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when we have pleasure from those acquired states of feeling, which we know are rather the perversion than the legitimate use of sensation Or, I might exemplify sensation as being positive in pleasure, negative in pain, and as being depraved when in a positive formula containing a negative result.
But with perception arises ideation, and in the process of acquiring experience, those faculties necessary for the use of whatever enters by the perception door; or in recapitulation, to quote from Mr. Morell, "In the sensational stage, the mind is least free, it acts as yet in immediate response to some physical impulse." "The second, or intuitional stage, the soul attaining somewhat more free activity, yet remains under the immediate influence of external realities." "The thing perceived, stands face to face with the percipient mind, and the latter wholly immersed in its object, exercises hardly any self consciousness or activity in the apprehension of it." "How can we possibly get beyond the sphere of intuition, or disentangle ourselves from the influence of subjective impressions? By a power by which we are enabled to recall our experiences, and afterwards to build upon them a still higher form of knowledge in the process of intellectual developement." These faculties, memory, imagination, association, language, &c., all playing upon the perceptive experience, give rise to the higher intelligences, for the faculty of conception, responding to the principle of causality and the desire for knowledge, raise man above the brute creation. We only can rise from the known to the unknown. Sensations are associated with perceptions, and with former sensations recalled by memory, and are compared with collateral experiences. The principle of causality with the imaginative powers, adds a creative energy to the reasoning powers, which, combined with the judgment, makes the intelligence of man. But this process, so easy in act, has many factors, and consequently many chances for error; and in daily life, thousands of instances of error do occur continually; but the incompatibility error intuitively causes it to be suspected, reconsidered and detected, makes correction easy, and keeps mankind in general accord; however, this is not always so. Conclusions,
the result of the higher faculties, will arise fixed, formed, and unimpeachable, leading to actions altogether in disaccord with these general known laws of mind, which govern the mass. These are delusions, and constitute the true mental symptoms of non compos mentis; as their stability is not compatible with the healthy action of the various intellectual faculties.
Now a little consideration of our experience will point out
that these erroneous intellectual actions, these "imaginary existences so entirely of mental origin," are, when analysed, but the mind seeking for, and endeavouring to explain its own sensations; that these delusions are but the conceptive powers interpreting its states of existence in a fantastic and extraordinary manner, and by processes of imagination, association, and judgment, not in accord with the constituted laws of mind or matter. Conception being a faculty, acting in certain states of the sensational mind, especially when these are on the negative side of existence, causes delusive ideation, entraining in its turn the general intelligence.
The faculty of renewing impressions of sensational consciousness, of sensibility, varies in each individual, and from its general distribution and intimate connection with the entire physical organization, does, when exalted and disturbed, act through the material organs upon the entire mind, even to its higher intellectual faculties. Hence arise emotions. These acutely experienced cœncestheses," (Noble,) malinterpreted (sensation can be only felt or interpreted, never perceived,) by the conceptive faculties answering falsely to the principle of causality, give delusions-the idée delirante, conception délirante. Thus sensation is more intimately connected with delusion than is the faculty of perception; but though the ground upon which delusion is raised is a morbid state of the higher faculties, they act upon sensation. Again, the elements of each of the three faculties, sensation, perception, and conception, exist in each of the morbid phenomena of illusion, hallucination, and delusion; for without there having been experience from previous perception, conception could not have been called in action; and without ideation and the previous action of the conceptive faculties, the perception could not have perceived what did not exist; yet, as I have before remarked, it is necessary, to prevent confusion, to have some definition of these terms whereby science may be rendered clearer, and our mutual understanding kept as perfect as possible. Nor is this incompatible; for who would deny the distinction between the a priori and a posteriori proofs of the divinity, because they mutually contain each other's element.
As the faculty of perception precedes in rise and development the higher faculties, so do we find, in the evolution of insanity, that illusions and hallucination, as the rule, precede the fixed delusion; that they are more especially the phenomena of the acute stages, and that, as earlier stages of mania sympathising with the body, they are more especially the
phenomena of general disease; and as such are not such grave prognostic signs as are delusions, the morbid action of the higher faculties.
Again, as the faculty of perception is lower in scale than conception, we can understand that illusions and hallucinations may exist, and yet in their effects, &c. be corrected by the higher powers, and therefore be quite compatible with sanity. (M. Lelut's researches are admirable exemplifications of this.) They are, therefore, in themselves not proofs of insanity; though when they are not corrected, and when the higher faculties do not withhold their assent, but build delusions upon the illusions and hallucinations arising from faulty perception, they become additional proofs of the aberration of the intellectual faculties.
We ought not then to err in the use of these terms; indeed, I can conceive no case, where, upon the above principles, not only a name may not be given to the mental action, but at the same time with the name may not be assigned its locality in the category of our intellectual faculties.
Statistics of Insanity, being a Decennial Report of Bethlem Hospital, from 1846 to 1855 inclusive. By W. CHARLES HOOD, M.D., Resident Physician of Bethlem Hospital, &c., &c., &c., pp. 121.
There can scarcely be a surer sign of the importance attached to scientific statistics, than the anxiety with which they are received, and the estimation in which, if worthy, they are held. And this proceeds not from mere curiosity or the pleasure of gratifying a speculative philosophy, but rather, as we hope and believe, from that pure, unquenchable love of truth which belongs to our better nature. Figures, like facts," are stubborn things," and herein lies their value. They plead with a force of their own, neither requiring the sophistry of words nor the skilful arguments of a logician, yet oft refuting the propositions of reasoners, and withal not to be gainsaid. It follows, then, that whosoever undertakes to collate and frame evidence of this description, superimposes on himself responsibilities of no slight or trivial nature. Statistics of life and death, of health and
disease, will ever have the highest claim on our attention. Life and the means of its enjoyment, and health, which constitutes its most important element, are subjects we can never tire of studying; and death, with its sad presage, we are equally concerned to know. But "life is short, and science is full long;" and did we each wait for our individual experience to bear fruit, or had we always to forge our own weapons to combat with disease, we might almost despair of success. Happily the accumulation of facts, the experience of years, the golden fruit of time, is not suffered to fall to the ground, and we find not a few engaged in their season, collecting and storing up these precious memorials for the benefit of all posterity.
In 1845, Dr. Thurman, then superintendent of the Friends' Retreat, published a comprehensive work on the Statistics of Insanity. In 1848, we have, among other similar productions, a well prepared Treatise on the Statistics of the Bloomingdale Asylum, U.S., by Dr. Earle, physician to that institution. A former Treatise by Dr. Hood, on the Statistics of Insanity in relation to Criminal Lunacy, has been much surpassed by the present subject of our review. On the principle that figures speak for themselves, we shall make frequent extracts, with short comments thereon, that the reader may form his own opinion as to the merit of the work in question. It may not be generally known that the rules of admission at Bethlem Hospital are far more stringent than at most other public asylums. The patients, with some exceptions (we do not allude to the criminal lunatics,) are not retained under treatment above a year. The result of this regulation must necessarily affect the evidence derived from statistics, as a reliable source of information. Thus we learn from Esquirol, as cited by Dr. Hood, "Of 2005 patients, who agreed in nothing except in being cases which were presumed to be curable, 604 recovered during the first year, 497 in the second, 71 in the third, and 46 in succeeding years. The numbers cured in the second year, as compared with those in the first year, are nearly as 5 to 6; sometimes even more patients were cured in the second year than in the first." Out of 2445 admissions into Bethlem, between the years 1819 and 1833, 385 were improper cases, hence the proper admissions numbered 2060. Of these $1124 were cured within the first year, and 643 were discharged uncured at the end of this time.' The following table shews the number of paticuts admitted as curable during the ten years ending 1855:
Ten years at St. Luke's Hospital from 1846 to 1855 inclusive, gives the following proportion, which we insert for comparison with the preceding.
In regard to the influence of age, Dr. Thurnam has stated that "the liability to insanity is nearly twice as great from 30 to 40, as from 50 to 60, and much more than twice as great at any age subsequent to 60." It seems that the largest number of admissions at the Friend's Retreat are between the ages of 20 and 30." At Bethlem, our author shews "the number admitted between 20 and 30, and 30 and 40, are nearly the same; 739 being admitted in the former period, and 759, an increase of 20 in the latter; and, after 40, there is a gradual decrease in the number for each quinquennial period, 284, 242, 204, 135, 110, 72.” ding to most authorities, we find the younger the patient, cæteris paribus, so much the greater hope for recovery. As age advances, Dr. Thurnam considers the chances of recovery are proportionably diminished, and Dr. Hood states "the mortality as a rule increases rapidly with age.' Great discrepancy of opinion has existed between celebrated mental physicians on the subject of sex; thus, Esquirol believed women were a little more subject to insanity than men;" but it has been shewn that he argued from false premises, having based his observations on incorrect data, the average number of females being greater than males in the general population. "The number of recoveries is greater in women than in men, and the deaths are nearly 50 per cent. higher in men than women: it is therefore evident, that to compare the single number of cases existing at any time, would give