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DISEASES 
 
 OF THE 
 
 NERVOUS SYSTEM; 
 
 OR, 
 
 Pathology of the Nerves and Nervoos Maladies. 
 
 A TREATISE OF 
 
 PSYCHOLOGICAL MEDICINE. 
 
 BY 
 
 ALBERT H. HAYES, M. D., 
 
 AUTHOR OF “ SCIENCE OF LIFE.” “ PHYSIOLOGY OF WOMAN AND HER DISEASES,” “ A 
 TREATISE ON THE DISEASES OF THE THROAT AND LUNGS,” CHIEF 
 CONSULTING PHYSICIAN OF PEAB >DY MEDICAL 
 INSTITUTE, LATE SURGEON OF THE 
 U. S. ARMY, ETC., ETC. 
 
 Canst thou not minister to a mind diseased, 
 Raze out the written troubles of the brain, 
 
 And with some sweet oblivious antidote 
 Cleanse the stuffed bosom of that perilous stuff 
 Which weighs upon the heart ? Shakespeare. 
 
 BOSTON, MASS.: 
 
 PUBLISHED BY THE PEABODY MEDICAL INSTITUTE, 
 No. 4 Bulfinch Street. 
 
 1878. 
 
Entered according to Act of Congress, in the year 1873, by 
 ALBERT H. HAYES, 
 
 In the Office of the Librarian of Congress at Washington. 
 
Ub' o 
 
 A 
 
 / 
 
 PREFACE. 
 
 The author has long entertained the opinion that a popular work 
 on “ Nervousness, or the Pathology of the Nerves, and Nervous 
 Maladies,” is a desideratum. Of technical works on this subject, 
 intended for the medical profession, the name is legion But he 
 knows of no popular treatise for the general and unprofessional 
 reader. In the following pages he has endeavored to furnish such a 
 work to the public. Having made the cure of Nervousness a spe- 
 cialty throughout his entire professional course, and having had an 
 enviable success in this specialty, he has, of course, drawn largely 
 from his own experience in writing the following chapters. But 
 he has had no hesitation in drawing on the experience of other 
 practitioners as detailed in their writings, whether in the form of 
 independent treatises, or as contributions to journals of psycholog- 
 ical medicine, whether published in English, French, or German. 
 It has always been his maxim to supplement and fortify his own 
 experience by that of others. Never was psychology, or the sci- 
 ence of mind, pursued with more fruitful results than it now is, in 
 connection with physiology. The Nerves and Brain, which are the 
 organs of the mind, demand as much study as the mind itself. 
 
 Psychology and Physiology now go hand in hand, and shed mu- 
 tual light on each other. The subject of the Nerves, and their Dis- 
 eases and Derangements, the writer unhesitatingly pronounces to be 
 at this fast and eventful epoch, when life is condensed, as it were, 
 the most important in the whole range of medical pathology. Mind 
 and body are such intimate companions, that they sympathize, so 
 
 to speak, with each other perfectly. If one is sound and buoyant, 
 ^ the other is ordinarily in the same condition, and vice versa. If 
 v the nerves, which are the organs of the mind, are healthy and vig- 
 
iv 
 
 PREFACE. 
 
 orous, the mind is bright and hopeful. On the contrary, if the 
 nerves are jaded, diseased, and unstrung, the mind is in the same 
 state. Mental pathology is necessarily a sad record of human 
 wretchedness and woe ; for what torments are like those caused by 
 “ a mind diseased ” ? It has been the writer’s aim to make his work 
 interesting, as well as instructive. He has dealt with nervous dis- 
 ease in all its thousandfold and most perplexing forms and man- 
 ifestations, and should know whereof he writes. Under the dread 
 name of Nervous Disease, what an awful category of human ills is 
 included ! Insanity ; suicide ; narcotism ; alcoholism ; epilepsy ; pa- 
 ralysis ; softening of the brain ; soul-crushing mental anxiety ; 
 “that strange melancholy,” “which rejoiceth exceedingly, and is 
 glad when it can find the grave,” to quote from the Hebrew Scrip- 
 tures ; that utter wreck of the will and helplessness, which is the 
 result of self-abuse, and which is a cause of a majority of the cases 
 of nervousness and general debility ; all these momentous subjects, 
 of course, are fully and popularly discussed in the following pages. 
 
 One word before closing on the subject of special medical prac- 
 tice. The special medical practitioner, who, confident in his power 
 of dealing successfully with the particular class of diseases to 
 which he devotes himself, seeks, by all legitimate and proper 
 means, to bring himself and his skill to public notice, must calcu- 
 late beforehand on incurring the occasional sneers and unkindly 
 criticism of jealous professional brethren. If such things can even 
 annoy him for a moment, he has mistaken his calling. A profes- 
 sional man is either a public man, or he is nobody. If a physician 
 has especial skill in treating, say, the diseases of the nervous sys- 
 tem, the public want to know the fact, and ought to know it. In 
 such a case, it is a duty to seek publicity, for it is a means of doing 
 good. The skilful, special practitioner will have triumphs enough, 
 in the long run, over those who sneer. He will oftentimes find 
 such reluctantly compelled to avail themselves, and their patients 
 in extreme cases, of his superior skill in his own particular prov- 
 ince. In such cases he gets his revenge by affording the desired 
 relief. 
 
 Peabody Medical Institute, 
 
 July 30 , 1873 . 
 
PRESCRIPTIONS 
 
 The following Prescriptions have proved, by the most extensive experience, 
 to be thoroughly efficacious in the treatment of the diseases the names of 
 which are appended to them. They are written in English, Latin names and 
 scientific terms being purposely avoided, and they can be obtained at all reliable 
 drug-stores throughout the country. While the following formulae are of 
 established merit, the reader should bear well in mind that it is important 
 that they be only applied for the dise nses for which they are recommended, 
 hence the importance of a correct knowledge of their complaint before using 
 them. 
 
 Prescription No. 1. 
 
 R Tinct. Musk, Bi. 
 
 Tinct. Hops, 3 iii. 
 
 Liq. Potassae, 3 ii. 
 
 Infus. Buchu, Svi. 
 
 Mix : Three tablespoonfuls after meals. 
 Very useful in Indigestion attended 
 with Nervousness and Flatulence. 
 
 Prescription No. 2. 
 
 R Gum Arabic, Bi. 
 
 Water, Oiss. 
 
 Simple Syrup, 3 ii. 
 
 Mix : A wineglass frequently. 
 
 In Stranguary and Irritant Poisoning. 
 
 Prescription No. 3. 
 
 R Gum Arabic mixture, Biss. 
 Water, Siiiss. 
 
 Syrup, Bss. 
 
 Mix: A tablespoonful frequently. 
 
 In Bronchial Catarrh of Children. 
 
 Prescription No. 4> 
 
 R Gum Arabic mixture, 3 ii. 
 Water, Siv. 
 
 Syrup Tolou. 
 
 Orange Flower Water, aaBi. 
 Mix : A tablespoonful every two hours. 
 
 Excellent in Slight Colds. 
 
 Prescription No. 5. 
 
 R Vinegar, Bi. 
 
 Water, Bxv. 
 
 Sugar, Sss. 
 
 Mix: To be taken as a common drink. 
 Very useful in Fevers to allay thirst. 
 
 Prescription No. 6. 
 
 R Distilled Vinegar, 3 ii. 
 
 Syrup, Bss. 
 
 Water, 3 ii. 
 
 Mix: A fourth part every three hours. 
 In Scarlatina (for a child of three 
 years). 
 
 Prescription No. 7. 
 
 R Dilute Acetic Acid, 3 i. 
 
 Tinct. Jalap, Hlxv. 
 
 Tinct. Orange Peel, 3i. 
 
 Mixture Camphor, 3x. 
 
 Mix : Make a draught to be taken 2 or 
 3 times a day'. 
 
 In Rheumatism in debilitated persons. 
 
 Prescription No. 8. 
 
 R Vinegar, 3 ii. 
 
 Ammonia Muriate, 3i. 
 
 Honey, Biss. 
 
 Water, Bxii. 
 
 Mix: Use as a gargle 3 or 4 times daily. 
 
 Good for a Sore Throat. 
 
 Prescription No. 9. 
 
 R Lemon Juice, 3 ii . 
 
 Camphor Mixture, Bi. 
 
 Mix: Make a draught, to be taken 3 
 times a day. 
 
 In Acute Rheumatism. 
 
 Prescription No. 10. 
 
 R Recent Lemon Juice, Bi. 
 
 Oil Sweet Almonds, Biss 
 Syrup Marshmallow, Bss. 
 
 Mix: A teaspoonful every 3 hours. 
 
 In Obstinate Diarrhoea. 
 
 Prescription No. 11. 
 
 R Camphor Mixture, Si. 
 
 Spts. Ether Comp., 3 ii. 
 
 Tinct. Cardamon Comp., 3iv. 
 Spts. Anise, 3vi. 
 
 Oil Carrowav, ITlxii. 
 
 Syr. Ginger, 3 ii. 
 
 Peppermint Water, Svss. 
 
 Mix: Take two tablespoonfuls. 
 
 For Troublesome Flatulence. 
 
PRESCRIPTIONS. 
 
 Prescription No. 12. 
 
 R Sulph. Morphia, grs. ii. 
 
 Sulph. Soda, 3ii. 
 
 Syrup Simple, 3ii. 
 
 Mix: Dose, £ a small teaspoonful to an 
 adult after each discharge. 
 
 Invaluable in Dysentery. 
 
 Prescription No. 13. 
 
 R Liquid Tar. 
 
 Powd. Alum, aa3v. 
 
 Powd. Liquorice, q. s. 
 
 Mix: Divide into 100 pills. Take from 
 6 to 10 every day. 
 
 Excellent in Gonorrhoea. 
 
 Prescription No. 14. 
 
 R Camphor Mixture, 3iss. 
 
 Liquid. Acetate Ammonia, 3iv. 
 Wine Anti mony et Potassia Tart, 
 drops xl. 
 
 Tinct. Opium, drops xx. 
 
 Mix: Take half of the quantity on 
 retiring. 
 
 Very beneficial in Acute Rheumatism. 
 
 Prescription No. 15. 
 
 R Antimony Potassia Tart., 1 gr. 
 Saltpetre, 3 ii. 
 
 Almon l Mixture, Sxii. 
 
 Tinct. Camphor Comp., Sss. 
 
 Mix : Dose, a tablespoonful every hour. 
 
 Excellent Cough Mixture. 
 
 Prescription No. 16. 
 
 R Horse-radish Root. 
 
 Contused Mustard Seed, aa3iii. 
 Warm Water, Ol. 
 
 Macerate for an hour, and strain. 
 Colaturae, 5vii. 
 
 Spts. Ammonia Arom., 3iss. 
 Spts. Pimentae, 3iii. 
 
 Mix: Two tablespoonfuls 3 times daily. 
 
 Very useful in Paralysis. 
 
 Prescription No. 17. 
 
 R Tinct. Arnica. 
 
 Tinct. Capsicum, aa3i. 
 Chloroform, pure, 3 ii. 
 
 Tinct. Sapo et Opii, 3 ii. 
 
 Mix: and mark external use. 
 
 Excellent in Bruises and Sprains. 
 
 Prescription No. 18. 
 
 R Ungt. Belladonna, 3i. 
 
 Powd. Camp., 3i. 
 
 Mix: Mark external use. 
 
 In Painful Cords or Piles. 
 
 Prescription No. 19. 
 
 R Bromide Potassa, 3 iii. 
 Cinnamon Water, 5i. 
 
 Mix: Dose, a teaspoonful as occasion 
 may require. 
 
 Useful in Headache, or to produce Sleep . 
 
 Prescription No. 20. 
 
 R Infusion Bucliu, Svii. 
 
 Tinct. Buchu. 
 
 Tinct. Cubebs, aa 3iv. 
 
 Mix: Dose. 2 tablespoonfuls 3 t rues a 
 day. 
 
 Useful in Kidney Difficulties. 
 
 Prescription No. 21. 
 
 R Fresh Milk, Oss. 
 
 Lime Water, 3i. 
 
 Mix: Four tablespoonfuls is a dose. 
 
 Useful in Sour Stomach. 
 
 Prescription No. 22. 
 
 R Tinct. Spanish Flies, drops ii. 
 Tinct. Henbane, lTlv. 
 
 Water, 3x. 
 
 Mix : Dose, tablespoonful every 2 hours. 
 Useful in Inability to hold Urine , or 
 Paralysis of the Bladder. 
 
 Prescription No. 23. 
 
 R Tinct. Spanish Flies. 
 
 Tinct. Camphor Comp., aa 3i. 
 Tinct. Cinchona Comp., 3x. 
 Mix: Dose, thirty drops, gradually in- 
 creased to a teaspoonful, 3 times a 
 day. 
 
 Beneficial in Whooping Cough. 
 
 Prescription No. 24. 
 
 R Acet. Spanish Flies, 3ss. 
 
 Aqua Cologne, 5i. 
 
 Aqua Rosae, 3i. ' 
 
 Mix: Make a wash. Rub on the head 
 when the hair falls out. 
 
 Prescription No. 25. 
 
 R Powd. Red Pepper, 3 ii. 
 
 Boiling Water, Oss. 
 
 Mix: Strain, and when cool take a tea- 
 spoonful 3 times a day. 
 
 Useful in Malignant Sore Throat. 
 
 Prescription No. 26. 
 
 R Elix.Peruvian Bark with Protox. 
 Iron, Sxii. 
 
 Dose, a dessert-spoonful after meals. 
 
 An Agreeable Tonic. 
 
 Prescription No. 27. 
 
 R Liquid Acetate Ammon., 3 ii. 
 Sweet Spirits Nitre, 3 iii. 
 
 Aqua Camphor, 3ss. 
 
 Syr. Simplex, 3iv. 
 
 Mix : Dose, a teaspoonful every 3 hours. 
 Very beneficial at the commencement 
 of Fevers. 
 
PRESCRIPTIONS. 
 
 Prescription No. 28. 
 
 R Powd. Peruvian Bark. 
 
 Powd. Rhubarb, Turkish, aaSss. 
 Carbonate Magnesia, 9i. 
 Confect. Aroinat. 9ss. No. 1. 
 Cinnamon Water, giss. 
 
 Mix: Make a draught. To be taken 
 twice a day. 
 
 Excellent Cathartic. 
 
 Prescription No. 29. 
 
 R Sulphate Magnesia, 3 ii. No. 2. 
 Fluid Ext. Senna, 3vii. 
 
 Simple Syrup, gii. 
 
 Mix: Take all at one draught. 
 
 An Excellent Physic. 
 
 Prescription No. 30. 
 
 R Bals. Copaiba. 
 
 Liquid Potassse, aaSiii. 
 
 Mucil. Gum Arabic, Si. 
 Peppermint Water, Svi. 
 
 Mix: A tablespoonful before meals. 
 Excellent in first stages of Gonorrhoea. 
 
 Prescription No. 31. 
 
 R Ammoniated Tartrate of Iron, 3 i. ' 
 Water, Svss. 
 
 Simple Syrup, S ss. 
 
 Mix : Dose, tablespoonful 3 times a day. 
 
 Beneficial in Bright's Disease. 
 
 Prescription No. 32. 
 
 R Ext. Henbane, 3ss. 
 
 Valerianate Ferri, 3i. 
 
 Mix: Divide in 30 pills; dose, 1 after 
 meals. 
 
 Excellent in Neuralgia. 
 
 Prescription No. 30. 
 
 R Extract Gentian. 
 
 Sesquicarbonate Ammonia 
 aa3i. 
 
 Mix: Divide into 30 pills; dose two, 2 
 or 3 times daily. 
 
 In Obstinate Heartburn. 
 
 Prescription No. 37. 
 
 R Glycerine. 
 
 Rose Water, aagii. 
 
 Powd. Borax, Dii. 
 
 Mix: Apply at bedtime. 
 
 An excellent application for Chapped 
 Hands , Chilblains , and bore Ripples. 
 
 Prescription No. 38. 
 
 R Ext. Henbane. 
 
 Camphor. 
 
 Ext. Hops, aa, grs. iii. 
 
 Mix: Make 2 pills; take at bedtime. 
 
 In simple Wakefulness. 
 
 Prescription No. 39. 
 
 R Tinct. Iodine Comp , gi. 
 
 Make external use ; apply with a brush 
 thrice daily. 
 
 Excellent Application to Swollen Joints. 
 
 Prescription No. 40. 
 
 R Powd. Peruvian Bark, Red. Si. 
 Lard, Sii. 
 
 Mix: Make ointment; use 3 times a 
 day on linen. 
 
 The best Salve for Sores and Ulcers. 
 
 Prescription No. 41. 
 
 R Powd. Dovers, grs. xl. 
 
 Hyd. Sub. Murias., grs. viii. 
 Mix: Divide into 8 powders; 1 in every 
 3 hours if awake. 
 
 Excellent in Pneumonia or Lung Fever. 
 
 Prescription No. 33. 
 
 R Bromide Ferri, 3i. 
 
 Syrup Orange, Sss. 
 
 Orange Water, giss. 
 
 Mix: Dose, teaspoonful every 6 hours. 
 
 Useful in Secondary Syphilis. 
 
 Prescription No. 34. 
 
 Prescription No. 42. 
 
 R Powd. Ipecac Root, grs.iv. 
 Mucilage Gum Arabic. 
 
 Simple Syrup, aaSii. 
 
 Distilled Water, gi. 
 
 Saltpetre, grs. xv. 
 
 Mix : Two teaspoonsfuls every 4 hours. 
 
 In Measles of Infants. 
 
 R Sulph. Ferri, Si. 
 
 Distilled Water, gxvi. 
 
 Mix : Make wash, apply on linen every 
 2 or 3 hours. * 
 
 Excellent in Erysipelas. 
 
 Prescription No. 35. 
 
 R Powd. Galls, 3i. 
 
 Sulphate Copper, 9i. 
 
 Lard, Si. 
 
 Mix: Make ointment, apply to the 
 affected part 3 times a day. 
 
 For Ringworm. 
 
 Prescription No. 43. 
 
 R Dover’s Powd. 
 
 Hyd. Cum Creta, aa grs.i. 
 
 Mix: To be taken at bedtime. 
 Excellent in the Diarrhoea of Teething 
 Infants. 
 
 Prescription No. 44. 
 
 R Ground Flaxseed, 3 iv. 
 
 Ground Poppy Flowers, Si. 
 Mix: Divide in 8 poultices; use a fresh 
 one morning and evening. 
 
 Excellent Poultice for a Felon. 
 
PRESCRIPTIONS 
 
 Prescription No. 45. 
 
 R Tinct. Lobelia, Sss. 
 
 Orange Water, 3ii. 
 
 Distilled Water, 3iv. 
 
 Mix: Dose, a tablespoonful 3 times a 
 day. 
 
 Beneficial in Asthma. 
 
 Prescription No. 46. 
 
 R Carbonate Magnesia, 9i. 
 
 Tinct. Cardamon Comp., 3ii. 
 Orange Water, 3ss. 
 
 Syrup, 3ii. 
 
 Mix: Dose, a teaspoonful frequently 
 during the day. 
 
 Excellent in Colic of Infants. 
 
 Prescription No. 47. 
 
 R Cod Liver Oil, 3iv. 
 
 Emulsion Almonds, 3i. 
 Whiskey, 3ii. 
 
 Mix : Dose, a tablespoonful after meals. 
 Very Beneficial in Consumption. 
 
 Prescription No. 48. 
 
 R Sweet Oil, Sviii. 
 
 Arom. Spts. Ammonia, 3ii. 
 
 Mix: Dose, 3 teaspoonfuls night and 
 morning. 
 
 Good to Expel and Destroy Worms. 
 
 Prescription No. 49. 
 
 R Citrate Iron et Quinine, 3iii. 
 Sherry Wine, 3 vii. 
 
 Mix : Dose, a teaspoonful before meals. 
 
 An Excellent Tonic. 
 
 Prescription No. 50. 
 
 R Tinct. Peruvian Bark. 
 
 Tinct. Gentian. 
 
 Tinct. Cardamon, aa3i. 
 
 Essence Checkerberry, gtts.xxx. 
 Mix: Dose, a teaspoonful before meals. 
 Excellent in a Capricious Appetite. 
 
 Prescription No. 51. 
 
 R Wine of Ipecac, 3i. 
 
 Dose, a teaspoonful to children in con- 
 vulsions. This is an invaluable rem- 
 edy, and always safe to administer, 
 care being taken not to strangulate 
 the patient from inability to swallow. 
 
 The reader must bear in mind that the use of the foregoing remedies is only 
 for adults, and that the author has purposely refrained from giving any formulae 
 for the diseases mentioned chiefly in this treatise, from the fact that nervous 
 diseases are the most insidious, painful, and destructive that afflict the popula- 
 tion of the earth, and the remedies therefore are most potential, and might 
 properly be classed as edge-tools in medicine. Apropos to this subject, I would 
 here quote the statement of the eminent Professor of Anatomy and Physiology 
 at Harvard Medical College to the Fellows of the Massachusetts Medical Society, 
 “that medicine as they'practised it (that is, the physicians in general or family 
 practice) did more harm than good; and if all the drugs they used were thrown 
 into the sea, it would be all the better for their patients, but all the worse for the 
 fishes.” From the daily observations of the author he can fully corroborate the 
 sentiments of this outspoken, truthful, and learned gentleman. Myriads of 
 broken-down, wretched invalids are constantly crowding upon his attention, 
 whose misery and wretchedness are owing wholly or in part to the ignorance of 
 previous medical advisers, and he feels constrained to admonish invalids of this 
 class to confide the treatment of their case to none except those who devote their 
 whole energy and abilities to the treatment of nervous diseases, and who give 
 undoubted evidence of their superior qualifications. 
 
CONTENTS 
 
 Chapter. 
 
 I. The Nerves and the Brain • 
 
 II. Nervous Disorders and the Temperaments . 
 
 III. A Chief Cause of Nervous Derangement 
 
 IV. Patients with the Nervous Temperament . 
 
 V. Convivial Habits and Nervousness . 
 
 VI. Anxiety of Mind 
 
 VII. Nervousness and Religious Excitement 
 
 VIII. Illusions and Hallucinations 
 
 IX. Sleep and Sleeplessness 
 
 X. Epilepsy 
 
 XI. The Suicidal Propensity 
 
 XII. Treatment of the Insane 
 
 XIII. Urinary Analysis, as a Detective of Disease 
 
 XIV. Various Urinary Deposits 
 
 XV. Pathology of the Nerves and Nervous Maladies 
 
 XVI. A Few Hygienic Observations on Nervous Affections 
 
 XVII. A Curious Case of Supposed Demoniacal Possession . 
 XVIII. Hope and Confidence as Therapeutic Agents 
 XIX. Alcohol, Tobacco, Opium, Hacshish . 
 
 XX. Body vs. Mind 
 
 XXI. General Paralysis 
 
 XXII. Dipsomania, or Drunken Insanity 
 
 XXIII. Late Suppers and Dreams 
 
 XXIV. The Uses and Abuses of the Popular Nervines . 
 
 Page. 
 
 1 
 
 11 
 
 24 
 
 31 
 
 39 
 
 43 
 
 48 
 
 52 
 
 66 
 
 74 
 
 78 
 
 89 
 
 101 
 
 114 
 
 124 
 
 132 
 
 140 
 
 146 
 
 150 
 
 158 
 
 167 
 
 178 
 
 183 
 
 189 
 

 ' 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 ■ 
 
 
 
 
THE NERVES AND THE BRAIN. 
 
 CHAPTER I. 
 
 INTRODUCTORY AND GENERAL REMARKS. 
 
 The barbarian, and the rude, ignorant European peasant, 
 scarcely know that they have nerves. But civilization, cul- 
 ture, and refined artificial modes of life bring the nerves into 
 almost fearful prominence. Few who live in cities, or come 
 in any way within the vortex of our social life, have escaped 
 occasional attacks of nervousness.* Is nervousness, then, 
 asks a distinguished English writer on the physiology and 
 pathology of the nerves, an inevitable condition of civiliza- 
 tion, a tax we must be content to pay for our advantages ; 
 or can we free ourselves from its assaults without paying too 
 great a price for the immunity ? What is the malady and 
 its cause, that we may know what the cure must be? And, 
 first, have the nerves really anything to do with it, or have 
 they borne the blame while other portions of our organiza- 
 tion have been at fault? When we are in that excitable, 
 tremulous condition, in which there is a morbid anxiety to 
 labor, with diminished power of performance ; when, without 
 any definite ailment, we seem deadened in every faculty, while 
 yet the least vexation is felt as an intolerable annoyance, 
 — are we right in saying that it is especially the nervous 
 
 * Vide Hinton’s works, whose admirable account of the nervous system 
 has been summarized in the following chapter, — our limits forbidding 
 extended and scientific details, which are always tedious and often unin- 
 telligible to the general reader, for whom we write. 
 
2 
 
 THE NERVES AND THE BRAIN. 
 
 system that breaks down? In order to answer this question, 
 we must get some definite idea of that complex machine, the 
 Nervous System, as it exists in man. Beautiful and myste- 
 rious as are its operations and results, its mode of action has 
 been well ascertained, and is exceedingly simple. The ner- 
 vous system is one of the chief characteristics of animal life, 
 especially of the higher animals. By its means the various 
 organs, which make up the body of an animal, arc blended 
 into a whole ; and thus the animal is a unit or individual, 
 while the plant always remains a mere bundle of more or 
 less similar parts. 
 
 Through the nerves the body is acted upon by, and can 
 react upon, objects that affect it from without, not only by a 
 motion of the part immediately affected, but by the combined 
 movement of many, and, it may be, distant organs. In this 
 lies the primary need of a nervous system. It is in its sim- 
 plest aspect merely a channel by which the affections of one 
 portion of the body are enabled to call out the activity of 
 another. Keeping this idea in mind, we shall find there is 
 no difficulty in following, in their general principles, the 
 structure or functions of the nervous system, even in its 
 most highly developed and complicated forms. If we look 
 at the human brain, we find that it consists mainly of a vast 
 mass of fibres. Their number, tenuity, and variety of direc- 
 tion are so great that no skill has hitherto availed to trace 
 them in detail, though their course has been pretty gener- 
 ally well made out. Emanating from the brain and spinal 
 cord, long lines of fibres pass to each region of the body, and 
 distribute themselves in a minute net-work, that, if we could 
 see it by itself, would appear before us a perfect image of 
 the body, all pure nerve. The fibres which constitute the 
 chief mass of the nervous system are simple in their struc- 
 ture, so far as the microscope can reveal it, and present a 
 very curious analogy to a telegraphic wire. Like the latter, 
 
INTRODUCTORY. 
 
 3 
 
 each nervous fibre consists of a small central thread (or 
 tube, perhaps, in the case of the nerve, though the tubular 
 structure cannot be demonstrated) , surrounded by a layer 
 of a different substance. The central thread (or axis) is of 
 a grayish color ; the surrounding material is of a glassy 
 appearance, soon becoming an opaque white after death, and 
 giving then the characteristic white appearance to the nerves. 
 The fibre, consisting of these two portions, is included in a 
 sheath, which isolates it. If we roll up a wax candle in 
 paper, that will give us a rough illustration of the nerve 
 fibre. The paper is the external " sheath”; the wax is the 
 intermediate white matter ; the wick is the central axis. It 
 is most natural to believe that the analogy suggested by this 
 structure is a true one, and that the white substance acts the 
 part of the gutta-percha round the electric wire, as an insu- 
 lating medium for the currents which travel along the cen- 
 tral portion. But this is not proved. Probably, owing to 
 the minuteness of the parts, it is beyond the possibility of 
 experimental proof. For in man two or three thousand of 
 these fibres would occupy but an inch in their largest part. 
 
 There is another kind of nervous matter, besides the fibres, 
 and that consists of cells. The nerve fibres sometimes run 
 into them ; sometimes they pass among them without ap- 
 pearing to communicate. Cells of this kind form a thin 
 layer over the surface of the brain, and its fibres for the 
 most part have their origin from or among them. They 
 also exist in large numbers in certain spots in the substance 
 of the brain, and they are found within the spinal cord in its 
 whole length. Wherever they are found they go by the 
 name of gray matter, the nerve fibres being called the white 
 matter. The fibres which constitute the nerves, strictly so 
 called, are conductors, and they conduct to and from the 
 cells. What, then, is the part played by the latter? But 
 before answering this question, it is worth while to peruse 
 
4 
 
 THE NERVES AND THE BRAIN. 
 
 and note the extreme simplicity of form exhibited by this 
 element of the nervous system. In the gray matter of the 
 brain, we have arrived at the very highest organic structure, 
 the great achievement of the vital force, the texture in which 
 bodily life culminates, and for the sake of which, we might 
 almost say, all the other organs exist. And we find a structure 
 of the very lowest form. Mere cells and granules — Nature’s 
 first and roughest work, her very starting-point in the organic 
 kingdom — strewn in a mere mass, with no appreciable order, 
 over the ends of a multitude of fibres, and loosely folded up, 
 as it seems, for convenient storage ! This is what meets the 
 eye. Is this the laboratory of reason, the birthplace of 
 thought, the home of genius and imagination, the palace of 
 the soul? Nay, is this even the source and spring of bodil} r 
 order, the seat of government and control for the disorderly 
 rabble of the muscles? Should we not have expected, when 
 we came thus to the inmost shrine of life, and penetrated to 
 the council-chamber of the mind, to find all that had before 
 appeared of skilful architecture and elaborate machinery 
 surpassed and thrown into the shade? But it is all cast 
 away. Mechanical contrivances for mechanical effects ! Skil- 
 ful grouping and complex organization there may be for the 
 hand, eye, the tongue ; for all parts and every function 
 where the mind is not. But where the spirit comes, take all 
 that scaffolding away ! The gray matter of the brain is very 
 abundantly supplied with blood. What is the office of the 
 cells or gray matter? The spinal cord of man is a series of 
 groups of cells, giving off nerves on each side, and connected 
 by communicating fibres with each other, and with the larger 
 groups in the brain, which also give ofl‘ nerves to the nose 
 and eye, the skin and muscles of the face, and other parts. 
 Thus, in man and all animals alike, masses of gray matter, 
 the cells, are placed at the centre, and nerve fibres connect 
 them with the organs of the body. It has been proved also 
 
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 Diseases of the Nervous System 
 
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INTRODUCTORY. 
 
 5 
 
 by the beautiful experiments of Sir Charles Bell that the 
 nerve fibres are of two kinds : some conveying an influence 
 from the organs to the centres, where the nerve cells are 
 placed ; and others carrying back an influence from them to 
 the organs; So these groups of cells evidently answer to 
 the stations of the electric telegraph. They are the points 
 at which the messages are received from one line and passed 
 on along another. They are called ganglia in scientific lan- 
 guage. But besides this the cells are the generators of the 
 nervous power. For the living telegraph flashes along its 
 wires not only messages, but the force also which ensures 
 them fulfilment. A nerve bears inward, say from the hand 
 or foot, an impression, it may be of the slightest kind ; but 
 the cells are thrown into active change by this slight stimu- 
 lus, and are thus able to send out a force along the nerves 
 leading to large groups of muscles, and excite them all to 
 vigorous motion. 
 
 In the above we have merely aimed at giving a general 
 account of the Nervous System. The nerves are the special 
 vehicles of will and feeling, hence their derangement is most 
 calamitous. By them we see, taste, smell, hear, and feel. 
 By them we command our limbs with the aid of the muscles. 
 Hence the terrible character of nervous disease and derange- 
 ment, which strikes at the very source of all our pleasurable 
 activity, enjoyment, and conscious life. Diseases of the 
 brain, of the spinal cord, of the nerve cells and of the facial 
 nerves, and cerebro-spinal disease, compose in general terms 
 the terrible bead-roll of nervous disorders. Under these 
 heads come insanity, softening of the brain, epilepsy, hydro- 
 phobia, all kinds of paralysis, neuralgia ; in short, all morbid 
 affections, which are specially characterized by pain and 
 dethronement of the mind. Fortunately for suffering hu- 
 manity, Dr. Hammond, in his great work on Diseases of the 
 .Nervous System, is strictly correct when he says, that " in no 
 
6 
 
 THE NERVES AND THE BRAIN. 
 
 department of medical science has progress been more de- 
 cided during the last decade, than in nervous affections. ” 
 The writer of this treatise, with a most ample and gratifying 
 experience in the treatment and cure of nervous disorders, is 
 able fully to indorse the above assertion. Whether or not 
 he himself has in his professional career contributed to this 
 progress in the means of ameliorating the acutest human 
 suffering, it is for his multitudinous patients to say. At any 
 rate, he is willing to abide by their verdict. 
 
 Derangements of the nervous system are seen in the par- 
 oxysms of asthma and the seizures of epilepsy, in both of 
 which affections the muscles are thrown into excessive con- 
 traction through a morbid condition of the spinal cord. Of 
 a different .order are the languor and feeling of utter disa- 
 bility for muscular exertion which creep over us at times. 
 These feelings show that the nerve centres which preside 
 over muscular exertion have become oppressed and sluggish, 
 likely enough through want of proper exercise. Of a differ-' 
 ent kind, again, are tremblings of the muscles, or involuntary 
 jerks and twitchings, and, in brief, all that condition known 
 by the expressive name of " fidgets.” What is the source of 
 this irritability, which renders it impossible to keep the 
 muscles still? We can answer in general that irritability 
 means weakness. A physician of eminence compares it to 
 the whirling motion of the hands of a watch of which the 
 mainspring is broken. In our physical, as in our moral 
 nature, strength is calm, patient, orderly; weakness hurries, 
 cannot be at rest, attempts too much. Strength in the 
 living body is maintained by the full but natural exercise of 
 each organ. 
 
 The full access of all healthful stimuli to the skin, and 
 through it to the nerves of sensation, is the first and chief 
 
 O 7 
 
 condition of the healthful vigor of the nervous system. 
 
 Among these invigorating influences, fresh air and pme 
 
INTRODUCTORY. 
 
 7 
 
 water hold the first place. The great and even wonderful 
 advantages of cleanliness are partty referable to a skin 
 healthily active, open to all the natural stimuli, and free 
 from morbid irritation upon the nerve centres of which it is 
 the appointed excitant. 
 
 The state of general vigor which we call " Tone ” also 
 depends upon the healthy action of these nervous centres. 
 It consists in an habitual moderate contraction of the mus- 
 cles, due to a constant stimulus exerted upon them by the 
 spinal cord, and is valuable less for itself than as a sign of a 
 sound nervous balance. Tone is maintained, partly by 
 healthful impressions radiated upon the spinal cord, through 
 the nerves from all parts of the body, and partly by the 
 stimulus poured down upon it from the brain. So it is dis- 
 turbed by whatever conveys irritating or depressing influ- 
 ences in either direction. A single injudicious meal, a 
 single sleepless night, a single passion or piece of bad news, 
 will destroy it. On the other hand, a vivid hope, a cheerful 
 resolve, an absorbing interest, will restore it as if by magic. 
 For in man these lower officers in the nervous hierarchy 
 draw their very breath according to the bidding of the higher 
 powers. 
 
 A chief condition of keeping the nerves and brain healthy 
 is to keep them in full vigor and in natural alternations of 
 activity and repose. Muscular exercise has a most bene- 
 ficial effect on a depressed or irritable state of mind. The 
 bodily movement, by affording an outlet to the activity of 
 the spinal cord, withdraws a source of irritation from the 
 brain, or it may relieve excitement of that organ by carrying 
 off its energy into a safe channel. 
 
 We see evidence of the same law in the delightful effect 
 of a cheerful walk, and in the demand for violent exertion, 
 which is so frequent in insanity. The power of the brain 
 over the vital condition of the body is exerted through a 
 
8 
 
 THE NERVES AND THE BRAIN. 
 
 particular set of nerves, which have been called "the sympa- 
 thetic system.” They are somewhat smaller and simpler 
 than the nerves of sensation and motion, with which, how- 
 ever, they are intimately connected. They are distributed 
 to the organs on which life depends (the lungs, heart, stom- 
 ach, etc.), and to the blood-vessels all over the body. Thus 
 the condition of the brain is necessarily the key to that of the 
 whole body v and its influence is universally paramount, both 
 directly by its power over the heart and breathing, and still 
 more profoundly by its indirect control over the supply of 
 blood. 
 
 There is no mystery on the effects produced on health by 
 excess of mental labor, or by long-continued cares, nor in 
 the bodily torpor which attends a merely inactive mind. 
 " Nervousness ” naturally results from an overtaxed brain. 
 The wonder is, not that it occurs so often, but that, amid the 
 rude shock to which pur life is subject, it is not more fre- 
 quently experienced. If we would have our bodies healthy, 
 our brains must be used, and used in orderly and vigorous 
 ways. The torpid, unhealthy frame and languid circulation 
 of the idiot are but an exaggerated instance of the unnat- 
 ural torpor to which he condemns himself, who wastes his 
 life in indolence, or consumes it in dissipation. To him 
 Nature, indeed, has been kinder than she has to the idiot, 
 — he does but abuse her bounty to become a worse enemy 
 to himself. 
 
 The perfect health of a man is not the same as that of an 
 ox or horse. The preponderating capacity of his nervous 
 part demands a corresponding life. But the very causes 
 which make the proper exercise of the brain especially 
 needful, render its excess especially baneful. The signs 
 of this excess, or excess combined with misdirection, meet 
 us on all hands : in weariness, despondency, disgust, or 
 causeless anger; in racking neuralgic pains, or gradual 
 
INTRODUCTORY. 
 
 9 
 
 decay of vital power, or in the insidious threatenings of 
 serious disease. How could these results be guarded 
 against, we ask. The answer can he but one. Health can 
 no more be obtained without its price than anything else. 
 Nature has forever forbidden it. The flame of life can 
 neither be fed nor renewed with stolen fire. 
 
 The condition of rescue from overwork is rest and change, 
 — fresh air, and the soothing influence of natural scenery, if 
 they can be obtained. 
 
 One word, before closing these somewhat general intro- 
 ductory remarks, on the subject of cities, as our modern life 
 is more and more concentrated in cities, which develop and 
 intensify the nervous energy wonderfully, and by their man- 
 ifold and constant excitements fearfully multiply nervous 
 disease in all its forms. A distinguished author observes, 
 that " the invention of 'towns were a pure gain to humanity, 
 if due admixture of the country life can be secured.” And to 
 obtain this advantage for our laboring populations is one of 
 the great tasks of our age, and one of the great problems for 
 managers of railroad corporations in particular. Our physi- 
 ology teaches us that the vice and misery of our great towns 
 can never be successfully combated in the strongholds which 
 they have made their own, and fortified for generations, — the 
 courts and alleys where the poisonous atmosphere combines 
 with all hateful sights and sounds at once to deaden and 
 irritate the nervous sensibility. From the continued breath- 
 ing of a vitiated atmosphere inevitably arises either apathy 
 or a craving for intoxicating drinks ; in all probability, each 
 in turn. 
 
 On the other hand, the splendor and allurements of city 
 life constantly acting upon the senses, especially of the 
 young and susceptible, are calculated to produce nervous 
 derangement, and prematurely use up those exposed to, them. 
 Indeed, modern civilization, with its splendid material tri- 
 
10 
 
 THE NERVES AND THE BRAIN. 
 
 umphs and manifold devices for comfort, luxury, and sem 
 sual enjoyment, grows ever more and more trying to the 
 nerves, and has rendered completely unfashionable the plain, 
 frugal, ascetic life of our ancestors. Hence it is that the 
 medical practitioner, who contributes by his skill and inge- 
 nuity to restore a jaded and disordered nervous system, and 
 check the spread of nervous affections, is emphatically a 
 Public Benefactor. 
 
CHAPTER II. 
 
 NERVOUS DISORDER AND THE TEMPERAMENTS. 
 
 A careful examination of numerous cases of nervous dis- 
 order has satisfied me that the study of the temperaments is 
 absolutely necessary on the part of the physician who aims 
 at even ordinary success in the treatment of disease. For 
 instance, were we to treat four different persons, all suffering 
 alike from the same nervous disorder, but all of them having 
 different temperaments, with precisely the same remedies, 
 without taking into account the peculiarities of each, or the 
 effect of these upon the constitution, as well as the nature of 
 the disease, — we should be as little likely to succeed in effect- 
 ing a cure as would the mariner in reaching his destination, 
 who steered in a direct right line by compass for the point 
 which he wished to reach, totally regardless of, nor making the 
 slightest allowance for, leeway, current, or any other disturb- 
 ing causes. It is therefore as indispensably necessary that 
 the physician take into account, not merely the general nature 
 and character of the disease, but also the various concomi- 
 tant circumstances, before he incur either risk or responsibil- 
 ity. It is the study of these circumstances, and the paying 
 due attention to them, that constitute the accomplished and 
 trustworthy physician ; and those traits alone can ensure 
 him success in practice. In the study of all disorders, we 
 must take into account and carefully review both the history 
 
 [ii} 
 
12 NERVOUS DISORDER AND THE TEMPERAMENTS. 
 
 of the disease and the history of the case. The first makes 
 us acquainted with all the general phenomena and tendencies 
 of the disorder, while the second brings us into relation with 
 all those specialties which require peculiar modifications of 
 treatment. 
 
 In the Nervous Temperament we find that the brain is 
 large and well developed, and its energies and those of the 
 nervous system are the most predominant, and take the 
 lead over those of all the other organs. The features are 
 
 Fig. 1. Nervous Temperament. 
 
 sharp and prominent, the eye large and expressive ; the 
 mouth betokens intelligence, and frequently there is a full 
 and intellectual forehead ; the skin thin and transparent, 
 with flossy, silky hair ; the muscles small but well marked, 
 with quick and active motions ; the face generally pale, and 
 frequently expressive of anxiety ; the brain and whole of the 
 nervous system in a high state of activity. Such persons are 
 for the most part quick and intelligent, and highly sensitive 
 
NERVOUS DISORDER AND THE TEMPERAMENTS. 
 
 13 
 
 to every kind of impression ; and they are readily excited 
 and easily depressed. At one time you may find them en- 
 joying themselves to the fullest extent, and in a very short 
 time after, perhaps in tears. The dispositions of persons in 
 whom this temperament predominates, arc much modified by 
 the circumstances in which they may happen to be placed. 
 Confinement, especially if the occupation be sedentary, never 
 fails to produce evil effects upon the constitution. Individ- 
 uals of this temperament are highly sensitive to all those 
 agents which act upon the nervous system. Such persons 
 require to be treated with great care and delicacy. 
 
 Fig. 2. Lymphatic Temperament. 
 
 But in the Lymphatic Temperament, in which the abdomen 
 is remarkably large and prominent ; the brain dull and in- 
 active ; the body round and soft ; action slow and heavy ; 
 skin muddy and flabby ; circulation weak and languid ; mus- 
 cles soft, flaccid, and feeble, with great aversion to either 
 
14 
 
 NERVOUS DISORDER AND THE TEMPERAMENTS. 
 
 mental or bodily exercise, — we find the energies of every 
 kind very feeble, indeed almost dormant. Thus we 
 see that persons of this temperament differ materially in 
 these particulars from persons of the former. Indeed, so 
 little excitable are people of the - purely lymphatic tempera- 
 ment, that it is not without the greatest difficulty they can 
 be aroused, or induced to exert themselves in the smallest 
 degree, while they are quickly exhausted when aroused to 
 exertion. It is obvious that this inert temperament is not 
 so liable to nervous derangement as the former, and when 
 thus disordered, that it does not require the same delicate 
 treatment as the other. 
 
 Persons of the Sanguineous Temperament differ widely 
 
 Fig. 3. Sanguineous Temperament. 
 
 from those of the Lymphatic. In the former, the lungs 
 and heart are large, and the power of the latter organ is con- 
 
NERVOUS DISORDER AND THE TEMPERAMENTS. 
 
 15 
 
 spicuous, predominating over all other systems. The pulse 
 is strong and regular ; the veins turgid, full, and blue ; the 
 chest large ; the complexion fair and florid ; muscles firm ; 
 hair reddish, chestnut, or auburn. Impressions made on the 
 nervous system are vivid ; imagination luxuriant ; temper 
 passionate, but not vindictive; and individuals of this class, 
 though readily excited, are still easily appeased. Now were 
 we to treat a patient of the sanguineous temperament, in the 
 same way that we should treat one of the lymphatic, suffering 
 from the same disease under exactly similar circumstances, 
 the consequences would be most deplorable. For instance, 
 wine, spirits, and such stimulants would be wholly inadmis- 
 sible in treating a patient of the sanguineous temperament, 
 because in such an one the heart and arteries are already too 
 prone to over-action. The use of stimulants by a patient of 
 sanguineous temperament would almost to a certainty bring 
 on inflammation ; or we should by such means incur the risk 
 of doing some violent injury to the heart or some other part 
 of the nervous system. 
 
 The Biliary Temperament, again, differs from the fore- 
 going, thus briefly noticed. In persons of this tempera- 
 ment, the liver is large, and its functions are readily called 
 into activity, and there is a great tendency to a redundant 
 secretion of bile. The pulse is stronger and more, frequent 
 than in the purely sanguineous; the veins are prominent, 
 the sensibility acute, and there is great constitutional 
 energy. The skin is generally dark or sallow, with 
 occasionally a yellow tinge ; hair black or dark brown, 
 and often short and crisp ; the muscles firm, and well devel- 
 oped ; temper abrupt, but not liable to such extremes of 
 excitement as in those of the purely nervous ; the concep- 
 tions are bold, while they themselves are inflexible in the 
 pursuit of a project, nor are they so readily exhausted as 
 persons of the nervous or other temperaments. In attaining 
 
16 NERVOUS DISORDER AND THE TEMPERAMENTS. 
 
 the object they wish, individuals of this temperament are 
 dauntless and persevering to the last. In treating persons 
 of biliary temperament, suffering from nervous affections, 
 
 Fig. 4. Biliary Temperament. 
 
 and m whom the secretion of bile is somehow faulty, 
 we must not turn our attention exclusively to the con- 
 dition of the stomach and bowels, as the only cause of 
 such disorders. It is true that too much food, or food of an 
 indigestible nature, taken into the stomach may affect the 
 liver, derange its functions, and so vitiate its secretion, and 
 thus bring on a train of nervous symptoms. Still, such are 
 not the sole causes of deranged bile ; and as the morbid 
 effects cannot be relieved till we have ascertained and re- 
 moved the cause, we must endeavor to discover this by 
 inquiring most minutely into the history and all the circum- 
 stances of the case as already explained. 
 
NERVOUS DISORDER AND THE TEMPERAMENTS. 
 
 17 
 
 The various passions, whether of a depressing or exhilarat- 
 ing character, have great influence in inducing nervous dis- 
 order. Sudden emotions, too, have the same effect ; and 
 the more sudden and violent, the greater their pernicious 
 effects, not only upon the system at large, hut upon the ner- 
 vous portion in particular, — ranging from mere temporary 
 trepidation or excitement, to the most inveterate mania or 
 confirmed insanity. Thus jealous}^, abused confidence, fear, 
 sudden alarm, prolonged or continued apprehension, anxiety, 
 grief, joy, unexpected good fortune, and similar emotions, 
 exert, very frequently, a most dangerous influence. Such 
 effects will violent emotions of this kind produce upon the 
 nervous system, that the functions of different and distant 
 parts become not only sensibly, but deeply implicated. Thus 
 very strong impressions upon the mind with the concomitant 
 conflict in the nervous system have so acted, even upon 
 young persons, as to turn the hair gray in a single night ; 
 while in other cases the skin, instead of exuding the ordinary 
 perspiration, has sweated blood. These results sometimes 
 supervene so rapidly, and come on so suddenly, as to 
 wholly exempt them from any interference, and place 
 them beyond all possible attempts at prevention or ar- 
 rest. Iam frequently called upon -to prescribe for patients 
 of biliary temperament suffering severely from nervous dis- 
 order, which I have traced to deranged state of the stomach 
 and bowels ; and these conditions were clearly referable to 
 the abuse of purgative and mercurial medicines. Costive- 
 ness by no means invariably indicates the necessity of re- 
 course to opening or purgative medicines. Many persons 
 live almost entirely upon food, nearly the whole of which is 
 not only convertible, but actually converted into nutriment 
 and completely assimilated, thus leaving little, or rather no 
 residue, to pass off through the bowels. If, then, in such 
 
18 NERVOUS DISORDER AND THE TEMPERAMENTS. 
 
 circumstances, it should he deemed advisable to move the 
 bowels, the more rational plan would be to alter the nature 
 of the diet, and substitute more of a vegetable, while we 
 reduce in a corresponding degree the amount of the more 
 concentrated and nutritious food. Vegetables contain less 
 of the nutrient principles, and consequently leave a larger 
 amount of residue, upon the expulsion of which superfluous 
 material* the action of the bowels may be more naturally and 
 far more legitimately and advantageously employed, than in 
 responding to the irritating influence of drastic purgatives. 
 "It is in cases of this description,” says Cowle, in his excel- 
 lent work on the Physiology of Digestion, "that the physi- 
 cian is more frequently consulted, and that he has the best 
 opportunity of showing his discrimination and judgment. If 
 he and the patient are satisfied with simply procuring relief, 
 he has ready means at hand in any of the ordinary purgatives ; 
 but if a cure is their object, they must go back to the root 
 of the evil, and begin by restoring the digestive organs 
 to health.” Nervous disorder in biliary temperament is 
 clearly traceable to the secretion of bile being vitiated or 
 otherwise deranged. In laying down plans for locating such 
 affections, we must not only determine their nature, but 
 inquire into and ascertain the cause, and remove this if pos- 
 sible. If, for example, we should find, upon careful exam- 
 ination, irregularity in diet to be the fundamental cause of 
 the evil, which is frequently the case, we should most per- 
 emptorily interdict all those kinds of food which either expe- 
 rience or science has taught us tend to vitiate or derange 
 the secretion of bile ; such, for instance, as a too free use of 
 porter, sugar, cream, butter, rich, fatty meats, ardent spirits, 
 wine, etc. These, it is well known, and chemistry confirms 
 our experience, increase the quantity of bile to an amount 
 far beyond what is required for the purposes of healthy 
 
NERVOUS DISORDER AND THE TEMPERAMENTS. 
 
 19 
 
 digestion ; and, further, the most moderate experience 
 has repeatedly shown that the superfluity often lays the foun- 
 dation of some nervous disorder. 
 
 I have also had many opportunities of witnessing the ill 
 effects, on particular cases, of meat suppers taken late at 
 night. This proves very injurious to persons of biliary tem- 
 perament, by the formation of a large quantity of bile during 
 the night, the individual frequently sleeping in a close, con- 
 fined, ill-ventilated chamber, while at the same time respira- 
 tory and circulating processes are slow and inactive. The 
 quantity of oxygen necessary to enable the lungs to burn 
 off the carbon being withheld through impurity and a defi- 
 cient supply of air, as well as from other causes, the liver is 
 called upon to assist in secreting the superfluous carbon under 
 the form of bile. The person in consequence awakes stupid, 
 unrefreshed, and for the most part with a bad, oppressive 
 headache. Indeed, so liable are biliary persons suffering 
 from this form of nervous disorder to the consequences above 
 stated, that I have repeatedly seen a severe attack of head- 
 ache brought on by the patient retiring to repose in an ill- 
 ventilated apartment, after taking a full meal. As a means 
 of immediate relief under such circumstances, a saline purge 
 is one of the most effectual, as it will drain the liver of its 
 redundant bile, and thus afford instantaneous, but still only 
 temporary relief. Permanent benefit must be sought for in 
 avoiding the exciting cause, by the inhalation of pure, fresh 
 air, friction and cleanliness of the skin, and warm bathing, 
 which will facilitate the exit of carbon and other impurities 
 through the other channels, the lungs and skin. By such 
 means, and avoiding late suppers, the liver will be relieved 
 from the necessity of over-activity, and of forming a super- 
 fluous quantity of bile; and thus, the real cause of the dis- 
 order being removed, the morbid effects will naturally cease. 
 
 Another fertile source of nervous diseases in bilious tern- 
 
20 
 
 NERVOUS DISORDER AND THE TEMPERAMENTS. 
 
 peraments, which formerly came under my observation more 
 than at present, was the taking large quantities of Cod 
 Liver Oil . It is well, before we indiscriminately prescribe 
 fashionable remedies, to consider how they are likely to act. 
 The Laplander, dwelling in the arctic regions, where it is 
 intensely cold, and the atmosphere in an equal bulk contains 
 a large quantity of oxygen, lives principally upon carbona- 
 ceous substances, as train oil, blubber, and fat. But the 
 Indian, who lives in the torrid zone, where the atmosphere 
 is rarefied, and for equal bulk contains but little oxygen, 
 selects rice, vegetables, and other diet containing but little 
 carbon, and it is found that such are best suited to the cir- 
 cumstances under which he lives. For the same reason, 
 Cod Liver Oil administered in summer, when it is hot and 
 oppressive, more especially if given to a patient of a biliary 
 temperament, will seldom fail to aggravate the disease it was 
 given to cure. Nature evidently intended that the liver 
 should free the blood from those principles which form the 
 radical or constituents of the bile, and apply them, so elimi- 
 nated, to perfect or complete the function of digestion. But if 
 more bile is formed than is necessary to this end, the excess 
 acts as an irritant to the bowels, and occasions what is com- 
 monly called "bilious diarrhoea.” If, however, on the other 
 hand, the bile be scanty in quantity, as often occurs with' 
 persons who have resided long in tropical climates ; or suf- 
 fered frequently and severely from agues ; or who have 
 indulged to a pernicious extent in a too free use of alcoholic 
 liquors, in consequence of which the liver pours out fibrin, 
 which, acting as a ligature upon the portal vessels, impedes 
 the flow of bile, — the consequence is that the bowels become 
 constipated ; the stools clay-colored ; the powers of digestion 
 greatly weakened, and otherwise impaired, attended with 
 great loss of strength and flesh. The skin becomes rough, 
 hard, and dry ; the countenance assumes a sallow aspect, or 
 
NERVOUS DISORDER AND THE TEMPERAMENTS. 
 
 21 
 
 a general yellowness pervades the skin, and true or confirmed 
 jaundice is the result. This is not unfrequently attended 
 with the formation of gall-stones, which greatly aggravates 
 the evil, and leads to very unfortunate consequences, an 
 instance of which, of remarkable severity, lately fell under 
 
 Fig. 5. 
 
 my observation. In this case, upon dissection after death, 
 the gall-bladder felt like an uniformly hard, solid mass, giv- 
 ing the impression that its cavity was wholly occupied by a 
 single calculus. Upon opening it, however, the cavity was 
 found filled with a number of distinct small calculi, the sur- 
 faces so moulded and fitted to each other as to appear to the 
 touch a single solid mass. The appearance of the gall-blad- 
 der (in this case) laid open and the calculi exposed is well 
 shown in Figure 5. This patient used to suffer, at intervals, 
 the most excruciating pain ; especially during the passage of 
 gall-stones into the intestines, which occasionally took place, 
 and was usually attended with jaundice and other hepatic 
 disorders. 
 
 In such cases, strict attention to regimen and diet should 
 
22 
 
 NERVOUS DISORDER AND THE TEMPERAMENTS. 
 
 be enjoined ; the food should be light but nutritious ; the 
 patient should abstain from all rich and fat meats, pastry, 
 doughy puddings, and, as far as possible, from spirituous 
 and fermented liquors. By carefully observing and abiding 
 by these rules, a person may live for many years, though ho 
 may have but little liver remaining. But if persons afflicted 
 with serious disease of the liver will still persist in indulging 
 in the pleasures of the table, and will continue to violate 
 those rules laid down for their guidance, they will speedily 
 bring existence to an end, and perish in the extreme of ema- 
 ciation and misery. 
 
 A gentleman consulted me four years ago, suffering very 
 severely from an affection of the liver, and for which, for sev- 
 eral years, he had been taking almost every kind of medicine, 
 without much benefit. I had every reason to believe that the 
 patient would never perfectly regain his health ; yet I felt sure 
 that much relief might be derived from the proper use of warm 
 baths with dry cupping, and the external use of nitro-muriatic 
 acid ; frictions to excite the skin : light, nutritious, unirritat- 
 ing diet ; the occasional use of a pill composed of aloes and 
 rhubarb ; horse exercise ; and a residence in a dry pure air, 
 — were the means which seemed best suited to prolong life. 
 Ho pursued the proposed plan for about five months ; and in 
 a note which I received from him, in the interval, he states : 
 ” The action of my bowels is now regular and nearly natural, 
 and I very rarely experience the sickness after food ; I gain 
 strength every day, and I can sleep the whole night without 
 being troubled with either sickness or nausea ; I am gaining 
 flesh ; can walk a long distance without feeling fatigued, and 
 I am not without hopes that I shall soon be quite well, and 
 able to resume practice.” This gentleman continued still to 
 improve ; but a few months after this period, being attorney 
 and counsel for several railway companies, he dined at sev- 
 eral public dinners, and, indulging rather freely in the pleas- 
 
NERVOUS DISORDER AND THE TEMPERAMENTS. 
 
 23 
 
 ures of the table, drank too liberally of wine and spirits, and 
 died, after a six weeks’ severe illness, greatly emaciated. 
 Upon the post-mortem examination, the liver was found 
 much atrophied, and indeed very little was left. Although 
 I felt satisfied that this patient would never have reached a 
 mature old age, yet I am convinced he might have lived 
 for many years, had he but conformed to the dictates of 
 common-sense, and abided by the rules laid down for his 
 guidance. 
 
 I have at this moment a patient under my care, suffering 
 severely from nervousness, lowness of spirits, and great de- 
 spondency, which the yellow tinge of the conjunctiva, the 
 harsh, hard, dry sfate of the skin, the feeling of uneasiness 
 after food, frequently attended with vomiting, and the clay- 
 colored stools, enable me at once to refer to congestion of 
 the liver as the cause. This gentleman had been under the 
 care of his medical adviser for a considerable time, and had 
 consulted some of the most eminent men in the profession, 
 who all prescribed a variety of means ; yet, strange as it may 
 seem, notwithstanding the dry, hard, harsh, and inactive 
 state of the skin, the use of the warm bath — so powerful a 
 means of promoting the action of this organ — had never 
 been even once suggested to him. lie has resorted now to 
 the warm bath, and his health is steadily progressing ; and I 
 feel satisfied that to its use, and dry cupping, we are chiefly 
 indebted for the improvement in the health of this patient, 
 which has recently taken place, and I have reason to believe 
 that he will perfectly recover. 
 
CHAPTER III. 
 
 A CHIEF CAUSE OF NERVOUS DERANGEMENT. 
 
 In another now well-known work of the writer, he has 
 gone at length into the subject of the abuse of the repro- 
 ductive organs. I allude to the work entitled " Science of 
 Life.” Therefore there is no necessity for more than a sin- 
 gle chapter of a general character in the present Volume on 
 this subject. But in a work on Nervous Affections and Mal- 
 adies, ifc was impossible to avoid allusion to this subject, 
 because of the mysterious psychological influence of the 
 organs in question on the health, and especially on the ner- 
 vous system, and through that on the mind. There is a close 
 connection between genital psychology and physiology and 
 pathology. Speaking of self-abuse and involuntary losses 
 of vitality through the reproductive organs, the " London 
 Lancet ” said many years ago : "It is a subject not less in- 
 teresting to the moralist than to the medical practitioner ; 
 and it really is surprising to see that nothing worthy of 
 notice- is to be found on a matter so important in the vari- 
 ous writings of standard authors.” This was written in 1841, 
 several years before the appearance of the great work of 31. 
 Lallemand, entitled " Des Pertes Seminalcs Involontaires.’ ” 
 "This circumstance,” continues the "Lancet,” "appears re- 
 markable and unaccountable, when experience convinces us 
 that sexual weaknesses and imperfections, either hereditary 
 
 [24] 
 
A CHIEF CAUSE OF NERVOUS DERANGEMENT. 
 
 25 
 
 or acquired, constitute the great majority, perhaps nine 
 tenths , of the causes of nervousness , mental imbecility, and 
 derangement . How, then, are we to account for a fact like 
 this — a fact of such frequent occurrence, and so highly 
 philosophic and instructive as it undoubtedly is — having 
 obtained so little attention? Can a general feeling of ill- 
 exercised tenderness towards the depraved habits of most of 
 the pitiable sufferers have operated in preventing the matter 
 from having been duly investigated, and candidly avowed and 
 discussed, or has it resulted from ignorance? The former 
 we are disposed to think can scarcely have been the case ; for 
 with the medical practitioner, less frequently, perhaps, than 
 with any other professionalist, from the confidence so read- 
 ily reposed in his calling, does delicacy or prudery supersede 
 utility.” Thus far the "London Lancet.” Everybody of any 
 experience in the world knows that there is extant much 
 unwholesome morality ; there is much substitution of words 
 for things ; much false delicacy which is miscalled virtue ; 
 much traffic in 
 
 “ The false commerce of truth unfelt 
 
 much conventional lying ; much conventional dissimulation. 
 For want of the reverse of all this, many fine minds are 
 overthrown. 
 
 There is nothing which is, which has actuality of existence, 
 that should not be fathomed, and whose rocks and quick- 
 sands should not be placed, as in an unfolded map, conspicu- 
 ously in sight. Upon subjects on which neither Religion nor 
 Science disdains to treat, correct information should be dif- 
 fused. It lies within the scope of our will to shun many of 
 the first approaches of insanity ; nay, even although the 
 first steps into error are those which are most easily retraced, 
 to extricate others and ourselves from its labyrinths when 
 deeply involved in them. Into these labyrinths we are usu- 
 
26 
 
 A CHIEF CAUSE OF NERVOUS DERANGEMENT. 
 
 ally misled by some of those passions and temptations which, 
 not peculiar to a few, are common to our whole species. 
 We cannot know too much; and minds may be capable and 
 yet unenlightened, hearts human and yet unawakened. The 
 subject of which we are speaking is one on which even 
 sane minds are apt to entertain many misconceptions. There 
 are psychological mysteries which it lies within the power 
 of pathology to elucidate, and which would without its aid 
 remain obscure. There have frequently been witnessed 
 deviations from the perfectly correct in conduct and amiable 
 in manners ; exhibitions of petulance of temper and tres- 
 passes against the minor moralities ; to account for which, 
 upon & post-mortem examination, there have been discovered 
 traces of painful and perhaps previously unsuspected organic 
 disease. 
 
 Among our currently nomenclatured diseases are some 
 which peculiarly tend to generate gloom, and even, in severe 
 or long protracted cases, to incite to suicide. There are 
 forms of gastric, hepatic, and cerebral diseases, which display 
 these or like tendencies. Sometimes it is rather ill-temper 
 that is induced, as by attacks of the gout. Anxiety of ex- 
 pression in the countenance is a symptom of enteritis, which, 
 although having a physical origin, has not a physical only, 
 but implicates the condition of the mind. The mind in each 
 of the varied forms of febrile excitement takes the peculiar 
 course of wandering, and surrounds itself with those peculiar 
 groups of hallucinations, which characterize the existing state 
 of the brain and sensory system. At the same time it may 
 be observed, that the mind of the patient individually deter- 
 mines the mode in which various morbid states of the brain 
 are manifested ; and will be found in a greater or less degree, 
 unless when torpor and incapacity are superinduced, to vin- 
 dicate its own idiosyncrasy. While under excitement it fre- 
 quently throws off such gigantic shadows of portions of its 
 
I 
 
 A CHIEF CAUSE OF NERVOUS DERANGEMENT. 27 
 
 being, as the microscope brings into view of the minuter tex- 
 tures of natural objects. We obtain glimpses of the very 
 infusoria , so to speak, which are engendered in the reason 
 and imagination of the patient. There are, on the other 
 hand, diseases, and these of a fatal character, which, during 
 the most part of their course, do not disturb the temper or 
 trouble the mind. Consumption, not always, indeed, but 
 frequently and commonly, deals in these respects very gently 
 with her victims . Investing them as with the hues of per- 
 petual youth, she leads them to the altar crowned with gar- 
 lands. Not till their near approach to the sacrificial flame 
 does the bright eye lose its lustre, the hectic flush give place 
 to paleness, — do the hues fade, the garlands wither. They 
 gradually, though still and evermore attended by Hope, be- 
 come less and less tenacious of existence ; they are gently 
 weaned from the things of time and sense, and from the 
 love of life ; their hopes in life are displaced by hopes of the 
 life beyond this life. We regard their fate almost with 
 envy. 
 
 After bereaved relatives have passed through the first bit- 
 terness of sorrow for their loss, their reminiscences of those 
 near and dear to them, who have died of this disease, become 
 almost pleasurable. 
 
 The patience of sufferers under a long-sustained mortal 
 affliction, is naturally regarded in the most amiable light. 
 But we must not forget, as psychologists, that, in com- 
 parison with many of the ills which flesh is heir to, this 
 complaint occasions less of bodily suffering, and less severely 
 tests the powers of endurance. We should remember this, 
 not that we may cast a shadow of disparagement upon the 
 characters of those who, having had something-; — probably 
 much — to endure, have endured it patiently, and left behind 
 them a pleasing image of tranquil resignation to the will of 
 heaven in the memories of survivors ; but that we may be 
 
28 
 
 A CHIEF CAUSE OF NERVOUS DERANGEMENT, 
 
 just to such as, having had more to suffer, have naturally, 
 and almost inevitably, displayed more of irritability and im- 
 patience. 
 
 Y* r e have noticed how bowel disease induces cerebral dis- 
 turbance ; how, through the medium of physical organ- 
 ization, the mind is made a party in the struggle. TTe 
 thus see clearly instanced the influence of the body on the 
 mind. The intense agony attendant upon the passage of 
 the gall-stones, or upon a paroxysm of tic-doloreux, are too 
 great to be borne by any human being with tranquillity. Wq 
 remember having heard some severe and unkind comments 
 passed upon a clergyman who could not refrain from mani- 
 festations of impatience under extreme suffering from the 
 former mentioned cause. It was inferred that ho came short 
 of his duty as a Christian minister in not setting his flock a 
 better example. There is no degree of strength of mind which 
 disease and pain may not master. The influence of the mind 
 on the body is manifold. There are the various passions which 
 inspire, exalt, and debase humanity. There are painful or 
 agreeable surrounding circumstances. These take each its 
 part in influencing health ; these constitute some of the links 
 which unite physiology and pathology with psychology. 
 There is also to be considered the influence of one mind 
 upon another, which is great ; likewise its power, as exer- 
 cised within or upon itself, as well as upon the body. There 
 is what is of a loftier order than intellectual, — there is moral 
 po wer ; there is strength of will, of an inferior order to both, 
 but capable of greater ostensible achievements than either. 
 There are none who have not observed the effect of hope as 
 a cordial, of fear as a depressant, upon invalids. Health 
 and longevity depend much upon circumstances, much upon 
 the due management of the mind. A man who upon a sick 
 bed is disturbed by the reflection that he has not succeeded 
 in making a clue provision for his family, may be inclined to 
 
A CHIEF CAUSE OF NERVOUS DERANGEMENT. 
 
 29 
 
 give himself up to despair, and actually suffer himself to die ; 
 or his want of resignation to his fate, his cherished designs 
 for the future, his sanguine determinations to carry out his 
 views upon his recovery, may conduce to his convalescence. 
 The subject is one not only of great, but of universal interest. 
 To pursue it further would be to expatiate over too wide a field. 
 It has been shown how close an affinity subsists between cer- 
 tain physical and psychological phenomena ; and while it has 
 to be conceded that there are diseases which act but slightly 
 and inappreciably as disturbing forces upon the mind,’ it will 
 be perceived that this concession can least of all be held to 
 apply to organic disease or functional disorder of the gen- 
 erative system ; not genital disease indeed, only, but the 
 ordinarily fulfilled functions of the reproductive organs while 
 in their normal state, much influencing the mind, and pro- 
 ducing, as the status of puberty becomes established, abso- 
 lute and* plainly perceptible changes in its character. The 
 same truths admit of being expressed in the blunt language 
 of science, which have given vitality to the poetry of every 
 language. Science, Philosophy, and Song concur in telling 
 the same tale, only that what the latter generalizes, science 
 expounds and specifies : they speak of the Master-Passion, 
 and hymn its eulogy or lament its pangs of discomfiture ; 
 science, of its more gross and corporal elements. 
 
 “Love lives ; Thought dies not; the heart’s music still 
 Prolongs its cadences from age to age ; 
 
 Perpetuates its melodies, which thrill 
 Through each voluptuous leaf of Nature’s page.” 
 
 Man perishes ; but the passions common to human nature 
 will endure as long as the world exists ; hence the interest in 
 them never ceases, never becomes obsolete ; hence our sym- 
 pathy with the joys and sorrows of the long since dead, as if 
 they were yet among the living. The passions, and among 
 these the master-passion especially, supply us with countless 
 examples of the agency of the body on the mind, of the 
 
30 
 
 A CHIEF CAUSE OF NERVOUS DERANGEMENT. 
 
 mind on the body, — of the reagency of each on the other. 
 With the advance of life their development becomes more 
 complete, their tendency and objects more clearly under- 
 stood. As in the female sex the frame becomes more wom- 
 anly, and a thousand new graces come into view ; so the mind 
 itself, in becoming more mature, becomes more feminine. In 
 both sexes, the distinctions of sex become more marked and 
 definite ; in the male sex, not the aspect and voice only, but 
 the mind undergoes a change. Those changes in persons of 
 both sexes which are of a psychological character are matters 
 of as plain recognition as those which are physical ; and so 
 also are any pauses in the march of nature towards perfec- 
 tion of frame and maturity of mind, which disease or other 
 obstacles to its progress occasion ; and, as we may add also, 
 any forced or unnatural acceleration of its pace. The 
 acclivhy from childhood to adolescence may be ascended too 
 rapidly; the ascent itself is not without its perils and diffi- 
 culties ; it extends indeed over one of the most dangerous 
 tracts of country which we have to pass in our journey 
 through life. Upon our safe conduct through it, the health 
 of body and vigor of mind of all after life greatly depend. 
 Through educational neglect, there may be hardy but wild 
 and worthless plants ; and a hot-house cultivation may pro- 
 duce such as are only calculated for useless and idle show. 
 There may be, in fact, an extreme cultivation of the mind, 
 which shall tend eventually to incapacitate rather than to 
 strengthen it ; causing it to lose in sensitiveness, more than 
 it gains in power ; prematurely exhausting those energies 
 which are requisite to wage the battle of life successfully. 
 During a requisite course of study, habits of abstraction of 
 mind may be formed, which renders persons as members of 
 society useless, because isolated and unsocial ; and which, 
 removing them from the ordinary temptations ot man’s 
 worldly condition, leave them but a more certain and easy 
 temptation from within. 
 
CHAPTER IV. 
 
 PATIENTS WITH A NERVOUS TEMPERAMENT. 
 
 The nervous temperament, as previously stated, is to be 
 distinguished by a quick, active brain ; and the nervous sys- 
 tem takes the lead over all the others. The eyes are large, 
 and generally piercing ; the features prominent and usually 
 sharp; the forehead clear; the hair black, but silky, not 
 crisp, as in the biliary temperament. The muscles, though 
 small, are still round and well marked ; the motions quick 
 and active, and the step firm ; the features generally expres- 
 sive of anxiety. Such persons are for the most part intelli- 
 gent, and alive to every kind of nervous impression ; being 
 easily excited and as readily depressed. The disposition as 
 well as the mind is frequently modified by associations; but 
 a sedentary and indolent life never fails to create morbid im- 
 pressions ; the persons themselves being best suited for occupa-’ 
 tions requiring activity and quickness. We very seldom, how- 
 ever, meet with the nervous temperament, or, indeed, any 
 of the others, perfectly pure and unmixed ; but they run 
 into, and are blended with, each other. Thus, we have the 
 bilio-nervous, the nervo-lymphatic, the nervo-sanguineous 
 temperaments. It requires some discrimination, and consid- 
 erable practice and experience, to thoroughly comprehend 
 the various temperaments, and modifications they are con- 
 stantly presenting in practice to our observation. The indi- 
 
 [ 31 ] 
 
32 
 
 PATIENTS WITH A NERVOUS TEMPERAMENT. 
 
 viduals themselves often seem complete enigmas. Thus, 
 some that are intelligent and courageous, will often faint 
 even at the sight of a drop of blood. I am acquainted with 
 a gentleman of highly nervous temperament, who is timid 
 and fearful on trivial occasions ; yet when suddenly placed 
 in real danger, has been known to be bold, decisive, and self- 
 possessed. But all attempts at describing the various phases 
 and shades assumed by this temperament must fail and prove 
 abortive. I have seen some hundred cases of the nervous 
 temperament, but have never yet met two precisely alike in 
 all respects. Climate, associations, hereditary tendencies, 
 and other innumerable circumstances, as grief, disappoint- 
 ment, etc., so far change, alter, and otherwise modify this 
 class of persons, as to render them one and all dissimilar, 
 — the same causes not being applied or not operating in all. 
 What I wish more particularly to insist on is, that when 
 the nervous temperament is present and in activity, or when 
 it is intermixed with others, it is of the greatest possible im- 
 portance that it be attentively and thoroughly studied ; for 
 no treatment of disease can be permanently successful if 
 these conditions be not taken into account. Redness, swell- 
 ing, heat, pain, and throbbing, are laid down, in the syste- 
 matic works upon medicine and surgery, as the characteristic 
 or distinctive signs of inflammation ; and in other tempera- 
 ments such signs may be relied on with safety ; but I would 
 recommend practitioners, not much accustomed to the man- 
 agement of nervous cases, that patients of this temperament 
 simulate not only inflammation, but also many of the incu- 
 rable diseases in which inflammation frequently terminates. 
 I am satisfied, after having strictly watched and carefully 
 attended to a large number of cases of purely nervous disor- 
 der, that all the phenomena indicative of acute inflammatory 
 action may be present, and yet no inflammation whatever 
 exist. 
 
PATIENTS WITH A NERVOUS TEMPERAMENT. 
 
 33 
 
 I shall briefly notice the following interesting and instruc- 
 tive case, which will, perhaps, more clearly illustrate what 
 I wish to inculcate. I was called, about three years ago, to 
 visit a young lady of highly nervous temperament. She 
 was an only child, and had been brought up in all the luxury 
 and delicacy that affluence could procure. She suddenly com- 
 plained of very severe pain in the knee, attended with all the 
 symptoms of inflammation in the joint. The pain was so in- 
 tense, that it was not without difficulty she could be prevailed 
 upon to allow even a superficial examination. The pain was 
 very speedily followed by swelling, heat, throbbing, and all 
 the usual symptoms of inflammation. The medical gentleman 
 who previously attended the case had applied leeches in 
 abundance, had tried cold and astringent lotions, purgatives, 
 and such other remedies, and had persevered most steadily 
 in the antiphlogistic plan of treatment for a considerable 
 time, — still the pain was in no way relieved, or even abated in 
 the slightest degree. The obstinacy and the general appear- 
 ance of the joint led to the belief that the young lady was 
 threatened with white swelling, and it was under these cir- 
 cumstances that I was called upon to visit the case. 
 
 When I first saw the patient, I was assured that the same 
 state of things as I then witnessed had existed without amelio- 
 ration, or, indeed, the slightest change, for a period of nearly 
 three months ; and this, too, notwithstanding the most ap- 
 proved means of subduing inflammation had been adopted, 
 and most strictly persevered in, ever since she had been first 
 taken ill. I had before seen several cases of a similar de- 
 scription. Therefore, after a minute and careful examination 
 of the joint, I expressed my doubts of the existence of any 
 real or true inflammation. Upon this I was the more de- 
 cided, because I had in the course of my inquiries ascertained 
 that the symptoms had neither increased nor decreased, but 
 hacj continued steady and stationary ; in fact, precisely as at 
 
34 
 
 PATIENTS WITH A NERVOUS TEMPERAMENT. 
 
 the very first day. Now, it is in accordance with my expe- 
 rience, that real inflammation, more especially when acute, 
 if not subdued, must certainly proceed to abscess or ulcera- 
 tion, or symptoms indicating the destruction of the joint 
 cither supervene or threaten before the lapse of so long a 
 period. These considerations, with the admitted irregularity 
 in the periodical health, the high degree of nervous excite- 
 ment, the acute sensibility, greatly increased by a luxuriant 
 and indolent mode of living, — induced me firmly to an- 
 nounce it as my opinion that the patient was suffering from a 
 purely nervous affection of the joint, and clearly and decidedly 
 the result of morbid irritability. 
 
 In accordance with these views, I recommended that the 
 limb, which had been hitherto confined in one position, 
 should be greatly exercised ; that the patient should remove 
 from the heated apartment to which she had been so closely 
 and strictly confined, and take carriage exercise in the open 
 air. It was at the same time strongly advised that external 
 applications to the limb should be discontinued ; for it was 
 very evident that the only effects of the lotions were to 
 attract her attention to the state of the limb, and create great 
 anxiety and alarm from the apprehension of being obliged to 
 suffer the loss of the leg ; for she had unfortunately been 
 told that the disease might end in white swelling. With the 
 view of restoring the periodical action of the uterus, which 
 had been for some time suppressed, the bowels were kept 
 regular, and the patient was directed to use warm, salt water 
 baths frequently ; and to give energy and tone to the general 
 system, which had been enfeebled, she was directed to take 
 the Tinct. Ferri , Acet. FEther , in regular doses three or four 
 times a day. It was indeed extremely gratifying to witness 
 the great improvement in her health, even in the course of 
 a few weeks, after the alteration in the treatment had been 
 adopted. Pure air, regular exercise, with plain, simple, but 
 
PATIENTS WITH A NERVOUS TEMPERAMENT. 
 
 35 
 
 nutritious diet, and the mind being set at ease, I am satis- 
 fied had much to do in effecting the cure which speedily fol- 
 lowed the adoption of the plan above stated. Although an 
 advocate for great simplicity of means in such cases, I am 
 far from wishing it to be understood that the treatment of 
 them is always as simple or equally successful. We have 
 often to contend with prejudice, — patients and their friends 
 having been, in most instances in which the case has been 
 prolonged, informed that there is danger of the disease turn- 
 ing to white swelling, and that exercise, or indeed motion 
 of any kind, is prejudicial and attended with the greatest 
 danger. Thus, under the influence of first impressions, they 
 rebel against any advice to the contrary, and persist in con- 
 fining the patient either to the bed or to the couch ; and this, 
 too, not unfrequently in a hot and ill-ventilated apartment. 
 
 These nervous affections of the joint are not always to be 
 easily distinguished from organic diseases of the same struc- 
 tures ; for it is not unusual to find that the natural appear- 
 ance of the joint has been completely altered by the effects 
 of repeated leeching, blistering, cupping, issues, setons, 
 etc., so that it is often extremely difficult to decide whether 
 the appearances be really in consequence of the remedies or 
 of the disease. The practitioner, therefore, who has not 
 paid special attention to these diseases, should be very care- 
 ful before deciding positively upon the nature of such affec- 
 tions, but more especially if the patient be a lady of the 
 nervous or bilio-nervous temperament. It is not long since 
 a very eminent surgeon at one of our great hospitals ampu- 
 tated above the knee, under the notion of the existence of 
 white swelling of the joint. But, to his great surprise, upon 
 dissection after the operation, the joint was found in a per- 
 fectly sound and healthy state, and it turned out that the 
 disorder was purely nervous and nothing more. 
 
 To fortify myself by eminent authority, I quote Sir Benja- 
 
36 
 
 PATIENTS WITH A NERVOUS TEMPERAMENT. 
 
 min Brodie, who says, " Among the local hysterical affections, 
 one of the most frequent is acute pain in the knee-joint. 
 Indeed, the affection is marked by almost every sign of 
 structural disease, save that it is more diffused. Yet this 
 is true neuralgia.” And Sir Benjamin concludes his sentence 
 thus : " I do not hesitate to declare that amonsf the hurher 
 classes of society, at least four fifths of the female patients 
 who are commonly supposed to labor under diseases of the 
 joints, labor under hysteria and nothing else.” 
 
 These nervous affections are not confined solely to the 
 joints, for I am often called upon to prescribe for similar 
 affections of the breast. Patients of this kind invariably 
 apprehend and suspect the beginning of cancer. The dis- 
 crimination of such cases is frequently a matter of considera- 
 ble difficulty. And, indeed, there are many instances of 
 breasts having been removed under the belief of the presence 
 of cancer, when really no such disease existed. While this 
 sheet is passing through the press, I have been called upon 
 to prescribe for a hard and painful tumor in the left breast, 
 which, upon examination, presented many of the symptoms 
 of cancer. This person was of a highly nervous tempera- 
 ment, and, on her first visit, gave me the impression that 
 she was under the influence of wine ; but, upon more strict 
 inquiry, I found it was laudanum, to the habitual use of 
 which she had been addicted. I declined giving an opinion, 
 when I was informed that the amputation of the breast had 
 been already resolved upon ; and that she had called for my 
 advice before submitting to the operation. I advised her to 
 go into the country, and try the effects of a pure, wholesome 
 atmosphere, for a fortnight at least; to leave off the use of 
 opium ; to take warm, sea-water baths ; to use the plainest 
 and simplest, but still mild and nutritious diet ; to live prin- 
 cipally upon milk, and thus remove any cause of constitu- 
 tional irritability. During the first ten days her sufferings 
 
PATIENTS WITH A NERVOUS TEMPERAMENT. 
 
 37 
 
 were most intense, in consequence of being debarred her 
 habitual doses of opium. Her firmness and strength of mind 
 were put to the severest proof in altogether renouncing the 
 narcotic ; and, as she informed me, it was only the hope of 
 beinof able to save her breast, that could have induced her to 
 forego its use. Upon her return to Boston, after somewhat 
 more than three weeks’ sojourn in the country, the irritation 
 was greatly reduced by change of air, bathing, and mild diet ; 
 and now a thorough examination could be endured without 
 apprehension, and was therefore readily submitted to. It at 
 once became evident that the tumor was the result of irrita- 
 tion, in an extremely sensitive and excitable system; and 
 that the care-worn, anxious, peculiar expression of counte- 
 nance, which we observe so constantly in true cancer, was, in 
 this instance, entirely occasioned by mental anxiety, greatly 
 increased and aggravated by the opium she was taking. She 
 was advised to continue the plan of living which had proved 
 so beneficial, and she faithfully promised me that she would 
 not again have recourse to opium, and I have every reason 
 to believe that she will perfectly recover. I cannot too 
 strongly denounce the immoderate use of opium in these 
 cases. If ever used at all, it should be given with the great- 
 est caution and circumspection to persons of nervous tem- 
 perament, and still more if the patient be young. Opium 
 renders the nervous system highly susceptible, and alive to 
 all sorts of nervous impressions. 
 
 Nervous affections of the spine are still more common than 
 those of the breast, and they are but too often treated as 
 really organic diseases. It is by no means uncommon to meet 
 with such instances ; they are constantly presenting them- 
 selves in practice. I have seen many who have been con- 
 fined to the couch for months, or stretched for a like period 
 upon the inclined plane. Had the cause of the disorder been 
 traced out and removed, instead of attending to and treating 
 
38 
 
 PATIENTS "WITH A NERYONS TEMPERAMENT. 
 
 effects, much present suffering and subsequent misery might 
 have been avoided. The history of the following case may 
 perhaps prove not uninteresting : A young lady, of highly 
 nervous temperament, was subjected to the inconvenience of 
 confinement upon the inclined plane, for nearly nine months. 
 This severity of discipline had its origin in the notion that 
 this unfortunate patient was laboring under severe disease of 
 the spine, and which, it was imagined, was the primary cause 
 of the disordered state of her health, which had been declin- 
 ing for some years. Her symptoms were watchfulness and 
 wakefulness, so that there was a total inability to sleep more 
 than about four or five hours during the night, all the rest of 
 which she remained awake. In consequence, her health had 
 become delicate, which was referred to disease of the spine 
 as the cause, as she complained of a good deal of pain in the 
 back. A careful inquiry into her history satisfied me that 
 the wakefulness was hereditary. From childhood she had 
 not slept as much as other persons. For years previous to 
 her birth her father had forced himself to very great mental 
 application. Being the architect of his own fortune, he had 
 not for a length of time allowed to himself more time for 
 repose than was imperatively required by exhausted nature. 
 Had, then, the history of this case been carefully investigated 
 at the commencement, I think very different results would 
 have been arrived at, and it would not have been thought 
 necessary to confine her to the inclined plane. The above 
 cases are cited to show how the cause of disease may be 
 overlooked by eminent physicians, and to show that the 
 study of the temperaments, a more strict inquiry into the 
 nature of nervous affections, and a more rigid investigation 
 into the causes of disease, would tend much to relieve many 
 of those distressing cases of nervous disorder which so con- 
 stantly come under the care of the physician. 
 
CHAPTER V. 
 
 CONVIVIAL HABITS AS A CAUSE OF NERVOUSNESS. 
 
 Op course the prompt and effective remedies for nervous- 
 ness, which the writer has ready at hand, are frequently 
 demanded to quell the nervousness of persons suffering 
 from convivial habits and good cheer, and occasional or 
 habitual abuse of wines and alcoholic drinks. The depression 
 of the nervous system, induced by such indulgence, is some- 
 times called alcoholism or alcoholic melancholy. There is in 
 every class of society a number of persons who, although they 
 do not become intoxicated, suffer from chronic alcoholism, 
 from drinking more spirits, wine, or ale than agrees with their 
 health. Most of these persons lead a useful and active life, and 
 apply for medical advice, being quite unaware of the cause 
 of their illness. The habit of indulging freely in wine at 
 frequent dinner parties, of drinking wine, ale, or whiskey at 
 times, of taking occasionally a glass of wine between meals, 
 or of sipping every evening two or three glasses of ale, or 
 punch, or whiskey and water, is quite sufficient to bring on 
 an attack of alcoholism. Drinking is not usually in these 
 cases an indomitable habit, and accordingly the patient will 
 gladly give it up, if he feels certain that by so doing his 
 health will be improved. Sleep disturbed by dreams, some- 
 times sleeplessness, diminution of the appetite and evacua- 
 tions, vomiting of mucus in the morning, trembling of the 
 
 [ 39 ] 
 
40 CONVIVIAL HABITS AS A CAUSE OF NERVEOUSNESS. 
 
 hands and arms more marked in the mornings, etc., are con- 
 sequences of these convivial habits. The chief symptoms of 
 chronic alcoholism are trembling of the feet and hands ; in- 
 creasing weakness ; the sleep is much disturbed by fright- 
 ful dreams, or it cannot be obtained either on account of 
 neuralgic pains in the limbs, or extreme restlessness. In the 
 more advanced stages of the disease, the night not unfre- 
 quently becomes a period of horrible suffering. The patient 
 in vain seeks to place his limbs in a position which would 
 afford relief to the uneasy sensations or burning pains which 
 affect them ; and if sleep or drowsiness steals upon him, 
 it is presently driven away by convulsive startings. The 
 neuralgic pains which at first haunt solely the night, begin 
 to affect the patient, and increase upon him by day. Vertigo 
 often happens, and at times the vision is clouded. Halluci- 
 nations are of common occurrence. They mostly affect the 
 organs of sight and hearing. For instance, one of my patients, 
 when walking in the street, had seen ropes dangling about 
 his head ; to another, objects appeared as if they were double ; 
 some occasionally perceived insects creeping about, — the 
 various visions often disappearing as soon as the attention 
 was directed to them. 
 
 These factitious perceptions of the sight appear sometimes 
 so real that the individual moves aside to avoid an imaginary 
 object standing in his way. A hackman I was treating for 
 chronic alcoholism told me he frequently pulled up his horse 
 suddenly, or drove to one side of the street, lest he should 
 run over some obstacle he distinctly saw in front of his horse, 
 and which he afterwards found not to exist in reality. In 
 most cases the patient is occasionally, or perhaps constantly, 
 troubled with shadows or black mist, or flying specks, 
 passing rapidly before his eyes, and causing a dimness of 
 sight, especially when he is looking attentively at something ; 
 in the act of reading, for example, the book is suddenly 
 
CONVIVIAL HABITS AND NERVOUSNESS. 
 
 41 
 
 darkened, and a state of almost complete blindness ensues, 
 lasting a few minutes. During the long and sleepless nights, 
 aberrations of the sight frequently happen. The wife of a 
 patient I was treating for chronic alcoholism, told me her 
 husband often fancied, whilst lying awake, that he saw rats 
 and cats, and various other descriptions of animals, on the 
 bedclothes ; he used to doze at intervals, and in the morning 
 could not remember anything of the nightly visions. The 
 aberrations of the sense of hearing are not so frequent, but 
 I have met with patients who occasionally heard voices 
 addressing them when nobody was present. " Doctor, I will 
 give you a wrinkle ,” said a friend to us, not long ago, as we 
 were gossiping concerning wine ; and an attendant was di- 
 rected to descend into the cellar, and bring from a particular 
 bin a bottle of champagne. It may be as well, perhaps, to 
 remark, lest the uninitiated should stumble over the term, 
 that a wrinkle , in the refined slang of the day, signifies a 
 little bit of practical wisdom. The phrase is highly meta- 
 phorical. Worldly wisdom increases with years ; so also do 
 the furrows w hich indent the forehead. Therefore an increase 
 of wrinkles in the forehead may be regarded as an index of 
 increasing wisdom, and a wrinkle may stand well enough for 
 an item of practical wisdom. This by the way. The cham- 
 pagne was in due time placed upon the table, and the spark- 
 ling fluid had a most agreeable taste and refreshing effect, 
 for the evening was hot and stifling. " Well, how do you 
 like the wine ? ” inquired our friend. " A pleasant drink for 
 a scorching day,” we replied. "Read that,” he said, putting 
 into our hands the cork which had just been extracted from 
 the bottle, and pointing to the inner extremity, — that which 
 had been next the wdne. There we saw and read, not a 
 little to our astonishment, the formidable word mort (French 
 death ) printed in clear, bold letters. "That,” said our 
 friend, " is a trade-mark ; and when you see it affixed to the 
 
42 
 
 CONVIVIAL HABITS AND NERVOUSNESS. 
 
 cork of a champagne bottle, you may rest assured that no 
 grapes ever contributed towards the formation of the wine.” 
 
 This was the wrinkle; but the singularity of the trade- 
 mark awoke other thoughts than those immediately connected 
 with the utility of knowing it. Should there have been a 
 full stop after the different letters, — each having a specific 
 signification, the formation of the word being merely acci- 
 dental ? Or was the trade-mark such as we read it — Mort 
 ( Death ) ; and if so, was it a piece of satire of the wine mer- 
 chant on the wine? Truly, a reversed cork so stamped and 
 placed upon the plates of the guests at a feast might well 
 serve the purpose of the mummy introduced at the old 
 Egyptian banquets ; or might convey as homely but as forci- 
 ble a lesson as that taught in Holbein’s drawing of the toper 
 in the Dance of Death, in which death is represented as 
 officiously pouring the inebriating drink into the mouth of 
 one of the carousers. Or may we regard this trade-mark 
 as a foreshadowing of that time when alcohol will no longer 
 be known as aqua vitce , but aqua mortis. And, indeed, as 
 we become more and more familiar with the remote effects 
 of alcohol upon the system, in whatever form the potent 
 spirit be consumed, we cannot resist the conclusion that, as 
 too commonly used, it would be more correctly termed 
 water of death, than aqua vitce, or water of life. 
 
 The writer can quiet the nerves shattered by vinous and 
 alcoholic excess, and drive from his pillow the ugly visions 
 which disturb the sleep of the victim of alcoholism. But 
 total abstinence, as it is called-, is better even than his 
 remedies. 
 
CHAPTER VI. 
 
 ANXIETY OF MIND. 
 
 Anxiety ! Is there a human breast in which this awful word 
 fails to produce an echo ? — from the youth, who fears to be 
 superseded in the affections of the object of his love ; from the 
 parent, who watches with alarm the flush in the cheek of his 
 child, lest its vividness indicate latent consumption, — to the 
 old man worn down with years and sorrow, who tries to esti- 
 mate the commercial convulsions that threaten to swallow up 
 the hard earnings of a long life of privation, and reduce him 
 to beggary. To specify the objects of this corroding care 
 would be to enumerate all the classes of society. The man 
 of poetical imagination might give a series of individual pic- 
 tures whose vividness would excite universal despair, like 
 the single captive of Sterne ; he might so harrow up the feel- 
 ings of the reader by the representation of social misery indi- 
 vidualized, that the whole world should seem a charnel-house 
 ,of wretchedness, unworthy of the benevolence of the great 
 Being who called it into existence. It is hard to believe it 
 in times of despondency and alarm ; but the man who stands 
 aloof from the turmoil of the world, and occupies the higher 
 station of independence, knows that all things work together 
 for good ; that God does not leave to a future state the expia- 
 tion of many of our errors and sins, but that even in this 
 world they work their own punishment. If we suffer for the 
 
 [ 43 ] 
 
44 
 
 ANXIETY OF MIND. 
 
 faults and crimes of others when acquitted by our own con- 
 science, we must endeavor to consider the misfortunes 
 inflicted on us as a part of the moral discipline by which it 
 is His purpose to work out our improvement, and fit us for 
 final happiness. This view of the case, however, is appro- 
 priately left to the clergyman. It is in the capacity of phy- 
 sician and man of the world that I put myself forward, in 
 the conviction that it is in my power to offer alleviation to 
 the afflicted, to show how misfortune may be best borne, 
 — how its physical and moral consequences may have their 
 force turned aside, and be rendered comparatively harmless ; 
 how inevitable bodily ailments may be modified or cured ; 
 how some admit of great alleviation, and some of entire 
 removal ; that even by acting on the body we may render 
 important service to the mind, and enable it to rise elastic 
 from the pressure that, if left alone, would have crushed it 
 to the earth. 
 
 It is not that I would evade the consideration of other 
 forms of unhappiness ; on the contrary, I hope, sincerely 
 and confidently, to render a service to my fellow-creatures 
 by showing that in all cases we may anticipate and prevent, 
 or give considerable relief to, the ailments, disorders, and 
 diseases produced by mental causes, even when it is obviously 
 impossible to alleviate and remove their source and origin. 
 The mind, that is, the a^reofate of the functions of the brain 
 (for we are not here speaking of the soul ) , can only produce 
 disease by some sort of action on the physical structure and 
 functions of the body. We see, however, that as accidental 
 injury to the body (an extensive burn or scald for example) 
 can produce a very serious effect on the mind, so also the 
 diseased or disordered state of body, directly caused by men- 
 tal emotion, acts reflexly on the functions of the brain, and 
 very often paralyzes all the efforts of the sufferer, and render 
 him incapable of using in its full power the intellect which 
 
ANXIETY OF MIND. 
 
 45 
 
 would have otherwise shown him a mode of extrication from 
 his embarrassment. 
 
 Men who have weighty care on their mind, — statesmen 
 whose confidence of retaining their position, and ambi- 
 tious hopes of further advancement, depend on the slender 
 and fragile thread of popular favor ; or where patriotism 
 looks forward with honorable fear to the result of a deep-laid 
 scheme for the advancement of their country’s welfare, liable 
 at every moment to be defeated by malevolent rivals, and 
 the unexecuted purposes rendered suspicious to those who 
 judge by results alone ; merchants who have staked vast 
 sums on the issue of au uncertain speculation ; gentlemen 
 of fortune who have perilled their whole possessions and 
 their honor on the result of a horse-race, — such men will, 
 perhaps, look down with contempt on the petty details of 
 the cares of humble life, but 
 
 Little things are great to little men. 
 
 The medical philosopher looks with as mucn interest on 
 the anxiety of the petty tradesman, as on a great leviathan 
 of the stock exchange or gold board, whose vast speculations 
 involve the fate of nations. There is as much real dignity 
 in the sufferings of the one as of the other, except in so far 
 as the wish for wealth is modified by the desire to possess 
 the means of benevolent power, and the exercise of an 
 enlightened beneficence (such as actuated the late Mr. Pea- 
 body, the patron of the Peabody Medical Institute), — the 
 hopes, fears, motives, sentiments, and feelings of the differ- 
 ent classes, as well as their mental and corporeal sufferings, 
 are essentially the same ; and, if regarded from the heights 
 of pure reason and philosophy, are equally deserviug of honor 
 or contempt. 
 
 It requires no argument to prove that anxiety affects 
 the health ; it is an object of daily experience ; our libraries 
 
46 
 
 ANXIETY OF MIND. 
 
 are full of books of counsel on the subject ; medical works, 
 in the enumeration of causes of lingering disease * are 
 crammed with cases arising from this source alone ; and there 
 is scarcely a disorder wherein this state of brain is not 
 assigned as one of the most prominent agents in disturbing 
 the bodily health, and establishing disease. Fevers, jaun- 
 dice, gout, consumption, insanity, dyspepsia, and a hundred 
 other diseases are so often thus created, that it would almost 
 appear to be the sole agent in their production. And yet, 
 with all this profusion of advice and description, I cannot 
 call to mind a single writer who has attempted to explain 
 the mode in which these innumerable effects are produced ; 
 yet, till this be clearly understood, we are not in possession 
 of half the available means of modifying or removing them. 
 The distress brought on by this inability to guide the thought, 
 
 — a frequent consequence of great anxiety, — this inability to 
 use the two brains concurrently, that is, to exercise attention 
 or study, is one of the most pitiable states of mind that can 
 be conceived. Happy those who have never had experience 
 of the infliction, — the utility of works of imagination is thor- 
 oughly appreciated in such cases, and the sufferer would be 
 always reading. In following the ideas of another man, he 
 can generally leave his own intellectual organs in quiet ; the 
 discordant action of the two brains may thus subside per- 
 haps into repose, and on resuming their duties they may 
 have re-established the unison and consentaneity which is 
 necessary to the tranquil exercise of the mind. On such 
 occasions, if there be no object of tender fondness, whose 
 soothing blandishments can turn the current of the thoughts, 
 
 — if a man look only with terror to the time when 
 
 “ Shall dawn the dreary morrow ; and the toils, 
 
 The cares, the ills of life, with scarcely hope 
 To brighten the involving gloom, and save 
 The fainting spirit,” 
 
ANXIETY OF MIND. 
 
 47 
 
 on these occasions, we feel acutely the value of such a 
 writer as Charles Dickens, — a man whose medical services , 
 if I may so term them, would have been cheaply purchased 
 by the nation at the price of the largest fortune ever pos- 
 sessed by an individual. Hoav many a harassed brain has 
 been soothed by his delightful fictions ; how many a lingering 
 disease has been rendered endurable ; from how many has he 
 not directed the dismal prospect of inevitable death ; to how 
 many an aching heart has he brought consolation and comfort 
 and the temporary oblivion of sorrow ; how many a suicide has 
 he prevented ; and how many a bewildered brain placed in 
 repose ! 
 
 Such men have their mission, — they are sent into the 
 world by a benevolent Deity for a specific pifrpose, and they 
 may be compared to the blessed remedies which have been 
 created for the relief of sufferers. I do not hesitate to say 
 that I attribute the recovery of many a nervous patient to 
 the mental composure produced by reading his admirable 
 stories, in which there is nothing to detract from the entire 
 satisfaction and assent of a virtuous mind. 
 
CHAPTER VII. 
 
 RELIGIOUS EXCITEMENT AND NERVOUSNESS. 
 
 The writer has had many cases of nervous depression and 
 melancholy resulting from religious excitement, and what are 
 known as revivals, although these cases are not so common 
 as they formerly were. Occasionally a nervous patient, who 
 believes himself or herself to have committed the unpardon- 
 able sin, and to be, therefore, destined to everlasting perdi- 
 tion, is brought to the writer for treatment ; but cases of 
 what may be called religious insanity are not so common 
 now as formerly, owing to the fact of a softening of the 
 creeds, and the elimination of the terrible penal articles of 
 faith, which once were insisted on more than all the rest. 
 Hysteria in connection with religious revivals is a well- 
 known medical phenomenon. When the nerves, especially of 
 uneducated people, of women in particular, who are unaccus- 
 tomed to self-control, are powerfully wrought upon by the rude 
 but powerful appeals and eloquence of a revivalist preacher, 
 paroxysms, convulsions, and outcries are the natural enough 
 expressions of the overwrought feelings of the auditors. 
 Hysteria seizes upon some extremely susceptible female, and 
 becomes straightway contagious. In fact, several leading 
 nervous disorders, such as catalepsy, ecstasy, chorea or St. 
 Vitus’ dance, and hysteria are historically associated with 
 religious excitements. Dr. Hammond truly says : "Most of 
 [ 48 ] 
 
RELIGIOUS EXCITEMENT AND NERVOUSNESS. 
 
 49 
 
 tho religious impostors, who have at various times made 
 their appearance, and many very sincere and devout persons, 
 have been ecstatics.” "In ecstasy,” he says, "the eyes are open, 
 the lips parted ; the face is turned upward, the hands are 
 often outstretched ; the body is erect and raised to its utmost 
 height. A peculiar radiant smile illumes the countenance, 
 and the whole aspect is that of intense mental exaltation. 
 In its combination with catalepsy, chorea, and hysteria, 
 ecstasy has played an important part in the history of the 
 civilized world, — at one time leading to a belief in witch- 
 craft ; at another, to demoniac and angelic possession ; at 
 another, to mesmerism and clairvoyance ; and, in our day, 
 to spiritualism. Ecstasy, though not entirely confined to 
 the female sex, is very much more common in women than 
 in men. It appears to be produced in those who are of deli- 
 cate and sensitive nervous organizations by intense mental 
 concentration on some one particular subject, — generally 
 one connected with religion. It was formerly quite common 
 among the inmates of convents, and is now not unfrequentty 
 met with at camp-meetings and spiritualistic gatherings.” 
 Chorea, or St. Vitus’ dance, is another well-known form of 
 disease having religious associations. Hence its name. The 
 convulsions and paroxysms of this nervous affection are often 
 of the most extraordinary character. " This affection,” we 
 again quote from Dr. Hammond’s admirable work entitled 
 "Diseases of the Nervous System,” "has often prevailed 
 epidemically. The first authentic visitation of the kind was 
 one which occurred at Aix-la-Chapelle, in 1374. This was 
 in the form of a dancing mania. It was named St. John’s 
 Dance. 
 
 " The men and women subject to it met in the streets asid 
 churches, where they formed circles hand in hand, and, ap- 
 pearing to have lost all control, continued dancing, regard- 
 less of the by-standers, for hours together, in wild delirium. 
 
50 
 
 RELIGIOUS EXCITEMENT AND NERVOUSNESS. 
 
 until at length they fell to the ground in a state of exhaustion. 
 . . . While dancing, they neither saw nor heard, being 
 insensible to external impressions through the senses, but 
 were haunted by visions, — their fancies conjuring up spirits, 
 whose names they shrieked out. Some of them afterwards 
 asserted that they felt as if they had been immersed in a 
 stream of blood, which obliged them to leap so high; others, 
 during the paroxysm, saw the heavens open and the Saviour 
 enthroned with the Virgin Mary, — according as the religious 
 notions of the age were strangely or variously reflected in 
 their imaginations. . . * 
 
 " Some religious monomaniacs are never safe. Pinel re- 
 lates the case of a fanatic who conceived the idea that man- 
 kind should be regenerated by the baptism of blood ; and 
 under this delusion he cut the throats of all his children, 
 and would have murdered his wife, had she not effected 
 her escape. Sixteen years afterwards, when a patient in the 
 Bicetre, he murdered two of his fellow-patients, and would 
 have killed all the inmates in the hospital, if his homicidal 
 propensity had not been restrained. 
 
 " In our own country we have had the J umpers and the 
 Shakers.” 
 
 In these practical, matter-of-fact days, the subjects of 
 these nervo-religious excitements, paroxysms, and convulsions 
 are cured of their disorders by an administration of the bro- 
 mide of potassium, or some of the other bromides, combined 
 with the oxide or sulphate of zinc and strychnia and other 
 tonics, reinforced by a proper hygiene of exercise in the air 
 and nutritious diet. 
 
 The physical phenomena of " the revival ” can be shown 
 to present, in their predisposing and exciting causes, in their 
 progress and in their results, a precise resemblance to the 
 hysteria commonly seen in medical practice, and produced 
 either by secular terrors or by amatory reverie. We are 
 
RELIGIOUS EXCITEMENT AND NERVOUSNESS. 
 
 51 
 
 clearly entitled to consider them as belonging to the same 
 family, and as being in fact very striking instances of morbid 
 action. Without trespassing upon "the domain of the theolo- 
 gian, yet we may regard these phenomena in their patholog- 
 ical relations, and may point out the methods by which they 
 may be prevented, and the manner in which they may be over- 
 come. It is incontestible that love to God, founded upon an 
 assurance of God’s love to man, is the only possible basis of 
 Christian, faith and duty ; and it is inconceivable that love to 
 God can be kindled at the flames of a literal hell. Denun- 
 ciations of the wrath to come, and frantic appeals to the 
 terrors of a congregation, produce either hysteria or indif- 
 ference, — either shake the physical frame, by positive dread 
 of impending torture, and mere selfish fears for personal 
 safety, or else harden the listeners by the natural reaction of 
 the human spirit against threats. ” Howling about hell-fire 
 in bad grammar,” as Thackeray says, very frequently ex- 
 presses nothing but the longing of the preacher to persecute. 
 I hold, therefore, that these denunciations of the wrath to 
 come, made prominent as the leading and essential feature 
 of scriptural teaching, are without any shadow of justifica- 
 tion or excuse. Hysteria, originating in terror, maintained 
 for effect, terminating in profligacy or insanity, is a sad con- 
 trast to the peace that passeth understanding. But, as I have 
 said, in these days of science and rational views, instances 
 of religious melancholy and insanity are becoming fewer and 
 fewer; as those, physicians, who, like the writer, make the 
 treatment of nervous affections a specialty, can testify ; al- 
 though such cases are by no means rare. Interesting cases 
 of this kind might be cited from the author’s own professional 
 experience, and described at length, but it is, perhaps, 
 unnecessary. More or less of such cases can be found in 
 every lunatic asylum. Most of them are curable by the pow- 
 erful remedies for nervous affections, which have been added 
 to the Materia Medica within the last decade. 
 
 u. OF ILL LIB. 
 
CHAPTER VIII. 
 
 ILLUSIONS AND HALLUCINATIONS. 
 
 It is said that hallucinations of the senses arise from some 
 defect in the organs of sense, or from some unusual circum- 
 stance attending the object. Hallucinations are sometimes 
 symptoms of general disease, as in fevers. The extent to 
 which we are subject to illusions and hallucinations shows 
 that we are fearfully and wonderfully made. The most 
 aggravated murders are frequently committed by persons 
 who are the victims of fixed ideas and hallucinations. They 
 are often aware of the fact that they are laboring under 
 mental disease, and yet they cannot hold themselves back 
 from the perpetration of the dreadful crime to which they 
 arc irresistibly impelled. The subject of hallucination is a 
 most important and interesting one. The various religions 
 owe to the hallucinations of their so-called holy personages 
 all their accounts of supernatural beings and incidents. 
 When a person actually insists that he sees, hears, or feels 
 what no one near him can see, hear, or feel, the question 
 arises, Are the senses which convey these impressions to the 
 brain in a sound condition, or is his mind delirious ? Is the 
 cause of the hallucination external or internal ? In order to 
 answer this question, we must first inquire how far the senses 
 are capable of misleading the reason and urging the imagi- 
 nation to unconnected dreams. We know that the nervous 
 [ 52 ] 
 
ILLUSIONS AND HALLUCINATIONS. 
 
 53 
 
 system is influenced by the condition of the body. Privation 
 of food, for instance, indulgence in alcoholic stimulants, 
 habits of narcotism, and congestion of the brain will power- 
 fully affect the nervous system, and through it produce illu- 
 sions and hallucinations of the senses. In fact, the history 
 of mankind, and the experience of those who have had the 
 opportunity of studying the ills to which flesh is heir, prove 
 that the manifold causes which give rise to hallucinations 
 can be referred to innumerable sources, which oftentimes 
 escape the curiosity of the most watchful and intelligent 
 observer. The power of the imagination is proverbial. 
 Shakespeare says the poet, the lover, and the madman are of 
 imagination all compact. The latter he represents as seeing 
 more devils than vast hell can hold. Whatever a person 
 firmly believes, that to him is a reality. So that an illusion 
 or hallucination, no matter how wild and irrational it may 
 be, has all the effect of a reality on the subject of it. There 
 is no limit to the force of a morbid imagination, and the 
 mad pranks and delusions to which it will reduce its unfor- 
 tunate victims. Burton asks, "What will not a fearful man 
 conceive in the dark? What strange forms of bugbears, 
 devils, witches, goblins? Melancholy and sick men, he says-, 
 conceive so many fantastical visions, apparitions to them- 
 selves, and have so many absurd apparitions, as that they 
 are kings, lords, cocks, bears, apes, owls.” 
 
 Burton furnishes perhaps as many and as striking instances 
 of illusions, delusions, and hallucinations as any other writer, 
 lie gives the case of a baker, who thought he was composed 
 of butter, and did not dare to sit in the sun or come near 
 the fire for fear of being melted. Another hallucinant 
 thought he was a nightingale, and sang all night ; and 
 another that he was a glass pitcher, and would let nobody 
 approach him, lest he should be broken. Recorded delu- 
 sions of a similar nature are innumerable. Old writers on 
 
54 
 
 ILLUSIONS AND HALLUCINATIONS. 
 
 the subject of melancholy and insanity furnish as varied 
 instances as the most recent authorities, and apparently en- 
 tertain as correct notions of the causes of such delusions. 
 Wierus, an old author, illustrates the force of a diseased 
 imagination by saying that persons suffering from hydropho- 
 bia seem to see the picture of a dog still in their water. 
 And apropos of hydrophobia. Dr. D. H. Tuke has lately 
 published a work on the Influence of the " Mind upon the 
 Body,” and in it supports the proposition that hydrophobia 
 is produced solely by the action of the imagination. The 
 author cites cases where, beyond all doubt, hydrophobic 
 symptoms were developed without inoculation. A notable 
 instance is that of a physician of Lyons (France), named 
 Chormel, who, having aided in the dissection of several vic- 
 tims of the disorder, imagined that he had been inoculated 
 with the virus. On attempting to drink he was seized with 
 spasm of the pharynx, and in this condition roamed about 
 the streets for three days. At length his friends succeeded 
 in convincing him of the groundlessness of his apprehen- 
 sions, and he at once recovered. Bush also tells of sponta- 
 neous cases of hydrophobia from no other cause but fear and 
 association of ideas. A German physician, too, Dr. Marx, 
 of Gottingen, is disposed to take this view of hydrophobia, 
 and to regard it as a psychical affection, the result of morbid 
 excitement of the imagination. This view is confirmed by 
 the fact that young children, who are not acquainted with the 
 common belief as to hydrophobia, may be bitten by mad 
 dogs and escape spasms and madness. We are indebted to 
 the " Popular Science Monthly ” for the above statements in 
 reference to hydrophobia. Certain it is that this awful affec- 
 tion leaves no traces of itself on the brain and nerves of its 
 victim. But as for young children being bitten with impu- 
 nity by rabid dogs, we doubt. Indeed, we know of cases 
 jiroving as fatal to children as to adults. 
 
ILLUSIONS AND HALLUCINATIONS. 
 
 55 
 
 In countries with superstitious forms of religious belief, 
 which nobody questions, the most intelligent traveller feels 
 the influence of the universal superstition stealing upon him. 
 The curse of a priest in the Sandwich Islands, in the old 
 days of barbarism, would take visible effect upon its object, 
 and destroy him. A superstition gets entire possession of 
 the soul, so to speak, of the ignorant portion of a commu- 
 nity, and it takes generations of culture to rid them of it. 
 Their imaginations are possessed by it. Hence the strength 
 of old religions, after they have been proved to be false. 
 
 The hallucinations of the sense of hearing are the most 
 frequent. Amongst those who are decidedly insane, this 
 species of false perception is infinitely more common than 
 that of any other of the senses ; it is not only one voice that 
 is heard, but many ; it is not only the less instructed, but 
 the intellectual ; it is among men of great imagination and 
 deep learning. It haunts the mind in the form of a demon, 
 as in the case of the poet Tasso, or as Satan wrangling upoji 
 divinity, as it did with the disputant Luther (who actually 
 hurled his inkstand at the Devil), or as a Deity revealing 
 his will, with the contemplative Swedenborg, wdio gives the 
 date and circumstances of his first interview with the Lord 
 in the most matter-of-fact, off-hand way. The most simple 
 of the hallucinations is that of noises in the ear, such as 
 sounds made during the night in the chimney. I have 
 known an invalid complain of a perfectly sleepless night 
 occurring for weeks, in consequence of the idea that dwelt 
 upon her mind that some swallows were building a nest in 
 her chimney. She had lately returned from the country. 
 At the end of a few weeks she had an intermittent fever, 
 after which the noises ceased. A singular case is recorded 
 in the books as having occurred in Paris in 1831, during one 
 of those bloody emeutes which have for so long a time been 
 characteristic of that gay but ill-starred city. A female saw 
 
56 ILLUSIONS AND HALLUCINATIONS. 
 
 her husband, a workman, fall dead at her feet, struck by a 
 ball. A month after this event she was safely delivered of a 
 child ; but the tenth day after her accouchement, delirium came 
 on. At its commencement she heard the noise of cannon, 
 the firing of pickets, the whistling of balls. She ran into 
 the country, hoping, in getting out of the city, to escape 
 from the noises by which she was pursued. She was arrested 
 and conducted to the Salpetriere (the insane asylum) . At 
 the end of a month she was completely restored. During 
 ten years, six similar paroxysms took place, and the delirium 
 always commenced with hallucination of sound. Always did 
 this patient run into the country to escape from ideal dis- 
 charges of cannon, from firing of guns. Frequently, in the 
 precipitation of her flight, she fell into the water ; twice she 
 threw herself into it to escape the horror of the sounds that 
 reminded her of the death of her husband, and recalled the 
 miseries she endured. Single voices are seldom so common 
 as two voices, and the subject is oftentimes accompanied and 
 caused by some emotion in the mind. 
 
 A young girl heard a voice constantly calling her thief, 
 and reproaching her with the object stolen. At length she 
 returned the article, and the hallucination soon ceased. 
 This was a case of conscience as well, as of hallucination* 
 Conscience let loose the Furies, hideous hags, upon the mui- 
 der'er in ancient times, giving him no rest, chasing him from 
 land to land. Some females, who have led the most irre- 
 proachable lives, have heard voices calling them by the worst 
 epithets. One of the most singular hallucinations to which 
 the sense of hearing lends itself is, to the carrying on a long, 
 uninterrupted conversation, during which the individual 
 speaks, addresses a third party, and waits to listen to the 
 reply, which seems to be perfectly new to the apparent lis- 
 tener, who gives every attention. Who that reads the life of 
 Tasso, the great Italian poet already alluded to, as given by 
 
ILLUSIONS AND HALLUCINATIONS. 
 
 57 
 
 his friend and biographer, Manso, does not remember to have 
 either himself met with a patient who has reminded him of 
 the description, or has heard from a medical friend some tale 
 which has carried the same marvellous air with it ? Any one 
 accustomed to what occurs within lunatic establishments must 
 have seen patients walking up and down, holding an imag- 
 inary conversation, or must have heard during the night, in 
 some cell or other, an earnest, long-continued dialogue. 
 Daring the hallucinations produced by taking the Indian 
 hemp, the intensity of the sense of sound is most startling. 
 The celebrated Theodore Gaultier related to Dr. Moreau, in 
 poetic language, which it is hopeless to attempt to translate 
 so as to give an idea of the style of the imaginative author, 
 the sensations produced. He says that " his sense of hearing 
 was prodigiously developed. I heard the noise of colors, — 
 green, red, blue, yellow sounds, reached me in waves per- 
 fectly distinct ; a glass overthrown, the creaking of a foot- 
 stool, a word pronounced low, vibrated and shook me like 
 peals of thunder ; my own voice appeared to me so loud that 
 I dared not speak, for fear of shattering the walls around me, 
 or of making me burst like an explosive shell ; more than 
 five hundred clocks rang out the hour with an harmonious, 
 silvery sound ; every sonorous object sounded like the note 
 of an harmonica or the seolian harp : I swam or floated in an 
 ocean of sound.” 
 
 The imagination is engaged in a very different manner 
 where the sight is in fault, than where hearing is disordered ; 
 it does not paint such exciting scenes ; it does not bring 
 the reason into action, as we have seen it during the dis- 
 turbance of the latter organ, when conversations sometimes 
 of an intellectual character occur, where the individual 
 has to listen to the advice, the reproaches, or the threats of 
 a supposed stranger. It is generally one object alone that 
 attracts the attention, or that is complained of ; it may appear 
 under various shapes, but it is more generally connected with 
 
58 
 
 ILLUSIONS AND HALLUCINATIONS. 
 
 some idea that has previously struck with great intensity on 
 the mind ; thus a person, after being in danger of his life at 
 a bridge, saw afterwards a precipice with a fearful abyss at 
 his feet. 
 
 Those whose minds are strongly bent on devotion, and 
 have yielded up their thoughts to religion, see angels and 
 the Virgin Mary. I was once in a church where the clergy- 
 man, who had for some time betrayed symptoms bordering on 
 alienation of mind, but who never had evinced its actual 
 presence, broke off his discourse, pointing to the presence of 
 the Holy Ghost. He was fortunately prevented, by timely 
 attention, from becoming insane, but he was considered ever 
 afterwards incapable of resuming his duties. 
 
 It is not generally known that the first Bonaparte was, in 
 the early part of his career, subject to an hallucination of sight 
 in consequence of the vivid impression made upon his mind 
 by one of the occurrences of his eventful life. In the heat 
 of one of the many battles in which he was engaged, he was 
 carried / by the ardor of his courage, into the very midst of 
 the slaughter. His immediate followers fled ; he was left alone, 
 surrounded on all sides by fierce assailants. How he escaped 
 from death unhurt no one was ever able to ascertain ; it was 
 one of those miracles which seemed to be worked by his 
 guardian genius. The deep impression, however, of the dan- 
 ger which he had run, was not effaced when he mounted the 
 throne ; at certain intervals a striking hallucination occurred. 
 Suddenly, in the midst of the silence of the palace, loud 
 cries were occasionally heard ; the emperor was seen fighting 
 with the utmost desperation amongst his visionary foes. It 
 lasted but a very short period, but during that time the bat- 
 tle seemed to be a tremendous one. This gave rise to the 
 report that he was subject to epileptic fits. These visions 
 will not unfrequently cease upon shutting the eyes : they 
 more generally, however, are permanent. 
 
 Starvation will cause hallucinations of the sight. The 
 
ILLUSIONS AND HALLUCINATIONS. 
 
 59 
 
 narratives of ships wrecked at sea abound with singular 
 phenomena ; the famished victims have seen not only beings 
 before them luring them on with promised food, but they 
 have had painted before them the most beautiful scenes which 
 the imagination can display, — gardens abounding with Hes- 
 perian fruit, crystal streams, delicious rills, ever-blooming 
 flowers, and all the fascinations that the poet and the painter 
 give to the Elysian fields. Sometimes angels minister to 
 them, robed in celestial garbs, and their last hours are ren- 
 dered happy by the delusions to which the senses gladly lend 
 themselves. There are certain tonics which also have an 
 effect somewhat extraordinary ; of this nature are the prep- 
 arations of iron, more especially when administered to 
 delicate females, but neither in my own practice nor in that 
 of the many friends with whom I have communicated, have 
 I learned any particulars springing from actual experience. 
 
 Hallucinations affecting the sense of smell are not unfre- 
 quent ; but they seldom attract much attention, and unless 
 they exist in unison with some more striking derangement of 
 the sensorial system, afford but little scope for observation. 
 It is very generally associated with a deranged state of the 
 sense of taste ; but this does not necessarily occur. An in- 
 sane person believed firmly that he could detect the exist- 
 ence of cholera by the odor which followed it everywhere . 
 He was first struck with it, he said, while dining ; it came 
 upon him like the smell of a dead body ; he recognized its 
 existence in a city, directly he entered it. Esquirol had 
 under his care a female who fancied that she had a most dis- 
 agreeable odor about her ; and on being asked to go into the 
 garden, she refused, on the plea that she was well aware that 
 she should kill all the vegetables there, by the scent which 
 she bore. A certain person insisted that his wife exhaled at 
 all times a most ambrosial smell, which captivated all who 
 approached her ; when the fact was she was very unsavory 
 
60 
 
 ILLUSIONS AND HALLUCINATIONS. 
 
 and untidy, and remarkable for anything rather than clean- 
 liness. I have known patients who believed that every 
 object round them was impregnated with some disagreeable 
 odor. This is not at all uncommon towards the termination 
 of fever. Those who enjoy religious ecstasies among maniacs 
 speak of the delicious perfumes, of the divine exhalations, 
 of the camphor, the myrrh, the frankincense ; the food is 
 holy manna, and the blood is that of the lamb, sweet and 
 savory. The language used by the poor beings is generally 
 that of happiness, and they are frequently made partakers 
 of some delicious repasts, which ordinary mortals know 
 not of. 
 
 The hallucination of touch varies exceedingly. It is sin- 
 gular enough to find, in an establishment where an individual 
 has been admitted who believes that he has rats crawling 
 over him, that spiders infest him, that he receives occasional 
 blows from an unknown hand, how very soon several others 
 of the confined persons take up the same notion ; and if by 
 any chance suspicion falls upon any attendant that he has 
 been accessory to a blow, all the others who complain, 
 whether from cunning or from the wish to obtain the com- 
 passion which is generally shown, load the servant with 
 charges of being the person who annoys them. Some inva- 
 lids will insist on it that cold water has been thrown on their 
 heads ; others that corrosive substances and poisonous pow- 
 ders have been thrown uponi them ; that hence their bodies are 
 metamorphosed; that they are unlike what they were, and 
 that they are grossly maltreated. Some of them cannot bear 
 the slightest breath of air to blow upon their bodies ; those 
 who have witnessed the horror expressed by patients labor- 
 ing under hydrophobia when the least air falls upon them, 
 can judge of the horror which some experience when they 
 fancy that they are blown upon. 
 
 An actress who had become melancholy, after expatiating 
 
ILLUSIONS AND HALLUCINATIONS. 
 
 61 
 
 with considerable energy upon the miseries which were in- 
 flicted upon her by unknown hands, added, " They are not 
 satisfied with these cruelties, but they are employed blow- 
 ing, night and day, ingredients which destroy me, upon my 
 skin, which is as pure and 'unsullied as my heart.” Many 
 patients believe that they have swallowed animals, reptiles, 
 insects ; and even those who have no other indication of the 
 slightest alteration of intellect, cannot be induced to lay 
 aside the impression. Sometimes they beat the stomach and 
 bowels with great violence, often wounding and severely 
 hurting themselves. They assert that the internal organs 
 have disappeared ; they know it by the sense of emptiness, 
 by the hollowness of sound. They occasionally accuse a 
 friend of being the cause, or they lay it at the door of some 
 one to whom they have taken, without apparent cause, a 
 violent aversion. Spiders and mice are frequently charged 
 with being the cause of the mischief, and of having entered 
 into the stomach. Sometimes the head is very light, at 
 others it is enormously heavy ; sometimes one arm is longer 
 than another; there may be three arms, — in fact, when the 
 sense of touch and the general sensibility are disordered, 
 hallucination appears in a thousand indescribable forms, 
 altering every day, and exhibiting itself under the most 
 extravagant guises. Sleep vanishes under their influence ; 
 day and night, for a series of years, are the unfortunate indi- 
 viduals haunted and persecuted ; devils take them by the feet 
 during the night, strike them constantly upon the back at 
 the moment when they most require repose ; they are seized 
 by vampires, who during the night suck the blood from 
 their veins till atrophy and deformity of their organs take 
 place. Invisible agency is constantly at work. In such 
 morbid phenomena as these, undoubtedly Salem witchcraft 
 had its rise. The bewitched people were the subjects of 
 hallucinations of hearing, sight, and touch. There are cases 
 
62 
 
 ILLUSIONS AND HALLUCINATIONS. 
 
 — especially in diseased states, such as delirium tremens — 
 in which the senses all partake of the hallucination alike ; 
 the eye, the touch, the hearing, the smell, and the taste are 
 so disordered as to convey unhealthy impressions to the 
 brain. Most generally one of the organs so predominates 
 over the other, that its deviations only are complained of ; 
 it is only by examination of the invalid, and by repeated 
 conversation, however, that this is perceptible. At a lead- 
 ing insane asylum there is at present a female, about sixty- 
 five years of age, who has now been of unsound mind for five 
 or six years ; she makes daily complaints of the frightful 
 sufferings she has to endure, and which are consequent upon 
 the hallucinations in which all her senses are wrapt. At 
 night she sees forms that menace her, — heads of bodies 
 which frighten her. Sometimes it is her own image, her 
 own portrait, that is represented to her. Once she saw her 
 mother, who has been some time dead, crawl towards her 
 on four paws. She constantly hears voices which insult her ; 
 oftentimes they tell her melancholy tales, — for instance, 
 they repeat that her mother is dead. They send the bodies 
 of putrefying children to her. She has sometimes the com- 
 plete odor of arsenic. This woman will eat nothing but 
 bread, because both flesh and vegetables taste of arsenic. 
 Besides all this, she receives blows upon the head — upon 
 the limbs. They give her cramps in the legs, icy sweats, 
 colds ; they take away her breath, and drive the blood to her 
 head. 
 
 Sometimes an individual gets a fixed idea, which remains 
 known only to himself. He struggles with it perhaps for 
 years, nor reveals the contest going on within him. This 
 " fixed idea ” may be either to destroy himself, or to kill some 
 near and dear relative, a wife or mother, for instance. It is 
 only when the madness bursts out with uncontrollable vehe- 
 mence in the perpetration of the terrible act, that it is 
 
ILLUSIONS AND HALLUCINATIONS. 
 
 63 
 
 known. The suicide has long fought with himself, before 
 he has rushed to the fatal extreme ; the homicidal maniac 
 conceals for an immense length of time the horrors by which 
 he is pursued ; and it is only when he can bear his fate no 
 longer, that he divulges his long-kept secret. There are 
 cases recorded where men laboring under the murderous 
 mania have had themselves bound hand and foot, notifying 
 the persons whom they felt irresistibly impelled to kill, of 
 the state of mind in which they were. Sometimes the pas- 
 sion of fear will take complete possession of a person. He 
 has a dread of the most overwhelming kind, which gradually 
 grows into a most complete oppression, weighing down all 
 the other faculties of mind. It is utterly in vain that he 
 endeavors to drive away the fixed idea; it remains rooted 
 to the very inmost part of his being ; the very circumstance 
 of his attempting to drive it from him only roots it deeper. 
 At length, completely overwhelmed with the intensity of the 
 suffering, he yields himself up to that sole persecuting 
 thought; there is a complete personal inertia, which for- 
 bids him to mingle further with the world ; the consciousness 
 of surrounding objects is lost, as well as that internal con- 
 science which governs the internal actions of man. The 
 result of this state of mind is quickly conveyed to the body, 
 which not only sympathizes with it, but is completely gov- 
 erned by it ; it is not only that the appetite fails, the power 
 of enjoyment, and the desire for locomotion, but the nutri- 
 tion of the body ceases, the secretions are not duly per- 
 formed, the circulation becomes languid, and all the organs 
 are in a state of torpor; this proceeds, gradually increasing, 
 till there is an almost complete suspension of all the powers 
 by which life is carried on ; the blood, no longer oxygenized, 
 is full of carbon ; it slowly meanders through the liver, where 
 the veins stagnate with their fluid ; the brain is after some 
 time surcharged with this venous blood, and that state which 
 
64 
 
 ILLUSIONS AND HALLUCINATIONS. 
 
 approaches the third stage of intoxication supervenes. 
 During this crisis there is, as in ordinary insanity, a sudden 
 change for the better where relief is obtained ; but where 
 it has not been watched and prepared for, there is a violent 
 paroxysm, whose intensity bears proportion to the previous 
 depression. This action and reaction, so strongly marked 
 in intermittent fever, affecting that portion of the nervous 
 system which is contained within the spinal column, produc- 
 ing the phenomenon in its greatest extent, of universal 
 tremor, acting upon the brain, evidently causes a large por- 
 tion of that which is displayed in the insane, under the guise 
 of alternate depression and excitement. 
 
 The sudden crisis, which leads to sudden, impulsive acts, 
 in the insane that had previously exhibited the form only of 
 imbecility and stupidity, most probably depends upon some 
 altered state of the arterial circulation, some momentary 
 determination to the brain ; and, were we followers of the 
 doctrines of Gall and Spurzheim to their fullest extent, we 
 should be naturally led to inquire whether the organ upon 
 which they assert that homicide .depends, was the seat of 
 some instantaneous action. When we find that there exists 
 in nature vegetable substances which produce this effect, or 
 which suddenly call into action the desire for spilling blood, 
 we must grant that this is owing to some condition of the 
 brain, produced by a physical agent. 
 
 It is not brandy or whiskey alone that will, in some con- 
 stitutions, cause a fearful ferocity {vide the daily accounts of 
 crime in New York city among the thugs of that metrop- 
 olis), but there is a vegetable, a species of mushroom, called 
 Ornanita muscovia , whose effects are of the most striking 
 character. Some of the Cossack tribes never go to battle 
 without adding a portion to the spirituous liquors which they 
 take, and they become inspired with a blood-thirstiness which 
 nothing can resist. Even the Cannabis indica has been known 
 
ILLUSIONS AND HALLUCINATIONS. 
 
 65 
 
 to inspire even a reflecting and humane individual with a 
 desire for destruction ; it often fills the mind with an impulse 
 that cannot he resisted. On one occasion, when Dr. Moreau 
 had himself taken it, by way of experiment, he piteously 
 entreated that the window should be immediately shut, as he 
 felt coming over him an irresistible propensity to throw him~ 
 self out. 
 
CHAPTER IX. 
 
 SLEEP AND SLEEPLESSNESS. 
 
 What refreshment and reinvigoration good sound sleep 
 brings to jaded, deranged nerves ! Sancho Panza blessed the 
 man who invented sleep. It is, indeed, the best medicine of 
 nervous disease, and it is precisely the most difficult thing for 
 the nervous patient to obtain, — that is, good, sound, natural 
 sleep. People may sleep too little or too much, too early 
 or too late. Overmuch sleep leads to corpulence, sluggish- 
 ness of the general functions, congestions of the chief viscera, 
 especially of the head, endangering attacks of apoplexy and 
 death. It is the bon vivant who is disposed to sleep ; a doze 
 in his easy-chair after dinner, and an inclination to nod over 
 the newspaper or during a prolonged discourse. The well- 
 nourished require more sleep than the lean, and the phleg- 
 matic more than the irritable. But in the present day som- 
 nolent obesity is a rare phenomenon. The evil that we have 
 to complain of, is an incapability of sleeping enough. 
 There is no fixed duration for sleep. The world roars 
 around us like a torrent of events. Everything is rapid ; 
 and we are whirled with velocity in the midst of a vortex as 
 vast as it is incessant. Repose there is none ; and instead 
 of sleeping on a pillow of down, we stand continually on the 
 tiptoe of expectation, awaiting the coming on of to-morrow, 
 big, as it were, with the doom of some great hereafter. It 
 [ 66 ] 
 
SLEEP AND SLEEPLESSNESS. 
 
 G7 
 
 is impossible to sleep ; nay, it is scarcely possible to survive. 
 This morbid excitement, fictitious though it be, is in reality 
 the pregnant source of a large family of ailments, of which 
 mania is neither the youngest nor the most insignificant 
 child. 
 
 A sleepless night cannot be recovered from by any sub- 
 sequent siesta snatched out of the business of the day. We 
 must wait for the following night, go to bed early, and sleep 
 soundly, if we hope to awake refreshed the next morning. 
 Nor can exhaustion from the want of sleep be relieved by 
 stimulants, either in the shape of food or medicine, although 
 the late hours of the modern world, which induce a perpetual 
 lassitude both of mind and body, are alleged as one of the 
 chief reasons, if not of the poor excuses, for indulging in 
 wine and hot condiments. There is a form of conditional 
 drunkenness to which people in good society are addicted, 
 without being aware of it, that produces effects quite as per- 
 nicious as dram-drinking among the lower orders : we mean 
 the free use of wine at the dinner-table. Such persons with- 
 out suffering in appearance, or losing flesh, get into a 
 chronic state of disturbed health, manifested by impaired 
 digestion and irritable nerves. Deprived of his usual mod- 
 icum, the gentleman is unable to sleep, and becomes fn a 
 certain degree delirious, unless allowed to return to his 
 ordinary habits. There is likewise a chronic sleeplessness, 
 chiefly among the better classes, where individuals suffer 
 from an almost total want of rest for months together, with- 
 out any loss of flesh, or visible impairment of the constitu- 
 tion. Such cases get well of themselves, after a shorter or 
 longer period, and do not require any medical treatment. 
 
 The evil consequences of not sleeping enough are clearly 
 manifested in the features, which become pale, lank, and 
 sharp ; the eye cold, blanched, and watery ; the hair shabby, 
 straight, and long ; the deportment wan, and the feelings lan- 
 
68 
 
 SLEEP AND SLEEPLESSNESS. 
 
 guid. The palms of the hands are hot, the lips dry and 
 peeling, and the utterance feeble or tremulous, while a low 
 fever feeds upon the vitals. If the want of sleep is volun- 
 tary, as in the pursuit of some necessary or interesting occu- 
 pation, or in consequence of fashionable engagements, it saps 
 the strength at an early period ; men become old at thirty- 
 five or forty ; and women, wasted in their prime, suffer from 
 difficult childbirth, or die in consequence of it. A city life 
 is most baneful in this respect, and may be considered as 
 limiting the average of longevity to forty-five or fifty years. 
 
 Those who go to bed late rise early, and early risers are 
 for the most part forced to retire equally early. Students, 
 who require more sleep than others, usually rise too early, 
 and sit up too late. Modern fine children, who are taught 
 to mimic their elders, are exotics, flowering in an artificial 
 atmosphere, but withering without fruit long before the 
 morning of their days has passed over their debilitated 
 heads. Nor learning nor fame nor money nor power is 
 equivalent to an elastic, vigorous constitution ; nor are the 
 lesser virtues usually styled accomplishments, pleasing and 
 graceful as they may be, of any value in comparison with the 
 decrepit nerves, and the still more decrepit morals, with 
 which they have been purchased. 
 
 The older physicians paid much more attention to this 
 inquiry than modern physicians and physiologists are accus- 
 tomed to do. Hippocrates long ago pointed out the impor- 
 tance of denoting the kind of sleep, the nature of the dreams, 
 and the particular posture of the sleeper in bed, as an acces- 
 sory means of forming a correct diagnosis of his disease. 
 Allowing for some puerilities peculiar to the remote epoch 
 in which he flourished, the fourth book of his treatise, entitled 
 " Regimen,” is a much more practical essay on this subject 
 than anything else of the sort that has yet been put forth by 
 later pathologists. Although Dr. Marshall Hall observes 
 
SLEEP AND SLEEPLESSNESS. GO 
 
 that sleep is a cerebral affection, and that the spinal and gan- 
 glionic systems never sleep, yet our notions are, we cannot 
 help avowing, somewhat different from his on this subject. 
 It seems to us that the power of sleeping is much more inti- 
 mately connected with the medulla oblongata and spinal 
 cord, than with the cerebrum and superior portions of the 
 hemispheres. The whole nervous system is a unit or entity, 
 in its essence compounded of distinct parts, entirely united 
 in their different, but by no means separate functions. The 
 intellectual powers would seem to belong to the cerebra, 
 perhaps to the cortical substance, or gray matter alone, as 
 some suppose ; the several senses would appear to have 
 their origin or root at the base of the brain ; the faculties of 
 the mere animal organs are apparently governed by the cer- 
 ebellum, while those of locomotion, speech, respiration, etc., 
 are evidently connected with the pons variolii, the medulla 
 oblongata, and the spinal cord. Now sleep is an absolute 
 suspension of sense and motion ; but then these two func- 
 tions, or sets of functions, are under the rule of the spinal 
 cord ; so that the spinal cord would seem to be the imme- 
 diate locality, if not the true centre, both of rest and action, 
 progression and repose, locomotion and inertia, or, in other 
 words, of waking and sleeping. 
 
 There are several physiological as well as pathological 
 phenomena confirmative of this view of the case. It has been 
 proved that the pupil of the eye is closed almost to a point 
 not larger than a pin-hole during sleep ; that the eyeball like- 
 wise is turned upwards, and that the upper eyelid falls down. 
 These phenomena are also the symptoms set down as indicat- 
 ing disturbance at the base of the brain among the diseases 
 of that organ. For a very contracted pupil is almost always 
 a fatal sign, by showing loss of power at the origin of the 
 respiratory nerves, whether from effusion or injury or 
 natural dissolution. The turning upwards of the eyeball 
 
70 
 
 SLEEP AND SLEEPLESSNESS. 
 
 is ii common symptom of convulsive affections proceeding 
 from spinal irritation, or mechanical mischief of that part. 
 And the drooping of the eyelid is indicative of incipient 
 paralysis, or loss of power, in the cord and medulla oblong- 
 ata, often forerunning paraplegia, loss of speech, and failure 
 of the locomotive power in general. These signs, which are, 
 physiologically speaking, in one sense the phenomena of 
 ordinary sleep, become, in another, leading symptoms in 
 the natural history of disease of the brain ; and both the 
 symptoms on the one hand, and the phenomena on the 
 other, point directly to one part of the grand system of 
 nerves, namely, the medulla oblongata and the spinal cord. 
 
 That sleep should be less connected with the cerebrum than 
 with the spinal cord is not so unlikely, if we consider the 
 nature of each part of the nervous system respectively ; for 
 we shall be enabled to remark, that sleep, which is the sus- 
 pension of action, belongs to the spinal portion rather than 
 to the brain or cerebrum, which, as the focus of will and 
 intelligence, only exerts itself in governing the rest of the 
 frame, and ceases from exertion as soon as the rest of its 
 parts cease to require governing. Disturbance of the supe- 
 rior hemispheres will of course hinder the cord from sleep- 
 ing quite as effectually as irritation of any other part of 
 the body would do ; but we mean that, in health, sleep 
 belongs to the cord rather than to the brain. Wakeful- 
 ness is one of the most vexatious symptoms of spinal dis- 
 ease ; of spinal exhaustion from venery, or excessive pedes- 
 trianism ; of spinal irritation produced by a sort of reflex 
 action from acid indigestion accompanied with cramps of 
 the legs, and of profuse diarrhoea, exhausting the spinal 
 cord so greatly as to give rise to incurable paraplegki. 
 All these signs, symptoms, and phenomena lead to one and 
 the same conclusion, — that the spinal cord, rather than 
 brain, is chiefly concerned in sleep and sleeplessness. But 
 
SLEEP AND SLEEPLESSNESS. 
 
 71 
 
 the ablest psychologist must admit that it is beyond his 
 power to explain the nature of sleep. The best works on 
 physiology offer us nothing more satisfactory than probable 
 opinions, curious conjectures, and interesting theories, while 
 pretending to solve a problem which still remains, as it has 
 hitherto remained, the monitor of the end of all things, — the 
 daily rehearsal of our death. There are some curious in- 
 stances on record of sleeping and waking. In Turkey, if a 
 person happens to fall asleep in the neighborhood of a poppy- 
 field, and the wind blows over towards him, he becomes 
 gradually narcotized, and would die, if the country people, 
 ho are well acquainted with the circumstance, did not bring 
 him to the next well or stream, and empty pitcher after 
 pitcher on his face and body. There is a reported case of a 
 gentleman, thirty years of age, who, from long-continued 
 sleeplessness, was reduced to a complete living skeleton, 
 unable to stand on his legs. It was partly owing to disease, 
 but chiefly to the abuse of mercury and opium, until at last, 
 unable to pursue his business, he sank into abject poverty 
 and woe. 
 
 The power of will may obtain or dissipate sleep. Some 
 persons have the power of willing themselves asleep as soon 
 as they lie down. There is no doubt that the habit of doing 
 so may be easily acquired. Some people require vastly more 
 sleep than others. There are cases recorded of people sleep- 
 ing seventeen or eighteen hours a day for years, or taking a 
 solid nap a month or six weeks in length, while in other 
 cases four or five hours’ sleep in the twenty-four was all that 
 was taken or needed by persons remarkable for their activity 
 and influence over mankind. According to Wilkinson, the 
 ancient Egyptians, who, as everybody knows, shaved their 
 scalps, slept with their heads resting on an iron prong, like 
 that of a pitchfork, welted with something soft. This they 
 did for the sake of keeping their heads cool, which they sup- 
 posed strengthened their wits. 
 
72 
 
 SLEEP AND SLEEPLESSNESS. 
 
 The sentinel will sleep at his post ; an entire battalion 
 of cavalry have been known to sleep on the march. It 
 is about three or four o’clock in the morning that this pro- 
 pensity to sleep is the most overpowering, — the moment 
 seized upon by troops for driving in the enemy’s outposts, 
 and taking the bivouac by surprise. Maniacs are reported, 
 particularly in the eastern hemisphere, to become furiously 
 wakeful during the full of the moon, more especially when 
 the deteriorating ray of its polarized light is permitted to fall 
 into their apartments, — hence tjie name lunatics. Sleeping 
 directly in the moon’s rays is said to be at all times preju- 
 dicial. 
 
 There is certainly a greater proneness to disease dur- 
 ing sleep than in the waking state ; for those who pass 
 the night in malarious districts inevitably become infected 
 with the noxious air, while travellers who go through with- 
 out stopping escape the miasma. Intense cold induces 
 sleep, and they who perish in the snow sleep on till they 
 sleep the sleep of death. Children sleep a great deal ; 
 infants much more irregularly ; while the old man scarcely 
 slumbers at all, watching, as it were, his end approaching 
 The bromides of potassium, etc., are now greatly used to 
 drug the posset of repose in disease and nervous attacks. 
 Allowing the patient to get up and wash himself and walk 
 about his room, making his bed afresh, giving him a glass of 
 cold water, or wine and water, will often succeed in procur- 
 ing refreshing sleep when all other means have failed. These 
 are practical points calling for experience and judgment in 
 their application. In these instances of wakefulness, which 
 are frequently observed towards the close of acute diseases, it 
 is always necessary to repeat the soporific or opiate for some 
 time after the first symptoms have been checked. The same 
 practice is likewise pre-eminently useful in the first stage of 
 delirium tremens, in its congestive onset, before the sub- 
 
SLEEP AND SLEEPLESSNESS. 
 
 73 
 
 acute inflammation and milky effusion have ensued. The 
 irritability, watchfulness, and phantasmagoria of this peculiar 
 malady are best treated by a combination of bitters, alkalis, 
 and opiates, or else with tonics and opiates at the same time. 
 Sometimes hot sponges applied to the head will cause sleep, 
 and sometimes cold. Nothing will relieve the wakefulness 
 of old age ; nor should soporifics, particularly opium, ever # 
 be tried, since the dose that is sufficient to procure sleep, 
 may end in death. 
 
CHAPTER X. 
 
 EPILEPSY. 
 
 Those who have attended the lectures of Brown-Sequard, 
 the greatest living neurologist, well remember how he pro- 
 duced the convulsions of epilepsy in a guinea-pig. This will 
 illustrate the insight which is being obtained into the physi- 
 ology and pathology of the nervous system. Epilepsy is the 
 most celebrated of the neuroses. " It is,” says Hammond, 
 " characterized by paroxysms of more or less frequency 
 and severity, during which consciousness is lost, and which 
 may or may not be marked by slight spasm, or partial or gen- 
 eral convulsions, or mental aberration, or by all these circum- 
 stances collectively. The essential element of the epileptic 
 spasm is loss of consciousness.” Some very famous men 
 have been epileptics. There are slight paroxysms and 
 severe. 
 
 "The respiration is forced and irregular, froth issues 
 from the mouth, and, if the tongue has been bitten, it is 
 covered with blood.” During the seizure, the epilept is liable 
 to make the most outrageous and furious demonstrations. 
 Some of the greatest writers have been epileptics. One of 
 the greatest living British poets is said to be. Dr. Ham- 
 mond gives as causes of epilepsy in one hundred and two of 
 his cases, fright, anxiety, grief, over mental exertion, denti- 
 tion, indigestion, venereal excesses, menstrual derangement, 
 [ 74 ] 
 
EPILEPSY. 
 
 75 
 
 blows on the head, falls, sunstroke, scarlet fever, measles, 
 diphtheria, pregnancy, syphilis. The starting-point of epi- 
 lepsy, according to Brown-Sequard, is often the sympathetic 
 nerve ; but generally the seat of primary derangement is, 
 according to Reynolds, the medulla oblongata and upper 
 portion of the spinal cord. The derangement consists in a 
 perverted readiness of action in these organs, the result 
 of such action being the induction of spasm in the contractile 
 fibres of the vessels supplying the brain, and in those of the 
 muscles of the face, pharynx, larynx, respiratory apparatus, 
 and limbs generally. By contraction of the vessels the brain 
 is deprived of blood, and consciousness is arrested ; the face 
 is or may be deprived of blood, and there is pallor ; by con- 
 traction of the vessels, which have been mentioned, there 
 is arrest of respiration, the chest walls are fixed, and 
 the other phenomena of the first stage of the attack are 
 brought on. The arrest of breathing leads to the special 
 convulsions of asphyxia. The subsequent phenomena are 
 those of blood poisoned by the retention of carbonic acid, 
 and altered by the absence of a due amount of oxygen. It 
 may be induced by conditions acting upon the nervous centres 
 directly, such as mechanical injuries, overwork, insolation 
 (sunstroke), emotional disturbances, excessive venery, etc. 
 The bromides of potassium, lithium, and sodium, and the 
 oxide of zinc, are invaluable remedial agents in the treatment 
 of epilepsy. It was anciently called the falling sickness. 
 The importance of hygiene in this neurose is considered equal 
 if not superior to that of medicine. There are some prac- 
 titioners, even, who look upon medicine as utterly useless in 
 such cases, and place their sole reliance on such measures as 
 serve to guard the patients against the causes which induce 
 the fits, and favor the action of such natural agents as are 
 capable of changing the constitution. Hippocrates recom- 
 mended a change of climate. 
 
76 
 
 EPILEPSY. 
 
 Epileptic fits are much more common in extremes of heat 
 and cold than in a climate little subject to atmospheric 
 changes. Excess in quantity or quality of food or drink 
 will prove injurious. More vegetable than animal food 
 should be taken, and cooling fruits may also be used. 
 Complete abstinence from wine, or at any rate the use of 
 the least stimulant wines, is recommended, and such should 
 only be taken in moderation. Those patients who are liable 
 to be attacked during the night, should make but a light 
 supper, to avoid increasing the cerebral plethora, which is 
 always greater during sleep. Cleanliness, baths, frictions, 
 and warm clothing are requisite. The hair should be cut 
 short ; in bed the patient should lie with his head high, to 
 assist the circulation of the blood through the brain. Con- 
 stipation should be avoided. Continence is essentially the 
 virtue of the epileptic ; sexual intercourse produces a ner- 
 vous shock, which too closely resembles the emotion which 
 occasions the epileptic attack, not to be attended with great 
 danger. Those who practise onanism have in general the 
 greatest number of fits. A peaceable and quiet life suits the 
 epileptics best. Exercise is very salutary ; an inactive, 
 sedentary life increases the morbid predisposition, and ren- 
 ders the consequences of the fits more deplorable. 
 
 Gardening, horse exercise, the gymnasium, swimming, 
 etc., are recommended. But out-door work, such as agri- 
 culture and gardening, are the best exercises. Variety of 
 occupation, intermingled with amusing relaxations, will 
 prove serviceable in cases of epilepsy. Intellectual em- 
 ployment requiring deep thought is injurious. Beading, 
 drawing, music, light compositions, and the elements of 
 chemistry, botany, physics, etc., afford great satisfaction, 
 and sustain the moral powers instead of exhausting them. 
 With respect to the treatment during the fit, it resolves 
 itself almost entirely to the prevention of bodily danger by 
 
EPILEPSY. 
 
 77 
 
 falls or otherwise. The patient should generally be placed 
 on his back in bed, all tight articles of clothing removed, 
 the head a little raised by pillows, in order to diminish the 
 determination of blood to the head, and the body placed a 
 little on one side, in order to favor the discharge of saliva, 
 which collects in quantity in the mouth, and might otherwise 
 prevent the passage of air into the lungs. Some patients, 
 when attacked during the night, have an unfortunate ten- 
 dency to turn on the face, and unless carefully watched, and 
 their position changed, may die asphyxiated. Another acci- 
 dent, which occurs in some instances, is the laceration, or 
 even the amputation, of the tongue during the fit. To pre- 
 vent this, a piece of wood, or a linen roll, may be placed 
 between the teeth, when the fit is coming on. 
 
CHAPTER XI. 
 
 THE SUICIDAL PROPENSITY. 
 
 It is said that as long as the most instant and efficient 
 agents of self-destruction are openly sold in every street, at 
 little or no price, and to any purchaser, without either let or 
 hinderance, so long will suicides be frequent, and even, in- 
 crease. The victim of the more extreme forms of nervous 
 disorder, from whatever cause arising, undoubtedly feels at 
 times a propensity to suicide, even the valley of the shadow 
 of death seeming to him a refuge from the ills of a deranged 
 nervous system. The inventor of the revolver has probably 
 furnished to the suicidally given the most efficient means of 
 self-destruction. The writer was once talking, in his office, 
 with a patient suffering from nervousness, who was detailing 
 his misery and wretchedness, when, in the midst of his ac- 
 count of his condition, he suddenly drew a revolver, and put- 
 ting the muzzle to his head, said he had a mind to blow his 
 brains out on the spot. He had cocked the weapon, and the 
 least motion of his tremulous forefinger would have been 
 fatal. Here was a dilemma. With the utmost sang froid , 
 the writer pretended to be struck by some peculiarity of the 
 weapon, and quietly requested of his patient permission to ex- 
 amine it, at the same time expressing a wish to compare it with 
 a revolver belonging to himself, which was in a neighboring 
 closet. The weapon was politely handed over for examina- 
 [ 78 ] 
 
THE SUICIDAL PROPENSITY. 
 
 79 
 
 tion, which of course terminated the possibility of a tragedy 
 at that consultation. It is a fact that suicides are increasing 
 to an alarming extent in this country. The most influential 
 causes of suicide in a free, enterprising, commercial com- 
 munity like ours are the range given to the social passions ; 
 the hazard and losses in mercantile and joint-stock specula- 
 tions and companies ; habits of dissipation ; the indolence 
 and ennui consequent upon wealth and sated enjoyment ; 
 the importance attaching to public opinion, and the insta- 
 bility of that opinion ; the violent shocks and collisions of 
 opposing parties, and the details of crime and suicide which 
 constitute a principal part of the daily reading of all classes 
 of the community. The history of all nations has demon- 
 strated the prevalence of this act, both as a disease and a 
 psychological phenomenon, during periods of surpassing 
 luxury, of criminal debasement, of public commotion, and 
 of the decline of public and private spirit and virtue. 
 
 A French writer remarks that the high civilization and 
 refinement, the luxury, the clash of interests, the repeated 
 political changes, combine to keep the moral feelings of the 
 Parisians i:i a state of tension. Life does not roll on in a 
 peaceful and steady current, but rushes onward with the 
 force and precipitation of a torrent. The drama of life is 
 full of miscalculations, disappointments, disgusts, and de- 
 spair ; hence the numerous suicides. 
 
 'When a person labors under a suicidal mania, we believe 
 it may generally be recognized by other signs ; as. deep 
 melancholy, eccentricity of conduct, etc. Most of those 
 suicidally inclined labor under a constant depression of 
 spirits, presaging nothing but evil ; imagining that they 
 have committed some heinous offence ; that their fiends 
 have forsaken them, and are watching their movements ; 
 that they are hated and despised by the world ; they com- 
 plain of neglect ; become morose and taciturn ; utter bitter 
 
80 
 
 THE SUICIDAL PROPENSITY. 
 
 complaints ; weep ; say they have committed the unpar- 
 donable sin ; that their damnation is inevitable, etc. More 
 or less bodily derangement is usually present in these 
 cases, as a weak and irritable nervous system, quickened 
 circulation, imperfect digestion, and especially derange- 
 ment of the liver or hepatic function. After this state 
 has continued for some time, the mental derangement be- 
 comes more prominent, and the wretched victim begins 
 to see visions and to hear strange voices, and believes that 
 he has communications from superior beings. At this 
 time the idea of self-destruction is frequently if not con- 
 stantly before the mind, and unless the patient be narrowly 
 watched, he will finally succeed, after various attempts, in 
 accomplishing his purpose. Suicides are most frequent 
 among persons of the melancholy temperament and bilious 
 constitution, with a pale or sallow or yellowish complexion, 
 and hard or sharp features. But the suicidal act is not 
 infrequently committed by the nervous and irritable, and 
 even by the sanguine and plethoric. Females of this latter 
 constitution occasionally attempt or perpetrate self-murder 
 just before or during the catamenia, or from some irregu- 
 larity of this evacuation. M. Esquirol states, that the scrof- 
 ulous diathesis is remarkable in the number of suicides. 
 Both sexes display the suicidal tendency, but the male sex 
 most frequently. M. Esquirol considers the proportion of 
 males to females to be three to one ; but there are differ- 
 ences, according to countries, arising from the greater or less 
 influence of many of the circumstances shown to favor this 
 act. Thus in France there are more suicides among women 
 than in Germany. It has been observed, both in England 
 and <^i the continent, that nearly two thirds of suicides were 
 unmarried. This state, therefore, is much more favorable 
 to self-destruction than the married condition. Suicides in 
 states of mania or delirium occur either from some .involun- 
 
THE SUICIDAL PROPENSITY. 
 
 81 
 
 tary or blind impulse, or from some delusion, hallucination, 
 or false perception. A patient for whom I was consulted 
 during an attack of mania, from which he recovered, expe- 
 rienced after a time similar symptoms to those which ushered 
 in the former attack. His friends were directed to take the 
 necessary precautions regarding him ; but these he eluded, 
 and committed suicide. In melancholia, and other states of 
 partial insanity, or even previously to any symptoms of in- 
 sanity being sufficiently prominent to attract notice, or in 
 consequence of some mental shock or perturbation, the pa- 
 tient may conceive that an internal voice calls upon him to 
 commit suicide, and may sometime act in conformity with 
 it. A lady consulted me on account of headache, during 
 which she could not look upon a knife without experiencing 
 a strong desire to use it against her own life ; but her reason 
 had always resisted the impulse, which disappeared after 
 treatment. Among persons who have been but little accus- 
 tomed to self-control, or to listen to the dictates of moral 
 principles, such impulses are often soon acted upon. M. 
 Esquirol furnishes several instances. 
 
 A monomaniac, he states, heard a voice within him say, 
 " Kill thyself ! kill thyself ! ” and he immediately obeyed the 
 injunction. This writer remarks, that he has never known 
 an instance of suicide from an irresistible impulse, without 
 some secret grievances, real or imaginary, serving as motives 
 to the suicidal propensity. There are few states of partial 
 insanity that may not be attended or followed by this pro- 
 pensity. Of the delusions which characterize melancholia, 
 there are none more productive of self-destruction, as Dr. 
 Darwin has remarked, than the fear of future damnation 
 and of present poverty, although the former apprehension 
 grows less and less operative from the softening of the penal 
 parts of religious creeds. Reverses, mortified pride, impa- 
 tience under misfortune, and disappointments, are frequent 
 causes of suicide, especially in commercial countries and 
 
82 
 
 THE SUICIDAL PROPENSITY. 
 
 under free governments, where there is a constant straining, 
 among almost all classes, after wealth, office, and other direct 
 or indirect means of power. Instances of self-destruction 
 from mortified pride, consequent upon the failure of attempts 
 at becoming conspicuous at public meetings, in the senate, 
 or at the bar, or even upon the boards qf a theatre, are not 
 rare in modern times. Self-murder has been often perpe- 
 trated in order to escape exposure and punishment conse- 
 quent upon detected crimes. Indeed, this is one of the most 
 common moral causes of suicide in this and other civilized 
 countries, and instances of it are of daily occurrence. The 
 desire of escaping from moral or physical pain, or from an- 
 ticipated or impending want, is not unfrequently productive 
 of self-destruction. Under this head may be comprehended 
 seduction, and despair however produced. Physical pain is 
 much less frequently a cause of suicide than moral suffering. 
 Many, however, of the ancient stoics put an end to pain by 
 terminating their lives. I have been told by several persons 
 that, while suffering the pangs of neuralgia, it required the 
 utmost efforts of their moral principles to restrain them from 
 perpetrating self-murder. Numerous instances are on record 
 of persons who, having believed themselves suffering incur- 
 able maladies, have had recourse to suicide as a more pleas- 
 ant mode of dying, the act being committed under the 
 impression that a natural death is more painful than that in- 
 flicted by themselves. But this is a mistake. Death from 
 disease, even when the mental faculties are retained to nearly 
 the last, is attended by a gradual abolition of the sensibility 
 that is by no means painful or distressing ; the patient ceas- 
 ing to exist as hopefully and calmly as when falling asleep, 
 unless under peculiar circumstances. Suicide is often com- 
 mitted in states of irritation and chagrin, particularly by per- 
 sons of a morose, splenetic, or irritable temper. It is some- 
 times suggested to such persons by a desire to excite regrets 
 
THE SUICIDAL PROPENSITY. 
 
 83 
 
 or self-reproach in the minds of those who have offended 
 them by a feeling of revenge. Most of the suicides com- 
 mitted by children are caused by a desire of this kind, par- 
 ticularly when they follow punishment of any description. 
 Suicide arising from jealousy also depends chiefly upon the 
 promptings of this feeling in connection with anger, and is 
 most apt to occur in hysterical, nervous, or weak-minded 
 females. 
 
 Some years ago I was present at an evening party, where 
 a young lady, engaged to a gentleman present, was seized 
 with hysterical convulsions in consequence of his attentions 
 to another. The following day she was taken out of a canal 
 in her full dress, she having gone upwards of a mile in order 
 to carry her design into execution. A lady on a similar 
 occasion took a large quantity of laudanum. The usual 
 means of restoration producing no effect, I was ultimately 
 sent for. She was finally recovered by the effusion of cold 
 water on her head. Domestic contrarieties and misery ; 
 the frequent recurrence of petty vexations ; the tyranny of 
 intimate connections, and the positive ill-usage of others ; 
 suits in courts (misnamed) of justice may from their continu- 
 ance, severity, and repetition, especially under aggravating 
 circumstances, and in states of high susceptibility in the 
 unhappy sufferer, drive even the strong-minded and the well- 
 principled into a state of temporary despair and desperation, 
 — may fire the brain to madness, during which self-destruc- 
 tion may be attempted. A most talented and accomplished 
 young lady, suffering from a combination of the above cir- 
 cumstances, took, upon retiring to rest, a very large quantity 
 of laudanum, more than is usually productive of a fatal 
 effect. She wakened late the following day with a most dis- 
 tracting headache and general disorder, recollected the* act 
 of the previous night, regretted the attempt, and sent for 
 medical aid, determined, however, to conceal the cause. Her 
 
84 
 
 THE SUICIDAL PROPENSITY. 
 
 health from this, and other circumstances alluded to, con- 
 tinued greatly impaired for many years, and several physi- 
 cians were consulted. She came under my care, and at last 
 mentioned the suicidal attempt, which was never further 
 divulged. She now continues in good health, to ornament 
 the society in which she moves. The state of desperation 
 into which a person inflamed by the passion of love may be 
 thrown by disappointment, is actually that of insanity, at 
 least moral insanity. A gentleman endeavored to obtain 
 the favorable notice of a lady, of whom he had become 
 enamored, but had not succeeded. He committed suicide by 
 opening a vein in his arm, and, while the blood was flowing, 
 he wrote a note with it, acquainting her with his act. She 
 was soon after attacked by nervous fever, which was fol- 
 lowed by insanity, during which she fancied that she heard a 
 voice commanding her to commit suicide. Instances of 
 associated suicide are not rare, particularly in recent times. 
 
 A wide publicity was not long ago given to the mutual 
 suicide of two young girls at Lewiston, Maine, by drowning. 
 Not unfrequently one of the parties who have agreed to 
 commit suicide, only pretends to do it, with the intention of 
 getting rid of an object no longer one of endearment. Mur- 
 der is often committed first, and suicide afterward, prompted 
 by jealousy. Suicide is often feigned or simulated with a view 
 of obtaining a desired end ; the lover threatens or seems to 
 attempt it, to induce a return of affection ; the spoiled child, 
 to obtain a compliance with his wishes ; and the indulged 
 wife, submission to her caprices. In such cases but a small 
 portion of laudanum is usually procured, and this is diluted 
 with some fluid, to increase the apparent quantity, or a large 
 quantity is taken when seen by some person, or when instant 
 relief may be obtained. Females have resorted to this plan 
 to try the affection, or to compel the fulfilment of the en- 
 gagement of their lovers ; but in cases of this kind, little 
 
THE SUICIDAL PROPENSITY. 
 
 85 
 
 more is necessary to be known than that such acts are some- 
 times resorted to ; and that a poisonous dose may be actually 
 taken, in order to appear the more in earnest, knowing that 
 assistance is near, and that it will be successfully employed. 
 
 Drowning even may be feigned in similar circumstances. 
 I have, however, seen two cases in which fatal results very 
 nearly followed this experiment upon the endurance of affec- 
 tion. Circumstances predisposing to suicide are hereditary 
 predisposition (Dr. Gall has observed the suicidal predis- 
 position in several successive generations, I have known it 
 in three generations) ; the melancholic, bilious, and irritable 
 temperaments ; the middle period of life ; the unmarried 
 state ; masturbation and sexual excesses ; drunkenness ; 
 immoral amusements and exhibitions ; the perusal of loose 
 productions and of criminal and suicidal details ; idleness 
 and indolence ; habitual recourse to powerful mental excite- 
 ment ; states of the air or of the weather, occasioning depres- 
 sion of the nervous energy ; disappointed love ; jealousy ; 
 gambling ; poverty ; fanaticism ; debt and domestic trouble ; 
 disgust of life ; religious excitement ; matrimonial strife ; 
 disease and pain ; crime and remorse. It is well known that 
 many philosophers and distinguished writers have attempted 
 to defend suicide under certain circumstances, oft the ground 
 that he to whom life has become a misery and burden, has a 
 risrht to rid himself of it. 
 
 A French writer on the subject of suicide, dogmatically 
 announces that " Suicide is the last term, the highest expres- 
 sions of man’s liberty ! Why have not animals ever con- 
 ceived suicide ? ” he asks. " Because their nature is every 
 way passive. They have not the choice and the preference. 
 Man, on the contrary, eminently active and free, has been 
 able to push his activity even to the destruction of himself.” 
 But this is an old idea of the Roman writer Pliny. " Indeed,” 
 says Pliny, "this constitutes the great comfort in this imper- 
 
86 
 
 THE SUICIDAL PROPENSITY. 
 
 feet state of man, that even the Deity cannot do everything. 
 For he cannot procure death for himself, even if he wished it, 
 which, so numerous are the evils of life, has been granted to 
 man as a chief good.” Let us have a care. We have apolo- 
 gists for suicide even now, and upholders of it, and the pre- 
 scriptions of both the law and the gospel in reference to it 
 are in a great measure unheeded. This is not a had starting- 
 point and groundwork in favor of a reactionary movement, 
 sympathetic of suicide ; and if we do not take heed, we shall 
 have our young men and maidens looking upon the deed as 
 a matter of feeling, and not of morality, while sympathy for 
 the self-destroyer would find an outlet in song. Would you 
 have an example of the song ? 
 
 “Then hie thee to the rope-yard, boy, 
 
 And purchase me a cord ; 
 
 Ride slowly home and give it me, 
 
 But do not speak a word.” 
 
 The frequency of suicides varies at different ages. Dur- 
 ing the early epochs of existence, the sanguine expectations, 
 which are generally indulged, and which soon take the place 
 of temporary despondency and distraction occasioned by dis- 
 appointments and losses, tend to diminish the number of sui- 
 cides. ‘ ' 
 
 In the middle and more advanced period of life, sensibility 
 becomes exhausted or blunted, while cares and anxieties 
 increase i:i number and intensity ; and the attachment to 
 life is much impaired. The desire of life afterward increases, 
 and frequently in proportion as old age advances. It is 
 from thirty-five to forty-five that the greatest number of sui- 
 cides occur. After forty-five suicide becomes more and more 
 rare ; and above seventy there are scarcely any instances of it. 
 
 It is difficult to obtain the actual statistics of suicide in a 
 given city or community, as many cases are undoubtedly 
 reported under other heads, as " sudden,” " apoplexy,” etc. 
 
THE SUICIDAL PROPENSITY. 87 
 
 In a work on Nervous Affections and Nervous Disorders, 
 it was impossible to overlook the momentous subject of sui- 
 cide, as nervous depression, and general or partial or mo- 
 mentary insanity, always precede the dread act of self- 
 destruction. There is usually cerebral disorder connected 
 with it. The increasing frequency of suicide, as well as of 
 manifest insanity, forces it upon the attention of all practi- 
 tioners who make nervous diseases a specialty and study. 
 Of course, so far as suicide is a product of vicious states of 
 society, it is beyond the power of the physician. But the 
 nervous condition which leads to it is curable by the pow- 
 erful remedial agents which have been added to the Materia 
 Medica within the last decade, and which enable the skilful 
 special practitioner to minister to a mind diseased, and restore 
 the equilibrium of the most disordered and demoralized ner- 
 vous system. In a young and hopeful community like our 
 own, where " there is no shadow, no antiquity, no mystery, 
 no picturesque and gloomy wrong, nor anything but a com- 
 monplace prosperity,” suicide ought to be rare. But it 
 unfortunately is not. Our people are beyond all others a 
 nervous, and therefore, under the pressure of great mental 
 excitement, a desperate people. Nowhere else is there such 
 a desperate and reckless pursuit of gain. It is to the ner- 
 vousness of our people that the frequency of suicide with us 
 is to be attributed. Of the hopeless and appalling poverty 
 which characterizes the dense communities of the Old W orld 
 we know but little. But our morbid passion for excitement, 
 our disposition to stake everything upon a single throw, the 
 frequency of our contested elections, and the personal and 
 exciting character of our political contests, all contribute to 
 demoralize the nervous system, and overturn the equilibrium 
 of the brain. Add to this the variety of foods, and the 
 hurry of eating, which lead to dyspepsia, — a disease which at 
 middle age causes low spirits, listlessness, and tedium vitce, 
 
88 
 
 THE SUICIDAL PROPENSITY. 
 
 or disgust of life, the very disposition of mind which leads 
 directly to suicide. The suicidal propensity is almost always 
 the result and accompaniment of nervous disorder and cere- 
 bral disease. If the medical adviser of one suicidally given 
 has the medical means of dealing effectively and promptly 
 with nervous disease in all its manifold gloomy and despair- 
 ing forms, he can restore his patient to cheerfulness and 
 health, and to that love of life which is so natural to the 
 healthy man or woman in a normal condition. It is need- 
 less for the writer to say that in his markedly successful 
 combats with nervous disease in all its forms and in thousands 
 of patients he has utterly ignored the old-fashioned treatment, 
 which consisted of local vascular depletion (bleeding) , dry 
 cupping, setons, blisters, repeated blood-lettings in the im- 
 mediate vicinity of the brain, etc. He cures mental and 
 nervous maladies by a different mothod, and by a remedy the 
 result of a more advanced medical knowledge, than that 
 which dictates such coarse and sanguinary attempts at heal- 
 ing a disordered mind and unstrung nerves. That his rem- 
 edy while simple is sure, prompt, and decisive in its action, 
 hosts of those who owe their restoration to health, business, 
 and society will testify. 
 
CHAPTER XII. 
 
 TREATMENT OF THE INSANE. 
 
 The most important question in psychological medicine 
 and mental pathology, is concerning the treatment of the 
 insane . Volumes have within a few years been written on 
 this subject in all the languages of the civilized world, and 
 the discussion still goes on. A writer on this subject says : 
 " I doubt if ever the history of the world, or the experience 
 of past ages, would show a larger amount of insanity than 
 that of the present day. It seems, indeed, as if the world 
 was moving at an advanced rate of speed proportioned to its 
 approaching end ; as though in this rapid race of time, in- 
 creasing with each revolving century, a higher pressure is 
 engendered in the minds of men, and with this there appears 
 a tendency among all classes constantly to demand higher 
 standards of intellectual attainment, a faster speed of intel- 
 lectual travelling, greater forces, and larger means than are 
 consistent with reason and health It is a matter of no slight 
 difficulty to determine, in all cases, the primary or predis- 
 posing cause of mental disorders, apart from an hereditary 
 taint existing in the constitution, and where there is no posi- 
 tive mental deficiency from birth ; for it is only too probable 
 that from a much earlier period than the actual manifestation 
 of disease, the fuel has been laid; and it therefore becomes a 
 matter of grave consideration for those who may have the 
 
 [ 89 ] 
 
90 
 
 TREATMENT OF THE INSANE. 
 
 power vested in their hands, not so much for the cure, hut, 
 which is of far greater import, the prevention of disease, that 
 many carry about with them unsuspected, perhaps, through 
 a long life-time the seeds of insanity. There is a fearful 
 balance of minds wholly free from inherited taint or consti- 
 tutional infirmity, and yet doomed to break down in the 
 terrible struggle of the age. 
 
 Insanity visits all classes of society alike, with an impar- 
 tiality like that of death. The amplest means of earthly 
 enjoyment will not purchase exemption from it. Indeed, it 
 often happens that an hereditary mental taint descends as a 
 curse with hereditary wealth and high social position. Fail- 
 ure of health, pecuniary embarrassments, over anxiety, too 
 great application to business, etc.-, are among the ordinary 
 recruiting sergeants, so to speak, of the ranks of mental 
 darkness and imbecility. Causes of insanity are not far to 
 seek among those, for instance, who earn their bread by the 
 sweat of their brow ; whose lives are a continual struggle, 
 whose daily toils are unmitigated by pleasure, to whom each 
 morrow brings fresh cares, and night scarce brings repose. 
 The hard-worked professional man, who spends his days in 
 painful efforts to make two ends meet ; the avaricious man 
 of commerce, only aiming to double his gains and grind fresh 
 profits from his wares ; the speculating capitalist, eager to 
 lay out his treasure in the best market ; the adventurous mer- 
 chant, whose temple is the counting-house. What a restless 
 sea ! What troubled waves of thought and care rise up even 
 within this single catalogue of callings ! But look we 
 further ; observe the young of all classes, with what sui- 
 cidal frenzy they commit themselves to sorrow. Whether 
 in obedience to the promptings of high ambition, weaving 
 an entanglement of thought, and straining the sinews of the 
 mind in attempting to achieve the gain of riper years, and to 
 wrest the victory ere the battle has begun; or else, led 
 
TREATMENT OF THE INSANE. 
 
 91 
 
 spell-bound by passion, the powers and resources of youth 
 are squandered in the bed of the voluptuary ; sin sinking 
 into the heart with all its accursed stains, polluting the foun- 
 tains of reason at their source, and embittering the springs 
 of life. Do we not find here predisposing causes with a ven- 
 geance, borne it may be long, but only waiting for the spark 
 to fall? 
 
 The tendency of dissolute habits towards inducing aberra- 
 tion of mind need not be dwelt upon. If prolonged habits 
 of dissipation frequently predispose towards insanity, fits 
 of intemperance prove not seldom the immediate exciting 
 cause. Intemperance is indeed a fertile source of insanity. 
 The prevailing superstitions of the day — spirit-rapping, 
 table-turning, etc. — exercise their baneful influence on sus- 
 ceptible minds. These are rocks in the fathomless sea of 
 mysticism, on which many an empty head has split, and 
 many a shallow mind been stranded. 
 
 But to our more immediate subject, the treatment of the in- 
 sane. Among the multitudinous works and periodical essays 
 on this momentous subject, with which the press has labored 
 of late, the writer is happy to refer to an American book, with 
 the significant title, "Behind the Bars,” as containing, upon 
 the whole, not only the latest but the best word upon the ques- 
 tion under consideration. The author of this most searching 
 and interesting exposition of the faults of the present system 
 of treatment of the insane, apparently writes from his or her 
 own experience as a patient. But the criticism of a vicious 
 system is tinctured with no harshness for that reason. In- 
 deed, I understand that this little book has already produced 
 a decided amelioration and revolution in the mode of treat- 
 ment in our own immediate asylums. I cannot do better than 
 to make several extracts in extenso from this work. Says this 
 writer : " If these nervous diseases must be treated by some 
 systematic form, surely no suitable progress has yet been 
 
92 
 
 TREATMENT OF THE INSANE. 
 
 made towards it, and no steps taken which are sufficient in 
 conformity with all that it seems to require. Many afflicted 
 with nervous diseases would shrink from the very name of 
 an insane asylum, or any retreat with so professional and 
 formidable a sound, yet who would gladly avail themselves 
 of some sort of refuge, some temporary home ( which asy- 
 lums are not ) , where they might escape for a time the cares 
 and toils of business, the excitements of society and pleasure, 
 or the trials of domestic life. 
 
 In England, insanity is regarded in a very different light 
 from the way it is looked upon in this country. There it is 
 made to appear as a disgrace or stigma of society or fami- 
 lies, and thought next to crime itself. There is an evidence 
 of inborn ignorance of the subject out of which all should 
 be educated. Here, we believe, there is no crime (hap- 
 pily for us) in misfortune, and it is only where it can be 
 traced to absolute vicious courses that there can exist any 
 disgrace. It is easy to understand how persons may shrink 
 from the very suggestion of asylums, either for friends or 
 kindred, for there is natural horror in removing a beloved 
 friend or relative from the home, from family or society, 
 from independent situations, free to act and do as they 
 please, and subjecting them like children to the rule and 
 government of strangers, and depriving them of nature’s 
 dearest boon — liberty.” . . . " As regards the patient him- 
 self, except in extreme cases of violent mania, never ought 
 the asylum to be experimented with.” That is good, sound 
 doctrine. 
 
 The writer proceeds : " There is nothing more sincerely to 
 be desired than the establishment of some proper sort of 
 home or retreat, or whatever it may be called, for the con- 
 cern and care, if not for any deliberate course of treatment, 
 of nervous diseases.” (The writer seems not to have been 
 aware of the existence of the Peabody Medical Institute, an 
 
TREATMENT OF THE INSANE. 
 
 93 
 
 establishment, one of whose specialties is the treatment of 
 nervous diseases, not by any crushing system of restraint and 
 utter seclusion, but by methods and remedies, kindly, sooth- 
 ing, and efficient.) The Institute, indeed, is exactly the 
 " place ” which the writer of " Behind the Bars ” desiderates, 
 "where the patient might act himself, and without opposi- 
 tion to natural tastes or positive restraint ; where he might 
 be indirectly watched and cared for ; where the development 
 of the disease may go on, or where it may be gently checked 
 by some suitable regimen.” 
 
 Well may this writer say that " although much has been 
 done of late years towards the amelioration of the treatment 
 of the insane, yet it has not yet reached that perfection to 
 which modern science, cultivation, and good sense should 
 elevate it.” This is too true in the case of the management 
 of public asylums, which are the chief and great receptacles 
 of the unhappy victims of nervous disease and insanity ; but 
 there are solitary practitioners here and there, as in the case 
 of the managers of the Peabody Institute, who have sum- 
 moned to the treatment of nervous derangement, of all de- 
 grees and names, all the resources of " modern science, 
 cultivation, and good sense,” with a grand result of cures, 
 which show what can be done for the amelioration of the 
 woes of humanity, when the ruts of vicious usage and rou- 
 tine are abandoned, and reason and common-sense are left 
 free to act. 
 
 "That the plan adopted for years past in our insane 
 asylums is wrong,” says the writer from whom I am quoting, 
 " cannot be doubted by any intelligent being who has seen 
 the victims of such a system, and witnessed the very instru- 
 ments of torture applied to the persons of the patients, 
 brought to operate, as they are, upon the harmless and gen- 
 tle, as well as the most violent.” "Are the patients of the 
 insane asylums treated kindly ? ” " The interest which sur- 
 
94 
 
 TREATMENT OF THE INSANE. 
 
 rounds tills question,” says the writer of " Behind the Bars,” 
 "and the anxiety to learn something definite of a subject 
 which the regulations of a system keep hid from their eyes, 
 often lead persons to take long journeys to see some un- 
 known patient released from an asylum, or are the impetus 
 to some confidential correspondence, often full of anxious 
 misgiving or bitter experiences.” "That the upholders of a 
 course of personal restraints do not mean to be cruel, and 
 that they believe their way the best for the patient, may be 
 charitably believed. . . . They believe in tying up the 
 
 body, that they may disenthral the mind. Are they not 
 slugs in an age of universal activity and progression, while 
 they cling fast to the old theories, and refuse to adopt the 
 new ? W ere the non-restraint system established throughout 
 our asylums, we should behold those patients who are so for- 
 tunate as to obtain their release in a far different aspect. 
 They would not still bear the marks about the world of the 
 fetters they had worn. Young girls who had entered there 
 at the age of development would not return changed in form, 
 bent, shrunken, and sometimes crippled. It is fearful to wit- 
 ness the shapes of these young persons in asylums, who are 
 subjected, if not daily, always nightly, to the 'rough strait- 
 waistcoats, tightly pressed against the chest, so as to prevent 
 all expansion, and giving to them the figures of very infirm 
 old women, rather than the fulness and shapeliness of youth 
 and health. . . > Why is it that the non-restraint Sys- 
 
 tem has not been adopted in our best asylums ? Why is it 
 that the experiment is not made of doing away with these 
 implements of torture? The answer from medical science 
 will be, that they are done away with ; that the chains and 
 irons and rings and fetters, belonging to past treatment of 
 the insane, have disappeared.* But are not the strait- 
 
 * Ransack history : the insane anciently were objects of buffoonery, or 
 burnt as being guilty of sorcery. Later, they were abandoned, and they 
 
TREATMENT OF TIIE INSANE. 
 
 95 
 
 waistcoats, the bed-straps, the leathers, the buckles, the 
 chairs, all in common use? Are not ladies fitted to these 
 waistcoats month after month, as though it were a legitimate 
 night-dress ? Whoever has passed any time in the asylum 
 will see plainly why these appliances are still kept up. 
 They save trouble. They save the employment of more at- 
 tendants, and they save trouble to those already employed. 
 Thus, the physicians say, they save attendants. The attend- 
 ant says, they save my time. How simple, upon looking at a 
 prospective project of reform in asylum life, seems to be the 
 alternative, — to do away with the troublesome accessories, 
 conjured up by force, and to rely upon moral safeguards 
 and persuasive strongholds, which come from and aim at the 
 heart and human sympathy, which the patient though dis- 
 eased is still supposed to possess, and be capable of awaken- 
 ing to and profiting by ! No non-restraint system can be 
 adopted without a vast change in the machinery of the old 
 management, and by breaking down the tyranny, and substi- 
 tuting a species of imaginary absolute freedom.” This writer 
 gives a bad account of the attendants in our lunatic asylums, 
 of the jeering and cruel manner in which they treat their 
 unfortunate charges. Indeed, she defines a lunatic asylum 
 to be a place where insanity is made, manufactories of mad- 
 ness rather than healers. "Take an instance,” she says ; "a 
 young woman from one of our country towns appears on a 
 certain day upon one of the best galleries. She is bright, 
 intelligent, and active, suggesting always the idea to the mind 
 of the beholder, that if educated she would have been rather 
 an uncommon person. She is lively, brisk, amusing, busies 
 herself at her needle or the care of her room, in which she is 
 
 perished for want of care in hideous prisons. The Turks still maltreat 
 their insane. In 1790 a law was passed in France, providing for the con- 
 finement of furious lunatics, and mischievous and ferocious wild beasts, 
 classing the insane with brutes. 
 
96 
 
 TREATMENT OF THE INSANE. 
 
 scrupulously neat. She not only performs these acts for her- 
 self, but she visits the rooms of the other patients, and im- 
 provises little reforms to be made in their clothing, offering 
 to mend or make garments for them, and 'fix them up ’ gen- 
 erally. Of course this sort of interference does not fall to 
 her requirement in the asylum. She must not direct, but be 
 directed. She is an intruder, agitating the patients with 
 outside influences and the like. Moreover she is very lively, 
 and talks a great deal, — so the attendants say ; too much, say 
 the physicians ; and so she must be moved to a less quiet and 
 comfortable gallery. They take her away. But where ? To a 
 wing of the building so different, that there is not even one 
 patient with whom she can have a sympathetic look. They are 
 idiotic, apathetic, cataleptic : all far, far wide of reason, incapa- 
 ble of talking, excepting babble, or even of apprehension. Let 
 the reader imagine for himself, let his own opinion determine 
 what the sanitary influence of society like this might have 
 upon a person of lively mind, however disturbed, during the 
 course of weeks and months. A year afterwards, the writer 
 again had an opportunity of beholding this patient, for whom 
 much interest had been felt. But what an object ! What a 
 contradiction of her former self was the unfortunate changed 
 to ! Her face looked as though stamped by imbecility. Her 
 lips moved to utter only incoherent jargon. Her eyes, which 
 had been bright and intelligently lighted, were like dead 
 eyes, and she was in no respect unfit for the gallery to 
 which they had confined her.” . . . What a system that 
 would be to practise, if, instead of this, patients were by 
 some charm of cunning made to feel that they were roam- 
 ing quite at large ; that they were not in a place of deten- 
 tion ; that they were free to go and come ; and yet all the 
 while, physicians and attendants, under these illusory 
 devices, were having it all their own way, though impercep- 
 tibly to their patients ! 
 
TREATMENT OF THE INSANE. 
 
 97 
 
 "A system of this sort would be worth inventing, and 
 would bring honor to the inventor, because depending upon 
 moral and higher elements than anklets for the feet and straps 
 for the discontented body. For it is certain, that just for 
 the reason that these patients know that they are confined, 
 know they cannot go home, know they may not see a friend 
 or relative, it is that they are so miserable. . , . It is amaz- 
 ing how the sense of liberty and the right of volition can 
 affect violent insane patients. Under bonds and restrictions 
 they conjure up all sorts of desperate and terrible things 
 which they would do were liberty allowed them. . . . But 
 untie their hands, take them out, unbar the door, tell them 
 they are free, — and what then? Are they very quick to 
 cut off by violent acts the apprehension and enjoyment of 
 this new-born blessing — liberty ? Not one of them would 
 do an act of harm to himself. . . . One patient who wore day 
 and night the strait-waistcoat, was perpetually imploring 
 that she might just be allowed (a delicate favor) to fling 
 herself upon the railway track, and end all by the coming 
 train. When she was permitted to go out unbound, her 
 chief fear of the world outside seemed to be, the danger 
 suggested by the sight of a locomotive.” I would gladly 
 quote more from this most interesting writer, because his or 
 her statements are those of an expert, who has fortunately 
 recovered the full sovereignty of reason, as the book from 
 which I have been quoting amply testifies on every page. 
 Such testimony is invaluable. I will boldly affirm that the 
 test of the civilization of a given community is the degree 
 of science, and even of charity, with which the insane are 
 treated in that community. Notwithstanding that statistics 
 show, during the last ten years, an increase in the number 
 of the insane, still I affirm that in proportion as true civil- 
 ization shall advance, insanity will diminish its ravages in 
 society. 
 
98 
 
 TREATMENT OF THE INSANE. 
 
 Our principal lunatic asylums are on too monstrous a scale, 
 and there is such a host of patients in them as to render it 
 impossible that each particular case can receive proper atten- 
 tion. Were the writer to establish a lunatic asylum strictly 
 so called, he should by all means establish it in the country, 
 because it is there only that the family life can be realized 
 suitably for the insane, who need air and space to act with- 
 out danger to any one, and especially to be removed from 
 the circumstances which surrounded the onset of this disease. 
 Such an establishment would be a therapeutical centre, which 
 would have a farm as a subsidiary establishment. The rich 
 would find diversion, and the poor work in the fields. The 
 air of the fields, as says one of the princes of science, Hum- 
 boldt, is the first and best therapeutical agent. The simple 
 contact of man with nature, that influence of open air, — or 
 in a more beautiful expression, of free air , — exert a sooth- 
 ing power. They soften pain , and they allay the passions , 
 when the soul is agitated in its utmost depths. At Gheel, 
 in the northeastern portion of Belgium, the insane are col- 
 onized. In this place is the church of St. Dympna, whose 
 intercession in the Middle Ages was supposed to cure luna- 
 tics, who were brought hither in great numbers. The taber- 
 nacle containing the saint’s bones stands on four stone 
 pillars behind the altar, so as thus to form a passage about 
 three feet in height, through which lunatics, brought here for 
 cure, were accustomed to pass on their knees. 
 
 The insane colony of Gheel cannot be here described at 
 length. Some idea of it can be obtained from the account 
 of a visitor : "When perambulating the various hamlets vis- 
 ited,” he writes, " often through pretty but devious path- 
 ways, we frequently noticed lunatics occupied, as agricultural 
 laborers in adjoining fields ; whilst some were quietly walk- 
 ing to or from neighboring cottages, quite as tranquilly as 
 ourselves. Being all acquainted with the inspecting phy- 
 
TREATMENT OF THE INSANE. 
 
 99 
 
 sician, these parties saluted him respectfully, and often 
 conversed with us familiarly ; in short, they behaved like 
 ordinary peasants, or any rational person. We saw others 
 sitting at the cottage doors, and some looking out of win- 
 dows ; while several were amusing themselves with children 
 of the family, in adjoining gardens or enclosures. In one 
 of the public roads we met a maniac who lived in a cottage 
 at some distance, then carrying an infant in his arms like 
 any nurse. He seemed to take great care of his innocent 
 charge ; and the physician remarked that such an occupation 
 constituted this lunatic’s chief enjoyment. Afterwards we 
 encountered another insane resident — a young man — amus- 
 ing himself with three little children, romping with them, 
 and at the same time taking care that they did no harm. 
 In a solitary lane, we next came up with a patient, who 
 was being conducted homeward to dinner by the juvenile 
 daughter of his host, after laboring in an adjacent field. In 
 various other instances, we observed insane persons saunter- 
 ing about, and some also going towards or returning from 
 neighboring farm-houses. In truth, had it not been for the 
 vacant-looking countenances noticed in most cases, and occa- 
 sionally that their legs were loosely tied together by leathern 
 thongs, so as to prevent the wearers from running fast 
 or going to any distance, I should scarcely have recog- 
 nized many of the parties then enjoying themselves, while 
 breathing the pure and open air of heaven, as real lunatics 
 residing in the Gheelois commune. Within the houses and 
 cottages we inspected, many insane residents were occupied 
 as ordinary servants ; some superintending cows, churning, 
 laboring in the barn, cooking food, cleaning the house, rock- 
 ing the cradle, and taking care of the cradle ; in short, em- 
 ployed in much the same way as they might have been at 
 home, or out at service. Various male patients, again, were 
 laboring in the gardens or fields ; others working in carpen- 
 
100 
 
 TREATMENT OF THE INSANE. 
 
 ters’ shops, also smithies, stable and farm yards ; besides 
 being engaged in such out-door employments as are common 
 amongst any agricultural population ; these occupations hav- 
 ing this very great advantage for lunatics, that whilst under- 
 going physical exertion — often so beneficial for their mental 
 malady — they, at the same time, are much in the open air, 
 breathe a purer and more salubrious atmosphere than most 
 inmates of wards, day-rooms, or frequently too confined 
 workshops, can enjoy in northern asylums. In several 
 houses, we also observed female lunatics comfortably sitting 
 with their hostess at table, knitting, sewing, making clothes, 
 and conversing as if equals, friends on a visit, or relatives. 
 Such spectacles were truly pleasing ; and when looking out 
 of the cottage windows, near such parties, upon sometimes 
 a pretty flower-garden, or towards open green fields, stran- 
 gers could hence scarcely suppose, from outward appear- 
 ances and surrounding circumstances, they were then visiting 
 the chamber of an insane occupant, afflicted most likely 
 with incurable mental alienation.” What a contrast have 
 we here to the hideous, strait-waistcoat, close-confinement, 
 restrictive system of our great, crowded lunatic asylums ! 
 
CHAPTER XIII. 
 
 URINARY ANALYSIS, AS A DETECTIVE OF DISEASE. 
 
 As a means of facilitating diagnosis or discrimination of 
 disease, I wish most strongly to inculcate the necessity of 
 analyzing urine ; and I feel satisfied from very extensive 
 experience, that if this were more generally attended to, that 
 diversity of opinion which now so unhappily prevails would 
 no longer exist, nor should we be so frequently taunted by 
 our patients with the reproach, " When doctors differ, who 
 is to decide ? ” As I have already observed, the clammy 
 tongue, dry skin, pain in the back, and failure of the strength 
 may exist in so many different diseases, that we should be 
 unable, relying on symptoms alone, to decide with any degree 
 of certainty the real nature of disease. But an examination 
 of the urine will often lead us to the true interpretation, 
 and under all circumstances will facilitate our inquiries into 
 the causes of morbid phenomena. For instance, a single 
 property from which much may be determined, I need only 
 mention that the specific gravity of the urine in health may 
 be averaged at about one thousand and twenty, but if the 
 urinometer should indicate a density of one thousand and 
 fifty, the urinary pathologist would immediately infer the 
 presence of a large quantity of sugar, and the existence of 
 diabetes in an aggravated degree. He would still further 
 confirm his notions upon this point, by setting a, portion aside 
 
 [ 101 ] 
 
102 
 
 URINARY ANALYSIS. 
 
 under the proper circumstances, and inducing those fungoid 
 vegetations, the appearance of which, under the microscope, 
 is shown in the subjoined diagram, Figure 6. Thus we 
 
 Figure 6, 
 
 should be enabled by one examination 
 to decide the nature of the disease, 
 without the possibility of mistake. 
 
 For the purpose of speedily taking 
 the specific gravity, we make use of 
 a little instrument, contrived by the 
 late and much to be lamented Dr. 
 
 Prout, called "the urinometer.” It Figure 7 . 
 
 consists of a hollow globe or glass, 
 
 or thin metal, from the upper part of which projects a 
 scale graduated from 0 to 60 ; in the opposite direction 
 there is a weight to keep the stem upright. Immersed in 
 the urine, it sinks and indicates the gravity of the urine 
 by the figure on the stem, which coincides, or is on a level 
 with the surface of the urine. Deference to Figure 7 
 will explain the use and nature of this instrument better 
 than any description. The value of this instrument in detect- 
 
URINARY ANALYSIS. 
 
 103 
 
 ing disease will at once be apparent, by mentioning the fol- 
 lowing case. 
 
 A few days ago, a gentleman, a perfect stranger, whom 
 I had never seen before, called upon me for my advice. 
 I requested him to furnish me with a specimen of the urine, 
 the specific gravity of which I immediately ascertained to 
 be 1038 . I boiled a small quantity in a test tube, with 
 a solution of potass, over the spirit-lamp, which speedily 
 changed to a dark-brown color. This led me at once to make 
 the following inquiries : If the thirst was not most urgent ; 
 if his appetite was unusually good ; if the skin was not unusu- 
 ally hard and dry ; if the quantity of urine passed in twenty- 
 four hours did not greatly exceed what was natural, and if he 
 had not lost flesh. He had as yet hardly given me any 
 account of himself, and appeared much surprised at my 
 inquiries, and looked steadfastly at a microscope that was 
 standing upon my table ; and I afterwards learned that he 
 attributed some extraordinary influence to the polished 
 reflector attached to the instrument. It appeared that he had 
 been suffering for some time from all the symptoms I had 
 mentioned, and felt at a loss how I could, in so short a time, 
 get to know so much about him, for I was not more than five 
 minutes in making the examination. To the urinary pathol- 
 ogist this could occasion no surprise, if it would be at once 
 apparent that I had tested for diabetes. Feeling satisfied of 
 its presence, it was then of course easy enough to enumerate 
 symptoms. I have found diabetes to occur between the ages 
 of twenty-two and thirty-six. I have seldom met with it in 
 advanced age ; a form of it sometimes ocqurs in young chil- 
 dren. It is of the utmost importance that this disease should 
 be detected in its earliest stages, for it is only then that it 
 can be kept in check, or possibly subdued. Instances, 
 indeed, are not wanting of perfect cure. If food containing 
 sugar or saccharine principles be allowed, even as luxuries, 
 
104 
 
 URINARY ANALYSIS. 
 
 it is the opinion of most urinary pathologists that no plan of 
 treatment can prove serviceable. " Even its occasional in- 
 fringement,” says Dr. Prout, " cannot be indulged in with 
 impunity. Thus I have known,” he continues, " a few 
 saccharine pears undo in a few hours all that I had been 
 laboring for months to accomplish.” With the view of still 
 further impressing on the mind the necessity and importance 
 of urinary analysis, I shall briefly mention another case of 
 diabetes that came under my notice. 
 
 The patient, a cooper, had been working for six or seven 
 years in a very damp cellar. He applied to me in 1866, 
 complaining of intense thirst. He had become greatly 
 emaciated, with a voracious appetite and other symptoms 
 usually present in diabetes. Examination of the urine fully 
 proved the existence of the disease. I explained to him the 
 nature of his disorder, and the necessity of at once procuring 
 a more suitable workshop, — one dry and properly venti- 
 lated. I also inculcated the necessity of strict attention to 
 diet, and explained some other necessary precautions calcu- 
 lated to improve his health, and the necessity of strictly 
 conforming to dietetic rules for some considerable time. I 
 was, however, soon supplanted by a medical gentleman, who 
 asserted that all the symptoms originated in a disordered 
 state of the liver, at the same time undertaking to set all 
 right in a month. To accomplish his purpose he directed 
 blue-pills to be taken, which was continued for the space of 
 ten days ; but the unfortunate patient, instead of being per- 
 fectly well at the end of the month, as promised, had become 
 worse, the symptoms much more severe, and he died a short 
 time afterwards of confirmed diabetes. Few persons not 
 accustomed to the treatment of these affections would be- 
 lieve the deleterious effects of even a dose or two of mercury. 
 Indeed, the mildest form of the disease may be speedily 
 converted, by the use of calomel or blue-pill, into the most 
 
URINARY ANALYSIS. 
 
 105 
 
 confirmed and aggravated diabetes. From several years’ 
 experience in the treatment of diabetes, I am decidedly of 
 the opinion, that if early detected the disease may be re- 
 moved ; but generally cases of this kind seldom terminate so 
 favorably as we could wish, or indeed as we have a right to 
 expect, and I am satisfied this is owing to the disease not 
 having been detected in its early stages. Most of the pa- 
 tients whom I have seen suffering from diabetes have been 
 more or less of the phlegmatic temperament ; not so, how- 
 ever, the' class T am to enter upon. We often find the urine 
 depositing certain sediments, the nature and variety of which 
 are often intimately connected with both the temperament 
 and the peculiar affection under which the patient may be 
 laboring. Oxalate of lime, correct delineations of which I 
 here subjoin (Fig. 8), most frequently occurs, according 
 
 Figure 8. 
 
 to my experience, in the nervous and biliary temperaments, 
 and not unfrequently in the sanguine. When it occurs in 
 this last, it is often associated with an eruption of the skin, 
 and attended with great mental and bodily irritation. 
 
 Not long since, I was consulted by a gentleman laboring 
 
106 
 
 URINARY ANALYSIS. 
 
 under this diathesis, oxalate of lime constantly appearing in 
 the urine. This patient was treated simply for a cutaneous 
 disorder, an eruption having appeared upon the skin. 
 Astringents in the form of ointments, applied to the surface, 
 succeeded in suppressing the cutaneous disorder ; but the 
 nervous excitement and mental distress increased to an 
 alarming extent. So severe were the symptoms, that the 
 patient found it quite impossible to remain at rest, but felt 
 obliged, as it were, to shift about from place to place. He 
 assured me he had suffered so much, that he often felt as if 
 he should lose his senses, were not the symptoms soon 
 relieved. Sulphur baths with diaphoretics, and irritating 
 frictions to the skin, soon brought out the eruptions again, 
 with immediate relief to the patient. I have found almost 
 invariably that affections of the skin, when accompanied with 
 an unnatural or disordered state of the urine, must not be 
 rashly interfered with, nor suppressed by external applica- 
 tions, till the disordered state of the urine has been corrected, 
 and the kidneys restored to the healthy discharge of their 
 functions. When oxalate of lime is constantly present in the 
 urine, which in my opinion is much more frequently the case 
 than is usually imagined, — the difficulty of detecting the na- 
 ture of these crystals enabling them to escape observation, — 
 there is frequently a feeling of distension in the stomach, 
 more especially when that viscus is empty. This feeling 
 frequently prevails to so great a degree, that the patient is 
 compelled to have his dress made very loose, and to adopt 
 every means of preventing pressure. This distension some- 
 times extends over the whole region of the stomach, which 
 bulges out, occasioning <n*eat irritation and distress. 
 
 The heart, or at least its motions, frequently become in- 
 volved. I have seem many instances of what may be named 
 nervous palpitation of the heart . Patients, from such palpita- 
 tions, often imagine themselves the victims of real disease of 
 
URINARY ANALYSIS. 
 
 107 
 
 the heart ; and this notion appears to he more strongly con- 
 firmed by the irregularity of pulse which prevails in these 
 circumstances, and indeed not unfrequently it intermits. A 
 medical gentleman consulted me some little time since for a 
 feeling of severe nervous depression, greatly aggravated by 
 a firm belief that he should die suddenly from an affection of 
 the heart. About two years before he consulted me, he had 
 endeavored to effect an insurance upon his life, which was 
 refused, however, under the impression of his suffering from 
 disease of the heart. Certainly palpitation was evident, and 
 there was irregularity of pulse, great difficulty in breathing, 
 with habitual coldness of the feet. On examining the urine 
 I found it loaded with octohedral crystals of oxalate of lime, 
 and remarkably so after dinner; which, perhaps, might be 
 attributed to an habitual indulgence in -sweets, etc., at this 
 meal. The digestive functions were deeply involved, and 
 yet the tongue was perfectly clean. The general circumstances 
 induced me to suspect a gouty tendency, and, on inquiry, I 
 learned that gout prevailed in his family. By regulating the 
 treatment upon these views, and paying due attention to the 
 digestive organs, the patient recovered, and is now attending 
 to a very extensive practice, which he had been forced to 
 relinquish. Disease of the heart is usually inferred when 
 there is habitual palpitation, with irregularity of pulse, 
 difficulty of breathing, coldness of the extremities, and 
 the pulsations of the heart audible over the whole extent 
 of the chest. It w 7 ill be well, however, to remember that 
 all these symptoms may be present, and yet the heart 
 itself bo perfectly free from disease. I feel reluctant to 
 refer to the numerous instances I have seen of persons 
 vffiose existence has been embittered, and their prospects 
 blighted, in consequence of functional irregularity being 
 mistaken for organic disease of the heart. I have already 
 mentioned a case of gout lurking in the system giving rise 
 
108 
 
 URINARY ANALYSIS. 
 
 to all the phenomena of diseased heart, and shall conclude 
 the subject by calling the attention of the profession to one 
 other remarkable instance. 
 
 A young gentleman, who consulted me, gave me the fol- 
 lowing preliminary history of himself: "I enjoyed,” he said, 
 " excellent health until I went to Harvard University ; there 
 I studied very hard. A friend gave an entertainment in 
 celebration of my success in gaining a prize for a literary 
 essay. After the entertainment we went upon a rowing ex- 
 cursion, and I exerted myself beyond what was usual. On 
 our return I became giddy, and at length fainted. I soon, 
 however, recovered my recollection, but became ill, and 
 was confined to bed six weeks. My digestion at this period 
 was much disordered, the pulse irregular, with a constant 
 feeling of uneasiness about the heart. I was advised to 
 return home ; to avoid all kinds of mental exertion or ex- 
 citement, and all sorts of active exercise, especially upon 
 ascents ; and to restrict myself to a very low and poor diet. 
 I took foxglove for a considerable time, in order, as it was 
 stated, to lower the heart’s action. My health was not suf- 
 ficiently restored to admit of my return to Cambridge the 
 following term. I remained at home for twelve months ; 
 and not being allowed to read, nor to take much exercise, 
 time hung heavily upon my hands, and at the end of that time 
 the symptoms were as severe as at first. I was compelled to 
 give up my studies, and have remained quite an idle man 
 ever since. I have taken a great deal of medicine, of one 
 kind and another, and I now begin quite to despair of 
 recovering my health.” 
 
 Upon analyzing this patient’s urine, I found the oxa- 
 late of lime in great abundance. The powers of the 
 digestive organs were greatly impaired, which I attributed 
 principally to the kind of diet to which he had been 
 restricted, he having lived mostly upon slops and vegeta- 
 
URINARY ANALYSIS. 
 
 109 
 
 bles, fearing that otherwise ho would make too much blood, 
 and disturb the action of the heart. After hearing the his- 
 tory of the case, and giving due attention to all the circum- 
 stances, I came to the conclusion that the patient had greatly 
 impaired his health by too close application to study. After 
 severe literary exertion, the indulgence in the pleasures of 
 the table, followed by the laborious exercise of rowing, acted 
 as the exciting cause ; and in his excitable, but still ener- 
 vated condition, proved quite sufficient to bring on fainting, 
 and the disordered state of frame which succeeded ; that 
 the bleedings to which he had been subjected, and the digi- 
 talis only served to keep up a degree of irritation in the 
 system ; and on his return home , being debarred from bodily 
 exercise, and deprived of all mental occupation, he had too 
 much time to think upon his disease and to dwell upon mel- 
 ancholy forebodings, which at length brought on a permanent 
 state of irritation in the system Acting upon these views, 
 I recomme ded that he should resume his studies, of course 
 under due restrictions as to intensity of application ; that he 
 should take horse exercise and adopt a more liberal and gen- 
 erous scale of diet. I also recommended means for restoring 
 the vigor of the digestive organs ; and advised him, during 
 his stay in Boston, to divert his mind by visiting the differ- 
 ent places of amusement and objects of curiosity. Ilis 
 health and spirits were greatly improved ; but still I fear 
 that the impression that his heart is seriously diseased, will 
 not be easily eradicated from his mind, notwithstanding that 
 he has been assured by the most eminent of the profession 
 hereabouts, that no such diseased state exists. 
 
 In the treatment of the oxalate of lime diathesis, great care 
 must be taken to order that kind of food which can be easily 
 reduced by the stomach ; therefore, oily substances, as butter, 
 cream, fat meats, should be wholly interdicted. Great atten- 
 tion should also be paid to the nature and kind of fluids used 
 
110 
 
 URINARY ANALYSIS. 
 
 as drink ; and water impregnated with carbonate of lime 
 should be carefully avoided. It is generally admitted that 
 the appearance of oxalate of lime, as a deposit in the urine, is 
 closely connected with the condition of the digestive organs ; 
 as it readily disappears and reappears under certain altera^ 
 tions in the diet. The dyspeptic symptoms under these cir- 
 cumstances are often referred to acidity of the stomach as 
 their cause. While upon this subject, therefore, I would 
 strongly impress upon the mind of the practitioner the 
 necessity of well weighing all the circumstances of the case 
 before he recommends that incessant resort to carbonate of 
 soda, so much in vogue. Acidity of stomach is now de- 
 nounced as one of the most common and constant accompa- 
 niments of nervous disorder ; and carbonate of soda and 
 liquor potassae, among the most favorite remedies. Many 
 cases of nervous disorder have fallen under my care, to 
 remove which was a work not only of time, but of extreme 
 difficulty, in consequence of the injurious effects of an im- 
 moderate and daily use of alkalies. 
 
 A gentleman of nervous temperament, engaged in a New 
 York warehouse, a tall, powerful man, applied to me in 
 consequence of suffering from pain in the region of the 
 stomach. The pain was confined to a spot which he could 
 cover with the tip of his finger. He suffered invariably after 
 dinner from a painful feeling of distension and fulness, with 
 an almost incessant desire of hawking up phlegm, which 
 seemed as if agglutinated in the throat, causing great irri- 
 tation, with an uncontrollable desire of getting rid of it. 
 The skin was dry, hard, and harsh. There were severe peri- 
 odical pains in the head, and, in fact, all the general symp- 
 toms characteristic of confirmed dyspepsia. He informed 
 me that having suffered for a considerable time, he had, 
 upon advice, been in the habit, for the last six years, of mix- 
 ing a quantity of carbonate of soda with the ale which he 
 
URINARY ANALYSIS. 
 
 Ill 
 
 used. He commenced with what he called " a small pinch, 
 or as much as would lie on a shilling.” This quantity was 
 gradually increased, till it amounted to a teaspoonful. The 
 soda generally relieved his distress, in some degree, for an 
 hour or two, when the uneasiness returned, and recourse to 
 t ie soda again became necessary. 
 
 The urine passed in my presence had a specific gravity of 
 one thousand and twenfy-two, with a very faint acidulous 
 reaction ; deposited a sediment consisting of mucous and 
 epithelium, and abounding in crystals of oxalate of lime. 
 After standing at rest for above twenty hours, the sur- 
 face became covered with a pellicle, which proved to be 
 the triple phosphate, and the sediment was found inter- 
 mixed with the same. The reaction was now alkaline. 
 From the history and general circumstances of the case, 
 I felt firmly convinced that the greater part, if not the 
 whole, of the misery and distress endured by this patient, 
 was caused by the inordinate daily quantity of carbonate 
 of soda which he daily took. I therefore recommended 
 the gradual discontinuance of the medicine, substituting for 
 it, first, the hydrochloric acid, and afterwards the nitro- 
 muriatic, beginning with very small doses, which were after- 
 wards gradually increased. Frequent recourse was had to the 
 warm bath ; while a plain, simple, but nutritious diet was 
 adopted. This plan he continued for some time and with 
 great benefit, as he became very much better ; but still he 
 was far from being relieved. He became, however, rather 
 impatient of restraint and rule, and gave way to a longing 
 alter his favorite dose of soda-water ; and as I would not 
 sanction this, he got tired, and consulted another physician. 
 I have heard from a friend of his who is a patient of mine, 
 that he is constantly changing his medical attendant, and that 
 he is at present in very bad health. When patients, under 
 false notions, habituate themselves to the daily use of soda, 
 
112 
 
 URINARY ANALYSIS. 
 
 they may be placed in the same category with the habitual 
 opium-eater or the dram-drinker. Such endure the greatest 
 misery, till they indulge in the accustomed dose ; and few 
 there are who possess firmness enough to resist the tempta- 
 tion, or fortitude enough to abandon its use. And here 
 again I must beg not to be misunderstood. I by no means 
 urge that the alkalies are always injurious in nervous affec- 
 tions ; on the contrary, I have met with a great number of 
 patients who have derived very great benefit from a judicious 
 and well-regulated course of these remedies, as will be seen 
 in the following example : — 
 
 A gentleman of the nervo-bilious temperament, connected 
 extensively with the public press, applied to me, complain- 
 ing of many of the symptoms just enumerated. In this case 
 the pain in the region of the stomach was by far more severe 
 than in any instance I remember to have previously met 
 with ; which may, perhaps, be explained by the great ner- 
 vous excitement and mental anxiety to which he was almost 
 constantly exposed, in consequence of the great responsibil- 
 ity imposed on him by his connection with an influential daily 
 journal. Great irregularity of habit was a necessary result ; 
 dining very irregularly, and at all hours. lie sat up, too, 
 almost all night, resorting to stimulants to keep awake and 
 active. Indulgence of this kind generally ended in great 
 depression and nervous exhaustion, which commonly lasted 
 till recourse to the usual beverage aroused the energies and 
 raised the spirits. I was called upon very suddenly by one 
 of his friends to visit this gentleman, whom I found suffering 
 from a very severe attack of nervous fever. It appeared 
 that upon a recent occasion he had been confined for several 
 hours, in a close and overheated apartment, being at the 
 same time exposed to intense mental anxiety ; he very in- 
 cautiously and most injudiciously exposed himself under 
 these circumstances, unsuitably clad, to the open air, on a 
 
URINARY ANALYSIS. 
 
 113 
 
 raw, cold, damp morning in the month of November. The 
 attack of nervous fever above mentioned was the conse- 
 quence. In this case, the perspiration and other secretions, 
 generally, indicated a great tendency to excessive acidity, 
 which justified a resort to a judicious and well-regulated use 
 of the alkalies ; and, indeed, I feel that the patient is mainly 
 indebted to their influence for his recovery. But even at 
 the present moment, when he is in the enjoyment of his 
 usual good health, he is obliged to avoid green vegetables, 
 oranges, light acescent wines, sugar, and other fermentable 
 articles, experience having taught him that, in his case, acid- 
 ity may be speedily and very easily induced by the slightest 
 deviation from rule ; and this acidity, when brought on, is 
 always attended with severe pain in the stomach, intense 
 headache, and nervous trepidation, — effects which speedily 
 supervene, but which require considerable time to subside. 
 
 Figure 0. 
 
CHAPTER XI Y. 
 
 VARIOUS URINARY DEPOSITS. 
 
 Nervous patients, with the oxalate of lime diathesis, I 
 find derive very great benefit from the exhibition of nitro- 
 muriatic acid with tincture of cinchona. It is, however, 
 necessary to caution against the too long-continued use of 
 the acids. Oxalate of lime is found in urine depositing 
 urate of ammonia, a diagram of which (Fig. 11) is subjoined, 
 
 Figure 11. 
 
 and even uric acid in the crystallized form, under which cir- 
 cumstances an incautious use of the acids might lead to great 
 inconvenience. In regulating the treatment, therefore, when 
 oxalate of lime appears in the urine, it ought to be analyzed 
 
 [ 114 ] 
 
VARIOUS URINARY DEPOSITS. 
 
 115 
 
 every third day, and immediately when either urate of am- 
 monia, or crystallized uric acid appears, the use of acids should 
 be suspended. Sulphate of quinine, oxide of silver, or tris- 
 nitrate of bismuth, may be given with great advantage, till the 
 time arrives when we may resume the acids. I have, at this 
 moment, a patient under my care who has suffered for many 
 years from this diathesis, and whose health has been much 
 injured by an empirical resort to alkalies, but who is now 
 deriving very great benefit from the cautious administration 
 of nitro-muriatic acid and cold baths. 
 
 XJrea — a diagram of which (Fig. 12), crystallized from its 
 solution in spirit, is here subjoined — is a urinary principle, 
 
 Figure 12. 
 
 excess or deficiency of which in the urine is often connected 
 with important nervous disorders. When urea is in excess, it 
 often causes a great deal of irritation ; there is a dull, heavy, 
 dragging pain in the lower part of the back, which is much 
 increased by exertion. A very constant symptom, more 
 especially in certain forms of excess of urea, is a frequent 
 voiding of the urine. There is often a greater quantity 
 voided than is consistent with health ; but from the frequent 
 calls, the quantity passed seems to the patient greatly to 
 
116 
 
 VARIOUS URINARY DEPOSITS. 
 
 exceed what is natural. Hence this affection is, and has 
 often been, confounded with diabetes, a disease of a very 
 different nature. 
 
 In speaking of the treatment of this affection, Dr. Prout 
 very justly observes, and in practice I find his views con- 
 firmed, "That calomel, black doses, and saline purgatives are 
 calculated to do infinite mischief, and will probably render a 
 manageable disease perfectly unmanageable,” — hence the 
 necessity of at once ascertaining the true nature of the dis- 
 order. 
 
 A patient lately consulted me, whose urine had for some 
 time contained an excess of urea. He had been taking cal- 
 
 Figure 13. 
 
 omel, which, however, had not relieved him, and he was rec- 
 ommended the daily use of fluid magnesia. 
 
 Upon examining the urine under the microscope, I discov- 
 ered crystals in beautiful tufts, which were at once copied by 
 the artist, and the delineations (Fig. 13) are here subjoined. 
 Upon further inquiry, I found them to consist of urate of 
 magnesia. This patient was much relieved by discontinuing 
 the medicine, — paying strict attention to diet, and taking 
 small doses of oxide of silver. 
 
VARIOUS URINARY DEPOSITS. 
 
 117 
 
 In certain forms of degeneration of the kidney — granular, 
 for instance — the serum of the blood passes off by the kid- 
 neys. Such urine is albuminous, coagulating by heat, more 
 especially if a few drops of nitric acid be added. When 
 albuminous urine depends upon granular kidney, it may be 
 regarded as a fatal symptom. We must, however, be cau- 
 tious in pronouncing such an unfavorable opinion. Not very 
 long since I was called upon to visit a gentleman who was 
 studying for the bar. For some time he had been suffering 
 from severe nervous, aching pain in the back and loins. A 
 medical gentleman, a friend of his, having discovered albu- 
 men in the urine, pronounced him suffering from organic dis- 
 ease of the kidneys. His friends became greatly alarmed, 
 especially when informed that nothing could be done to save 
 the patient. At this juncture I saw the case. 
 
 The general appearance was not such as to excite in my 
 mind the notion of organic disease. All those symptoms, 
 — the swollen face and eyelids, the harsh, dry state of skin, 
 the dull, stupid look and tendency to drowsiness, — were not 
 present in the slightest degree, nor was there the least indi- 
 cation of any tendency to dropsy. I was, in consequence, 
 induced to doubt that the kidneys had anything to do with 
 the diseased condition of the urine. I therefore washed 
 out the bladder with distilled water, by means of a double 
 catheter ; and then made him drink, in my presence, two or 
 three tumblers of filtered water. He was placed, on his 
 bare feet, upon a cold marble slab, and in less than ten min- 
 utes passed a considerable quantity of urine, which, on ex- 
 amination, afforded not a trace of albumen. This sufficiently 
 proved that the kidneys were not the source of the albumen. 
 Upon stricter inquiry it was found that the albumen was de- 
 rived from the mucous coat of the bladder. It disappeared 
 very shortly under the influence of the tincture of sesqui- 
 chloride of iron, in doses of twenty drops three times a day. 
 
118 
 
 VARIOUS URINARY DEPOSITS. 
 
 I mention this case to show the necessity of caution, and the 
 inconvenience which may result from inferring degeneration 
 of the kidneys merely because of a little albumen in the 
 urine. 
 
 Lithic or uric acid, of which there is a diagram (Fig. 14) 
 attached, is likewise a principle by which the urine is des- 
 tined to carry out certain effete matters from the system. It 
 however sometimes happens that more lithic acid is formed 
 than is evacuated with the urine. The superabundance 
 
 Figure 14. 
 
 either is retained in the kidney, giving rise to the formation 
 of renal calculi, or it remains in the blood, and occasions 
 various forms of nervous disorder. It is well known that 
 in rheumatism the blood comparatively abounds in lithic 
 acid. Occasionally this acid, after remaining for some time 
 in the kidney, passes into and remains in the bladder, form- 
 ing a nucleus for further deposition, and vesical calculus is 
 the result. 
 
 One of my patients requested my attention to a poor man, 
 a shoemaker, who had been suffering for thirteen years from 
 a nervous affection, which latterly had increased so much, 
 and occasioned so great a degree of distress, that he could 
 
VARIOUS URINARY DEPOSITS. 
 
 119 
 
 hardly attend to his work. He had tried a variety of reme- 
 dies, and consulted numerous practitioners, and various 
 views were taken of the nature of the case. 
 
 Having obtained several specimens of the urine, I found, 
 upon examination, that it abounded in lithic acid, which was 
 deposited in the crystalline form. The appearance of the 
 acid, with the general circumstances of the case, induced me 
 to suspect the existence of stone in the bladder, as the cause 
 of the nervous symptoms from which he suffered. He came 
 to Boston, and, on sounding, the existence of calculus was 
 clearly and decidedly proved. 
 
 There were a great number of very small calculi of the 
 lithic kind, many of which I succeeded in crushing. lie 
 became impatient, however, it being inconvenient to him to 
 be so much in Boston. He therefore determined upon going 
 into the Boston Hospital to be cut for stone. The opera- 
 tion was very skilfully performed, and the stones adroitly 
 extracted from the bladder ; but inflammation set in on the 
 third day, of which the patient unfortunately died. 
 
 When lithic acid deposits in the joints in the form named 
 " chalk stones,” there is much nervous irritation set up in the 
 system ; and patients of this class suffer so much from ner- 
 vous derangement, that the most trifling incidents will throw 
 them into a nervous paroxysm. These gouty concretions do 
 not consist of chalk, but of urate of soda ; and the diagram 
 (Fig. 15) shows the form of crystallization assumed by the 
 uric acid when liberated from its combination with the soda. 
 
 When the lithic acid diathesis prevails, the digestive func- 
 tions are usually much out of order, and the patient complains 
 of flatulence and great acidity of stomach, much increased 
 by acescent fruits and vegetables, and indulgence in port 
 wine. 
 
 It is of the utmost importance that such derangements of 
 the system should be speedily recognized. A few grains of 
 
120 
 
 VARIOUS URINARY DEPOSITS. 
 
 carbonate of potass taken three or four hours after dinner, 
 and persevered in for a short time, will remove a great deal 
 
 Figure 15. 
 
 of mischief, and prevent the formation of stone in the bladder, 
 which cost the patient, whose case I have just mentioned, 
 his life. 
 
 Cystine, or Cystic oxide (see diagram, Fig. 16 ), is very 
 
 Figure 16. 
 
 rare, but when it occurs is attended with severe nervous 
 derangement. It was first described by Dr. Wollaston, and 
 
VARIOUS URINARY DEPOSITS. 
 
 121 
 
 afterwards by Marcet ; and a very excellent account of the 
 substance itself, and of the state of the urine in which cystine 
 prevails, was published by my friend, Dr. Venables, some 
 years ago, in the "American Journal of Medicine.” Little 
 or nothing has been added to Dr. Venables’ excellent detail. 
 
 Liebig has lately announced the existence of hippuric 
 acid (Fig. 17), as a constituent of human urine. It is occa- 
 
 Figrure 17. 
 
 sionally present in quantity in the urine of hysterical and 
 nervous females, and in the urine of persons who have been 
 compelled to live for some time upon a poor, low, and bad 
 diet. Change of air, and good nutritious food, with tran- 
 quillity of mind, will be found among the most effectual rem- 
 edies. 
 
 The earthy phosphates are constantly deposited from the 
 urine of nervous patients, and many of the symptoms in 
 such cases, are analogous to those which occur in the lithic 
 acid diathesis. The triple or ammonio-magnesian phosphate 
 is delineated in Fig. 18. 
 
 The deposition of the prismatic phosphate is generally 
 
122 
 
 VARIOUS URINARY DEPOSITS. 
 
 accompanied with severe pain in the back, much increased 
 by any kind of exertion, especially if the lumbar and dorsal 
 muscles are much or actively employed. 
 
 We frequently find cutaneous eruptions upon different 
 parts of the body associated, or in some way connected, 
 with the deposition of the triple salt. " That tendency to a 
 deposition of these earthy salts in the urine,” says Dr. 
 Prout, "is sometimes hereditary, there can be no doubt. 
 Moreover, this tendency often assumes different forms in dif- 
 
 Figure 18 . 
 
 ferent members of the same family, and even in the same 
 individual at different periods of his life. Thus, when one 
 individual of a family has suffered from a deposition of the 
 phosphates, another has suffered from gout, a second from 
 asthma, a third from cutaneous disease. 
 
 I have for some time attended a gentleman who has been 
 suffering for many years from spasmodic asthma. The urine 
 deposits the phosphates in great abundance. I have also 
 attended the brother of this gentleman, likewise his nephew, 
 and three of his children, all suffering from what they name 
 nervousness, which it is said runs in the family. No two, 
 
VARIOUS URINARY DEPOSITS. 
 
 123 
 
 however, suffer alike. The gentleman told me that he 
 thought he should have lost his life in consequence of having 
 gone, on the recommendation of a physician, to a watering- 
 place, and drank largely of an alkaline spring. He was 
 reduced to such a degree, and his health so very much shat- 
 tered, that many months elapsed before it was restored to its 
 ordinary state. One can hardly reconcile the probability of' 
 such an error, had there been even but an imperfect analysis 
 of the urine. 
 
 There is scarcely a day passes that I have not applications 
 from members of the profession requesting me to examine 
 the urine of their patients. This is very often accompanied 
 with another, — that I would be so good as to forward, by 
 return of post, a report, with a full account of the analysis 
 Perhaps the little attention bestowed upon inquiries of this 
 sort, by gentlemen in general practice, will account for their 
 not being aware that days are often necessary before the in- 
 vestigation can be completed, and the analysis perfected. 
 
CHAPTER XV. 
 
 PATHOLOGY OF THE NERVES AND NERVOUS MALADIES. 
 
 The dominion of the nerves over the mental and physical 
 actions of man is unbounded. The various workings of in- 
 tellect, sensation, volition, motion, secretion, nutrition, — 
 the essence of all these is nervous influence. There is no 
 animal without nerves, but myriads without circulation of 
 the blood. Blood and nerve are, however, about equally 
 implicated in the phenomena of health and disease. When 
 the nerves are powerfully affected, how quickly the heart is 
 affected also ! Alarm and terror are mental impressions ; but 
 how instantaneously the heart is affected by undue enerva- 
 tion is evidenced by palpitation, increase or arrest of cir- 
 culation, by blush or pallor. The phenomena of mental 
 disorders, or of a class of them, at least, are dependent on 
 an abnormal supply of carbonized or oxygenized blood on 
 the brain, or a deficiency of phosphorus. Excess of arterial 
 or venous blood will equally induce a train of morbid phe- 
 nomena in the nerve, as in any other organic tissues of the 
 body. There is indeed a marvellous connection between the 
 nervous and vascular systems throughout the animal frame. 
 Too great action in the minute arteries, congestion in the 
 veins, an anaemious or bloodless state of the vascular sys- 
 tem of the brain, alike induce morbidly exalted and impaired 
 conditions of the mental and cerebral functions ; spectres, 
 [ 124 ] 
 
PATHOLOGY OF THE NERVES. 
 
 125 
 
 delirium, insomnia or sleeplessness, amaurosis, stupor, coma ; 
 violent involuntary actions, or paralysis of the volun- 
 tary motions, etc. The higher the nervous energy, or the 
 more vigorous the circulation of the blood, the greater the 
 power of the vital tissues to resist contagious diseases. 
 Hope will preserve the energy of the body under the most 
 depressing influences, the most laborious exertions. The body 
 cannot have rest or health till the mind be satisfied. The 
 nerves are valuable servants, but they are despotic masters. 
 Let them once get the whip-hand, and woe betide their slave. 
 Now, have we not an apology to make to them ? We either 
 coax and pet and indulge them as we do spoiled children, or 
 work them to the utmost ; and then we wonder that their 
 evil qualities turn the tables on ourselves, and render us slaves 
 to the tempter. Let us take a brief glance at those excited 
 conditions of the mind which are so often the spring of ner- 
 vous maladies, real and imaginary. It is true we cannot 
 always 
 
 “ Minister to a mind diseased, 
 
 Pluck from the memory a rooted sorrow ; ” 
 
 but, by a little self-denial, a sound mind (mens sana), to a 
 degree* at least, may be preserved to us. If, in the effort, 
 even self-interest or self-gratification be sacrificed, the tran- 
 sient tears of regret will, we may hope, be consecrated, and 
 turned to those of joy and thankfulness, when the struggle 
 is over. 
 
 Intense impression on the mind is a subject full of inter- 
 est. The illusions so often induced by it are contrasted in 
 their influence over the system. They may be consolatory, 
 an agreeable and happy deception, and should in some cases 
 be even encouraged. We will glance at a story told by 
 Kotzebue, the poet, in illustration. It was of a young lady 
 whose lover died. His harp, on which he was wont to 
 
126 
 
 PATHOLOGY OF THE NERVES. 
 
 accompany her, hung in her chamber. After a period of 
 melancholy and grief, she touched the cords of her instru- 
 ment ; the harp, tuned in accordance , responded. Surprise 
 and terror were at first the consequences ; but these now 
 yielded to a romantic melancholy, with a conviction that 
 the spirit of her lover swept the strings of the harp. Her 
 music became her only consolation, until a. scientific friend 
 explained to her the principle of phonic harmonies. From 
 that moment the illusion vanished, and she drooped and 
 died. But if the impression be foreboding of misfortune, 
 of course it should be removed if possible. We could cite 
 many cases of those unhappy prognostics from dreams, and 
 the prophecy or dread of the fortune-teller, regarding the 
 termination of operations or of childbirth. Anxiety is pros- 
 pective sorrow, — its subjects various. In that which may 
 be termed moral anxiety, as that of a wife or a mother for 
 the safety of her husband and her child, there is a sacred- 
 ness which excites our deepest sympathy. Others have a 
 more uuholy spring; a heart tainted with pride or avarice, 
 those besetting sins which so deform human nature, and to 
 the pains of which there is no end, — for pride and avarice 
 are never satisfied, — there is no real meaning but a negative 
 one in the word enough . These passions are the very bane 
 of existence. Yet how ihany, even of those who decry them, 
 cherish the serpents in their bosom, trusting to honor or 
 riches for sublunary happiness, forgetting the monitory lines 
 of Young, — 
 
 “ Why all this toil for triumphs of an hour? 
 
 What though we wade in wealth or soar in fame ? 
 
 Earth’s highest station ends in 1 Here he lies ’ ; 
 
 And dust to dust concludes her noblest song.” 
 
 The feeling of anxiety is one continued heart-ache ; it is 
 the dread of something worse tb*ui the present. It is pro- 
 
PATHOLOGY OF THE NERVES. 
 
 127 
 
 gressive in its degree, and therefore more poignant than real 
 sorrow or grief, which is the pain of memory, and which so 
 constantly, from the mere elasticity of th6 mind, gradually 
 fades and disappears. For the anxious heart there is often 
 no relief, save from the eloquent lips of sympathetic friend- 
 ship, or the consolation of religion. If it he not relieved, 
 low nervous fever will be the consequence, with remora of 
 the circulation, inducing local congestions ; then, not only 
 are the secretions diminished, but those which are formed 
 arc depraved and unhealthy. For so surely as the enliven- 
 ing passions oxygenize the blood, do the depressing emo- 
 tions accumulate carbon. By this poison a constant morbid 
 and ineffective reaction is going on, which wofully aggravates 
 the original affection. Thus is established a train of ner- 
 vous maladies, — neuralgia, hypochondriasis, melancholy, — 
 inducing that corroding action in the brain, which, in the 
 words of the son of Sirarh, " consume th marrow and bone.” 
 In the end, if the brain be long oppressed by its poison- 
 blood, toedium vitce , or weariness of life, must be the result, 
 the climax of which may be suicide. During this progress 
 the system is in a state of universal malady, — all is going 
 wrong. Circulation, digestion, assimilation, nutrition, the 
 nurses of life, fail ; absorption of fat succeeds, and atrophy 
 is the result. In the anxious mother, the secretion of the 
 milk is checked or depraved, by which half-poisonous fluid 
 the numerous convulsive and gastric diseases of infancy are 
 brought on. 
 
 The influence of anxiety also constantly lights up those 
 latent germs of constitutional disease, which might never 
 otherwise have been developed. The miliary tubercle of 
 phthisis is thus excited to action, and youth and beauty, till 
 then in seemingly blooming health, are at once doomed to 
 decay and perish. 
 
 But the great source of anxiety and its train of ills is to 
 
128 
 
 PATHOLOGY OF THE NERVES. 
 
 be sought in those ardent longings for worldly possessions, 
 which are the especial debasement of this age. But even 
 the fullest measure of success in the insane struggle for opu- 
 lence soon palls on the sense. When all earthly grandeur 
 and power are at length attained, the proud and anxious 
 possessor stalks through his gorgeously furnished halls, 
 counts over his millions, and wonders and deplores (that is, 
 if he can moralize) that his heart is not sufficiently capacious 
 to enjoy all the splendor, and opportunities of gratification, 
 which it commands. We cannot 
 
 “Through the loop-hole of retreat 
 Look out upon the world,” 
 
 agitated as it is at this moment with the intense desire of 
 gain, with the eager haste to be rich, without a thrill of pity 
 and sympathy for the blind votaries of Mammon, who daily 
 and hourly prostrate themselves before the golden image 
 they have themselves set up ! Tranquillity of mind ! It 
 were a miracle indeed if such a condition of brain could be 
 preserved amid the tumult of a stock and share market and 
 gold-board, in the face of desperate ventures, in which mil- 
 lions may be involved, and families reduced to irretrievable 
 ruin, in the twinkling of an eye, as it were. And it were a 
 vain effort to check the headlong course of one on whom the 
 monomania of gaming has taken so deep a hold. Yet while 
 Mammon thus reigns in every alley, the health of the body 
 is sapped, the intellect is impaired and perverted, the condi- 
 tion of its organ gradually destroyed, the earthly climax of 
 which may be drivelling or raving insanity, or death, self- 
 inflicted from the muzzle of the revolver in the grasp of des- 
 peration. On the slaves of pleasure, anxiety is ever an 
 attendant demon. True, the orgies of Bacchus and Venus, 
 during their intense excitement, drown the heart and mind 
 in one voluptuous flood, while the cup of Nepenthe or the lips 
 
PATHOLOGY OF THE NERVES. 
 
 120 
 
 and arms of beauty throw their spell over the senses ; but the 
 deep anxiety of after-thought and feeling can never he com- 
 pensated by a thousand-fold of such enjoyment. And is the 
 penalty merely transient? Alas, it lasts a life-time ! It is 
 deeply painful to reflect on the prolific springs of disorder 
 from these slavish passions ; the brain and heart are the 
 especial organs into which their poison is infused. Either 
 the intellect or the senses are reduced to a brutal apathy, or 
 the sensitiveness (hypersesthesia) of the nervous system is 
 so morbidly increased, that, on the slightest disappointment, 
 or social competition even, the whole system is deranged, 
 and there is no philosophy, no piety, to tranquillize a mind 
 so subdued, for irreligion must be the predominant prin- 
 ciple of such a life. 
 
 Grief and its prototypes is another fertile source of deep 
 or protracted nervous maladies. The intense degree of grief 
 is all-absorbing. The mind broods over the one subject of 
 its woe, and so reluctant is it to admit another, that it is 
 often annoyed by conversation of friends, or even impression 
 on the senses. Hence, the deep mourner retires into lonely 
 seclusion, and soon may be lighted a train of feelings as dis- 
 tressing as they are obnoxious to remedy — melancholy. 
 
 When this sad condition is the result of bodily causes, we 
 can cure it ; but when it springs from moral causes, time, of 
 course, is an element in the cure. But the maladie imagi- 
 naire is mostly the result of mere corporal derangement and 
 break-down. We will conclude our remarks on the pathol- 
 ogy of nervous maladies by glancing at the hygiene best 
 adapted to remedy them. (As for their medical treatment, 
 we can best administer that directly and personally, rather 
 than through the medium of a work on Nervous Affections. 
 As has already been said, the resources of the Materia 
 Medica for nervous maladies has been powerfully reinforced 
 within the last ten years, by an entirely new class of reme- 
 
130 
 
 PATHOLOGY OF THE NERVES. 
 
 dies, based on our greater knowledge of the nervous system 
 and its action. The writer himself has introduced a new 
 and most potent remedy.) 
 
 If we believe in the irritation or disturbance of mind as a 
 fertile source of the neuroses, or nervous affections, we may 
 also believe that the inducing a different state of mind will 
 prove a curative or preventive oftentimes, — at any rate, a 
 great help to a cure. This state of mind would be the oppo- 
 site of pride, envy, hatred, and sordid greed of gain, which 
 passions, as a great moralist remarks, have no holidays, — 
 that which we term repose, — contentment, tranquillity, 
 happiness. By mental repose we do not mean the apathetic 
 state of the thoughtless or the slothful ; the dolce far niente 
 of the useless do-nothing, is the mere scum on the surface of 
 the cup of idleness which contains a poisonous bitter in its 
 dregs. Under the placid condition of mind, not only is the 
 vis medicatrix allowed to exert its potent influence, but the 
 various functions of the body are almost ensured, or restored 
 to their former integrity. "To laugh and grow fat” has 
 become a proverb. Yet, to ensure this happy mood, how 
 manifold are the precepts, — amusements and moderate occu- 
 pation, and those most congenial to the disposition. But 
 this mental election must not be negative ; the mind must 
 be brought not only to forego those perilous pleasures of 
 sense and of sensibility, to which luxury and sloth are so 
 naturally prone, but also to act on the subject of its thoughts, 
 not with fatigue and labor, but with that degree of energy 
 which will afford food for immediate reflection, and the 
 memory of which will be the constant spring of tranquil 
 satisfaction. "We should live pleasant,” and regard cheer- 
 fulness as a duty. To ensure this requires often a high 
 degree of self-control, as well as the sympathy of friendship. 
 The greatest caution in conversation is sometimes essential ; 
 allusions to subjects which are agreeable, congenial, and 
 
PATHOLOGY OF THE NERVES. 
 
 131 
 
 consolatory to the invalid, should be adopted, both . in con- 
 versation and reading ; and objects of beauty and of interest 
 should as much as possible be presented to the mind ; for it 
 has been observed how influential are odor and color and 
 form in mitigation of more decided maladies. Of the antipa- 
 thies of smell and taste we have known very curious instances 
 in nervous patients. The olfactory nerves may become so 
 acutely sensitive as to be oppressed by even grateful odors, 
 so that the poet scarcely exaggerates when he says, — 
 
 “ And quick effluvia darting to the brain, 
 
 Die of a rose in aromatic pain.” 
 
 The morbid eccentricities of touch or feeling are among the 
 most painful maladies of the neuroses. They are eminently 
 characteristic of hysteria. A lady, who was for several 
 years under the writer’s care for phthisis, was occasionally 
 affected with intense hyperassthesia (excessive sensitiveness) 
 of the skin. During this state* a feather dropped on her 
 person would instantly produce such intense agony as to 
 draw forth a shrill and prolonged scream. But to resume 
 * our remarks on the hygiene for shattered nerves. We fear 
 that the lesson which we are endeavoring to inculcate is not 
 so easy in this excited, artificial age. We have, in truth, so 
 multiplied our wants, that we become restless, if we do not 
 accomplish all the mind can conceive. Like Ariel, we would 
 put a girdle round the globe in forty minutes or seconds. 
 The age is a nervous one, and hence the desirability — to 
 the world-worn, jaded man — of repose, and the exceeding 
 need of procuring it. 
 
CHAPTER XYI. 
 
 A FEW HYGIENIC OBSERVATIONS ON NERVOUS AFFECTIONS. 
 
 In regard to nervous patients, Brown-Sequard insists that 
 " A serious aim in the daily occupations is of the greatest 
 value, and for many persons, quite essential to prevent or to 
 check nervous disturbances. The applications of this princi- 
 ple are, of course, he says, very difficult, and often impossi- 
 ble, in certain neuroses ; but in those cases in which any 
 kind of serious work, either mental or physical, but not too 
 fatiguing or exciting, is liked by the patient, he should be 
 induced to do it. In cases of hypochondria, of hysteria, of 
 chorea, or even of epilepsy, a great benefit can be derived 
 from a serious employment of the mental and physical activ- 
 ity of the sufferer. How often have I not seen young epilep- 
 tics kept in idleness (alas ! by medical advice), and having 
 gained more or less of the vices it leads to, improve rapidly 
 from having their minds occupied at regular hours, in nearly 
 the same way as healthy people of their age. The second 
 principle of moral treatment is, that we must, in the interest 
 of our nervous patients, as much as, if not more than in our 
 own, give them confidence and hope in the treatment we rec- 
 ommend. In hysterical and all nervous complaints allied 
 with it, and also in hypochondria, a great hope of cure will 
 do much to work out the cure. No doubt you will say, But 
 how can you give hope ? I answer that the best means for 
 [ 132 ] 
 
OBSERVATIONS ON NERVOUS AFFECTIONS. 133 
 
 that purpose is to have hope ourselves, and to express our 
 hope with the accent of conviction. And, as you would ask 
 how can we command hope in ourselves ? I answer that the 
 very knowledge of the truth of the principle I am now 
 speaking of, is enough to render one hopeful. I need not 
 now repeat that I am now only speaking of those nervous 
 diseases in which the power of the mind upon the body is so 
 great, that under the influence of an emotion, or another 
 moral cause, a sudden or almost sudden cure is not very 
 rare.” * It has repeatedly occurred to me to see patients 
 who stated that they had been for years in the habit of taking 
 large quantities of opening medicines to keep up the due 
 action of the bowels, but still without the slightest advantage 
 or even effecting the purpose ; yet have I seen these persons 
 derive infinitely more benefit, in a few weeks, from a few 
 "globules,” and strictly attending to the admirable dietetic 
 rules prescribed by Hahnemann, viz. giving up the use of 
 wine, spirits, and all such stirnulants, than could possibly 
 have been derived from the adoption of all the routine disci- 
 pline so commonly insisted on. It may be said, and I have 
 no doubt with a great deal of truth, that the abstaining from 
 the use of wine and ardent spirits, with the strict attention 
 to diet, etc., were really the means of cure; and that the 
 minute doses of medicine in the globules were merely incen- 
 tives to regimen, but in every other particular wholly inert. 
 Upon this, however, as a purely practical man, I need only 
 observe, that it matters but very little to the patient by what 
 means his health has been restored, so that he perfectly 
 regain it ; nor can it interest him much what particular plan 
 of treatment has been the truly efficacious one in curing his 
 disorder. But if patients will not be satisfied without tak- 
 ing large quantities of medicine, they may as well be grati- 
 
 * Lecture's on the Diagnosis and Treatment of Functional Nervous Affec- 
 tions. By C. E. Brown-Sequard. 
 
134 
 
 OBSERVATIONS ON NERVOUS AFFECTIONS. 
 
 tied and amused with globules, or something at least equally 
 harmless, so that they may sustain no injury, while pursuing 
 a rational mode of living, and one conducive to health. 
 Again, I have seen similar benefit, in habitual and obstinate 
 constipation of the bowels, and indeed confirmed ill health, 
 from a few mouths’ well-regulated hydropathic treatment ; 
 and such patients have really obtained inconceivably more 
 advantage from strict observance of these rules, and due 
 attention to diet, air, and exercise, than had accrued from the 
 prolonged adoption of the plans recommended by the most 
 judicious and skilful allopathic practitioners. In such cases, 
 regimen seems to have been an important element of suc- 
 cess. It has been already observed that the dietetic and 
 sanitary measures inculcated by homoeopathy ; the invigorat- 
 ing influence of hydropathy ; and the various means at the 
 disposal of and resorted to by the allopathist, may, when prop- 
 erly applied, prove of the greatest benefit ; but on the con- 
 trary, if indiscriminately adopted or injudiciously used, they 
 may prove not only inert, but often very injurious. It must 
 therefore be apparent that, as already observed, before we 
 can determine with any prospect of success on the treatment 
 of disease, we must diligently inquire into the nature of the 
 case, so as to ascertain the cause and remove it ; for if this 
 be allowed to continue in operation, it will be vain to expect 
 that the effects will cease, — still less be permanently re- 
 moved. 
 
 But let us suppose that we should prove successful in 
 checking or suppressing the effects, as may sometimes hap- 
 pen, without subduing the cause, we should only aggravate 
 the mischief, and induce confirmed derangement in the sys- 
 tem, the cause of which perhaps no subsequent efforts would 
 be sufficient thoroughly to eradicate. Possibly this may 
 be rendered more intelligible by the following illustration. 
 Purging, for instance, may be occasioned by cold applied 
 
OBSERVATIONS ON NERVOUS AFFECTIONS. 
 
 135 
 
 to the skin while it is hot and perspiring ; the perspiration 
 being suddenly and over-precipitately checked, purging is 
 set up on the part of nature to compensate the suppressed 
 action of the skin, and thereby relieve, at least in part, the 
 system by the removal of noxious principles. Any similar 
 derangement of the bowels may arise from taking too much 
 food into the stomach. Here, then, we find the same effect 
 — relaxation of the bowels — produced by two causes differ- 
 ing altogether in their nature and mode of action. Were we 
 to treat the disorder of the bowels, so occasioned, by the 
 same means, we should most assuredly fail of success, 
 the causes in each being so very different ; and therefore 
 the treatment should be varied, and suited to the peculiar 
 circumstances of each case. Instead of checking the purging 
 in the first instance, by administering astringents, absorb- 
 ents, etc., the warm bath and the administration of medi- 
 cines, calculated to restore the suppressed or suspended action 
 of the skin, will be more in accordance with the true princi- 
 ples of treatment. But, in the second case, in which too 
 much food, or. of an indigestible nature, has been the cause 
 of the derangement, the appropriate treatment will be its 
 immediate evacuation by an emetic or a suitable laxative. A 
 very frequent cause of nervous affections is, intense or unsea- 
 sonable application of the mind, as in reading while at din- 
 ner. By this untimely exercise of the brain, the blood is 
 diverted from its proper course — viz. the stomach — at a 
 time when it is particularly required there to enable the vis- 
 cus to secrete and supply a sufficiency of gastric juice. Such 
 patients cannot be benefited except they alter their habits, 
 because so long as they force the current of blood towards 
 the brain, when the vital fluid is required elsewhere for the 
 purpose of digestion, this function will be impaired, and but 
 very imperfectly performed, and nervous derangement will 
 continue to result. 
 
136 
 
 OBSERVATIONS ON NERVOUS AFFECTIONS. 
 
 Another and very common cause of nervous disorder I have 
 found to prevail much amongst gentlemen engaged the whole 
 day in the city, and who seldom take any food till they 
 return home to a six-o’clock dinner. They then indulge too 
 freely in the pleasures of the table, and burden the stomach 
 with more food than there is gastric juice to dissolve ; con- 
 sequently a considerable portion of the food remains undi- 
 gested, and, undergoing spontaneous decomposition, gives 
 rise to the evolution of different gases in large quantities in 
 the stomach, painfully distending the organ, and causing 
 belching, acidity, acrid eructations, hiccup, etc. Unless we 
 remove the cause by a more suitable mode of living, the 
 effects will not cease. Medicines may relieve, but will not 
 cure the patient. 
 
 Nervous disorder proceeding from another and very differ- 
 ent cause, frequently falls under my notice. The affection 
 is attended with violent nervous headache, severe palpita- 
 tions of the heart, with a sense of sinking and exhaustion. 
 It occurs in persons who are engaged for many hours during 
 the day in active exercise of both mind and body, and who 
 at certain seasons cannot spare time for refreshment till a 
 very late hour, when the energies of the frame have become, 
 as it were, completely exhausted. But even at this late 
 period they are frequently disturbed and called away, before 
 they have had time to finish their repast. Under such cir- 
 cumstances, the frame is enfeebled and overpowered before 
 any opportunity for refreshment presents itself, the stomach 
 naturally participates in the general debility, and in conse- 
 quence becomes unequal to healthy digestion. Hence, such 
 individuals emaciate, become feeble, and ultimately are pros- 
 trated both in mind and body. In such cases medicine is of 
 little or no use ; nothing but a more rational mode of living 
 can restore such persons to health and strength. Indeed, it 
 is surprising to see how speedily they recover, when, by 
 
OBSERVATIONS ON NERVOUS AFFECTIONS. 
 
 137 
 
 altering their mode of life, the cause of disorder has been 
 removed. 
 
 Analogies drawn from the inferior animals often lead us 
 to the knowledge of the true principles of cure. Experience 
 has taught the groom the evil consequences that result from 
 feeding the horse immediately after severe exercise ; and phys- 
 iology unfolds tQ us the rationale. The blood requisite to 
 enable the stomach to form and secrete a sufficient quantity 
 of gastric juice for the purpose of digestion, has not yet 
 reverted from the muscles, whither the current of blood had 
 been more abundantly directed, to increase the muscular 
 energies and activity, and proportion them to the exertions 
 they were called upon to make while under the stimulus of 
 severe exercise. Hence it is necessary to allow the animal 
 sufficient time for repose, that the muscular system may 
 relapse into its ordinary state of quiescence. The animal 
 may then be fed, not only with safety, but with advantage ; 
 the stimulus which the food creates brings an increased afflux 
 of blood to the stomach ; gastric juice is secreted more 
 copiously, and poured in sufficient quantit}^ into the cavity 
 of the viscus, and, acting with energy upon the food, it is 
 readily dissolved, and prepared for its final formation into 
 nourishment. The same laws hold good with respect to 
 man ; and thus it is that analogies often lead to the adoption 
 of true principles, as well as to their explanation. 
 
 "Nervousness,” says Dr. Trail, "is as much distinguished 
 from all other maladies by mental perversity, as it is by 
 bodily infirmity. Without being criminal or addicted to any 
 particular vices, nervous persons are ill-tempered, peevish, 
 jealous, passionate, and always unreliable. They are un- 
 trustworthy, not because of dishonest motives, but because 
 of ungovernable impulses. They are unreliable, not because 
 of intentional wrong, but because of fickleness of disposition 
 and feebleness of will power. They are very selfish, and 
 
138 
 
 OBSERVATIONS ON NERVOUS AFFECTIONS. 
 
 sometimes mean, not because they lack benevolent emotions 
 and a right conscience, but because their outward conduct 
 expresses their internal conditions. Cure them of their ner- 
 vousness, and they may become agreeable, generous, truth- 
 ful, and faithful, as they have been before. But everything 
 has a cause, and so has nervousness. It has many causes, 
 as many as individuals have unhygienic habits. All personal 
 habits that are unwholesome conduce to it. But in all cases 
 there is some local point of irritation or obstruction, perhaps 
 trivial in itself, from which the whole trouble proceeds. A 
 person may be very weak, as in cholera or paralysis, with- 
 out being nervous.” 
 
 "He maybe dangerously sick, as of fever, and no one 
 accuse him of nervousness. But if the blood is congested 
 in some part or organ, no matter where nor from what 
 cause, to the extent of disturbing the equilibrium of the 
 circulation, yet not sufficient to occasion acute disease, 
 the person so affected will inevitably have a more or less 
 aggravated form of nervousness. And this fact explains why 
 so many persons are more or less nervous, and why this 
 ailment is peculiar to high civilization.” 
 
 Among the more prominent special causes are too much 
 night work, want of sleep, great mental anxiety, indigestible 
 viands, narcotic stimulants, as alcohol and tobacco, late sup- 
 pers, and sedentary habits. Any cause, also, that impairs 
 the vitality and drains the vital fluids, as running sores, fre- 
 quent bleedings, chronic diarrhoea, will result in nervousness. 
 A very torpid liver, a very inactive skin, and prolonged 
 constipation, never fail to occasion severe and obstinate 
 forms of nervousness. Obstruction, therefore, being the 
 primary and predisposing cause, and unbalanced circulation 
 the proximate condition, the remedial plan is self-evident. 
 Promote circulation to the whole surface as much as possible 
 by occasional bathing, and daily frictions with dry towels ; 
 
OBSERVATIONS ON NERVOUS AFFECTIONS. 
 
 139 
 
 use only plain and simple viands, so that the internal viscera 
 may be unloaded ; and exercise as much as possible, within 
 the limits of fatigue. Sleep all you can, avoid all convex 
 sation concerning your manifold miseries, and in due time 
 this nervousness will disappear. Great numbers of men in 
 the vortex of city life seem to suppose that they can indulge 
 constantly and with impunity in sensual excesses, and 
 especially the abuse of wines and liquors, of good cheer, of 
 venereal pleasures, and intellectual excesses, represented 
 particularly by prolonged watchings and preoccupations with 
 business enterprises, works, etc. But sooner or later all 
 such find their mistake in shattered and disordered nervous 
 systems. The writer has by his remedies enabled hundreds 
 of persons guilty of such habitual excesses and violation of 
 the plainest hygienic laws to escape the consequences of their 
 folly. But he has done it by his insisting, when his reme- 
 dies had done their perfect work in restoring the nerves to 
 their wonted healthful action, upon an entire abandonment 
 of previous bad habits and practices, so that the effects of 
 his medicine might be reinforced by a proper regimen and 
 life. 
 
CHAPTER XVII. 
 
 A CURIOUS CASE OF SUPPOSED DEMONIAC POSSESSION. 
 
 I could very easily fill a dozen chapters with interesting 
 narratives of the manifold illusions, delusions, and hallucina- 
 tions which I have had to deal with in treating a vast num- 
 ber of nervous cases. These various instances of the 
 maladie imaginaire have been, of course, the results of a 
 disturbed condition of the functions of the brain and nervous 
 system. Several years ago a patient was under my treat- 
 ment, who was thoroughly convinced that he was possessed 
 by unclean or evil spirits. This person was a gentleman of 
 uncommon intellectual power and culture, and on all other 
 subjects, except that of his own demoniacal possession, was 
 sensible, rational, and intelligent. On his first visit at my 
 office, he placed in my hands a lengthy account of his sup- 
 posed affliction. It was addressed to me, and was in the 
 form of a letter. It is too long for the limits of this volume 
 entire, but I will give the most interesting portions of it, 
 merely prefacing it with the remark that the writer was ulti- 
 mately cured of his most uncomfortable monomania, and now 
 looks back upon it with almost the curiosity of a disinter- 
 ested third person. The epistle is subjoined. 
 
 " Dear Doctor : 
 
 "It was my intention, some time since, to have written 
 you a short account of the sufferings I have experienced for 
 [ 140 ] 
 
SUPPOSED DEMONIAC POSSESSION. 141 
 
 several years past, from the possession of evil spirits ; but 
 in consequence of having been constantly pitied and smiled 
 at, and having met with no one who would sympathize with 
 me, whenever I have broached such a notion, and instanced 
 myself as a proof of the existence of such spirits, I had 
 almost come to the conclusion not to write at all. Unac- 
 quainted as I am with theological discussion, and wholly 
 unused to argumentative composition, I am at a loss in what 
 manner to set about an explanation on the subject required.” 
 (Here the writer gives a sketch of his life. It seems that he 
 was living with his wife and several line children in the city 
 of New York, engaged in professional pursuits, which yielded 
 him a lucrative income at the time he was attacked by the 
 singular monomania.) "The profits from my profession,” 
 he writes, " still continuing on the increase, I at this period 
 entered into some money speculations, which caused me a 
 little anxiety and some pecuniary embarrassment, but I 
 retained all my usual buoyancy of spirit. It was then while 
 taking a quiet walk one evening, far from the busy hum of 
 men, I heard the sound of voices near me, speaking of me. 
 I looked in every direction, but could not discover any one. 
 I got over some banks, thinking that, probably, the persons 
 might have been concealed from view by them ; but no 
 human creatures were there. I walked away from the spot, 
 still the voices pursued me. I mixed with the thickest of 
 the throng in the metropolis ; the voices still continued to 
 haunt me, and the words then uttered were 'Who is he? — 
 do you know who he is? ’ The response was, ' He is Satan’s 
 own.’ These words seemed continuously to proceed from 
 the persons I passed. I crossed and re-crossed the streets ; 
 still the same voices followed me. Every one appeared to 
 ask the same or a like question, and there was a similar 
 reply. Other queries and answers succeeded to these relat- 
 ing to my walking, — for my pace was very rapid, as I 
 
142 
 
 SUPPOSED DEMONIAC POSSESSION. 
 
 trusted to escape the notice or recognition of the passers-by ; 
 but the " Devil’s Own ” was either whispered or shouted to 
 me, apparently by* almost every one ; and those from whom 
 the sounds did not emanate, appeared hastily to get out of 
 my way, or, in my imagination, shrunk from me with looks 
 expressive of surprise. No doubt, however, that my strides 
 were those of a possessed person, and caused those I met or 
 overtook to make ample space for me. 
 
 " The whole night did I thus perambulate New York and 
 its environs, occasionally dozing, as I stood still for a few 
 minutes ; and iu this manner I twice accomplished the cir- 
 cuit of the great city, vainly hoping that daylight would end 
 my illusion. Such hope was indeed vain, and I must men- 
 tion, that not merely the " Devil’s Own ” was sounded in my 
 ears, but observations and conversations relating to me inces- 
 santly occurred. Yet was I perfectly in my senses. I went 
 to the place in which the sounds first reached me, and exam- 
 ined it and the neighborhood minutely ; of course I could 
 not discover any human power to account for them. I then 
 began to think of spiritualism, on which I had thought little 
 before, as an explanation of the strange phenomena. . . . 
 The voices loudly and clamorously spoke of all my misdeeds, 
 and taxed me with sins of which I had not been guilty. And 
 I was dared to meet the parties who charged me with such 
 and with other crimes. I did accordingly go to a friend of 
 mine, who is now dead, and told him I had been affected, 
 and that I wished him to be present to hear the voices, if he 
 could, and the charges to be made against me, which I was 
 to deny, or to admit, as the circumstances might be. Sev- 
 eral voices then made various accusations against me, and I 
 appeared to be put on a regular trial. I replied to the 
 charges by my thoughts, without speaking, but occasionally 
 my tongue could not refrain from moving within my lips, to 
 express my thoughts without, however, giving utterance to 
 them. 
 
SUPPOSED DEMONIAC POSSESSION. 
 
 143 
 
 " One of the voices was remarkably clear and loud. It 
 appeared to be that of a being of authority in conversation 
 with another, and although slightly favorable in his expres- 
 sions of my good conduct throughout life, yet strong and 
 severe were his animadversions on my bad thoughts and 
 actions. And here everything I had said or done, or omitted, 
 was elucidated instantly ; hidden motives and thoughts and 
 actions were unravelled, to my great astonishment, and my 
 heart and brain seemed completely laid open. All was 
 * written down or directed so to be, and the next day was 
 appointed for a further examination. I asked my friend 
 repeatedly during this trial if he heard any voices. He told 
 me he did not. I mentioned what was now and then said to 
 me, and of me. I smiled at myself, for I knew I was only 
 in a room, and that it was impossible for any worldly being 
 to speak or communicate with me except my friend. I 
 looked at him — he was deeply engaged in writing ; could 
 there be any ventriloquism in the case ? I knew that piy 
 friend was not thus gifted ; besides, the voices were with 
 me before I saw him that day. What could have occasioned 
 the sensation of sound I had experienced ; the direct appeal to 
 my heart and brain ? I was entirely in my senses, and reasoned 
 on the absurdity of my harboring any opinion contrary to my 
 own received notion of the ordinary laws of nature. I began 
 to think of spiritualism — of clairvoyance. . . . The more I 
 thought, the less could I account for the extraordinary ordeal 
 to which I was subjected. I did not believe in evil spirits. 
 ... I did not believe in the commonly received notions of 
 hell-fire, and flames had no terrors for me, nor have they 
 now. . . . The next day I went prepared for another 
 examination, but I was not again put on trial. The parties 
 seemed partly satisfied with my mental engagement of com- 
 pensation, as far as I had the ability, of any persons I might 
 have injured in thought, word, or deed. ... I returned ; 
 
144 
 
 SUPPOSED DEMONIAC POSSESSION. 
 
 still the voices followed me. ... In the day-time I did 
 not feel the annoyance so much, but in the stillness of night, 
 the torments I endured were unutterable — indescribable. 
 The hellish sounds, the dreadful impieties that were spoken 
 of, that were foisted on me. . . . When I attempted to 
 pray, I could not, for the jeering and laughter. . . .For 
 change of scene, and hoping I could get rid of the voices, I 
 went twice abroad. I tried all kinds of amusements, and 
 also the effect of living very well, thinking my nerves might 
 be improved by a still more generous regimen than I had 
 ever been accustomed to. These having no effect, I had 
 myself cupped, and entirely altered my diet, living chiefly 
 on vegetables, and avoiding all vinous or spirituous liquors. 
 Nothing, however, made any difference in my sensations. 
 The sounds accompanied me everywhere, and I still contin- 
 ued the prey of evil spirits. I could plainly distinguish 
 about seven voices : two of them struck me as the voices of 
 females ; one of them sometimes spoke in over-soothing, 
 complaisant accents to me, but these were generally used to 
 turn me into ridicule afterwards. . . . It is now five 
 
 years and four months that I have had this singular visita- 
 tion from God, and although I have no faith in dreams, yet 
 most singularly I dreamt of my father’s death about the 
 time it occurred, and I have not dreamt of him since, until 
 the beginning of this month of September, when I dreamt 
 that I saw him interceding with God for the suspension of 
 my sufferings from evil spirits, and, strange to say, I expe- 
 rienced for a time relief from their presence and perse- 
 cutions. . . . Suffice it to say that the writer finally 
 became a firm believer in evil or unclean spirits, and their 
 power to haunt or possess man. He concluded his singular 
 communication to me, which is very long, in the following 
 words : " It strikes me that many persons, who are consid- 
 ered and pronounced deranged, are, really, instead, possessed 
 
SUPPOSED DEMONIAC POSSESSION. 
 
 145 
 
 by evil spirits. It may be said that I may myself be in a 
 state of derangement. To this I would oppose these facts — 
 that I do not pretend to having had any ocular demonstration 
 of any spirit, nor have I had any distorted visions or ideas. 
 I have not spoken incoherently, nor have I acted contrary to 
 rationality ; but I have always been blessed with my senses, 
 notwithstanding this heavy calamity of evil possession with 
 which it has pleased God to visit me. . . . 
 
 I am, sir, your obedient servant, 
 
 « » 
 
 When the writer of the above singular account came under 
 my treatment, he had only occasional and greatly mitigated 
 attacks from his imaginary infernal tormentors. In fact, the 
 case had ceased to be very distressing, notwithstanding the 
 patient had become a firm believer in demoniacal influences. 
 He was a sceptic, in the height of his monomania and suffer- 
 ing. It perhaps should be remarked that the gentleman was 
 the son of what is called an Eurasian ; that is, his grand- 
 father was English and his grandmother an East Indian lady, 
 which fact accounted for certain psychological peculiarities 
 as well as peculiarities of temperament. I easily reinforced 
 the happy effects which the lapse of years had begun to have 
 on this patient’s most delicate and excitable nervous system, 
 with a class of remedies specially adapted to such a case, 
 which was marked by a morbid condition of the auricular 
 nerve. The patient was* completely cured under my treat- 
 ment, and I finally succeeded in demonstrating to him that 
 demoniacal possession was nothing more nor less than one 
 of the forms of nervous malady. The belief in possession by 
 unclean spirits was natural enough in ages of ignorance and 
 superstition, when the mysteries and peculiarities of the 
 nervous system were not in the least understood, and per- 
 sonal agencies were supposed to account for everything. 
 
CHAPTER XVIII. 
 
 HOPE ANT) CONFIDENCE AS THERAPEUTICAL AGENTS. 
 
 The physician who cannot inspire hope and confidence in 
 his patient, might as well understand that he has mistaken his 
 calling ; and just in proportion as the medical man is able to 
 excite these two exhilarating, buoyant, and curative emotions 
 in the breasts of those whom he treats, just in that propor- 
 tion ordinarily will be his success. In treating diseases of the 
 melancholic-nervous class, especially, the physician without 
 self-reliance cannot hope to beget reliance in his patient. A 
 third thing, says old Burton, in his famous book on Melan- 
 choly, to be required in a patient, is confidence, to be of 
 good cheer, and have sure hope that his physician can help 
 him. Galen, the old Greek physician, holds confidence and 
 hope to be more good than physic. He cures most, in whom 
 most are confident. The great success of another old Greek 
 physician, Hippocrates, was accounted for on the ground 
 that hie common people had a most strong conceit of his 
 worth. The young student of medicine is told in Faust, 
 
 “ If you on yourself rely, 
 
 Others on you will place reliance.” 
 
 It is wonderful the healing effect which a hopeful, confi- 
 dent state of mind in the patient has upon his disease. But 
 when one considers the intimate connection of mind and 
 [ 146 ] 
 
HOPE AND CONFIDENCE AS THERAPEUTICAL AGENTS. 147 
 
 body, the mystery is solved. Reputation and wide-spread 
 notoriety are valuable to a physician, because they give him 
 a power and sort of magical influence over the mind of his 
 patient. This influence, too, may be given by personal qual- 
 ities, such as appearance, etc. There is a certain genius for 
 the cure of disease, and an intuitive insight into the ills to 
 which flesh is heir, which some men possess, and which are 
 more valuable than the fruits of the profoundest study. A 
 perusal of the lives of eminent physicians will convince one 
 of the fact, or an acquaintance with one of these natural con- 
 querors of disease. Their presence inspires a certain con- 
 fidence in the patient, a sort of magnetic influence, which 
 reinforces the medicines administered, and causes the happi- 
 est effects. Professional jealousy and rivalry may cause these 
 born physicians to be denounced as quacks and empirics, but 
 the public cannot be diverted from recourse to such. Per- 
 sonal power, a strong will, is as necessary in a conqueror 
 of disease, as of armies. In nervous-melancholic maladies, 
 the first thing which the physician has to contend against in 
 his patient, is a fearful depression and downheartedness. 
 Out of this abyss of despair he must be able by his will to 
 lift the victim of nervous malady who has recourse to him. 
 For the victims of nervous disease dwell, as it w^ere, "in a 
 land of darkness, as darkness itself ; and of the shadow of 
 death . . . and where the light is as darkness.” 
 
 To quote from quaint old Burton again : " Of those diverse 
 gifts which our Apostle Paul saith God hath bestowed on 
 man, this of physic is not the least, but most necessary, and 
 especially conducing to the good of mankind. Next, there- 
 fore, to God, in all our extremities ('for of the most high 
 cometh healing ’) , we must seek to and rely upon the physi- 
 cian, who is Manus Dei (the hand of God), and to whom he 
 hath given knowledge, that he might be glorified in his 
 wondrous works. With such doth he heal men, and take 
 
148 HOPE AND CONFIDENCE AS THERAPEUTICAL AGENTS. 
 
 away their pains. When thou hast need of him, let him 
 not go from thee. When we have now got a skilful, an 
 honest physician to our mind, if his patient will not be con- 
 formable, and content to be ruled by him, all his endeavors 
 will come to no good end. Many things are necessarily to 
 be observed and continued on the patient’s behalf : first, that 
 he be not too niggardly miserable of his purse, or think it 
 too much he bestows upon himself, and, to save charges, 
 endanger his health. The Abderites, when they sent for 
 Hippocrates, promised him what reward he would, "all the 
 gold they had, if all the city were gold he should have it.” 
 Naaman the Syrian, when he went into Israel to Elisha to 
 be cured of his leprosy, took with him ten talents of silver, 
 six thousand pieces of gold, and ten changes of raiment.” 
 W e are not sure but that Burton’s Anatomy of Melancholy 
 is not even yet the best treatise on Nervousness and Nervous 
 Maladies, quaint as it is. " Melancholy,” he says, "is either 
 in disposition or habit. In disposition is that transitory mel- 
 ancholy, which goes and comes upon every small occasion 
 of sorrow, need, sickness, trouble, fear, grief, passion, or 
 perturbation of the mind ; any manner of care, discontent, 
 or thought which causeth anguish, dulness, heaviness, and 
 vexation of spirit ; any ways opposite to pleasure, mirth, 
 joy, delight, causing frowardness in us, or a dislike. In 
 which equivocal and improper sense, we call him melan- 
 choly, that is, dull, sad, sour, lumpish, ill-disposed, solitary, 
 any way moved, or displeased. And from these melan- 
 choly dispositions, no man living is free ; no stoic, none so 
 wise, none so happy, none so patient, so generous, so godly, 
 so divine, that can vindicate himself. Melancholy in this 
 sense is the character of mortality. The name is imposed 
 from the matter, and the disease denominated from the ma- 
 terial cause, viz. black bile.” Among the causes of melan- 
 choly he includes the imagination , which, he says, as it is 
 
HOPE AND CONFIDENCE AS THERAPEUTICAL AGENTS. 149 
 
 eminent in all, so most especially it rageth in melancholy 
 persons. . . . This we see verified in sleepers, who by 
 
 reason of humors and concourse of vapors troubling the 
 phantasy, will give many times absurd and prodigious 
 things, and in such as are troubled with incubus (night- 
 mare), if they lie on their backs, they suppose a hag rides 
 and sits hard upon them, that they are almost stifled for 
 want of breath. . . . This is also evident in such as walk 
 
 at night in their sleep and do strange feats. . . . All 
 
 ecstacies are referable to this force of imagination, such as 
 lie wholje days together in a trance ; as that priest whom 
 Celsus speaks of, that could separate himself from his senses 
 when he list, and lie like a dead man void of life and sense. 
 . . . Many times such men, when they come to themselves, 
 
 tell strange things of heaven and hell, what visions they 
 have seen. . . . The like effects, almost, are seen in such 
 
 as are awake ; how many chimeras, antics, golden moun- 
 tains, and castles in the air, do they build unto them- 
 selves ? ” 
 
CHAPTEE XIX. 
 
 ALCOHOL, TOBACCO, OPIUM, HACSHISH, LEAD. 
 
 It is through the nerves that the five dread agents enu- 
 merated at the head of this chapter have their fearful hold 
 upon humanity. These five agents are continually making 
 war upon the healthy equilibrium of the nervous system, 
 and through that deteriorating the race. The symptoms of 
 alcoholic poisoning are those of alternate excitement and 
 depression. Partial paralyses are but the precursors of 
 more grave affections, which terminate finally in general 
 paralysis, deterioration, and ultimate loss of intelligence. 
 A French writer maintains that insanity is merely the last 
 degree of degeneracy. In the first generation you have 
 immorality, depravity, alcoholic excess, brutish disposition ; 
 in the second, hereditary drunkenness, maniacal accessions, 
 and general paralysis ; in the third, sobriety, hypochondriac 
 and maniacal tendencies, systematic ideas of persecutions 
 and homicidal impulses; in the fourth, weak intelligence 
 originally, access of mania, stupor, transition to idiocy ; 
 finally , extinction of the race. M. Morel, the French 
 writer, already alluded to, asks, in his work on the " De- 
 generacy of the Human Eace,” what may be the part which 
 tobacco plays in the production of degeneration? And 
 admitting 1 even that its degenerative action is an ascer- 
 tained fact, how far would it be good medical hygiene to 
 [ 150 ] 
 
ALCOHOL, TOBACCO, OPIUM, HACSHISH, LEADi 151 
 
 attack the usage of tobacco, which has become for alt nations 
 not only a habit but an imperious necessity, to be satisfied 
 at any risk? I have no intention, he says, of attacking its 
 use, and this for many motives : first, it is far from being 
 proved that the habit of smoking, in moderation , is in any 
 way injurious ; and, secondly, it would not be without dan- 
 ger to invoke the force of an absolute legislation against a 
 habit passed into such an irresistible necessity. Medical 
 men engaged in the investigation and treatment of the dis- 
 eases of the brain and disorders of the mind, occasionally 
 have brought under their notice cases of severe nervous dis- 
 order and mental impairment, clearly traceable to an exces- 
 sive and immoderate use of tobacco. Shattered nervous 
 system, premature loss of mental vigor, impaired memory, 
 mental'? alienation, are too often the well-defined result of 
 excessive tobacco-smoking. These are facts that cannot be 
 ignored when considering the question. 
 
 If society were in a more natural condition, or one more 
 in accordance with the most obvious rules of hygiene, it is 
 highly ^probable that no poisonous agent, whether narcotic 
 or stimulant, would be habitually desirable or allowable. It 
 would not be easy to define accurately what is a natural state 
 of society; but it is easy to say what is not. For instance, 
 it is not natural for man to pass his life underground, as in 
 mines ; to be exposed, in addition to the ordinary atmospheric 
 changes, to those of moisture and cold, in connection with 
 sieges and the life of armies in active service, and to migra- 
 tions from mild to extreme climates and new conditions of 
 existence ; to be immersed perpetually in poisonous or irri- 
 tating vapors, as in various branches of art or industry ; to 
 be suffering the extremes of misery, privation, and heredi- 
 tary disease. It does not appear improbable that in the war- 
 hire with evil influences which man is constantly called upon 
 to wage, that within moderation the use of tobacco may have 
 
152 ALCOHOL, TOBACCO, OPIUM, HACSHISII, LEAD. 
 
 as beneficial effect in enabling him to resist successfully some 
 of these influences, as any other prophylactic agency may 
 have in other cases. It may be injurious to the normal con- 
 stitution normally treated, but may it not avert or resist the 
 abnormal consequences of a different condition ? In other 
 words, the use of tobacco in moderation , and under circum- 
 stances of great hardship and privation, is upheld by many 
 men of high scientific attainments and sound judgment, as 
 not only not injurious, but beneficial. Then, again, it is said 
 by high authorities, that cases of general paralysis and soft- 
 ening of the brain are fearfully multiplied by tobacco-smok- 
 ing. As for opium, that is an agent whose effect upon the 
 nervous system is of an appalling character. The use of 
 this seductive drug is enormous. The Indian hemp or 
 Hacshish forms the basis of most of the intoxicating prepa- 
 rations in Egypt, Syria, and most Oriental countries. The 
 leaves are smoked alone or mixed with tobacco. Besides 
 the habitual hallucinations which the extract of Indian hemp 
 produces in some individuals, its prolonged usage induces 
 incurable dementia. There is reason to believe that such is 
 the case in many persons met with in the cities of Egypt, 
 'who are venerated as holy men (santons) by the people, but 
 who are merely fallen into a state of dementia from the use 
 of hacshish. To return to tobacco for a moment. A dis- 
 tinguished English physician avers his belief that cases of 
 general paralysis are more frequent in England than they 
 used to be, and he suspects that smoking tobacco is one of 
 the causes of that increase. He further believes that if the 
 habit of smoking advances in England as it has done for the 
 last ten years, that the English character will lose that com- 
 bination of energy and solidity that has hitherto distin- 
 guished it, and that England will sink in the scale of nations. 
 Tobacco is reprobated because it produces insanity, paralysis, 
 consumption, laryngitis, tonsillitis, short sight, emaciation, 
 
ALCOHOL, TOBACCO, OPIUM, HACSHISH, LEAD. 
 
 153 
 
 dyspepsia, and an infinity of minor disorders. It is upheld 
 because it is pleasant ; because it is a valuable therapeutic 
 and hygienic agent, a preservative against cold and starva- 
 tion, a substitute for food, a solace to the weary, whether of 
 mind or body. One writer attempts to settle its value by an 
 appeal to final causes, asking, "Why was tobacco created, if 
 not to be smoked ? ” perhaps overlooking the fact that the 
 same trenchant argument applies to every vice. Another 
 writer says, if the evil ended with the individual who, by 
 the indulgence of a pernicious custom, injures his own health 
 and impairs his faculties of mind and body, he might be left 
 to his enjoyment, his fool’s paradise unmolested. This, how- 
 ever, is not the case. In no instance is the sin of the father 
 more strikingly visited upon the children than in the sin of 
 tobacco-smoking. The enervation, the hypochondriasis, the 
 hysteria, the insanity, the dwarfish deformities, the con- 
 sumption, the suffering lives and early deaths of the children 
 of inveterate smokers, bear ample testimony to the feebleness 
 and unsoundness of the constitution transmitted by this per- 
 nicious habit. This is the a<?e of narcotics and narcotism, 
 and they undoubtedly have much to do with the marked in- 
 crease in the number of cases of disease of the brain and 
 nervous system We think the fact is indisputable. Phy- 
 sicians who have favorable opportunities of investigating 
 this subject, not only agree in opinion that such diseases are 
 of more frequent occurrence, but that a certain unfavorable 
 (but in its incipient stage certainly not incurable) type of 
 cerebral disorganization develops itself in the present age 
 at a much earlier period than formerly. Softening of the 
 brain, for example, now manifests itself at the early age of 
 thirty and thirty-five ! It is indeed lamentable that the 
 brain and mind should yield to the influence of certain nox- 
 ious moral and physical agents, at a time of life when the 
 intellect ought to be in an active and vigorous condition of 
 exercise and health. 
 
154 ALCOHOL, TOBACCO, OPIUM, IIACSHISH, LEAD. 
 
 Speaking of the immense use of narcotics, let us take 
 China, whose habit of opium-smoking has invaded Europe 
 and our Pacific slope. Neither tobacco nor Indian hemp 
 (nor perhaps alcohol) compares with opiums either in the con- 
 stitutional result, or in the difficulty of breaking the habit. 
 China presents a curious spectacle of moral disease. Three 
 hundred millions of individuals united under one absolute 
 government, speaking the same language and having identi- 
 cal religious notions, present to us the sad spectacle of a 
 people menaced, as to its dearest interests, by the most fatal 
 and degrading habit that it is possible to conceive — that of 
 smoking opium. The effects of this habit, immediate and 
 remote, are thus described: "The first impression is a feel- 
 ing of content and slight excitement, manifested by loquacity 
 and involuntary laughter. Sometimes there are fits of 
 anger. Soon the eyes become brilliant, and the respiration 
 and circulation are quickened and excited. At this stage of 
 the nervous exaltation, the smoker feels a peculiar comfort, 
 and the temperature is augmented. The impressions are 
 lively, and the imagination wanders into strange illusions. 
 Now we observe a phenomenon frequently remarked in men- 
 tal alienation. Facts and ideas, long forgotten, present 
 themselves to the mind in all their original freshness. The 
 future appears all bright, and every happiness ever wished 
 for appears realized by the smoker. If he continues smok- 
 ing, exaltation gives place to depression and utter prostra- 
 tion. The action of the senses is suspended. He hears 
 nothing ; he becomes silent ; his face becomes pale, his tongue 
 hangs out ; a cold sweat inundates the whole body ; and 
 insensibility supervenes, often lasting for several hours. The 
 awakening is what might be expected 'after such a debauch.” 
 Except some few smokers, who, thanks to an exceptional 
 organization, can restrain themselves within the bounds of 
 moderation, all the others attain rapidly a fatal termination, 
 
ALCOHOL, TOBACCO, OPIUM, HACSHISH, LEAD. 155 
 
 having passed in quick succession the stages of idleness, 
 debauch, misery, the ruin of their physical strength, and the 
 utter degradation of their moral and intellectual faculties. 
 Nothing can cure an advanced smoker of opium. 
 
 Another poisonous agent which wages war upon human- 
 ity and conduces to degeneracy, is lead. There are analo- 
 gies between lead colic, and partial lead paralysis, and 
 alcoholic poisoning. There is, in the commencement, trem- 
 bling, weakness, and paralysis of the lower extremities, 
 and diminution of the general sensibility. Soon there are 
 twitchings and cramps, dizziness, fantastic dreams and hal- 
 lucinations ; and these are exactly the symptoms of the 
 anaesthetic form of alcoholic poisoning. These are the 
 symptoms inseparable from all chronic poisonings ; and 
 more than that, they are the essential signs which announce, 
 by their duration and their constant progress, that the indi- 
 vidual is smitten in the most important functions, and is 
 tending to degenerative transformation more and more radi- 
 cal. Those who present the first signs of the action of the 
 poison of lead, as the blue line in the gums, and the yellow 
 tinge of skin, appear for a time to be quite well ; all the func- 
 tions are correctly performed ; the subject complains of no 
 pain, and follows his employment as usual. The nervous 
 lesions which ultimately occur assume all forms of delirium, 
 coma, epilepsy, etc., sometimes after several attacks of colic, 
 sometimes unpreceded by it. After the occurrence of these, 
 especially the epileptic seizure, the reason is never sound 
 again. In lead poisoning, the individuals affected are too 
 few, comparatively, and the fatal termination too sudden, to 
 permit any very definite calculation as to the effect finally 
 upon the race. But the effects which the use of alcohol, 
 tobacco, and opium, wide-spread as it is and has been, has 
 had upon the Nervous System of the Race, both directly 
 and by transmission, must defy calculation. What a sum- 
 
156 ALCOHOL, TOBACCO, OPIUM, IIACSHISH, LEAD. 
 
 total of degeneracy and degradation, both moral and physi- 
 cal, have these mighty agents of nervous elevation and 
 depression caused ! What wonder that general paralysis 
 and softening of the brain are becoming the most frequent 
 diseases mentioned in the death-list ! No one is ignorant 
 
 O 
 
 that many organic dispositions in the human race are trans- 
 missible from one generation to another ; but it is not gen- 
 erally known how far this principle extends. It is believed 
 in general that form and appearance are transmissible, but it 
 goes much further than this. It is ascertained that all mor- 
 bid dispositions, all pathological predispositions , are inherit- 
 able from parents to children, as well those belonging to 
 the organs of vegetative as of animal life. The predisposi- 
 tion to nervous maladies, to epilepsy, to mania, is transmissi- 
 ble as well as that of gout, rheumatism, scrofula, etc. Now 
 the predispositions have not constantly existed in all preced- 
 ing generations, but have been acquired by some part of the 
 ancestry, and handed down to the descendants, the morbid 
 taint becoming moro and more pronounced in every genera- 
 tion. Whatever may be the form of the physical degradation, 
 and whatever the nature of the lesions experienced by the 
 individual, whether arising from alcohol, opium, or other 
 causes, it is not necessarily the same typical form, nor the 
 same lesions, which are to be expected in his descendants. 
 The deviation from the normal type of humanity shows 
 itself in succeeding generations, by internal and external signs 
 perhaps much more alarming : since they represent enfee- 
 bled faculties, an addiction to the worst tendencies, and the 
 limitation of intellectual life to a certain period, beyond which 
 the individual is no longer in condition to fulfil the functions 
 of humanity. In contemplating successive generations under 
 these unhappy conditions, we observe a series of manifold 
 nervous phenomena having in general a convulsive type ; and 
 forming those pallid, suffering, and morbid temperaments, 
 
ALCOHOL, TOBACCO, OPIUM, HACSHISH, LEAD. 157 
 
 as well as those incredible moral perversities and intel- 
 lectual aberrations, which, by their nature and frequency, 
 justly astonish those who have not watched intently the for- 
 mation of such degenerate races. As long ago as the last 
 part of the eighteenth century, the abuse of alcoholic liquors 
 in Sweden had produced a degeneracy in stature and physi- 
 cal strength among the people of that country. In this 
 country, at the present time, the annual list of the victims 
 of alcoholism is enormous. The moral effect of the use of 
 opium in China is marked. It is almost impossible to imag- 
 ine, says Hue, the readiness with which the Chinese commit 
 suicide. The merest trifle, or a word, induces them to hang 
 or drown themselves, the favorite modes of suicide. Mental 
 aberration, serious as it is in any point of view, in this light 
 becomes doubly so, when it is not merely an individual affec- 
 tion, but the fatal climax, and as it were resume of a long line 
 of individual and hereditary affections. It is easy to con- 
 ceive how, from one generation to another, the moral and 
 physical condition is greatly deteriorated, when what was 
 the habit merely of one generation, became an instinct and 
 impulse in the next ; when, added to the hereditary taint, was 
 the force of example positively, and negatively the absence of 
 all instruction and useful education ; when to the disease of 
 the mind already existing, either actually or potentially, 
 was systematically denied the exercise of the commonest 
 rules of hygiene or therapeutics, and the ordinary restraints of 
 morals and religion. In cases representing so deplorable an 
 ancestry as this, medicine will do little in altering the condi- 
 tion of the individual, which may be considered virtually 
 beyond cure ; but there remains a noble part to play in the 
 enunciation of principles which, when carried out, will tend 
 to the removal of those causes to which so many of these 
 evils are attributable. 
 
CHAPTER XX. 
 
 BODY VS. MIND. 
 
 It is a curious and interesting study to trace the variety of 
 opinions which have been held concerning the respective 
 existence and the mutual relations of the Body and the Mind, 
 — opinions which have, in turn, taken up every position 
 between the absolute non-existence of Mind, save as a form 
 or function of Matter, on the one hand; and, on the other, 
 the merely phenomenal existence of Matter dependent upon 
 the variations of a sentient or thinking immaterial existence, 
 1 — the Mind. 
 
 The scientists now generally maintain that Mind is a result 
 of organization. But for ages the belief has been that man 
 is a compound being, consisting of a material man, the Body, 
 and an immaterial active principle, the intelligent Mind. 
 Those that maintain this doctrine are now called animists, 
 from anima, the soul. In the old gentile nations the body 
 was carefully trained along with the mind. But under the 
 peculiar views of Christianity, when it was introduced into 
 the world, the body became gradually neglected and despised, 
 though this result was naturally of tardy growth. Chris- 
 tianity was not at the start muscular , as the phrase now 
 is. The Christian doctrine of immortality, though a belief 
 in immortality was not peculiar to Christianity, gave to the 
 mind, or spirit, which was supposed to be the deathless prin- 
 [ 158 ] 
 
BODY VS. MIND. 
 
 159 
 
 ciple in man, a supremacy over the body in the estimation 
 of believers Body and Mind began henceforth to be held, by 
 philosopher and Christian, to have separate and antagonistic 
 interests. To the former, the body was a clog, an impedi- 
 ment to the acquisition of knowledge, a something perpetu- 
 ally interfering, by its pains, its sorrows, and its imperfections, 
 with the clear views of truth which he supposed the unencum- 
 bered soul would obtain, — constantly distracting the atten- 
 tion by its material relations and requirements, — ever of the 
 earth, earthly, — tending to its own source, bending and drag- 
 ging the soul along with it. To the Christian, the body was 
 sin incarnate, the source of all evil and temptation, the bar- 
 rier between the soul and heaven. In the early centuries of 
 our era, the body seemed to be of ever less and less estima- 
 tion. There is something even amusing in the excess of 
 contempt in which it was held ‘and the abuse heaped upon it. 
 A prison-house, a cage, aweary load of mortality, — these 
 were by comparison complimentary terms. One old ascetic 
 Christian writer, a saint of course, calls the body " an ill-sav- 
 ored sink,” " a begrimed, pestiferous workshop,” " a lump of 
 flesh, which mouldereth away and draweth near to corruption 
 while we speak of it. ” The torments of the body were 
 so utterly despised as to be scarcely considered personal 
 matters. In fine, the body was considered the source of all 
 evil, and, as such, worthy of no consideration. The saints 
 and philosophers held that these our mortal members do pro- 
 duce the effect of fear, desire, joy, and sorrow, in our bodies ; 
 from which four passions the whole inundation of man’s 
 enormities have their source and spring. One old sect 
 of religionists held that the body was so evil, that its crea- 
 tion cannot be ascribed to the same author as that of the soul. 
 They held all flesh the work of the Devil. In their opinion 
 the great object of the government of the God of light was 
 to deliver the captive souls of men from their corporeal 
 
160 
 
 BODY VS. MIND. 
 
 prisons. Of course these folks must have regarded a skilful 
 physician as a servant of the Evil One, because he cured the 
 body of disease, and prolonged its existence. 
 
 Thus did theology cause an antagonism, a division of in- 
 terests, so to speak, between the material and the immaterial 
 elements of man’s nature, — one which in various forms, in 
 accordance with the spirit of the times, has been propagated 
 even until the present ; now one and now the other being 
 held in paramount esteem, in accordance with the demands 
 necessary to be made upon their functions. Here, brain has 
 been had in honor; there, thews and sinews. But the pres- 
 ent is essentially an iron and a practical age ; both strong 
 limbs and thoughtful minds are in requisition ; and the 
 spirit of the age is in nothing more manifest than in the 
 manifold attempts, by the spread of national education and 
 the increased attention to the sanitary condition of the 
 masses, to balance the interests of these hitherto conflicting 
 elements. The present prime minister of Great Britain, Mr. 
 Gladstone, about half a generation ago, said, "There still 
 remains in some quarters a vulgar notion that there is a nat- 
 ural antagonism between corporeal and mental excellence. I 
 trust that corporal education will never be forgotten ; that 
 the pursuit of manly sports will always receive the counte- 
 nance and encouragement, not only of the boys who engage in 
 them, but of the masters who are responsible for the welfare 
 of those boys.” These were memorable words at the time they 
 were uttered, and produced an effect which is perceptible on 
 both sides of the water, especially in our colleges and 
 schools. 
 
 Now, our leading clergymen are foremost as hunters and 
 fishers and rovers of the forest and lake. Fifteen years ago, 
 before the revolution in regard to gymnastics in our institu- 
 tions of learning had fully taken place, the "London Times” 
 said, " It was a great point in ancient philosophy, the value it 
 
BODY VS. MIND. 
 
 161 
 
 attached to the body, and the proper training of it, the pres- 
 ervation of its health, strength, and all its proper powers. 
 Ancient philosophy did not despise the body, did not regard 
 it as a mere husk and outside of human nature, or treat it as a 
 despicable and absolutely vile thing ; it regarded the body as 
 a true part of human nature, deserving of proper deference, 
 for the failure of which it was sure to retaliate upon the whole 
 man. 
 
 Hence the gymnastics of the Greeks, which were not only 
 fostered by the boxers and wrestlers, but went on under the 
 solemn sanction of sages. There is a distinction between 
 ancient and modern thought on this subject, and the ancient 
 has certainly the advantage over the modern in this particu- 
 lar point — at least over the modern before the latest im- 
 provements. It lias been too much the fashion with us to 
 decry the body, to talk it down, to speak scornfully of it in 
 every possible way, to be always comparing it with the mind 
 for the sole purpose of showing how vile and worthless it is 
 in comparison, — a mode of speaking which if it be abstractly 
 true, may be indulged in such a degree as to involve a prac- 
 tical untruth. . . . After all our sublime abuse of the body, 
 a body man has, and that body is part of himself ; and if he 
 is not fair to it, he himself will be th# sufferer. The whole 
 man will be the sufferer, — not the corporeal man only, but 
 the intellectual man as well. If the body is thoroughly out 
 of condition, the mind will suffer. It may show a morbid 
 enlargement of one faculty or another, but the direct- 
 ing principle — that which alone can apply any faculty or 
 knowledge to a good purpose, can regulate its use and check 
 its extravagances — is weakened and reduced. How miser- 
 able is the spectacle of morbid learning, with its buried 
 hoards, and its voracious, insatiable appetite for acquisition, 
 united with the judgment of a child ! Such study does, in 
 short, leave men children with remarkable memories and 
 
162 
 
 BODY VS . MIND. 
 
 acquisitive powers, who know as much history, philosophy, 
 and poetry as would make a learned man, but who are not a 
 bit nearer being men in consequence, because they simply 
 know by rote what they know, — they do not understand 
 their own knowledge. This is to a considerable extent the 
 case with all morbid learning, where the general intelligence 
 has not been cultivated, — which general intelligence depends 
 on the soundness and health of the whole man, body and 
 mind too. The picture of a Kirke White dying at the age 
 of twenty-one of nocturnal study, wet towels round heated 
 temples, want of sleep, want of exercise, want of air, want 
 of everything which Nature intended for the body, is not 
 only melancholy because it is connected with an early death : 
 it is melancholy, also, on account of the certain effect which 
 would have followed such a course unchecked if he had lived. 
 We see, when we look down the vista of such a life, an en- 
 feebled and a prostrated man, very fit to be made a lion of, 
 like a clever child, and to be patted on the head by patrons 
 and patronesses of genius, but without the proper intellect 
 and judgment of a man. How sad even is the spectacle of that 
 giant of German learning, Neander, lying his whole length 
 on the floor among his books, absorbing recondite matter till 
 the stupor of repletion comes over him, forgetful of time and 
 place, not knowing where he is, on earth or in the moon, led 
 like a child by his sister to the lecture-room when the lecture 
 hour came, and led away home again, when it is over. Is 
 this humanity, we ask, as Providence designed us to be? Is 
 it legitimate, rational human nature? It can hardly be called 
 so. We must not let the mind feed itself by the ruin of the 
 body. The mind has no right to this indulgence, this dissi- 
 pation and whole-length abandonment to its cravings, any 
 more than the body has to sensual indulgence. This mental 
 drain, the noxious stimulant which produces this overgrowth 
 of mind, is as contrary to nature as the coarser stimulant 
 
BODY VS. MIND. 
 
 163 
 
 which unduly excites the body. The mind should be a good, 
 strong, healthy feeder, but not a glutton. We have no right 
 to despise the body, or to speak of it only and exclusively as 
 something which is vile in comparison with the mind. This 
 language will lead astray ; it will make ardent, ambitious 
 student youth neglect health, and abandon themselves to the 
 process of acquisition at the cost of body, and ultimately of 
 mind too. Do not use too unsparingly the motive of ambi- 
 tion in dealing with youth. It is a motive which is perfectly 
 honest and natural within proper limits, but when pushed to 
 excess it produces a feeble, sickly, unmanly growth of char- 
 acter ; it creates that whole brood of fantastic theorists, 
 sentimentalists, and speculators, which in art, science, and 
 theology alike, are the seducers and the corrupters of man- 
 kind. Nowadays there is happily no danger of neglect of 
 the body. The mind is now studied in connection with the. 
 nervous system. Brain and mind are now used convertibly. 
 The brain proper is the one organ which increases from the 
 fish to man in proportion to the intelligence. It is now rec- 
 ognized that without a healthy body the mind cannot be 
 healthy or sane. Within a few years past we have seen the 
 students of our oldest university contending with those of 
 an English university, not in scholarship, but in the purely 
 physical art of rowing. It is scarcely necessary to allude 
 even slightly to the proof that the brain is the material 
 organ (and the only one) through which the mind acts, and 
 communicates with the external world, — this is generally 
 acknowledged. 
 
 It is less understood that the brain, as an organ, is subject 
 to precisely the same laws, chemical, dynamic, and automatic, 
 as other organs and tissues. It is also not disputed that every 
 action of the body is attended by the phenomenon of nutri- 
 tion, including the decomposition of some of the old tissue, 
 and the supply of its place by new particles ; and that the 
 
164 
 
 BODY VS. MIND. 
 
 evidences of such decompositions in the blood and the excre- 
 tions are in exact ratio to the energy and and continuity of 
 such actions. But although the laws of nutrition are in as 
 active operation in the brain as in any part of the system, we 
 find it at first difficult to realize the fact so well established by 
 undisputed physiological testimony, that these acts of nutrition 
 are in their essence the necessary conditions of every act of 
 intelligence, perception, or volition ; that, like all other tissues 
 actively concerned in the vital operations, nervous matter is 
 subject to a waste or disintegration , which bears an exact pro- 
 portion to the activity of its operations ; or, in other words, 
 that every act of the nervous system involves the death and 
 decay of a certain amount of nervous matter, the replacement 
 of whifch will be requisite in order to maintain the system in a 
 fit state for action ;* in short, that every idea, every emotion, 
 every act of volition, and every perception, however passive 
 or fleeting, is necessarily attended by a waste and decay of a 
 certain portion of brain tissue. Carpenter says, " In the healthy 
 state of the body, when the exertion of the nervous system 
 by day does not exceed that which the repose of the night 
 may compensate, it is maintained in a condition which fits it 
 for moderate constant exercise ; but unusual demands upon 
 its powers — whether by the long-continued and severe ex- 
 ercise of the intellect, by excitement of the emotions, or by 
 the combination of both in that state of anxiety which 
 the circumstances of man’s condition too frequently induce 
 — produce an unusual waste, which requires for the res- 
 toration of its powers prolonged repose.” It is certainly 
 inexplicable how matter and mind can act and react 
 one upon another ; the mystery is acknowledged by all to 
 be past finding out, and will probably ever remain so; the 
 co-ordinate phenomena, however, are open to investigation, 
 and it is clearly ascertained that to certain mental condi- 
 
 * Carpenter. 
 
BODY VS. MIND. 
 
 165 
 
 tions a certain state of the material organ is attached ; 
 and for certain mental acts, certain chemical changes in this 
 organ are requisite. A German physiologist says, " With- 
 out phosphorus, without thought. A due supply of arterial 
 blood is requisite for the proper action of the mind. Loss 
 of consciousness follows abstraction of this stimulus. The 
 quality of the blood circulating through the brain also influ- 
 ences the development of ideas ; if it be deficient in oxy- 
 gen, delirium of course follows. The digestion of food 
 introduces a quantity of imperfectly assimilated material into 
 the circulation ; until this new material has undergone the 
 necessary changes, and while certain matters, altogether 
 unfit for nutrition, are mingled with it, ifc is not adapted to 
 excite those states of the brain which are necessary for the 
 proper manifestation of mind ; and as it is conveyed to that 
 organ by the circulation, it produces an injurious change in it, 
 and impedes or destroys the mental functions. Hence the 
 indisposition to mental labor experienced by some persons 
 after meals.”* The same effects are produced in a more 
 marked degree by wine, spirituous liquids, narcotics, and 
 the presence of bile or urea in the blood. The organic affec- 
 tions of the brain necessarily and obviously modify the men- 
 tal conditions, not only by destroying the efficiency of a certain 
 portion of the tissue , but by interfering with the due per- 
 formance of the organic changes in the other parts. All this 
 is sufficiently comprehensible, that the organ being deranged 
 is no longer capable of performing the behests of the mind. 
 It is much less so how the derangement of the immaterial 
 essence can effect the organic structure ; yet the fact is indis- 
 putable. The simplest illustration may be drawn from an 
 occurrence not unfrequent in ordinary experience. A per- 
 son in perfect health receives a letter containing, perhaps, some 
 fatal news; he drops down, smitten with appolexy, and after 
 
 * Muller. 
 
166 
 
 BODY VS. MIND. 
 
 death it is found that the cerebral tissue is torn by an effu- 
 sion of blood into its substance. Joyous emotion may pro- 
 duce the same or analogous result. A young Frenchman 
 received a complimentary letter from the Directory ; he was 
 struck motionless, and his head immediately became affected 
 in a manner from which he never recovered. The paleness' 
 of the skin, and weakness of the circulation accompanying the 
 depressing emotions ; blushing, and other determination of 
 blood ; excitement of the arterial action, under the influence 
 of anger and the allied passions, — all illustrate powerfully 
 and sufficiently the force of mind. Enough has been said to 
 show the powerful influence which states of mind have upon 
 the body. 
 
CHAPTER XXI. 
 
 GENERAL PARALYSIS. 
 
 A preliminary idea of the nature of the affection of which 
 we speak may be obtained by a glance over the various names 
 by which it has been known. It has been called general 
 paralysis of the insane, paralytic insanity. Incomplete and 
 progressive paralysis, from its symptoms and its connection 
 with mental disorder, from its usual pathological characteris- 
 tics it has been termed slow or chronic meningitis, and men- 
 ingo-cerebritis. It is a disease which may be briefly said to 
 be characterized by disorder of the intellectual and volitional 
 powers, — not always, or even generally, in strict proportion 
 one to the other. The mental affection is usually of the 
 expansive character, attended by exaggerated notions of the 
 wealth, position, or personal qualifications of the subject, 
 terminating in dementia, or total eclipse of the mind. The 
 physical disorder consists in a progressive weakness and un- 
 certainty of action of the voluntary muscular system gener- 
 ally ; in a majority of cases, beginning with the muscles of 
 the tongue, and those connected with articulation, so that 
 stammering is very often the first symptom of the invasion 
 of this affection. In a patient who has evinced any tendency 
 to mental derangement, there can be few symptoms of more 
 serious import than this, — a tendency to stammer, or a diffi- 
 culty of pronunciation of certain words ; it may be appre- 
 [ 167 ] 
 
168 
 
 GENERAL PARALYSIS. 
 
 headed with a great amount of certainty that general paral- 
 ysis is imminent, and that death, soon or late, will follow as 
 the almost necessary result, let the physical health have been 
 up to that time ever so good. It may be expected that very 
 soon the tongue and the muscles of the face will act irregu- 
 larly and tremulously, and that this feebleness and uncer- 
 tainty of function will extend to the entire locomotive system, 
 sometimes attacking first the inferior and sometimes the supe- 
 rior extremities. The term "general paralysis” is, however, 
 somewhat deceptive, as not indicative of the absolute phe- 
 nomena of the disease in its progress. It is not until the 
 latest stages that the paralysis becomes truly general, and no 
 voluntary power is left, not even of the sphincters. But it 
 is in so far general that it is not hemiplegian or paraplegia, 
 nor local paralysis, differing from all these essentially, inas- 
 much as all the muscles of the body are indiscriminately liable 
 to be attacked, and sooner or later are so affected. It is rather 
 singular that a disease so well marked in its phenomena, and 
 so serious in its results, should only have attracted attention 
 in so comparatively late a period of medical history. Many 
 of our hospitals for the insane simply refuse admission to 
 patients affected with paralysis, as being incurable. This is 
 a highly important subject, and why ? it is getting to be, even 
 numerically, very prominent in the causes of death affecting 
 our bills of mortality, much more so than has hitherto been 
 suspected. There are forcible reasons, in a scientific point of 
 view, why it is deserving of special attention. The physical 
 causes of insanity are hitherto involved in great uncertainty. 
 
 Some pathologists go so far as to assert that in a majority of 
 changes cases of simple derangement of intellect, no morbid 
 condition of the nervous centres can be detected, and that in 
 a majority of the remainder, such changes are too unimportant 
 and too undefined and unspecific to be considered as causes. 
 Others aver that they have never examined the brain of a 
 
GENERAL PARALYSIS. 
 
 169 
 
 patient who has died insane, without detecting some morbid 
 alteration of the brain or its membranes ; and these authorities 
 are certainly amongst those who have had opportunities, not 
 by units or tens, but by hundreds of cases. Again, others 
 affirm that the visible and palpable changes are certainly 
 in many cases deficient, but would, doubtless, be revealed 
 were our means of investigation by the microscope and by 
 chemical analysis more perfect. And, in addition to all this 
 variety of opinion, it has to be taken into account that what- 
 ever may have been the proximate cause of the mental affec- 
 tion, certain additional, physical changes must have taken 
 place in order to cause death ; and there is the superadded 
 difficulty of deciding what has dethroned reason, and what 
 has destroyed life. In short, we are still ignorant of what 
 may cause mental aberration, and what is its essential, mate- 
 rial element ; nor have we as yet obtained any certain start- 
 ing-point, any positive data whereon to found a clearly 
 inductive system of research. One of the principally con- 
 tested points concerning this affection is, whether it is essen- 
 tially connected or not with mental disorder, for it appears 
 to occur sometimes entirely independent of mental affection ; 
 sometimes to supervene upon it ; and sometimes to precede it 
 by months, or perhaps years. The causes of general paralysis 
 are immediate and predisposing. The former are such in gen- 
 eral as produced prolonged over-excitement of the brain, — 
 sensual excesses, especially the abuse of intoxicating drinks, 
 over-feeding, sexual indulgence, and intellectual excesses, 
 accompanied by prolonged vigil. The predisposing causes 
 may be considered to be such as belong to insanity and brain 
 affection generally ; the disease moreover attacks men much 
 more frequently than women, and both chiefly between the 
 ages of thirty and forty-five years. The symptoms of gen- 
 eral paralysis (of the insane) consist of a non-febrile lesion 
 of the intelligence, the sensibility, and voluntary motion. 
 
170 
 
 GENERAL PARALYSIS. 
 
 The intelligence is constantly affected from the commence- 
 ment of the malady. Sometimes only observed as a feeble- 
 ness of memory or judgment ; and most frequently, as mania 
 with the delirium of grandeur and power ; sometimes as 
 melancholia, and sometimes again, as simple dementia from 
 the outset, a condition into which all the previous forms have 
 a tendency to merge, as the disease makes progress. What- 
 ever may be the original specific type of the mental affection, 
 the faculties are observed to be enfeebled progressively even 
 during the excitement of the opening delirium ; and this goes 
 on until the last phase is characterized by the utter extinction 
 of all intelligence. The alteration consists in progressive 
 weakness of the voluntary movements, commencing by trem- 
 bling of the muscles of the tongue and mouth, by a more or 
 less marked difficulty in the pronunciation of words, and 
 afterwards by hesitation in walking and uncertainty in stand- 
 ing, with trembling and weakness of the hands and arms. 
 The loss of muscular power extends often, and especially in 
 the later stages, to the sphincters of the bladder and anus. 
 When arrived at the extreme, the loss of power condemns the 
 sufferer to absolute immobility and muteness. The loss of 
 sensibility has not been studied with the same amount of care 
 and attention as has been bestowed on that of motion and 
 intelligence. Yet it is ascertained that the general sensibil- 
 ity is notably diminished, and the sense of touch greatly 
 deteriorated. The sight and hearing partake in some meas- 
 ure in the general dulness of sense. The seat of the malady 
 is in the cortical layer of the cerebral hemispheres. The 
 progress of the development of this affection has certain 
 characters which are special to it, as relating to the connec- 
 tion and succession of the symptoms, and the termination of 
 the disease. Impairment of the memory and judgment is 
 evident from the first, and continues always increasing until 
 their entire abolition. One of the most special and distinctive 
 
GENERAL PARALYSIS. 
 
 171 
 
 as well as most serious characters of general paralysis is that 
 it terminates constantly by death . As we proceed, we may 
 find some exceptions to this in the general paralysis occurring 
 independent of mental disease, but most observers agree, 
 that when once general paralysis has appeared, even slightly, 
 in an insane person, there may possibly be a remission of 
 symptoms even fora considerable period, but there can be or 
 rather has been hitherto no cure, — death is imminent and 
 certain, although at a very uncertain period. Perhaps the 
 average duration may be from two to three years. It is 
 very common before the close of life to observe gangrenous 
 sloughs in all parts of the body that are exposed to pressure ; 
 the phenomena of life are merely vegetative for some time 
 before dissolution. It is very common to see patients who 
 have gradually fallen into dementia without presenting any 
 of the symptoms of reaction or delirium, or in whom these 
 have been extremely slight and subordinate. As this decay 
 of the intelligence is established, we notice at first slight, and 
 then more marked signs of paralysis ; and shortly we have 
 developed a paralytic insanity so marked, that none can mis- 
 take it. By the side of this numerous group there is another 
 which is yet more so, especially amongst men. The patient 
 begins by presenting the signs of an excitement more or less 
 lively ; he moves about perpetually, and cannot remain still 
 for a moment. At the same time he forms large projects, 
 buys all manner of objects, gets angry when opposed, and 
 cannot sleep. To this state succeeds a complete maniacal 
 delirium, with predominance of ambitious ideas, and a special 
 muscular agitation quite distinct from that of ordinary name. 
 At the same time, if we are in the habit of attentively observ- 
 ing such patients, we shall detect a little hesitation in the 
 pronunciation of certain words. Such are in the two groups 
 which are at present designated under one name, that of 
 insane paralysis. These symptoms are assuredly very much 
 
172 
 
 GENERAL PARALYSIS. 
 
 opposed. In the one case we see debility, inaction, and the 
 slow extinction of the cerebral functions ; in the other, force, 
 violence, and an increase of physical and intellectual activity. 
 Authors have related a few cases of recovery, even after the 
 patients had presented the gravest symptoms of paralysis ; 
 and that although these facts may be considered exceptional, 
 they are doubtless of the highest significance. Observation 
 1st, — Mania for some months, with predominance of ambi- 
 tious delirium ; very marked symptoms of paralysis, with 
 difficulty of walking and standing. Stammering not present, 
 but some hesitation occasionally before a word. Formation 
 of gangrenous sloughs, followed by recovery, which lasted 
 
 twenty-five years. Observation 2d, — M , aged forty- 
 
 one, had some insane relations, and became melancholic him- 
 self after some domestic trouble. He had some epileptic 
 attacks ; the speech became imperfect, and one arm weak. 
 After his entry into the asylum, he was in continual agitation 
 and had the delirium of grandeur and riches fully developed. 
 Pupils unequal, tongue furred, pulse accelerated. The sen- 
 sibility became very much diminished, and the paralysis 
 extended to sphincters. He could not walk nor write his 
 name ; there appeared a great number of sloughs on the body, 
 some apparently without cause, some where his agitation had 
 bruised the skin. After attaining almost the lowest state of 
 paralysis, he began to recover, — as it is stated not by means 
 of therapeutic agency, — and both his reason and his bodily 
 powers returned. He was alive and well when the account 
 was Avritten, ten years afterwards. 
 
 (From the " American Journal of Medical Science.”) Ob- 
 servation 3d, — General paralysis, apparently of the worst 
 kind ; symptoms of the last period. Acute oedema of one 
 leg, with gangrene. Rapid recovery which is known to have 
 lasted six years. Observation 4th, — Acute mania, with ten- 
 dency to ambitious ideas ; feebleness of the memory, uncer- 
 
GENERAL PARALYSIS. 
 
 173 
 
 tain walk. Eruption of boils with abundant suppuration, 
 embarrassment of speech ; recovery. Duration of the malady, 
 one year. Duration of the recovery, five years. Sudden 
 death from cerebral haemorrhage. The fifth case recovered 
 after an abscess of the liver ; the sixth after a purulent dis- 
 charge from the ears ; and the eighth after an amputation, fol- 
 lowed by profuse suppuration. In all these cases the paralysis 
 was so far advanced as to be unmistakable ; the authorities 
 from whom they are quoted are unimpeachable. We must 
 therefore admit the possibility of paralytic ambitious mania 
 being cured. As for remedies : moderate local bleedings, 
 says Pinel, at the outset only, and when there are signs of 
 congestion, — issues at the base of brain, repeated vesications 
 over the scalp — general affusions, and revulsives from the 
 intestines and extremities, are the principal means to be used. 
 There are well authenticated cases of recovery. I am 
 convinced, says Pinel, that general paralysis is not a disease 
 especially appertaining to the insane ; that it is not a form of 
 insanity ; that it does not necessarily and fatally induce it ; 
 that it is an affection independent of this latter, so long as the 
 alteration which produces it does not extend to that portion 
 of the molecular structure of the brain, which presides over 
 intelligence ; and I believe that this portion of the brain may 
 escape lesion during the whole period of life. 
 
 The question of the essential nature of general paralysis 
 has perhaps been complicated more than by any other con- 
 sideration, by that of the variety of manners in which it makes 
 its first appearance. We will briefly sketch three. General 
 .paralysis presents itself in four forms, two of which are 
 marked by bodily disorder, and two by mental. 1. The 
 paralytic variety . This is the most insidious of all the forms 
 in which this fearful disease appears, and has perhaps given 
 rise to more contest as to its nature than any other. For 
 some time the only disorder appears to the ordinary observer 
 
174 
 
 GENERAL PARALYSIS. 
 
 to be one of the motor functions exclusively. The patient 
 himself perceives that his actions become irregular, trembling, 
 and wanting in precision. He lets fall objects which he holds 
 in his hands, and cannot perform any acts which require 
 delicacy of manipulation ; writing, drawing, or playing on any 
 instrument becomes difficult. He stumbles against the 
 slightest obstacle, and walks with a jerk ; he is more quickly 
 fatigued than formerly, and all his motions lack co-ordina- 
 tion. All this, which comes on very slowly and impercepti- 
 bly, is accompanied from the outset by a peculiar hesitation 
 and embarrassment of the articulation, or stammering. Ordi- 
 narily there is a slight pain in the head, and dizziness, an 
 unequal dilatation of the pupils and not unfrequently genital 
 impotence, with occasional incontinence of urine. During 
 this period the patient is conscious of his failing strength, and 
 troubles himself about it. He appears at first to enjoy the 
 full exercise of his faculties ; but although in some rare cases it 
 is not possible to detect any intellectual weakness, in general 
 the practised observer will recognize some indication of this. 
 There is an undefined alteration of character or disposition, 
 a mobility of temperament that scarcely admits of descrip- 
 tion, the performance of odd, bizarre acts that pass for 
 eccentricity, a tendency to make mistake in his usual employ- 
 ment, a slight weakness of memory for recent events, and, 
 what is the most serious symptom of all, a combination of 
 a marked hypochondriac tendency, with a general feeling 
 and expression of satisfaction and pleasure, the sure forerun- 
 ner to an outbreak of the expansive ambitious maniacal 
 delirium, which is not then long delayed. 2. The congestive 
 variety in this form, the physical symptoms again predomi- 
 nate over the psychical. The predominant character is one of 
 transient and recurrent congestion of the brain with or with- 
 out loss of consciousness, ordinarily slight, though some- 
 times very severe, simulating apoplexy or epilepsy, and 
 
GENERAL PARALYSIS. 
 
 175 
 
 giving rise to the opinion that the subsequent paralysis has 
 been caused by one of these affections. This form of conges- 
 tion is distinguished from the ordinary apoplectic form, by 
 leaving more serious and persistent traces in the moral and 
 physical nature. The speech remains for a long time disor- 
 dered, the movements of the limbs become difficult, and 
 sometimes there is even incomplete hemiplegia, which dimin- 
 ishes and disappears slowly, to return perhaps after the next 
 congestion. The intelligence is affected after each attack, 
 as well as the motive powers ; but if there be any consider- 
 able interval, both orders of phenomena partially disappear, 
 and the patient is restored to a comparatively healthy condi- 
 tion ; apparently , immediately after the attack we may 
 detect a considerable feebleness of memory and the other 
 faculties ; but in time the intellect appears to resume its ac- 
 tivity. After several attacks, however, both the physical and 
 intellectual nature is found to be unmistakably deteriorated, 
 and dementia, accompanied by various forms of delirium, 
 supervenes. In short, like the last form, the malady assumes 
 the ordinary aspect of " general paralysis of the insane.” 
 
 Melancholic Variety . — In this form the psychical disorder 
 first attracts the attention. It is only in comparatively rare 
 instances that the physician sees the first stage of the malady ; 
 but in inquiring into the history of paralytics, he will not 
 unfrequently find that the first phenomenon that attracted 
 attention was a state of marked moral and physical weak- 
 ness or depression, with lowness of spirits, and incapacity, 
 real or supposed, for any form of action ; presenting every 
 appearance of hypochondriacal melancholia. Even at this 
 period there may sometimes be detected slight disorders of 
 mobility, as stammering or hesitation in speech, or feebleness 
 and trembling of the limbs. But these symptoms arc over- 
 looked, the melancholia absorbing the whole attention. 
 The melancholic period may be very short, or it may have 
 
176 
 
 GENERAL PARALYSIS. 
 
 lasted some time ; but in all cases that are paralytic it disap- 
 pears gradually, to give place to the normal condition. But 
 this is very transitory ; almost as soon as the signs of mel- 
 ancholia begin to disappear, the attentive observer may 
 detect frequently the symptoms of an opposed condition. 
 The patient experiences a sensation of exaggerated comfort ; 
 he was never so well in his life, body or mind ; he begins to 
 be unnaturally active, moving incessantly ; he forms projects 
 of which he would never have thought before, perhaps not 
 absurd, and altogether out of accordance with his fortune or 
 profession, but still quite opposed to his previous habits and 
 tastes. He then either passes gradually into the true expan- 
 sive delirium, or a fierce mania with predominance of am- 
 bitious ideas breaks out suddenly, after which his history is 
 the same as that of the next variety. 
 
 The expansive Variety. — This is the most frequent form 
 of the debut of general paralysis ; and from the marked char- 
 acter of the symptoms clearly requiring immediate attention, 
 it is more frequently noticed in its earlier stages than any of 
 the others, and on this account has been erroneously supposed 
 absolutely essential to the character of general paralysis. 
 Those paralytics who present themselves from the outset 
 with the expansive form of delirium, have been ordinarily 
 men of active minds and habits, enterprising, rash, and gen- 
 erally of irritable, violent character, with much generosity. 
 The expansive delirium is an exaggeration of this character ; 
 and so gradually does it sometimes sweep on, that the mo- 
 ment of actual outbreak is difficult of detection. The 
 patient appears at first to be simply more active, more rash, 
 more irritable, and by fits and starts more generous and 
 lavish in his expenditure than before. By and by all this 
 passes clearly beyond the normal state. The subject is in 
 perpetual motion, takes no rest, cannot sleep, feels an exag- 
 gerated sense of power and general well-being, and conceives 
 
GENERAL PARALYSIS. 
 
 177 
 
 projects of the most stupendous character, that must be at 
 once carried out, all of which, if not quite irrational, are 
 opposed utterly to his previous habits and tastes. He adopts 
 excesses which are not habitual to him, passes an irregular 
 and disorderly life, and commits acts which greatly astonish 
 his friends, such as undressing in society, sleeping in the 
 fields, and out of his own house, and perhaps committing 
 petty thefts without any motive. He is possessed of bound- 
 less wealth or power with which he will perform the most 
 unheard-of deeds. He will give away his property, and if he 
 has none he will profess to do so. He is endowed with 
 supernatural attributes, he is God’s vicegerent upon earth, 
 he is some mighty potentate. Acting upon some of these 
 convictions, he commits an offence against society, himself, or 
 property, which demands his seclusion, when the true nature 
 of the case is readily recognized. 
 
CHAPTER XXII. 
 
 DIPSOMANIA, OR DRUNKEN INSANITY. 
 
 This is a learned word which signifies an insane thirst, a 
 moral insanity in regard to wines and liquors. A man is a 
 drunkard who gets drunk at the festive board, who seeks 
 occasions for getting conveniently drunk without interfering 
 with his ordinary occupation, who takes a few days drinking 
 at a time when he has plenty of money, and returns to his 
 duties and employments when he has finished his superfluous 
 cash and his "bender” or "spree,” as it is called. Some 
 men, on the other hand, get systematically and regularly 
 drunk every day after dinner, some every night before going 
 to bed, and will perform their daily duties with propriety 
 and efficiency. Obviously they do not come under the head of 
 insane drinkers, for they exercise a certain amount of self- 
 control, a sufficient amount of restraint upon their appetites, 
 not to allow the quantity Avhich they drink to affect their 
 aptitude for business, or driving a good bargain. The prin- 
 cipal feature of this disease — that of insane drinking, or 
 dipsomania — is, on the other hand, the absence or loss of the 
 power of self-control or self-regulation. Persons affected 
 with this form of moral insanity do not drink from the pleas- 
 ure which the social board affords, but, on the contrary, will 
 not unfrequently preserve a certain amount of decorum 
 while in company. Neither do they drink for the pleasure 
 [ 178 ] 
 
DIPSOMANIA, OR DRUNKEN INSANITY. 
 
 179 
 
 which the wine gives them ; they will drink any kind of intox- 
 icating stuff. Nor do they drink at a convenient time and 
 place, and only occasionally ; they drink as often as they can, 
 and as much as they can ; their craving for stimulants is inces- 
 sant and uncontrollable ; no considerations of self-respect, no 
 regard to public opinion, or common decency, or domestic 
 ties, or religion, or the certainty of impending ruin, degra- 
 dation, or even the fear of death, can prevent their drinking 
 till they can drink no longer. Such persons will often 
 deplore their fatuity, their inability to control their appetites, 
 and will say with tears in their eyes, as some have done, 
 that if hell were yawning at one side of them, and a bottle 
 of brandy standing at the other, they would drink, although 
 the next moment they were to be thrown into the bottomless 
 abyss. In a word, such persons drink because they cannot 
 help it , and if they really cannot help it, they must be 
 regarded as no longer responsible agents, — as, therefore, 
 insane, and proper objects for being restrained and protected 
 against themselves. The loss of self-control is, indeed, the 
 most essential condition of almost all cases of insanity. 
 The most constant symptoms of insanity are those referable 
 to altered affections, perverted desires, and morbid propen- 
 sities. In almost all cases of this variety of moral insanity 
 there is a total disregard for truth. Such persons are singu- 
 larly mendacious. They will resort to every possible device 
 to procure stimulants, to excuse their conduct, to deceive 
 their friends and medical attendant, will display an ingenuity 
 and fertility in deceit which is truly marvellous. They 
 will become faint, or be in agony with the toothache, or tic, 
 or cramp in the stomach, or colic, etc., and represent them- 
 selves at death’s door in order to get brandy, wine, or opium 
 administered. They will pawn every available article of 
 dress or furniture or jewelry. They will borrow from all 
 and sundry. They will get whiskey smuggled home with 
 
180 
 
 DIPSOMANIA, OR DRUNKEN INSANITY. 
 
 their clothes from the tailor or laundress. They will evade 
 the most vigilant surveillance, and tell the most deliber- 
 ate falsehoods in their attempts to deceive, solemnly appeal- 
 ing to God for their truth. When shut off from the ordi- 
 nary sources of stimulation, they will sometimes resort to 
 almost anything to relieve their craving. I have known 
 a young and delicate lady, after being prevented getting 
 wine or spirits, and deprived of lavender water and 
 eau de Cologne , take creosote, vinegar, tobacco. Again, 
 such persons will insist on a total denial of their habits of 
 over-indulgence. They will very frequently disavow most 
 solemnly having ever exceeded the bounds of strict tem- 
 perance in their use of stimulants ; and, if admitting at 
 all that they have ever been the worse for drink, they will 
 blame some other person or circumstance as the cause of it. 
 Accompanying this disregard of truth, there are often other 
 indications of moral perversion in the insane drunkard, such 
 as extreme licentiousness, or a propensity to theft. The 
 disease is frequently hereditary ; and it will be found, on 
 inquiry, that a grandfather, or father or mother, or one or 
 more brothers, have died of delirium tremens, or have other- 
 wise shown the fatal propensity. The constancy with which 
 the hereditary predisposition to this disease is transmitted is 
 most remarkable, and, in a vast majority of cases, can be 
 traced either through the the maternal or paternal side of the 
 family. To illustrate the truth of these remarks, I have ana- 
 lyzed the records of eighty-six of the cases of this form of 
 moral insanity which I have had under my care, of which 
 twenty were females and sixty- six males. Of the former one 
 half presented natural peculiarities in their mental constitu- 
 tion, being either of weak minds, of very violent and uncon- 
 trollable passions, or subject to hysterical attacks of great 
 violence, combined in some instances with great moral 
 depravity. Of ^the males, thirty, or nearly one half, were 
 
DIPSOMANIA, OR DRUNKEN INSANITY. 
 
 181 
 
 naturally of weak mind, or presented some mental peculiar- 
 ity, such as silly vanity, general depravity of disposition, 
 and, in some cases, considerable talent, but combined with 
 eccentricity. In regard to hereditary predisposition, it is 
 difficult generally to trace this in a public hospital, partly 
 because many cases come in without any information regard- 
 ing them at all, and partly because the friends, when they 
 have friends, are generally very solicitous to deny or conceal 
 the existence of an hereditary taint in the family. Of this 
 malady there are three divisions, the acute , the periodic, and 
 the chronic. Under the head of acute , I would include all 
 those cases of uncontrollable drinking which occur to persons 
 of previously temperate or regular habits, but in whom this 
 insane craving has been generated under the influence of 
 some accidental cause, — such as the novelty and excitement 
 of a new sphere of duty, and the temptations of new asso- 
 ciates and habits, all combining to lead to intemperance ; or 
 the depressing effects of some overwhelming calamity, or of 
 some debilitating accident, or disease, or other agency. It 
 is w^ell known that the use of stimulants, begun or indulged 
 in under any of these circumstances, has gradually merged 
 in many instances into an inordinate and uncontrollable 
 craving, and an insatiable and destructive use of them. 
 Cases of this kind, if taken in time and treated judiciously 
 and firmly, are generally curable without recourse to any step 
 for depriving the patient of his personal freedom. Periodic 
 or recurrent attacks of this disease are generally dependent 
 upon some constitutional or hereditary peculiarity. Some- 
 times they occur at the critical age in females, and preserve 
 a periodic form coinciding with the menstrual period. Some- 
 times they arise from injuries of the head. Cases of this 
 kind are less easily treated than the acute, particularly 
 where there is a hereditary predisposition. They hardly 
 justify confinement. The uncontrollable impulse will come at 
 
182 
 
 DIPSOMANIA, OR DRUNKEN INSANITY. 
 
 its accustomed time. Nor does this form of the disease inter- 
 fere materially, in many cases, with the duties of life. 
 Many individuals have distinguished themselves in literature 
 or in professional or mercantile life, who have been known 
 for a long term of years to retire periodically into the pri- 
 vacy of their own chamber, and, after indulging this morbid 
 appetite to satiety for a week or two, in their voluntary 
 seclusion, to reappear again on the stage of life, and pur- 
 sue their usual avocations with credit and success. Such 
 cases are perhaps rare, and more frequently it happens that 
 the periodic or recurrent form gradually degenerates into the 
 chronic variety of the disease, the intervals becoming shorter 
 and the attacks longer, until the intervals cease altogether, 
 and a chronic disease or a fatal issue ensues. It is the 
 chronic form of this disease which is the least curable and 
 most troublesome to manage. Here the craving for stimu- 
 lants, brought on perhaps by indulgence and irregular habits 
 operating upon a constitution hereditarily predisposed, 
 becomes constant, insatiable, and incontrollable ; and the 
 daily or hourly indulgence suffers only now and then a tem- 
 porary check by illness caused by it, by attacks of delirium 
 tremens, or outbursts of mania. I believe it is agreed by all 
 parties, that this form of the disease can only be treated 
 effectually by prolonged and complete abstinence from all 
 stimulants. 
 
CHAPTER XXIII. 
 
 LATE SUPPERS AND DREAMS. 
 
 We have alluded to the subject of the effect of late suppers 
 on the nervous system already. A late supper is an unwhole- 
 some meal from whatever point looked at. The influence 
 both of food and drink on the mind is acknowledged. A man 
 may be said to think according as he eats and drinks. Every- 
 thing which affects the circulation of the blood, or which in- 
 creases or diminishes the nervous force, may and does interfere 
 with, modify, or stimulate the action of the mental faculties. 
 Dreams merely indicate a disturbed condition of the stomach 
 or brain. I can best illustrate this subject by relating some 
 curious dreams in point, dreams which have been occasioned 
 by food which has disagreed with the digestive organs, or 
 which have exercised a peculiar influence upon the nervous 
 system, or which have been induced by food taken at an 
 improper time, or which have happened when sleep has been 
 indulged in immediately after taking food. * 
 
 It is a curious fact that not only the kind of food may 
 determine the events of a dream, but often, also, that the pur- 
 suits of the dreamer will tend to give his dreams some spec- 
 ialty. For example, we knew a medical man who after 
 attending a lecture was very hungry, and, contrary to his 
 usual practice, ate a hearty supper of rich fish with a stuffing 
 composed of liver mixed with savory herbs and spices, and 
 
 [183J 
 
184 
 
 LATE SUPPERS AND DREAMS. 
 
 some stimulating sauce. When he went to bed he had a 
 
 rather dry and feverish skin, but he soon fell asleep and 
 
 dreamt the following curious adventure : He said, "that he 
 
 thought he was travelling in a very hot country, which 
 
 abounded with a number of poisonous serpents, particularly 
 
 the ' cobra di capella, ’ and that, having the opportunity to 
 
 dissect some of them, he seemingly did so without harm 
 
 to himself, until he proposed showing the structure of the 
 
 secretory glands, which generated the poison. These he 
 
 traced to the lower surface of the tongue, and when in the 
 
 act of carefully pressing these glands to ascertain the color 
 
 of the deadly fluid, a little of it squirted into his flice and 
 
 / 
 
 caused him great pain. The sense of his dangerous position 
 awoke him, and he was highly gratified to find merely a little 
 eruption on his nose and face, evidently caused by the rich 
 food of which he had partaken the previous night,” and he 
 added that indigestion was invariably relieved in his own 
 case by eruptions on the skin. 
 
 We select another instance to prove that particular food 
 not only gives the specialty of the dream, but also in this 
 case revived impressions of the past, and gave them all 
 the vividness of reality. The person said, " The other night 
 I was very hungry and was induced to eat supper, and added 
 to the outrage of partaking of cold roast beef, the folly of 
 eating about a dozen pickled onions. But as I felt very com- 
 fortable and had a long way to walk, there was not any mis- 
 giving that for so doing any great punishment would result. 
 By the time I reached home it was at least two if not three 
 hours after taking the unwholesome meal, and soon after- 
 wards I went to bed. I felt somewhat uneasy, but it was not 
 long before I fell asleep. Soon afterwards I dreamt that for 
 some offence of etiquette I was doomed to eat ' sour-crout.’ 
 Now it so happened that this kind of pickled cabbage 
 always caused me most painful nausea even when smelling it, 
 
LATE SUPPERS AND DREAMS. 
 
 185 
 
 so that I had never been prevailed upon to taste it. Never- 
 theless, in the vision, it seemed that great pains and penal- 
 ties awaited me, unless I abided by the unchangeable fiat of 
 the judges. 'I fancied myself brought into a large room 
 in the centre of which was the reeking crout , and what with 
 its acid fumes and its fatty smell I was almost overpowered, 
 and I experienced a sense of nausea and disgust. Still I made 
 the effort to eat, but every mouthful which I endeavored to 
 swallow was immediately rejected, and the painful and sick- 
 ening sensation increased at every attempt to retain the 
 abominable stuff. My situation was indeed pitiable ; and 
 the perspiration trickled down me, from the agony I experi- 
 enced. It was a battle between sour-crout and the stomach, 
 and the struggle was desperate ; but the stomach conquered, 
 and I awoke. My mouth was filled with acidity and the 
 disagreeable taste of the onions, which together rendered 
 my sensations most unpleasant. This condition of the mouth 
 had evidently suggested the dream, and an early antipathy 
 for fermented sour cabbage was reproduced with as much 
 vividness as if the crout had been positively served up, and 
 coercion had been used to enforce it being eaten.” This 
 individual was advanced in life and had not seen or smelt 
 the sour-crout since his boyhood, yet its odor appeared as 
 disagreeble to him in his dreams as it would have been in 
 his wakeful moments. Here is a somewhat funny dream 
 which occurred during not a late supper, but an after-dinner 
 nap. A gentleman fond of good living, who invariably did 
 justice to his meals, one day had dined at home wdth his 
 family, and being very hungry, he had despatched slice after 
 slice of some roast or boiled mutton, declaring that he had 
 never eaten a more delicious, juicy, tender specimen of mutton ; 
 and as a proof of his sincerity, he refused all the et-ceteras 
 of a wealthy citizen’s dinner meal. After dinner he took his 
 usual short siesta . He had been but a short time asleep, 
 
186 
 
 LATE SUPPERS AND DREAMS. 
 
 when he began to laugh, and that so heartily, that it was con- 
 tagious, and the risible chorus soon awoke him. Imme- 
 diately all asked him what he had dreampt about that had 
 so tickled his fancy. "Well, ” he replied, " I thought that I 
 was at a public dining-table, at which there were many stran- 
 gers. The tables were well supplied with fish, meats, and 
 vegetables of all kinds in season, and I myself only partook 
 of mutton. But what tickled my fancy in the first instance 
 was, that I overheard the waiters speak of the different vis- 
 itors, giving each the name of the ' dainty dish ’ he or she 
 had preferred. There were Mr. Fish, Mrs. Steak, Miss Stew, 
 Lady Cabbage, Mr. Rice, Miss Duck, Old Squire Bread, and 
 numerous others distinguished by what they most enjoyed. 
 I thought it curious that I had not been mentioned, and prob- 
 ably I should not have been, had not one of the ladies asked 
 my name, ' 0, ’ said the domestic addressed, 'you mean 
 Old Mutton. ’ This audible reply was not considered rude, 
 as he had feigned deafness. He thus became the topic of 
 conversation. 'Old Mutton is a curious, eccentric person- 
 age,’ observed a sly fellow, who with a most bewitching lisp 
 proposed Old Mutton’s health and ' let him know our admira- 
 tion is excited,’ said the speaker, 'because he sticks so lov- 
 ingly to his family connections, and gives them the preference, 
 as we all have witnessed.’ All the company rose simul- 
 taneously, and turned towards me, then with mock gravity 
 bowed, saying, ' Old Mutton’s good health.’ Whilst a few, 
 not improved in their manners by what they had drunk, 
 shouted out, ' Here ’s to jolly Old Mutton.’ Then I opened 
 my eyes and stared at them, and thus addressed the com- 
 pany : 'Thank you, my innocent lambs, but you bleat most 
 discordantly.’ The surprise that was depicted on every face 
 looked most ridiculous, and I continued in a strain of badi- 
 nage. 'Well, you pretty innocent, wool-covered creatures, 
 I am very glad you are not foxes, or else " Old Mutton,” 
 
LATE SUPPERS AND DREAMS. 
 
 187 
 
 " Jolly Old Mutton,” would have had little chance of saving 
 himself from your chops ! ” All this and much more had 
 taken place during a doze of a few minutes. Here is 
 another amusing dream, suggested by the nerves of taste 
 which occurred to a lady, a friend of the writer, and which 
 furnishes some speculative thoughts to the psychologist. 
 Mrs. — had a slight cough, and one of her daughters brought 
 her some barley-sugar to suck when in the act of lying down, 
 or in case the cough disturbed her during the night. She had 
 on the occasion we are about to relate, taken a piece of this 
 sweet medicine into her mouth, and soon afterwards fell 
 asleep with the confection undissolved. She dreamt that she 
 was a very little girl, and that she was spending the even- 
 ing in a juvenile party, at which, besides tarts and jellies, 
 there was added an abundance of sweet-meats of the most 
 delicious kinds. She felt superlatively happy, and, what 
 contributed to ensure this satisfactory state, all her early 
 associates were present. These friends of her childhood 
 appeared the same laughing girls and boys, and were appar- 
 ently undisturbed by care or annoyance of any kind. Yet 
 she seemed to have some undercurrent of misgiving, for 
 many of these spectra had been dead for years, and others 
 she had not seen since their school days, when she herself 
 was but a little girl. But these reflections did not affect her ; 
 for she fancied herself entering into all kinds of childish 
 sports and pastimes with all the glee imaginable, and so 
 she continued to laugh with those around her until she awoke 
 with a smile on her features ; and so brief was the whole 
 period of the dream that her daughter had not left the bed- 
 side, for she had not been asleep more than a few moments. 
 The explanation is, that as she was going to sleep the passing 
 idea occurred : " I am like a little child, to go to bed with 
 sweet-meats.” This suggested to her mind the train of 
 pleasing thoughts. For when the world was closed on her 
 
188 
 
 LATE SUPPERS AND DREAMS. 
 
 unconscious senses, the soul thus untrammelled revived the 
 scenes of her juvenile days, and called forth from the 
 shadowy past her former associates, companions who had 
 been forgotten during her maturity, with its hopes and 
 fears. 
 
CHAPTER XXIV. 
 
 THE USES AND ABUSES OF THE POPULAR NERVINES. 
 
 Particular kinds of remedies and medici • s, like other 
 things, are at particular times all the rage, and are supposed 
 during their brief period of popularity to be absolute cura- 
 tives for the particular class of affections and ailments for 
 which they are designed. Of course in this high-pressure 
 age, when nervous affections and nervous diseases of all 
 descriptions are the prevalent ills of the flesh, at least 
 among all those classes who employ head-work, whether 
 professional, literary, or mercantile, nervous remedies are 
 in especial demand. 
 
 The danger is that when a particular remedy becomes thus 
 popular, it will be used in excess, and so, in the end, prove 
 detrimental. For instance, there was a time when prepara- 
 tions of mercury were all the rage, and when it was supposed 
 that such preparations were actual panaceas or cure-alls. 
 The consequence was that mercury was not only used prop- 
 erly, but misused and abused, until it has become a synonyme 
 of all that is deadly as a medical prescription. So with 
 bleeding, it was regarded as such a sovereign remedy at one 
 time, that a physician who visited a patient without his lan- 
 cet, was thought to be without the means at his command to 
 properly practise his profession. And cupping was practised 
 to such an extent, that the last dregs of the cup of human 
 
 [189J 
 
190 
 
 USES AND ABUSES OF POPULAR NERVINES. 
 
 life were in clanger of being drained. So hydropathy had its 
 run, and was esteemed at one time a sovereign remedy. So 
 at the present time, which may be called the era of nervous 
 diseases, there are certain fashionable nervines which are mis- 
 used and which are abused to full as great if not to a greater 
 extent than calomel, phlebotomy, and the cold-water pack 
 used to be. The writer has recently had a nervous patient 
 who, by the excessive use of belladonna (deadly nightshade) 
 injudiciously prescribed by a friend, evidently with the best 
 intentions, became so addicted to the inordinate use of the 
 drug, as a nervous remedy, as to induce amaurosis and come 
 near a total loss of eyesight. It is well known that chloral 
 is a powerful hypnotic (or sleep producer), and wakefulness 
 being one of the most distressing symptoms and incidents 
 of nervous diseases, this remedy was naturally hailed as 
 almost a benison from heaven, and became in literary and 
 fashionable circles, in all cases where, either through ill health 
 or over-indulgence, the nerves were unstrung, a universal 
 resort as a prescription. The consequence was that the 
 patients using this powerful remedy, not taking into consid- 
 eration the reaction which inevitably follows, became inca- 
 pable of any but an unnatural, artificially induced sleep, 
 which only continued during the effect of the drug. In 
 short, healthful, ordinary slumber became an utter stranger 
 to their pillows, while phantasies and disturbing visions of 
 all kinds continually haunted their nocturnal hours. There 
 is another class of nervines, which have come into great use 
 and celebrity within the past ten years, which deserve espe- 
 cial mention and consideration. I allude to the multitudi- 
 nous salts of potassium, prominent amongst which are the 
 bromides and iodides. This class of nervine remedies has 
 of late been considered the great resource in the treatment of 
 nervous affections, particularly in cases of cerebral congestion 
 or irritation of the base of the brain and spinal colu/nn, 
 
USES AND ABUSES OF POPULAR NERVINES. 
 
 191 
 
 and in gastralgia ana dyspepsia or inflammation of the stom- 
 ach, either acute or chronic. Every patient suffering from 
 hysteria, alcoholism or delirium tremens, melancholy, de- 
 spondency, or venereal excesses, has been liberally dosed 
 with bromide of potassium. While I do not wish it to be 
 inferred that I entirely ignore this class of nervous remedies, 
 or deny their utility and beneficial effects when judiciously 
 administered, I still must insist that these remedies should 
 never be administered alone, or in quantities which may be 
 well termed excessive, as the invariable result of such im- 
 proper administration is a depression of the nervous system, 
 from which the patient seldom if ever rallies. Furthermore, 
 it is a well-known therapeutical fact that bromide of potas- 
 sium produces a permanent anaemia (or absence of blood) 
 in the brain throughout the whole capillary and arterial cir- 
 culation. Consequently, as must be evident even to the un- 
 professional reader, if its use be continued the result is con- 
 tinued until the brain, deprived of nutrition, loses its tonicity, 
 and softening is the inevitable consequence. No more terrible 
 affliction, of course, can, befall a human being than this. 
 Henceforth he wanders about a lack-lustre idiot, until death 
 comes to his relief, much, also, to the relief of his friends. 
 In 1812 aconite was introduced as a nervous sedative by 
 Sir Benjamin Brodie. The peculiar action of this drug upon 
 the nervous fibre is due to the alkaloid, which does produce 
 a very rapid and tranquillizing effect on the brain, at the 
 same time also producing a very depressing effect on the 
 heart and circulation. In other words, the brief beneficial 
 effect of the administration of the drug in quieting the brain 
 is secured at the expense of the permanent depression of the 
 nervous system. The administration of this drug, when 
 persisted in, is almost sure to produce apoplexy. Where 
 there is too much tone, excessive tension of the nerves is a 
 result, and when there is too much depression, effusion is 
 
192 
 
 USES AND ABUSES OF POPULAR NERVINES. 
 
 pretty sure to follow. Even the small- doses of this drug 
 prescribed by homoeopathic physicians finally induce the 
 same results as in a more heroic practice. I will close this 
 cursory discussion of the merits and demerits of some of 
 the popular nervines by a word or two about the most com- 
 mon and popular of all the nervines (for a nervine it is to 
 all intents and purposes, and not by any means perfectly 
 harmless) , to wit : Tea, one of the chief constituents of 
 this beverage " which cheers but not inebriates,” is tannin, a 
 substance so powerfully astringent as to produce derangement 
 of the liver and all the excretory organs. Hence the exces- 
 sive use of tea is oftentimes at the bottom of the complete 
 derangement of these organs. As a result, come spleen, 
 melancholia, and nervous derangement. As for the other 
 nervines, such as valerian, morphine, lactucarium, hyoscy- 
 amus, etc., they all have their devotees, and are too well 
 known, both in their curative and pernicious effects, to need 
 special notice. Suffice it to say that all the nervines are 
 necessarily perilous agents, except in the hands of a skilful 
 practitioner, who has made nervous affections a life-long 
 study and specialty of treatment. 
 
INSTRUCTIONS TO PATIENTS. 
 
 Dr. Hayes, having for many years devoted his attention to the treatment 
 and cure of diseases of the Nervous System described in the preceding 
 pages, may be personally consulted, together with Dr. Parker, his assistant 
 and former pupil, from nine in the morning until six in the evening, daily, 
 Sundays excepted, at his office, No. 4 Bulfinch St., Boston, Mass. 
 
 Cases can be treated by correspondence when a personal interview is im- 
 possible, providing the patients will minutely detail all of their bodily infir- 
 mities and mental disturbances, written ill a simple and natural style, and in 
 accordance with the unerring dictates of their own feelings. One personal 
 interview, however, even with patients resident at a distance, is highly de- 
 sirable when practicable, and will more than repay the patient the expense 
 and trouble of a visit to Boston. The advantages of such a visit are 
 apparent and manifold. A single visit in most cases will enable the Doctor 
 to form an accurate opinion and note particulars which might be lost sight 
 of in mere correspondence, particularly when a microscopic and chemical 
 examination of the urine is absolutely necessary. 
 
 Patients not Resident in the City, 
 
 Who wish to transact their business through the mail, or by express, can 
 have their necessary remedies sent to any address, or left at any railway 
 station or coach office in the United States or Canadas until called for, care- 
 fully packed and securely sealed. 
 
 All communications must contain the usual consultation fee of five dol- 
 lars ; otherwise no notice will be taken of their application. A distinct 
 name and address is necessary. Money can be forwarded by enclosing 
 bank notes in a registered letter, to ensure their safety, by Postal order, 
 drafts on New York or Boston bank's, or by express. 
 
 The entire correspondence of the Institution comes under the personal 
 inspection of Dr. Hayes, whether addressed to the Peabody Medical Insti- 
 tute, Dr. W. H. Parker, his assistant, or himself. 
 
 [ 193 ] 
 

 
 
 
 
TESTIMONIALS 
 
 By way of conclusion to this volume, the author is gratified to 
 be able to place before his multitudinous readers a number of cer- 
 tificates and testimonials of his success in the cure of nervous 
 diseases from grateful patients residing in different parts of the 
 countiy. These testimonials have been unsolicited, and are such 
 tributes as would be flattering even to the most distinguished mem- 
 bers of the medical profession. Naturally enough, patients who 
 have been cured of the most depressive class of ailments and ills 
 to which flesh is heir, are somewhat warm in their expressions of 
 gratitude towards their medical benefactor. The writer could fill 
 a volume with authentic testimonials of a similar nature. Many 
 of these testimonials are from prominent and influential persons 
 in the various localities in whiph they reside, — from persons, in 
 short, in all avocations of life. 
 
 AN ALMOST HOPELESS CASE OF NERVOUS DISEASE. 
 
 Perfect Cure. — A Grateful Testimonial. 
 
 Boston, May, 1873. 
 
 In June of the year 1865 the undersigned went to California and took 
 charge of a large mining interest, in which his own fortunes, as well as 
 those of several friends, were largely involved. The interest was in litiga- 
 tion, and for a year and a half was under the constant strain of intense 
 mental anxiety, to say nothing of incessant bodily activity. My manage- 
 ment was successful ; but at the end of a year and a half I found myself 
 
 [ 195 ] 
 
196 
 
 TESTIMONIALS. 
 
 completely prostrated and broken down by excessive mental and bodily 
 exertion. I was, in fact, the subject of one of the most serious forms of 
 nervous disease, caused, I was told by the medical. authorities, by conges- 
 tion of the base of the brain. 
 
 To be thus suddenly arrested ip the very midst of a lucrative and most 
 promising enterprise, just when I had reached blue water, as it were, and 
 all difficulties had been overcome, and doubts of success had been dispelled, 
 — to be arrested, I say, at such an interesting juncture by an alarming ner- 
 vous affection, which completely incapacitated me for any mental or bodily 
 exertion whatever, was sufficiently discouraging and disheartening. It was 
 like drowning, not only in sight of land, but with one’s clutch on the shore. 
 It was useless to struggle. I was obliged to succumb ; and, by advice of 
 my friends, I went reluctantly east to Philadelphia, where I was placed 
 under the care of a most prominent physician. At this time my memory 
 failed me, and I had lost the perceptions of taste, touch, and smell. My left 
 side was paralyzed. I was constantly tormented by hallucinations and 
 gloomy forebodings as well as by incessant pain, so that a nurse at my side 
 was a necessity that could not be dispensed with by night or day. 
 
 As I showed no symptoms of recovery, I was taken to Saratoga, that a 
 physician resident there, who was somewhat celebrated for his treatment 
 of nervous affections, might be consulted. Perhaps also it was thought that 
 the mineral waters might be beneficial. I remained six months at Saratoga, 
 not only without amendment of my health, but I had grown worse instead 
 of better. 
 
 Matters had now become so serious that immediate recourse to the best 
 medical advice and ability to be found in the city of New York was deemed 
 the best step. I was soon under the care of the most noted specialist in 
 nervous disease in the commercial metropolis. After a course of treatment 
 in which electricity formed a prominent feature, my friends were notified 
 that my case was hopeless. There was life left in me, it is true, but the 
 verdict was that there was no hope. Henceforth I was to be a burden to 
 myself and my friends, until death came to my relief. 
 
 At this critical point an eastern gentleman, who had business with one 
 of my friends in New York, happened to be informed of my hopeless con- 
 dition. He called to see me, and strongly advised that I should be taken to 
 Boston for a personal interview with Dr. Hayes, the consulting physician 
 of the Peabody Medical Institute in that city. He was told that I had been 
 taken from place to place for medical treatment several times already with- 
 out receiving the least advantage, and that another removal to a distant 
 point would probably result in another failure to obtain relief, and would 
 therefore be worse than useless. But the eastern gentleman, being of a 
 sanguine temperament, would not give my case up so, and finally prevailed 
 upon those who had me in charge to take me to Boston. 
 
TESTIMONIALS. 
 
 197 
 
 Alexander E. Raitt, 
 
198 
 
 TESTIMONIALS 
 
 After a careful examination of my case, Dr. Hayes said that he could 
 afford me partial relief, but he did not speak encouragingly in regard to a 
 permanent cure. Under no circumstances the doctor informed me could I 
 expect much mitigation of my sufferings from his treatment in a less time 
 than at the end of six weeks. Even partial relief was worth more than a 
 six months’ stay in Boston, to say nothing of six weeks. Suffice it to say 
 that I found myself at once subjected to a new treatment, entirely different 
 from anything which I had experienced at the hands of my previous med- 
 ical advisers. It began to tell on my shattered nerves at once , working like 
 a charm. 
 
 At the end of two weeks the gentleman, who had originally advised my 
 recourse to the doctor, called to see me in my new quarters, and under my 
 new treatment. Sensation had already begun to return to my left side. I 
 was recovering the use of my lost senses, and warmth and motion were 
 taking the place of partial paralysis. The gentleman gave me a look, 
 which said louder than words — “I told you there was hope and cure for 
 you.” In fact I felt health dawning anew in me. With returning strength 
 came hope and confidence, which reinforced the treatment and medicine 
 wonderfully. The doctor acknowledged that he had underestimated the 
 recuperative power of my system. 
 
 At the end of the six weeks, which he had mentioned as the earliest date 
 of even a partial recovery, he assured me of a perfect cure. His assur- 
 ances were made good by the event. I am at the date of this writing a 
 well man, and have been for several years. Indeed my present occupation 
 requires vigorous health, and I am fully equal to it. I frequently indulge 
 in gymnastic exercises, and am noted for muscular strength. During my 
 illness my weight, which is now from 175 to 200, fell to 120 pounds. I am 
 induced to write this letter by a sense of duty to others who are suffering 
 as I suffered. It was this sense of duty, combined with a feeling of intense 
 personal regard for my healer and benefactor, Dr. Hayes, which has 
 prompted me unsolicited to pen these lines as a guide to all prostrated with 
 severe nervous disease. I refer to Adjutant-General Cunningham and 
 Judge Abbott, who are personal acquaintances. 
 
 Alexander E. Raitt. 
 
 Suffolk, ss. 
 
 August 1G, 1873. 
 
 Then personally appeared the above-named Alexander E. Raitt, and 
 made oath that the above statement by him subscribed is true. 
 
 Before me, 
 
 T. E. Nutter, 
 
 Justice of the Peace. 
 
TESTIMONIALS. 
 
 199 
 
 East Woodstock, Conn., March 8, 1873. 
 
 To whom it may concern : In the year 1871, my nervous system and phys- 
 ical powers became so reduced by an unnatural drain, and my mind so dis- 
 eased, that my people deemed it necessary, for my protection as well as 
 their own, to send me to the Insane Asylum at Worcester. I was admitted 
 
 Edward L. Morse. 
 
 to the asylum Sept. 12, 1871, and during the many weeks I was confined 
 there, I grew worse, day by day, until it seemed as though I should become 
 a raving maniac, unless I could get relief, which I was sure I could never 
 obtain in that institution. 
 
 The last of November I managed to escape, and by some mysterious 
 providence I was led to the Peabody Medical Institute, Boston. Dr. Hayes, 
 
200 
 
 TESTIMONIALS. 
 
 the chief consulting physician, and his assistant, Dr. Parker, immediately 
 interested themselves in my case ; and after a most thorough and rigid ex- 
 amination, they pronounced my case curable. This I could not realize or 
 believe, my mind being so much diseased ; but my father was subsequently 
 convinced of Dr. Hayes’s great skill in such cases as mine, hnd also of the 
 honorable business principles that governed the management of the Pea- 
 body Medical Institute in every particular. He, therefore, at once placed 
 me under the treatment of Dr. Hayes and his assistant. The proper rem- 
 edies were furnished me, and I returned home with my father, where I have 
 remained in safety ever since, visiting the doctor occasionally. The results 
 have been an astonishing change in my condition for the better. I have 
 now been taking Dr. Hayes’s remedies for a little more than a year, and con- 
 sider the good results but little less than miraculous. I do not take med- 
 icine now, nor do I need any. When I was forced, or rather entrapped, 
 into the insane asylum, the doctors there pronounced me incurable, — and 
 I think I was incurable at their hands. 
 
 If this testimonial, which I feel it is my duty to give, should fall under the 
 notice of any sufferer from nervous disease in any shape or form, or from 
 the diseases described in Dr. Hajns’s “ Science of Life ” ; or should this be 
 seen by the friends of such a sufferer, I would conscientiously and earnestly 
 recommend them to the author of this book, Dr. Hayes, as a skilful physi- 
 cian and an honorable gentleman. Nor can I do less ; and should any poor, 
 suffering fellow-being wish to make further inquiry, I will with delight give 
 them all the information in my power. 
 
 Edward L. Morse. 
 
 Suffolk, ss. March 8, 1873. 
 
 Subscribed and sworn to before me, 
 
 Joseph Bennett, 
 
 Justice of the Peace. 
 
 Springfield, Illinois, May 9, 1873. 
 
 Dr. Hayes: 
 
 Having been under your treatment for the past three months for epilepsy, 
 I take pleasure in saying, in gratitude for kind and skilful attention, that I 
 have derived such essential and marked benefit from your skilful practice 
 as to make me certain that I am cured ; at any rate the symptoms of the 
 disease have entirely disappeared, I feel confident not to return. 
 
 J. S. K. 
 
 When a person is cured of a disease which, though not generally deemed 
 incurable, is yet manageable only by the most skilful treatment and pecu- 
 liar remedies, it is his duty to those similarly affected to make it known. 
 
TESTIMONIALS 
 
 201 
 
 For a long period I suffered from chorea or St. Vitus’ dance. The action of 
 my brain was disordered and my mind was decidedly impaired. My feel- 
 ings were easily excited and my temper was fretful and irritable. Hallu- 
 nications of sight and hearing also troubled me. My sleep was disturbed 
 by disagreeable dreams. These mental troubles were accompanied by the 
 usual disorderly muscular contractions. Acting on the advice of a friend 
 who some years ago was cured by your treatment of a like disease, I too 
 placed myself under your care, and after two weeks of constant treatment 
 was radically cured, and the constitutional disturbances entirely disap- 
 peared. 
 
 I am confident that others similiarly affected with myself, by placing 
 themselves under your care, and following your advice, will be rewarded 
 with like benefit. 
 
 G. W. P. 
 
 Richmond, Va., March 3, 1873. 
 
 Dr. Hayes: 
 
 Dear Sir : — Gratitude to you for a perfect restoration to health, society, 
 and business, leads me to write you this letter, hoping that you will make 
 it public, so that others similarly affected with myself may know to whom 
 to have recourse for relief. Owing to youthful indiscretions and excesses, 
 I was a sufferer from constant depression of spirits and mental anxiety of the 
 most disheartening nature. Life was a burden and I found myself the vic- 
 tim of hypochondriasis in the very prime of manhood. I found myself also 
 contemplating death as the only refuge from the deep gloom which clouded 
 my life and prospects. At this critical time I was directed to you, and in 
 a few weeks, under your advice and remedies, I became well again, with the 
 buoyancy of spirits natural to health and mental and bodily vigor. 
 
 J. T. S. 
 
 Hartford, Conn., Jan. 27, 1873. 
 
 Fitchburg, Dec. 29, 1872. 
 
 To the Public: 
 
 For the good of those affected with paralysis agitatus, or shaking palsy, 
 I am pleased to state that Dr. Hayes radically cured this affection in myself, 
 it being the result of an exhausting disease from which I had suffered. 
 
 F. N. B. 
 
 Springfield, Mass., June 7, 1872. 
 
 Dr. Hayes: 
 
 Dear Sir : — Under your skilful treatment and remedies, and by strictly 
 conforming to your advice, and the hygiene recommended by you, I was 
 completely rescued from the horrors of a shattered nervous system, and 
 
202 
 
 TESTIMONIALS. 
 
 made once more capable of complete self-control, so far as the accursed 
 habits are concerned which drove me almost to suicide. 
 
 Gratefully yours, 
 
 A. P. 
 
 Toronto, Canada West, April 3, 1873. 
 
 Dr. Hayes: 
 
 Dear Sir : — I was attacked with what was undoubtedly incipient soften- 
 ing of the brain. Good luck led me to have recourse to you. The terrible 
 infliction was arrested by your remedies, and I am now enjoying good 
 health, and have the use of my mental faculties. It is due to you and the 
 public that I should thus signalize your skilful and successful treatment of 
 my case. 
 
 R. D. 
 
 Buffalo, N. Y., Feb. 12, 1872. 
 
 Friend Hayes: 
 
 Arduous and unremitted professional labors for a course of years, almost 
 without recreation, had reduced me to such a state of nervous depression 
 that I was rapidly nearing the dread goal of insanity and complete mental 
 imbecility when I put myself under your treatment. That I have escaped 
 the calamity of a permanently deranged mind, I owe to your remedies, and 
 to the regimen which you advised. 
 
 Gratefully yours, 
 
 C. E. L. 
 
 Worcester, Mass., June, 1873. 
 
 Dr. Hayes: 
 
 It is with feelings of intense gratitude that I find myself, through the use 
 of your remedies, once more capable of sound, natural sleep. Previously 
 to my application to you for relief, my memory had become impaired. I 
 could not sleep ; or if I did, I awoke in a state of excitement and alarm, 
 sometimes in horror. I could not get any sleep for hours after I went to 
 bed. At length this constant insomnia, or wakefulness, reached a point 
 where relief had become an absolute necessity. I could no longer endure 
 the dreadful illusions, hallucinations, and nocturnal visions which haunted 
 what should have been hours of repose, but were not. Learning of your 
 skill and success in the treatment of nervous affections, I had recourse to 
 you, feeling that your advice was a last resort. Nor did it fail me. A few 
 weeks of conformity to your directions, with the use of your prescriptions, 
 have restored me to perfect health. 
 
 E. W. B. 
 
TESTIMONIALS. 
 
 203 
 
 Dr. Hayes: 
 
 Dear Sir : — I take great pleasure in saying that your professional efforts 
 in my case of paralysis of the left arm resulted in a permanent cure, and 
 were in the highest degree satisfactory. 
 
 I am yours, very truly, 
 
 R. H. W. 
 
 Syracuse, N. Y. 
 
 Dr. A. H. Hayes: 
 
 Dear Sir : — For several years I was the victim of alcoholism, which had 
 been originally induced by convivial habits, and the temptations set before 
 me by the society of numerous and hospitable friends. Almost before I 
 was aware of it, owing to a singularly sensitive and impressible nervous 
 system, I found myself tormented by all the distressing and appalling 
 symptoms and incidents of the above disease. I would have given all I 
 possessed on earth to be relieved from the sufferings and nervous agitation 
 which ensued. I feel that it is to you I owe my final extrication from 
 the gulf of despair, in which a disposition naturally social and too easily 
 yielding to convivial temptations had involved me. Please accept my grate- 
 ful acknowledgments for the thorough relief which your skill has afforded 
 me. 
 
 S. R. C. 
 
 Haverhill, N. H. 
 i 
 
 Dear Doctor : 
 
 After having been extricacted from a gulf, into which one has been 
 plunged by his own youthful follies, and the excessive indulgence of his 
 passions and appetites, it is not pleasant to recur to the misery and despair 
 which you have alleviated in my case. But I should be wanting to myself, 
 to you, and to society, if I was altogether silent after having been the sub- 
 ject of your skill and care, until I have been relieved of the consequences 
 of my follies. You have given me back the manhood which I had lost and 
 forfeited. Why should I indulge in the gloomy details of my case with which 
 you are so well acquainted, and which others reduced to a a like strait can 
 readily imagine ? Suffice it to say that I am cured, and sit clothed and in 
 my right mind. 
 
 With the utmost esteem I subscribe myself, 
 
 Yours ever, 
 
 J. W. W. 
 
 Boston, July 15, 1873. 
 
 West Chelmsford, Feb. 25, 1873. 
 
 Doctor Hayes : 
 
 Dear Sir : — Yours of yesterday is at hand and with pleasure I would has- 
 ten to reply. When I first visited you one year ago last January (1872), I 
 
204 
 
 TESTIMONIALS 
 
 was a used-up man, both mentally and physically, and it was with much 
 pain and suffering that I performed my daily labor, and my nervous system 
 was in a very bad condition. It was with much difficulty that I could sit 
 still and read a paper in the evening, and it was a common occurrence to lie 
 awake in bed until eleven, twelve, one, and two o’clock in the morning, 
 and then I would sometimes get up and stand on a stone doorstep, or go 
 out into the snow barefooted and get chilled so that my nerves would get 
 quieted down so that I could sleep. My head also troubled me very much. 
 
 But now, by the blessing of God and your very skilful treatment , I feel like 
 a new man. I can now sit and read without suffering from nervousness, and 
 to use an old saying, “I can sleep like a pig.” I often say to my wife 
 that I never enjoyed sleep so well in all my life as at the present time. 
 And in every respect I can truthfully say I am a hundred per cent better than I 
 was one year ago, and a more healthy man than I was fifteen years age. 
 
 I would most earnestly recommend you to all suffering from nervous 
 disease as a true gentleman and a skilful physician. 
 
 Most respectfully subscribed, 
 
 A. W. Parkhurst. 
 
 Commonwealth of Massachusetts. 
 
 Middlesex, ss. 
 
 Chelmsford, April 7, 1873. 
 
 Personally appeared A. W. Parkhurst and made oath to the within state- 
 ment. 
 
 Before me, 
 
 Jonas J. Hoyt, Justice of the Peace. 
 
 Foxboro’, July 14, 1873. 
 
 Dr. Hayes : 
 
 Dear Sir : — Words will never express my gratitude to you for the help 
 you have rendered. I feel as though I was a new man. I did not gain 
 flesh while in the shop ; have been out a week and gained four pounds, and 
 am in most excellent spirits. I have medicine enough to last four days, 
 please send another supply on receipt of this. 
 
 Yours truly, 
 
 Fred N. B. 
 
A NEW AND SPLENDID ILLUSTRATED WORK 
 
 ON THE 
 
 “SEXUAL PHYSIOLOGY OF WOMAN,” 
 
 By ALBERT II. HAYES, M. D. 
 
 AUTHOR OF “ SCIENCE OF LIFE,” ETC. 
 
 This work from the pen of Dr. Hayes, on the Sexual Physiology of Woman, is 
 in every sense the best book of the kind which has been published. The different- 
 chapters have been perused by several scientific gentlemen, while the work was 
 going through the press, and it has elicited their heartiest approbation. It is an 
 unique book among physiological treatises. It is a compound of the science and 
 poetry of the subject, and is splendidly illustrated by a distinguished artist. The 
 author has aimed at producing something more than a mere book of dry details 
 and technical phraseology. He has popularized Physiology, and rendered it an 
 agreeable as well as a useful study. In the language of the title-page, woman is 
 treated of in this work physiologically, pathologically, and aesthetically ; and the 
 sociological aspects of the subject, which are being now so widely discussed both 
 in the journals, the halls of legislation, and on the lecture rostrum, are also 
 glanced at in several of the chapters. In this work the fair sex will find exactly 
 the knowledge they need in all the relations of life, and at all its periods, whether 
 in girlhood or maturity, in marriage or celibacy, in youth or age, in maidenhood 
 or maternity. Hot only is the subject fully discussed in its physiological and 
 pathological aspects, but topics naturally suggested by it are treated of, such as 
 dress, the social vice, marriage, and hygiene. The chapters on these collateral 
 topics will be found to be most full and interesting. It is elegantly gotten up 
 typographically, and so far as binding is concerned, and artistically illustrated. 
 It will be found to be ornamental, as well as useful and entertaining. Below will 
 be found its table of contents, etc. Among the various chapters may be noted : 
 
 Preliminary Remarks. — Introductory: Woman. — The Woman’s Rights 
 Question, The Author’s Stand-point purely Physiological and Professional, 
 Peculiar Hardships of Woman, Character of our Current Life, Object of the 
 Present Work, Woman’s Sphere, Woman’s Destiny. 
 
 Mystery of Life. — Whether Adam and Eve had a Navel, The Greatest Mys- 
 tery, The Beginning of Life, God still continues to Create Species. 
 
 Marriage : Its Philosophy and Hygiene. — The Principle of Sex runs through 
 Nature, Marriage the Foundation of the Family and the State, Why People do 
 not Marry, No Genuine Life for Man without Woman, and vice versa ; Modes 
 of Courtship, Value of Beauty to Woman, Quotation from Milton, Marriage- 
 able Age of Women, Author’s Opinion. 
 
 Beautiful Offspring. — Elizabeth of Brunswick, her Beauty; Mothers should 
 be Surrounded by Beautiful Objects of Art, Beauty begets Beauty, Effects of 
 Christianity on Personal Beauty. 
 
 Puberty.— The Young Girl at Puberty to be Closely Watched, Boarding Schools 
 and Licentious Novels. 
 
 Menstruation. — Physiological Definition of Menstruation, Woman an Invalid 
 ' Fifteen and Twenty Days in each Month, Premature Puberty, Age of Menstru- 
 ation varies, Suppression of Menses, Causes of ; Obstruction from Malforma- 
 tion. 
 
 Maternity (Physiologically Considered). — Conception, Transmission of 
 Qualities, Quickening, Duration of Pregnancy, Parturition, Natural Labor, 
 Unnatural Labor. 
 
 Embryology. — The Foetal Child, Nutrition of; Monstrosities, Mother’s Marks. 
 Infancy. — The Period of Infancy, Changes after Birth, Great Mortality in In- 
 fancy, Cities Deleterious to the Young. 
 
 Abortion. —Induced Abortion Nullifies the Purposes of Deity, The Maternal 
 Instinct, Maternity Unfashionable, John Stuart Mill’s Opinion of Progeny and 
 Love between the Sexes, Dr. H. R. Storer’s Prize Essay, The Confessional 
 Saves Thousands of Infant Lives, Serious Consequences of Abortion, Moral and 
 Physical ; The Production of Abortion a Felonious Act, More Dangerous than 
 Ordinary Child-bed ; Ignorance as to True Character of Wilful Abortion. 
 
 Beauty: its Value to Woman. — The Sort of a Woman to Marry, Sidney 
 Smith’s Opinion, Domestic Happiness and Good Looks, Milton’s Eve, Madame 
 de Stael, and Marv, Queen of Scots, What makes Beauty, Bulwer Lytton’s 
 Opinion, Hysterical Wives. 
 
General Hygiene of Women. — Women Sensative to Atmospheric Changes, 
 Stimulating Food and Drinks to be Avoided, Perfumes Deleterious, Influence 
 of the Passions and Feelings on Health, Rural Pursuits, A Quotation from 
 Michelet’s “Woman.” 
 
 Magdalenism ; or, The Social Vice. —Remarkable Ignorance of the Subject, 
 Society Discourages Investigation, Prostitution has Tainted the Blood of the 
 Race with its Diseases, Prostitution in the United States, Our late Civil War 
 increased the Vice, Perils and Shortness of a Courtesan’s Life, More than two 
 thirds of the Courtesans Diseased, Possibility of Checking the Social Vice. 
 
 The Social Scourge (Historical). —The Venereal Plague, The Fifteenth Cen- 
 tury, Naples in 1495, Superstition in regard to Origin of Syphilis. 
 
 Miscellany. — Youth, Disappointed Love, Early Betrothals and Long Engage- 
 ments, Corpulence, Marriage Excesses, Solitary Vice, Ignorance among Married 
 People, Author’s Experience, January and May, Sexual Attraction. 
 
 Sexual Love. — Object of Sexual Love, Wrong to Propagate Misery, Nature's 
 Cunning, Prevention, — when Proper. 
 
 The Change of Life. — A Delicate Period, Quack Medicines to be Avoided, 
 Should avoid Crowds and Feather Beds, This Period passed, Prospect of a Long 
 Life, Early Infractions of the Laws of Health Punished at this Time. 
 
 The Sexual Feeling in Woman. — The Sexual Feeling in the Female in Abey- 
 ance, A Vile Aspersion, A Modest Woman. 
 
 Prevention of Conception. — A Mooted Question, Author’s Experience, A 
 Dangerous Doctrine. 
 
 Dress, Cleanliness. Cosmetics. — Dress, Fallen Decency, Sudden Changes of 
 Garments, Dress of Females should be Loose, The Corset a Support, Tight 
 Dresses, Effect on Heart and Lungs, Fashionable Dress and the Organs of 
 Maternity, Quotations from Distinguished Female Writers, Costumes of differ- 
 ent Styles of Beauty, Fresh Water as an Article of the Female Toilet, Modern 
 Cosmetics, Mostly Hurtful, Belladonna, The Mystery of Cleanliness. 
 
 The Hysterical Malady. — The Womb the Starting-point of Hysteria, Pre- 
 disposing Causes of Hysteria, Women subject to Hysteria, Symptoms, The End 
 of the Fit, Treatment, Green-sickness, Erotomania. 
 
 The Female Sexual Organs. Barrenness. — Two Kinds of Natural Bar- 
 renness, Impotence, Causes of; Falling of the Womb, Sterility or Barrenness, 
 Causes of ; Sterility in Prostitutes, The Use of Aphrodisiacs, Their Effects com- 
 monly Injurious, Treatment, No Signs to Distinguish Fruitful Women. 
 
 Whites. — Definition of, Large Cities productive of, No Age free from it, Moist 
 Climate Promotive of, Womb centre of Morbid Action in Females, Whites 
 sometimes Epidemic, Suppression of Whites. 
 
 Diseases of the Womb, especially Falling of the Womb. — Why Female 
 Sexual Organs are more Subject to Disease than the Male, The Womb the 
 Centre of Impressions, First Variety of Prolapsus, Why rare in Virgins, Second 
 Variety, Third Variety, Exciting and Predisposing Causes, Treatment, Conceal- 
 ment through False Modesty, Effect of, Presence of Foreign Bodies in Vagina. 
 
 Diseases of Pregnancy. — The Author’s Aim, Cases of Supposed Pregnancy, 
 Depraved Conception, Moles, Salivation, Capricious Appetite and Longing of 
 Pregnant Women. 
 
 The Nerves and Nervous Diseases. 
 
 Dr. Hayes’s book is not addressed to the better class only ; there is not a mother 
 who ought not to be imbued with its principles, and to seek for her daughters 
 physical training as complete in its way as that she desires for her sons. We 
 earnestly hope that the book will find not only many readers, but earnest disci- 
 ples. It will be for the benefit of the State as well as of the individuals, if such 
 be the case. 
 
 Price T wo Dollars. 
 
 Sent by mail, securely sealed, postage paid, on receipt of price. 
 
 PEABODY MEDICAL INSTITUTE, 
 
 4 BTXLFINCH STREET, BOSTON. 
 
 The Trade supplied by the New England News Co. t 41 Court St., Bo' ton, Mass.