I *33ox f JVo. Essex Institute. LIBRARY OTP FIR, ATS" CIS PEABODY. PRESENTED BY Released Ei. L 196.1 XI US. MARTHA PEABODY. The Library Committee shall divide the books and other articles belonging to the Library into three classes, namely: (a) those which are not to be removed from the building; (b) those which may be taken only by written permission of three members of the committee; (c) those which may circu- late under the following rules Members shall be entitled to take from the Library two folio or quarto volumes, or four volumes of lesser fold, with the plates belonging to the same, upon having them recorded by the Librarian, or Assistant Librarian, and promising to make good any damage they sustain, wiiile in their posses- sion, and to replace the same if lost, or pay a sum fixed by the Library Committee. No person shall lend any book belonging to the Institute, excepting to a member, under a penalty of one dollar for each offence. The Library Committee may allow members to take more than the allotted number of books upon a written applica- tion. and may also permit other persons than members to use the Library under such conditions as they may impose. No person shall detain any book longer than four weeks from the Library, if notified that the same is wanted by an- other member, under a penalty of five cents per day, and no volume shall be detained longer than three months at one time under the same penalty. The Librarian shall have power by order of the Library Committee to call in any volume after it has been retained by a member for ten days. ‘On or before the first Wednesday in May, all books shall be returned to the Library, and a penalty of five cents per day shall be imposed for each volume detained. No book shall be allowed to circulate until one month after its receipt. The person charging this material is re- sponsible for its return to the library from which it was withdrawn on or before the Latest Date stamped below. Theft, mutilation, and underlining of books are reasons for disciplinary action and may result in dismissal from the University. UNIVERSITY OF ILLINOIS LIBRARY AT URBANA-CHAMPAIGN APR 2 9 1975 APR 2 • IS75 1978 lv ? ? 197# NOV 1 4 1982 NOV i 7 1982 ^mall Xoofe0 on ©reat Subjects. EDITED BY A FEW WELL WISHERS TO KNOWLEDGE. ON MAN’S POWER OVER HIMSELF TO PREVENT OR CONTROL INSANITY. COMMUNICATED TO THE MEMBERS AT THE ROYAL INSTITUTION OF GREAT BRITAIN, ON FRIDAY EVENING, MAY 26 th, 1843. BY THE REV. JOHN BARLOW, M.A. OF TRINITY COLLEGE, CAMBRIDGE. SECRETARY OF THE ROYAL INSTITUTION OF GREAT BRITAIN, F. R. S. ETC. LONDON: WILLIAM PICKERING 1843. Digitized by the Internet Archive in 2016 https://archive.org/details/onmanspoweroverhOObarl ADVERTISEMENT. T HE history of this little book is iden- tical with that of “The Connection between Physiology and Intellectual Phi- losophy/’ which I published last year. Each of these volumes contains the sub- stance of a communication made to the :v- Members of the Royal Institution, at one of their Friday evening Meetings. ^ Both are offered to the public at the desire of many who were present on those occasions ; and I may add with respect to the work now in the Reader’s hands, that the President of the Institution was pleased to require its publication. Both this book and its predecessor owe not only their origin, but large contribu- tions of material, and great assistance in Ctheir composition and arrangement, to a ^Society of intimate friends with whom I 3 ? * 4 IV ADVERTISEMENT. have the honour to be connected. Both may therefore be regarded as the effects of a confederacy whose object, as already declared (vid. Advertisement to “ Connec- tion, &c.” p. vi.) is “to bring philosophy into a form that might benefit the mass of mankind, instead of being the mere luxury of a few learned men.” For whatever success may have attended the former publication, I cannot but be much indebted to the favourable judgment pronounced upon it by the most eminent physiologists of this country, to whom I desire to express, on behalf of those with whom I am allied, as well as on my own, our sense of the encouragement afforded by them to our enterprise. Henrietta Street, Cavendish Square, London, June 19, 1843. # fc/vVj Jv^t */T* */tTU JKP* tAfKt J\Fv Jv^t JW* %A DF\rf •/&* * r \A/' r \iV' 'Vy* W 'Vy* * VV * *> A /» >-^y» r \£^* ^ yy * ?CAi)(I^(lAl)QAl)eAl)(lAl)CAI)ClAie^ ON MAN'S POWER OVER HIMSELF TO PREVENT OR CONTROL INSANITY. I. 1. r T^WO years ago, I had the honour of A submitting to you some views with regard to intellectual science, which appeared necessarily to result from recent discoveries in anatomy. — Now it is the property of all scientific views if true, that they announce a few simple principles which admit of an ex- tensive practical application; and I endea- voured to apply this test to the theory I then brought forward as to the dual nature of man. I asked myself how it bore on that most terri- ble of all diseases connected with the brain — madness; and I found that wise and good men, even without thinking of the theory, had practically applied it in the treatment of ma- niacs ; whose intelligent will they had roused to a certain degree of self-control by a system of kind and rational treatment, instead of the B 2 man’s power over himself to chains and whips of former times. Still, if I might credit the assertion of a gentleman whose experience gives him a claim to atten- tion, Dr. Thomas Mayo, though facts were accumulated, an hypothesis, which should give these facts the character of results from great principles, was wanting: — and I asked myself further, if a theory, which coincided with the views of so many men illustrious in science, might not have enough of the charac- ters of truth to supply the desideratum which Dr. Mayo points out. 2. In order to make myself clearly under- stood, it will be necessary to take a brief view of the structure and functions of the brain and nerves as explained in my former com- munication. This apparatus consists of ex- ceedingly minute hollow filaments, filled with a semi-fluid substance. These filaments are either compressed into a mass, as is the case in the brain and those brainlike structures called ganglia— or else extend from the brain down the back, as spinal marrow ; and from thence they are distributed to the remotest parts of the body in the form of nerves : some employed in carrying intelligence to the brain, others in executing its mandates. PREVENT OR CONTROL INSANITY. 3 3. The vital functions, which go on uncon- sciously and unceasingly, are regulated by a peculiar set of nerves, extensively, though in- directly connected with the brain and spine. They are united into a separate system by means of numerous ganglia ; and in colour and texture they bear the same resemblance to the gray matter of the brain and spine, that the spinal nerves and those of especial sense do to the white matter : though even in these ganglionic nerves, as they are called, white filaments are perceivable, derived from the spinal marrow. These will account for the influence exercised over the vital functions by the disturbing force which we shall presently have to notice, as well as by any sudden shock to the brain or spine. The circulation of the blood is under the immediate charge of the ganglionic nerves, one of which accom- panies every blood vessel. The nerves of smell, sight, hearing, and taste, are derived immediately from the brain, as are those which regulate the movements of the face, and some of the upper portions of the body. The nerves of touch for the most part com- municate with the brain through the spinal marrow, as do the larger portion of the motor 4 man’s power over himself to nerves also : — nevertheless much of the move- ment which ensues on the excitement of the nerves of sensation, is effected without the intervention of consciousness, as is seen in palsy, where movements are caused by touch, though the patient is unconscious of it. In the lower orders of animals, where the brain is almost, or wholly wanting, the movements seem also to be mechanically propagated from one set of nerves to the other. 4. In the human species a portion of the brain, which begins to develope itself in the higher order of animals, assumes a preponde- rance over the rest. I mean the hemispheres — which fill the upper part of the skull. Less immediately connected with the nerves of sense, this part has its own peculiar function : and I formerly brought examples to prove that this function is that of thought.* I then took occasion to notice a peculiar force found in man, which is capable of assuming a con- trol over this portion of the brain ; and, through it, over the greater part of the bodily functions — a force whose agency, as Professor Leibig has well observed, is f< entirely distinct Vide No. II. of Small Books on Great Subjects. PREVENT OR CONTROL INSANITY. 5 from the vital force, with which it has nothing in common/’* but in so far as it is viewed in connection with matter, manifests itself as an acceleration, a retarding, or a disturbance of the “ processes of life.” We find therefore, as this acute observer goes on to state, “ two forces in activity together, namely the me- chanical-vital force — or, as he terms it, vege- tative life , and the source of the higher phe- nomena of mental existence, which is of a perfectly distinct, and so far a superior nature, that it is able sometimes to exercise a dominion over the vital force which nullifies its action, and at all times controls and modifies it. 5. In my former communication, I called your attention to a Tablet arranged so as to exhibit the functions of these two forces, whose existence it was my purpose to esta- blish. I hardly then anticipated that I should find my views supported by such men as M. Jouffroy in France, and Professor Liebig in Germany, but such being the case, I feel the less diffidence now in bringing forward a * Leibig’s Animal Chemistry, p. 5. t Small Books, &c. No. IT. p. 38. 6 MAN’S power over himself to theory, where, if I err, I err in such good company. 6. In the two great divisions of this Table,. I have placed side by side the two great forces which manifest themselves in the phenomena of man’s nature. The vital force by virtue of which he is an animal — and the intellec- tual force by virtue of which he is something more. Throughout nature we find the advance to a higher grade of being, made by addition rather than by change. The power of assimi- lation is added to chemical affinity, and we have organized life as in vegetables ; but set in motion by external causes : nervous matter is added in the animal ; and vegetative life proceeds still unconsciously, but by means of a main-spring within the body ; and this lowest kind of life is found, as I formerly observed, in the rooted zoophyte no less than in man. It forms the first subdivision of the Table. Nerves of sensation and of movement are added, and the animal becomes loco- motive, and is impelled by a feeling of pain or of pleasure to the acts needful for the main- tenance of vegetative life: and this state of being is marked in the second division. Then the hemispheres of the brain are developed in PREVENT OR CONTROL INSANITY. 7 addition, as in the class mammalia, and the animal seeks its object by contrivance and by suiting the means to the end. Finally, as in the great step from in-organized to organized matter, a fresh force is added, not superseding, but availing itself of the other ; and man steps forth a denizen of two worlds, and capable of an advance which we can set no limit to. 7. Such is the constitution of man. When in healthy action, we cannot easily figure to ourselves anything better calculated to produce the most admirable results than the reciprocal influence of the different parts and forces of this complex being: but in proportion to the variety of parts is the danger of derangement : and our business to-night is not to consider man in his normal, but in his abnormal state. I shall therefore now endeavour to apply the theory, which I have just given a brief abstract of, to practical use, first by giving a classifica- tion of the different kinds of mental derange- ment, and next by considering how far the immense power of the Intellectual force can in any case be applied to their prevention or cure. I prefer the term mental derangeineyit to that of Insanity , because it will embrace all departures from the normal condition of man. 8 MAN’S power over htmself to as far as the functions of the brain are con- cerned: and I conceive (herein following the great authority of Dr. Gonolly *) that a certain degree of mental derangement may exist with- out constituting insanity in the usual sense of that word. 8. I propose to classify mental derangement thus : I. Morbid affections of the nervous system and brain. 1. Morbid affection of brain caused by derangement of the sympathetic sys- tem, as inflammation, &c. 2. Morbid affection of the nervous sys- tem producing delusions as to sight, sounds, &c. . 3. Morbid affections of the hemispheres of the brain producing loss of memory, &c. II. Morbid affections of the Intellectual force. 1. Inefficiency , where either the appetites or instinctive emotions, &c. are left wholly uncontrolled. * Vide An Enquiry concerning the Indications of In- sanity. By John Conolly, M. D. PREVENT OR CONTROL INSANITY. 9 2. Misdirection , where delusions of sense are reasoned and acted upon. 3. Occullation , where the organs of thought are impaired or wanting. 9. It will be readily seen that a force which is capable of acting as an acceleration, a re- tarding, or a disturbance of the vital functions, must have no small influence over so delicate an organ as the brain ; and accordingly we find paralysis, inflammation, or brain fever, and a variety of other diseases of this kind, produced in many instances by causes purely mental — I need hardly give cases ; they will occur readily to the recollection of every one. — Now a force which can produce disease, must have some power also in removing or prevent- ing it; and my business to-night will be to endeavour at least, to mark out how far this force can be made available to so desirable an object. In this attempt to establish true prin- ciples where they are so much needed, I have had large assistance. To Dr. Conolly, Dr. Webster, and Mr. Samuel Solly, I must beg thus publicly to tender my cordial thanks ; as well as to many others who have aided my views in various ways : indeed I can claim no merit to myself but that of an earnest desire 10 man’s power over himself to to fulfil my part of the great duty which every human being is sent into the world to per- form ; and in which, if we knew “ what be- longed to our peace/’ we should find our happiness too. It is not in the pursuit of fame or of profit that a man finds his noblest employment, though these may advance to meet him in his unshrinking career : it is in the being, as it were, the vice-gerent of the Deity on earth, and spreading peace and com- fort around him, that he carries out the inten- tions of his Creator: and I know of none who have fulfilled that great mission better than some of those I have alluded to. Though in many instances struggling against prejudice and neglect, they have nearly carried their point, and rescued a large portion of their fellow creatures from a state of the most hope- less misery. 10. But to return — I have said that mental derangement and madness are different things : — thus a person may fancy he sees others around him who have no existence, as in the well-known cases of Nicholai of Berlin and Dr. Bostock.* This is a certain degree of * Vide Appendix A. PREVENT OR CONTROL INSANITY. 11 mental derangement while it lasts ; but as both soon satisfied themselves that these per- sonages were merely the creation of a morbid physical state, they were not mad. A man of less resolution would have shrunk from the labour of convincing himself that he was fooled by his senses, and would have insisted that the figures were real, and then he would have been mad. On these cases Dr. Conolly very justly remarks — a Let any one reflect how Nicholai preserved his reason under such visionary and auditory delusions for so many months; and why the English physiologist, though visited with the images which are so well known to be familiar with mad people, never lost the use of his excellent understand- ing. The ready answer will be ‘ they never believed in their real existence.' But why did they not? and why does the madman believe in their real existence P The evidence of both is the same — the plain evidence of sense. The explanation must be this. The Printer of Berlin and the Physician in London retained the power of comparison : they compared the visual objects of delusion with the impres- sions of other senses,” and the perceptions of other persons, and became convinced of their 12 man’s power oyer himself to unreality. “This is exactly what madmen cannot do. One form of madness consists in this very illusion of sense, but it is conjoined with the loss or defect of the comparing power, and the madman concludes that what is only an illusion is a reality. But the illusion is not the madness.” Thus, according to the opinion of this very able judge, the affection of the brain which causes these delusions, is not madness, but the want of fower or resolu- tion to examine them , is* Nothing then but an extent of disease which destroys at once all possibility of reasoning, by annihilating, or entirely changing the structure of the organ, can make a man necessarily mad. In all other cases, the being sane or otherwise, not- withstanding considerable disease of brain, depends on the individual himself. He who has given a proper direction to the intellectual force, and thus obtained an early command over the bodily organ by habituating it to processes of calm reasoning, remains sane amid all the vagaries of sense ; while he who has been the slave, rather than the master of his animal nature, listens to its dictates with- Vide Appendix B. PREVENT OR CONTROL INSANITY. 13 out question even when distorted by disease, — and is mad. A fearful result of an uncul- tivated childhood ! 11. If I am right in what I have advanced, a man may labour under a mental delusion, and yet be a responsible agent : and if sanity or insanity be in a great many instances the consequences of a greater or less resolution in exerting the power of reasoning still pos- sessed, the same kind of motives which influ- ence a man in common life, are still available, though they may require to be somewhat heightened. It is on this principle that the treatment of lunatics has been generally con- ducted. Fear, one of the lowest, but also one of the most general of instinctive emotions, has been called in to balance the delusions of sense,* and, excepting in cases where the structural disease is so extensive as to deprive the man of all power of connecting cause and effect, it has been found sufficient to curb violence, and enforce a certain degree of peaceable demeanour towards the attendants. And in this the insane person differs not from the cultivated man who is left at liberty, whose Vide Appendix C. 14 man’s power over himself to self-control rarely amounts to more than the avoiding actions which would have unpleasant consequences to himself. Suppose an irascible man, incensed by a false report ; which, how- ever, he believes to be true ; he seeks his sup- posed enemy, and horsewhips or knocks him down : he does not assassinate, because he fears for his own life if he does ; for it is clear that no feeling of duty has held his hand, or he would not have transgressed the laws both of God and man by thus revenging himself. The madman has the false report from his own senses; wherein do the two differ? Nei- ther has employed means within his power to ascertain the truth, and both are aware that such vengeance is forbidden. I can see no distinction between them, save that the delu- sion of sense has, as a chemist would say, decomposed the character, and shown how much of the individual’s previous conduct was rational, and how much the result of mere animal instinct. It would be well for the world if the soi-disant sane were sometimes to ask themselves how far their sanity would bear this test ; and endeavour to acquire that rational self-command which nothing but the last extremity of cerebral disease could unseat. PREVENT OR CONTROL INSANITY. 15 We do not descend from our high rank with impunity ; — and as, when matter has become organized, if the process of change, occasioned by the vital force, be impeded or arrested, the plant pines away and perishes: — as, after the organs of locomotion have been superadded, the animal debarred from the use of them, languishes and becomes diseased ; so man, if he give not full scope to the intellectual force, becomes subject to evils greater than animals ever know, because his nature is of a higher order. 12. Til the classification which I have just given of the various kinds of mental derange- ment, I have endeavoured to make that dis- tinction between structural and functional disease which I consider the first step towards understanding the nature of insanity. Every anatomist knows, that extensive structural disease can exist without producing irration- ality. Paralytic patients, though the disease has its origin in the brain, may lose memory, speech, sensation, or any other faculty, and yet use the rest calmly and rationally : in- flammation may cause pain and irritation, which will produce frenzy without impairing the rational will— for I have known an in- 16 man's power over himself to stance where the patient, feeling that the brain was escaping from her control, gave her hands to be held by the attendants, that she might do no mischief during the paroxysm, and then maintained an obstinate silence, that no irrational words might pass her lips. None could doubt that this patient was sane, and exercised a complete self-control in the midst of structural disease. Neither do severe injuries from external causes, though, like paralysis, they may cause a loss of those faculties which connect man with the world about him, necessarily discon- nect him with the world within, so as to place him beyond his own command. A case has been communicated to me illus- trative of this. A young lad who had been carefully instructed in the principles of reli- gion and virtue by the clergyman of his parish, afterwards went to sea. When he was about twenty-two he unfortunately fell from the mast upon his head on the deck, and the in- jury to the brain was such that he was dis- charged from the service in a state of imbe- cility, and sent home to his parish. E{e was then in possession of the use of his limbs and hearing : but articulation was apparently dif- TO PREVENT OR CONTROL INSANITY. 17 ficult to him, and collected thought, which should enable him to speak connectedly, still more so : his sight too was subject to a delu- sion which made him imagine he saw gold and silver coin strewed about on the ground ; which, as was natural, he eagerly endeavoured to pick up. He was now visited by the Cler- gyman who had been the instructor of his youth, who in kind terms assured him he was under a false impression, and advised him to give no heed to what he imagined he saw. The poor young man thanked him, and pro- mised to do as he desired, and for a time ab- stained from attempting to pick up the coin, but gradually the delusion became too strong for his resolution, and he recommenced. — Yet after every visit of his former instructor, he again controlled himself for a time: and, if he did not come, anxiously sought him at his own house. — He died in a few months, but during the whole time was mild and sub- missive, seeming perfectly aware that his mind was disordered ; and, like a child who distrusts his own power, seeking to throw himself on the guidance of one whose kindness he re- membered, and whose character he respected. This man was suffering mental derangement c 18 man's power oyer himself to from injury of the parts, but was not insane: for the faculties left him were rationally exer- cised. 13. It has already been seen that the delu- sions of sense may coexist with perfect sanity : the instances of this, indeed, are so numerous that I should not have time to relate half that I have heard or read of within the last three or four months : but there is another kind of mental derangement, still in a certain degree connected with sense, which is of a more fear- ful kind, and yet this too is not inconsistent with sanity. A case in point has been given by M. Marc which has been copied into many works on this subject. The mother of a re- spectable family in Germany, on returning home one day, met a servant against whom she had no cause of complaint, in the greatest agitation.— The servant begged to speak with her mistress alone; threw herself upon her knees, and entreated that she might be sent out of the house. The mistress, astonished at this request, inquired the reason, and learned that whenever the unhappy woman undressed the little child which she nursed, she was struck with the whiteness of its skin, and ex- perienced an almost irresistible desire to tear PREVENT OR CONTROL INSANITY. 19 it to pieces. — She felt afraid that she should not have power to resist this desire, and there- fore begged to be allowed to leave the house that she might be in no danger of committing so great a crime.* Some other cases are also given by M. Es- quirol where the desire to commit an atrocious act was accompanied by a full conception of its enormity ; was resisted, and finally over- come. Cases of this kind have been considered by some as a peculiar type of insanity. By French authors it is entitled manie sans delire. Dr. Prichard styles it instinctive madness. I am inclined nevertheless to refer such de- ranged propensities in some instances to a peculiar and morbid state of sensation, and these will come under the head we are now considering, consequently the desire is not irresistible, though strong, for we see that it has been successfully resisted : — in others I should refer it to the second class under the head of “ Inefficiency of the intellectual force,” and then it depends on the resolution of the person so affected whether the morbid sensa- Esquirol, Maladies mentales, vol. ii. p. 807. 20 man’s power over himself to tion shall be meditated on and indulged, and thus acquire fresh force, or whether by exciting other sensations, it shall be weakened, and by degrees vanquished.* There is no greater error than to suppose, that thinking about a propensity which ought not to be gratified, will conquer it: on the contrary, every hour of lonely thought gives it fresh force — but let the man plunge into business that must be attended to, or even a lighter occupation, so it be an engrossing one ; and do this resolutely, however irksome it may at first appear, and the very repose thus given to the diseased part, if there be disease, by throwing the whole stress on other portions of the brain, will assist in effecting the cure. The maid-servant who sought to avoid the sight of the child, did wisely : fresh objects of attention would relieve the part subjected to a morbid affection, and in a short time it would recover its tone. If there be no disease, the self-control thus begun will gradually eradicate the depraved inclination. This cure for insanity was known long ago : Celsus re- commends committing things to memory ; * Vide Appendix D. PREVENT OR CONTROL INSANITY. 21 and everyone who has given a rational atten- tion to the subject, has been earnest in recom- mending application to some study which should occupy the mind without agitating the feelings, as one of the most effectual modes of counteracting morbid impressions. The con- stant repetition of this recommendation, shews that it must have been sometimes found effec- tual, and, if so, it can only be on the prin- ciple that I have advanced — namely, the ex- istence of a power in man to direct the opera- tion of the brain, unless it be in a state of such complete disorganization as to be inca- pable of any. 14. Imbecility of intellect, whether conge- nital or produced by subsequent injury, as in the case of the young seaman I have men- tioned, is equally under the rule of the guiding power. I believe no instance has been found of incapacity so complete as to preclude moral government, if due attention be paid. I will take an instance of this from the work of the younger Pinel. A young girl, hydrocepha- lous from her birth, was received into the hos- pital of La Salpetriere, at Paris. She was six- teen years of age, but in a state of most com- plete brutishness : her look stupid ; her limbs 22 man’s power over himself to as small as those of a child of six years old. She was as incapable of understanding as of acting. After the lapse of a few months a nurse, who had taken a liking to her, succeeded in teaching her first to hold the knitting nee- dles, and then to knit ; then to articulate a few words and phrases, till, at the end of a year, she could talk readily, and reply rationally to the questions that were asked her, though there was a degree of mental imbecility. A remark- able change, observes M. Pinel, since the time of her admission, when she appeared a mere senseless machine. — Wherever the mind is capable of connecting cause and effect, moral impressions may be made ; therefore this un- happy child, with early culture, might have been rendered capable of self-control, and pro- bably of a much greater advance in mental power. 15. I think I have now produced grounds for assuming that there is no one of the morbid affections of the brain and nerves, which I have placed in my first class, wfflich necessarily ren- ders the individual an irresponsible agent. There are too many authenticated cases in which a rational self-government has been exercised, even under these afflicting circum- PREVENT OR CONTROL INSANITY. 23 stances, to leave any doubt of its 'possibility . How much previous mental culture may be required to make this possible, is another ques- tion : it is sufficient for me here to establish this one great principle, that diseases of the brain and nervous system , however distressing , may and do, where the mind has been duly cultivated, leave the individual capable of knowing right from wrong, and of seeking exterior aid to combat the effects of mental derangement consequent on dis - ease — a derangement of which he is either conscious at the time, or has an anticipatory knowledge of, which enables him rationally to provide against its violence. The second class of mental derangement will afford a more melancholy contemplation. In the first we have seen man's nobler part triumphing over all the ills of the body, and vindicating his claim to an immortal nature. In the second, we shall have to look on his degradation, and to note the consequences of neglected education, of unregulated passions, of vice, of misery, and, alas that it should be so ! of mismanagement also ! 24 MAN’S POWER OVER HIMSELF TO II. 16. It will be recollected that when I for- merly treated of the functions of the brain, I shewed its constitution to be such, that in the mere animal it was little else than the recipient of sensation, by which indeed its hemispheres might be excited to something like contrivance ere the motor nerves received the impulse, but that, until the intelligent will assumed the sway over it, even in man it was merely the tool of the animal instinct: — and I added that, like all other bodily organs, it might, by disuse, become so impaired in its capability as finally to be in the state of a limb never developed by exercise, which the will strives in vain to direct. When a man has reached mature age w ithout making any effort to ren- der the brain subservient to the rational will, the fatigue and even pain consequent on the en- deavour to obtain the mastery over it, is such that few have resolution to undergo it volun- tarily. Thus the man subsides more and more into the animal, and is at last guided only by those instinctive emotions which belong to the vital force merely. His passions assume a deli- PREVENT OR CONTROL INSANITY. 25 rious violence, and he is only distinguished from the brute by the greater skill with which he pursues their gratification. There is no disease of brain, but it has been left unexer- cised and ungoverned, till it is as unmanage- able as a limb that has been treated in the same way. Toes have been used for writing and other arts which are usually performed by fingers ; they are capable therefore of such use, but those who have constantly worn shoes cannot direct one toe separately from the rest, as they can the fingers. Yet with much trouble this power of directing might be acquired. It is thus that the brain, unaccustomed to direc- tion from the intellectual force, rebels against it, and if this latter fails to assert its sway, it may justly be termed inefficient. In a man thus animalized, the actions differ from those of his more spiritualized fellow men, who hap- pily are more numerous ; and when they find no such motive as they would consider a suf- ficient one, for his conduct, they call him mad, by way of accounting for it. He commits a crime, and the plea of insanity is set up as a shelter from punishment. I will give an in- stance. — It is recorded by the elder Pinel. “ An only son, educated by a silly and indulgent 26 man’s power over himself to mother, was accustomed to give way to all his passions without restraint. As he grew up, the violence of his temper became quite uncontrol- lable, and he was constantly involved in quar- rels and law-suits. If an animal offended him, he instantly killed it; yet, when calm, he was quite reasonable* managed his large estate with propriety, and was even known to be be- neficent to the poor: but one day, provoked to rage by a woman who abused him, he threw her into a well. On his trial, so many wit- nesses deposed to the violence of his actions, that he was condemned to imprisonment in a mad-house.”* Yet any choleric man who does in his rage what he is sorry for after- wards, is as much insane as this man was: both are under the influence of the vital force. A shock to some nerve of sensation stimu- lates the sympathetic system : the circulation is hurried, and the blood flowing more rapidly through the brain, gives an unusual activity to the motor nerves — the movements are sudden and violent, the speech hurried, loud, and perhaps incoherent : but the intellectual force knows the source of these symptoms, and can curb them by resolute silence and inaction * Pinel, Alienation raentale, p. 156. PREVENT OR CONTROL INSANITY. 27 till the blood again flows at its usual pace : if it does not, the man for the time is in a state of mania, but is not the less responsible for having allowed himself to be so. 17. Let us suppose another case : the thing is so constantly seen, that every one could quote examples of it. — A man unaccustomed to self-control, becomes occupied by one thought: — his ambition has been disappointed perhaps, or a law-suit has plagued him, or he has been much employed in some engrossing pursuit. Unable to regulate his thoughts at will, he finds the one which circumstances have made habitual, recur uncalled for. An effort would dismiss it, for every one who has studied, knows that he has had to dismiss many an intruding thought, and with some effort too, if he wished to make progress in what he had undertaken : but this individual has never been accustomed to make any such effort, and he knows not how to free himself from the subject that thus haunts him. If it be an unpleasant one, he is wearied and worn by it ; but every day that it is not driven off, it assumes a greater power, for the part of the brain thus brought into action is now by habit rendered more fit for use than any other: —he has not resolution enough to free him- 28 man's power, over himself to self from his tormentor by a determined appli- cation to something else which would require all his attention : he sits brooding over it, and, when life has thus become irksome, he strives to terminate his discomfort by suicide : yet here is no structural disease ; and if the man could be persuaded to exert himself, he might be sane. I will give an instance. The master of a parish workhouse, about thirty years ago, was subjected frequently to groundless sus- picions of peculation. Being naturally a taci- turn, low-spirited man, these false accusations, which involved his character, and conse- quently the maintenance of his family, preyed upon his mind, and a profound melancholy was the result, attended by the usual sympto- matic derangement of the digestive functions, and a constant apprehension that he had done something wrong; he did not know what. No assurance on the part of those who knew and esteemed him had any effect, and finally after some months of melancholy, he at- tempted to destroy himself. He was then re- moved to St. Luke’s Hospital, whence, after a year had elapsed, he was discharged incur- able. He was now placed in a private recep- tacle of the insane, and here suffered all the PREVENT OR CONTROL INSANITY. 29 misery which at that time pauper lunatics were subjected to. He was visited at this place by a benevolent man, who, seeing* his state, immediately ordered him to be removed into the gentlemen’s apartments, and paid for his maintenance there. In a few months after- wards, he was visited by the clergyman of his parish, who, on conversing with him, consi- dered him sane. The man begged to be al_ lowed to rejoin his wife and family, and the reGtor, after many difficulties and some threats to the parish authorities, succeeded in setting him free. The man from that time was able to maintain his family by his trade of shoe- making, for if ever a fit of melancholy came over him, a threat from his wife that he should be sent back to the madhouse, was sufficient to engage him to make an effort to resume his cheerfulness, and he remained to old age a sane man. Here the insanity had been merely inefficiency of the intellectual force . Placed in a situation of comparative ease, his mind had become calm ; the wish to return to his wife and family, and the hope of it, kept up by the visits of benevolent friends, did the rest ; for, be it observed that during the whole time he never felt himself abandoned. 30 man’s power over himself to 18. The poor and the uneducated are the classes which most usually suffer from the inefficiency of the intellectual force : it is among’ the higher ranks usually that its misdirection is a source of insanity. Among these, more distant objects of pursuit keep the thoughts longer upon the stretch towards one point ; the organs of mechanical memory are strength- ened, nay, even strained by the habit of learn- ing much by rote, while the constant supply of learning ready-made leaves no necessity for the more laborious processes of reasoning and comparison. Hence we not unfrequently find an elegant scholar, who can readily quote the words and opinions of others, unable hirm self to carry on a course of close argument, or to prove the truth of what he advances. Who^. ever has moved in society, knows that it is rare to meet with any one who can command his thoughts in conversation sufficiently to reject all that is not relevant to the subject, so as to keep on the chain of reasoning un- broken. When the mind is thus exercised in remem- bering the opinions of others, thus unaccus- tomed accurately to examine its own, what wonder is it if it should become prepossessed PREVENT OR CONTROL INSANITY. 31 with some irrational notion which cannot be removed by reasoning, because the individual man in his healthiest state had never chosen so to exercise his mind ; or if, when a delusion of sense occurs, he should choose rather to act upon it as truth, than to examine into the grounds he has for believing it to be such. It is a melancholy fact, that a great number of mankind are in this state as regards the facul- ties most requisite to self-control, and depend far more on the accident of good health, than the exertion of their own intellectual power, for their sanity. 1 have heard of more than one instance of hard livers , as they were termed, who probably in consequence of a slight affec- tion of the brain from the unnatural stimulus of wine long kept up, became possessed with an opinion that they were slighted by one or more of their friends ; and, resisting all rea- soning on the subject, ended by destroying themselves. Yet, they were rational on other matters of importance, and therefore it is to be concluded, that, even on this point they were capable of being rational also, had they chosen to make the exertion. It is recorded of Henri of Bourbon son of the great Conde, that at times he imagined himself transformed 32 man’s power oyer himself to into a dog, and would then bark violently. Once this notion seized him whilst in the King’s presence : he then felt it needful to control himself, and he did so : for though he turned to the window and made grimaces as if barking, he made no noise.* Had the King’s eye been upon him, it is probable that he would have avoided the grimaces also. 19. Insanity from misdirection of the intel- lectual force is so various in its forms, that it would be impossible to give instances of all ; but it has one very general character — namely, that at first there are very few symptoms, if any, of structural disease. Some derangement of general health may be observed, but even this is not constant, or, at least, not sufficient in many instances to excite attention : it seems therefore not unreasonable to conclude, that the evil originates rather in the misuse than in the impairment of the organ. Thoughts too long and too intensely fixed on one object, weary the part of the brain so employed, and we usually then seek relief by varying our occupation : if this is not done, the weariness may end in disease. * Pinel, Alienation mentale, p. 393. PREVENT OR CONTROL INSANITY. 33 I remember being told by a friend, that having determined to commit to memory a certain number of Greek primitives every day, after persisting some time, he found that though competent to other study, this wearied him. Resolved not to be thus mastered, he persevered in spite of weariness, but in a short time delirium came on. He took the hint, laid aside the Greek primitives, and recovered himself very quickly. Here the misuse of the organ had produced temporary disease : had the subject been one not so easy to lay aside, the temporary disease might have be- come permanent ; especially if the engrossing thought were one originating in instinctive emotion which always influences the circula- tion largely, and thus is likely to induce an unnatural rush of blood through the brain. “ The indulgence of violent emotions," ob- serves Dr. Conolly, “ is singularly detrimental to the human understanding — and it is to be presumed, that the unmeasured emotions of insanity are sometimes perpetuated in conse- quence of the disorder of brain originally in- duced by their violence. A man is at first only irritable, but gives way to his irritability. Whatever temporarily interferes with any D 34 man’s power over himself to bodily or mental function, reproduces the disposition to be irritated, and circumstances are never wanting to act upon this disposition till it becomes a disease. The state of the brain or part of the brain, which is produced whenever the feeling of irritation is renewed, is more easily induced at each renewal, and concurs with the moral habit to bring on the paroxysm on every slight occasion — other vehement emotions and passions effect the same disorders of the mind.” Time will not allow me to do more than quote the conclusions drawn by this very able writer from his preceding observations. “ See- ing that any feeling in excess may become independent of the restraint of the comparing powers, and thus impair or disorder the un- derstanding, we cannot but remark the im- portance of cherishing that governing and protecting action of the mind by careful culti- vation and exercise. Whoever will converse with lunatics, will soon be satisfied that a very small portion of them consists of persons whose talents have been regularly and judi- ciously cultivated”* — for “those who most * Conolly’s Inquiry concerning the Indications of In- sanity, p. 102. PREVENT OR CONTROL INSANITY. 35 exercise the faculties of their minds are least liable to insanity, and nothing is rarer than to find a mad mathematician : for, as no study demands more attention than mathematics, so it secures the student during a great part of his time, from the recurrence of feelings which are always the most imperious in those who are the least occupied.”* 20. The diseases which come under the last division of my classification are the most dis- couraging, for here either the organs requisite to correct perception are wanting, or there is adhesion or other disease which impedes their action. Yet even among those apparently hopeless cases, we find such unequivocal symptoms of a struggle between the intellectual force and the defective organs, that it becomes probable at least, that this very struggle may be made to operate beneficially on the dis- eased parts, as we find a palsied limb bene- fitted by the attempt to use it. M. Esquirol in his work “ les Maladies mentales, observes that among his idiotic patients at Charenton, he had generally found a physical difficulty in fixing the attention even where there was a * Ibid, p. 347. 36 man’s power over himself to wish to do so. In other words, the organs did not respond to the will which endeavoured to direct them. He mentions that he had wished to have plaster casts of the heads of many of his patients, and that with the ma- niacs he had succeeded. Even the most furious had consented to keep quiet long enough for this purpose : — a strong proof, by the by, of the immense power of the intellec- tual will even in such cases, if a motive can be found strong enough to induce its exer- tion — but the idiots could never keep their eyes shut, and themselves quiet, long enough to complete the operation, though they were anxious to do so. “ I have seen some,” says he, “ who wept because the casts had not succeeded, and undertook afresh and for seve- ral successive times to remain quiet, but always in vain.”* I have myself heard of an instance of a girl of weak intellect who wept bitterly because she could not learn as others did. There can hardly be a doubt, that in these cases moral training, which happily requires no great effort of memory or stretch of thought. * Esquirol, Maladies mentales. Vol. i. p. 21. Vide Appendix E. PREVENT OR CONTROL INSANITY. 37 might be perfectly practicable. The strong will is there ; imprisoned indeed, with scarcely a glimmering of light from this lower world, but it is still potent, and I have had more than one case communicated to me, where, though the individual possessed not enough of intel- lect to be entrusted with the management of the most trifling affairs, his moral sense seemed unimpaired, and his conduct was exemplary. In one instance, the father was a blacksmith ; and the imbecile son had been taught to strike with the great hammer, which he did perse- veringly when told to do so, and thus earned a subsistence, though his limbs had the usual shambling movement of idiots, and though he was scarcely able to express his meaning by words. On one occasion he accidentally killed a neighbour’s goose by throwing a stone — he was inconsolable, and could only be pacified by the fullest restitution to the owner. In this case, the intellectual force had been wisely employed to counteract the natural defect, for the man became more and more capable as years passed on ; and finally having earned enough to supply his frugal subsistence and allow of saving besides, he spent the last years of his life in repose — a 38 man’s power over himself to respected member of society— for though his mental deficiency was known, he was hon- oured for the worthy use he made of the little capacity he possessed. Such probably might have been the happier history of many an unfortunate being now abandoned to a state of brutalism, if those about him had done their duty towards him in early life. HI. 21. Of course in the investigation of a sub- ject which might occupy a year more fitly than an hour, I have had to select my infor- mation, and compress it into the smallest possible space : yeti cannot but flatter myself that I have given enough to bear out my opinion, that man has in the resources of his own nature the antagonist power which, if properly used, can set at naught the evils, ay, and the so called irresistible propensities too, of the bodily organism. So nicely balanced indeed is the machine, that a grain can turn it to either side, but it is in the power of the will to cast that grain. Cast on the side of instinct, the propensity becomes passion, and the passion crime, and both are for the time PREVENT OR CONTROL INSANITY. 39 insanity: — For when once the intelligent will has lent its force to the blind impulses of the body, whether diseased or in health, it becomes only a question of time whether the individual is to be called insane and placed under res- traint or not. — The man who recovers quickly from his madness is called a sane man, though during the few preceding minutes or hours he may have exhibited the flushed face, the rapid and violent language and gestures, and the unreasoning conclusions of a maniac : but, strange to say, if this be very frequent, he is excused and considered innocent of the crimes he perpetrates, exactly because he has committed the greatest of all crimes by deli- vering over his godlike intellect to be the sport of that brute nature which it ought to regulate. There can hardly be a stronger proof of the necessity of some such classifica- tion of mental derangement as I have pro- posed. 22. It is observed by those professionally conversant with the subject, that up to fifteen years of age cases of insanity are very rare : — after that period, and during the period of maturity, they are frequent — so frequent, that statistical reports give a proportion of one in 40 man’s power over himself to between six and seven hundred of the whole population of England of persons so affected. As far as regards age, the statistics of crime give us nearly the same results as those of insanity. — I have been informed by two gen- tlemen who had large opportunities of obser- vation, one in a manufacturing, the other in an agricultural district, that sixty per cent of the offences attended with violence which have come under their notice, have been com- mitted by persons between fifteen and thirty* — to which we may add that crime and insanity generally keep pace. During the French Revolution of 1793, when men were let loose to commit all sorts of violence, insanity in- creased to a frightful extent: with the resto- ration of order, it again decreased ; and in England I believe it will be found that in proportion as criminals have become more numerous, the registers of lunatic asylums shew that the numbers of their inmates have also increased. Something must be allowed for the larger population : but even where that is allowed for, I am afraid we shall find that both are growing evils. 23. Even had we paid no attention to the symptoms and the state of the mentally de- PREVENT OR CONTROL INSANITY. 41 ranged, this parallelism would give some cause for inquiry whether the two might not be in some way connected : and if, as I have inferred from a close examination of cases, violent and unreasonable insanity is most frequently the result of either a frivolous and ill-governed mind, or of loose moral prin- ciples; for excesses of all kinds affect the brain fearfully * — then the connexion between the two becomes sufficiently apparent, and the remedy for both would be a sound and moral education. A brain strengthened by rational exercise, not merely by committing words to memory, but by applying the power of thought to whatever subject is presented, and neither exhausted nor loaded by irregu- larities of life, is but little likely to be attacked by disease: but if it be, mental derangement may occur, but not mischievous insanity : and thus the larger half of the evil is removed. 24. But how has the danger of such a ca- lamity, frightful as it is, been met by poor and rich ? — A country with an extensive fron- tier exposed to invasion from powerful ene- mies, if its governors be wise, erects fortifica- * Vide Appendix F. 42 man's power over himself to tions, forms strong alliances, and disciplines its inhabitants in the use of arms. Every child is in the situation of such a country, — but are its governors wise? Where are its fortifications of mental occupation — its alli- ance with a better world — its discipline of self-control ?— The reports of commissioners lately made public, have given a fearful an- swer to the question as regards the poor. — Are the rich better cared for? What advantage does the child receive from its educated pa- rents ? Its clothing is finer, its food more deli- cate; but during those six precious years when the brain is acquiring the bent which may form the character through life, it is consigned to the nursery: to the companion- ship of uneducated and misjudging, perhaps vicious, at any rate, uninterested persons: shut out, even more than the children of the poor, from the experience of life, with no con- versation to stimulate the young brain to fur- ther developemenf, no principles instilled, no curiosity gratified, A dull routine of lessons is perhaps carried on, taxing the tender organ beyond its powers — thus inducing instead of preventing disease, while the inquisitiveness, which seems the very instinct of childhood. PREVENT OR CONTROL INSANITY. 43 and the attempt to reason on what is pro- pounded, are sternly repressed : obedience, not ^//-management is enforced : and the child grows up, notwithstanding the shew of learning or accomplishment, with an unregu- lated mind, ignorant of man's best knowledge, motiveless, and dependent on circumstances. The boy is then to be sent forth into a world full of difficulties, to sink or swim : to make a character for himself if he can As well might troops begin to make their muskets when the enemy is in sight. 25. But if this be the case as regards the male sex, how much more fearfully then is it of the female ! Here the Drawing-room but perpetuates the inertness of the Nursery, — and woman, so largely endowed by nature, is degraded by social prejudice, and the frivo- lous education consequent upon it, till she is left at the mercy of events, the creature of impulse and of instinct. Yet physiologists have demonstrated that the organs of thought are proportionably larger in woman than in man :* and many a bright example has shewn how well they can be employed. One plain statistical fact shows that no terms that I can Vide Appendix. 44 MAN’S POWER OVER HIMSELF TO use in the reprobation of this cruel system can be too strong. The registers of Lunatic Asylums show the number of female patients to exceed that of males by nearly one third.* — We have the assurance of professional men well experienced in the treatment of the in- sane, that nothing is more rare than to find among them a person of a judiciously culti- vated mind ; and yet, with this fact staring us in the face, we systematically consign the mo- thers of the rising generation to a species of training which leaves them and their families a prey to one of the worst ills that flesh is heir to. We need not ask what woman’s destination is — nature has written it in characters too clear to be mistaken : the large development of the intellectual organs, and the feeble muscular power, mark her for the high-minded purifier of society — her strength must be that of know- ledge: — yet, we refuse the kind of culture which such an organization requires, hide the victim of mis-management in a madhouse * Webster’s Observations on the Admission of Medical Pupils to the Wards of Bethlem Hospital , p. 52. Though the observation is there made on the registers of the Hospitals and Asylums for Lunatics in France, it holds good equally with respect to England. PREVENT OR CONTROL INSANITY. 45 — and then talk proudly about an enlightened age ! 26. Should my position, that the difference between sanity and insanity consists in the degree of self-control exercised, appear para- doxical to any one, let him note for a short time the thoughts that pass through his mind, and the feelings that agitate him : and he will find that, were they all expressed and in- dulged, they would be as wild, and perhaps as frightful in their consequences as those of any madman. But the man of strong mind represses them, and seeks fresh impressions from without if he finds that aid needful : the man of weak mind yields to them, and then he is insane. That this is the true view of the case, may be proved from the innumerable cases where insanity has been cured, not by any medical treatment, but by fear of what was unpleasant ; or some deep impression which sufficed to counteract the former one. Dr. Conolly mentions that in the Glasgow Lunatic Asylum, a patient afflicted with religious melancholy had made up his mind to destroy himself, but that a short passage from the Scriptures, im- pressively and kindly spoken to him, not only 46 man’s power over himself to prevented the commission of suicide at the time, but had the effect of permanently check- ing the tendency to it. The same dreadful thoughts frequently returned to the patient’s mind, but the recollection that "no murderer hath eternal life” returned also, and the crime was refrained from.* — This man then had the power to restrain himself: yet had those words never been spoken, and had he com- mitted suicide, he would have been held in- sane and incapable of doing otherwise. — I must not multiply examples, though it would be very possible, but will merely quote the words of a Physician in extensive practice, lately addressed to myself.— I completely coincide with you in opinion,” says he, “ as to the power of the will in suppressing the manifestation of insanity — a fact sufficiently illustrated by the dexterity with which the insane contrive to conceal their delusions ; of which I, in common with others, have seen many examples. I have often observed with astonishment that when patients are put upon their guard, or have any purpose to achieve, they will keep their hallucination out of sight Conolly’s Inquiry, &c. p, 25. PREVENT OR CONTROL INSANITY. 47 in a most surprising manner. What is now fashionably termed monomania , is more often owing to a want of moral control over the mind than to any unsoundness of the intellec- tual faculties : so that in fact it ought to be viewed as moral depravity rather than mental disorder.” This is strikingly exemplified in a case recorded by M. Georget, of a young man seventeen years of age, who, after committing all sorts of outrages, finished by murdering his father. On seeing the dead body of his parent a short time after, he addressed it with — “ Ah, my dear father, where are you now?” ---and after some other remarks he concluded — “ It is you and my mother who have caused this misfortune-- 1 foretold it you a long time ago : — but if you had brought me up better, it would not have been thus.”* I may add in corroboration of the opinion here expressed that instances are by no means rare, when the post-mortem examination in cases of decided and violent insanity, has exhibited no apparent sign of disease in the brain ; a circumstance which of course would lead to a suspicion that the morbid affection Georget, Discussion Medico-legale sur la Folie, p. 144. 48 man’s power over himself to was rather functional than structural. It has been observed to me by a distinguished friend, who formerly filled the office of Secre- tary of State in the Home Department, that the increase of crime has generally been in the ratio of the want of employment for the people ; and that it is probable that the same cause may operate towards increasing insanity. A mind kept on the stretch with thinking how the next meal may be provided, or sunk in the apathy which, among uncultivated peo- ple, the lack of any call upon the attention is apt to produce, may well operate in diseasing an organ which will neither bear too much exercise nor too little. 27. The result then of the whole inquiry appears to be, that man being a compound of two natures, mental derangement is of two kinds. In the one kind, structural disease deadens or distorts the perceptions, and if this extends itself to the organs of all the faculties, the intellectual force having no longer the means of external action, the indi- vidual remains to all appearance a helpless machine. But, as such extensive structural disease is hardly compatible with life, so it is of very rare occurrence, and, if any part of the PREVENT OR CONTROL INSANITY. 49 organ remain perfect, then there is good rea- son to hope, that a mind thoroughly well- trained in early years, will still contrive to make the little that is left available to con- duct, if not to the higher intellectual func- tions : as we see the loss of the right hand replaced in some degree by the increased activity of the left. — But in the other case, no structural disease exists in the first instance, and the inefficiency or misdirection of the in- tellectual force is the sole cause of derange- ment : sometimes by the violence of the ex- citement producing disease, sometimes, as I have already noticed, continuing to the last without affecting the bodily organs. 28. The cases of insanity, we are told, have nearly tripled within the last twenty years ! — a fearful increase even after allowing to the utmost for a larger population ! — of these cases it is calculated that less than three hun- dred * in one thousand are the result of disease, or of unavoidable circumstances, thus leaving above seven hundred resulting from bodily excess or mental misgovernment. — On the heads then of legislators, of teachers, and of * Vide Appendix Hi E 50 man’s power over himself. parents, lies the heavy charge of having in all these instances, left those godlike faculties uncultivated, which, if duly used, might make earth the ante-room of heaven, and man the fit Vice-gerent of the Deity in this fair world. What man is generally, and what the world is in consequence, I need not detail. — We all know and feel it. Would to heaven we all knew what man can be, and had felt what the world might be were he such ! APPENDIX. A. STRIKING instance is on record, which does not on first sight seem to admit of explanation. It is that of Nicholai, of Berlin, related by himself to the Royal Society of that city in 1799. He was a man of much imagina- tion and great industry; during the year 1790, he had been subjected to causes of great anxiety and sorrow ; and it would seem that he had that year also neglected to lose blood by venesection or leeches so frequently as for some years, in consequence of vertigo and other complaints resulting from studious and sedentary habits of life, he had been accustomed to do. Early in February, several incidents of a disagreeable nature occurred to him ; and on the 24th of that month he relates : — 4 At ten o’clock in the fore- noon my wife and another person came to con- sole me : I was in a great perturbation of mind, owing to a series of incidents which had alto- gether wounded my moral feelings, and from which I saw no possibility of relief ; when sud- denly I observed at the distance of ten paces 62 APPENDIX A. from me a figure, the figure of a deceased person. I pointed at it, and asked my wife whether she did not see it. She saw nothing, but being much alarmed, endeavoured to compose me and sent for a physician. The figure remained some seven or eight minutes, and at length I became a little more calm.’ — ‘ In the afternoon a little after four o’clock, the figure, wdiich I had seen in the morning, again appeared. I was alone when this happened : a circumstance, which, as may easily be conceived, could not be very agreeable. I went, therefore, to the apartment of my wife, to whom I related it. But thither also the figure pursued me. Sometimes it was present, sometimes it was absent, but it was always the same standing figure.’ — 4 After I had recovered from my first impression of terror, I never felt myself particularly agitated by these apparitions, as I considered them to be, what they really were, the extraordinary con- sequences of indisposition : on the contrary I en- deavoured as much as possible to preserve my composure of mind, that I might remain dis- tinctly conscious of what passed within me. I observed those phantoms with great accuracy, and very often reflected on my previous thoughts, with a view to discover some law in the associa- tion of ideas, by which exactly these or other figures might present themselves to the imagina- APPENDIX A. 53 tion.’ ‘ The figure of the deceased person never appeared to me after the first dreadful day, but several other figures showed themselves after- wards, very distinctly; sometimes such as I knew, mostly, however, of persons I did not know ; and amongst those known to me were the semblances of both living and deceased per- sons, but mostly the former : and I made the observation that acquaintance with whom I daily conversed, never appeared to me as phan- tasms : it was always such as were at a distance. When these apparitions had continued for some weeks, and I could regard them with the greatest composure, I afterwards endeavoured at my own pleasure to call forth phantoms of several ac- quaintance, whom I for that reason represented to my imagination in the most lively manner, but in vain.’ — 4 The phantasms appeared to me in many cases involuntarily, as if they had been presented externally like the phenomena of na- ture, though they certainly had their origin in- ternally; and at the same time I was always able to distinguish, with the greatest precision, phantasms from phenomena. Indeed I never once erred in this, as I was in general perfectly calm and self-collected on the occasion. I knew extremely well when it only appeared to me that the door was opened, and a phantom entered, and when the door really was opened, and any 54 APPENDIX A. person came in.’ These figures appeared to Nicholai when alone or when in company, or even in the street, and continued to haunt him for about two months : — at last they disappeared ; sometimes returning for a time, and lastly, dur- ing the time in which he was writing an account of them. (Nicholson’s Journal of Natural Phi- losophy, Chemistry, and the Arts, vol. vi. p. 161). A correspondent in the Journal from which I have quoted the case of Nicholai, describes him- self as having been the subject of such halluci- nations during an attack of fever : he saw innu- merable faces all very agreeable — but fancying that these appearances indicated a breaking up of the system, and that the confusion of his senses was but the precursor of his speedy de- struction, the spectra assumed a character asso- ciated with this uncheering belief ; and instead of the very prepossessing faces which had before visited him, he beheld a visage of an enraged expression, which seemed to belong to a figure which pointed again at him. The patient began to perceive the influence which his thoughts had upon his waking visions, and voluntarily directed them towards architectural recollections and natural scenery ; and, after some time, a corre- sponding change came over the appearances which were presented to him. — He then turned his thoughts towards music, and dreamed during APPENDIX A. 55 a short sleep that a cat leaped upon his back, and awoke him with shrill and piercing screams. The sleeping and the waking dreams were thus plainly enough proved to be formed very much in the same manner. 44 A distinguished physiological writer of our own country has related something similar which occurred in his own person. 4 1 was labouring,’ he says, 4 under a fever, attended with symp- toms of general debility, especially of the ner- vous system, and with a severe pain of the head, which was confined to a small spot situated above the right temple. After having passed a sleepless night, and being reduced to a state of considerable exhaustion, I first perceived figures presenting themselves before me, which I imme- diately recognized as similar to those described by Nicholai, and upon which, as I was free from delirium, and as they were visible for three days and nights with little intermission, I was able to make my observations. There were two circum- stances which appeared to me very remarkable ; first, that the spectral appearances always fol- lowed the motion of the eyes: and secondly, that the objects which were the best defined, and remained the longest visible, were such as I had no recollection of ever having previously seen. For about twenty-four hours, I had constantly before me a human figure, the features and 56 APPENDIX B. dress of which were as distinctly visible as that of any real existence, and of which, after an in- terval of many years, I still retain the most lively impression : yet neither at the time nor since, have I been able to discover any person whom I had previously seen who resembled it. During one part of this disease, after the disap- pearance of the stationary phantom, I had a very singular and amusing imagery presented to me. It appeared as if a number of objects, principally human faces or figures, on a small scale, were placed before me, and gradually re- moved, like a succession of medallions. They were all of the same size, and appeared to be all situated at the same distance from the face.” — (Dr. Bostock’s System of Physiology, vol. iii. p. 204). Conollxfs Inquiry concerning the Indica- tions of Insanity , p. 105. et seq. B. “ X USED frequently to see a poor maniacal JL creature, in whose malady there were many intervals of sanity : and during these in- tervals she would grievously complain of the annoyance she experienced from simultaneous illusions of sight, smell, hearing, and general sensation : all kinds of animals seemed to be scampering before her ; the smell of brimstone, APPENDIX B. 57 and the continual sound of singing voices con- spired to trouble her , and with all this her ex- pression used to be that she felt “ stilly and as if she could die at any moment,” yet she was at such times quite conscious that her sensations were diseased, and was of sane mind : she could exercise her observation on others, and by com- parison of their unconcern with the false images which her senses figured to be around them, remain convinced that the images were unreal. It may be remarked by way of example, that in a fever the patient’s bed will seem in flames : or voices will whisper in his ear, &c. If we talk with patients thus affected, some will tell us, in a very quiet way, that they are thus tormented ; others will seem confused, and make a visible effort of sight and hearing before they tell us how they are troubled ; and others will tell us what they see, and what they hear, with an ex- pressed belief, on their part, of the reality of what we know to be delusion. Of these three classes of patients, the last are in a state of delirium, the second are approaching to it, the first are in a state of sound mind.” Conolly s Inquiry , %c. p. 115. 58 APPENDIX C. c. CURIOUS instance of the effect of fear in the control and final cure of insanity will be found in the treatise on alienation men - tale in the Diction naire de Medecine et de Chirurgie pratiques, p. 576. I quote the words of the author IVl. Foville, “ J’ai vu les prepara- tifs de cette application (cautere actuel a la nuque) causer une frayeur extreme a une jeune maniaque qui jusque la n’avait pas eu un instant de connaissance. Lorsqu’elle se sentit touchee par le fer rouge, elle fit de tels efforts pour se soustraire a son action quelle echappa aux mains de plusieurs personnes employees a la contenir. Pendant cinq minutes, elle jouit de toute sa raison, demanda ce qu’on voulait d’elle, pria avec instance qu’on l’epargnat. M. Esquinol lui dit qu’il consentait a differer l’application du cautere actuel a condition qu’elle se conduirait raisonnablement, qu’elle se mettrait au travail. Elle le promit, et tint parole ; elle fut immedi- atement transferee dans la division des conva- lescentes, ou la guerison devint parfaite en peu de temps.” He adds “ Elle avoua, quand elle fut guerie, que la frayeur causee par le fer rouge avait plus que toute autre chose contribue a ramener sa raison.” The author of this treatise adds farther that the actual cautery had no APPENDIX C. 59 beneficial effect in any cases where the pain was not felt ; so that it is evident that, in the cases where it succeeded, the success was owing to the stimulus it gave to the will of the patient, who, till then, had been too indolent to exert its full power over the brain. Another case is given by M. Pinel to exemplify the use of the Douche, not only as a punishment, but also as a means of suddenly diverting the thoughts of the patient from the subject which is engrossing them. A woman of strong constitution who had been mad at intervals for ten years, was most violent ; struck every one around her, tore in pieces her clothes, bed clothes, &c., and was perfectly unmanageable. On her admission into the Saltpetriere, as soon as she began tear- ing every thing around her, a strong douche was applied, and she was fastened down in her bed by a straight waistcoat. As soon as she entreated for pardon she was released ; and on a relapse the same means immediately re-adopted. She became better, but the physician, under whose superintendence alone these measures were allowed to be used, fell ill during twelve days. The patient relieved from all fear of punishment fell into her old ways, and was as bad as ever. The doctor then took his place again, and threatened to punish her, of which she took no heed* She was conducted to the 60 APPENDIX D. bath, and had a strong douche of cold water, during which the doctor spoke to her strongly, but without anger, and told her she would be still more severely treated. She shed a torrent of tears, became quite calm, and was soon after cured. These persons so capable of exerting mental self-control, when thus urged to it by fear, needed not to have been mad at all : the same resolution that at last cured , would have pre- vented madness, had it been exerted. D. I SHALL here give a case which M. Georget has recorded in his 44 Discussion vnedico- legale sur la folie” on the authority of M. Marc. From this case, and others of the same kind, he infers that there is a degree of mental disease ; 44 qui ote a Fhomme sa liberte etle porte a commettre des actes reprehensibles . . . il ex- iste une monomanie homicide,” and I give it for the sake of showing the fallacy of the reasoning by which he arrives at that conclusion. In this case (Discussion, &c. p. 39) a woman, aged about thirty, cut off the head of a child four years old, the daughter of a poor man, who was driving her and this child in a cart. She had the day before prevailed on the man to give the child APPENDIX D. 61 the drive, and she got him out of the way on some pretence while she perpetrated the crime. It appeared on inquiry that there was a liti- gation pending between this woman and a Ser- jeant’s wife ; that the latter had obtained a warrant against her ; that, flying from the officers of justice, she took refuge with a person with whom she was slightly acquainted, and whose hospitality she obtained on this occasion on some false pretence ; that, while she was considering in what direction she should proceed, being determined not to return home, the idea of mur- dering the children of her entertainer occurred to her ; from this plan she was however diverted by the thought of the ingratitude of such a pro- ceeding. She then resolved on selecting some other child for the same purpose, when this peasant offered her a seat in his cart to the village. She found out that he had an only daughter, whom she resolved on assassinating on the following strange reasoning. 44 L’enfant du paysan est fille unique ; moi aussi je suis fille unique, et j’ai toujours ete tres malheureuse. Un semblable sort est peut-etre reserve a cet enfant ; en consequence, il vaut autant que ce soit lui que je tue qu’un autre.” For this pur- pose she stole a knife from her host, and sharp- ened it carefully that her victim might suffer the least possible pain. There was evidence 62 APPENDIX D. that she had previously been deranged, and she was acquitted on the score of insanity. Now it is observable, in this case, that so far from being under an irresistible influence, this woman could control herself. She felt the moral turpitude of killing the children of her bene- factor, and she abstained from the act: — she was, therefore, capable of resisting the impulse if she chose to exert a small share of resolution. The primary cause of the disposition to murder may probably be found in that peculiar state of the nervous system described by Dr. Conolly. “ In any general excitement of the nervous sys- tem,” he observes, “ it is not uncommon to find irritation referred to the extremities of nervous ramifications. The susceptible child, when inte- rested with its book, bites the ends of its fingers ; the nervous man in a state of anxiety or emotion does the same. The approach of maniacal dis- order is sometimes indicated by a disposition to bite, cut, and tear the fingers. The injuries and wounds inflicted on themselves by lunatics are often to be similarly accounted for.” — (Conolly’s Inquiry, &c. p. 98.) Instead therefore of the “ monomanie homicide ’ of M. Georget, which “ ote a l’homme sa liberte,” — it would appear simply that excitement of the brain produces an extraordinary irritation of the nerves, which leads to cutting or tearing whatever comes in APPENDIX E. 63 the way of the person so excited ; but that never- theless this disposition is under the control of the will: and the patient might generally, if previously well disposed, claim exterior aid to control this irritation, if he found it growing too strong for self-government. E. I T is observed by Professor Tiedernann, that “ the brain of men endowed with but feeble intellectual powers is often very small ; particu- larly in congenital idiotismus. The brain of an idiot fifty years old, weighed but 1 lb. 8 oz. 4dr ., and that of another, forty years of age, weighed but 1 lb. 11 oz. 4dr. The brain of a girl, an idiot, sixteen years old, weighed only lib. 6oz. I dr. * The brain of men who have distinguished themselves by their great talents, on the con- trary, is often very large. The brain of the celebrated Cuvier, weighed 4 lbs. 11 oz. 4 dr. 30 gr.”\ As in the above cases of idiocy, the weight of brain scarcely exceeds that of a new born child, it is to be presumed that by some means it has been arrested in its growth. * Troy or Apothecaries weight, t Phil. Trans. 1836, part 2, p. 502. 64 APPENDIX F. F. M FOVILLE,inhis Anatomiepathologique, . in noticing the “ alterations chroniques de la substance corticate” gives a case which I shall again quote in his own words : “ J’ai observe cette alteration au plus haut degre d’intensite chez un jeune horame d’une constitution deterio - ree par des exces de tout genre ; une emotion vive determina chez lui l’explosion d’une alie- nation mentale compliquee, de son debut, de paralysie generale ; quelques semaines suffirent pour porter au plus haut point la degradation morale et physique. Dans les derniers temps de la vie la maigreur, deja tres prononcee, fit de nouveaux progres si rapides, qu’en trois jours les globes oculaires etaient veritablement retires au fond des orbites, tandis que les paupieres etaient restees tendues demi ouvertes, quelques lignes au devant des yeux. La substance corticale des con- volutions tres brune, tres humide, d’une mollesse diffluente cedait au plus leger contact. La perte de substance, les inegalites produites par l’ap- position des doigts ou d’un linge disparaissaient en un instant comme cela aurait lieu a la surface d'un corps qui entrerait en fusion. D’ailleurs chez ce malade la substance blanche etait elle APPENDIX F. 65 meme profondement alteree d’ une maniere ana- logue a la grise.” Another analogous case is given in the Reper- toire de M. Baillarger, where a “ ga^on marchand de vin,” aged thirty, was received into an hospital for lunatics, May 23, 1827, after having led a life of great excess and profligacy, to which the state he was then in was attributed. “ La memoire et le jugement etaient fort affaiblis. II avait de la difficult^ a parler, beaucoup de lenteur et de roideur dans la marche, mais pas precisement de delire maniaque ni d’incoherence dans les idees.” He was in the Bicetre six or eight months ; the paralysis and the difficulty of walking in- creased, he was attacked with scurvy, and died in January. Post-mortem examination — Le feuillet cerebrale de l’arachnoide et la pie-mere reunis sont d’un mineure extreme. Ces deux feuil- lets ne sont ni injectes, ni adherents a la surface du cerveau, les deux substances du cerveau, du cervelet, et des moelles, sont fermes, mais pales et decolorees et ne contiennent pas de sang. La teinte de la substance corticale est d’un gris legerement jaunatre. Les deux feuillets de Y arachnoide rachidienne sont unis dans toute leur etendue par de tres petites adherences extreme- ment minces et transparentes. II y a une grande quantite de sang infiltre dans le tissu cellulaire du canal rachidien .” — Annales medico -psycholo* F 66 APPENDIX G. giques , Janvier , 1843. Repertoire , 180. 181. Would space permit, instances of this kind might be lamentably multiplied. G. P ROFESSOR Tiedemann, in an elaborate paper published in the Phil. Trans, for 1836, part 2, on the brain of the negro, takes occasion to notice the comparative weight and size of the brain in Europeans, both males and females. The parallelism is incomplete ; I can therefore only cite a few examples from the table given by him. The weight indicated is Troy or Apothecaries weight. Weight of Brain as Sex. Age. Weight of Body. Weight of Brain. compared of the Bo- lb. oz. dr. gr. lb. oz. dr. gr. dy. Male New-born 7 3 2 8 1 1 1 10 ; as 1 : 6*63 Female Ditto 7 2 0 0 1 0 4 40 1 : 6*83 Male Fifteen 100 7 0 3 4 6 0 0 1 : 24 70 Female Thirteen 63 2 6 23 3 6 2 30 1 : 17*93 Ditto Sixteen 3 10 2 0 Male Thirty 3 11 7 0 Female Ditto 3 11 0 0 Ditto Ditto 123 4 2 25 3 7 0 0 1 : 34 42 Male Fifty 132 8 4 35 3 10 7 5 1 : 33-96 Ditto Ditto 181 8 2 0 4 1 0 10 1 : 44 47 Ditto Ditto 141 1 0 0 3 8 1 40 1 : 37-76 Female Ditto 134 6 2 57 3 4 0 40 1 : 40-27 Ditto Sixty 135 11 0 0 3 5 5 0 1 : 3918 Male Sixty-one 3 7 4 0 Here it will be seen that the female brain is frequently, relatively to the size of the body, APPENDIX G. 67 somewhat larger than the male, and the Profes- sor observes hereupon “ Although Aristotle has remarked that the female brain is absolutely smaller than the male ; it is nevertheless not relatively smaller, compared with the body ; for the female body is in general lighter than that of the male. The female brain is for the most part even larger than the male, compared with the size of the body.” Dr. Fletcher, in his Rudiments of Physiology, observes that “ the size of their brain as com- pared with their spinal marrow is somewhat greater in females than in males. Hence we might be led to conclude that in reality it is not their faculty of thinking, but their materials for thought, which are less than in males.” Whe- ther therefore we consider the size of the brain relatively to the size of the body or relatively to the size of the nerves, which go to make up the spinal marrow, we find the female brain has very commonly a trifling advantage over that of the male. It was indeed to be expected that the inferior muscular power should have a com- pensation ; as we find that in animals deficient in strength, superior skill in contrivance is usually given as a defence. 68 i APPENDIX H. H. I N one thousand male patients the causes of insanity have been referred as follows : Epilepsy 78 Born Idiots 71 Old Age 69 Accidents 39 Poisonous effluvia 17 Malformation 4 Drunkenness 110 Consequences of dis- ease 100 Ambition 73 Excessive labour 73 Misfortunes 69 Chagrin 54 Love 47 Religious enthusiasm 29 Political events .. 26 Ill-usage 12 Crimes, remorse, and despair 9 Pretended insanity... 5 Other and unknown causes 115 I T may be as well here to add, lest any mis- understanding should arise, that the author, in giving his classification of insanity, has only endeavoured to sketch a broad outline, leaving the shades of difference, and the details gene- rally, to be filled up by those whose professional experience enables them to do so with greater precision. — Every one who has attempted to classify any subject knows how one division blends into another, and how often even a plant is with difficulty adjusted into its proper place- — Much more must disease become complicated in its details, where two dissimilar forces are in action together, at once influencing and dis- turbing each other. 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