e 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
recovered to all appearances entirely; and my own list of patients
condemned to the removal of the ovaries but recovering and remaining
well has now grown to a formidable length. Playfair observes also that
he believes it possible that in even very severe and extensive disease
the health of the patient may be sufficiently improved to render
operation unnecessary.[14]

In cases of floating kidney some very satisfactory results have been
reached by long rest; and although it may be necessary to keep the
patient supine for three months or more, the reasonable probability of
permanent replacement of the organ is much greater than from operative
attempts at fixation, apart from the danger and pain of surgical
procedures. Persons with floating kidney are nearly always thin, often
giving a history of rapid loss of weight, have usually various symptoms
of gastric and intestinal disturbance, and present therefore subjects in
all ways suitable for a fattening and blood-making _regime_ which shall
furnish padding to hold the kidney firmly in its normal place.

The treatment of locomotor ataxia and some allied states by this method,
with certain modifications, has yielded such good results that I now
undertake with reasonable confidence the charge of such patients; and
the subject is so important and has as yet influenced so little the
futile drugging treatment of these wretched cases that it seems worth
while to devote a special chapter to it, although the affections named
can scarcely be said to be included under the head of neurasthenic
disease.

In the following chapters I shall treat of the means which I have
em