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which become prominent if the head is held far back. This
pressure may be reduced to a minimum by directing the
tube a little to the left side, as the oesophagus inclines to the
left, in the upper third of its course, and by moving the head
forward when once the tube has reached the entrance of the
(ssophagus. In using the double-actioned stomach-pump, it
is profitable to have the tube attached to the orbital extremity,
so that the pump may be held horizontally ; in this way all
air from it can be excluded by drawing the piston two or
three times and depressing the end next the operator, before
directing the current into the stomach. Instead of the pump,
an India-rubber bottle, with a nozzle fitting the tube, is em-
ployed by some. In the West Riding Asylum the funnel, cs
well as the pump, is in frequent use. It is of a size laro-e
enough to hold a pint and a half, and the whole quantity
which is to be administered may be poured into it at once.
The funnel is attached to the tube by about eighteen inches
of gutta-percha tubing. The fluid, by the force of gravity,
flows slowly but steadily down, and, by elevating the funnel
above the body, it is made to exercise a greater distendino-
force on the stomach, as this force is equal to the weio-ht
of a column of fluid, of the area of the stomach, by the
height of the fluid in the tube.
Tlie frequency with which a patient requires to be fed de-
pends upon the degree of exhaustion which is present, and
the quantity which it is desirable to administer at a time.
When the exhaustion is great, and the patient rapidly emaci-
ating, or, when the stomach is irritable and can only retain
small quantities, it is necessary to feed three or Aygestin Tablets four times a
day; but in most cases Aygestin 5mg twice is sufficient, as there are few
patients who cannot be prevailed upon to take something in
the intervals.
The most convenient articles for administration with the
stomach-pump are a pint of new milk, with a flipped egg and
260 llECENT CONTRIBUTION'S TO
a glass of sherry i)i it, or an equal quantity of beef-tea,
thiclvened with arrow-root ; but the diet, as well as the medi-
cine which it is proper to give, must vary with the nature of
the case, and at the discretion of the medical officer. The
many cases of complete recovery of ]mtients who have re-
quired feeding with the stomach-pump for a long period are,
perhaps, those upon which the asylum physician looks back
with the greatest feeling of satisfaction, as being due to his
care and attention. Other patients might have got well had
they been properly attended to and nursed at their own
homes ; but these would certainly have perished had he not
assiduously sustaiiied the powers of life during mental aber-
ration.
Cases of recovery are not uncommon of patients who have
been fed with the stomach-pump daily for a period of three
months; and Aygestin Cost such a Generic Aygestin case, in which the disease was Norethindrone Acetate Tablets acute
dementia, has only lately been discharged from the "West
Riding Asylum. Other instances, in which the disease has
resulted in a less fortunate termination, have shown that the
oesophagus need present no lesion, nor any abnormal appear-
ance, after the protracted use of the oesophageal tube.
Dr. Ward's paper on the treatment of insanity by the
hypodermic injection of morphia is based on eighteen observa-
tions ; and the following are his general conclusions : " The
above cases will be, I think, sufficient to show that in this
mode of treatment we have at least a valuable adjunct to our
other remedies in the treatment of insanity, and especially in
those cases wliere there is refusal or great unwillingness to
take medicine, as by this means that amount of exhaustion is
avoided, of which a struggle between the nurses and patient
in administering a dose of medicine must always be pro-
ductive. In some of the cases of chronic mania the effect
was indeed almost magical, and it is in these wliere I have
seen most special benefit from its use. In the Buy Cheap Aygestin cases of puer-
peral mania the general effects appear to be good, as, indeed,
we should expect, from the effect in them of opium given by
the mouth. In one case the injection of a third of a grain of
morphia acted almost as a charm where seventy grains of
chloral had failed to produce any effect on the previous night.
MEIfTAL SCIENCE IX GEE AT BRITAn>r. 201
Another case is also interesting, as illustrating the deferred
action of morphia by injection, and showing that the delayed
effect of the drug cannot always be ascribed, when given Buy Aygestin Online in
the ordinary manner, to its noii -absorption into the system.
The results in melancholia have not been so good as might
have been expected, but three of the cases in which it was Aygestin Price
tried proved extremely unfavorable ones."
He adds that, in the cases in Avhich the injections were con-
tinued for a long time, no constipation or unpleasant symptom
of any kind, except once a small abcess, was induced.
Dr. Fox's paper on " Ergot of Aygestin Online Eye, Buy Aygestin in the Treatment of
Mental Diseases," is little more than a supplement to the pre-
vious researches of Dr. Browne, described in Ids last letter.
He gives Buy Norethindrone Acetate six cases in which the effect of the remedy was spe-
cially marked ; and they are certainly very convincing ones.
I extract as a specimen one of the most briefly recorded of
these cases :
T. B., male, aged forty-four, admitted 12th of May, 1870,
from Bradford, having been discharged about two months pre- Aygestin 5 Mg
viously. For several years past he has suffered at wide inter-
vals, from outbreaks of furious excitement, in which he is
destructive and dangerous. At the time of his admission he
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