causes of that apparent incurability, and find proof of its being amenable to rational and enlightened management, in the simple fact, that, in spite of the atrocious manner in which asylums were formerly conducted, cures were nevertheless far from uncommon; and perceiving, too, how greatly the number of cures has been increased by the obvious, but still imperfect improvements which have been adopted, they may form some conception of the success which may be expected from every future addition to the efficacy of our treatment. The medical reader may, perhaps, think that the harrowing details in the third chapter might have been spared; but he must recollect that, although the scenes described are familiar to him, and are now, we hope, gone for ever; they are not equally well known to the public, by whom, since the excite ments occasioned by the parliamentary investigations, has to a considerable extent subsided, they have been almost entirely for gotten. We conceive, that any blame which now attaches to the management of asylums, must in a great degree he borne by the public, that portion of it in particular, which is intrusted with the funds, appropriated to the maintenance and improvement of these institutions. Neither can the relations of the insane be allowed to escape without a share of the blame. Already have medical men, both attached and unattached to asylums, testified not only their willingness, but their ardent desire, to assist in the furtherance of the system of treatment. The chief obstacle seems to have been the difficulty of convincing those under whose control they are required to act, of the necessity of the various improvements. Another impediment of not less magnitude, has been the want of a cordial co-operation on the part of the relations of the insane. The difficulty of inducing them to consent to the removal to asylums, and the early employment of effectual treatment, in short, to recognise the existence of disease, has been often insisted on in practical works. Less has, however, been said of the frequent neces sity of their co-operation during the progress of the malady. In some cases they persist in intruding on the patient when their presence is certain to be fraught with evil consequences, but much more frequently the patient is left in a state of utter desertion, when intercourse with sane individuals might be of the most essential service. Mr Browne has laboured, we think with success, to put what we know in the various divisions of the subject into a shape, attractive at once to unprofessional and professional persons. In this he has acted with much good sense, as he will thus be more successful in reaching and impressing correct ideas on the minds of those on whom the important trust of regulating asylums, and the condition of the insane, whether in asylum or not, has been devolved. By the opportunities which he possesses, as medical superintendent of a public asylum, Mr Browne is well qualified for the task which he has undertaken. Of the acuteness with which he can examine the intricacies of mental affections, our readers are already able to judge from several excellent papers by him, which have appeared in former numbers of this Journal; and, in particular, a series on religious insanity, the illustrations of which were derived from patients in the institution now under his care, To our readers it will also be a recommendation, that the doctrines contained in these lectures have been based, as far as possible, on the principles of Phrenology. On this point we shall lay before our readers Mr Browne's own remarks. "A large portion of the volume refers to the past, and is necessarily occupied with historical details: that portion which refers to the future I have as scrupulously as was practicable collected and collated from the writings and opinions of others: and when presenting a synoptical view of the different forms under which mental disease may appear, I was indebted rather to the science upon the principles of which that arrangement was founded, than to any peculiar views or philosophical analysis of my own. To those who are acquainted with the doctrines of Phrenology, the extent of my obligations in this particular case, and throughout the work, will be readily recognized; and to those who are still ignorant of these doctrines, I have to offer the assurance that Insanity can neither be understood nor described, nor treated by the aid of any other philosophy. I have long entertained this opinion: I have for many years put it to the test of experiment, and I now wish to record it as my deli. berate conviction. While, however, I have constantly availed myself of the principles, I have avoided the phraseology of the science, first, because my original auditors were not, and my readers may not be phrenologists; and, secondly, and chiefly, because my object was not to advocate or promote particular truths, but to employ and apply these in the elucidation of the object in view, and thereby to place in as clear, and conclusive, and acceptable a manner as possible, the noble cause which I have undertaken." In his first lecture, Mr Browne enters into an examination of the preliminary questions of the nature, causes, and definition of insanity, and the classification of its different species. The connection of insanity with the brain is shortly explained, and the attempts to include all its different varieties within the narrow limits of a definition reprobated; and believing an accurate description of the different kinds of insanity to be of much more practical value, Mr Browne proceeds to lay before the reader the leading features of these. In most of the nosological arrangements which have been made, the chief defects have been either their cumbrous minuteness and fine-spun distinctions, or their vague generality. The first attempt to form a regular nosological table on phrenological principles, so far as we are aware, is that of Mr Browne. It appears to include all the species generally met with, each of which will be immediately referred by the phrenological reader to its appropriate cerebral seat; but there are phenomena which it is still difficult, by any method of analysis, to refer to their organic causes. The following is THE AUTHOR'S ARRANGEMENT. I. Idiocy, Non-development of faculties. 1. Gradation. 2. 3. 4. Non-development of all the powers. A propensity or affection developed. II. Fatuity. Obliteration of Faculties. III. Monomania. 1. Satyriasis. Derangement of one or more faculties. SECTION 1. 2. Homicidal and destructive. 3. Proud. 4. Vain. 5. Timid. 6. Cunning and suspicious. 7. Religious and superstitious. 8. Desponding and suicidal. 9. Imaginative. 10. Avaricious. 11. Benevolent or affectionate. SECTION II. 12. Incapability of perceiving relation of ideas. IV. Mania. Derangement of all the faculties. 1. Mania with increased activity. 2. Mania with diminished activity. form The remarks on the third division, monomania, are interesting, and illustrate the doctrine which so much pains has been taken to inculcate; that the same fundamental faculty may the leading characteristic of individuals widely distinguished by their actions. A question of much importance at the present time is, whe ther insanity has increased with the progress of civilization. This question has been much agitated of late years, and much alarm excited in the breasts of those who entertain the hope that civilization will banish many of the evils which have hitherto afflicted mankind. It is difficult, amidst many conflicting statements, and in the absence of positive data, to form an opinion; but it seems certain, that, although many accounts of the in crease have been much exaggerated, there is no reason to doubt that insanity is more frequently met with among civilized men, than among savages. It does not appear, however, that the ratio corresponds exactly among civilized nations, with the rank which each is supposed to hold in the scale. It would be strange, indeed, if those who are much exposed to the exciting causes of a disease, did not present cases of that disease more frequently than those who are less exposed. In that state of society which is now termed civilized, the sources of mental excitation and disease are almost beyond computation."The occupations, amusements, follies, and above all, the vices of the present race, are infinitely more favourable for the development of the disease than at any previous period. We live under the dominion of the propensities, and must pay the penalty for so doing: and madness is one of these. There is one feature which has often struck me in examining tables of the causes of insanity in reference to the matter under discussion. One-half of these is resolvable into crime, follies, and ignorance. If we consult Esquirol's Table, published in 1835, comprehending 1557 cases, and exclude 337 instances of hereditary taint, as the exciting circumstances under which this burst forth are not noted, it will appear that 579 are attributable to the excess or abuse of the passions, or to the weakness of the uneducated intellect.*" It is not, then, from the legitimate employment of our minds that the disease derives its origin; but from the abuse of our powers, especially the animal propensities. As the dictates of sound morality and physiology come to be listened to, which, however, they will not be till the adoption of a more rational system of moral as well as intellectual education, for hitherto our moral has not kept pace with our intellectual improvement, and even the latter has not been very general, there is reason to hope, then, that this scourge will be less severely felt. And this hope is cherished by the symptoms' now evident of a tendency in the people themselves towards the improvement of their moral condition. Mr Browne's observations on those external circumstances which have an influence on the occurrence of insanity, possess so much interest, that we cannot refrain from laying them before our readers. The assertion of the greater prevalence of mental disease under free than under despotic forms of government, may be treated in the same spirit as that displayed in examining the alleged connexion of insanity with civilization. I admit the fact, but deny the inference. Tyranny has no protective influence-liberty is not the foe of mental health. Consumption has * Annales d'Hygiène Publique, Janvier 1835, doubled its ravages since the use of tea prevailed, and cholera has invaded the country since the passing of the Reform Bill; and these facts have nearly the same connexion that the preva lence of insanity has with the nature of the constitution under which a people lives. But although the form of government which, it will be observed, is generally the result and represen tation, and not the cause of the existing state of feeling, exer cises no influence in the production of insanity, the mode in which it is administered, the social relations, the tranquillity or fluctuations in the habits, value of property and rank, the degree of prosperity, and the moral and religious condition which arise out of it, must obviously do so. In that state, then, be it mo narchical or republican, in which the sources of moral agitation and excitement are most abundant, will the proportion of insa nity be the highest. Panics in the commercial classes, civil commotions, war, rapid influx and reflux of wealth, and ambitious projects, which are the most fertile and frequent moral causes of the disease, may occur, and have occurred, under every form of government, and affect mankind, not because they are slaves or citizens, but because their bodies are weak and vitiated, their minds excitable and ill-balanced. A state in which wide-spread. ing changes did not and could not take place, would afford, to a certain and great extent, a guarantee against madness. Were despotism another word for tranquillity, and freedom for turmoil, the line of exemption would be clearly defined. But publie order and disorganization, although undoubtedly favoured by political relations, flow more from the character than the actual condition of a people, and accordingly affect indiscriminate ly the bond and the free Thus the free Américan is comparatively more liable to derangement than the free Swiss ;--cretinism is, of course, excluded from the comparison. The enslaved Turk is exempt; the conquered Hindoo liable. The act of liberation, however, is certainly inimical to mental peace. It operates, like all other great political movements, by powerfully affecting the interests of the mass, by calling forth the deepest sympathies, the most ungovernable passions of the human breast. The French Revolution is said to have filled the asylums to overflowing. The immediate effects of the Crusades, the Reformation, and the retreat from Moscow were similar. These statements, from the remoteness or the peculiar character of the periods to which they refer, are necessarily vague and unsup ported by proof. But on turning to the Irish rebellion, the traces and history of which are still fresh and before us, we find from Hallaran that of 693 cases, 108, or nearly one-seventh, were produced by the terror, the hostility, and the hopes then prevailing.* * Hallaran on the Causes and Cures of Insanity. |