Madness is attributed to moral and physical causes. Physicians do not agree as to the prevalence of either of these sources of human misery. Some of them, most unjustly accused of materialism, seem to lean to the opinion that, generally speaking, physical causes can be traced in post mortem examination; while others, equally skilled in accurate anatomical investigations, maintain that these organic derangements are very seldom met with.

Lawrence affirms that he had “examined after death the heads of many insane persons, and had hardly seen a single brain which did not exhibit obvious marks of disease;” and he further states, “that he feels convinced from his own experience, that very few heads of persons dying deranged will be examined after death without showing diseased structure, or evident signs of increased vascular activity.” The celebrated Morgagni gives similar results of his extensive dissections. Meckel and Jones are of the same opinion. However, Pinel, whose anatomical pursuits on the subject were most extensive, clearly declares that he never met with any other appearance within the cavity of the skull than are observable in opening the bodies of persons who have died of apoplexy, epilepsy, nervous fevers and convulsions. Haslam, whose experience in this matter was also very great, asserts that nothing decisive can be obtained in reference to insanity from any variations of appearance that have hitherto been detected in the brain. Greding observed in two hundred and sixteen maniacal cases which he examined, the whole of whom died of disorders unconnected with their mental ailments, that three of the heads were exceedingly large, two exceedingly small; some of the skull bones were extremely thick, others peculiarly thin; in some the frontal bones were small and contracted, in others the temporal bones compressed and narrow.

In this confusion and clashing of opinions, when unfortunately each theorist views, or fancies that he views, functional or organic derangements sufficiently evident (in his eyes at least) to support his doctrine, it is no easy matter to come to a fair conclusion. It can only be observed, that, as the wonderful sympathies of the brain with other organs especially the viscera of the abdomen, are universally acknowledged, the morbid condition in which the brain is occasionally found may have arisen from a primary morbid condition of some other organ. Hence it is difficult to say whether insanity is most generally a primary or a secondary affection. Physical causes act both upon the brain and the abdominal system. Concussion and compression of the brain will occasion nausea, vomiting, and hepatic affections, and the presence of worms in the intestines will excite convulsions and epilepsy. In regard to moral causes, they may also act directly or indirectly upon the brain, or the parts that sympathize with it. Sudden or violent emotions are known to produce an immediate effect upon our digestive functions, which may in turn by their sympathetic connexion act upon the brain and the mind, although the connexion between brain and mind is not yet proved in any conclusive manner.

However, in a practical point of view, whatever discrepancy of opinion may prevail on this subject, I think it will be found advisable to consider most, if not all recent cases of insanity, as arising from physical causes, and therefore to submit the patient to such a medical treatment in addition to moral aid, as the prevalence of morbid symptoms of local derangement are more or less evident. My own experience has fully convinced me that a morbid condition of the cerebral organ, and the viscera of the thorax and abdomen, are invariably met with, and must have proved of sufficient importance to develop symptoms which the slightest observations might have detected. How far the organic derangement may have been either the cause or the result of insanity I am not prepared to say, but they have generally borne the appearance of having originated in undue excitement.

On this most important subject I feel much gratification in quoting the following opinion of the experienced Pinel: “It appears in general that the primitive seat of insanity is in the region of the stomach and intestinal canal, and it is from this central part that mental aberration is propagated as by irradiation.” Esquirol is of opinion that insanity arises from a lesion of the vital functions of the brain, and not unfrequently from a disturbance in the various points of sensibility in different parts of the system.

That mental emotions, whether producing any alteration in the physical condition of the individual, or not, occasion various degrees of insanity, is proved by experience. The French revolution, during its execrable phases, offered a wide and fertile field of observation on this subject; and the various events that marked those fearful times were certainly well calculated to affect any brain capable of becoming deranged. The following results of these observations are curious: “Among the lunatics confined at BicÊtre,” says Pinel, “during the third year of the Republic, I observed that the exciting causes of their maladies, in a great majority of cases, were extremely vivid affections of the mind; such as ungovernable or disappointed ambition, religious fanaticism, profound chagrin, and unfortunate love. Out of one hundred and thirteen madmen with whose history I took pains to make myself acquainted, thirty-four were reduced to this state by domestic misfortunes, twenty-four by obstacles to matrimonial union, thirty by political events, and twenty-five by religious fanaticism. Those were chiefly affected who belonged to professions in which the imagination is unceasingly or ardently engaged, and not controlled in its excitement by the exercise of the tamer functions of the understanding, which are more susceptible of satiety and fatigue. Hence the BicÊtre registers were chiefly filled from the professions of priests, artists, painters, sculptors, poets, and musicians, while they contained no instances of persons whose line of life demands a predominant exercise of the judging faculty,—not one naturalist, physician, chemist, or geometrician.”

The following is a return of the supposed moral causes of insanity observed in the SalpÉtriÈre. In the years 1811 and 1812

In Mr. Esquirol’s private establishment during the same period:

It must be observed that the latter return, in which we find twenty-eight persons maddened by disappointed ambition and offended pride, is of a private establishment, whose inmates of course belonged to the better classes of the community.

By the return from Pennsylvania, out of fifty lunatics, thirty-four cases arose from moral causes. Of physical causes hereditary madness is the most prevalent, as appears clearly from the following table extracted from the registers of the SalpÉtriÈre.

When speaking of hereditary madness, Dr. Abercrombie is of opinion that where a tendency to insanity exists, there may be in many cases, circumstances in mental habits or mental discipline calculated to favour or to counteract the tendency, when the mind wanders away from the proper duties of life or luxuriates amid scenes of imagination, thus permitting mental emotions, of whatever kind, to be excited in a manner disproportional to the true relation of the object which gave rise to them; allowing the mind to ramble among imaginary events, or to be led away by slight and casual relations, instead of steadily exercising the judgment in the investigation of truth.

These observations are no doubt most luminous, yet as I have elsewhere remarked, hereditary predisposition to insanity may be brought into action, by the constant scenes that pass in the presence of those individuals who may daily have to witness the aberrations of an unhappy relative. The mind dwells on the sad subject, and it becomes a source of constant apprehension, when the mere dread of an hereditary evil is perhaps sufficient to drive to madness. So powerful is the sway even of imaginary terror, that we need not wonder that natural fear should be productive of results still more injurious to our intellects. There seems to exist a certain fascination in what we should dread and avoid; instead of resisting evil, by a strange fatality we seem to be self-impelled to court it. We indulge in thoughts, in hopes and fears, too often chimerical, instead of endeavouring to dismiss them from our mind, by other pursuits and busy occupation; and we brood upon future and ideal miseries until we actually, from supineness and timidity, sink under their overwhelming influence.

Esquirol relates some curious coincidences of hereditary insanity. A Swiss merchant lost both his sons in a state of mania at the age of 19. A lady lost her senses after childbirth at the age of 25. Her daughter became insane in her 25th year. In one family, the grandfather, the father, and the son, destroyed themselves at the age of 50. Near Newton, seven insane sisters had been observed in one family. An unfortunate female in the SalpÉtriÈre, under the influence of liquor, threw herself three times in the river and her sister in a state of intoxication drowned herself. A gentleman whose intellects became deranged in consequence of the misfortunes of the revolution remained for ten years secluded in his chamber. His daughter became insane about the same period, and with equal obstinacy could not be prevailed upon to leave her room.

There is no doubt, but that were these early predispositions attended to and watched, an active course of education adopted, and change of locality resorted to, much future misery might be avoided, and possibly the invasion of the malady arrested.

If the observations of the phrenologist are entitled to consideration, the mind may become mainly instrumental in attaining this desideratum, as the detection of certain propensities may place us upon our guard in the education of youth. This would be a point of still greater importance, were these organs innate, dooming us to the blind law of fatality; but the phrenologists maintain, that the development of these organic inequalities on the surface of the cranium are produced and developed by a corresponding enlargement of the brain, which is greater or lesser in the ratio of the preponderance of the organ as the indulgence in the propensities which they indicate.

Pinel relates a curious case of hereditary mania in a man who, up to the age of fifty, fulfilled with intelligence and activity the duties of an important office which he held. At this period he indulged in various excesses, and sunk in the debasement of the lowest society. These excesses he represented to his wondering friends and acquaintances as the source of divine pleasure and celestial enjoyment. He declared that he would erect a temple to the god of love, and officiate himself as high priest at his altars; he compared the very lowest of women to angelic creatures; and finally was confined, a furious and desperate maniac.

Education carried on upon mistaken principles has also been known to prepare the way to insanity, and La Bruyere has justly observed, that there are parents, the study of whose life appears to have been, their giving their children just reason not to regret their loss. Pinel has given us the interesting history of two orphan brothers, who had been brought up in a most anomalous manner—with extreme kindness and effeminacy by a nurse, and with much harshness and injustice by a tutor. The result of this erroneous management was a deficient development in their intellectual faculties, and a debilitated frame, which gradually led to a state of imbecility. When examined by Pinel at the age of twenty and twenty-two, their conversation was puerile in the extreme, and they both displayed a taste for infantile sports and pastimes, befitting children of three or four years old. They sought to express themselves with great volubility, but their language, consisting chiefly of broken syllables, was scarcely intelligible. Notwithstanding their apathic appearance, by a sort of automatic habit, every evening brought on an absurd scene of sentimentality. They would join each other in earnest conversation in a corner of the room; and, with bitter tears and deep sighs, bewail the loss of their parents, who had thus left them in a helpless orphan condition, in their tender years, expressing the sincerest affection for their nurse, but speaking of their tutor with bitter imprecations. A great partiality shown to one sister has driven another one to a state of dementia, that arose from her continually dwelling on the wrongs she experienced, which, of course, were exaggerated by jealousy.

External agents producing sudden terror have been frequently known to bring on insanity. It is related of a child of three years of age, who was so terrified on being brought into a madhouse, that he was subject to horrible dreams and visions until his seventeenth year, when he became a perfect lunatic. Women frightened during pregnancy have often become alienated; and there are two cases reported of young ladies who were found insane the day after their nuptials.

While disappointments and misfortunes are often the origin of insanity, a sudden melioration in circumstances, and unexpected pleasing intelligence have been also known to derange the intellects. A man who came into the possession of a large fortune, after having lived for many years in penury, was so alarmed at the thought of losing this property, that the apprehension of the evil deprived him of his senses. An instance is recorded of a young girl, long separated from her lover by parents averse to their union, who became insane immediately after her marriage.

Children are generally exempted from this calamitous visitation; yet Frank relates the case of a child at St. Luke’s who had been deranged since he was two years old. Age, to a certain extent, seems to influence insanity, and most individuals are alienated between their twentieth and fiftieth years. Haslam states, that out of one thousand six hundred and sixty-four patients admitted into Bedlam, nine hundred and ten came within this period of life. In France it appears that most cases of insanity are noticed between the ages of twenty-five and thirty-five. One-fifteenth of these cases among men, and one-sixth among women, are observed before their twentieth year; and in the wealthy classes of society one-fourth occur before the same period. The following table from BicÊtre regarding age is not without interest.

Thus it would appear that the astounding events which took place in France, but more especially in Paris, from the year 1789, the breaking out of the revolution, to 1793, the reign of terror, had no effect upon the intellects of the population; unless it is supposed that the entire nation being in a state of insanity, either madmen were not noticed as any peculiarity, or rushed into mischief and were murdered. This observation as to the influence of public events is confirmed by the following statement of admissions in the SalpÉtriÈre during the comparatively tranquil years of 1811, 1812, 1813, and 1814, although many cases of insanity were said to have arisen from the harsh laws of the conscription.

Therefore one might fairly conclude that the taking of the Bastille, the execution of Louis XVI., the bloody sway of the Jacobins, the ambitious wars of Napoleon, and the restoration of Louis XVIII., did not in the slightest degree affect the brains of our happy and philosophical neighbours.

It has been generally imagined that women are more subject to mental alienation than men; this, however, is by no means proved by observation in other countries, as will appear by the following calculation:

In the Lunatic Asylum of Hanwell I have now under my care 265 males, and 351 females.

It has long been a current opinion that madness is a more common disease in our country than any where else. This may possibly arise from the greater number of our eccentric countrymen that are widely scattered over the globe; and whenever an individual is observed whose manners and conduct are totally at variance with the habits of any other member of the community, he is generally considered an Englishman. Voltaire came to the sweeping conclusion that one half of the nation was scrofulous, and the other moiety insane.

However, it would appear that insanity is on the increase; for in the report of the commissioners for licensing lunatic establishments we find the following statement: “Insanity appears to have been considerably on the increase; for if we compare the sums of two distant lustra, the one beginning with 1775, and the other ending with 1809, the proportion of patients returned as having been received into lunatic asylums during the latter period, is to that of the former nearly as one hundred and twenty-nine to one hundred.” Dr. Burrows has endeavoured to impugn the correctness of this statement by proving that suicide is more frequent in other countries; now, unless Dr. Burrows can prove that suicide is always an act of insanity, which will by no means be admitted, his observation can bear no weight.

It is but too true that in melancholy madness we often observe a prevailing propensity to self-destruction. Dr. Abercrombie’s views on this subject are so luminous that I shall transcribe them.

“When the melancholic hallucination has fully taken possession of the mind, it becomes the sole object of attention, without the power of varying the impression, or of directing the thoughts to any facts or considerations calculated to remove or palliate it. The evil seems overwhelming and irremediable, admitting neither of palliation, consolation, nor hope. For the process of mind calculated to diminish such an impression, or even to produce a hope of the palliation of the evil, is precisely that exercise of mind which in this singular condition, is lost or suspended; namely, a power of changing the subject of thought, of transferring the attention to other facts and considerations, and of comparing the mental impression with these, and with the actual state of external things. Under such a conviction of overwhelming and hopeless misery, the feeling naturally arises of life being a burden, and this is succeeded by a determination to quit it. When such an association has once been formed, it also fixes itself upon the mind, and fails to be corrected by those considerations which ought to remove it. That it is in this manner the impression arises, and not from any process analogous to the determination of a sound mind, appears, among other circumstances, from the singular manner in which it is often dissipated, namely by the accidental productions of some new impression not calculated in any degree to influence the subject of thought, but simply to give a momentary direction of the mind to some other feeling. Thus a man mentioned by Pinel had left his house in the night, with the determined resolution of drowning himself, when he was attacked by robbers. He did his best to escape from them, and having done so, returned home, the resolution of suicide being entirely dissipated. A woman mentioned, I believe by Dr. Burrows, had her resolution changed in the same manner, by something falling on her head, after she had gone out for a similar purpose.

“A very irregular modification occurs in some of these cases. With the earnest desire of death, there is combined an impression of the criminality of suicide; but this instead of correcting the hallucination, only leads to another and most extraordinary mode of effecting the purpose; namely by committing murder, and so dying by the hand of justice. Several instances are on record in which this remarkable mental process was distinctly traced and acknowledged; and in which there was no mixture of malice against the individuals who were murdered. On the contrary, these were generally children; and in one of the cases, the maniac distinctly avowed his resolution to commit murder, with the view of dying by a sentence of law; and at the same time his determination that his victim should be a child, as he should thus avoid the additional guilt of sending a person out of the world in a state of unrepented sin. The mental process in such a case presents a most interesting subject of reflection. It appears to be purely a process of association, without the power of reasoning. I should suppose that there had been at a former period, during a comparatively healthy state of the mental faculties, a repeated contemplation of suicide which had been always checked by an immediate contemplation of its dreadful criminality.

In this manner a strong connexion had been formed, which when the idea of suicide afterwards came into the mind, during the state of insanity, led to the impression of its heinousness, not by a process of reasoning, but by simple association. The subsequent steps are the distorted reasonings of insanity, mixed with some previous impression of the safe condition of children dying in infancy. This explanation I think is strongly countenanced by the consideration that, had the idea of the criminality of suicide been in any degree a process of reasoning, a corresponding conviction of the guilt of murder must have followed it. I find, however, one case which is at variance with this hypothesis. The reasoning of that unfortunate individual was, that if he committed murder, and died by the hand of justice, there would be time for his making his peace with the almighty between the crime and his execution, which would not be the case if he should die by suicide. This was a species of reasoning but it was purely the reasoning of insanity.”

Still these remarks do not go to prove that suicide is always the result of insanity, since it can in most instances be attributed to a moment of despair and impatience under a heavy visitation of calamity, or the dread of contempt of society. The frequency of this rash act, cannot therefore be adduced as a proof of the greater prevalence of madness in any country. With greater reason, self-destruction is to be referred to the want of a proper religious education and feeling, which will enable man to bear up against the world’s vicissitudes, and deem life a more or less painful journey to a peaceful abode.

Montesquieu was one of the many writers who attributed this propensity as being nearly exclusive to the English. “Les Anglais,” he says, “se tuent sans qu’on puisse imaginer aucune raison qui les y dÉtermine; ils se tuent dans le sens mÊme du bonheur. Cette action, chez les Romains Était l’effet de l’Éducation, elle tenait À leur maniÈre de penser et À leurs coutumes; dans les Anglais c’est l’effet d’une maladie, elle tient À l’État physique de la machine.”

Two very curious works on suicide have been lately published in Germany by Dr. Arntzenius and Dr. Schlegel. The former writer divides this fatal propensity into acute and chronic; the first marked by great physical excitement, the latter accompanied or preceded by sadness, moroseness, and love of solitude. Curious cases are related in illustration of this doctrine, amongst others we remark that of an English nobleman who cast himself into the crater of Vesuvius. A German in the same year, not being able perhaps to travel so far, threw himself into a smelting furnace. Several cases are recorded of individuals who formed the desperate resolution of starving themselves. It appears that in many instances the most trifling circumstance has driven these reckless beings to the commission of this desperate action. The case of a young Parisian author of the name of Escoupe, who suffocated himself because one of his dramatic productions had been severely criticised, is well known. A German student destroyed himself because he had a club-foot, and another youth put an end to his existence in consequence of his not having been allowed to put on his Sunday clothes. Dr. Schlegel has given a curious table of the means of destruction resorted to according to the several ages of individuals, and we give the following abstract:

In classing 9000 cases of suicide which happened in Paris between the years 1796 and 1830, Dr. Schlegel concludes that what he terms the “philosophic suicide,” is that which is perpetrated after deliberation, during the night or shortly before sunrise; whilst when it is not the result of premeditation, it occurs during the day.

The choice between shooting and hanging may be accounted for on the same grounds. A young man, in a fit of frantic passion, from disappointed love, or losses at play, will probably, on his return home, seize a pistol and blow out his brains; whereas hanging needs reflection and some preparation and precaution, which would alone suffice to bring a reflective creature to a proper sense of his folly, unless predetermined to destroy himself by “philosophic suicide.”It appears in these accounts that suicide in France has greatly increased since the revolution. The average number during the last forty-two years being 409?, the number in Paris being 1639 annually. Dr. Schlegel informs us that there exists a society in Paris called, “Society of the Friends of Suicide.” It consists of twelve members, and a lot is cast annually to decide which of them is to destroy himself in the presence of the others. Certain qualifications and testimonials were required before a candidate could be admitted into this amiable club:

1. He must prove himself a man of honour.

2. He must have experienced the injustice of mankind, been injured by a dear friend, or betrayed by a mistress or a wife.

3. He must have experienced, for some considerable time, a miserable vacuity of soul, and a discontent with every thing in the world.

This association reminds me of a ball that was established in Paris after the reign of terror, called Le Bal des Victimes, to which no person could be admitted unless they had had a near relation guillotined.

Dr. Schlegel has also given the following statistical table of the proportion of suicides to various populations—both as regarding counties and principal cities:

According to our ingenious author, drunkenness is the chief cause of suicide in England, Prussia, and Germany; love and gambling in France; whilst bigotry, or the fear of dying without having received the sacrament, he supposes, prevents it in Spain, where, comparatively speaking, suicide is seldom heard of.

The same remark may apply to Italy, where a Roman lady, having heard of such an action, exclaimed, “Dev’ essere un forestiere; gli Italiani non sono tanto matti.” She was right, the suicide was a melancholy German tailor.

In India, where the doctrine of predestination is generally prevalent, it is calculated that in one year there were forty suicides in a population of 250,000, twenty-three of which were females.

Arntzenius quotes Gall’s opinion, that suicide arises from too great a predominance of the organ of cautiousness. Combe and other phrenologists are of opinion, that with this predominance a deficient development of hope and a large destructiveness must be conjoined.

It has been remarked that in Spain and Portugal, where insanity is comparatively rare, malconformation of the brain and consequent idiotism are very frequent.

Since the peace it may be more difficult to arrive at any conclusion on the subject of increase of lunacy, founded on the admission of lunatics into public and private establishments, since emigration has carried so many families and operatives of every description abroad, many of whom, from various disappointments and vexations, might have been predisposed to insanity.

It appears that in 1836 there existed in England and Wales 6402 lunatics, 7265 idiots—13,667 lunatics and idiots. Of paupers alone, or lunatics and idiots, there were 1.00098 of the total population, or 1 in 1024.

However, according to the most probable calculation, the number of lunatics in England amounts to about 14,000, out of which about 11,000 are paupers. Idiots are nearly as numerous as lunatics. Sir A. Halliday states the former to amount to 5741, and the latter to 6806. To this it must be observed that many harmless idiots are allowed to remain in their usual residence. In Wales it appears that idiots are to lunatics in the proportion of seven to one. The difficulty of obtaining any certain information on this subject, however, is such, that it is scarcely possible to decide the question with any chance of a probable certainty.In regard to the prevalence of lunacy in other countries, the following are curious statistical statements:

In Spain, in 1817, according to the report of Dr. Luzuriaga, there only existed in the asylums of Toledo, Granada, Cordova, Valencia, Cadiz, Saragossa, and Barcelona, 509 lunatics—only fifty were in the hospitals of Cadiz, sixty in that of Madrid, and thirty-six in the kingdom of Granada.

In Italy, in twenty-five asylums in Turin, Genoa, Milan, Brescia, Verona, Venice, Parma, Modena, Bologna, Ferrara, Florence, Sienna, Lucca, and Rome, Mr. Brierre only found 3441 patients. The population of these parts of Italy amounting to about 16,789,000 inhabitants, which gives one lunatic to 4879 persons.

Scott, who accompanied Lord Macartney’s embassy to China, observed that very few insane persons were to be found there. Humboldt states that madness is rare amongst the natives of South America. Carr made the same remark in Russia. In Spain and Italy, religious melancholy, and that most vexatious species of insanity called erotomania, are the more common.

In the savage tribes of Africa and America insanity is very rare. Dr. Winterbotham affirms, that among the Africans near Sierra Leone, mania is a disease which seldom if ever occurs. Idiotism was likewise a rare phenomenon among them. Among the negro slaves in the West Indies it is scarcely known, and during three years’ residence in the Bahamas, only one case of monomania fell under my observation. Amongst the native races of America it scarcely exists. From these observations we may conclude, with Esquirol, that insanity belongs almost exclusively to civilized races of men, that it scarcely exists among savages, and is rare in barbarous countries. To what circumstance are we to attribute this exemption? Possibly it may be attributed to simplicity in living, which predisposes to less disease and morbid varieties of organization, and to the absence of that refined education which exposes man to the artificial wants and miseries of high civilization. It is moreover probable that the constant occupation which the existence of the savage requires to satisfy his absolute necessities, does not leave him leisure time to ponder over gloomy ideas and fictitious sufferings. In addition to these circumstances, Dr. Pritchard has justly remarked, that we might also conjecture that congenital predisposition is wanting in the offspring of uncivilized races. The same author admits the probability of the brain receiving a different development in the progeny of cultivated races, or of those whose mental faculties have been awakened.

Various professions have been supposed to exercise much influence on the intellectual faculties. The following observations at the SalpÉtriÈre during one year may tend to illustrate this subject:

In Mr. Esquirol’s establishment:

According to the prevalence of the ideas connected with their former pursuits do we observe the hallucination of these unfortunate persons to be of a different character. Dr. Abercrombie relates the case of a Scotch clergyman, who was brought before a jury to be what is called in Scotland cognosced, or declared incapable of managing his affairs. Amongst the acts of extravagance alleged against him was, that he had burnt his library. When he was asked by the jury what account he would give of this part of his conduct, he replied in the following terms: “In the early part of my life I had imbibed a liking for a most unprofitable study, namely, controversial divinity. On reviewing my library, I found a great part of it to consist of books of this description, and I was so anxious that my family should not be led to follow the same pursuits, that I determined to burn the whole.” He gave answers equally plausible to questions which were put to him respecting other parts of his conduct; and the result was, that the jury found no sufficient ground for cognoscing him; but in the course of a fortnight from that time, he was in a state of decided mania.

What a school of humility is a lunatic asylum! What a field of observation does it not present to the philosopher who ranges among its inmates! We find the same aberrations that obtain in society; similar errors, similar passions, similar miserable self-tormenting chimeras, empty pride, worthless vanity, and overweening ambition. There we

See that noble and most sovereign reason,
Like sweet bells jangled, out of tune and harsh.

Each madhouse has its gods and priests, its sovereigns and its subjects, terrific mimicry of worldly superstitions, pomp, pride, and degradation! There, tyranny rules with iron sway, until the keeper’s appearance makes tyrants know there does exist a power still greater than their own. In madhouses egotism prevails as generally as in the world, and nothing around the lunatic sheds any influence unless relating to his wretched self. In this struggle between the mind and body, this constant action and reaction of the moral and the corporeal energies, when reason has yielded to the brute force of animal passions, and the body with all its baseness has triumphed over the soul, one cannot but think of Plutarch’s fanciful idea, that, should the body sue the mind for damages before a court of justice, it would be found that the defendant had been a ruinous tenant to the plaintiff.

In many cases of insanity we observe a singular fertility of glowing imagination and a vivacity of memory which is often surprising. Dr. Willis mentions a patient who was subject to occasional attacks of insanity, and who assured him that he expected the paroxysms with impatience, as they proved to him a source of considerable delight. “Every thing,” he said, “appeared easy to me. No obstacles presented themselves either in theory or in practice. My memory acquired of a sudden a singular degree of perfection. Long passages of Latin authors occurred to my mind. In general I have great difficulty in finding rhythmical terminations, but then I could write verse with as much facility as prose.”

Old associations thus recalled into the mind are often mixed up with recent occurrences, in the same manner as in dreaming. Dr. Gooch mentions a lady who became insane in consequence of an alarm of fire in her neighbourhood. She imagined that she was transformed into the Virgin Mary, and that a luminous halo beamed round her head.

It is said that the Egyptians placed a mummy at their festive board, to remind man of mortality. Would not a frequent visit to a lunatic asylum afford a wholesome lesson to the reckless despot, the proud statesman, and the arbitrary chieftain? There they might converse with tyrants, politicians, and self-created heroes, in all the naked turpitude of the evil passions, who in their frantic gestures would show them that which they wish to be—that which the world considers they are! Often would they hear the maniac express the very thoughts that ruffle their own pillows, until the dreaded bell that announces the doctor’s visit, and which with one loud peal destroys his fond illusions, herald of that knell which sooner or later must call them from the busy world they think their own. How beautifully has Filmer expressed the madman’s fears!

See yon old miser laden with swelling bags
Of ill-got gold, with how much awkward haste
He limps away to shelter! See how he ducks,
And dives, and dodges with the gods; and all
Only in hope to avoid, for some few days
Perhaps, the just reward of his own sad extortions.
The hot adulterer, now all chill and impotent
With fear, leaps from the polluted bed,
And crams himself into a cranny!
There mighty men of blood, who make a trade
Of murder, forget their wonted fierceness;
Out-nois’d, they shrink aside, and shake for fear
O’ th’ louder threat’nings of the angry gods.

Whatever may be the nature of insanity or our fallacious views regarding it, it is a matter of great consolation to find that our mode of treating it is at last founded on rational and humane principles. The unfortunate lunatic is no longer an object of horror and disgust, chained down like a wild beast, and sunk by ignorance or avarice, even below the level of that degradation in the scale of human beings, to which it had pleased Providence to reduce him,—we no longer behold him rising from his foul and loathsome bed of straw, scantily covered with filthy tatters, his hair and beard wild and grisly—his eyes under the influence of constant excitement, darting menacing looks—the foam bubbling through his gnashing teeth—clanking his fetters with angry words and gestures, threatening heaven and earth—gazed at with dismay, through massive bars—the very female seeming of doubtful sex:

Her unregarded locks
Matted like fury-tresses, her poor limbs
Chain’d to the ground; and stead of those delights
Which happy lovers taste, her keeper’s stripes,
A bed of straw, and a coarse wooden dish
Of wretched sustenance.[18]

Now, the unfortunate persons are restored to social life as much as their sad condition allows; they enjoy every comfort that can solace them in their lucid intervals, when their hallucinations cease; in illness they are treated with kindness and liberality, and in health, their former associations with the busy world, are recalled by labour, voluntarily performed or stimulated by the incentive of some additional comfort. No coercion is resorted to, except to prevent the furious maniac from injuring himself and others, and then, such means are adopted that restrain his violence without a painful process. Even the straight waistcoat, which impedes respiration, is generally banished in all well-regulated establishments, and belts, sleeves, and muffs, which merely secure the hands, without preventing a free motion of the articulations, are usually resorted to. To such an extent is healthy occupation carried on in lunatic asylums, that at this moment at Hanwell, out of upwards of 600 inmates under my care, 421 are at work and distributed as follows:

Hanwell may be said to be an asylum for incurables, since it is doomed to receive old cases that scarcely ever afford a chance of recovery; to which are added a large proportion of the idiots and epileptics of Middlesex, whose families cannot support them.

Let us hope from this gradual amelioration in the condition of this illfated class of our fellow-creatures, that every institution, both public and private, will shortly be conducted upon a similar plan, having sufficient grounds attached to it, to give occupation to such of their inmates as may still be able to enjoy some share, however trifling it may be, of the blessings of this life.