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On the buildings, grounds, situation, and system, necessary 1
for all purposes of an efficient classification
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 15
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
This view of these cases is confirmed, and their danger 18
forewarned, by an examination of the natural constitution
of mind and previous habits of those subject to these
states
The delicate treatment which such cases often require, 25
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
That cases under this system, are induced, when they know 28
it from experience, or have it faithfully explained to
them, to come and return without fear or reluctance
The great importance of this first step; and of making 29
_truth the basis_. The manner of doing this explained, and
its beneficial influence stated
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 49
entire seclusion
Illustrated by cases, No. 425 and No. 429 51
On the beneficial influence of their being accustomed to 53
the usual habits, manners, and privileges of civilized life
On the propriety of diminishing the prejudices which exist 59
against the mere residence at an Asylum, if for the purpose
of restoration
The evils of considering diseases of the brain as a greater 61
disgrace, and as an indication of greater criminality than
other diseases
That our aim in all our moral treatment should be, to call 65
forth self-control, and all the better principles and
feelings of the human mind; and that this important subject
will be resumed
Illustrated by a case, No. 372. 69
Do. do. No. 395. 71
That often we have only a choice of evils, and must choose 73
the least
Illustrated by a case, No. 421. 75
Do. do. No. 396. 77
On the use of exercise, and a retired situation for the 78
purpose
An account of a system of cure, by being made to work, 81
related by Dr. Gregory
Regular work always useful, when willingly undertaken, but 82
not otherwise; easily managed with the labouring, but as
difficult with a higher, class of patients
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 89
influence,
Notwithstanding all this apparent extra trouble, it is, 100
when done from right motives, the safest and easiest in the
end
That these views are based on the firm ground of Christian 108
philosophy
CONTENTS OF APPENDIX.
EXPLANATION of the object of this Appendix; which is, by 111
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
Case No. 1.—His eccentricity, and exaggeration of his 113
natural character and that of his family. Has seasons of
excitement
Observation 1st.—That the fluctuations of the animal 115
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
Case No. 2.—Though in a very torpid state, yet he has (as 116
every case has) his distinguishing peculiarities
_Illustrated by a Portrait_ 116
Observation 2nd.—That mind is a garden which we must 116
cultivate—a fire which requires stirring and feeding
Case No. 3.—An example, which indeed every one is, more or 118
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
_Illustrated by a Portrait_ 118
Observation 3rd.—On the use of employment, and its easy 119
application
Case No. 4.—That of an idiot. Odd displays of an increase 120
of animation
_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, 122
evinced by the most extravagant fancies and exploits, which
he delights to detail to every one, yet he is constantly
employed, useful, and happy
_Illustrated by a Portrait_ 122
Observation 4th.—The explanation of the peculiarity of his 124
character, proves that, in all cases, truth should never be
violated in our conduct towards them
Case No. 7.—A very singular case of periodical violence and 125
sleep. His habit of gyration described
Observation 5th.—His habit of gyration explained. How far 127
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
The influence of temperature, moisture, climate, seasons, 129
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
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 136
modify these physical influences
Why this is differently exhibited by the insane, than it is 137
by those who retain the power over their own spirits
That this view is proved to be correct, by the fact that 139
these causes produce different effects by their being under
different modes of treatment
That the various character of insanity is but the same 143
excitement of the vital energies operating on different
parts of the mind, according to previous or present habits
and states
Hence, the insane are often caracatures of their own, as 146
well as of family habits and character
The truth of this reasoning proved by the fact, that the 147
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
The practical object of these observations 150
Case No. 8.—One of the extreme cases of furious mania, with 151
a leprous eruption of the skin
Observation 6th.—Whether cutaneous disorders are common to 153
the insane? The treatment of this case
Case No. 9.—One proof, out of many, which proves, that the 154
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
Case No. 10.—In which an injury on the head produced 155
symptoms in correspondence with the phrenological office of
the part injured
Case No. 11.—Apparently perfect dementia, and yet he is 156
always employed
Observation 7th.—An excellent illustration that there is 157
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
Case No. 12.—A female instance of scolding and kindness by 158
turns
Case No. 13.—Constantly talking to imaginary objects, but 159
still perseveres in his habits of usefulness
Case No. 14.—A beautiful exhibition of female kindness and 159
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
_Illustrated by a Portrait_ 159
Case No. 15.—Like a passionate and proud man in a constant 161
state of inebriation
Observation 8th.—A striking instance of the correspondence 162
between cause and effect
Case No. 16.—Vanity turned into stone 163
_Illustrated by a Portrait_ 116
Case No. 17.—An unmarried female, useful as a laundress, 163
and distinguished by her affection for cats and kittens
Case No. 18.—An extreme instance of the most furious 164
excitement of the vindictive and destructive passions, and
the habits and states to which his treatment had reduced
him
Observation 9th.—The mistake of calling those facts, which 166
are the effects of improper treatment, symptoms of insanity
Case No. 19.—Constantly like one muttering in his dreams. 167
Very good-natured
Observation 10th.—Perhaps his reason might have been 168
re-awakened by constant judicious treatment and attention
Case No. 20.—An ideot, but employed 168
_Illustrated by a Portrait_ 168
Case No. 21.—Was formerly in states of furious revenge, now 169
gradually diminished in frequency and degree, by kindness
Observation 9th.—A happy illustration of the effects of 170
kindness
Case No. 22.—Mind a perfect wreck—the effect of 170
disappointed love
Case No. 23.—A very interesting caricature of political 171
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
Observation 12th.—That the correspondence between the 175
present and previous habits of mind, are, in most cases,
and certainly in this, most striking
On the effects of heat and cold, and the changes of 175
temperature in the insane
That we are not to mistake, which is often done, the mind, 175
in a state of abstraction, being insensible to the external
changes of temperature, for the physical system being
unaffected by their action
That the changes and unequal diffusion of heat correspond 176
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
To discriminate those differences is necessary to regulate 179
our treatment according to the exigencies of the case
Observation 13th.—On the effects of intense study and 180
general intemperance of the mind
That when study is blamed, I have often found that the 180
intemperate feelings, wicked and irregular habits, were the
real causes
That proper mental exercise is as essential to the health 181
as bodily exercise
That it is a great error to suppose such exercise injurious 182
or discountenanced by religion, provided always the mind is
under the influence of right motives
Case No. 25.—A dignified exhibition of all the mental 190
energies arranging and concentrating themselves under his
self esteem
_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 194
cases retains something of a family resemblance
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 197
suspended twice by a physical accident and disease
Observation 18th. {26}—On the doctrine of demons, and that 198
the subject will be resumed in an after part of this work
Case No. 30.—A very interesting demonstration of the misery 199
of ill-assorted marriages, and that the painful and
powerful association of the original cause of the disease
produced its frequent recurrence
Observation 19th.—On the evils of such marriages, and that 202
the consideration of this important subject will be resumed
in an after part of this work
Case No. 31.—A singular and most interesting case of an 203
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
_Illustrated by a Portrait_ 203
General explanation of the peculiar complexion of this 207
work, and of the Appendix in particular
Concluding observations, that the object of this Essay, and 209
especially of the Appendix, has been to lessen the
prejudices against and better the treatment of, the insane
* * * * *