occasional conduct will establish the fact
of constant insanity. Again, we hear the expression: "He cannot be
insane; there is too much method in such madness." The answer to this
silly remark is that there is method in all madness except some
epileptic insanity and terminal dementia. Insane people prepare
careful plans, with all the details thoroughly considered, and perfect
methods to escape from hospitals with the greatest cunning. One must
never take it for granted that the insane person is so demented
mentally as to be unable to appreciate what is said and done. One
should never talk about the insane man in his presence, but should
include him in the conversation as if sane, as a general rule,
allaying his suspicions and avoiding antagonism. Do not agree with the
delusions of an insane person, except so far as may be necessary to
draw them out. Yet avoid argument over them. Simply do not agree, and
do not strengthen them by appearing to share them. His food should be
prepared for him, and his medicines administered to him as to any
other sick person. His baths should be regularly taken.

A depressed patient should be very carefully watched. If the slightest
suspicion of a suicidal impulse be present, the patient should never
be left alone. Many a valuable life has been saved through the moral
support of constant companionship; while we read very frequently of
the death of an insane patient who sprang from a window during a brief
period of relaxation of watchful care. Some people think it a
protection to one insane to elicit from him a promise not to be
depressed, and not to do anything wrong. One might as well secure a
promise not to have a rise of temperature. The gloom of despondency
and the suicidal impulse are as powerful as they are unwelcome and
unsought; and the wretchedly unhappy patient cannot alone meet the
issue and resist.

It is unreasonable to be offended by acts or speeches of an insane
patient, to bear a grudge or expect an apology. Very frequently such a
patient will turn savagely upon the nearest and dearest, and make
cutting remarks and accusations or exhibit baseless contempt. All this
conduct must be ignored and forgotten; for the unkind words of an
unaccountable and really ill person should not be taken at all
seriously.

Should a patient escape from home, it is the duty of the one in charge
without hesitation to overtake him, and then accompany him or at least
follow at a short distance.