should be firm and fixed to the floor and should have a straw mattress. The attendants should be carefully instructed. "If the sight of other persons irritates them and only in very rare instances, restraint by tying may be employed, but with the greatest precaution, without any unnecessary force, and after carefully protecting all the joints and with especial care to use only restraining apparatus of a soft and delicate texture, since means of repression employed without judgment increase and may give rise to furor instead of repressing it." He used fomentation by applying warm moist sponges over the eyelids to relax them and influence the circulation in the membranes of the brain. He advised emollient and astringent applications, the latter made of galls, alum, etc., soothing and invigorating poultices, baths of oil and natural hot baths. He denounced abstinence and ordered a full diet. He spoke against the practice of making the patient intoxicated, the use of hellebore, of aloes and of venesection. During convalescence he recommended farming, walking, riding, singing and theatrical entertainments. In the latter scenes of a solemn and tragic character were to be enacted to guard against excitement.
With the passing of Galen and Coelius Aurelianus the sun goes down into the black clouds of ignorance succeeding the fall of the Roman Empire; and the lunatic is left to drag out a miserable existence, generally neglected and alone throughout the dark centuries following, to and through the middle ages. There is a fitful gleam faintly illuminating the scene momentarily as when Alexander of Tralles (A. D. 560), or Paulus Aegineta (A. D. 630) reiterates the teachings of Aurelianus, but they lay stress more upon the medicinal than the hygienic treatment and are forgetful of his admonitions against chains and imprisonment. The earliest hospital for the insane known was founded in Jerusalem in the fifth century as a refuge for anchorites whose minds became affected through their penances.
The middle ages are defined by Hallam as dating from the invasion of France by Clovis at the end of the fifth century to the invasion of Naples by Charles VIII. at the end of the fifteenth. During the first half of this period there seems scarcely to have been any intellectual or political development. The whole of Europe was, almost without exception, sunk in the darkest ignorance and the most wretched barbarism. In some countries the awakening was earlier than in others, but the darkness did not anywhere die out at once. As gradually the clouds began to lift and the signs of returning light were here and there discernible only a fraction of a special class, a limited portion of the clergy, were in any way affected, and the mass remained for long bound down by servility, ignorance and superstition. "The struggle among the races for the possession of the countries that had been loosed from the Roman yoke," says Sibbald, '"continued for centuries
