As the office I hold affords me abundant means of acquiring information on
the subject of mental disorders, I should feel myself unworthy of that
situation, were I to neglect any opportunity of accumulating such
knowledge, or of communicating to the public any thing which might promise
to be of advantage to mankind. The candid reader is therefore requested to
accept this sentiment, as the best apology I can offer for the present
production.
It has been somewhere observed, that in our own country more books on
Insanity have been published than in any other; and, if the remark be
just, it is certainly discouraging to him who proposes to add to their
number. It must, however, be acknowledged, that we are but little indebted
to those who have been most capable of affording us instruction; for, if
we except the late Dr. JOHN MONRO'S Reply to Dr. BATTIE'S Treatise on
Madness, there is no work on the subject of mental alienation which has
been delivered on the authority of extensive observation and practice.
It is not intended to present the following sheets as a treatise, or
compleat disquisition on the subject, but merely as remarks, which have
occurred during the treatment of several hundred patients. As a knowledge
of the structure, and functions of the body, have been held indispensably
necessary in order to become acquainted with its diseases, and to a
scientific mode of treating them; so it would appear, that he who proposes
to write on Madness should be well informed concerning the powers and
operations of the human mind: but the various and discordant opinions,
which have prevailed in this department of knowledge, have led me to
disentangle myself as quickly as possible from the perplexity of
metaphysical mazes.
As some very erroneous notions have been entertained concerning the state
of the brain, and more especially respecting its consistence in maniacal
disorders, I have been induced to examine that viscus in those who have
died insane, and have endeavoured with accuracy to report the
appearances. It seemed proper to give some general history of these cases;
perhaps the account which has been related of their erroneous opinions
might have been spared, yet some friends whom I consulted expressed a wish
that they had been more copiously detailed.
Of the difficulty of enumerating the remote causes of the disease I have
been fully aware, and have mentioned but few, that I might be accused of
the fewer mistakes. The prognosis contains some facts which, as far as I
am informed, have not hitherto been made known, and appear to me of
sufficient importance to be communicated to the public.
As it is my intention at some future period to attempt a more finished
performance on the subject of Insanity, I shall feel grateful for any
hints or observations, with which the kindness of professional gentlemen
may supply me.
BETHLEM-HOSPITAL,
MARCH 14, 1798.