The popular treatment for depression is the use of tonics and stimulants. The theory of the application is that they impart strength to the enervated system. That this is not the case, however, is well known to every scientific physician. Indeed, not a few of the most eminent physicians declare with emphasis that stimulants are not strengthening, that stimulation means simply excitement, which, as we have already seen, in depression is always followed by an increase of depression, and that stimulants decrease rather than augment vital force. We also have good authority for the statement that tonics and stimulants are precisely alike in their action, differing only in degree. On account of their mildly stimulating effects, the depression following the use of tonics is not so noticeable as in the employment of stimulants proper. We cannot but regard the use of tonics and stimulants in chronic debility of any sort as erroneous in principle and deceptive in practice. They produce a feeling of strength which is not accompanied with an actual increase in vigor.

This is well shown in the experiments of Dr. Smith upon tea and coffee, two of the mildest of all agents of this class. He found that after taking a cup of strong tea, although previously depressed from prolonged exercise, he felt an increased disposition to active exercise and found himself able to take muscular exercise with much greater ease than under ordinary circumstances. Thus far the effects of the stimulant and tonic seemed to be satisfactory, but unfortunately for the theory which maintains the utility of these agents he found upon awakening the next morning after the experiment, even though he had been recuperated by the influence of sleep, that he felt very much more fatigued and exhausted than after exercise without the use of tonics or stimulants. This experiment conclusively shows that the supposed strength imparted by tonic or stimulant is not real force or vigor, but simply apparent. By the use of tonics and stimulants the system is goaded into an expenditure of the force and vigor which it already possesses, but no additional strength is imparted.

This view of the action of tonics and stimulants is based upon scientific evidence so conclusive that there can be no doubt of its correctness. We do not say, however, as the reader has doubtless observed, that tonics and stimulants should never be employed in conditions of depression. What we insist upon is that they should never be employed with the idea that they impart strength, since this is a thoroughly exposed fallacy. They should be employed only when it is desired to accomplish what they are only capable of accomplishing; namely, to bring into action or develop forces which the system already possesses in a latent form. There are, no doubt, many cases in which this is in the highest degree desirable.

These cases are those in which there has been a sudden depression of vital action from any cause whatever. In these cases the sudden lowering of vital activity may be so great as to occasion death by the cessation of some of the important functions of the body before the system has had time to recover itself, although there may be sufficient vital force to bring about recovery if it were only developed at the right moment.

In cases of this sort the most powerful stimulants and tonics may be employed, as in the depression attendant upon asphyxia from any cause, syncope, or fainting, from loss of blood, great prostration as the result of poisoning, sudden collapse occurring in the course of some intensely acute disease, etc. In these cases life may be saved by the judicious employment of stimulants; yet even in such cases great care should be used that the stimulant is not employed so freely nor for so great length of time as to exhaust the vital forces beyond the extent to which they are recuperated, as when this is done much more harm than good results from their use. Hence, the utility of stimulants is of a very limited character, and they should be employed only when good can be accomplished by their transient effects. Ordinarily, stimulants and tonics should be most sedulously avoided in the continuous treatment of depression. They are only for cases of emergency, and should never be employed day after day, week after week, or continued for months, as is often the case.

We firmly believe with many noted physicians that notwithstanding the good results which may be obtained by the proper use of stimulants, they may be dispensed with altogether, if proper substitutes are employed, without any detriment to the patient's chances for recovery. Electricity as a stimulant is vastly superior to alcohol or any other stimulant or tonic furnished by the materia medica. This potent agent so closely resembles the nerve force itself that it seems to be almost equivalent to a substitute in cases of extreme depression. As an excitant of vital action it is vastly superior to alcohol, and when properly used no unpleasant effects whatever follow its employment. It is indicated in all cases of debility or depression in which its use is not interdicted by some personal idiosyncrasy antagonistic to its influence. Sunlight employed in the form of the sun-bath is another natural tonic, the application of which may be indefinitely repeated without fear of causing subsequent increase of the diseased condition for which it is employed.

In all cases characterized by debility, avoid the use of all depressing agents. The patient should be relieved of care, and should be surrounded with cheerful conditions. The food should be abundant and wholesome, but simple in character and easy of digestion. As a general rule in chronic depression, the severe practices of the old-fashioned water-cure treatment should be most carefully avoided. Water may be employed judiciously with great advantage as a means of increasing nutrition. Massage may be carefully employed for the same purpose to very great advantage. More specific directions for treatment will be given in the consideration of various diseases characterized by depression and debility.