There is no word in the English language more deserving of a precise
definition than madness: and if those who have treated on this subject
have been so unfortunate as to disagree with each other, and consequently
have left their readers to reconcile their discordant opinions; yet it
must be confessed that considerable pains have been bestowed, to convey a
clear and accurate explanation of this term. Although this contrariety of
sentiment has prevailed concerning the precise meaning of the word
madness, medical practitioners have been sufficiently reconciled as to the
thing itself: so that when they have seen an insane person, however
opposite their definitions, they have readily coincided that the patient
was mad.
From this it would appear that the thing itself, is, generally speaking,
sufficiently plain and intelligible; but that the term which represents
the thing is obscure. Perhaps, we might be somewhat assisted, by tracing
back this word, in order to discover its original meaning, and shewing
from its import the cause of its imposition.
If the reader, as is now the custom, should turn to Johnson's Dictionary
for the meaning and etymology of this word, he will find that the Doctor
has derived it both from the Anglo-Saxon gemaad and the Italian
_matto_; but without giving any meaning as the cause of its employment.
The word is originally Gothic, and meant anger, rage, [Gothic: Mod].
[Mod]. It is true that we have now controverted the o, into a, and write
the word mad: but mod was anciently employed.
"Yet sawe I MODNESSE laghyng in his _rage_."
_Chaucer. Knight's Tale, fol. 1561, p. 6._
There is so great a resemblance between anger and violent madness, that
there is nothing which could more probably have led to the adoption of the
term. Dr. Beddoes, who appears to have examined the subject of insanity
with the eye of an enlightened philosopher, is decidedly of this opinion,
he says, HYGEIA, _No. 12, p. 40_, "Mad, is one of those words which mean
almost every thing and nothing. At first, it was, I imagine, applied to
the transports of rage; and when men were civilized enough to be capable
of insanity, their insanity, I presume, must have been of the frantic
sort, because in the untutored, intense feelings seem regularly to carry a
boisterous expression."
MAD is therefore not a complex idea, as has been supposed, but a complex
term for all the forms and varieties of this disease. Our language has
been enriched with other terms expressive of this affection, all of which
have a precise meaning. Delirium, which we have borrowed from the latin,
merely means, _out of the track_, de lira, so that a delirious person, one
who starts out of the track regularly pursued, becomes compared to the
same deviation in the process of ploughing. _Crazy_, we have borrowed from
the French _ecrase_, crushed, broken: we still use the same meaning, and
say that such a person is crack'd. Insane, deranged, or disarranged,[1]
melancholic, out of one's wits, lunatic, phrenitic, or as we have
corrupted it, frantick, require no explanation. _Beside one's self_ most
probably originated from the belief of possession by a devil, or evil
spirit.
The importance of investigating the original meaning of words must be
evident when it is considered that the law of this country impowers
persons of the medical profession to confine and discipline those to whom
the term mad or lunatic can fairly be applied. Instead of endeavouring to
discover an infallible definition of madness, which I believe will be
found impossible, as it is an attempt to comprise, in a few words, the
wide range and mutable character of this Proteus disorder: much more
advantage would be obtained if the circumstances could be precisely
defined under which it is justifiable to deprive a human being of his
liberty.
Another impediment to an accurate definition of madness, arises from the
various hypotheses, which have been entertained concerning the powers and
operations of the human mind: and likewise from the looseness and
unsettled state of the terms by which it is to be defined.
Before treating of the intellect in a deranged state, it will perhaps be
expected that some system of the human mind, in its perfect and healthy
condition, should be laid down. It will be supposed necessary to establish
in what sanity of intellect consists, and to mark distinctly some fixed
point, the aberrations from which are to constitute disease.
To have a thorough knowledge of the nature, extent, and rectitude of the
human faculties, is particularly incumbent on him who undertakes to write
of them in their distempered state; and, in a legal point of view, it is
most important that the medical practitioner should be enabled to
establish the state of the patient's case, as a departure from that which
_is_ reason.
The difficulty of proposing a satisfactory theory of the human mind, must
have been felt by every person, who has touched this delicate string since
the days of Aristotle, and failure must be expected in him who attempts
it: yet the endeavour is laudable, and miscarriage is not linked with
disgrace. Every contribution, to illustrate what are the powers of mind we
possess; how we are acted upon by external circumstances in the
acquisition of knowledge; and concerning the manner in which we use this
knowledge for the purposes of life; ought to be candidly received.
Enquiries of this nature have been usually conducted by commenting on the
numerous and discordant authorities which have treated on metaphysical
subjects; these persons, however they may differ on many points, appear to
be pretty generally agreed, that the human mind possesses certain
faculties and powers; as imagination, judgment, reason, and memory. They
seem to consider these, as so many departments, or offices of the mind,
and therefore class men according to the excellence or predominance of
these powers. One man, is said to be distinguished by the brilliancy of
his imagination; another, by the solidity of his judgment; a third, by the
acuteness of his reason; and a fourth, by the promptitude and accuracy of
his recollection.
As far as I have observed respecting the human mind, (and I speak with
great hesitation and diffidence,) it does not possess, all those powers
and faculties with which the pride of man has thought proper to invest it.
By our senses, we are enabled to become acquainted with objects, and we
are capable of recollecting them in a greater or less degree; the rest,
appears to be merely a contrivance of language.
If mind, were actually capable of the operations attributed to it, and
possessed of these powers, it would necessarily have been able to create a
language expressive of these powers and operations. But the fact is
otherwise. The language, which characterizes mind and its operations, has
been borrowed from external objects; for mind has no language peculiar to
itself. A few instances will sufficiently illustrate this position. After
having committed an offence it is natural to say that the mind feels
contrition and sorrow.
Contrition is from _cum_ and _tero_, to rub together, which cannot
possibly have any thing to do with the operations of the mind, which is
incapable of rubbing its ideas or notions together. Contrition is a
figurative expression, and may possibly mean the act of rubbing out the
stain of vice, or wearing down by friction the prominences of sin.
If we were to analyze the word Sorrow, which is held to be a mental
feeling, we should find it to be transferred from bodily sufferance: for
the mind, is incapable of creating a term correctly expressive of its
state, and therefore, it became necessary to borrow it from _soreness_ of
body.--_See Mr. Tooke's Diversions of Purley, vol. ii. p. 207_, where
_sore_, _sorry_, and _sorrow_ are clearly made out to be the same word.
It is customary to speak of a man, of accurate perceptions, and of
another, who has grand and luminous conceptions of human nature.
Perception, from _per_, and _capio_ to take, seize, grasp, through the
medium of the organs of sense, being implied. But to take, seize, and
grasp are the operations of the hand, and can only, by extreme courtesy,
be attributed to mind.
Mr. Dugald Stewart, the most thoughtful and intelligent of modern
metaphysicians, has said, "By conception I mean that power of the mind
which enables it to form a notion of an absent object of perception, or of
a sensation which it has formerly felt."--_Elements of the Philosophy of
the Human Mind, 8vo. p. 133._
This definition means merely memory; and by perusing attentively the whole
chapter the reader will be convinced of it. Conception, from _cum_ and
_capio_, has been applied to mind from the physical sense of embracing,
comprehending, or probably from the notion of being impregnated with the
subject. It may be remarked, that these three terms, by which conception
has been explained, have been all applied to mental operation.
The words reason and reasoning, I believe, in most languages, strictly
imply numeration, reckoning, proportion; the Latin _ratio_, _ratiocinor_,
_ratiocinator_ are sufficient examples. A curious coincidence between the
Latin _ratio_ and the Gothic _rathjo_, together with some pertinent and
interesting observations, may be seen in Ihre's Glossarium Svio-gothicum,
_p._ 393, _art._ Raekna. As we now acknowledge the science of number to be
the purest system of reasoning, a system, on which all persons agree, and
so unlike medicine, politics, and divinity, concerning which there is a
constant, and hostile variety of sentiment, it adds some force to the
argument. Indeed, Mr. Locke, who almost personifies reason, after having
painfully sifted this matter, appears to be much of the same way of
thinking: he says, "Reason, though it penetrates into the depth of the sea
and earth, elevates our thoughts as high as the stars, and leads us
through the vast spaces and large rooms of this mighty fabrick, _yet it
comes far short of the real extent of even corporeal being_; and there are
many instances wherein it fails us: as,
"First: it perfectly fails us where our ideas fail: it neither does, nor
can extend itself farther than they do, and therefore, wherever we have no
ideas our reasoning stops, and we are at an end of our reckoning: and if
at any time _we reason about words, which do not stand for any ideas_, it
is only about those sounds, and nothing else.
"Secondly: our reason is often puzzled, and at a loss, because of the
obscurity, confusion or imperfection of the ideas it is employed about;
and there we are involved in difficulties and contradictions. Thus, not
having any perfect idea of the least extension of matter, nor of infinity,
we are at a loss about the divisibility of matter; _but having perfect,
clear, and distinct ideas of number, our reason meets with none of those
inextricable difficulties in numbers, nor finds itself involved in any
contradictions about them_."--_Works. 4to, vol. i, p. 431._
It can scarcely be necessary, longer to fatigue the patience of the
reader, by reverting to the etymology of those terms, which have been
considered as significant of mind and its operations. Every one will be
able sufficiently to develope imagination, reflection, combination, [as
applied to ideas, importing the amalgamation of _two_ into one]
abstraction, [_vide Mr. Tooke, from p. 15 to 426, vol. ii._] and a
variety of others; and to shew, that they have arisen from physical
objects, and the circumstances which surround us, and are independant of
any operation which mind has elaborated.
But as madness, by some, has been exclusively held to be a disease of the
imagination, and by others, to be a defect of the judgment; considering
these as separate and independant powers or faculties of the intellect; it
is certainly worth the trouble to enquire, whether such states of mind did
ever exist as original and unconnected disorders. With respect to
imagination, there can be but little difficulty; yet this will so far
involve the judgment and memory, that it will not be easy to institute a
distinction. If a cobbler should suppose himself an emperor, this
supposition, may be termed an elevated flight, or an extensive stretch of
imagination, but it is likewise a great defect in his judgment, to deem
himself that which he is not, and it is certainly an equal lapse of his
recollection, to forget what he really is.
Having endeavoured to give some reasons for not according with the
generally received opinions, concerning the different powers of the mind,
it may be proper shortly to state, that, from the manner in which we
acquire knowledge, the human mind appears to be composed of a sum of
individual perceptions: that, in proportion as we dwell by the eye, the
ear, or the touch on any object (which is called attention,) we are more
likely to become acquainted with it, and to be able to remember it. For
the most part, we remember these perceptions in the succession in which
they were presented, although, they may afterwards, from circumstances, be
differently sorted.
The minds of ordinary men are well contented to deal out their ideas, in
the order in which they were received; and, not having found the necessity
of bringing them to bear on general subjects, they are commonly minutely
accurate in the detail of that which they have observed. By such persons,
a story is told with all the relations of time and place; connected with
the persons who were present, their situation, state of health, and a vast
variety of associated particulars; and these persons, however tedious,
generally afford the most correct account. On the other hand, those who
are men of business, and have much to communicate in a given space, are
obliged to subtract the more material circumstances from the gross
narrative, and exhibit these as the sum total. It is in this way, that
words, originally of considerable length, have been abbreviated for the
conveniency of dispatch, and from this necessity short hand writing has
been employed.
As the science of arithmetic consists in addition to, or subtraction from,
a given number; so does the human mind appear to be capable solely of
adding to, or separating from, its stock of ideas, as pleasure may prompt,
or necessity enforce.
Language, the representative of thought, bears the same construction; and
it is curious to remark in the investigation of its abbreviations, that
those words, which serve to connect ideas together, (_conjunctions_) and
which have been supposed to mark certain operations of intellect, postures
of mind, and turns of thought, have merely the force and meaning of to
add, or to subtract.
Insanity is now generally divided into Mania and Melancholia, but formerly
its distributions were more numerous. Paracelsus, speaking of this
disease, says, "Vesaniae hujus genera quatuor existunt: primi _Lunatici_
vocantur: secundi _Insani_: tertii _Vesani_: quarti _Melancholici_,
Lunatici sunt qui omnem suum morbum ex Luna accipiunt, et juxta eam sese
gerunt ac moventur. Insani sunt, qui malum id ab utero materno hauserunt,
veluti haereditarium, uno subinde insaniam in alterum transferente. Vesani
sunt, qui a cibis ac potibus ita inficiuntur ac taminantur, ut ratione
sensuque priventur. Melancholici sunt, qui ex intimae naturae vitio a
ratione deturbantur, et ad vesaniam precipitantur." Paracelsus, however,
thinks that a fifth genus may be added. "Ad quatuor hac genera genus
insuper aliud quodammodo annumerari potest, videlicet _obsessi_, qui a
diabolo variis modis occupari solent."--_Paracelsi Opera, folio, tom. i.
fol. 572._
The idea of being besieged, beset, or possessed by the devil was formerly
a very favourite notion, and is derived to us by an authority we are
taught to reverence: indeed it is still the opinion of many harmless and
believing persons, some of whom have bestowed considerable pains to
convince me that the violent and mischievous maniacs in Bedlam were under
the dominion of this insinuating spirit. They have employed one argument
which would seem to have considerable weight, namely, that the most
atrocious crimes are stated in our indictments (much to the credit of
human nature) to have been committed by the instigation of the devil: and
they have also endeavoured to explain, how a late and eminently successful
practitioner, by an union of the holy office with consummate medical
skill, was enabled to cure nine lunatics out of ten, which certainly has
not hitherto been accounted for.
Paracelsus, who contemplated this subject with uncommon gravity and
solicitude, is of opinion that the devil enters us much in the same manner
as a maggot gets into a filbert.--_Vide Fragmentum Libri Philosophiae de
Daemoniacis et Obsessis, tom. ii. p. 460._
To conclude this part of the subject, and to exhibit the state of belief
at that period, I shall take the liberty of extracting a portion from the
11th chapter of Dr. Andrewe Boord's Extravagantes, which "doth shewe of a
Demoniacke person, the which is possessed of or with the devyll or
devylls.
"Demoniacus or Demoniaci be the Latin wordes. In Greke it is named
Demonici. In Englyshe it is named he or they, the whiche be mad and
possessed of the devyll or devils, and their propertie is to hurt and kyll
them selfe, or els to hurt and kyll any other thynge, therfore let every
man beware of them, and kepe them in a sure custody.
_The cause of this Matter._
"This matter doth passe all maner sickenesses and diseases, and it is a
fearefull and terryble thyng to se a devyll or devylles shoulde have so
muche and so greate a power over man, as it is specified of such persons
dyvers tymes in the gospell, specyally in the IX. Chapitre of St. Marke.
Chryste sendynge his disciples to preache the worde of God, gevynge them
power to make sicke men whole, lame men to go, blynde to se, &c. Some of
them dyd go by a mans that was possessed of devils and they coud not make
him whole. Shortly to conclude, Chryst dyd make hym whole. The dysciples
of Chryste asked of him why that they coud not make the possessed man of
the devylls whole. And Jesus Chryste said to them: this kynde of devylls
can not be cast out without prayer and fastynge. Here it is to be noted,
that nowe a dayes fewe or els none doth set by prayer or fastynge,
regardyng not gods wordes; in this matter, I do feare that suche persons
be possessed of the devil, although they be not starke madde, and to shew
further of demoniacke persons the whiche be starke madde. The fyrste tyme
that I dyd dwell in Rome, there was a gentilwoman of Germani, the whych
was possessed of devyls, and she was brought to Rome to be made whole.
For within the precynct of St. Peters church, without St. Peters chapel,
standeth a pyller of whyte marble grated round about with iron, to the
which our Lorde Jesus Chryste dyd lye in hymselfe unto the Pylates hal, as
the Romaynes doth say, to the which pyller al those that be possessed of
the devyl, out of dyvers countreys and nacions be brought thyther, and as
they say of Rome, such persons be made there whole. Amonge al other this
woman of Germany, which is CCCC myles and odde from Rome, was brought to
the pyller, (I then there beyng presente,) with great strength and
violently with a XX or mo men, this woman was put into that pyller within
the yron grate, and after her dyd go in a preeste, and dyd examine the
woman under this maner in the Italian tonge. Thou devyl or devyls, I do
abjure thee by the potencial power of the father, and of the sonne our
Lorde Jesus Christe, and by the vertue of the Holy Ghoste, that thou do
shewe to me, for what cause that thou doeste possess this woman: what
wordes was aunswered I will not write, for men will not beleve it, but
wolde say it were a foule and great lye, but I dyd heare that I was afrayd
to tarry any longer, lest that the devyls shulde have come out of her, and
to have entred into me; remembrynge what is specified in the viii Chapitre
of St. Matthewe, when that Jesus Christ had made two men whole, the
whiche, was possessed with a legion of devils. A legion is IX M. IX C.
nynety and nyne: the sayd devyls dyd desyre Jesus, that when they were
expelled out of the aforesayde twoo men, that they might enter into a
herde of hogges, and so they did, and the hogges did runne into the sea
and were drowned. I consyderynge this, and weke of faith and afeard,
crossed myselfe and durste not heare and se such matters, for it was to
stupendious and above all reason yf I shulde wryte it; and in this matter
I dyd marvell of an other thynge; if the efficacitie of such makynge one
whole, dyd rest in the vertue that was in the pyller, or els in the wordes
that the preest dyd speake. I do judge it shulde be in the holy wordes
that the prest dyd speak, and not in the pyller; for and yf it were in the
pyller, the Byshops, and the Cardinalles that hathe ben many yeres past,
and those that were in my tyme, and they that hath bin sence, wolde have
had it in more reverence, and not to suffre rayne, hayle, snowe, and such
wether to fal on it, for it hath no coverynge, but at laste when that I
did consyder that the vernacle, the phisnomy of Christ, and scarse the
sacrament of the aulter was in maner uncovered and al St. Peters Churche
downe in ruyne, and utterly decayed, and nothing set by, consideringe in
olde chapels, beggers and baudes, hoores and theves dyd lye within them,
asses and moyles dyd defyle within the precincte of the Churche, and
byenge and sellynge there was used within the precinct of the sayde church
that it dyd pytie my harte and mynde to come and se any tyme more the
sayde place and churche."--_Andrewe Boorde,[2] the seconde Boke of the
Brevyary of health, 1557, fol. 4th._
To return from this digression. Dr. Ferriar, whom to mention otherwise
than as a man of genius, of learning, and of taste, would be unjust, has
adopted the generally accepted division of insanity into mania and
melancholia. In mania he conceives "false perception, and consequently
confusion of ideas, to be a leading circumstance." The latter, he supposes
to consist "in intensity of idea, which is a contrary state to false
perception." From the observations I have been able to make respecting
Mania, I have by no means been led to conclude, that false perception, is
a leading circumstance in this disorder, and still less, that confusion of
ideas must be the necessary consequence of false perception.
By perception I understand, with Mr. Locke, the apprehension[3] of
sensations; and after a very diligent enquiry of patients who have
recovered from the disease, and from an attentive observation of those
labouring under it, I have not frequently found, that insane people
perceive falsely the objects which have been presented to them.
We find madmen equally deranged upon those ideas, which they have been
long in the possession of, and on which the perception has not been
recently exercised, as respecting those, which they have lately received:
and we frequently find those who become suddenly mad, talk incoherently
upon every subject, and consequently, upon many, on which the perception
has not been exercised for a considerable time.
It is well known, that maniacs often suppose they have seen and heard
those things, which really did not exist at the time; but even this I
should not explain by any disability, or error of the perception; since it
is by no means the province of the perception to represent unreal
existences to the mind. It must therefore be sought elsewhere; most
probably in the senses.
We sometimes (more especially in the early stages of furious madness) find
patients from very slight resemblances, and sometimes, where none whatever
can be perceived by others of sound mind, confounding one person with
another. Even in this case it does not seem necessary to recur to false
perception for the explanation. It is equally probable that the organs of
vision are affected in consequence of the disease of the brain, and
therefore receive incorrect sensations: and still more likely, from the
_rapid succession_ in which objects are noticed, that a very slight trait
of countenance would recal the idea [or name] of some particular person.
I have known many cases of patients who insisted that they had seen the
devil. It might be urged, that in these instances, the perception was
vitiated; but it must be observed there could be no perception of that,
which was not present and existing at the time. Upon desiring these
patients to describe what they had seen, they all represented him as a
big, black man, with a long tail, and sharp talons, such as is seen
pictured in books; a proof that the idea was revived in the mind from some
former impressions. One of these patients however carried the matter a
little further, as she solemnly declared, she heard him break the iron
chain with which God had confined him, and saw him pass fleetly by her
window, with a truss of straw upon his shoulder.
That "confusion of ideas" should be the necessary consequence of false
perception, is very difficult to admit. It has often been observed that
madmen will reason correctly from false premises, and the observation is
certainly true: we have indeed occasion to notice the same thing in those
of the soundest minds. It is very possible for the perception to be
deceived in the occurrence of a thing, which, although it did not actually
happen, yet was likely to take place; and which had frequently occurred
before.--The reception of this as a truth, if the person were capable of
deducing from it the proper inferences, could neither create confusion nor
irregularity of ideas.
Melancholia, the other form in which this disease is supposed to exist, is
made by Dr. Ferriar to consist in "intensity of idea." By intensity of
idea, I presume is meant, that the mind is more strongly fixed on, or
more frequently recurs to, a certain set of ideas, than when it is in a
healthy state. But this definition applies equally to mania; for we every
day see the most furious maniacs suddenly sink into a profound
melancholia, and the most depressed and miserable objects become violent
and raving. There are patients in Bethlem Hospital, whose lives are
divided between furious and melancholic paroxysms, and who, under both
forms, retain the same set of ideas. It must also have been observed, by
those who are conversant with this disorder, that there is an intermediate
state, which cannot be termed maniacal nor melancholic: a state of
complete insanity, yet unaccompanied by furious or depressing
passions.[4]
In speaking of the two forms of this disease, mania and melancholia, there
is a circumstance sufficiently obvious, which hitherto does not appear to
have been noticed: I mean the rapid or slow succession of the patient's
ideas. Probably sound and vigorous mind consists as much in the moderate
succession of our ideas, as in any other circumstance. It may be enquired,
how we are to ascertain this increased, proportionate, and deficient
activity of mind? From language, the medium by which thought is conveyed.
The connexion between thought and utterance is so strongly cemented by
habit, that the latter becomes the representative of the former.
The physiology of mind, I humbly conceive to be at present in its infancy,
but there seems good reason to imagine, that furious madness implies a
rapid succession of ideas; and the circumstance of rage, from whence its
origin has been deduced, points out the hurried consecution. In this state
of mind the utterance succeeds
--------------------"sudden as the spark
From smitten steel; from nitrous grain the blaze."
and it frequently happens, after the tumult has subsided, the person
remembers but little of that which had escaped him.
"I then, all-smarting with my wounds, being cold,
(To be so pestered with a popingay)
Out of my greefe, and my Impatience,
Answered (neglectingly) _I know not what_--
_He should, or should not_: for he made me _mad_."
From this connexion between thought and utterance, we find many persons
(particularly those who are insane) talking to themselves; especially when
their minds are intently occupied; and taking the converse, we frequently
observe those who are desirous to acquire any subject by heart, repeating
it aloud.
From the same cause we have often occasion to remark, that strong, and
perhaps involuntary, propensity to repeat the emphatical words in a
sentence, and which are commonly the last, before we endeavour to reply
to, or confute them.
"_King._ No: on the barren Mountaine let him sterve:
For I shall never hold that man my friend
Whose tongue shall aske me for one peny cost
To ransome home revolted Mortimer.
"_Hotsp._ Revolted Mortimer?
He never did fall off, my Soveraigne Liege,
But by the chance of warre:"
As the terms Mania and Melancholia, are in general use, and serve to
distinguish the forms under which insanity is exhibited, there can be no
objection to retain them; but I would strongly oppose their being
considered as opposite diseases. In both there is an equal derangement. On
dissection, the state of the brain does not shew any appearances peculiar
to melancholia; nor is the treatment, which I have observed most
successful, different from that which is employed in mania.
As the practitioner's own mind must be the criterion, by which he infers
the insanity of any other person; and when we consider the various, and
frequently opposite, opinions of these intellectual arbitrators; the
reader will be aware that I have not abstained from giving a definition of
madness without some reason. There is indeed a double difficulty: the
definition ought to comprize the aberrations of the lunatic, and fix the
standard for the practitioner.
But it may be assumed that sound mind and insanity stand in the same
predicament, and are opposed to each other in the same manner, as right to
wrong, and as truth to the lie. In a general view no mistake can arise,
and where particular instances create embarrassment, those most conversant
with such persons will be best able to determine.
The terms sound mind and insanity are sufficiently plain. If to an
ordinary observer, a person were to talk in an incoherent manner, he would
think him mad; if his conduct were regular, and his observations
pertinent, he would pronounce him in his senses: the two opposite states,
well marked, are well understood; but there are many different shades,
which are not so likely to strike the common examiner.