Diseases of the brain not dissimilar to affections of other organs—Early symptoms of insanity—The good effects of having plenty to do—Occupation—Dr. Johnson’s opinion on the subject—The pleasure derived from cultivating a taste for the beauties of nature—Effect of volition on diseases of the mind—Silent grief injurious to mental health—Treatment of ennui—The time of danger, not the time of disease—The Walcheren expedition—The retreat of the ten thousand Greeks under Xenophon—Influence of music on the mind in the cure of disease—Cure of epidemic suicide—Buonaparte’s remedy—How the women of Myletus were cured of the disposition to suicide, and other illustrations—Cases shewing how easily the disposition to suicide may be diverted—On the cure of insanity by stratagems—On the importance of removing the suicidal patient from his own home—On the regulation of the passions.

In treating this most important class of affections, we must dismiss from our minds all those pre-conceived notions which we have been led to form of what constitutes mental derangement. We must view the subject as medical philosophers in the most liberal acceptation of the term, and not as nisi prius barristers; we must consider ourselves at the bed-side of a suffering patient, demanding from our skill that relief which he is led to believe we have in our power to afford, and not as in a court of justice, undergoing an examination at the hands of a lawyer anxious to establish his case; and, above all, we must apply to the disease of the brain and its disordered manifestations those pathological principles which guide us in the elucidation of the affections of other organs. If we consider insanity not as a specific disease invariably exhibiting the same phenomena, but as it really is, the effect of a disordered condition of the sentient organ, having an incipient, as well as an advanced stage, we may, by a judicious application of the principles of therapeutics, succeed in many cases in crushing the disposition to suicide before it has taken a formidable hold of the constitution. In the great majority of cases the premonitory indications are well marked and unequivocal. The experienced physician and accurate observer will be able to detect, before the mental alienation becomes apparent to others, the early dawnings of derangement. He knows that it is frequently manifested by some change in the person’s usual healthy habits of thinking and acting,—by the exhibition of odd fancies and whims. Although surrounded by everything calculated to contribute to his happiness, he is the most miserable of human beings. Trifles annoy and irritate him; he sees in his dearest friends his deadliest enemies; talks of conspiracies, of plots, and stratagems; becomes suspicious of everything and everybody; his former objects of pleasure afford him no delight; he avoids society, and is occasionally heard muttering strange things to himself. In the majority of cases these are the early dawnings of cerebral disease leading to unequivocal insanity, and yet so tied down are we to definitions, arbitrary standards and poetical tests, that we will not admit derangement of mind to be present until the symptoms are so self evident and glaring that the condition of the mind becomes apparent to the most superficial observer. When this view of insanity is recognised as orthodox, and moral treatment adopted in the early stages of the disease, much good may be expected to result.

How often do we see in society, and during the intercourse of private friendship, individuals complaining of the severest mental sufferings, the effect of morbid alterations of feeling almost in every respect similar to insanity, dependent upon the same causes, manifesting the same symptoms, and removed by the same remedial agents. How are these mental ailments treated? The poor sufferer is perhaps smiled at; he is considered to be fanciful, and no regard is paid to the cerebral affection. The disease is allowed to advance until other faculties of the mind are implicated, and then the mental alienation exhibits itself so unequivocally that no one doubts its existence.

The success of the mental treatment of suicide will be mainly dependent on our paying strict attention to those apparently trifling alterations of temper and disposition, those deviations from the usual mode of thinking and acting, which so often predicate the presence of the incipient stage of insanity. An invincible love of solitude exhibited in a patient considered as labouring under an hypochondriacal affection, and who, when induced to converse, complains of being constantly pestered with one or two trains of ideas from which he cannot for a moment escape, although his efforts are great and unremitting, let his friends beware. These changes are, however, but rarely noticed, until some alarming event causes every friend to lament the want of timely attention.

Occupation is an infallible specific for many of the imaginary and real ills of life. In cases where the mind is sinking under the influence of its own weight, and the fancy is allowed to dwell uninterruptedly on the ideas of its own creation, until the individual believes himself to stand apart from all the world, the very personification of human misery and wretchedness, the physician can recommend no better remedy than constant and steady occupation for the mind and body. Burton concludes his able work on Melancholy with this valuable piece of advice:—“Be not solitary; be not idle.” Dr. Reid recommended a patient, labouring under great mental depression, to engage in the composition of a novel, which, during the time he was occupied in the task, effected much good. By interesting himself in the distresses of fictitious beings, he diverted his attention from sufferings which were no less the offspring of the imagination.

It has been suggested with great truth that the habit of gaming, prevalent as it is among persons in the upper ranks of life, is not to be attributed exclusively to a feeling of avarice. The man who is surrounded by everything to make his condition in life happy, as far as wealth is concerned, does not fly to dice for the purpose of aggrandisement, but he does so to seek refuge from the miseries of indolence and vacuity; from the gnawings of his own mind; from an eager desire to expose himself to that mental agitation which nature tells him is so necessary to make life supportable. “A woman is happier than a man,” says Dr. Johnson, “because she can hem a pocket-handkerchief.”

Our faculties, like the vulture of Prometheus, devour our souls, if they have no action beyond ourselves. “Real lassitude is always mingled with grief,” says an eminent female genius; and Madame de StaËl considers the observation a profound one.

“The man in the Spectator who hanged himself to avoid the intolerable annoyance of having to tie his garters every day of his life, is but a satire on the misery of many who, having no useful occupation, find the flight of time marked only by the swift repetition of petty troubles.

“The restlessness of Rousseau, his discontented and morbidly irritable disposition, was closely allied to insanity; and the painful struggles of Lord Byron, when ‘came the fit again,’ are detailed in words which shew too plainly how they disturbed and threatened the integrity of his judgment. In such natures, every strong emotion, or the occurrence of disease, may destroy the delicate balance, and make a ruin of a mind which even in ruins continues to excite a mournful admiration. The diversion of social intercourse, which to other men is necessary to prevent mental torpor, becomes to them a source of irritation by impeding the workings of their imagination: they find that, when alone, all the nobler aspirations of the soul are free, and images of beauty, and virtue, and wisdom, occupy the mind. Society transforms them into a being they despise, deprives them of all their high and valued thoughts, and it enables them to feel what slight circumstances, acting on the man without, may affect the man within. But the pleasures of solitude are transient; their train is followed by baseless fancies, by fears undefined, by griefs unexpressed, and black despondency, from which society can alone relieve. We learn, from observing such effects, arising from such causes, the advantage of mixed and varied occupations, suited to a being not made solely for contemplation or for action; and we may gather rules from these observations, the application of which to minds in a morbid state is very direct.”50

With no less beauty than truth has the author of Rasselas depicted the insanity of the astronomer as gradually declining under the sanative influence of society and mental gratification. The sage confesses, that since he has mixed in the gay scenes of life, and divided his hours by a succession of amusements, he found the notion of his influence over the skies gradually fade away, and began to trust less to an opinion which he could never prove to others, and which he now found subject to variations from causes in which reason had no part. “If,” says he, “I am accidentally left alone for a few hours, my inveterate persuasion rushes upon my soul, and my thoughts are chained down by an uncontrollable violence; but they are soon disentangled by the prince’s conversation, and are instantaneously released by the entrance of Pekuah. I am like a man habitually afraid of spectres, who is set at ease by a lamp, and wonders at the dread which harassed him in the dark.”

It is difficult to lay down general rules for the treatment of particular cases of melancholia with a tendency to suicide. Travelling, agreeable society, works of light literature, should be had recourse to, in order to dispel all gloomy apprehensions from the mind.

In persons predisposed to insanity, or who manifest some slight indication of disease, how important it is to endeavour to call into exercise the higher faculties of the mind,—the judgment and reasoning powers,—and thus preserve the intellectual faculties in a healthy state of equilibrium. There is much wisdom in Lord Bacon’s advice, that “if a man’s wits be wandering, he should study the mathematics.” The patient should be taught to derive a pleasure from the contemplation of those objects that afford variety, and that are always within his reach. A beneficent Creator has wisely placed around us endless sources of the purest and most elevating enjoyments. In a ratio to our intellectual attainments, so are we enabled to derive pleasure from circumstances that appear trifling and foolish to others. Mungo Park could, in the solitude of an African desert, when exposed to the most distressing circumstances, derive a most exquisite pleasure from the sight of a small flower. How fully can we enter into the feelings of the man who, after being prostrated to the earth by an accumulation of worldly disappointments, yet spoke in a tone of noble triumph at his having retained, amidst the wreck of all his hopes, a perception of the beauties of nature!

A devotion to the common pleasures of sense is better than a state of absolute indifference; for even if these give no kind of pleasure, whilst all higher pursuits are neglected, there is danger lest a man become of the same opinion as Dr. Darwin’s patient, “that all which life affords is a ride out in the morning, and a warm parlour and a pack of cards in the afternoon;” and, like him, finding these pleasures not inexhaustible, should shoot himself because he has nothing better to do!

The miserable man should endeavour to make himself practically acquainted with the distresses of others. However desperate the circumstances of a person may be, he may still have it in his power to whisper a word of consolation to one whose situation may be more humiliating than his own.

Human nature is accused of much more selfishness than it has any just claim to; a thousand kindly emotions break in upon and redeem our daily and interested life.

How few have anything like a proper conception of the power which the will can be made to exercise over the physical and mental ailments.52 The stimuli which we all more or less have at command, if properly directed, will often subdue the early dawnings of disease, which, if permitted to take its own course, would have assumed a most formidable character. It is our duty to combat with the first menace of disordered feeling. Once the enemy is allowed to take up a favourable position, it will be fruitless to enter single-handed into the contest. “I will be good,” says the child, when he sees the rod ready to direct the will into the way of goodness; and “I will be cheerful,” ought the dull and dyspeptic to say, who observes a cloud of hypochondriacal fancies ready to burst upon his head. It may be said it is useless to struggle against the natural tendencies of the mind and body, or to declare war with habits which have become firmly rooted in the constitution. In reply to this we would say, let not the patient yield to the influence of those causes which have formed the habit; let him not hug to his bosom the viper which is preying upon his mind; let him not exclaim to gloom, “Henceforth be thou my god.”

The hypochondriac may say, when advised to rouse himself from his state of mental despondency, and to exhibit the attributes of a free agent—

But it is exercising a conscientious duty to resist the encroachments of those ideal pleasures which sap the foundation of our moral constitution.

I am inclined to concur in the opinion expressed by the late Dr. Uwins, that when melancholy is stripped of all its ornamental and poetical accompaniments, it will be found to be based in a great measure upon pride, selfishness, and indolence. This benevolent physician observes—“I cannot conceive a more delightful spectacle than that of an individual, whose constitutional cast is melancholy, warring against his temperament, and determining to enter with hilarity into the scenes and circumstances of social life.”

Dr. Haindorft, in his German translation of Dr. Reid’s “Essay on Hypochondriasis,” in alluding to the possibility of the patient labouring under hypochondria being able, by an exercise of the power of volition, to control his morbid sensations, justly observes—“We should have fewer disorders of the mind if we could acquire more power of volition, and endeavour, by our own energy, to disperse the clouds which occasionally arise within our own horizon; if we resolutely tore the first threads of the net which gloom and ill-humour may cast around us, and made an effort to drive away the melancholy images of a morbid imagination by incessant occupation. How beneficial would it be to mankind if this truth were universally acknowledged and acted upon—viz., that our state of health, mental as well as bodily, principally depends upon ourselves!”

It was the remark of a man of great observation and knowledge of the world—“Only wear a mask for a fortnight, and you will not know it from your real face.”

“I am determined to believe myself a happy man,” said a poor fellow, sunk in the lowest stage of melancholy, to Esquirol; and he did endeavour to triumph over his gloomy apprehensions, and for a short period he enjoyed the sunny aspect of life; but not having sufficient resolution to continue this effort of volition, he again gave way to despair.

A thousand years before the Christian era, there were, at the two extremities of Egypt, temples devoted to Saturn, to which those labouring under hypochondriasis resorted in quest of relief. Some cunning priests, profiting by the credulity of these patients, associated with the pretended miracles of their powerless divinities and barren mysteries, natural means by which they always solaced their patients, and succeeded often in effecting cures by amusing the mind, and withdrawing the attention from the contemplation of physical suffering. The patients were religiously subjected to a variety of diversions and recreative exercises. Voluptuous paintings and seducing images were exposed to their view; agreeable songs and melodious sounds perpetually charmed their ears; gardens of flowers and ornamental groves furnished delightful walks and delicious perfumes. Every moment was consecrated to some diverting scene and amusement, which had a most beneficial result on the diseased mind, interrupted the train of melancholy thought, dissipated sorrow, and wrought the most salutary changes on the body through the agency of the mind. The Egyptian physicians recommended their patients to repair to these famous temples, as the faculty of the present day suggest a trip to a fashionable spa.

That many suicides result from an indulgence in long-continued and corroding grief must be apparent to all who have given this subject any consideration. The medical man will find it difficult to manage such patients. Everything should be done to rouse the person from his state of mental abstraction. The immortal poet had a just conception of the baneful influence of silent grief on the mind and body; he makes Malcolm say, imploringly, to Macbeth,

An eminent London physician communicated to me the particulars of the following case:—A young lady, connected with a family of rank, and possessing great accomplishments, had formed, unknown to her parents, a secret attachment to a gentleman who often visited the house. When it was discovered, he was requested to abandon all notions of the lady, as it was the determination of her relations to refuse their consent to an alliance with him. Both parties took it much to heart. The lady suffered from a severe attack of nervous disorder, which terminated in suicidal mania. She endeavoured several times to jump out of the window, and would have done so had she not been most carefully watched. Her symptoms were most distressing. The mind appeared to be weighed down to the earth by an accumulation of misery and wretchedness, which she was unable to shake off. “Oh! could I but be happy!” she would exclaim. “Will no one come to my relief? What can I do?” She would walk about the room, occasionally giving utterance to expressions similar to those just quoted. More than once she observed, that, could she cry, she felt assured her mind would be relieved; but not a tear could she shed. After a fearful struggle for some time, one evening, as she was retiring to rest, she burst into a flood of tears. The effect was most beneficial; from that moment she began to recover. The copious lachrymal secretion had the effect of relieving the cerebral congestion, and in this way the brain was restored to the performance of its healthy functions.

It is difficult to lay down any particular instructions for the treatment of ennui. How is it possible to restore enjoyment to a man who has quite exhausted it? In such cases the advice which FÉnÉlon gives to Dionysius the tyrant, by the mouth of Diogenes, will naturally apply,—“To restore his appetite, he must be made to feel hunger; and to make his splendid palace tolerable to him, he must be put into my tub, which is at present empty.”

A lady became insane in consequence of a sudden and unexpected acquisition of wealth. In a few months she was reduced, by the failure of the house in which all her property was embarked, to complete indigence. Being compelled to work for her daily bread, her reason was soon restored. The great preservative from tedium vitÆ is, in keeping the mind and body in a state of healthy activity. How true it is—

In the army, it is proverbial that the time of fatigue and danger is not the time of disease; it is during the inactive and listless months of a campaign that crowds of patients pass to the hospitals. In both these cases it is the active exercise of the mind giving strength to the brain, and through it, healthy vigour to the body, which produces the effect. Shakspeare has not been unobservant of the consequences of excitement of mind on the bodily functions. In King Henry IV., when Northumberland is told of the fatal tidings from Shrewsbury, and is informed of the death of his son Percy, he breaks out,—

In illustration of the same principle, we have only to refer our readers to the ever-memorable Walcheren expedition. It has been stated that while our troops and seamen were actively engaged in the siege and bombardment of Flushing, exposed to intense heat, heavy rains, and poisonous exhalations from the malarious soil, inundated by the turbid waters of the Scheldt, scarcely a man was on the sick list; the excitement of warfare, the prospects of victory, and the expectation of booty, completely fortifying the body against all the potent causes of disease that environed the camp and the fleet.

In the celebrated retreat of the “Ten thousand Greeks” under Xenophon, the troops were subjected to great mental despondency. They had to cross rapid rivers, penetrate gloomy forests, drag their weary way over vast and burning deserts, scale the summits of rugged mountains, and wade through deep snows and pestilent morasses, in continual fear of death or capture. It was a sense of the despondency which misfortune was producing among the troops that induced Xenophon, in his address to his companions on the fearful night which preceded the murder of Clearchus, to say, “The soldiers have at present nothing before their eyes but misfortune. If any one can persuade them to turn their thoughts into action it would greatly encourage them.” It was to effect this purpose that the consummate general ordered everything in the camp, except the sword, to be abandoned. He inspired the hopes of his soldiers, roused their minds into activity, and thus prevented the development of serious disease among the troops.

Lord Anson says, in speaking of the ravages which the scurvy made under his command, that “whatever discouraged the seamen, or damped their hopes, never failed to add new vigour to the distemper; for it usually killed those who were in the last stages of it, and confined those to their hammocks who before were capable of some kind of duty.”

In certain diseases of the nervous system, particularly when associated with morbid conditions of the mind leading to suicide, the influence of music may be had recourse to with great advantage to the patient. The ancients, who paid more attention to the moral treatment of disease than the moderns have done, had a just appreciation of the beneficial effect of music on the nervous system. The learned Dr. Bianchini has collected all the passages found in ancient authors relative to the medical application of music; and from these it appears that it was used as a remedy by the Egyptians, Hebrews, Greeks, and Romans, not only in chronic, but in acute cases of disease.

M. Burette, in his able and scientific work on music, allows it to be possible, and even probable, that music, by the impressions it makes upon the nerves, may be of use in the cure of certain maladies; yet he by no means supposes the music of the ancients possessed this power in a greater degree than that of the moderns. Homer attributes the cessation of the plague among the Greeks, at the siege of Troy, to music:—

In the Memoirs of the French Academy of Sciences, for 1707 and 1708, there are many accounts of cases of disease which, after having long resisted and baffled the most efficacious remedies, had yielded under the influence of the soft impressions of harmony; and M. de Mairan, in the same records, published in 1735, has entered very fully into the consideration of the modus operandi of music on the body in health and disease.

The effect of music on the system is explained in two different ways. The monotony of the sound is supposed to have a soothing influence over the mind, similar to what is known to result from the gurgle of a mimic cataract of some mountain rill, or to a distant waterfall. How often has the music caused by the waves gently dashing upon the beach excited sleep, when all our narcotics have failed in producing a similar effect. This soporific effect of the repetition or monotony of sound is beautifully alluded to by Mackenzie, in his Man of Feeling. When his hero, Mr. Harley, arrives in London, he finds that the noise and varied excitement of the metropolis increase his nervous state of habit, and prevent him from sleeping. Ordinary narcotics produce no effect upon him, and he must have continued to suffer from watchfulness if he had not happily touched his shoe-buckle, which lay upon the table, when the vibration produced a monotonous sound so closely resembling the voice of his good aunt, who nightly read him asleep in the country, that from that time he regularly applied to the same narcotic, and always slept soundly. Music acts, secondly, by causing an association of agreeable ideas. A lady who was confined in an asylum in the vicinity of London, and who had been separated for some months from her home, and from all she held dear, was pronounced partially convalescent. She was, however, still melancholy; and it was suggested by her father that a piece, of which she was passionately fond, and which was associated with the happiest period of her life, should be played within her hearing. This wish was complied with; the effect produced was highly gratifying. For the first few minutes, no notice was taken of the music; in a short period, however, a smile was seen to play upon a countenance where all had been dark and gloomy for months. As the music proceeded, the effect became more sensible and powerful; ideas of a most pleasurable kind appeared to rush upon a mind which had previously been a blank; a chord had been touched which thrilled through her, until she appeared absorbed in the pleasing associations which the favourite air had conjured to her recollection. The past was no longer forgotten, and she for the first time gave evidence of being conscious of the situation in which she was in. A fatal blow had been given to the disease, and in a short period she was considered sufficiently recovered to be allowed to return home to the bosom of her family.

The disease of Saul was alleviated by David’s harp. Aristotle maintains that actual madness in horses may be cured by the melody of lutes. “Experience has proved,” says Gibbon, “that the mechanical operation of sounds, by quickening the circulation of the blood and spirits, will act on the human machine more forcibly than the eloquence of reason and honour.” In illustration of the above observation the following fact may be adduced:—At the battle of Quebec, in April, 1760, while the troops were retreating in great confusion, the general complained to a field-officer of Fraser’s regiment of the bad behaviour of his corps. “Sir,” he answered, in great warmth, “you did very wrong in forbidding the bagpipes to play this morning; nothing encourages Highlanders so much in the day of action,—nay, even now the pipes would be of use.” “Let them blow, then, like the devil,” replied the General, “if it will bring back the men.” The bagpipes were ordered to play a favourite martial air. The Highlanders, the moment they heard the music, returned and formed with alacrity, and fought like infuriated lions.

The influence of music over animals is known to be very great. Burney says that an officer, being shut up in the Bastille, had his lute allowed him; upon which, after a trial or two, the mice came issuing from their holes, and the spiders, suspending themselves from their threads, assembled round him to enjoy the melody.53

Falret alludes particularly to the benefit which often accrues from music in peculiar disorders of the nervous system attended with a disposition to suicide. So exalted an idea had M. Appert of its effects on the mind, that he has observed, alluding to criminals, “that the man sensible to the influence of harmony is not irretrievably lost.” A young lady passionately fond of music manifested an inclination to kill herself; she was sent by her family to an hospital, where she was carefully watched. The idea of suicide was not, however, removed until she was allowed the use of her favourite instrument, the harp. The good effect was soon perceptible; her melancholy gradually subsided, and with it the suicidal disposition. She expressed to her friends how grateful she felt that she was allowed to indulge in her favourite amusement, and was conscious of the benefits which she had derived from it.

The progress of epidemic suicide has been stayed by having recourse to measures which have powerfully affected the imagination.

The young women of Marseilles, at one period, were seized with a propensity to commit suicide. In order to prevent the contagion from spreading, a law was passed to the effect that the body of every female who was guilty of self-murder should be publicly exposed after death. The beneficial result of this law became immediately apparent; the epidemic was stopped; the sense of shame prevailed over the recklessness of human life.

In the French army, during the reign of Napoleon Buonaparte, a grenadier killed himself. This suicide was followed by another case, and it was feared that the disposition would assume an epidemic character. Buonaparte saw the necessity of prompt and decisive measures, and with a view of striking terror in the minds of the soldiers, and putting a stop at once to the spread of what appeared to be a contagious malady, he issued the following “order of the day,” dated St. Cloud, 22 Floreal, an X.:—

“The grenadier Groblin has committed suicide, from a disappointment in love. He was, in other respects, a worthy man. This is the second event of the kind that has happened in this corps within a month. The First Consul directs that it shall be notified in the order of the day of the guard, that a soldier ought to know how to overcome the grief and melancholy of his passions; that there is as much true courage in bearing mental affliction manfully as in remaining unmoved under the fire of a battery. To abandon oneself to grief without resisting, and to kill oneself in order to escape from it, is like abandoning the field of battle before being conquered.

“Signed,xxxxxxxxxxx“Napoleon,
“Bessieres.”

The effect of this masterly appeal to the courage of the French soldiery was truly magical. The disposition was completely quelled, and no case of suicide occurred for a considerable time afterwards. The course which Napoleon adopted shewed his great knowledge of human nature, as well as the thorough insight he had obtained into the character of the people over whose minds he exercised so tremendous an influence.

An account of the punishment inflicted on the women of Miletus, a city of Ionia, who were seized with an epidemic suicide, is transmitted to us in the writings of Plutarch. He says, “The Milesian virgins were at one time possessed with an uncommon rage for suicide. All desire of life seemed suddenly to leave them, and they rushed on death (by the help of the halter) with an impetuous fury. The tears and entreaties of parents and friends were of no avail; and if they were prevented by force for awhile, they evaded all the attention and vigilance of their observers, and found means to perpetrate the horrid deed. Some ascribed this extraordinary species of desperation and frenzy to certain occult and maddening qualities of the air at that season, somehow or other peculiarly injurious to the female frame and texture, both of body and mind, (since the men were not visibly affected by it;) while the superstitious considered it as a calamity sent from the gods, and therefore beyond the power of human remedy. But whatever was the cause, the effect was visible and important, and could not be suffered to rage long without manifest injury to the state. While speculative men, therefore, were attempting to account for the phenomena, the active magistrate was endeavouring to arrest the progress of the contagion, for which purpose the following decree was issued;—“That the body of every young woman who hanged herself should be dragged naked through the streets by the same rope with which she committed the deed.” This wise edict had in a short time the desired effect. Plutarch adds—“The fear of shame and ignominy is an argument of a good and virtuous mind; and they who regarded not pain and death, which are usually esteemed the most dreadful of evils, could not, however, endure the thoughts of having their dead bodies exposed to indignity and shame.”

In the Magdalen Asylum, at Edinburgh, a girl was seized with typhus fever, at the time that it was raging in the city, and though she was instantly removed, as well as all her bed-clothes &c., two more were seized next day, and an alarm or panic was soon spread over the whole house. Next day, no fewer than sixteen were in the sick-room, and in the course of four days, out of a community of less than fifty individuals, twenty-two were apparently labouring under decided fever. It now struck Dr. Hamilton that there was mad delusion in all this, and that the disease arose as much from panic and irritation as from any other causes. Acting on this belief, he went to the sick-room, and told the girls that such a rapid spread of the disease was entirely unprecedented; that they were under the delusion of yielding to their fears, and of imitating others who were now undergoing all the tortures of bleeding, blistering, and purging, in Queensbury Hospital. He assured them that the fumigation and other precautions must have destroyed the contagion, and that if they would only keep a good heart and dismiss their fears, he would pledge himself the fever would soon disappear. The effect of the Doctor’s speech was magical. All apprehension was instantly banished from the mind, the cheering influence of hope was inspired, moral courage was developed, and the progress of the pestilence stopped. Not one case of fever occurred afterwards, and those who had the fever at the time perfectly recovered.54

It is only on the same principle that we can account for the success which Dr. A. T. Thompson met with in the treatment of the following case of whooping-cough, which had been kept up by habit. The patient, a young boy, was threatened with the application of a large blister; although it was not applied, but merely placed within his view, yet the dread of it completely removed the cough. Boerrhave cured epilepsy in a whole school, by marching into it at the moment of the expected attack with a red-hot poker, which he threatened to thrust down the throats of those who should have a fit.

A remarkable instance of epidemic suicide occurred as far back as the reign of Tarquinius Priscus, which as it required, so it received, an effectual check by the spirited introduction of an extraordinary mode of punishment. After this king had employed the Roman people in successful wars abroad, he filled up their leisure at home in works of less apparent honour, though of greater utility. These were to cut drains and common sewers of immense size and durability. When the soldiers disdained these servile offices, and saw no end to their labours, many of them committed suicide by throwing themselves off the Capitoline Hill. Others followed their example, until the contagion spread through the whole of the men. The king, in order to strike terror into the minds of those who might contemplate self-destruction, issued an order commanding the bodies of those who should commit suicide to be nailed on crosses, and then exposed as spectacles to the rest of the citizens, and left a prey to the fowls of the air. The feeling of shame and horror had the effect of checking the disposition to sacrifice life, and thus the king’s purpose was effected.

Whether any measures of a similar character could be adopted in cases where the disposition to suicide has a tendency to assume an epidemic form is a matter of considerable doubt.

Experience has established the effect of some simple remedies in preventing the return of paroxysms of melancholia with a propensity to suicide. But it has likewise, and not unfrequently, evinced their insufficiency, and at the same time the influence of a strong and deeply impressed emotion in producing a solid and durable change. A man who worked at a sedentary trade consulted Pinel, about the end of October, 1783, for dyspepsia and great depression of spirits. He knew of no cause to which he could ascribe his indisposition. His unhappiness at length increased to such a pitch that he felt an invincible propensity to throw himself into the Seine. Unequivocal symptoms of a disordered stomach induced Pinel to prescribe some opening medicines, and for some days occasional draughts of whey. His bowels were effectually opened, and he suffered but little from his propensity to self-destruction during the remainder of the winter. Fine weather appeared to restore him completely, and his cure was considered as perfect. Towards the decline of autumn, however, his melancholia returned. Nature assumed to him a dark and dismal aspect, and his propensity to throw himself into the Seine returned with redoubled force. The only circumstance that in any degree restrained the horrid impulse was, the idea of leaving unprotected a wife and child, whom he tenderly loved. This struggle between the feelings of nature and his delirious frenzy was not permitted to continue long; for the most unequivocal proofs soon after appeared of his having executed his fatal project.

A literary gentleman, devoted to the pleasures of the table, and who had lately recovered from a fever, experienced in the autumnal season all the horrors of the propensity to suicide. He weighed with shocking calmness the choice of various methods to accomplish the deed of death. A visit which he paid to London appears to have developed, with a new degree of energy, his profound melancholy, and his immovable resolution to abridge his term of life. He chose an advanced hour of the night, and went towards one of the bridges of that capital for the purpose of precipitating himself into the Thames; but at the moment of his arrival at the destined spot, he was attacked by some robbers. Though he had little or no money about him, he felt extremely indignant at this treatment, and used every effort to make his escape, which, however, he did not accomplish before he had been exceedingly terrified. Left by his assailants, he returned to his lodgings, having forgot the original object of his sally. This rencontre seems to have caused a thorough revolution in the state of his mind. His cure was complete.

A watchmaker was for a long time harassed by the propensity to suicide. He once so far gave way to the horrid impulse, that he withdrew to his house in the country, where he expected to meet no obstacle to the execution of his project. Here he took a pistol, and retired to an adjoining wood, with the full intent of perpetrating the fatal deed; but missing his aim, the contents of the piece entered his cheek. Violent hÆmorrhage ensued. He was discovered, and conveyed to his own house. During the healing of the wound, which was long protracted, an important change took place in the state of his mind. Whether from the agitation produced by the above tragic attempt, from the enormous loss of blood which it occasioned, or from any other cause, he never afterwards shewed the least inclination to put an end to his existence. This case, though by no means an example for imitation, is well calculated to shew that sudden terror, or any other lively or deep impression, may divert, and even destroy, the fatal propensity to suicide.

A few years ago, an officer went into Hyde Park with an intention of shooting himself. He applied a pistol to his forehead; the priming flashed, but no discharge followed. A man of poor appearance, whom the officer had not observed, or perhaps thought unworthy of his notice, instantly ran up, and wrested the pistol from his hands. The other drew his sword, and was about to stab his deliverer, who, with much spirit, replied, “Stab me, Sir, if you think proper; I fear death as little as you, but I have more courage. More than twenty years I have lived in affliction and penury, and I yet trust in God for comfort and support.” The officer was struck with these spirited words, continued speechless and motionless for a short time, and then, bursting into tears, gave his purse to the honest man. He then inquired into his story, and became his private friend and benefactor; but he made the poor man swear that he would never make inquiries concerning himself, or seem to know him, if chance should ever bring them in sight of each other.

A female patient, who had often threatened to destroy herself, one day assured M. Esquirol that she was about to do it. “Very well,” he answered; “it is nothing to me; and your husband will be delivered of a great torment.” She instantly ceased the preparations she was making to accomplish the act, and never spoke of committing it again.

How easily lunatics may be diverted from their purpose by presence of mind, an intimacy with their character, and the tact to employ the destructive feeling by which they are actuated as the means of protection, is well exemplified in an anecdote related by Dr. Fox. He had accompanied a suicidal and furious maniac, who was at the time calm, to the upper story of his asylum to enjoy the prospect beyond the walls. In returning, the spiral staircase struck the eye of the patient; the opportunity roused the half-slumbering propensity, and a fit of frenzy ensued. His eyes glared, his teeth ground against each other; he panted like a bloodhound for his prey, and seizing the Doctor by the collar, howled into his ears, “You jump down, and I will jump after you.” The Doctor for the moment was petrified with horror; he was alone with a powerful man, frenzied by insanity; to escape was out of the question; to attempt to overcome him by force was still more futile: in a moment he hit upon a stratagem. Turning to the infuriated madman, he exclaimed, with a look of coolness and collectedness, “Bah! my child could jump from this place; it requires no nouse to do that; the thing is to jump up—that is the difficulty.” The madman listened with attention to what the Doctor said, and then observed, “But you cannot do so, can you?” The Doctor replied, he could, and they both hurried down to put the boast to the proof, and the sanguinary threat was forgotten before they reached the lobby.

Physicians not practically acquainted with the treatment of insanity are too much inclined to believe that it is fruitless to attempt to reason a madman out of his morbid delusion, and that to have recourse to a trick in order to dispel the mental illusion is a species of practice unbecoming the dignity of a professional gentleman. Numerous cases are recorded in which patients have been cured of monomania by a well-contrived artifice; and in many cases of suicidal insanity, when other treatment fails, the medical man may have recourse to this mode of cure without any danger of sinking himself in public or professional estimation. The following cases are illustrations of the foregoing remark:—

A celebrated watchmaker, at Paris, was infatuated with the chimera of perpetual motion, and to effect this discovery he set to work with indefatigable ardour. From unremitting attention to the object of his enthusiasm coinciding with the influence of revolutionary disturbances, his imagination was greatly heated, his sleep was interrupted, and, at length, a complete derangement of the understanding took place. His case was marked by a most whimsical illusion of the imagination. He fancied that he had lost his head on the scaffold; that it had been thrown promiscuously among the heads of many other victims; that the judges, having repented of their cruel sentence, had ordered them to be restored to their owners, and placed upon their respective shoulders; but that, in consequence of an unfortunate mistake, the gentleman who had the management of the business had placed upon his shoulders the head of one of his unhappy companions. The idea of this whimsical exchange occupied his thoughts night and day, on account of which his relations sent him to the HÔtel Dieu; and from thence he was transferred to the Asylum de BicÊtre. Nothing could equal the extravagant overflowings of his heated brain. He sung, cried, or danced incessantly; and as there appeared no propensity in him to commit acts of violence or disturbance, he was allowed to go about the hospital without control, in order to expend, by evaporation, the effervescent excess of his spirits. “Look at these teeth,” he constantly cried; “mine were exceedingly handsome; these are rotten and decayed. My mouth was sound and healthy; this is foul and diseased. What a difference between this hair and that of my own head!” To this state of delirious gaiety, however, succeeded that of furious madness. He broke to pieces, or otherwise destroyed, whatever was within the reach or power of his mischievous propensity. Close confinement became indispensable. Towards the approach of winter, his violence abated; and, although he continued to be extravagant in his ideas, he was never afterwards dangerous. He was therefore permitted, whenever he felt disposed, to go to the inner court. The idea of perpetual motion frequently recurred to him in the midst of his wanderings; and he chalked on all the walls and doors as he passed the various designs by which his wondrous piece of mechanism was to be constructed. The method best calculated to cure so whimsical an illusion appeared to be that of encouraging his prosecution of it to satiety. His friends were accordingly requested to send him his tools, with materials to work upon, and other requisites, such as plates of copper and steel, watch-wheels, &c. The governor permitted him to fix up a work-bench in his apartment. His zeal was now redoubled; his whole attention was rivetted upon his favourite pursuit. He forgot his meals. After about a month’s labour, which he sustained with a constancy that deserved better success, our artist began to think that he had followed a false route. He broke into a thousand fragments the piece of machinery which he had fabricated at so much expense of time, thought, and labour; entered on the construction of another upon a new plan, and laboured with equal pertinacity for an additional fortnight. The various parts being completed, he brought them together, and fancied that he saw a perfect harmony amongst them. The whole was now finally adjusted; his anxiety was indescribable; motion succeeded; it continued for some time, and he supposed it capable of continuing for ever. He was elevated to the highest pitch of enjoyment and triumph, and ran as quick as lightning into the interior of the hospital, crying out, like another Archimedes, “At length I have solved this famous problem, which has puzzled so many men celebrated for their wisdom and talents.” But, grievous to say, he was disconcerted in the midst of his triumph. The wheels stopped; the perpetual motion ceased! His intoxication of joy was succeeded by disappointment and confusion. But to avoid a humiliating and mortifying confession, he declared that he could easily remove the impediment; but tired of that kind of employment, he was determined for the future to devote his whole time and attention to his business. There still remained another maniacal impression to be counteracted,—that of the imaginary exchange of his head, which unceasingly recurred to him. A keen and an unanswerable stroke of pleasantry seemed best adapted to correct this fantastic whim. Another convalescent, of a gay and facetious humour, instructed in the part he should play in this comedy, adroitly turned the conversation to the subject of the famous miracle of Saint Denis. Our mechanician strongly maintained the possibility of the fact, and sought to confirm it by an application of it to his own case. The other set up a loud laugh, and replied, with a tone of the keenest ridicule, “Madman as thou art, how could Saint Denis kiss his own head? Was it with his heels?” This equally unexpected and unanswerable retort forcibly struck the maniac. He retired confused, amidst the peals of laughter which were provoked at his expense, and never afterwards mentioned the exchange of his head. Close attention to his trade for some months completed the restoration of his intellect. He was sent to his family in perfect health, and has now for more than five years pursued his business without a return of his complaint.

Mr. Cox recollects a singular instance of a deranged idea in a maniac being corrected by a very simple stratagem. The patient asserted that he was the Holy Ghost; a gentleman present immediately exclaimed, “You the Holy Ghost! What proof have you to produce?” “I know that I am,” was his answer. The gentleman said, “How is this possible? There is but one Holy Ghost, is there? How then can you be the Holy Ghost, and I be so too?” He appeared surprised and puzzled, and, after a short pause, said, “But are you the Holy Ghost?” When the other observed, “Did you not know that I was?” his answer was, “I did not know it before. Why, then, I cannot be the Holy Ghost.”

A Portuguese nobleman became melancholy, and fancied that God would never forgive his sins. Various means were tried to subdue this morbid impression, but in vain, until the following artifice was adopted, which proved successful in restoring the lunatic to reason. During midnight, a person dressed as an angel was made to enter his bed-room, having a drawn sword in its right hand, and a lighted torch in the other. The imaginary angelic being addressed the monomaniac by name, who, rising from his bed, spoke to the supposed angel, beseeching it to tell him whether his sins would ever be forgiven; upon which the angel replied, “Be comforted, your sins are forgiven.” The poor man’s delight knew no bounds. He rose from his bed, summoned every one in the house to his presence, and explained to them all that had passed. From that moment the man rapidly recovered in bodily health, and his delusion has completely vanished.

A man fancied he was dead, refused to eat, and importuned his parents to bury him. By the advice of his physician, he was wrapped in a winding-sheet, laid upon a bier, and in this way he was carried on the shoulders of four men to the churchyard. On their way, two or three pleasant fellows (appointed for that purpose) meeting the hearse, demanded in a commanding tone of voice to know whose body they had in the coffin. They replied it was a young man’s, and mentioned his name. “Surely,” said one of them, “the world is well rid of him; for he was a man who led a bad and vicious life, and his friends have good reasons to rejoice that he has thus ended his days, otherwise he would have died an ignominious death on the scaffold.” The young man overheard this observation, at which he felt extremely indignant; but feeling that it was not consistent with propriety or the laws of nature for a dead man on his way to his last home to exhibit any indications of passion, he satisfied himself by coolly replying, “That they were wicked men to do him that wrong, and that if he had been alive he would teach them to speak better of the dead.” “It is well,” said one of the men in reply, “that you are no more; both for yourself and family. You were a mean, pitiful scoundrel, guilty of every abomination, and the world is rejoiced that you no longer live.” This was too much for the patience of the dead man to endure, and feeling that he could no longer suffer such unjust aspersions to be cast on his character, he leaped from the coffin, procured the first stick he could lay hands on, and commenced belabouring his vile accusers. As it may be supposed, they gave him plenty to do, and by the time he had gratified his indignation, and well chastised his calumniators, he had become completely exhausted. In this state he was taken home, and in a few days he was completely cured of the morbid idea which had taken possession of his imagination.

Menecrates, as we learn from Ælian,55 become so mad, as seriously to believe himself the son of Jupiter, and to request of Philip of Macedon that he might be treated as a god. But it is not always that the man thus deranged falls into such good hands as those of the Macedonian monarch; for Philip humorously determining to make the madman’s disease work its own cure, gave orders immediately that his request should be complied with, and invited him to a grand entertainment, at which was a separate table for the new divinity, served with the most costly perfumes and incense, but with nothing else. Menecrates was at first highly delighted, and received the worship that was paid to him with the greatest complacency; but growing hungry by degrees over the empty viands that were offered him, while every other guest was indulged with substantial dainties, he at length keenly felt himself to be a man, and stole away from the court in his right senses.

Many cases of suicidal insanity have been cured by removing the persons so unhappily afflicted from their own homes, friends, and relations. In these cases the physician has no little difficulty in persuading the friends of the invalid that a separation from old associations is absolutely indispensable; that without it, a return to sanity cannot be reasonably expected. When Dr. Willis undertook the cure of George III., he insisted, in the first instance, in dismissing all the old servants, changing the furniture, and removing everything from the king’s sight that might tend to awaken in his mind ideas of the past. The success that attended his treatment is said mainly to have depended on this circumstance.

Mr. ——, forty-seven years old, of a neuro-sanguineous temperament, was happy in his domestic circle, and his business had prospered until the year, 1830, from which period he was much harassed in the management of his affairs. In December, 1831, after a very trifling loss, he grew sorrowful and melancholy; his face was flushed, his eyes became blood-shot, his breathing was difficult, and he shed tears, incessantly repeating that he was lost. On the next and following days, he made several attempts to commit suicide, so that they were obliged to cover his apartment with wadding. He wished to strangle himself, tried to swallow his tongue, filled his mouth with his fist in hopes of suffocating himself, and then refused all nourishment. At the expiration of six days, the patient was brought to Paris, and entrusted to Esquirol’s care. From the moment of his arrival all desire to commit suicide vanished, and the patient appeared restored to reason. “The impression that I received,” said he, “on finding myself transported to a strange house cured me.” In fact, sleep, appetite, and a return of connected, and sometimes lively conversation, induced the belief that a cure was effected. Three weeks seemed enough for convalescence, when his wife and son came to fetch him. They passed two days at Paris to finish some business there, and then returned to the country. Scarcely had he arrived at his home when he felt himself impelled by the same desires, in consequence of which, he returned to Paris, transacted some business whilst he remained there, and appeared perfectly well. On returning to his home again, he made fresh attempts to commit suicide, struck his son, and those who waited upon him, and endangered the life of his wife. Neither the grief of his family, the watch placed over him, nor the pretended authority of those about him, could overcome these feelings. The patient passed several days without food; he tore up his linen to make a cord to hang himself, tied it round his neck, and got upon his bed in order to throw himself upon the floor; and at last, deceiving the watchfulness of his relations, escaped to throw himself into the river. He was immediately put into a carriage, and accompanied by his wife; but, notwithstanding the strait-waistcoat, he left no means untried to kill himself. On arriving at Paris, and being again confined, he became perfectly reasonable, and made no attempt to destroy himself during the six weeks that his second confinement lasted. There was reason to believe his cure complete. If he was asked why he did not overcome his terrible impressions at his own house as he did at Paris, he answered in an evasive manner, affirming that this time the trial had been long enough, that he was cured, and that he insisted upon returning home. “Deprived of my wife and son,” said he, “I am the most unhappy of men, and I cannot live.” “But if you are so unhappy here,” said Esquirol to him one day, “why do you not try to destroy yourself, as it is very easy to do so?” “I know not,” he replied; “but I am cured, and I wish to live.” This patient enjoyed the greatest liberty, and although no apparent precaution was taken to prevent his destroying himself, he never made the least attempt. He afterwards ceased to talk unreasonably; but Esquirol was never able to obtain an avowal of the motives which induced him to commit suicide at his own house, whilst he thought no more of it as soon as he came amongst strangers. On returning to his home for the fourth time, although he was able to transact important business, the same phenomena returned with equal violence.

M. ——, twenty-seven years old, after experiencing some reverses of fortune, became maniacal, with a tendency to commit suicide. The elevated situation of the room which he inhabited, the position of the staircase, the reiterated visits of his friends, “who came to contemplate his misfortunes,” and the despair of his wife, were so many circumstances which induced him to terminate his existence; and although he avowed that he had no motive for so doing, and that he was ashamed, and considered himself criminal for having attempted it, he left no means untried for more than a month to effect that end. When he was taken away from his home, and lodged in a ground-floor which led into a garden, the idea no longer harassed him. “It would be of no use,” he said; “I could never kill myself here; every precaution is taken to prevent me.”

A baker’s wife, of a lymphatic temperament, experienced a violent fit of jealousy, which caused her much distress, and induced her to watch her husband’s steps, who vented his discontent in threats and reproaches. At last, this unhappy woman, being unable to bear the feeling any longer, threw herself out of the window. Her husband ran to pick her up, and bestowed marks of the most attentive kindness upon her. “It is useless,” she said; “you have a wife no longer.” She refused every kind of nourishment, and neither the solicitations, tears, prayers of her relations, and those of her husband, who never quitted her room, were able to overcome her resolution. After seven days of total abstinence, Esquirol was called in. They hid from him the cause of the disease, but he observed that every time her husband approached the bed, her face became convulsed. The patient was told that she was about to be sent into the country, but that it was necessary for her to take a little nourishment in order to support the journey. A little broth which was offered her was accepted; but notwithstanding her attempts, she could only swallow a few drops. She tried again the following morning, but she expired in the course of the day. “Had this woman,” says Esquirol, “been removed from her home immediately after the accident, there is little doubt but she would have been restored. How could she desire to live, her distress being continually aggravated by the presence of her husband?”

The chief means of controlling the passions, and of keeping them within just bounds, is to form a proper estimate of the things of this life, of the relation of our present to a future state of existence, and of the influence which our actions in this world will have upon our happiness hereafter. Such a right estimate every rational man will labour to attain. He will endeavour, by correcting error, and acquiring such habits as are consistent with just sentiments, to withdraw the nourishment from the very root of passion, rather than be for ever fruitlessly occupied in merely pruning the luxuriance of some of its branches.

It may be useful to impress strongly upon the minds of those who have not sufficient command over their feelings, the persuasion that the indulgence of any passion to excess, and especially of the selfish and malevolent ones, is likely to be injurious to health, will certainly be destructive of serenity and comfort; and of course, by diminishing happiness, will frustrate its own aim and intention, and may, by repetition, acquire accumulated force and facility of excitement, become at length unconquerable and habitual, and according to its nature, violence, and frequency, will, in a greater or less degree, be subversive of happiness, and leave them more or less open to the attacks of insanity.

Such persons will therefore see it highly expedient, while under the influence of these impressions, to do all in their power to avoid them; to compare their urgent and apparent importance when they occur, with the probable diminution of the comfort and health of body and mind which they might induce; and to lay it down as a rule never to indulge any passion whatever, till, independently of moral considerations, and the notions of duty and obligation, they have deliberately reflected, whether the importance of the cause will be a sufficient counterbalance to the certain pain inflicted and the injury which may be thence derived to their health of body and ease and soundness of mind. A habit of such deliberation once acquired,—and it may be acquired by diligence and resolution,—will entirely put an end to exorbitant excitement, since by checking the very beginnings of emotion, its growth and progress will be altogether prevented.

And as every one has some weak point on which he is more open to a successful attack, some constitutional or habitual feeling, the approaches of which he cannot easily withstand, all persons who are convinced of the expediency and necessity of subduing their passions, if they would consult their own ease, will be aware of the importance of keeping a diligent watch, and placing a strong guard, upon the one that most easily and successfully besets them.

And whoever would secure a reasonable portion of present happiness will be sensible of the necessity of learning the art of contentment, which, difficult as it may seem to those who have not used themselves to check the wanderings of imagination, and to keep their desires within prudent bounds, not only appears indispensable, but easy, to the man who feels a lively and practical conviction of its wonderful tendency to multiply the sum of actual enjoyment.

With the same view of promoting and securing their own present felicity, such persons will see the propriety of acquiring habits of good nature, and of cultivating the emotions of benevolence. And as virtue seldom fails to bring her own dowry, contentedness and benevolence will infallibly introduce habits of cheerfulness, which, while they improve our happiness, act as powerful preservatives against disease, and as determined enemies of insanity.