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Dr. Rush,) in conjunction with intellectual powers not strikingly deficient or even of superior quality, is a proposition not so generally recognised, nor so easily estabblished. It is obviously one which must be carefully considered in the description of mental diseases. With its medico-legal bearing we are not now concerned.

Many analogies subsist between the moral and intellectual faculties, and in many respects they may be observed to be under the influence of the same laws. The sentiments, no less than the intellect, are indicated by, or associated with, certain temperaments and physical signs; thus good nature usually co-exists with a sleek and fat habit of body. Virtuous and vicious tendencies would often appear to be hereditary; or, as congenital, are displayed from the earliest infancy, in children subjected to the same educational influences. The moral faculties may be either excited or depressed by disease. "Who has not seen," asks Dr. Rush, "instances of patients in acute diseases discovering degrees of benevolence and integrity that were not natural to them in the ordinary course of their lives?" Dreams affect the moral faculties as well as the intellect; under their influence we are benevolent, devotional, passionate, and affectionate, as well as imaginative and talkative.

Ray, after treating of mania as it affects the intellectual powers, proceeds to observe, that a more serious error can scarcely be committed than that of limiting its influence to them. "It will not be denied," he adds, "that the propensities and sentiments are also integral portions of our mental constitution; and no enlightened physiologist can doubt that their manifestations are dependent on the cerebral organism. Here, then, we have the only essential condition of insanity --a material structure connected with mental manifestations; and until it is satisfactorily proved that this structure enjoys a perfect immunity from morbid action, we are bound to believe that it is liable to disease, and consequently that the affective as well as the intellectual faculties are subject to derangement.' This writer cites from Hoffbauer the following unqualified assertion to the same effect: "It is clear," he says, "that mania may exist uncomplicated with mental delusion. It is, in fact, only a kind of moral exaltation (tollheit), a state in which the reason has lost its empire over the passions, and the actions by which they are manifested, to such a degree that the individual can neither repress the former, nor abstain from the latter. It does not Jurisprudence of Insanity, p. 163.

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follow that he may not be in possession of his senses, and even his usual intelligence, since, in order to resist the impulses of passions, it is not sufficient that the reason should impart its counsels; he must have the power to obey them."

One of the most striking features of insanity in general, and the strongest proof of the presence of any of its forms, is the change which takes place in the individual's character and habits. To cases of congenital deficiency of the intellect, however, whether altogether idiotic or only partially imbecile, it is at once manifest that this test does not and cannot apply. In such instances, the natural character is itself in an abnormal condition, and ceases to be the standard of health.

This observation applies with equal force to the matter now under consideration. If there ever be, congenitally, a condition of the moral sense analogous to imbecility, it is impossible to apply, in such instances, the test referred to -a test which is alone applicable to mental disease when acquired. I have seen several well marked examples of lunatics, who, on arriving at manhood, were placed under restraint, because age brought with it a certain legal responsibility, the absence of which in early life, rendered the patients' friends willing to content themselves with their own surveillance. In such cases, parents assert that the child, the boy, and the young man, alike presented the symptoms of an inert moral nature, and of an activity of the animal propensities, over which threats, rewards, or punishments exercised a very trifling control. There was formerly a patient at the Richmond Lunatic Asylum, Dublin, whose case illustrates this class. We are informed that "he exhibited a total want of moral feeling and principle, yet possessed considerable intelligence, ingenuity, and plausibility." "He has never," says Dr.

Crawford, "been different from what he now is; he has never evinced the slightest mental incoherence on any one point, nor any kind of hallucination. He appears, however, so totally callous with regard to every moral principle and feeling, so thoroughly unconscious of ever having done anything wrong, so completely destitute of all sense of shame or remorse, when reproved for his vices or crimes; and has proved himself so utterly incorrigible throughout life, that it is almost certain that any jury before whom he might be brought would satisfy their doubts by returning him insane." Dr.' Prichard speaks of a youth,*"an incorrigible thief, and addicted to falsehood and deception in every way, and apparently devoid of all perception of right or wrong. The mother of this * On the Different Forms of Insanity, 1847, p. 157.

"Das Beste das du wissen kanst

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Darfst du den Buben doch nicht sagen."

But his teaching will strengthen the mental digestion, and after a while stronger diet may be ventured upon. Is Physiology never to be freed from the incubus of a supposed tendency to atheistic opinions? It has, indeed, been unfortunate that this beautiful science has found some of its most diligent cultivators among men of such opinions, who have perverted its truths to the support of their impious sophisms. But at the present day, Atheism and its twin sister, Pantheism, have their strong-hold among the anti-physiological spiritualists, while the great hope of the Christian in a future life, and the basis of his faith in a personal God, are defended even by the ablest Divines, upon physical grounds. (See the Rev. Isaac Taylor's Physical Theory of a Future State of Existence.)

All that Mr. Paget says respecting the physiological growth of brain upon the pathological type of disordered sensation, will fully apply to the same growth on the type of disordered emotion; and his views afford an admirable basis of the only rational explanation of partial insanity occurring in persons in whom, during life, there are no physical phenomena of diseased brain, and in whom, after death, there are no pathological appearances in the organ of mind.

To resume, the theory of partial insanity without appreciable change of the brain, is as follows: When the disease first exists, it is attended by pathological states of the cerebral vessels. A morbid condition of the cerebral organization is occasioned, attended by the phenomena of insanity. After a short time the vessels recover their tone, the brain is nourished, and its size maintained as a whole. But the original balance of its organs is not regained; their nutrition having been impressed in the type or mould of their diseased state. Perhaps some of the cerebral organs encroach on others by their actual bulk; undoubtedly, some of them overbear others by their greater activity. The result is chronic mental disease, of a nature which leaves behind no pathological appearances.

(To be continued.)

On the various Forms of Mental Disorder, (being the Substance of Lectures Delivered at the York School of Medicine,) by DANIEL H. TUKE, M.D., Visiting Medical Officer to the York Retreat.

(Continued from page 246.)

In describing the symptoms arising from the derangement of the group of faculties last under consideration, namely, those termed moral, and with which man is specially endowed, as contrasted with the lower animals, it might have seemed natural to detail those morbid mental phenomena, which Prichard and others have so much dwelt upon when treating of moral insanity. But such a perverted condition of the moral sense is so almost invariably indicated, and often only discovered by the activity of the animal propensities, that it is more convenient to treat of it under the third class of mental disorders. It is likewise more consistent with our adopted principle of classification, which consists in referring each mental disorder to that group of faculties, the affection of which is essential to its manifestations. In homicidal mania, the animal propensities are of necessity called into action, whether the homicidal act be the result of their diseased action, in association with a healthy condition of the higher sentiments, or of their normal action when associated with, and therefore uncontrolled by, a state of the moral sense rendered powerless or feeble by disease; be it congenital or acquired, or the result of functional disorder or structural changes. We usually become cognizant of diseased mental conditions by positive, not by negative, symptoms; some overt act or explosion of passion will, in general, be the first proof of such disease of the moral sentiments, as involves their occlusion or inertness, when they ought to be in exercise. Should the disease be of such a nature as to increase the activity of these faculties, then we have an exhibition of religious excitement or ecstasy, a morbid condition already treated of.

That intellectual power, and the perception of moral truths do not necessarily exist in the same degree in the same person; that they do not always develop themselves pari passu, are propositions which, as the result of common observation, obtain general acceptance. But that there should be anything like congenital defect of the moral sense (anomia of

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Dr. Rush,) in conjunction with intellectual powers not strikingly deficient or even of superior quality, is a proposition not so generally recognised, nor so easily estabblished. It is obviously one which must be carefully considered in the description of mental diseases. With its medico-legal bearing we are not now concerned.

Many analogies subsist between the moral and intellectual faculties, and in many respects they may be observed to be under the influence of the same laws. The sentiments, no less than the intellect, are indicated by, or associated with, certain temperaments and physical signs; thus good nature usually co-exists with a sleek and fat habit of body. Virtuous and vicious tendencies would often appear to be hereditary; or, as congenital, are displayed from the earliest infancy, in children subjected to the same educational influences. The moral faculties may be either excited or depressed by disease. "Who has not seen," asks Dr. Rush, "instances of patients in acute diseases discovering degrees of benevolence and integrity that were not natural to them in the ordinary course of their lives?" Dreams affect the moral faculties as well as the intellect; under their influence we are benevolent, devotional, passionate, and affectionate, as well as imaginative and talkative.

Ray, after treating of mania as it affects the intellectual powers, proceeds to observe, that a more serious error can scarcely be committed than that of limiting its influence to them. "It will not be denied," he adds, "that the propensities and sentiments are also integral portions of our mental constitution; and no enlightened physiologist can doubt that their manifestations are dependent on the cerebral organism. Here, then, we have the only essential condition of insanity --a material structure connected with mental manifestations; and until it is satisfactorily proved that this structure enjoys a perfect immunity from morbid action, we are bound to believe that it is liable to disease, and consequently that the affective as well as the intellectual faculties are subject to derangement."* This writer cites from Hoffbauer the following unqualified assertion to the same effect: "It is clear," he says, "that mania may exist uncomplicated with mental delusion. It is, in fact, only a kind of moral exaltation (tollheit), a state in which the reason has lost its empire over the passions, and the actions by which they are manifested, to such a degree that the individual can neither repress the former, nor abstain from the latter. It does not

*Jurisprudence of Insanity, p. 163.

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