should die during the night. I foresaw a thousand dangers, fearing to go blind, or to break a leg or an arm simply in walking.

"A man in the enjoyment of natural thought occupies himself with many different and new ideas; he reads, and retains the sense or general impression of what he has read. If any idea does not suit him, he dismisses it, &c., but I cannot do so; I cannot rid myself of my constant ideas—death, the cemetery, the grave, God, and religious ideas."

The following is a remarkable passage:

"Deprived of natural thought, and of intelligent reflection-if I may so express it-I cannot have any consecutive idea; I cannot occupy myself with any given subject; I am not capable of a moment's attention. It is matter which has always thought within me.”

"What (says M. Baillarger) is all this but the automatism of dreaming transported into the waking state ?" He further describes himself as incapable of reading, or taking any interest in anything— "c'est comme l'eau qui passe sur la roche de la rivière."

"After passing a day in reading and studying, I asked myself what I had read. I knew nothing; nothing remained with me. One remark, or rather discovery, I have made, which is that I have never read, like others, with my head; but I have articulated inwardly the words, whilst my mind was incessantly occupied with a thousand irrelevant matters." "In attempting to recal a letter which I have writen, I must articulate word for word the phrases I have used, or the ideas themselves will not return." At last this process becomes necessary in conversation. "My thought, before being expressed in words, is formularised internally; do you understand that ?" Again: "There is in my chest or stomach as it were a tongue, which articulates internally. Ordinarily when one wishes to write a letter, the head thinks, the intellect is at work; but with me, the head is of no use: it is the stomach which is at work; c'est cette langue intérieure qui formule. I regret not to be able better to explain this sensation."

The next passage we present without translation:-

"Privé de cette pensée instinctive et naturelle à tout homme, je ne puis livrer mon esprit à aucune occupation, je ne suis capable d'aucune attention, ma pensée a changé de siége; tout n'est que matière chez moi, c'est la matière qui pense. Ma pensée gît, il me semble, à la poitrine, à l'estomac; je suis portée à croire qu'il y a chez moi une double pensée, car il s'opère en moi comme un controle; il y a comme un autre moi-même qui inspecte toutes mes actions, toutes mes paroles, comme un écho qui redit tout, et me représente constamment tout ce que je fais ou tout ce que je dis."

It remains (says M. Baillarger) to indicate the explanation which the patient gives of these phenomena. Instead of seeing in all which he felt a state of illness, he reproaches himself with having by his own fault deviated from the right way. "Little by little I discovered the frightful truth. My existence divides itself into two parts. I lived an ordinary life up to my seventeenth year; but at this epoch I went out of the place assigned me by nature. I followed a false path; j'ai compromis tout mon être moral.”

To prove more fully that he has lost his intellectual faculties, and that their functions are performed by the stomach, he says:—

"The proof that I have no intellectual thought is, that after having read or written a long time, my mind has never felt fatigued. I have been obliged to cease because my back pained me; the body, matter, demanded repose: but

the mind, thought, never." "A last proof of the same position is this, that if I possessed intellectual faculties I should go mad. A long time ago, when I was, or believed myself to be, in life, I had the idea, without any reason for it, that I should become insane. Now I know, that being deprived of intelleetnal faculties, I cannot become so."

M. Baillarger concludes thus:

"The patient had delirious ideas besides those of a hypochondriacal nature. He attributes to himself all unfortunate events; amongst others, the earth quake in 1839. He believed that he could never die, and that the most virulent poisons would be harmless to him. He imagined that every one was examining him, and speaking of him; he therefore avoided society. His affection was, in my opinion, hypochondriacal monomania, brought on by seminal discharges, by a debilitating regimen, and by severe study."

Practical Observations on the Domain of Psychiatry, with a Retrospect of the last Thirty Years. By Dr. STEINTHAL.

(From the Allegemeine Zeitschrift, 1855.)

DR. STEINTHAL commences by some general observations upon the increased attention bestowed upon mental affections on the Continent during late years, both by the profession and the public; the interest of the latter being evidenced by the vast increase of establishments both public and private for the care and treatment of the insane. Amongst those who by diligence, science, and a philosophic spirit have greatly contributed to the advancement of psychology, he mentions the names of Nasse, Jacobi, Jessen, Flemming, Ideler, Damerow, Bergmann, and many others. Still much remains to be done, and in particular, it is requisite to have a clearer definition of terms, as it appears that the specific forms of insanity have different meanings attached by different writers. Dr. S. considers the classification of Pinel, Reid, and Horn to be the most practically useful-Mania, Melancholy, Folly (ie., general perversion and weakness of the mental powers), and lastly, Fatuity (Blödsinn, i.e., abnormal asthenia of the intellect, palsy of the judgment).

If we enter more closely into the inner nature of insanity, it is recognised as an abnormal condition of Thought, of Feeling, and of Will. "Let us ask ourselves," says Dr. Jessen, "whereby we know that a man is insane. We must answer, we know that he speaks, behaves, and acts otherwise than we have known him to do; and as there is no other manifestation of the psychical life than through speech, behaviour (or disposition), and action, so these being abnormal we consider their source morbidly affected." On this Dr. Steinthal remarks, that however difficult it may be in some given case to distinguish between the somatic affection (mere hypochondria it may be) and the hypochondriacal melancholia already amounting to insanity, or between the mere moral defect and the actual mental aberration, yet the criteria in Dr. Jessen's simple exposition are clearly pointed out, by which we may distinguish insanity from all other diseases. Hence it is important not to found our judgment merely upon the condition of the patient at the time of examination, but to examine into

the minutest details of his previous life and conduct-a point often overlooked in judicial inquiries, and the neglect of which is productive of serious error and injury.

"Concerning the origin of insanity, no unanimity has been arrived at. Two hostile camps appear opposed to each other, called, according to their principles, the Somatic and the Psychical. The former party are much the more numerous. The principal supporters of the psychical or moral theory, Heinroth and Ideler, differ from each other only in this: that the former seeks the origin of insanity in general sinfulness and criminality; the latter, in excessive or disproportionate excitability. Amongst the supporters of the somatic theory, some consider that the brain, as the seat of thought and the source of action, is always and exclusively the seat and origin of insanity; others, that it may be produced by disease and suffering of any other organ. Acknowledging myself as one of this party, I must go a step further, according to my individual experience, and seek the chief source of insanity in affections of the abdominal viscera-acknowledging, however, that the abnormities of thought, feeling, and will have their dynamic seat in the brain. The overpowering majority of cases treated by me, induce me to attribute the origin of the affection to disease of the digestive organs, and the genital system in the female, and only in a proportionately small number to diseases of other organs, the brain included. Even in cases where, during life, it was scarcely possible to detect any physical anomaly; and when the most prominent reasons seemed to point to a psychical origin; the result of opening the body after death has announced the somatic source of the malady in a very unexpected manner."

In the remarks on proximate cause there is nothing of peculiar interest. Hereditary predisposition is mentioned as the most important, and as an illustration, the writer mentions that in one family he himself treated ten cases, and that four or five others were related to him. Under the head Prognosis, Dr. S., after alluding to the difference betwen public and private treatment, especially urges the necessity of never, under any circumstances, relinquishing the hope of cure. He considers, as to treatment, that there has been no advance, but rather the contrary, during the last thirty years-at least so far as medicine is concerned. He likewise enters a protest against the utter exclusion of all methods of coercion; and states, that in his hands, the happiest results have occasionally followed the judicious use of the strait jacket and the rotatory chair. On moral treatment, he says:"Decidedly I differ from those who would cure the really insane by so-called rational appeals, through religious representations, or methodistical religious practices. Scarcely a single case is known to me, where an evident insanity was checked in the bud by reason, by religious appeal, or by any direct psychical influence. It is quite different when the patient approaches convalescence."

He disapproves in toto of the water-cure for insanity-it only produces mischief.

Much stress is laid upon the direct and indirect somatic treatment, and upon the absolute and negative psychical influences. The general observations are concluded by a brief notice of quinine and opium as curative agents. The author has not generally found much benefit from them. The cases mentioned by Dr. S. are extremely interesting, but too lengthy for quotation. They are chiefly directed to the illustration of the somatic origin of affections of the mind, and in par

ticular to the important part which the diseases of the abdominal organs play in the production of aberration. The first is especially instructive, being the case of an old woman (sixty-two), who without any particular bodily affection, i.e., without any defined illness, became affected with melancholia passing into mania, apparently owing to mental trouble, grief, two unhappy marriages, and the like. There was no very especial bodily derangement accompanying the insanityit seemed a clear case of aberration, dependent purely on psychical causes-yet after death scarcely an organ in the body was found in a normal condition. It might be objected that these morbid changes were the cause of death, not of insanity; but most of them were evidently of long standing.

On the Causes of Insanity. By M. TRELAT.

(From the Annales Medico-Psychologiques, 1855.)

M. Trelat comments strongly upon the danger of concluding hastily upon the causes of insanity :

:

"A fact exists-we wish to know the cause. Why not take one, almost by chance, in the immense ocean of deceptions, of troubles, of torments of every kind, which agitate humanity! It is always easy to accuse the unknown. Misery is great, its privations are cruel; violence, ambition, love, envy, cause many and great sufferings! Is there not sufficient here to account for loss of reason?

We are not of this opinion; and although we occasionally recognise the influence of an unexpected disaster, of a great misfortune, a violent fear, a disappointment in love; of transports of jealousy, of an excessive abuse of the intellectual powers; we do not hesitate to consider madness from these causes as very rare exceptions.

Man has been placed in the world with a necessity for labour, with its trials and sorrows; he has received appropriate armour,-vigour, patience, and courage. Unhappiness is rife everywhere-it is the history of man. Strife, more or less painful, is the condition of his existence. Great and prolonged sufferings give a marked superiority to those who endure them. There is nothing more feeble and inefficient than the man who has never suffered. The most persistent adversity has its limits; courage has none.

"We believe much more in internal causes than in those which are without."

ILLUSTRATIONS.

"CASE 1.-S., æt. 36, falls upon his head, feels no inconvenience at the time, but four years later is seized with melancholia, which is attributed to the fall. On inquiry, it is found that there are three insane persons in his family.

"CASE 2.-Madame C., æt. 30, made an unhappy marriage, and suffered much sorrow. She showed symptoms of insanity, which rapidly increased. This was attributed by her friends and her medical adviser to her domestic troubles; but the first inquiries elicited the facts that her mother was insane, and her grandmother had been so.

"CASE 3.-A young English girl, living in Paris, was forsaken by a young man who had promised her marriage; she became insane. The victim inspired much interest; which, however, diminished, when it became known that long before this, she had taken to excess intoxicating liquors. This tendency was the result of a morbid state; she died consumptive,—her mother died insane.

"CASE 4.-Madame R., æt. 40, had passed a life full of care; the death of her husband threw herself and two young children into great sorrow and poverty. She was attacked with epilepsy and great mental derangement. She had an insane sister. Her daughter had many attacks of epilepsy. One of her nearest relatives was epileptic. It is in herself, not in her misfortunes, that the root of the evil is to be sought."

Many other, and even more striking cases are adduced to show that the cause of mental derangement is internal and personal, and not adventitious. The writer dwells at some length upon a very interesting series of four cases, females, who were all attacked with insanity, whilst fulfilling the same, or analogous functions, as superintendent of the insane in the prison of St. Lazare.

"This series of facts of the same nature, in the same place, in so short a time, calls forth very serious reflections. Does madness then propagate itself by imitation? Did not their chances progressively become less and less, by seeing the fate of their predecessors? If this be so, nothing can be more perilous to the reason than exercising any functions about the insane. Should not the physicians themselves be as liable to such attacks as the inferior officials?

"Observation does not support these views. Although these four, who seemed by their age, their physical health, and by every indication of a fine moral organization, to promise long and useful services, had been struck in so similar a manner, we must not be led away by the superficial appearance of

the facts.

"It was a pure coincidence-all these had had insane members in their families respectively-one, a sister; another, an aunt and a grandmother; the third, her mother; the fourth, many relatives. Two of the four had had previous attacks of insanity."

The circumstances in which these four persons were placed must, however, be considered as exciting causes, although there was a strong original or constitutional tendency.

"In pointing out the hereditary origin of insanity, we pretend to no novelty. Our examples are chosen from those which abound in insidious appearances, in causes sufficiently numerous and satisfying, to turn us from any further search. There is the danger. Distrust the first aspect of facts-if you only wish for probabilities, you may always have an abundant supply. Where is the man, whose life does not include a sum of sorrow, of misfortunes, or of deceptions, sufficient to explain, by the ordinary and received rules, any derangement of intelligence? Were the sentiments and intellect of man given to be unemployed? You make man of too little a stature.

"Labour, calamities, torments, persecutions; strife in all its forms-these are not the source of man's misery-they are his riches and the glory of his character. It is not here that is found the germ of deterioration and deathit is the germ of life and of development.

"The imbecile and the idiot, who do not strive-who think, feel, and suffer little-they have a short life. The intelligent and the strong, whose combat is rough, are generally gifted with long life."