This complaint attacks women after childbirth. The most common time for it to begin is a few days, or a week or two before delivery; more frequently among those who are recently confined. The danger diminishes in proportion to the length of time that has elapsed since confinement. Puerperal Mania seldom takes place without a suppression of the discharges.

At the commencement of the complaint the pulse is weak without any apparent cause; the nights are restless, and the temper easily ruffled: soon, however, there is great change and peculiarity in her manner; her conduct and language are wild and incoherent,, and at length she becomes decidedly maniacal.

The disease, although frequently tedious, is oftener removed than any other species of mania. The restorations to health are usually marked either by the return of the lochial discharge, by the accession of milk in the breasts, by copious leucorrhoea, by diarrhoea, by a return of the monthly discharges which had been suppressed during pregnancy, or by abscesses, but very rarely by pregnancy.

Melancholy madness comes on later among lying-in women than furious delirium. The disease differs nothing in appearance or symptoms from melancholy occurring at other times. It is, however, frequently obstinate, but it commonly goes off after the child is weaned, and the woman's strength has returned.

In the treatment of Puerperal Mania our attention should be directed to prevent the patient from injuring herself. Whenever possible, she ought to be in the care of a nurse accustomed to the management of such cases, as she will be safer than in the charge of one to whom such cases are strange. The bowels should be kept relieved by small doses of Castor Oil, or by means of injections. If the patient is feverish she may take the Mixture No. 9 or the Mixture No. 23.

Hydrate of Chloral is strongly recommended in Puerperal Mania. Dr. J. Begbie speaks highly of Bromide of Potash in quieting maniacal excitement. A dose of thirty grains (in two cases), administered every second hour, reduced the patients to quietness, and procured sleep, of which they had been deprived for days.

"When the patient is convalescent, great attention must be paid to her health; she should have gentle exercise, with light, nourishing, and easily digestible food; with wine or beer, as she may prefer.