A bracing cure for madness

Dr G.G. Brown of Bath writes to the Annals of Medicine in 1799:

If you have a vacant page in your Annals of Medicine for the present year, may I request you will, for the benefit of unfortunate individuals, insert the following simple method of cure in the apoplexia mentalis, or delirium fine febre.

Dr Brown believes he has struck upon a simple remedy for madness, which he has tried successfully on five patients:

After a failure of the most approved medicines and practice, the application of cold water to the head, assiduously persevered in for many days, performed the cure. 

He acknowledges that many other doctors have tried this in the past and been disappointed with the results; but apparently they were doing it wrongly:

The method I pursued the first four cases was, by winding an handkerchief round the head, and keeping it continuously wet with a spunge dipped in cold water, until it produced a shivering-fit: it was then desisted from, for about an hour more or less, and re-applied as before.  After the first twenty-four hours, there was no inconvenience felt in having it always kept round the head.  Between thirty and fifty hours from the commencement of the application, sobbing and sighing came on; which have hitherto proved the criterion of the incipient return of rational ideas.  This being effected, the vitriolic acid alone, or combined with the cinchona, in conjunction with the cold application, have uniformly perfected the cure.

Cinchona, also known as Peruvian bark, was derived from a South American tree and contains quinine.  Since the latter is effective in suppressing shivering, it makes some sense that it would give the appearance of physical improvement.

From seven to fifteen days, where the delirium had been of considerable standing, have been the extent of this mode of practice; although I should not have hesitated continuing it a much longer time, had it been found necessary… I have also reason to believe, that it will be found equally successful in some other diseases, not only of the head, but the trunk of the body.

Since the 1950s medically-induced hypothermia has in fact been a valuable technique, especially to heart surgeons.

Dr Brown concludes with an update on the condition of his patients: two remained in perfect health, one was ‘in a state of convalescency’, and one had died of old age.  The fifth had succumbed to pneumonia – though since this occurred three years after her treatment, we cannot blame Dr Brown’s freezing-water therapy.

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