A. L , male, aged 22, admitted May 17th, 1886. A recent case of mania. A very intractable patient, not markedly incoherent, and rarely giving expression to delusions. Believing himself to be illegally detained, he refused food and required to be fed forcibly. For the sake of having his case investigated, or for no assigned reason at all, he used to make desperate assaults on his fellow-patients and others. He slept little, and used to lie in wait for the night at tendant's visit to assault that officer or endeavour to escape. Hypnone was administered under the skin in five minim doses nightly from the 17th June to the 4th July. During that time he seemed to sleep soundly from seven to nine hours each night, and he was not found out of his bed on more than one occasion. From the 27th of June he took food voluntarily. There was from the same date a very marked improvement in general tranquillity.
R. J., male, aged about 50, a chronic inmate of asylums. Many years ago he suffered from an attack of melancholia with tendency to suicide. He recovered imperfectly, remaining weak-minded, a useful worker, not usually depressed while employed, but liable at intervals to outbursts of passion passing into a subacute maniacal condition of short duration, which again is followed by intense depression. One of these outbreaks, apparently depending upon a well-marked emotional cause, was succeeded by the customary depression. He became acutely conscious of his recent violence, which he loudly and incessantly deplored. From the state of agitation he began to pass into a duller condition, was silent, stood for a length of time in one place staring fixedly before him, &c. He said he " had nothing to complain of, for nothing could be bad enough for him." At this time he had slept little or not at all for the previous seven nights. He got five minims of hypnone under the skin at bed time ; fell asleep in about an hour, and slept five hours with an interval of about half an hour's wakefulness. Next night, after the same amount of hypnone, he dozed in about half an hour, but his sleep was light and broken all night, and he did not sleep more than half an hour at a time. Hypnone in the same quantity was continued for seven nights. On the third night he fell asleep in half an hour and slept for six hours. The following nights he was reported as sleeping well. Meanwhile he was certainly less depressed by day. He spoke freely, and could be roused to smile and talk cheerily of the future. Improvement continued after the disuse of the drug. He slept well, and gradually returned to the status quo ante.
