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| On the buildings, grounds, situation, and system, necessary for all purposes of an efficient classification | 1 |
| Illustrated by an interesting case of recovery, No. 106. | 5 |
| Do. do. do. No. 195. | 12 |
| On the common division of Insanity into Mania and Melancholia, not necessarily being separate classes of cases, but generally, merely variable states of the same case, requiring corresponding changes and modes of moral treatment | 15 |
| This view of these cases is confirmed, and their danger forewarned, by an examination of the natural constitution of mind and previous habits of those subject to these states | 18 |
| The delicate treatment which such cases often require, renders a separate house, where the medical proprietor and superintendant and family reside, of great importance, as well for them as for milder and convalescent cases | 25 |
| That cases under this system, are induced, when they know it from experience, or have it faithfully explained to them, to come and return without fear or reluctance | 28 |
| The great importance of this first step; and of making truth the basis. The manner of doing this explained, and its beneficial influence stated | 29 |
| Illustrated by an interesting case of recovery, No. 335. | 36 |
| Ditto do. do. No. 373. | 45 |
| Further observations on such cases and the above principles | 47 |
| That suitable classification and association is better than entire seclusion | 49 |
| Illustrated by cases, No. 425 and No. 429 | 51 |
| On the beneficial influence of their being accustomed to the usual habits, manners, and privileges of civilized life | 53 |
| On the propriety of diminishing the prejudices which exist against the mere residence at an Asylum, if for the purpose of restoration | 59 |
| The evils of considering diseases of the brain as a greater disgrace, and as an indication of greater criminality than other diseases | 61 |
| That our aim in all our moral treatment should be, to call forth self-control, and all the better principles and feelings of the human mind; and that this important subject will be resumed | 65 |
| Illustrated by a case, No. 372. | 69 |
| Do. do. No. 395. | 71 |
| That often we have only a choice of evils, and must choose the least | 73 |
| Illustrated by a case, No. 421. | 75 |
| Do. do. No. 396. | 77 |
| On the use of exercise, and a retired situation for the purpose | 78 |
| An account of a system of cure, by being made to work, related by Dr. Gregory | 81 |
| Regular work always useful, when willingly undertaken, but not otherwise; easily managed with the labouring, but as difficult with a higher, class of patients | 82 |
| The danger of irritation, illustrated by a case | 83 |
| The contrary system of soothing, illustrated by a case | 84 |
| Further remarks and quotations on this subject | 86 |
| The talents and sacrifices all this requires, and their influence, | 89 |
| Notwithstanding all this apparent extra trouble, it is, when done from right motives, the safest and easiest in the end | 100 |
| That these views are based on the firm ground of Christian philosophy | 108 |
CONTENTS OF APPENDIX. |
| Explanation of the object of this Appendix; which is, by giving a correct description of the state and character of a fair average number of old insane cases, to counteract the usual misconceptions and prejudices existing against them | 111 |
| Case No. 1.—His eccentricity, and exaggeration of his natural character and that of his family. Has seasons of excitement | 113 |
| Observation 1st.—That the fluctuations of the animal spirits of the old insane often depend on causes which equally act on the sane; but, that from differences of state and circumstances, the effects are very different | 115 |
| Case No. 2.—Though in a very torpid state, yet he has (as every case has) his distinguishing peculiarities | 116 |
| Illustrated by a Portrait | 116 |
| Observation 2nd.—That mind is a garden which we must cultivate—a fire which requires stirring and feeding | 116 |
| Case No. 3.—An example, which indeed every one is, more or less, of the correspondence, as far as the remnants of mind exist, between his present and original character and organization. His habits of employment, and its happy influence | 118 |
| Illustrated by a Portrait | 118 |
| Observation 3rd.—On the use of employment, and its easy application | 119 |
| Case No. 4.—That of an idiot. Odd displays of an increase of animation | 120 |
| Illustrated by a Portrait | 120 |
| Case No. 5.—Torpid lethargy. His natural character amiable | 121 |
| Case No. 6.—Though in a very singularly deranged state, evinced by the most extravagant fancies and exploits, which he delights to detail to every one, yet he is constantly employed, useful, and happy | 122 |
| Illustrated by a Portrait | 122 |
| Observation 4th.—The explanation of the peculiarity of his character, proves that, in all cases, truth should never be violated in our conduct towards them | 124 |
| Case No. 7.—A very singular case of periodical violence and sleep. His habit of gyration described | 125 |
| Observation 5th.—His habit of gyration explained. How far the generally alternate states of excitement and depression of the insane is the return of their primary disease, or for the most part, merely the habits acquired of irregularly expending their nervous energy, which fluctuations are further increased by the usual atmospheric causes of excitement and depression | 127 |
| The influence of temperature, moisture, climate, seasons, diurnal periods, atmospheric changes, and different years, on our health and spirits, and the type of our diseases, (and that this subject will be resumed), and how all this is modified by the states, habits, and circumstances of the insane | 129 |
| Why they are less subject to the prevailing diseases | 133 |
| The mental condition must, in all diseases, be considered | 134 |
| Illustrated by cases | 135 |
| How the state of mind and circumstances of the insane must modify these physical influences | 136 |
| Why this is differently exhibited by the insane, than it is by those who retain the power over their own spirits | 137 |
| That this view is proved to be correct, by the fact that these causes produce different effects by their being under different modes of treatment | 139 |
| That the various character of insanity is but the same excitement of the vital energies operating on different parts of the mind, according to previous or present habits and states | 143 |
| Hence, the insane are often caracatures of their own, as well as of family habits and character | 146 |
| The truth of this reasoning proved by the fact, that the greatest number of insane cases occur when mental conflicts and worldly struggles are greatest, and among those whose minds are ill regulated or miserably circumstanced; but still it does not necessarily and always follow that those whose minds are most wicked are soonest overthrown, but sometimes the reverse | 147 |
| The practical object of these observations | 150 |
| Case No. 8.—One of the extreme cases of furious mania, with a leprous eruption of the skin | 151 |
| Observation 6th.—Whether cutaneous disorders are common to the insane? The treatment of this case | 153 |
| Case No. 9.—One proof, out of many, which proves, that the last strongest impression of their sane state continues prominent, even when their minds seem for ever lost to themselves and all passing objects around them | 154 |
| Case No. 10.—In which an injury on the head produced symptoms in correspondence with the phrenological office of the part injured | 155 |
| Case No. 11.—Apparently perfect dementia, and yet he is always employed | 156 |
| Observation 7th.—An excellent illustration that there is scarcely any insane person’s mind so much lost, but that still, provided labour has been their early common habit, they may with ease be brought into habits of useful employment, and which with such a class, should, both for their cure and comfort, be adopted, and arrangements made for the purpose | 157 |
| Case No. 12.—A female instance of scolding and kindness by turns | 158 |
| Case No. 13.—Constantly talking to imaginary objects, but still perseveres in his habits of usefulness | 159 |
| Case No. 14.—A beautiful exhibition of female kindness and love of children, as well as of many other symptoms which indicate that her former habits and general natural character and disposition have been amiable | 159 |
| Illustrated by a Portrait | 159 |
| Case No. 15.—Like a passionate and proud man in a constant state of inebriation | 161 |
| Observation 8th.—A striking instance of the correspondence between cause and effect | 162 |
| Case No. 16.—Vanity turned into stone | 163 |
| Illustrated by a Portrait | 116 |
| Case No. 17.—An unmarried female, useful as a laundress, and distinguished by her affection for cats and kittens | 163 |
| Case No. 18.—An extreme instance of the most furious excitement of the vindictive and destructive passions, and the habits and states to which his treatment had reduced him | 164 |
| Observation 9th.—The mistake of calling those facts, which are the effects of improper treatment, symptoms of insanity | 166 |
| Case No. 19.—Constantly like one muttering in his dreams. Very good-natured | 167 |
| Observation 10th.—Perhaps his reason might have been re-awakened by constant judicious treatment and attention | 168 |
| Case No. 20.—An ideot, but employed | 168 |
| Illustrated by a Portrait | 168 |
| Case No. 21.—Was formerly in states of furious revenge, now gradually diminished in frequency and degree, by kindness | 169 |
| Observation 9th.—A happy illustration of the effects of kindness | 170 |
| Case No. 22.—Mind a perfect wreck—the effect of disappointed love | 170 |
| Case No. 23.—A very interesting caricature of political mania of a person of family and title. He fancies himself constantly employed in making calculations and in doing many strange acts, all necessary parts of his mighty task of paying the national debt, which abstracts him from all external objects, and from all consciousness to his own bodily sensations | 171 |
| Observation 12th.—That the correspondence between the present and previous habits of mind, are, in most cases, and certainly in this, most striking | 175 |
| On the effects of heat and cold, and the changes of temperature in the insane | 175 |
| That we are not to mistake, which is often done, the mind, in a state of abstraction, being insensible to the external changes of temperature, for the physical system being unaffected by their action | 175 |
| That the changes and unequal diffusion of heat correspond with the general and particular state of the mind, and that in cases of pure intellectual abstraction, and in those excited by the bad passions, it is very different, and in cases of gradual decay of mind, it is altogether defective | 176 |
| To discriminate those differences is necessary to regulate our treatment according to the exigencies of the case | 179 |
| Observation 13th.—On the effects of intense study and general intemperance of the mind | 180 |
| That when study is blamed, I have often found that the intemperate feelings, wicked and irregular habits, were the real causes | 180 |
| That proper mental exercise is as essential to the health as bodily exercise | 181 |
| That it is a great error to suppose such exercise injurious or discountenanced by religion, provided always the mind is under the influence of right motives | 182 |
| Case No. 25.—A dignified exhibition of all the mental energies arranging and concentrating themselves under his self esteem | 190 |
| Illustrated by a Portrait | 190 |
| Case No. 26.—A caricature of a masculine female | 193 |
| Case No. 27.—One of extreme torpor and debility | 193 |
| Observation 14th.—That the character of all hereditary cases retains something of a family resemblance | 194 |
| Case No. 28.—A caricature of Johanna Southcott’s followers | 195 |
| Illustrated by a Portrait | 195 |
| Case No. 29.—A most horrible object of demoniacal violence suspended twice by a physical accident and disease | 197 |
| Observation 18th. [26]—On the doctrine of demons, and that the subject will be resumed in an after part of this work | 198 |
| Case No. 30.—A very interesting demonstration of the misery of ill-assorted marriages, and that the painful and powerful association of the original cause of the disease produced its frequent recurrence | 199 |
| Observation 19th.—On the evils of such marriages, and that the consideration of this important subject will be resumed in an after part of this work | 202 |
| Case No. 31.—A singular and most interesting case of an active, excitable, and overworked mind being overthrown by family afflictions, his power of personating various celebrated characters of different periods of the world, which he believes himself for the while to be. His splendid eloquence and conversations with imaginary beings, &c. Still, there were encouraging symptoms, that by proper and laborious methods of mental occupation, he might possibly have had the balance of his mind restored | 203 |
| Illustrated by a Portrait | 203 |
| General explanation of the peculiar complexion of this work, and of the Appendix in particular | 207 |
| Concluding observations, that the object of this Essay, and especially of the Appendix, has been to lessen the prejudices against and better the treatment of, the insane | 209 |
