Since the use of this very simple and efficient instrument, which I constructed about twelve years ago, I can truly affirm, that no patient has ever been deprived of a tooth, and that the food or remedy has always been conveyed into the stomach of the patient.

The manner in which this compulsory operation is performed, consists in placing the head of the patient between the knees of the person who is to use the instrument: a second assistant secures the hands, (if the straight-waistcoat be not employed) and a third keeps down the legs. As soon as the mouth is opened, the instrument may be introduced; it presses down the tongue, and keeps the jaws sufficiently asunder to admit of the introduction of the medicine, which should be contained in a vial, or tin pot with a spout, to allow it to run in a small stream. The nose of the patient being held by the left hand of the person who uses the instrument, a small quantity of the medicine is to be poured into the mouth, and when deglutition has commenced, is to be repeated, so as to continue the act of swallowing until the whole be taken.

A little address will obviate the determination of the patient to keep his teeth closed: he may be blindfolded at the commencement, which never fails to alarm him, and urges him to enquire what the persons around him are about: causing him to sneeze, by a pinch of snuff, always opens the mouth previously to that convulsion, or tickling the nose with a feather commonly produces the same effect.

With delicate females, where one or more of the grinder-teeth are wanting, the finger may be introduced on the inside of the cheek, which being strongly pressed outwards will prevent the patient from biting, and form a sufficient cavity to pour in the liquid. With a wish of speaking confidently on this subject, I have usually performed the business of forcing, more especially amongst the females, and it has, in some degree, rewarded my trouble; it has ascertained the practicability of administering remedies; and it has also afforded the consolation, that, where the means employed have produced no good, the patient has sustained no injury.

Purging.

An opinion has long prevailed, that mad people are particularly constipated, and likewise extremely difficult to be purged. From all the observations I have been able to make, insane patients, on the contrary, are of very delicate and irritable bowels, and are well, and copiously purged, by a common cathartic draught. That, which has been commonly employed at the hospital, was prepared agreeably to the following formula:

but, within the last seven years, the tinctura jalapij has been substituted for the tinctura sennÆ. It is so far an improvement, that it operates more speedily, and produces less griping.

This medicine seldom fails of procuring four or five stools, and frequently a greater number.

In confirmation of what I have advanced, respecting the irritable state of the intestines in mad people, it may be mentioned, that the ordinary complaints, with which they are affected, are diarrhoea and dysentery: these have heretofore been very violent and obstinate.

Perhaps it may be attributed to superior care that the occurrence of these complaints has, of late years, been comparatively rare, contrasted with the numbers who were formerly attacked with such diseases; and, when they do happen, an improved method of treatment has rendered these intestinal affections no longer formidable or fatal.

In those very violent diarrhoeas, which ordinarily terminate in dysentery, from five to ten grains of the pilula hydrargyri have been given according to the sex, constitution, and nature of the complaint, once or twice a day, and with general success.

It may be necessary to add, that it is proper, during the course of this mercurial remedy, which shortly arrests the disease, to keep the bowels in an open state, by some of the milder purgatives employed every third or fourth day.

Diarrhoea very often proves a natural cure of insanity; at least, there is sufficient reason to suppose, that such evacuation has very much contributed to it. The number of cases, which might be adduced in confirmation of this remark, is considerable; and the speedy convalescence, after such evacuation, is still more remarkable.

In many cases of insanity there prevails a great degree of insensibility, so that patients have scarcely appeared to feel the passing of setons, the drawing of blisters, or the punctures of cupping. On many occasions, I have known the urine retained for a considerable time, without complaint from the patient, although it is well ascertained, that there is no affection more painful and distressing than distension of the bladder.

Of this general insensibility the intestinal canal may be supposed to partake; but this is not commonly the case; and, if it should frequently prevail, would be widely different from a particular and exclusive torpor of the primÆ viÆ.

But, sometimes, there arises a state of disease in maniacs, where the stomach and intestines are particularly inert. The patient refuses to take food, and is obstinately constipated: the tongue is foul, and the skin is tinged with a yellowish hue: the eyes assume a glossy lustre, and exhibit a peculiar wildness. In this state, I have given two drachms of the pulvis jalapij for a dose, and which, on some occasions, has procured but one stool, so that it has been necessary several times to repeat the same quantity. After the bowels have been sufficiently evacuated, the appetite commonly returns, and the patient takes food as usual.

Much mischief may be produced, if it be attempted to force food into the stomach in such a case, which the ignorance of keepers may attempt, supposing it to originate in the obstinacy of the patient. In order to continue the bowels in a relaxed state, after they have been sufficiently emptied of their contents, the following formula has been employed with advantage:

From two to three table spoonsful may be given once or twice a day, as occasion may require.There are some circumstances unconnected with disease of mind, which might dispose insane persons to costiveness. I now speak of such as are confined, and who come more directly under our observation. When they are mischievously disposed they require a greater degree of restraint, and are consequently deprived of that air and exercise which so much contribute to regularity of bowels. It is well known that those who have been in the habits of free living, and who come suddenly to a more temperate diet, are very much disposed to costiveness. But to adduce the fairest proof of what has been advanced, I can truly state, that incurable patients, who have for many years been confined in the Hospital, are subject to no inconveniences from constipation. Many patients are averse to food, and where little is taken in, the egesta must be inconsiderable.To return from this digression: it is concluded, from very ample experience, that cathartic medicines are of the greatest service, and ought to be considered as an indispensable remedy in cases of insanity. The good sense and experience of every practitioner must direct him as to the dose, and frequency with which these means are to be employed, and of the occasions where they would be prejudicial.

Vomiting.

However strongly this practice may have been recommended, and how much soever it may at present prevail, I am sorry that it is not in my power to speak of it favourably. In many instances, and in some where blood-letting had been previously employed, paralytic affections have within a few hours supervened on the exhibition of an emetic, more especially where the patient has been of a full habit, and has had the appearance of an increased determination to the head.

It has been for many years the practice of Bethlem Hospital to administer to the curable patients four or five emetics in the spring of the year; but, on consulting my book of cases, I have not found that such patients have been particularly benefited by the use of this remedy. From one grain and half to two grains of tartarized antimony has been the usual dose, which has hardly ever failed of procuring full vomiting. In the few instances where the plan of exhibiting this medicine in nauseating doses was pursued for a considerable time, it by no means answered the expectations which had been raised in its favour by very high authority. Where the tartarized antimony, given with this intention, operated as a purgative, it generally produced beneficial effects.

Ten years have elapsed since the former edition of this work appeared; but this length of time, and subsequent observation, have not enabled me to place any greater confidence in the operation of emetics, as a cure for insanity.

An author[36] who has lately published a work, entitled “Practical Observations on Insanity,” is however a determined fautor of emetics in maniacal cases. In his skilful hands they have worked marvellous cures; nor have any prejudicial effects ever resulted from their employment. Perhaps no one has enjoyed a fairer opportunity of witnessing the effects of remedies for insane persons than myself; and when emetics are employed in Bethlem Hospital they have the best chance of effecting all the relief they are competent to afford, as they are given by themselves, without the intervention of other medicines; and this course of emetics usually continues six weeks. Had Dr. Cox confined himself to the relation of his own victories in combating madness with vomits, it would have been sufficient; but he endeavours to raise the leveÉ en masse of medical opinion to co-operate with his sentiments. He says, page 78, “Yet every physician, who has devoted his attention to this branch of the profession, must differ from him when he treats of vomiting.” It was never my intention to deny, in a disordered state of the stomach, that the madman would be equally benefited with one in his senses by the operation of a vomit: but I have asserted, that after the administration of many thousand emetics to persons who were insane, but otherwise in good health, that I never saw any benefit derived from their use. It will also be granted, that some ascendancy may be gained over a furious maniac by forcing him to take a vomit, or any other medicine, but this is widely different from any positive advantage resulting from the act of vomiting. Sir John Colebatch, in his “Dissertation concerning Misletoe,” says, p. 35, “But I have been for some years afraid of giving vomits, even of the gentlest sort, in convulsive distempers, from some terrible accidents, that have been likely to ensue, from moderate doses of Ipecacuanha itself.”

In St. Luke’s hospital, the largest public receptacle for insane persons, where the medical treatment is directed by a physician of the highest character and eminence, and whose experience is, at least, equal to that of any professional man in this country, vomits are by no means considered as the order of the day; they may be employed to remove symptoms concomitant with madness, but are not held as specifics for this disease.

In reading over the cases related by Dr. Cox, there is no one, where emetics have been solely employed as agents of cure; they have been always linked with other remedies; and it requires more sagacity than even the doctor can exact, to pronounce, when different means of cure are combined, to which the palm should be adjudged. In the relation of my own experience concerning vomiting, as a remedy for insanity, I have had only in view the communication of facts, for I entertain neither partiality nor aversion to any remedies, beyond the fair claim which their operations possess. Had I modestly ventured to state, after the example of the Doctor, “that I had devoted myself exclusively and assiduously for a series of years, to the care of insane patients in an establishment, where persons of both sexes are received,”[37] it might be suspected, that the superstructure of my philosophy had been reared on the basis of private emolument.

Camphor.

This remedy has been highly extolled, and doubtless with reason, by those who have recommended it: my own experience merely extends to ten cases; a number, from which no decisive inference of its utility ought to be drawn. The dose was gradually increased, from five grains to two drachms, twice a day; and, in nine cases, the use of this remedy was continued for the space of two months. Of the patients, to whom the camphor was given, only two recovered: one of these had no symptoms of convalescence for several months after the use of this remedy had been abandoned: the other, a melancholic patient, certainly mended during the time he was taking it; but he was never able to bear more than ten grains thrice a day. He complained that it made him feel as if he were intoxicated. Considering the insoluble nature of camphor, and the impracticability of compelling a lunatic to swallow a pill or bolus, it has been found convenient (when a large quantity was required) to give this medicine in the form of an emulsion, by dissolving the camphor in hot olive oil, and afterwards adding a sufficient quantity of warm water and aqua ammoniÆ purÆ.

Cold Bathing.

This remedy having for the most part been employed, in conjunction with others, it becomes difficult to ascertain how far it may be exclusively beneficial in this disease. The instances where it has been separately used for the cure of insanity, are too few to enable me to draw any satisfactory conclusions. I may, however, safely relate, that in many instances, paralytic affections have in a few hours supervened on cold bathing, especially where the patient has been in a furious state, and of a plethoric habit. That this is not unlikely to happen may be supposed from the difficulty of compelling the patient to go head-foremost into the bath. In some cases vertigo, and in others a considerable degree of fever ensued after immersion. The shower-bath was employed some years ago in the hospital, and many cases were selected in order to give a fair trial to this remedy, but I am unable to say, that any considerable advantage was derived to the patients from its use. If I might be permitted to give an opinion on this subject, the principal benefit resulting from this remedy, has been in the latter stages of the disease, and when the system had been previously lowered by evacuations. As a remedy for insanity cold bathing has been disregarded by a celebrated practitioner. To a question from a select committee of the House of Commons to Doctor Willis, 9th March, 1807, the following answer was given.

Question. Are you of opinion that warm and cold baths are necessary for lunatic patients?

Answer. I think warm baths may be very useful, but it can seldom happen that a cold bath will be required.[38]

Blisters.

These have been in several cases applied to the head, and a very copious discharge maintained for many days, but without any manifest advantage. The late Dr. John Monro, who had, perhaps, seen more cases of this disease than any other practitioner, and who, joined to his extensive experience, possessed the talent of accurate observation, mentions, that he “never saw the least good effect of blisters in madness, unless it was at the beginning, while there was some degree of fever, or when they have been applied to particular symptoms accompanying this complaint.”[39] Dr. Mead also concurs in this opinion. “Blistering plasters applied to the head will possibly be thought to deserve a place among the remedies of this disease, but I have often found them do more harm than good by their over great irritation.”—Medical Precepts, page 94. Although blisters appear to be of little service, when put on the head, yet I have, in many cases, seen much good result from applying them to the legs. In patients who have continued for some time in a very furious state, and where evacuations have been sufficiently employed, large blisters applied to the inside of the legs, have often, and within a short time, mitigated the violence of the disorder.

In a few cases setons have been employed, but no benefit has been derived from their use, although the discharge was continued above two months.

Respecting opium, it may be observed, that whenever it has been exhibited, during a violent paroxysm, it has hardly ever procured sleep: but, on the contrary, has rendered those who have taken it much more furious: and, where it has for a short time produced rest, the patient has, after its operation, awaked in a state of increased violence.

Many of the tribe of narcotic poisons have been recommended for the cure of madness; but, my own experience of those remedies is very limited, nor is it my intention to make further trials. Other, and perhaps whimsical modes of treating this disorder, have been mentioned: whirling,[40] or spinning a madman round, on a pivot, has been gravely proposed; and, music has been extolled, with a considerable glow of imagination, by the same gentleman.—That the medical student may be fully aware of the manifold agents which practical physicians have suggested for the restoration of reason, I shall conclude my volume with the following extract.[41]

“The medical philosopher, in his study of human nature, must have observed, that sympathetic correspondence of action between the mind and body, which is uniformly present in health and disease, though varying with circumstances. The different passions, according to their nature, the degree or intensity of application, and the sensibility of the party, exhibit certain characteristic expressions of countenance, and produce obvious changes, actions, or motions, in the animal economy. Music has been found to occasion all these actions, changes, and movements, in some sensible systems; and where one passion morbidly predominates, as frequently happens in mania, those species of simple or combined sounds, capable of exciting an opposite passion, may be very usefully employed. If then such effects can be produced by such a power, acting on a mind only endued with its healthy proportion of susceptibility, what may we not expect where the sensibility is morbidly increased, and where the patient is alive to the most minute impressions? Cases frequently occur where such acuteness of sensibility, and extreme delicacy of system exist, that most of the more common, moral, and medical means are contra-indicated; here relief may be often administered through the medium of the senses; the varied modulations, the lulling, soothing cords of even an EÖlian harp have appeased contending passions, allayed miserable feeling, and afforded ease and tranquillity to the bosom tortured with real or fancied woe: and I can easily imagine, that jarring discord, grating harsh rending sounds, applied to an ear naturally musical, would uniformly excite great commotion. Under circumstances calculated to assist this action, by producing unpleasant impressions through the medium of the other senses, as when SCREECHES and YELLS are made in an apartment painted black and red, or glaring white, every man must be painfully affected: the maniacal patient, however torpid, must be roused: or, on the contrary, where an opposite state obtains, extreme sensibility and impatience of powerful impression, there much may be expected from placing the patient in an airy room, surrounded with flowers breathing odours, the walls and furniture coloured green, and the air agitated by undulations of the softest harmony. Much of this may appear FANCIFUL and RIDICULOUS, but the enquiring practitioner will find, on making the experiment, it deserves his serious attention; and no mean is to be despised that is capable of arresting the attention, changing the trains of thought, interesting the affections, removing or diminishing painful sensations, and ultimately rendering both mind and body sensible to impressions, and all this has been effected by music. Every individual is not capable of accurately estimating the extensive powers of this agent; but I would ask the musical amateur, or the experienced professor, if he have not frequently felt sensations the most exquisite and indescribable; if he have not experienced the whole frame trilling with inexpressible delight, when the tide of full harmony has FLOWN on his ear, and the most wretched miserable feeling, UNIVERSAL HORRIPILATIO and CUTIS ANSERINA from the grating crash of discord? All the varied sensations from transport to disgust, have been occasioned by the different movements in one piece of music. I might amuse my readers with a great variety of instances where persons have been very singularly affected by means of music, and where its powers have extended to the brute creation, but this I purposely avoid.”

FINIS.

Printed by G. Hayden,
Brydges Street, Covent Garden.

Footnotes:

[1] The choice of these words must be left to the taste of the reader, Dr. Johnson not having thought proper to admit them into his dictionary.

[2] Some doubts are entertained whether Dr. Boord was physician to King Henry the eighth, but he was certainly a fellow of the College.

[3] Apprehension of sensations. This is perhaps only an endeavour to explain the thing, by the thing, or producing words of similar import with different sounds. Junius, speaking of the word hand (as derived from the gothic Handus) says, “Quidam olim deduxerunt vocabulum ab antiquo verbo HENDO, Capio: unde Prehendo, APPREHENDO, &c.”—Gothicum Glossarium, p. 188. Professor Ihre conceives it equally probable that the old latin word hendo may have had a northern origin. “Id vero non possum, quin addam, oppidÓ mihi probabile fieri, ipsammet hanc vocem latio olim peregrinam non fuisse, quod quippe augurar ex derivato HENDO, capio, unde prehendo cum derivatis pullularunt.”—Glossarium Sviogothicum. tom. i. p. 778.

[4] Quere. Why should the most active characteristics of our nature be termed Passions? The word seems properly employed in Passion week, the period commemorative of Christ’s suffering or Passion. But we are said to fly, or fall into a passion, and then passion gets the better of us. For the softer sex we conceive the most delicate, refined, and honorable passion, yet every one allows the dreadful consequences which ensue from an indulgence of our passions, and most persons agree that passion, carried to excess, constitutes madness—we live in a world of metaphor.

[5] In many instances, although it is far from being general, pain of the head, and throbbing of its arteries precede an attack of insanity; sometimes giddiness is complained of as a precursory symptom. Those who have been several times disordered, are now and then sensible of the approaching return of their malady. Some have stated, a sense of working in the head, and also in the intestines, as if they were in a state of fermentation. Others observe that they do not seem to possess their natural feelings, but they all agree that they feel confused from the sudden and rapid intrusion of unconnected thoughts.

[6] To illustrate how necessarily our sensations, or ideas must become confused, when their succession is too rapid, the relation of some experiments on that subject will sufficiently conduce.

“But by the able assistance of Mr. Herschel, I am in a condition to give some approximation, at least, towards ascertaining the velocity of our audible sensations. For having, by means of a clock, produced sounds, which succeeded each other with such rapidity, that the intervals between each of them were (as far as could be judged) the smallest posible; he found he could evidently distinguish one hundred and sixty of them to flow in a second of time. Now as each interval must in this case be reckoned as a sensation likewise, as it might be filled up with a sound thereby making it a continued one; it follows, that we are capable of entertaining at least three hundred and twenty audible sensations in that period of time.”—Vide a Treatise on Time, by W. Watson, Jun. M. D. F. R. S. 8vo, 1785, page 32.

[7] The late Dr. Johnson was remarkably distinguished by certain peculiarities of action when his mind was deeply engaged. Sir Joshua Reynolds was of opinion “that it proceeded from a habit he had indulged himself in, of accompanying his thoughts with certain untoward actions.” “One instance of his absence, and particularity as it is characteristic of the man, may be worth relating. When he and I took a journey into the West, we visited the late Mr. Banks, of Dorsetshire; the conversation turning upon pictures, which Johnson could not well see, he retired to a corner of the room, stretching out his right leg as far as he could reach before him, then bringing up his left leg, and stretching his right still further on. The old gentleman observing him, went up to him, and in a very courteous manner assured him, that though it was not a new house, the flooring was perfectly safe. The Doctor started from his reverie like a person waked out of his sleep, but spoke not a word.”—Boswell’s Life of Dr. Johnson, vol. i. p. 76. In the same work other of his tricks are recorded, as talking to himself, measuring his steps in a mysterious manner, half whistling, clucking like a hen, rubbing his left knee, &c. Many sensible persons, with whom I am now acquainted, when particularly thoughtful, discover strange bodily motions, of which they are by no means conscious at the time.

[8] This gritty matter, subjected to chemical examination, was found to be phosphat of lime.

[9] This appearance I have found frequently to occur in maniacs who have suffered a violent paroxysm of considerable duration: and in such cases, when there has been an opportunity of inspecting the contents of the cranium after death, water has been found between the dura mater and tunica arachnoidea.

[10] Morbid Anatomy, page 304.

[11] Mr. Fourcroy does not appear to have given any particular attention to this fluid. He says, “Cette humeur ne paraÎt pas diffÉrer de celle qui mouille toutes les parois membraneuses du corps humain en general, et dont j’ai dÉja parlÉ. C’est un liquide mucoso gelatineux, plus ou moins albumineux, et contenant quelques matiÉres salines.”—SystÉme des Connoisances Chimiques, 8vo. tom. ix. p. 303.

[12] It may be remarked, that all children in the early attempts at language, speak of themselves and others in the third person, and never employ the pronoun; they likewise never use connectives, or the inflections of verbs, until they begin to acquire some knowledge of numbers. Beyond this rude state our patient never advanced.

[13] For this term the indulgent reader must give the author credit, because he finds himself unable adequately to explain it.—It is a complex term for many ideas, on which language has not as yet, and perhaps will never be imposed. Very unfortunately there are many terms of this nature, equally incapable of description—a smile, for instance, is not very easy to be defined. Dr. Johnson calls it “a slight contraction of the face” which applies as properly to a paralytic affection. He also states it to be “opposed to frown.” If curiosity should prompt the inquisitive reader to seek in the same author for the verb, to frown, he will find it “to express displeasure by contracting the face to wrinkles.” He who would

“Finde the minde’s construction in the face”

must not expect to be able to communicate to others, in a few words, that knowledge which has been the slow and progressive accumulation of years.

[14] These are the usual terms employed by writers on this subject, but the propriety of their use must be left to the judgment of the reader. Every person will occasionally hesitate whether certain occurrences, said to be causes, ought to be referred to one class, in preference to the other. They are loose and vague names: for instance, a course of debauchery long persisted in, would probably terminate in paralysis; excessive grief we know to be capable of the same effect. Paralysis frequently induces derangement of mind, and in such case it would be said, that the madness was induced by the paralysis as a physical cause. But it often happens that debauchery and excessive grief are followed by madness, without the intervention paralysis. Moral, in this sense, means merely habitudes or customs, reiteration of circumstances confirmed into usage; and these may be indifferently accounted physical or moral.

[15]

“——nessun maggior dolore,
Che ricordarsi del tempo felice
Nella miseria.”—Dante.

[16] The Jews also were particularly instrumental in the practice and propagation of medical knowledge at that period.

[17] Cogitatio, (hÎc minimÈ prÆtereunda) est motus peculiaris Cerebri, quod hujus facultatis est proprium organum: vel potiÙs Cerebri pars quÆdam, in medulla spinali et nervis cum suis meningibus continuata, tenet animi principatum, motumque perficit tam cogitationis quam sensationis; quÆ secundÙm Cerebri diversam in omnium animalium structuram, mirÈ variantur.—Tolandi Pantheisticon, p. 12.

[18] 1796, 1797.

[19] Vide Report, Part II. p. 25.

[20] Report, p. 59.

[21] Ibid, 57.

[22] Report 54.

[23] “We shall use the general term of methodism, to designate these three classes of fanatics, [Arminian and Calvinistic methodists, and the evangelical clergymen of the church of England] not troubling ourselves to point out the finer shades, and nicer discriminations of lunacy, but treating them all as in one general conspiracy against common sense, and rational orthodox christianity.”—Edinburgh Review, Jan. 1808, p. 342.

[24] TraitÉ Medico-Philosophique sur l’Alienation Mentale, 8vo. Paris, an. 9, p. 47.

[25] The late Reverend Dr. Willis.

[26] With respect to the persons, called Keepers, who are placed over the insane, public hospitals have generally very much the advantage. They are there better paid, which makes them more anxious to preserve their situations by attention and good behaviour: and thus they acquire some experience of the disease. But it is very different in the private receptacles for maniacs. They there procure them at a cheaper rate; they are taken from the plough, the loom, or the stable; and sometimes this tribe consists of decayed smugglers, broken excisemen, or discharged sheriffs’ officers:

“All that at home no more can beg or steal.”

How well such a description of persons is calculated to regulate and direct the conduct of an insane gentleman may be easily conjectured. If any thing could add to the calamity of mental derangement, it would be the mode which is generally adopted for its cure. Although an office of some importance and great responsibility, it is held as a degrading and odious employment, and seldom accepted but by idle and disorderly persons.

[27] Vide Cullen, First Lines, vol. iv. p. 154.

[28] “D’uno luogo chiamato Timarahane, dove si castigano i matti.

“In Costantinopoli fece fare un luogo Sultan Paiaxit dove si dovessero menare i pazzi, accioche non andassero per la citta, facendo pazzie, et È fatto À modo d’uno Spedale, dove sono circa cento cinquanta guardiani in loro custodia, et sonvi medicine, et altre cose per loro bisogni, e i detti guardiani vanno per la citta con bastoni cercando i matti, et quando ne truovano alcuno, lo’ncatenano per il collo con cathene di ferro, et per le mani, et À suon di bastoni lo menano al detto luogo, et quivi gli mettono una catena al collo assai maggiore, che È posta nel muro, et viene sopra del letto, tal mente che nel letto per il collo tutti gli tengono incatenati, et vene saranno per ordine, lontano l’uno dall’altro numero di quaranta, i quali per piacere di quelli della citta molte volte sono visitati, et di continovo col bastone i guardiani gli stanno appresso: Percio che non essendovi guastano i letti, et tiransi le tavole l’uno À l’altro: et venuta l’hora del mangiare, i guardiani gli vanno esaminando tutti per ordine, et trovando alcuno, che non istia in buon proposito, crudelmente lo battono, et se À caso truovano alcuno, che non faccia piu pazzie, gli banno miglior cura, che À gli altri.” J. Costumi et la vita de Turchi di Gio. Antonio Menavino Genovese da Vultri, 12mo, in Fiorenza, 1551.

[29] TraitÉ sur la Mania, page 103.

[30] The frequent recurrence of any propensity leads, by sure steps, to the final adjustment of the character; and even when the propensity is ideal, the repetition of the fits will, in the end, invest fancy with the habitudes of nature.—Criticism on the Elegy written in a Country Church Yard, p. 3.

[31] Remarks on Dr. Batties’ Treatise on Madness, p. 38.

[32] Dr. Cox, Practical Observations on Insanity, p. 28.

[33] Dr. John Monro’s Remarks on Dr. Battie, p. 39.

[34] Vide Dr. Cox’s Practical Obs. on Insanity, p. 42.

[35] It is a painful recollection to recur to the number of interesting females I have seen, who, after having suffered a temporary disarrangement of mind, and undergone the brutal operation of spouting, in private receptacles for the insane, have been restored to their friends without a front tooth in either jaw. Unfortunately the task of forcing patients to take food or medicines is consigned to the rude hand of an ignorant and unfeeling servant: it should always be performed by the master or mistress of the mad-house, whose reputations ought to be responsible for the personal integrity of the unhappy beings committed to their care.

[36] Dr. Cox.

[37] See Dr. Cox’s Advertisement prefixed to his book.

[38] Vide Report from the select committee appointed to enquire into the state of lunatics, page 25.

[39] Remarks on Dr. Batties’ Treatise on Madness.

[40] See Dr. Cox, page 102.

[41] Dr. Cox, p. 61.