Alienists made a distinction between chronic insanity, which was difficult to cure, and insanity which had only recently manifested and might be cured through quick intervention. An article written in 1900 by Dr. C. B. Burr, medical director of the Oak Grove Hospital for Nervous and Mental Disorders, explained the steps alienists ought to generally take when confronted by a potentially curable case of insanity. The first step was to reduce excitement. That meant that patients should lie in bed in a quiet room, under the observation of a day nurse and night nurse. Family members should be excluded from the sickroom.
Burr then discussed the chronic constipation found among Americans at that time, saying that neglect of the bowels led to a large percentage of nervous diseases. The first order of the day, then, was to administer calomel (a toxic mercury compound) to purge the insane person’s body of impurities, and then to keep it purged with laxatives and/or enemas.
“Tonics and remedies to promote tissue building are needed in all cases,” continued Burr. Among milder preparations like eggnog and milk punch, Burr also recommended “the bitter tonics and strychnine, capsicum, and nux vomica” (a strychnine preparation). Burr discussed depression separately, saying that general treatment remained the same as for other types of insanity, but “certain drugs like kola, coca, and caffein, are useful also in painful emotional states.”