examination and condemnation, she became quite ferocious. She was now put under the care of an experienced attendant, separated entirely from her husband, children, and friends, placed in a neat cottage surrounded by agreeable country, (it was the finest season of the year,) and visited regularly by her physician. For several weeks she manifested no improvement: sometimes she was occupied with one notion, sometimes with another, but they were always of the most gloomy description. At last it became her firm belief, that she was to be executed for her crimes in the most public and disgraceful way: every noise she heard was that of workmen erecting the scaffold; every carriage, the officers of justice assembling at the execution: but what affected her most deeply, was that her infamy had occasioned the disgrace and death of her children and husband, and that his spirit haunted her. As soon as the evening closed, she would station herself at a window at the back of the cottage, and fix her eyes on a white post that could be seen through the dusk: this was the ghost of her husband-day and night he was whistling in her ears.

'Several weeks passed in this way; the daily reports varied, but announced nothing happy. At length her husband became impatient, and begged to have an interview with her, thinking that the best way to convince her he was not dead, was to show himself. This was objected to: he was told the general fact, that patients are more likely to recover when completely separated from their friends;-that if she saw him, she would say it was not himself, but his ghost; but the husband was obstinate, and an interview was consented to.

"As soon as I entered the drawing-room, where she usually spent the day," (I copy his statement, written at the time, and now before me,)" she ran into a corner, hid her face in a handkerchief, then turned round, looked me in the face, one moment appearing delighted at the thought that I was alive, but immediately afterwards assuming a hideous expression of countenance, and screaming out that I was dead, and come to haunt her. This was exactly what Dr. had anticipated, and for some minutes I thought all was lost.

"Finding that persuasion and argument only irritated and confirmed her in her belief, I desisted, and tried to draw off her attention to other subjects. It was some time since she had seen me or her children; I put her arm under mine, took her into the garden, and began to relate what had occurred to me and them since we parted; this excited her attention, she soon became interested, and I entered with the utmost minuteness and circumstantiality into the affairs of the nursery, her home, and her friends. I now felt I was gaining ground, and when I thought I had complete possession of her mind, I ventured to ask her, in a joking manner, whether I was not very communicative for a ghost? She laughed; I immediately drew her from the subject, and again engaged her attention with her children and friends. The plan succeeded beyond my hope. I dined, spent the evening with her, and left her at night perfectly herself again."

'He went next morning, in a state of intense anxiety, to know whether

whether his success was permanent; but her appearance at the window, with a cheerful countenance, soon relieved his apprehensions. While he was there, Dr. came in; he went up stairs, without knowing the effect of the interview, and came down, saying, " It looks like magic!" She had a relapse, in which, for several weeks, she was as bad as ever; but which ceased as suddenly as before, in consequence of interviews with friends calculated to remove the apprehensions by which her mind was haunted. She has since then continued perfectly well, and has had another child, without the slightest threatening of her former malady.

The conclusion which I deduce from the foregoing case is, not that violent mania is curable by conversation (if it should occasion the irruption of relatives during the height of the disease, the communication may do more harm than good); but that there is a stage approaching convalescence, in which the bodily disease is loosening its hold over the mental faculties, and in which the latter are capable of being drawn out of the former by judicious appeals to the mind.'

This case, then, is an example of a second error into which practitioners are liable to fall, and have fallen. Dr. Gooch expressly says, that he is fully aware of the efficacy of seclusion in ordinary cases, in the active states of the disease; yet, who can doubt, that the foregoing melancholy history is not applicable to many now in a similar condition? while they who have the care of them little suspect the efficacy of a kind word uttered by a friend; or of the virtue there is in calling up the association of those days when the reason and the feelings were unoppressed. Dr. Heberden and others, in their examinations before the Committee of the House of Commons, stated, that maniacs often felt keenly the neglect of friends. Surely, nothing can be more horrible than the situation of one, whose mind has suffered a partial taint, and is struggling against the infirmity, and who sees herself governed by menials, associated with lunatics; while kindred and friends are content to sigh away their sympathies at a distance.

The last rule,' says Dr. Gooch, I have to mention, relates to seclusion and control. There can be no doubt that it is generally necessary and useful to separate the patient from all those persons who are sources of excitement of any kind. This, however, can be effected only in one of two ways—either in a separate house, or part of a house, where the patient has no other associates but her nurses, or in a receptacle for the deranged, where she has no other associates than her nurses and persons similarly afflicted with herself. This is the only society she has, excepting the short and occasional visits of her physician. Thus the power of controlling her, even by force, is placed in the hands, not of enlightened and benevolent persons, but of uneducated menials. I do not know how it can be otherwise, though I wish it could; but I think such a charge ought never to be placed in such hands without the most vigilant scrutiny of its exercise. There may

be

be cases-or, there may come a time, at which some interruption to this solitary life may be advisable. When the disease has lasted long-when the patient expresses a strong wish to see some near friend-when she entertains illusions, which the sight of some one may efface, the admission of such person is worth a trial. I shall be told, that when patients are mending, or have recovered, the most common cause of relapse is too early an introduction of friends, and too early a return home. When the patient is recovering, or has recovered, I do not recommend these measures; it is when the patient has not recovered, and is not recovering, that I advise them to be tried: when month after month passes without amendment, and her mental delusions assume a shape accessible to moral impressions,—then it is that I would advise an interview with a friend!'

There is a third error, into which the most experienced practitioners are liable to fall, and actually have fallen,—that is, in granting certificates of the insanity of persons who really are not insane. This is an error of judgment to which we are all liable; it is, therefore, of the utmost importance that the cases in which it is most likely to be committed should be separated from the rest, and distinctly pointed out so as to form a class easily recognizable. It is manifest, that no doubt can be entertained about the insanity of a man who raves, or of one who believes himself to be the Virgin Mary, or the Grand Seignor; but there are cases in which the supposition of mental unsoundness rests on the entertainment of a particular notion-which notion, it is assumed, is wholly unfounded. Lord Erskine, in one of the best speeches ever pronounced on the subject,* mentions the following case: A gentleman took up a notion that his brother had administered poison to him, and it became the prominent feature of his insanity; in a few months he recovered his senses, returned to his profession, was a sound and eminent barrister, and, in all respects, a most intelligent member of society; but he never could dislodge from his mind the morbid delusion which disturbed it ;-and, under the pressure of that prepossession, disinherited his brother. The question was first tried at the King's Bench, and the jury found for the will. A contrary verdict, however, being given in the Common Pleas, a compromise ultimately took place. Suppose it to have been absolutely true, that the brother had attempted to administer the poison, nothing could have been more rational than to have disinherited him. The crime would have met with, not an adequate, but a very suitable punishment. How is it possible, in such a case, to come to absolute certainty or even moral probability, as to whether the assertion was wholly unfounded or not? and yet, two sets of men, and two judges, in two

different courts, acted as if they did know, and in each case returned a verdict the very discrepancy between them proving that the evidence was not sufficient to warrant a decision either way.

Now, in this and similar cases, where it is difficult, or perhaps impossible, to ascertain whether the single notion, supposed to constitute insanity, be well or ill founded, what is the gauge by which the unsoundness of mind is to be measured? Suppose a husband imagines that his child is not his own :-it is asserted that, as to the paternity of the child, he is under a morbid delusion, and that his conduct to his wife and child is that of a madman, because he has repudiated the one, and disinherited the other-the feelings excited being disproportionate to the cause ;— but he may be right; and yet shall two doctors dare to measure the exact degree of feeling which a sane husband could exhibit under such circumstances! Surely it would be wiser, as well as more humane, to confess ignorance, than to shut up a man in a mad-house upon such evidence.

We now come to some of the erroneous notions prevalent in society respecting insanity.-One of the most common of these is, that insanity is a disease, not of our physical, but of our moral constitution. A short answer to this theory is, that every other deviation of the faculties of the mind from their natural state, with which we are acquainted, is allowed to be caused by bodily disease. Thus the delusion of the nightmare, caused by indigestion-the melancholy accompanying liver affections-the delirium of fever the different forms of hysteria-are all referable to corporeal disorder, and remediable by medicines affecting the frame. Why should mania, then, be an exception?

One of the arguments which have, probably, given currency to the notion of insanity being a moral disease, is, that it often arises from passions, or from efforts of the mind; the cause and the effect being both mental, the whole must needs be a disease of our moral nature.'-The error lies in supposing that the cause affects the mind directly, and not through the medium of the body. There is no poison, whose action leaves more distinct traces in our frame than the mind. The perusal of a letter, the sudden communication of bad news, will sometimes strike the stoutest to the ground, and render the broken heart something more than a metaphor. Fear can paralyze the limbs; Hope instantaneously give soundness and vigour to the frame; Despair render it lean and tottering. A word-the sight of a personwill crimson the cheek. In short, every organ, to the minutest artery, is affected by mind. And there is no more difficulty in supposing the vessels of the brain to be affected by passion or by

thought,

thought, than those of the cheek; while all analogy in medicine leads to the inevitable conclusion that it is the organ which is diseased, and not the power residing in it.

A second cause for the belief in the moral theory of insanity is the supposition, that the bodily disease which accompanies it, is too slight to occasion mental derangement.' This is a question of fact, and not of conjecture; and our ideas of great and little, as to other matters, apply very loosely to the wonders of our organization. Abscesses containing several ounces of matter have existed in the brain, and produced no sensible effect on mind; yet half a tea spoonful lodged under the skull has created furious madness, and, when let out, the same has ceased. Bullets* have been lodged in the substance of the brain, and caused no derangement; and yet a spicula of bone, not bigger than the point of a needle, has created phrensy. The objection, says Dr. Gooch, is founded on the supposition that bodily disease is only capable of disturbing the brain of the patient in the same degree that it strikes the senses of an observer. It is certain, he adds, that puerperal insanity depends on a peculiar state of the bodily constitution; yet this state, so far from being obvious, is often known to exist only by a disordered condition of the mind.

A third cause of belief in the moral theory of insanity arises out of a contemplation of the mode in which Eccentric Habits are acquired. It is seen that habit has the power of generating in healthy minds something similar to the essential features of insanity; and, as in the one case, no bodily disease is inferred, so neither should it be in the other.'

It is well known (says Dr. G.) that strange habits of mind long continued, are capable of generating great singularity of opinion and feeling between this moral eccentricity and insanity, there is often a striking resemblance. It is not easy to confound boisterous madness with healthy singularity; but when a lunatic is harmless in conduct— insane only on one point, and talks so rationally on all others, that it is not easy to detect his infirmity, his state of mind is wonderfully like those eccentric and absurd opinions which intellectual habits are capable of producing, and which often cause their possessors to be called mad, half in joke, yet half in earnest. A little insight into the mode of their production will enable us to judge whether this resemblance is apparent or real.

It is so well known that the mind may brood over a subject till it loses the power of seeing it in a right point of view, that it is commonly said a man may tell a lie till he believes it. "I wish," said Dr. Johnson, rebuking Boswell for the zeal into which he had

Vide a paper by Sir Everard Home, in the Philosophical Transactions, on the injuries of the brain.

worked