persons who are demonstratively hysterical. As a rule, the worse the
case, the more emaciated, the more easy is it to manage, to control, and
to cure. It is, as Playfair remarks, the half-ill who constitute the
difficult cases.

I am also very careful as to being sure of the absence of certain forms
of organic disease before flattering myself with the probability of
success. But not all organic troubles forbid the use of this treatment.
Advanced Bright's disease does, though the early stages of contracted
kidney are decidedly benefited by it, if proper diet be prescribed; but
intestinal troubles which are not tubercular or malignant do not; nor do
moderate signs of chronic pulmonary deposits, or bronchitis.[13]

Some special consideration needs to be given to the subject of
heart-disease. Especially in cases of broken compensation, by lessening
the work required of the heart so that it needs to beat both less often
and with less force, the simple maintenance of the recumbent position is
a great aid to recovery, and massage properly used will still further
relieve the heart. Disturbed compensation is usually accompanied by
failure of nutrition, often by distinct anaemia, and these and the
anxiety which naturally enough affects the mind of a person with cardiac
disorder are all best handled, at first at least, by quiet and rest.
Later, the methods of Schott, baths and resistance movements, may carry
the improvement further. Even in old and established cases of valvular
disease much may be done if the patient have confidence and the
physician courage enough to insist upon a sufficient length of rest. The
palpitation and dyspnoea of exophthalmic goitre are promptly helped by
rest and massage, and with other suitable measures added, cures may be
effected even in this intractable ailment.

In former editions I have advised against any attempt to treat the true
melancholias, which are not mere depression of spirits from loss of all
hope of relief, by this method, but wider experience has convinced me
that rest and seclusion may often be successfully prescribed to a
certain extent and in certain cases.

Those in which the most good has been done have been the cases of
agitated melancholia with attacks, more or less clearly periodic, of
excitement, during which their delusions take acuter hold of them and
drive them to wild extravagance of noisy talk and bodily restlessness.
Whether such patients must be put to bed or not on