/ frequ5tly occur ov] bony projections :]e ! weight comes 9 ly+1 z ^u ! hips1 back1 or %\ld]s4 ,su* pati5ts1 %\ld1 if possible1 be made to sit up sev]al h\rs e day1 or plac$ fir/ on "o side1 !n on ! back1 & !n on ! o!r side4 ,if x c be done1 !y %\ld1 z !y lie 9 b$1 re/ _! hips on an inflat$ rubb] r+1 & if ! sk9 is r$ ! "p %\ld be ba!d 9 dilut$ alcohol4 ,aft] be+ ba!d & dri$ ! sk9 ab\t ! hips %\ld be du/$ ) "s dry p[d]4 ,p[d]$ oxide ( z9c is p]haps ! be/1 b ord9>y corn-/>* fl\r is valuable & s]ves a good purpose4 ,insane pati5ts frequ5tly w resi/ all c>e & e ef=t to prev5t b$-sores1 te>+ (f ! b&ages & dress+s & pick+ & irritat+ ! sores4 ,b$-sores %\ld nev] be all[$ to come because ( want ( att5tion or cleanl9ess1 b !re are conditions 9 :i* !y w appe> 9 spite ( e prev5tive4 ,b$-sores once =m$ %\ld be treat$ z ulc]s & accord+ to ! direction ( ! physician4 ,,*apt] ,,ix4 ,,"s ,,( ,,! ,,common ,,accid5ts ,,among ,,! ,,insane1 ,,& ,,! ,,treatm5t ,,( ,,em]g5cies4 ,! insane1 l o!rs1 may suff] f almo/ any accid5t4 ,x is n int5d$ to treat ( all accid5ts1 nor h[ to c>e = e em]g5cy4 ,?is is s l>ge a subject z to dem& a sep>ate text-book1 & !re are sev]al excell5t ones1 t att5dants w\ld d well to read4 ,b !re are among ! insane c]ta9 k9ds ( accid5ts t are likely to occur1 c]ta9 classes :o are liable to receive accid5ts1 & c]ta9 em]g5cies t frequ5tly h to be c>$ = by ! att5dant1 & ^! w be describ$4 ,e injury receiv$ by a pati5t %\ld be imm$iately report$ to a physician4 ,att5dants1 9 ! c>e ( ! insane %\ld always rememb] ! liability to accid5t & gu>d aga9/ x4 ,! old1 ! feeble1 ! p>alytic1 & p>etic ne$ special c>e4 ,!y are weak1 easily pu%$ ov]1 or /umble & fall1 & !y _c break ! weight ( _! fall1 or s def5d !mselves2 !y are irritable1 *ildi%1 & (t5 provok+ly tr\blesome to ! o!r pati5ts1 & _! bones seem to be easily fractur$4 ,"s injuries are self-inflict$1 "s come to ! pati5t 9 consequ5ce ( 8 own or o!rs' viol5ce1 & "s1 z has be5 said1 f ! v weakness ( ! pati5t4 ,c>e ( ,fractur$ ,bones4--,any ( ! bones may be fractur$1 & f slight cause4 ,! bones mo/ frequ5tly fractur$ are3 ! coll> bones1 ! ribs1 ! bones ( ! =e>m j above ! wri/1 ! bones ( ! l[] leg & ( ! ?igh4 ,?is la/ bone1 ! femur1 is among old p mo/ frequ5tly brok5 at its neck1 :i* is ! con/riction ( ! bone j bel[ ! r\nd$ end t fits into ! jo9t at ! hip4 ,fractures %\ld1 z mu* z possible1 be let alone till ! physician comes4 ,! p>ts %\ld be kept quiet s z n to cause unnecess>y pa91 & d fur!r injury4 ,by r\gh h&l+ x is v easy to pu% a fragm5t ( bone ?r\gh ! sk91 ?us mak+ a simple fracture a comp\nd "o4 ,:5 a rib is fractur$ a %>p end may pi]ce ! sk9 or ! lung2 ei!r complication is s]i\s4 ,if ! lung is injur$ ! sputa w be bloody1 & ! appe>ance ( su* a condition %\ld be at once report$4 ,sometimes pati5ts are viol5t aft] ! injury & ne$ to be firmly held1 & sometimes !y h to be c>ri$ to ! w>d f ! outside1 or plac$ ^u a b$4 ,always c>ry ! fractur$ limb z well z ! pati5t4 ,if tempor>y spl9ts are put on d n make !m too tight1 & loos5 !m f "t to "t z ne$$4 ,! extremities sometimes swell rapidly aft] a fracture1 & ! spl9ts may s /op ! circulation t1 9 a few h\rs1 gangr5e may be caus$ by !m4 ,besides1 _m pati5ts _c tell u if ! "p is swoll5 or pa9ful4 ,! ,c>e ( ,w\nds4--,bites4 ,insane pati5ts (t5 bite o!rs & p5etrate ! sk94 ,!y may be v angry1 _! m\?s f\l & runn+ ) saliva1 & ?is irritat+ sub/ance introduc$ into ! w\nd by ! tee? may set up an ugly inflammation4 ,! w\nd %\ld be imm$iately & ?or\ghly wa%$4 ,x %\ld be well clean$ ) a wet sponge or clo?1 & soak$ 9 w>m wat]4 ,a good aft]-dress+ is p[d]$ iod(orm1 spr9kl$ ov] ! w\nd4 ,w\nds ( ! ,head4--,^! w\nds are q common4 ,!y %\ld be ?or\ghly wa%$ & clean$ f dirt & hair4 ,hemorrhage may be controll$ by cont9u$ pressure ^u ! bones ( ! skull1 & if an art]y is cut1 x c 9 ?is way be kept f ble$+ till ! physician arrives4 ,mo/ w\nds ( ! head1 ev5 ?\gh l>ge1 g5]ally heal quickly1 b ! mo/ trifl+ ones may assume s]i\s proportions1 & ev5 prove fatal4 ,if )9 two or ?ree days heat1 pa91 r$ness1 & swell+ appe>1 pus is probably =m+ b5ea? ! scalp1 & ?is1 )9 a few h\rs1 may spread "u a l>ge surface & d s]i\s injury1 or erysipelas may be set up4 ,injuries f ,bl[s on ! ,head4--,p]sons are sometimes /unn$ by bl[s on ! head4 ,!y %\ld be plac$ 9 b$ ) ! head elevat$1 & kept p]fectly quiet till ! doctor comes4 ,ef=ts %\ld n be made to ar\se !m1 !y %\ld n be giv5 liquor ( any k9d1 b ice may be appli$ to ! head4 ,! dang] to be fe>$ is f ! skull be+ fractur$1 or f ble$+ vessels inside ( ! skull4 ,ei!r ( ^! conditions may1 by pressure ^u ! bra91 cause unconsci\sness1 p>alysis1 & dea?4 ,! ,c>e ( a ,cut ,?roat4--,pati5ts may cut _! ?roats f e> to e> & d really little injury1 or !y may make a small /abb+ w\nd & divide a l>ge blood-vessel & die almo/ imm$iately1 or !y may cut ! w9dpipe & n cut ! blood-vessels4 ,! w9dpipe y c notice ^u y\rselves z a l>ge1 /iff tube1 prom95tly situat$ 9 ! middle & front ( ! neck2 ! blood-vessels are toge!r on ea* side ( ! w9dpipe1 & situat$ q deep d[n among ! muscles1 & ! c>otid art]y may be felt beat+ by ! f+]4 ,little c be done by ! att5dants to /op ! fl[ ( blood1 ev5 if ! great blood-vessels are n cut4 ,! head %\ld be kept b5t =w>d & ! *9 press$ aga9/ ! *e/4 ,aft] ! physician has dress$ ! w\nd1 con/ant wat*+ day & night may be requir$ to prev5t ! pati5t te>+ (f ! b&ages & reop5+ x4 ,?is same rule ( wat*fulness applies to ! aft]-c>e ne$$ to be giv5 to _m cases ( fracture1 & o!r s]i\s injuries among ! insane4 ,c>e ( ,w\nds ( ! ,extremities ) ,hemorrhage4--,! hemorrhage f mo/ simple w\nds involv+ ! cutt+ ( sk9 & fle% or small art]ies1 c usually be controll$ by direct & cont9u$ pressure4 ,?is may be done by a pad made ( clo?1 pack$ & press$ into ! w\nd1 or l9t may be us$ 9 ! same way4 ,wat] z hot z c be borne p\r$ into ! w\nd w frequ5tly /op a hemorrhage :5 o!r means fail2 cold applications & ice are also useful4 ,if dirty1 a w\nd %\ld be ?or\ghly clean$1 be+ wa%$1 &1 if necess>y1 soak$ 9 w>m wat]4 ,iod(orm spr9kl$ s z to cov] w\nds1 is ! be/ dress+ = all att5dants or nurses to apply1 :ile await+ directions f a physician4 ,x keeps !m clean1 promotes heal+1 & less5s ! dang] ( inflammation or ! =mation ( pus4 ,:5 ! art]ies ( ! extremities are cut1 pressure %\ld be made on ! l>ge art]y lead+ to ! "p4 ,:5 ! w\nd is high up on ! arm1 pressure is made by ! f+]s or a padd$ key ^u ! art]y t lies back ( ! coll> bone1 & ! attempt %\ld be made to press x aga9/ ! bone4 ,?is is a difficult ?+ to d1 b nev]!less x %\ld be attempt$4 ,:5 ! w\nd is l[] d[n1 pressure is to be made by ! f+]s on ! inn] side ( ! upp] arm1 at ab\t ! middle po9t & aga9/ ! bone4 ,! art]y runs d[nw>d1 ne> ! inn] bord] ( ! biceps muscle1 :i* is ! l>ge1 bulg+ muscle ( ! upp] arm1 & c1 ) a little c>e1 be felt beat+ by ! f+]s4 ,pati5ts 9 break+ glass (t5 cut "o or bo? art]ies at ! wri/-jo9t :]e ! pulse is felt4 ,^! are l>ge & ble$ rapidly1 & :5 cut ne$ ! c>e j describ$4 ,:5 ! art]y 9 ! leg is w\nd$1 pressure is to be made on ! inn] side ( ! ?igh1 j bel[ ! gro94 ,! position ( ^! l>ge art]ies1 & h[ to press aga9/ ! bone1 is be/ le>n$ by in/ruction & demon/ration f a physician1 & ) a little practice att5dants w be able to easily & successfully d ! act4 ,x is v tiresome to cont9ue pressure ) ! f+]s = a long "t1 & att5dants %\ld relieve "o ano!r till ! physician comes4 ,! ,c>e ( ,spra9s4--,spra9s are a common accid5t & easily produc$4 ,! great end ( treatm5t is to keep ! spra9$ jo9t quiet4 ,if ! ankle or knee is spra9$1 ! pati5t %\ld be c>ri$ to b$4 ,p]haps ! be/ e>ly treatm5t1 & ! "o t gives ! greate/ relief to pa91 is to place ! jo9t 9 a tub ( wat] z hot z c be borne1 & keep x hot by p\r+ 9 m4 ,! "p %\ld be kept 9 ! wat] until x is p>boil$4 ,! sk9 ( "s feeble or p>alytic pati5ts is easily scald$1 & "s _c tell :5 x is too hot2 ! wat] !re=e %\ld nev] be uncom=table to ! h& ( ! att5dant4 ,c>e ( ,pati5ts ,*ok+4--,?is is a frequ5t accid5t1 & 9 ord] to "k :at to d :5 x occurs1 x is necess>y to h a k ( ! air passages ( ! ?roat4 ,we brea! ?r\gh ! m\? & nose4 ,!y op5 into a common passage1 ! ph>ynx1 :i* c be se5 by look+ into ! m\?1 ly+ back ( ! tonsils4 ,pass+ d[nw>d1 x divides by bran*+ into two tubes2 "o ! w9dpipe1 :i* is 9 front1 beh9d x is ! oesophagus or gullet4 ,! po9t ( division is j beyond ! tongue1 & is almo/ )9 rea* ( ! =ef+] :5 cr[d$ into ! m\?4 ,! air we brea! passes ?r\gh ! m\? & nose to ! ph>ynx1 !nce to ! lungs by ! w9dpipe4 ,! food we eat passes f ! m\? to ! ph>ynx1 & !nce to ! /oma* by ! oesophagus4 ,!re is at ! op5+ ( ! w9dpipe a cov]1 ! epiglottis1 :i* is g5]ally op51 b :i* closes :5 food is swall[$ & helps to keep food f ent]+4 ,:5 a sub/ance t\*es ! op5+ ( ! w9dpipe1 we in/antly c\gh to expel x4 ,a p]son may *oke1 :5 ! m\? & ! ph>ynx back ( x are fill$ ) food2 or :5 a piece is lodg$ 9 ! w9d-pipe1 or a l>ge piece 9 ! oesophagus at ! po9t ( division1 & :i* cr[ds ^u ! w9dpipe1 or cov]s ! op5+4 ,food gets into ! w9dpipe1 by be+ drawn 9 by a sudd5 & unexpect$ inspiration ( air4 ,?is may happ5 :ile eat+ or 9 vomit+ solid food4 ,) ?is accid5tal exception all brea?+ /ops dur+ ! act ( swall[+4 ,"s pati5ts1 f p>alysis1 especially p>etics1 d n feel food :5 x is lodg$ 9 ! ?roat2 o!rs1 f great dem5tia1 may n "k :5 !y are *ok+1 & %[ no emotional signs ( di/ress4 ,p>etics are p>ticul>ly liable to bolt _! food1 & cram ! m\? & ?roat full4 ,! symptoms ( *ok+ are imm$iate1 & if no relief is obta9$1 ! suff]] w die 9 a few m9utes4 ,if ! pati5t kn[s any ?+1 he w %[ imm$iate signs ( di/ress1 viol5t b ineffectual attempts to brea!1 & ! face quickly becomes a d>k blue color1 f ! accumulation ( c>bonic acid 9 ! blood4 ,imm$iate effects %\ld be made to remove ! ob/ruction1 & cont9u$ until ! physician arrives1 :o is to be s5t = at once4 ,:atev] is 9 ! m\? & ?roat c be easily remov$ by ! f+]s2 ! =ef+] %\ld !n be cr[d$ d[n ! ?roat to feel = o!r ob/ructions1 c>e be+ tak5 n to pu% a piece ( food into ! w9dpipe4 ,if any ?+ is felt1 x c sometimes be pull$ out by ! f+]s1 or a hair-p9 may be /raight5$ & b5t1 or a piece ( wire1 & an ef=t made to fi% x out4 ,:5 9 ! gullet & beyond ! f+]s1 x may be pu%$ into ! /oma* by a fe$+-tube4 ,artificial respiration may be ne$$1 b att5dants mu/ rememb] x is ( no use until ! ob/ruction to brea?+ is remov$4 ,m>bles1 co9s1 buttons1 pieces ( p5cils1 ne$les1 p9s1 & fi%-bones1 are frequ5tly swall[$4 ,! physician %\ld be in=m$ at once4 ,directions h[ to ,p]=m ,artificial ,respiration4--,:at is to be done mu/ be done quickly2 tight clo?+ ab\t ! neck & *e/ mu/ be remov$1 & ! m\? %\ld be clean$ ( dirt1 wat]1 or any ob/ruction to ! fl[ ( air4 ,! body is !n laid out flat on ! back1 cov]$1 if possible1 ) light w>m blankets1 & "s article %\ld be fold$ & plac$ "u ! %\ld]s1 s z to raise !m ?ree or f\r in*es4 ,! m\? mu/ be kept op51 & ! tongue pull$ well =w>d1 z x is liable to fall backw>ds1 & cov] ! op5+ ( ! w9d-pipe4 ,"o p]son1 kneel+ beh9d ! head1 %\ld grasp ea* arm at ! elb[1 &1 draw !m /eadily ar\nd s t ! arms w meet above ! head4 ,a /rong pull %\ld be made ^u !m1 & !y %\ld be held a few seconds4 ,^! movem5ts elevate ! ribs & enl>ge ! *e/ & produce an inspiration4 ,! arms are !n to be br\ght to ! side1 & press$ /rongly aga9/ ! l[] ribs4 ,?is la/ movem5t drives ! air out ( ! lungs1 & makes an expiration4 ,^! manipulations %\ld be repeat$1 sl[ly & regul>ly1 ab\t sixte5 times a m9ute1 & %\ld1 :5 !re is ! slighte/ hope ( life1 be cont9u$ at lea/ ?irty m9utes4 ,! he>t %\ld be li/5$ to1 9 ord] to he> if x /ill beats4 ,w>m?1 by hot-wat] bags1 bricks1 & soap/ones %\ld be secur$1 c>e be+ tak5 n to burn ! sk94 ,! limbs may be g5tly rubb$ ) w>m clo?s1 ?\gh x is n s important z "s well-mean+ p ?9k4 ,! rubb+ %\ld be t[>ds ! he>t4 ,z ! brea?+ beg9s1 x %\ld be /ill aid$ by ! artificial means z long z necess>y4 ,:5 ! pati5t c swall[1 teaspoonful doses ( br&y or :iskey1 to two or ?ree ( wat]1 may be giv5 & repeat$ sev]al times4 ,z soon z possible ! pati5t %\ld be put 9 a w>m b$1 & milk & light food giv54 ,c>e ( ,pati5ts :5 ,fir/ ,burn$4--,:5 a pati5t's clo?+ is fir/ on fire1 da% wat] ov] him if ne> at h&1 if n wrap him 9 a blanket or "s heavy wooll5 g>m5t1 & smo!r ! fire4 ,!n unroll ! pati5t & ext+ui% ! sm\ld]+ pieces ( clo?+4 ,! clo?+ mu/ be cut & clipp$ (f4 ,great c>e mu/ be tak5 n to te> op5 ! bli/]s4 ,if any application is made1 x may be by l95 clo?s soak$ 9 sweet or ca/or oil1 or equal p>ts ( l9se$ oil & lime-wat]1 or a lay] ( fl\r & molasses may be appli$ ov] ! burn$ surface4 ,^! bl& sub/ances act l>gely by exclud+ ! air1 :i*1 if bl[+ ev] s quietly1 is always pa9ful & irritat+1 & !y also protect ! w\nd f ! irritation ( ! b$ & body clo?+4 ,burns f scald+ are practically treat$ 9 ! same way z burns f fire4 ,c>e ( ,fro/-bites4--,toes1 f+]s1 e>s1 & noses are mo/ frequ5tly froz54 ,!y w sometimes freeze 9 a few m9utes on a v cold day4 ,aft] a "p is froz5 !re is no feel+ ( cold or pa91 & x looks p]fectly :ite1 & is s /iff x may be brok54 ,p]sons :o are fro/-bitt5 %\ld n be tak5 into a w>m room4 ,!y %\ld be left 9 a cool room1 & ! froz5 "p rubb$ ) cold wat]1 or ice1 or sn[4 ,z ^! la/ melt !y melt ! froz5 fle%4 ,if ! p>ts are ?aw$ too quickly gangr5e is liable to foll[4 ,c>e ( ,pati5ts 9 ,/ates ( ,unconsci\sness4--,?is is n an accid5t1 b a frequ5t em]g5cy4 ,! m$ical ^w = unconsci\sness is coma4 ,x may be p>tial or complete1 may come on sudd5ly or sl[ly1 or may be accompani$ by convulsions or p>alysis4 ,! m frequ5t causes ( coma1 are epilepsy1 ! convulsions ( p>esis1 bl[s on ! head1 hemorrhage 9 ! bra9 or apoplexy1 "s diseases ( ! bra91 sun/roke1 & "s poisons4 ,:5 coma comes on1 att5dants %\ld obs]ve1 if x is sl[ or sudd52 if ! pati5t compla9s ( pa9 9 ! head2 if ! respirations are *ang$1 & h[2 ! condition ( ! pupils1 :e!r l>ge1 contract$1 unev51 or *angeable2 if ! m\? & face are drawn to "o side2 if !re is any p>alysis ( ! arms or legs2 if !re are any convulsions1 or twit*+ ( muscles2 if ! pati5t c be ar\s$1 & f "t to "t obs]ve & c\nt ! pulse4 ,apoplexy is a t]m t is mu* us$1 & is a condition ( coma1 caus$ by pressure on ! bra94 ,?is organ is 9 a tight1 rigid box1 ! skull4 ,if ! fluid ( ! bra9 is mu* increas$1 or blood-vessels ruptur$1 pressure is ! result1 & ! s(t tissues yield1 r ?an ! bony cov]+4 ,?is pressure may de/roy or injure ! cells & fibres1 & s int]f]e ) ! function ( ! "p4 ,ano!r way t apoplexy occurs is by plugg+ ( an art]y ( ! bra91 s t x _c deliv] blood to ! "p to :i* x goes1 & consequ5tly ! "p loses its ability to p]=m its function4 ,! plugg+ is mo/ frequ5tly due to a small clot float+ 9 ! blood1 & :i* is usually =m$ 9 ! he>t4 ,p>alysis & apoplexy are (t51 ?r\gh ignorance1 us$ synonym\sly1 b !y really mean v diff]5t conditions4 ,p>alysis is a loss ( p[] ( contract+ a muscle1 due to disease or injury ( ! n]v\s sy/em2 x frequ5tly foll[s or is associat$ ) apoplexy4 ,9 ! case ( apoplexy1 & mo/ conditions ( coma1 !re is g5]ally little = ! att5dant to d4 ,! pati5t %\ld be put to b$1 ) light cov]+s1 & ! head rais$ on pill[s4 ,d n annoy ! pati5t by try+ to r\se him1 & d n give /imulants4 ,c>e ( ,sun/roke4--,a sun/roke is a v s]i\s condition1 & :5 x occurs1 requires imm$iate ef=ts to save ! life ( ! "o suff]+ f x4 ,x g5]ally comes on sudd5ly1 ! pati5t fir/ compla9+ ( ! head2 he soon becomes unconsci\s1 ! sk9 hot & dry1 & ! pulse full & b\nd+4 ,! treatm5t consi/s ( tak+ ! pati5t to a cool1 %ad$ place1 remov+ all unnecess>y clo?+1 apply+ ice or cold wat] to ! head1 & ba?+ or spong+ ! body 9 cold wat]4 ,if ! pati5t recov]s1 ! temp]ature w fall "u ?is treatm5t4 ,if ! he>t beg9s to fail1 or ! pulse becomes weak or flutt]+1 small doses ( :iskey & wat] may be giv5 & repeat$4 ,pati5ts %\ld n be tak5 out 9 ! fields nor expos$ places on v hot days1 except z ord]$ by ! physicians2 !y %\ld we> light clo?+ & a /raw hat2 if p]mitt$ to g out1 !y %\ld n ov]work1 & %\ld be all[$ frequ5tly to re/ 9 ! %ade4 ,pati5ts are easily injur$ by work+ 9 ! sun2 heada*e caus$1 recov]y ret>d$1 & bad symptoms br\ght back1 )\t hav+ ! al>m+ conditions ( sun/roke4 ,unconsci\sness f ,poison+4--,opium & its prep>ations1 includ+ morph9e1 *loral1 & ! two extracts ( hyoscyamus1 n[ s mu* employ$ 9 asylums1 namely1 hyosc9e & hyoscyam9e1 are m$ic9es frequ5tly giv51 t poison 9 ov]-doses & produce coma4 ,^! m$ic9es & _! effects w be describ$ 9 ! next *apt]1 & at ! same "t ! symptoms ( poison+ by !m1 & ! treatm5t4 ,poison+4--,poison\s drugs are n kept ^u ! w>ds4 ,att5dants frequ5tly h /rong ammonia 9 _! rooms to clean _! clo?+1 & a pati5t may get x & dr9k x4 ,x is a /rong alkali1 & burns ! ?roat & m\?4 ,v9eg> is ! be/ ready antidote1 b %\ld be giv5 imm$iately or n at all4 ,s(t soap is a /rong alkali1 & if eat5 becomes an irritat+ poison4 ,aga9 v9eg> is ! be/ antidote4 ,! be/ antidotes = acids are soda1 lime-wat]1 soap-suds1 & *alk2 = alkalies1 weak acids1 su* z lemons1 oranges1 v9eg>1 or cid]4 ,olive oil1 eggs1 & mucilag9\s dr9ks are ! mo/ bl& & soo?+ rem$ies to give4 ,to vomit a p]son :o has tak5 poison1 give a p9t or a qu>t ( lukew>m wat]2 to x may be add$ "o or two teaspoonfuls ( mu/>d4 ,syrup ( ipecac is a common rem$y1 ! dose is a teaspoonful1 & repeat$ 9 t5 m9utes if necess>y4 ,x assi/s vomit+ to tickle ! ?roat ) a f+] or a fea!r4 ,if aft] poison+ !re is depression or approa*+ coma1 v /rong tea or c(fee is ! be/ /imulant1 & x is z well an antidote to _m poisons4 ,if ! he>t & pulse are v weak1 :iskey dilut$ ) wat] may be giv5 & repeat$4 ,injury f ,eat+ ,glass4--,pati5ts sometimes eat glass4 ,?is injures by ! edges cutt+ & inflam+ ! walls ( ! /oma* & inte/9es4 ,?is may be s sev]e z to cause dea?4 ,9 ! treatm5t d n give an emetic or a ca?>tic4 ,su* food z has a t5d5cy to con/ipate ! b[els1 & su* z w also enclose ! glass & coat its %>p edges1 is to be giv54 ,potatoes1 especially sweet1 oatmeal1 or ?ick indian-meal pudd+1 are appropriate4 ,cotton1 :i* is g5]ally at h&1 w1 if swall[$1 engage ! glass 9 its fibres1 & s protect f injury4 ,injury ) ,ne$les4--,?is is a self-injury1 b x may be sev]e & require imm$iate att5tion4 ,pati5ts may op5 a ve9 or an art]y ) a ne$le1 or plunge x into ! eye4 ,b ! m common way is = a pati5t to /ick _m ne$les "u ! sk91 sometimes to ! numb] ( sev]al hundr$4 ,sometimes pati5ts introduce !m ne> ! he>t or lungs1 & z a ne$le w (t5 travel :5 9 ! fle%1 x may "w its way into a deep] "p1 & s a numb] get into ! lungs or ! he>t1 caus+ dea?4 ,)9 a few weeks ,i saw two ne$les tak5 f a man's he>t1 :o di$ 9 consequ5ce ( _! pres5ce !re4 ,an attempt or desire to s injure "o's self %\ld be gu>d$ aga9/ by ! att5dants1 & if accompli%$ %\ld be at once report$ to ! physician1 t ef=ts may be made to extract ! ne$le4 ,,*apt] ,x4 ,,"s ,,s]vices ,,frequ5tly ,,dem&$ ,,( ,,att5dants1 ,,& ,,h[ ,,to ,,d ,,!m4 ,! ,adm9i/ration & ,effect ( ,m$ic9e4--,! only prop] way ( giv+ m$ic9e is by us+ /&>d weights & measures4 ,dropp+ m$ic9e1 or us+ spoons or cups1 is n suffici5tly accurate4 ,a drop may be half a m9im1 or z l>ge z two or ev5 ?ree4 ,! mod]n teaspoon holds n9ety or m m9ims1 & a tablespoon m ?an half an ounce4 ,m$ic9es are introduc$ into ! sy/em ?r\gh ! /oma*1 ! lungs1 ! rectum1 ! sk91 or by be+ inject$ into ! tissues1 "u ! sk94 ,!y are ei!r local or g5]al 9 _! effects4 ,a bli/] or a p\ltice is a local rem$y1 s is an emetic1 t acts by irritat+ ! walls ( ! /oma*4 ,g5]al m$ic9es are absorb$ into ! blood1 & c>ri$ to diff]5t p>ts ( ! body4 ,! foll[+ are a few ( ! reasons = :i* m$ic9e is giv53 to relieve pa91 to give sleep1 to produce vomit+1 to *eck vomit+1 to move ! b[els1 to *eck di>rhoea1 to assi/ dige/ion1 to produce a great] or dim9i%$ fl[ ( ur9e1 to increase ! p]spiration1 to increase ! r$ blood corpuscles1 to *eck hemorrhage1 to regulate ! action ( ! he>t1 to ov]come ! effects ( poison1 to increase or dim9i% ! am\nt ( blood 9 ! bra91 to control spasm1 to dim9i% ! temp]ature 9 fev]4 ,9 "s cases ! effect desir$ & expect$ f a m$ic9e giv5 to a pati5t is told to ! att5dant1 :o %\ld closely obs]ve & be able to report ! result4 ,sometimes m$ic9es are left 9 ! h& ( ! att5dant1 to give 9 repeat$ doses1 at /at$ int]vals1 till a desir$ effect is produc$4 ,! att5dant is also in/ruct$ to wat* = c]ta9 symptoms :i* %[ t ! m$ic9e is do+ h>m1 :5 x is to be discont9u$4 ,an att5dant1 :o has /udi$ & le>n$1 h[ & :at to obs]ve 9 8 pati5t1 w be able to give intellig5tly any m$ic9e ord]$ by a physician4 ,sometimes m$ic9es1 giv5 9 l>ge or long-cont9u$ doses1 cause symptoms t an att5dant %\ld notice & report to ! physician2 "s ( ^! are1 eruptions on ! face & body1 puff9ess ab\t ! eyes1 irritation & runn+ ( ! eyes1 a metallic ta/e 9 ! m\?1 ble$+ ( ! gums or sor5ess ( ! tee? & pr(use fl[ ( saliva1 nausea1 vomit+1 di>rhoea1 con/ipation1 indige/ion1 r++ ( ! e>s1 feel+ ( fulness 9 ! head1 heada*e1 dizz9ess1 dr[s9ess1 coma1 convulsions1 or convulsive movem5ts ( muscles4 ,9 asylums1 m$ic9es are mo/ly s5t to ! w>ds 9 s+le doses1 ea* cup or bottle be+ m>k$ ) ! "n ( ! pati5t = :om x is int5d$4 ,! tray 9 :i* !y are c>ri$ %\ld nev] be set d[n & left1 = a mis*iev\s or suicidal pati5t may poison himself by tak+ e ?+ he c get hold (4 ,no pati5t1 unless ord]$ by ! physician1 %\ld be all[$ to keep 8 cup & take 8 m$ic9e at 8 leisure4 ,suicidal pati5ts (t5 ask to d ?is1 & !n save ! m$ic9e1 until !y h en\gh to poison !mselves4 ,o!rs w ?r[ ! m$ic9e away4 ,! way to adm9i/] m$ic9e to ! insane is to give x p]sonally to ! pati5t1 & also see t x is swall[$4 ,x is a frequ5t cu/om ( _m pati5ts to reta9 ! m$ic9e 9 ! m\?1 &1 :5 ! att5dant has left1 to spit x out4 ,x is (t5 v important t pati5ts %\ld take ! m$ic9e ord]$1 & e ef=t %\ld be made to induce !m to take x4 ,su* pati5ts %\ld be designat$ by ! physician4 ,night m$ic9es1 or ^? giv5 ab\t b$time1 are usually ( great importance4 ,all pati5ts :o refuse to take _! m$ic9e %\ld be report$ to ! physician4 ,! reasons = refus+ m$ic9es are v>i\s2 "s say !y are p]fectly well & ne$ no m$ical treatm5t1 o!rs ?9k ! m$ic9e injures !m1 t x turns _! sk9 black1 or poisons !m1 or t x is wrong to take x1 or displeas+ to ,god2 ideas mu* l ^? t we le>n$ 7 ! causes = ! refusal ( food4 ,att5dants are to use e ef=t to get pati5ts to take m$ic9e1 & may employ z mu* =ce z !y 7 in/ruct$ to use 9 giv+ food1 b no m4 ,pati5ts %\ld n be deceiv$ ab\t m$ic9es1 nor told by att5dants t x is no?+1 t x is only a little wat]1 or "s nice dr9k t is s5t to !m1 nor %\ld an attempt be made to give !m1 by try+ to disguise !m 9 food or dr9k1 except by ! p]mission ( a physician4 ,pati5ts %\ld1 on ! o!r h&1 be told t x is m$ic9e1 t ! doctor ord]$ x = !m1 t x is = _! good to take x1 t x is giv5 to help !m get well4 ,! giv+ ( m$ic9e & food is among ! mo/ important & frequ5t duty t an att5dant is call$ ^u to p]=m1 or assi/ o!rs 9 do+4 ,att5dants mu/ rememb] t _m m$ic9es are injuri\s or ev5 poison\s1 if n prop]ly giv51 or if mix$ ) o!r m$ic9es1 or if giv5 to ! wrong pati5t2 !y %\ld !re=e1 nev] make a mi/ake1 or1 if by c>elessness !y commit "o1 %\ld imm$iately report x4 ,opium & ,"s ( its ,prep>ations4--,opium is a m$ic9e t is v frequ5tly giv5 to pati5ts 9 an asylum4 ,! ord9>y dose is "o gra94 ,t9cture ( opium1 or laudanum1 is opium dissolv$ 9 alcohol4 ,t5 m9ims equal "o gra9 ( opium4 ,camphorat$ t9cture ( opium1 or ,p>egoric1 is a weak] alcoholic solution1 ) "s camphor1 & flavor$ ) a pleasant aromatic4 ,"o half a fluid ounce equals a gra9 ( opium4 ,morph9e is a :ite p[d] extract$ f opium4 ,an eigh? ( a gra9 ab\t equals a gra9 ( opium4 ,opium1 9 "s ( its =ms1 is a common h\sehold rem$y4 ,to an adult1 n m ?an "o gra9 %\ld be giv52 x %\ld n be repeat$ m ?an once1 nor less ?an six h\rs aft] ! fir/ dose4 ,x w\ld be bett] if nev] giv51 except by a physician's ord]4 ,"u no circum/ances %\ld any "o b a physician give x to a weak or old p]son1 or to a "y *ild4 ,opium1 is giv5 9 ord9>y doses to relieve pa91 to *eck di>rhoea1 to relax spasm ( muscles1 & to produce sleep4 ,! sleep f opium is g5]ally quiet & refre%+1 & "o f :i* ! pati5t c be easily ar\s$4 ,an att5dant w frequ5tly be told :5 ! m$ic9e is giv5 & direct$ to note & report its effect4 ,opium ,poison+4--,! tak+ ( opium is a frequ5t way ( committ+ suicide by p]sons outside ( asylums4 ,sometimes pati5ts manage to save _! doses1 or !y /eal x f ! tray1 or1 if !re is "s s5t to ! w>d = repeat$ doses1 !y secure x ?r\gh ! c>elessness ( an att5dant1 or occasionally x is secretly s5t to pati5ts by (fici\s outside fri5ds1--?us poison+ by opium sometimes occurs among asylum pati5ts4 ,! full symptoms ( poison+ are pr(\nd coma1 pupils contract$ to p9-po9ts1 & :i* d n respond to light2 v sl[ respiration1 (t5 n m ?an f\r or six times a m9ute1 b heavy & labor$4 ,sometimes ! effect ( ! drug is b p>tial1 ! pati5t c be ar\s$ = a mom5t1 b falls to sleep aga91 or ! symptoms may be ev5 less pron\nc$4 ,! treatm5t ( opium poison+1 be=e ! physician comes1 consi/s 9 giv+ v /rong c(fee1 or tea1 an emetic1 & 9 try+ to keep ! pati5t awake by walk+ him ab\t1 or1 if ?is is n possible1 to keep him f fall+ into deep] coma1 by %ak+1 call+ l\dly 9 ! e>1 & /rik+ & slapp+ ! body ) wet t[els4 ,*loral4--,?is is a :ite cry/al1 ) a pung5t1 burn+ ta/e4 ,x is always disp5s$1 dissolv$ 9 wat]1 & %\ld be fur!r dilut$ :5 giv5 to a pati5t4 ,! dose is f t5 to ?irty gra9s4 ,x is too p[]ful a drug to be giv51 except ^u ! ord] ( a physician4 ,*loral is giv5 to produce sleep1 :i* is usually quiet & natural4 ,! effect la/s ab\t f\r or six h\rs4 ,! symptoms ( poison+ are n s m>k$ z to make x easy to "k t !y are caus$ by *loral4 ,!re is g5]ally a weak he>t & pulse1 & feeble respiration1 & ! pati5t is 9 a deep sleep1 f :i* he may be ar\s$2 or ! coma may be pr(\nd1 & cont9ue un9t]rupt$ till dea?4 ,! treatm5t consi/s 9 giv+ an emetic1 /imulants1 c(fee1 &1 if necess>y1 p]=m+ artificial respiration4 ,hyoscyam9e & ,hyosc9e4--,^! are extracts1 f ! leaves & se$s1 ( ! plant hyoscyamus4 ,^! are v p[]ful m$ic9es1 & are nev] giv5 except on ! ord] ( a physician4 ,!y are always giv5 9 solution4 ,! action ( bo? is practically ! same4 ,9 ord9>y doses !y quiet re/lessness1 produce muscul> weakness1 flu%+ ( ! face1 dryness ( ! tongue1 wide dilatation ( ! pupils1 & frequ5tly cause sleep4 ,^! effects %\ld be notic$ & report$4 ,^! m$ic9es are mo/ly giv5 to pati5ts :o are cont9ually re/less1 viol5t1 & sleepless1 & ! object is to br+ quiet1 repose1 & sleep4 ,l>ge doses may produce coma1 v heavy brea?+1 & great muscul> weakness2 ! pulse h[ev] is full & /rong1 b if x %\ld fail1 ! physician %\ld be at once s5t =4 ,alcohol & ,/imulants4--,x is ! alcohol 9 liquors t intoxicate1 & x is t "p1 also1 ( liquor t /imulates :5 giv5 z a m$ic9e4 ,:iskey1 br&y1 & g9 are ab\t "o half alcohol4 ,! dose is a tablespoonful1 9 wat]1 & n repeat$ (t5] ?an two or ?ree times4 ,w9es are ab\t "o fif? alcohol1 be]s & cid] ab\t "o tw5tie?4 ,liquors conta9+ alcohol are nev] to be giv5 to pati5ts z a bev]age1 b always z a m$ic9e1 &1 except 9 em]g5cies1 nev] )\t a physician's ord]4 ,d n give !m 9 em]g5cies1 )\t a good reason = s do+1 & n simply because y feel y mu/ d some?+1 = 9 "s em]g5cies !y may d a great deal ( h>m1 & p]haps1 a fatal injury4 ,alcohol is mo/ly giv5 to /imulate ! action ( ! he>t4 ,a /imulant is some?+ t ar\ses or excites to action4 ,x is giv5 79 ! doses j m5tion$7 9 accid5ts1 :5 ! he>t is v weak1 ! pulse almo/ or q imp]ceptible1 ! face pale & p9*$1 & ! extremities cold4 ,9 cont9u$ sickness1 ) exhau/ion1 /imulants are sometimes left ) ! att5dant to give1 ) directions ab\t ! size ( ! dose & its frequ5cy4 ,if x quiet ! pati5t1 /r5g!n ! he>t & pulse1 x is do+ good2 b if re/lessness comes on1 ! face becomes flu%$1 or if ! pulse is made m rapid & feeble1 x is probably do+ h>m1 & %\ld be discont9u$1 & ! physician in=m$4 ,dry & ,moi/ ,heat4--,9 apply+ heat1 ei!r dry or moi/1 to ! insane1 c>e mu/ always be us$ to protect ! sk9 f be+ bli/]$4 ,?is happ5s v easily :5 x is appli$ directly to old1 feeble1 p>alyz$1 or p>etic pati5ts1 & also to ^? :o are too dem5t$ to compla9 if !y are be+ burn$4 ,burns are v s]i\s accid5ts among ?is class ( pati5ts1 & may1 if !y ext5d ov] a l>ge surface1 ev5 ?\gh n deep1 heal ) difficulty1 & ev5 prove fatal4 ,dry heat is appli$ by means ( rubb] bags fill$ ) hot wat]1 hot-s& bags1 bricks1 or soap/ones1 & by ! lamp ba?4 ,moi/ heat by hot ba?s1 fom5tations1 turp5t9e /upes1 & p\ltices4 ,hot ,ba?s & ,wet ,pack+4--,hot ba?s are sometimes prescrib$ = pati5ts4 ,! wat] %\ld be ab\t #ajj degrees ,f41 &1 if ord]$1 sl[ly increas$ to #aaj deg4 ,! pati5t is to be left 9 z long z direct$1 :i* may be b a few m9utes1 or half an h\r1 or ev5 long]4 ,sometimes a blanket is ord]$ ?r[n ov] ! tub1 ! head only be+ uncov]$4 ,:5 ! ba? is be+ giv51 ! pulse %\ld be c\nt$2 if x become weak & rapid1 if ! face become flu%$1 & ! pati5t compla9s ( dizz9ess1 or if ! lips %[ v5\s conge/ion1 ! pati5t %\ld be at once remov$1 &1 unless !re is imm$iate recov]y f ^! evil effects1 ! physician %\ld be in=m$4 ,9 giv+ a wet pack1 ! pati5t is wrapp$ 9 a %eet1 )\t any clo?+1 wet ei!r 9 cold or w>m wat]1 z ord]$1 & !n roll$ 9 a blanket1 put to b$1 & left 9 x z long z direct$4 ,^! me?ods ( treatm5t are frequ5tly ord]$ by physicians = pati5ts :o are re/less1 viol5t1 & sleepless1 ) a view ( giv+ quiet & sleep4 ,! att5dant %\ld obs]ve & report ! result4 ,application ( ,cold4--,! att5dants are frequ5tly ord]$ to apply ice to "s "p ( ! body1 = ! purpose ( produc+ local cold4 ,! ice %\ld be brok5 into small pieces & put into a bladd]1 or rubb] bag1 p>tly fill+ x4 ,x rema9s suffici5tly cold until all ! ice is melt$4 ,ano!r way is to put a piece ( ice 9 a sponge & ba! ! "p4 ,:5 cold clo?s or compresses are appli$1 ! heat ( ! body soon w>ms !m1 :5 !y become w>m applications & act z a p\ltice2 !y %\ld !re=e be frequ5tly *ang$4 ,9 apply+ moi/ dress+s c>e mu/ be us$ n to h any leak+ nor wett+ ( ! b$ or clo?+4 ,hypod]mic ,injections4--,morph9e1 hyoscyam9e1 or hyosc9e1 9 solution1 are frequ5tly inject$ "u ! sk94 ,! direction to d ?is1 & ! quantity to be giv51 w1 9 e case1 be ord]$ by ! physician4 ,a fold ( ! sk9 is held betwe5 ! f+] & ?umb1 :ile ! ne$le held 9 ! o!r h& is quickly pu%$ /raight "u ! sk9 to ! dep? ( ab\t half an in*4 ,c>e %\ld be us$ to inject no air1 & n to inject ! cont5ts ( ! syr+e1 into a ve94 ,=cible ,fe$+ ) ! ,/oma*-,tube4--,att5dants are frequ5tly call$ ^u to assi/ 9 ! =cible fe$+ ( pati5ts1 & 9 "s cases may !mselves be direct$ to d x4 ,! dang]s ( fe$+ are t ! ph>ynx may be fill$ ) fluid1 & ! pati5t *oke1 or x may be drawn into ! lungs1 t ! w$ge ) :i* ! m\? is held op5 may be s loosely held t 9 ! /ruggle ( ! pati5t ! s(t p>ts ( ! m\? may be injur$1 & occasionally x happ5s t ! m]e pressure ( ! tube causes *ok+4 ,att5dants %\ld wat* ! process ( fe$+1 & p>ticul>ly ! face1 = symptoms ( v5\s conge/ion1 & report to ! physician any ?+ !y see t d5otes dang]4 ,9 prep>+ = fe$+1 att5dants mu/ see t ! food is prop]ly made ready4 ,if any ?+ is to be mix$ ) milk1 x %\ld be mix$ s z to be p]fectly smoo?1 )\t lumps1 & s x w run easily ?r\gh ! tube4 ,if "s conc5trat$ food is us$1 x is bett] to put x 9 a small quantity ( milk1 j en\gh to make x liquid1 t x may be giv5 fir/4 ,m$ic9es ord]$ = fe$+ are n to be mix$ ) a l>ge quantity ( milk1 b sav$1 t !y may be giv5 directly f ! disp5s+ bottle :5ev] ! physician desires to d s4 ,e ?+ %\ld be got ready = fe$+ be=e ! physician arrives4 ,^u a tray %\ld be all ! fe$+ app>atus--! food & m$ic9e1 sev]al spoons1 & cups1 & a pit*]4 ,ne> at h& %\ld be pl5ty ( wat]1 soap1 & t[els1 & a t9 bas94 ,x is v provok+ to h to wait = _m ?+s to be br\ght aft] ! pati5t has be5 got ready4 ,_m pati5ts are easily f$4 ,"s l x1 b "s viol5tly & furi\sly resi/4 ,su* pati5ts %\ld be re/ra9$ to a *air fix$ to ! floor1 & ! m securely ?is is done ! m easily c !y be f$1 & ) less fatigue & dang] ( _! be+ injur$4 ,! pati5t's clo?+ %\ld be well protect$ f be+ soil$1 by t[els ab\t ! neck1 & a bas9 %\ld always be held "u ! *9 to cat* fall+ liquids & any ?+ vomit$4 ,! hold+ ! head & w$ge is an important matt]1 & is "s ?+ t belongs to ! att5dant to d4 ,! att5dant /&s beh9d ! pati5t1 & holds ! *9 by ! "r h&1 & ) ! left firmly grasps ! w$ge1 :i* is ins]t$ /raight into ! m\?1 betwe5 ! back tee?1 ab\t two or ?ree in*es4 ,! w$ge %\ld be grasp$ ) ! palm upw>ds1 & ! little f+] & side ( ! h& %\ld be press$ firmly aga9/ ! *94 ,if held 9 ?is way !re is little dang] t 9 viol5t /ruggles1 ! w$ge c be sudd5ly driv5 backw>d & w\nd & te> ! s(t p>ts ( ! m\?4 ,if ! ?roat fills ) fluid1 ! att5dant :o holds ! head %\ld b5d x f> =w>d1 t x may1 if possible1 run out ( ! m\?4 ,aft] fe$+1 pati5ts' faces %\ld be wa%$4 ,!y %\ld be wat*$ = "s "t to see t !y d n vomit1 or1 z is (t5 ! case1 t !y d n make !mselves vomit4 ,!re is no special diff]5ce 9 c>+ = a pati5t f$ ) a nasal tube1 except t ! w$ge is n us$4 ,if att5dants are all[$ to fe$1 !y mu/ rememb] all ! dang]s1 & gu>d aga9/ !m4 ,9 introduc+ ! tube1 ! =ef+] ( ! "r h& is to be introduc$ at ! same "t1 &1 z ! tube passes ov] ! tongue x is to be turn$ d[nw>d by ! f+] & g5tly pu%$ into ! oesophagus4 ,if !re seem to be unusual difficulty 9 s do+1 sev]e & unusual /ruggl+1 or ! slighte/ symptom ( dang]1 cease ! ef=t to fe$1 & report to ! physician4 ,( c\rse no att5dant w\ld und]take to fe$ any pati5t unless ord]$ to d s by ! physician1 :i* ord] w\ld be giv51 if at all1 only aft] c>eful tra9+ & 9 cases easily f$4 ,nutritive ,enemata4--,x is (t5 necess>y to fe$ pati5ts by ! rectum4 ,?is is done by inject+ food1 to ! am\nt ( f\r or six ounces4 ,c>e %\ld be us$ to inject no air4 ,! nozzle ( ! syr+e well oil$ is to be g5tly introduc$1 & ! fluid sl[ly =c$ into ! b[el4 ,! pati5t %\ld lie on ! left side1 ne> ! edge ( ! b$1 ) ! knees well drawn up4 ,if ! pati5t resi/1 he mu/ be plac$ ^u ! back1 ! legs sep>at$ & firmly held4 ,?is may require f\r or six att5dants1 b en\gh %\ld always be at h& to ?or\ghly & easily ov]come ! pati5t4 ,be=e giv+ ! fir/ injection ( food ! b[els %\ld be mov$ by an injection ( soap & wat]4 ,sometimes ! inject$ food escapes f ! rectum4 ,! pati5t %\ld be wat*$ to see if ?is happ5s4 ,9 su* a case a long tube c be introduc$ into ! rectum1 ab\t f\r or six in*es1 & ! food inject$ ?r\gh x4 ,! tube %\ld be well oil$1 & introduc$ sl[ly & ) g5tle =ce4 ,pati5ts (t5 ?rive ^u ?is way ( fe$+4 ,! "* ( ! food w be ord]$ by ! physician4 ,,publications ,,( ,g4 ,p4 ,,putnam',s ,,sons4 ,,/ud5ts' ,,manuals4 ,manual ( ,prescription ,writ+4 ,by ,,mat!w ,d4 ,,mann1 ,m4,d41 late ,exam9] 9 ,mat]ia ,m$ica & ,!rapeutics 9 ! ,college ( ,physicians & ,surgeons1 ,new ,york4 ,revis$ edition4 #afmo1 clo?4 #a4jj4 ,manual ( ,practical ,normal ,hi/ology4 ,by ,t4 ,,mit*ell ,,prudd51 ,m4,d41 ,director ( ! ,physiologica1 & ,pa?ological ,laboratory ( ! ,alumni ,association ( ! ,college ( ,physicians & ,surgeons1 ,n4 ,y41 etc4 #afmo1 clo?4 #a4be4 ,/ud5ts' ,manual ( ,v5]eal ,diseases1 be+ ! ,univ]sity ,lectures deliv]$ at ,*>ity ,hospital1 ,b4 ,i41 dur+ ! ,w9t] ,session ( #ahgi-hj4 ,by ,f4 ,s4 ,,/urgis1 ,m4,d41 ,cl9ical ,lectur] on ,v5]eal ,diseases 9 ! ,m$ical ,dep>tm5t ( ! ,univ]sity ( ! ,city ( ,new ,york1 etc41 etc4 ,f\r? edition4 #afmo1 clo?4 #a4be4 ,/ud5ts' ,manual ( ,diseases ( ! ,sk94 ,by ,l4 ,d4 ,,bulkley1 ,m4,d4 ,l>ge #afmo4 #a4be4 ,/ud5ts' ,manual ( ! ,diseases ( ! ,nose & ,?roat4 ,by ,j4 ,m4 ,w4 ,,kit*51 ,m4,d4 #afmo1 illu/rat$1 clo?4 #a4jj4 ,/ud5ts' ,manual ( ! ,ph>macopoeia ( ! ,diseases ( ! ,?roat4 ,by ,,george ,m4 ,,leff]ts1 ,m4,d4 #a4jj4 ,/ud5ts' ,manual ( ,rational ,electro-,!rapeutics4 ,by ,r4 ,w4 ,,amidon1 ,a4,m41 ,m4,d41 ,lectur] on ,!rapeutics at ! ,woman's ,m$ical ,college ( ! ,n4 ,y4 ,infirm>y1 etc41 etc4 #afmo4 #a4jj4 ,/ud5ts' ,manual ( ,diseases ( ! ,n]ves4 ,by ,e4 ,c4 ,,segu91 ,m4,d4 7,9 prep>ation47 ,,sugge/ive ,,!rapeutics4 ,a ,treatise on ! ,nature & ,uses ( ,hypnotism4 ,by ,h4 ,,b]nheim1 ,m4,d41 ,pr(essor 9 ! ,faculty ( ,m$ic9e at ,nancy4 ,translat$ f ! second & revis$ ,fr5* edition1 by ,,*ri/ian ,a4 ,,h]t]1 ,m4,d41 ( ,new ,york4 ,octavo1 clo? #c4ej ,i pres5t ?is volume to ! ,engli%-speak+ m$ical public 9 ! belief t x ?r[s important light ^u a subject :i* has too long be5 misund]/ood & ignor$4--,,extract ,,f ,,translator',s ,,preface4 ,,psy*iatry4 ,a ,cl9ical ,treatise on ,diseases ( ! ,=e-,bra91 ,bas$ ^u a ,/udy ( its ,/ructure1 ,functions1 & ,nutrition4 ,by ,,!odor ,,meyn]t1 ,m4,d41 ,pr(essor ( ,n]v\s ,diseases & ,*ief ( ! ,psy*iatrical ,cl9ic 9 ,vi5na4 ,translat$ 7"u au?ority ( ! au?or7 by ,b4 ,,sa*s1 ,m4,d4 ,octavo1 clo? #b4ge ,we mo/ e>ne/ly urge our read]s to put ?is "w 9 _! libr>ies z "o t w prove indisp5sable4--,qu>t]ly ,j\rnal ( ,inebriety1 ,jan41 #ahhf4 ,,! ,,insane ,,9 ,,=eign ,,c\ntries4 ,by ,,william ,p4 ,,let*wor?1 ,presid5t ( ! ,new ,york ,/ate ,bo>d ( ,*>ities4 ,octavo1 clo? #c4jj ,,! ,,errors ,,( ,,refraction4 ,by ,,francis ,,valk1 ,m4,d41 ,new ,york4 #bde pages4 ,num]\s illu/rations 7"s 9 color7 #c4jj ,,physiological ,,notes ,,on ,,prim>y ,,education ,,& ,,! ,,/udy ,,( ,,language4 ,by ,,m>y ,,putnam ,,jacobi1 ,m4,d4 #abmo1 clo?4 #a4jj ,,ess5tials ,,( ,,physics ,,& ,,*emi/ry4 ,by ,,condict ,w4 ,,cutl]1 ,m4,s41 ,m4,d4 ,?ird edition1 enl>g$ & revis$4 ,clo? #b4jj ,,! ,,/ory ,,( ,,! ,,bact]ia4 ,by ,t4 ,m4 ,,prudd51 ,m4,d41 au?or ( ,a ,manual ( ,practical ,normal ,hi/ology4 #afmo1 clo? 4#ge ,,hy/]ia ,,& ,,o!r ,,n]v\s ,,affections4 ,a ,s]ies ( ,essays1 by ,,m>y ,,putnam ,,jacobi1 ,m4,d4 #b4jj ,,cont5ts--#a4 ,loss ( ,n\ns 9 ,aphasia4 #b4 ,case ( ,nocturnal ,rot>y ,spasm4 #c4 ,! ,prophylaxis ( ,insanity4 #d4 ,antagonism betwe5 ,m$ic9es1 & betwe5 ,rem$ies & ,disease4 #e4 ,hy/]ical ,locomotor ,ataxia4 #f4 ,consid]ation on ,tumors ( ! ,bra94 ,,alt4 ,! ,human ,eye 9 its ,normal & ,pa?ological ,conditions4 ,by ,,adolph ,,alt1 ,m4,d41 ,lectur] on ,oph?almology 9 ,tr9ity ,m$ical ,college1 ,toronto1 ) ! editorial assi/ance ( ,t4 ,r4 ,,pooley1 ,m4,d4 #hvo1 illu/rat$4 #c4jj4 ,,al?aus4 ,on ,scl]osis ( ! ,sp9al ,cord4 ,includ+ ,locomotor ,ataxy1 ,spa/ic ,sp9al ,p>alysis1 & o!r ,sy/em ,diseases ( ! ,sp9al ,cord2 _! ,pa?ology1 ,symptoms1 ,diagnosis1 & ,treatm5t4 ,by ,,julius ,,al?aus1 ,m4,d4 ,) n9e illu/rations4 #hvo1 clo?4 #b4ge4 ,,br[ne ,,& ,,behnke4 ,voice1 ,song1 & ,spee*4 ,a ,practical ,guide = ,s+]s & ,speak]s1 f ! ,comb9$ ,view ( ! ,vocal ,surgeon & ! ,voice-,tra9]4 ,by ,,l5nox ,,br[ne1 ,f4,r4,c4,s41 ,surgeon to ! ,?roat & ,e> ,hospital1 ,london1 & ,,emil ,,behnke1 au?or ( ,! ,me*anism ( ! ,human ,voice4 ,) num]\s illu/rations by wood-cutt+ & photography4 #hvo1 clo?4 #d4ej4 ,,buhl4 ,inflammation ( ! ,lungs1 ,tub]culosis1 & ,consumption4 ,by ,pr(essor ,,ludwig ,,buhl1 ( ,muni*4 ,translat$ by ,drs4 ,m4 ,d4 ,,mann & ,s4 ,b4 ,,/4 ,,john4 #hvo1 clo?4 #a4ej4 ,,bulkley4 ,eczema & its ,managem5t4 ,a ,practical ,treatise ,bas$ on ! ,analysis ( ,two ,?\s& ,five ,hundr$ ,cases ( ! ,disease4 ,new & ,revis$ ,edition4 ,by ,l4 ,d4 ,,bulkley1 ,m4,d4 ,l>ge #hvo4 #c4jj4 ---- ,acne & its ,treatm5t4 ,a ,practical ,treatise ,bas$ on ! ,/udy ( ,"o ,?\s& ,five ,hundr$ ,cases ( ,diseases ( ! ,sebace\s ,gl&s4 #hvo1 illu/rat$4 #b4jj4 ,,cl>ke4 ,a ,manual ( ! ,practice ( ,surg]y4 ,by ,,fairlie ,,cl>ke1 ,m4,d41 ,f4,r4,c4,s41 late ,assi/ant ,surgeon to ,*>+ ,cross ,hospital4 ,?ird ,edition1 ,revis$1 ,enl>g$1 & ,illu/rat$ by #aij ,engrav+s on ,wood4 #b4ej4 ,,corn+4 ,bra9-,re/4 ,by ,j4 ,,leon>d ,,corn+1 ,m4,d4 #afmo1 clo?4 #a4jj4 ,,croom4 ,manual ( ! ,m9or ,gynecological ,op]ations & ,appliances4 ,by ,j4 ,,halliday ,,croom1 ,physician to ! ,royal ,mat]nity ,hospital1 ,ed9burgh4 ,second ,edition1 ,revis$ & ,enl>g$1 ) #ab ,plates & #dj ,wood-cuts4 #b4be4 ,,cutt]4 ,a ,diction>y ( ! ,g]man ,t]ms ,us$ 9 ,m$ic9e4 ,by ,,george ,r4 ,,cutt]1 ,m4,d41 ,surgeon ( ! ,n4 ,y4 ,eye & ,e> ,infirm>y1 etc41 etc4 #hvo1 clo? extra4 #c4jj4 ,,d>l+ ,,ranney4 ,! ,ess5tials ( ,anatomy1 prep>$ z a ,text-book = ,/ud5ts1 & a ,"w ( ,easy ,ref]5ce = ! ,g5]al ,practition]4 ,by ,,wm4 ,,d>l+1 ,pr(essor ( ,anatomy1 & ,a4 ,l4 ,,ranney1 ,adjunct ,pr(essor ( ,anatomy1 9 ! ,m$ical ,dep>tm5t ( ! ,new ,york ,univ]sity4 #hvo4 #c4jj4 ,,ranney 7,a4 ,l41 ,editor74 ,anatomical ,plates4 ,arrang$ z a companion volume = ,! ,ess5tials ( ,anatomy1 & = all works ^u ,descriptive ,anatomy4 ,compris+ #dci designs on /eel by ,pr(4 ,j4 ,n4 ,,masse1 ( ,p>is1 & num]\s diagrammatic cuts select$ or design$ by ! ,editor1 toge!r ) explanatory lett]-press4 ,l>ge #hvo1 clo? extra4 #c4jj4 ,,d[se4 ,syphilis ( ! ,bra9 & ,sp9al ,cord4 ,%[+ ! "p :i* ?is ag5t plays 9 its production ( ,p>alysis1 ,epilepsy1 ,insanity1 ,heada*e1 ,neuralgia1 ,hy/]ia1 ,hypo*ondriasis1 & o!r ,m5tal & ,n]v\s d]angem5ts4 ,by ,,?omas ,,/ret* ,,d[se1 ,m4,d41 ,fell[ ( ! ,royal ,college ( ,physicians 9 ,ed9burgh1 ,presid5t ( ! ,nor? ,london ,m$ical ,society1 etc41 etc4 #hvo1 illu/rat$4 #c4jj4 ---- ,neuralgia3 ,its ,nature & ,curative ,treatm5t4 ,=m+ ,"p ,,ii4 ( ,diseases ( ! ,bra9 & ,n]v\s ,sy/em4 #hvo1 clo? extra4 #b4be4 ---- ,! ,bra9 & ! ,n]ves4 #hvo1 clo?4 #a4ej4 ,,jacobi4 ,infant ,diet4 ,by ,a4 ,,jacobi1 ,m4,d41 ,cl9ical ,pr(essor ( ,diseases ( ,*ildr51 ,college ( ,physicians & ,surgeons1 ,new ,york4 ,revis$1 enl>g$1 & adapt$ = popul> use by ,,m>y ,,putnam ,,jacobi1 ,m4,d4 #abmo1 bo>ds4 #ej c5ts4 ,,kit*54 ,consumption3 ,its ,nature1 ,causes1 ,prev5tion1 & ,cure4 ,by ,j4 ,m4 ,w4 ,,kit*51 ,m4,d4 #abmo1 clo?4 #a4be4 ,,knapp4 ,coca9e & its ,use 9 ,oph?almic & ,g5]al ,surg]y4 ,by ,h4 ,,knapp1 ,m4,d4 ,) supplem5t>y contributions by ,drs4 ,f4 ,h4 ,,boswor?1 ,r4 ,j4 ,,hall1 ,e4 ,l4 ,,keyes1 & ,,wm4 ,m4 ,,polk4 #hvo1 clo?4 #ge c5ts4 ,,mattison4 ,! ,treatm5t ( ,opium ,addiction4 ,by ,j4 ,b4 ,,mattison1 ,m4,d4 #hvo1 clo?4 #ej c5ts4 ,,mitt5dorf4 ,a ,manual ( ,diseases ( ! ,eye & ,e>4 ,by ,w4 ,f4 ,,mitt5dorf1 ,m4,d4 ,?ird ,edition1 ,revis$4 ,fully ,illu/rat$4 #hvo1 clo? extra4 #d4jj4 ,,p>k]4 ,canc]3 ,its ,nature & ,etiology4 ,) ,tables ( #cig ,illu/rat$ ,cases4 ,by ,,will>d ,,p>k]1 ,m4,d4 #hvo1 clo?4 #a4ej4 ,g4 ,p4 ,,putnam',s ,,sons1 ,,new ,,york ,,& ,,london