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 one must judge in each
instance, taking into account the general nutrition. In my own practice
I certainly do put them to bed now much oftener than formerly. It is not
desirable to keep them there for the six or eight weeks which full
treatment would demand. Usually it will be of advantage to order, say,
two weeks of "absolute rest," observing the usual precautions about
getting the patient up, prescribing bed again when the early signs of an
attack of agitation appear, and keeping him there for a couple of days
on each occasion, during which the full schedule of treatment is to be
minutely carried out.

Goodell and, more recently, Playfair have pointed out the fact that some
cases of disease of the uterine appendages such as would ordinarily be
considered hopeless, except for surgical treatment, have in their hands