CONTENTS.

Page

On the buildings, grounds, situation, and system, necessary for all purposes of an efficient classification 1

Illustrated by an interesting case of recovery, No. 106. 5

Do. do. do. No. 195. 12

On the common division of Insanity into Mania and Melancholia, not necessarily being separate classes of cases, but generally, merely variable states of the same case, requiring corresponding changes and modes of moral treatment 15

This view of these cases is confirmed, and their danger forewarned, by an examination of the natural constitution of mind and previous habits of those subject to these states 18

The delicate treatment which such cases often require, renders a separate house, where the medical proprietor and superintendant and family reside, of great importance, as well for them as for milder and convalescent cases 25

That cases under this system, are induced, when they know it from experience, or have it faithfully explained to them, to come and return without fear or reluctance 28

The great importance of this first step; and of making truth the basis. The manner of doing this explained, and its beneficial influence stated 29

Illustrated by an interesting case of recovery, No. 335. 36

Ditto do. do. No. 373. 45

Further observations on such cases and the above principles 47

That suitable classification and association is better than entire seclusion 49

Illustrated by cases, No. 425 and No. 429 51

On the beneficial influence of their being accustomed to the usual habits, manners, and privileges of civilized life 53

On the propriety of diminishing the prejudices which exist against the mere residence at an Asylum, if for the purpose of restoration 59

The evils of considering diseases of the brain as a greater disgrace, and as an indication of greater criminality than other diseases 61

That our aim in all our moral treatment should be, to call forth self-control, and all the better principles and feelings of the human mind; and that this important subject will be resumed 65

Illustrated by a case, No. 372. 69

Do. do. No. 395. 71

That often we have only a choice of evils, and must choose the least 73

Illustrated by a case, No. 421. 75

Do. do. No. 396. 77

On the use of exercise, and a retired situation for the purpose 78

An account of a system of cure, by being made to work, related by Dr. Gregory 81

Regular work always useful, when willingly undertaken, but not otherwise; easily managed with the labouring, but as difficult with a higher, class of patients 82

The danger of irritation, illustrated by a case 83

The contrary system of soothing, illustrated by a case 84

Further remarks and quotations on this subject 86

The talents and sacrifices all this requires, and their influence, 89

Notwithstanding all this apparent extra trouble, it is, when done from right motives, the safest and easiest in the end 100

That these views are based on the firm ground of Christian philosophy 108

CONTENTS OF APPENDIX.

Explanation of the object of this Appendix; which is, by giving a correct description of the state and character of a fair average number of old insane cases, to counteract the usual misconceptions and prejudices existing against them 111

Case No. 1.—His eccentricity, and exaggeration of his natural character and that of his family. Has seasons of excitement 113

Observation 1st.—That the fluctuations of the animal spirits of the old insane often depend on causes which equally act on the sane; but, that from differences of state and circumstances, the effects are very different 115

Case No. 2.—Though in a very torpid state, yet he has (as every case has) his distinguishing peculiarities 116

Illustrated by a Portrait 116

Observation 2nd.—That mind is a garden which we must cultivate—a fire which requires stirring and feeding 116

Case No. 3.—An example, which indeed every one is, more or less, of the correspondence, as far as the remnants of mind exist, between his present and original character and organization. His habits of employment, and its happy influence 118

Illustrated by a Portrait 118

Observation 3rd.—On the use of employment, and its easy application 119

Case No. 4.—That of an idiot. Odd displays of an increase of animation 120

Illustrated by a Portrait 120

Case No. 5.—Torpid lethargy. His natural character amiable 121

Case No. 6.—Though in a very singularly deranged state, evinced by the most extravagant fancies and exploits, which he delights to detail to every one, yet he is constantly employed, useful, and happy 122

Illustrated by a Portrait 122

Observation 4th.—The explanation of the peculiarity of his character, proves that, in all cases, truth should never be violated in our conduct towards them 124

Case No. 7.—A very singular case of periodical violence and sleep. His habit of gyration described 125

Observation 5th.—His habit of gyration explained. How far the generally alternate states of excitement and depression of the insane is the return of their primary disease, or for the most part, merely the habits acquired of irregularly expending their nervous energy, which fluctuations are further increased by the usual atmospheric causes of excitement and depression 127

The influence of temperature, moisture, climate, seasons, diurnal periods, atmospheric changes, and different years, on our health and spirits, and the type of our diseases, (and that this subject will be resumed), and how all this is modified by the states, habits, and circumstances of the insane 129

Why they are less subject to the prevailing diseases 133

The mental condition must, in all diseases, be considered 134

Illustrated by cases 135

How the state of mind and circumstances of the insane must modify these physical influences 136

Why this is differently exhibited by the insane, than it is by those who retain the power over their own spirits 137

That this view is proved to be correct, by the fact that these causes produce different effects by their being under different modes of treatment 139

That the various character of insanity is but the same excitement of the vital energies operating on different parts of the mind, according to previous or present habits and states 143

Hence, the insane are often caracatures of their own, as well as of family habits and character 146

The truth of this reasoning proved by the fact, that the greatest number of insane cases occur when mental conflicts and worldly struggles are greatest, and among those whose minds are ill regulated or miserably circumstanced; but still it does not necessarily and always follow that those whose minds are most wicked are soonest overthrown, but sometimes the reverse 147

The practical object of these observations 150

Case No. 8.—One of the extreme cases of furious mania, with a leprous eruption of the skin 151

Observation 6th.—Whether cutaneous disorders are common to the insane? The treatment of this case 153

Case No. 9.—One proof, out of many, which proves, that the last strongest impression of their sane state continues prominent, even when their minds seem for ever lost to themselves and all passing objects around them 154

Case No. 10.—In which an injury on the head produced symptoms in correspondence with the phrenological office of the part injured 155

Case No. 11.—Apparently perfect dementia, and yet he is always employed 156

Observation 7th.—An excellent illustration that there is scarcely any insane person’s mind so much lost, but that still, provided labour has been their early common habit, they may with ease be brought into habits of useful employment, and which with such a class, should, both for their cure and comfort, be adopted, and arrangements made for the purpose 157

Case No. 12.—A female instance of scolding and kindness by turns 158

Case No. 13.—Constantly talking to imaginary objects, but still perseveres in his habits of usefulness 159

Case No. 14.—A beautiful exhibition of female kindness and love of children, as well as of many other symptoms which indicate that her former habits and general natural character and disposition have been amiable 159

Illustrated by a Portrait 159

Case No. 15.—Like a passionate and proud man in a constant state of inebriation 161

Observation 8th.—A striking instance of the correspondence between cause and effect 162

Case No. 16.—Vanity turned into stone 163

Illustrated by a Portrait 116

Case No. 17.—An unmarried female, useful as a laundress, and distinguished by her affection for cats and kittens 163

Case No. 18.—An extreme instance of the most furious excitement of the vindictive and destructive passions, and the habits and states to which his treatment had reduced him 164

Observation 9th.—The mistake of calling those facts, which are the effects of improper treatment, symptoms of insanity 166

Case No. 19.—Constantly like one muttering in his dreams. Very good-natured 167

Observation 10th.—Perhaps his reason might have been re-awakened by constant judicious treatment and attention 168

Case No. 20.—An ideot, but employed 168

Illustrated by a Portrait 168

Case No. 21.—Was formerly in states of furious revenge, now gradually diminished in frequency and degree, by kindness 169

Observation 9th.—A happy illustration of the effects of kindness 170

Case No. 22.—Mind a perfect wreck—the effect of disappointed love 170

Case No. 23.—A very interesting caricature of political mania of a person of family and title. He fancies himself constantly employed in making calculations and in doing many strange acts, all necessary parts of his mighty task of paying the national debt, which abstracts him from all external objects, and from all consciousness to his own bodily sensations 171

Observation 12th.—That the correspondence between the present and previous habits of mind, are, in most cases, and certainly in this, most striking 175

On the effects of heat and cold, and the changes of temperature in the insane 175

That we are not to mistake, which is often done, the mind, in a state of abstraction, being insensible to the external changes of temperature, for the physical system being unaffected by their action 175

That the changes and unequal diffusion of heat correspond with the general and particular state of the mind, and that in cases of pure intellectual abstraction, and in those excited by the bad passions, it is very different, and in cases of gradual decay of mind, it is altogether defective 176

To discriminate those differences is necessary to regulate our treatment according to the exigencies of the case 179

Observation 13th.—On the effects of intense study and general intemperance of the mind 180

That when study is blamed, I have often found that the intemperate feelings, wicked and irregular habits, were the real causes 180

That proper mental exercise is as essential to the health as bodily exercise 181

That it is a great error to suppose such exercise injurious or discountenanced by religion, provided always the mind is under the influence of right motives 182

Case No. 25.—A dignified exhibition of all the mental energies arranging and concentrating themselves under his self esteem 190

Illustrated by a Portrait 190

Case No. 26.—A caricature of a masculine female 193

Case No. 27.—One of extreme torpor and debility 193

Observation 14th.—That the character of all hereditary cases retains something of a family resemblance 194

Case No. 28.—A caricature of Johanna Southcott’s followers 195

Illustrated by a Portrait 195

Case No. 29.—A most horrible object of demoniacal violence suspended twice by a physical accident and disease 197

Observation 18th. [26]—On the doctrine of demons, and that the subject will be resumed in an after part of this work 198

Case No. 30.—A very interesting demonstration of the misery of ill-assorted marriages, and that the painful and powerful association of the original cause of the disease produced its frequent recurrence 199

Observation 19th.—On the evils of such marriages, and that the consideration of this important subject will be resumed in an after part of this work 202

Case No. 31.—A singular and most interesting case of an active, excitable, and overworked mind being overthrown by family afflictions, his power of personating various celebrated characters of different periods of the world, which he believes himself for the while to be. His splendid eloquence and conversations with imaginary beings, &c. Still, there were encouraging symptoms, that by proper and laborious methods of mental occupation, he might possibly have had the balance of his mind restored 203

Illustrated by a Portrait 203

General explanation of the peculiar complexion of this work, and of the Appendix in particular 207

Concluding observations, that the object of this Essay, and especially of the Appendix, has been to lessen the prejudices against and better the treatment of, the insane 209