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Mapa, plataa. charta, ate, may ba filmad at diffarant raductlon ratioa. Thoaa too larga to ba antiraly includad In ona axpoaura ara filmad baglnning in tha uppar laft hand cornar, laft to right and top to bottom, aa many framaa as raquirad. Tha following diagrama lllustrata tha mathod: Las cartas, pianchas, tableaux, ate, pauvant Atra filmto A daa taux da rMuction diff Grants. Loraqua la document eat trop grand pour Atre reprodult en un seui ciichA, 11 est film* A partir da I'anghi supArlaur gauche, de gauche h droite, et de haut en has, en prenant la nombre d'Imagea nicaaaaira. Lea diagrammes suivanta illuatrant ia mAthode. irrata to peiure. in A 1 2 3 32X 1 2 3 4 5 6 iij!-::^* MS 'i*mi*^*< AN ESSAY OH MADNESSf COHTAnmO THS OUTUItKS or A NEW THEORY. BY ROBEirr SPEAB^ SAomoK uttt ucBiTMn or mkoicihi, ov tri minmtrn o» OkMniWttt wwan or 1 a* Mt ai> oobuca «r raTswiuif . iomwm TORONTO: -H: & W. R0W8ELL. al- Ht AN ESSAY y OS MADNESS CONTAIMKQ THE OUTLINES OF A NEW THEORY. BY ROBERT SPEAR, •AOHILOK AND MCBMTUTB OF MEDIl'INE, OF THB UMVBR9ITY OF CtMBRIDOP.t MKHIIKk OP THI ROYAL COLLKGB OF PHYSICIANS, LONDON TORONTO : H. & W. ROWSELL. 1844. // ///.^ P-^^ '^^■'^■O f^ 4'^-<^, ROW8KLLB AND TnOMPSON, PRINTEBE. f AN ESSAY ON MADNESS. 1. My object in this essay is not to consider the peculiarities of one madness from another, except in so far as such considerations may lead to the solution of the question, What is the nature of a mad fit ? and when madness in a man is mentioned, unless otherwise expressed, the actual invasion of a mad fit is meant, and not a latent madness, as in a madman asleep, or talking rationally and acting with propriety and in concert with sane men. A latent madness would appear to refer, either to the bodily type of the disease supposed to be running on, but masked ; or to the very high probability that -). particular man is in a fit state, and from the slightest exciting cause, to shew madness. For it by no means follows, that because a man is mad all his discourse is absurd, or that all his actions indicate madness : he is reasonable enough at times, and on certain subjects ; and when they alone are before his mind, he will often shew discrimination and accuracy in his discourse ; or if they lead to B 3 action, ho will art liko other nuMi. It may sur- prise us that a nuuhuan shouUl have tliis power, that ho should he ahle to think on any other suhject than tho one on which he is heside him- self ; that he shouUl, for instaniu;, (mo moment consider himself misorahle in hell, and shortly after he talking roasonahly with those ahout him, and actin«r in many respects as they do ; or that his com})ani(ms or keepers should ho able, by barely introducing other subjects, to lead him off from tho consciousness of torments which a moment ajifo ho considered real and everlasting. Still, if wc consider our own ideas and feelings, how the most pleasant and painful of them make way for others to which wo are indifferent ; how the most delightful and bitter passions have their ebb as well as flow ; and that the mind appears subject to a law which renders it unable to fix itself for any considerable time to the contemplation of one invariable idea ; then perhaps wc may bo able to conceive how it is that madness should become latent in a man, and that ho should appear to be free from his madness for a while. This state to which wo have alluded, must not be confounded with that in which the disorder has disappeared or is over-ruled for a time, and in which the mind is itself again ; for if such an one wore mad because he conceived himself to be imperatively called on to kill his neighbour or himself, ho is then sane when he considers J i 8U(^h a niunlrr jis luijustitinblo arnl with ropnjnr- nnnco, and vvhcni all his actioii>< iiulicatc a drtcr- miiuul and altogether sufficient Helt'-[)()ssesai()n. Tau<,dit by experiijnco, however, that such is not in very many eases a durable sanity, so when it terminates, or when it is supposed that it will tenninate in another tit of madness, it is called a lucid interval. A true lucid interval from madness (as from an incurable epilepsy) cannot therefore be con- sidered as the same with a perfect sanity, and also it differs from a latent madness : it is some- where between these. These states, however, in pfreat measure depend on the physical consti- tution of the mind, which is unknown. 2. Whatever amount of injury a man's body may have received, or whatever natural defect thereof may exist, the diaj^nostic mark of mad- ness is not looked for cith(»r in the one or in the other, but in the actions sprinj[»in«]^ from, or imparted throut^h the mind : hence madness cannot be traced in infants. Moreover all obser- vations prove, that a man must have exercised his mind rightly before he can shew madness, and in this it differs from idiocy. A natural defect of parts may in one human being give idiocy, but the same natural defect of parts in the same human being cannot also give madness ; to produce this, other influences must be added which are acquired, and which are developed in the man at a stated period of his existence, and wo thereforo iissumo that idiocy and madnosa differ in kind one from the other. 3. As in the sane mind we have the two ehief powers of the unders ndin^ and the will, so also we have a dorangcntent of the under- standing and a derangement of the will. This two-fold division of the disorders of the mind appears, in a medico-legal sense at least, to he requisite and sufficient. For the ideas in a man*s understanding may be so few, or his associations of them so arbitrary and peculiar, or the signs or terms he makes use of, so mis- applied, or his identity so lost sight of, or con- founded with another person, thing, or quality, that he cannot perform ordinary matters, or discourse rationally, or distinguish between what he is and what he is not, or between that which is real and fantastical, and therefore is con- sidered incapable of managing his own affairs ; or on the other hand he may have lost all con- trol over his volitions, and the impulses to unlawful actions may be paramount or irre- sistible. But this division evidently includes other disorders, so called, of the mind, besides mad- ness ; therefore a little further insight is required, that we may understand in what madness con- sists, and in what respects it differs from other actions of the mind apparently allied to it. 4. It is not the existence of an idea or doc- trine in the mind, however vague, extravagant. ' bad, or falso, '.vhich ((uistilutt's niadiu'ss. To tliis must 1)0 added, discourses or conduct tvliich, 8|)rin^in^ from sucli idea or doctrine, jinivcs tlio hold of citluT on tlio mind and actions of the man, to be the result of conHrmed disease, over the manifestations of which he has no control. If this be 8o, it will be useless for us (following others) to look for madness in a man's under- standing alone. For example, suppose first, a man who believes that he perceives an apparition, yet his mind is sufficiently itself, to counteract the influence of that apparition on his conduct, !=ince he is aware that it is only perceived by himself, and more- over ho is assured by his other senses that t\w. apparition has no external reality ; still the sen- sation or phantasm, from some alteration in the brain, or from some irregular motions in it, is at times present, although ]vi is convinced that the object is brain-real merely. Let us suppose, secondly — thot the man feels assured of the reality and exkcrnal v^xistence of that phantasm ; that he flies from it, is caught by it, converses with it, as it may happen. In the first supposi- tion the man was not mad ; that is, so long as his mind had suflicicnt power to consider the phantasm as the result of some bodily infirmity ; but in the second supposition he was mad — that is, when this power failed him, and when con- sidering the object as external and present ho acted accordingly. . . 6 So a man who in his roasonin<Ts draws cM>n- I'lusions which contradict the knowlcdjj^o of mankind, or which contradict those principles which the man himself previously allowed, is judged to be mad only when his actions indicate derangement. And when a man's reascmings have an immediate reference to action, and con- tradict our perceptions and belief of things — if his will be uninfluenced by his doctrines — if he act precisely like other men — we make no ques- tion of his perfect sanity ; and although ho demonstrates that there can be no motion or matter, time or space, good or evil, mind or idea, &c., in the world, still it suits him to act as if all these things did exist : it ib only when a man's actions coincide with such doctrines that he is considered to be insane. Occasionally we find that a man has such obstinately rooted belief in his own absurd fancies or principles, that it is impossible to divest him of it. And it mav be asked, how he is to be distinguished from a madman who holds the same doctrines ? The difference between them consists in this, that such belief in the mind of the former, has some restraints over it which are derived from other determinations of the mind influencing the will, and by these the man is enabled to keep his belief within such limits, as to prevent its determining, on all occa- sions when it mav be before him, that sort of action which it requires of him : he is from first to last * aware that lie views some things difFerently from other men, and he is also able to perceive those things as other men perceive them ; and with this knowledge he curbs his volitions, and he acts in a sort of medium, giving some deference to the opinions of others, and reserving to him- self at C(mvenicnt opportunities to let loose the full flow of action which his belief sanctions. But a man who can so bend to the opinions of others, how extravagant soever his belief, having perfect command over the enunciation of that belief and over the actions which it entails, knowingly differing from other men, and seeing well enough his own peculiarities, cannot be a madman ; unless indeed a man can assume a fit of madness and throw it off" again at will, which is scarcely to be conceived, and which, if our theory be correct, cannot be in the power of any one unaided to accomplish, who is not either on the very verge of madness, or at the precise period of his release from it ; and then, and in either case, it would be the product of new or altered motions going on in the body, which would have gone on and established or blotted out madness, if the man at the time had been thinking on something else, or had been asleep and not thinking at all. Locke strongly insists on madness being the result of wrong associations in the mind, brought about bv custom or bv chance, and which are Jooked on as naturally and truly connected — that 8 in this way fallacies are taken for truths, and fancies for realities. But whatever wrong asso- ciations the had or the good, the ignorant or the learned man, may possess, they have not, neither are they considered to have, the same sort of force which they have in the insane. Moreover very many wrong associations give way, and the mind forgets them in madness, and the cha- racter is changed ; also in other cases the asso- ciations were produced at the same time with madness, and are not recollected after recovery. And in the example given by Locke of a wrong association, where a madman takes himself to be a king, and acts as if he were a king, it will surely be allowed, that were we to do all in our power to make this a right association, by placing him on a throne, he would continue to be a madman still. Giving then to wrong or sudden and overpowering associations their ful- lest scope in some cases of madness, we have still to account both for the change in the sensations and character of the man, and also for that loss of power in the mind to think on other and wonted objects ; in other words we still have madness to account for. Thus, a mother from the death of her child becomes at once insane ; she perpetually raves about it, nor has she apparently any power to think on other ideas, or to notice objects ; her dearest relations are as strangers before her, and her volitions may have reference to her dead and buried 9 i'h\]([ as talkiniT to it, rnrossinir it,, surkling it, layin<r it out, &c. Ask ]u;r to porforni other actions, and sho appears as much at a loss as if she were hiborin^ under a paralysis, or under a total forj^etfulness of the world without her : this is not a great sorrow, or the association of a present sufferin*^ with previous joys, for were her child brought to life again and placed before her she would not know it. In such a case there is an insensibility to impressions, which can only be accounted for by the mind's having lost its directive power ; it still thinks, but it thinks in one direction, and all objects appear as if viewed through one medium. Again, a man may be at issue with the rest of mankind on a particular belief or association, and for all that he may be considered sane. Thus the mayor of Queensborough, a man of learning and a friend of Locke's, took himself to be the same person with Socrates of old. Still how could a plea of madness be founded on this most extravagant belief, if he thought and acted judiciously in his capacity as mayor of Queens- borough, and was not constrained by his belief to go back two thousand and odd years for the sake of adopting the life and death which hap- pened to Socrates ? It is reported of the great Pascal, that from a sudden fright, he afterwards at intc^'vals during his life had the sensation of a precipice on one side of him, nor was he for the time at ease till he had placed his chair, or his c 10 foot, wlioiH! tlio pri'oipico ap])oarp(l. This associa- tion Pascal had sufficient command over himself to correct, and it did not in other respects influence his conduct or actions.* These examples will suffice to show, that a man with wr(m<,^ associations merely, is still linked with the rest of his fellows, who on some subjects are all of them })rcjudiced ; hut a madman while in his fit is a man apart, incajjahle of raticmally discoursing, or of acting in harmony with the wise or with the foolish on the subject of his madness. In fine, there are many eases in which the manifestations of madness are so directly tand indisputably connected with physical causes, that there can be no suspicion of wrong associations having had any sh.arc in their production. Thus insanity of (me or other sort often results from injuries to the head, from the so-called metastasis of diseases to the brain, from the suppression of an habitual discharge, from the operation of cer- tain medicines, from the puerperal state, from exposure at sea to the strong heat of a tropical sun — as in the madness termed calenture, and * One of tlic most extraordinary niathcinaticians that jK'rhaps over took a senior wrangler's degree at Cambridge, told me that he was puzzled how to get rid of an odd asaoeiation that he often had while over his books and at other times, viz. — of driving a coaeh and four. The same assoeiation has been known to exist in a mad- man : the whole eonduct was influeneed by it ; it was not only a sort of belief but a reality ; and he went about the streets chirping and whistling to his horses — now drawing liis reins on tliis side, now on the other, and thus walking, convinced that he was driving his coach and four. 11 mor(5 rarely from some unknown constitution of the air rendcrintr it epidemic, as mentioned by Morgani, &c. Further, we may suppose the understanding in a man to be in a state of integrity, or secondarily aifibeted, and yet that man may be mad ; because he may have lost the power to turn his mind from one thought to another thought, to do or to forbear from doing particular actions ; and he may be constrained to think on a ])articular thought, and to do a particular action. So if one idea be exelu- siyely or for the most part the subjt^ct of a man's discourse — if he cannot turn his mind to the con- templation of other ideas or objects, but is ever and anon harping on that one idea, associating it with the circumstances of each moment, and of every place — he would be mad. So also if those actions which the sane man can, save in extreme cases, conmiand the doing or not doing, such as eating, drinking, or the actions ])roceed- ing from anger, f(»ar, lust, &c. ; if any one of these be indulged in beyond all measure of con- trol — if the will be rivetted to the performance of any one of them day ift(^r day, at intervals, and in all places alike — tliat man would be mad ; for in either case the man is unable to ])erceive objects disassociated from that particular object which occupies in chief his consciousness — the only power which could unsbackle, so to speak, his consciousness, so that lu^ might perceive other objects of sense or of memory disassociated n from thsit one, is held duriiifr the fit sulvjocfc to that Olio ohjcct ; all his discourse runs on it, and it is the only standard oT ideas, whether real or unreal, and of jictions, whether good or bad ; it is for him an object of sense, because objects of sense appear to tally with it, and to be related to it ; or it is a familiar friend, taken as an enemy ; or it is the thunders or the hapi)iness of heaviiii within and about him ; because he has no power to rid himself of that aii^er or fear, or reli'iious enthusiasm, which one or other, as it may hap- pen, draws as into a vortex all other objects. Nay, oftentimes, according to the object which has fastened on the madman's consciousness, his bodily state is lost sight of, he is a dead man or a murderer, &c. ; the idea has giv(m its peculiar coloring to every object without him, and to every idea in his memory ; hence any other object is either not noticed, or if noticed is con- sidered as part of that idea, or train of ideas, from the contemplation of which his mind has no power to shift his consciousness ; he must inevitably then, if he perceive other things at all, perceive them as forming part of or associated with that idea which c(mstitutes for the time his conscious self; and some of these things have often been observed in a well-marked fit of mad- ness. Still further, and very analogmis to, and often conjoined with the last-mentioned forms of mad- ness, is one long-continued and unvaried bodily l.'i IV action (the body l)i!in<> in an apimrently lioalthy state) : the man stands or sits, or lies down stock still, or he looks in one direction, or listens as if to one sound ; or thinking on an object, he keeps it with a tight grasp ; or he ])erfornis one feat, or sets himself to accomplish one particular Avork, unmeaning or otherwise ; and at times and in cases the actions whith the thoughts of the mad- man entail are full of dangei", being bent on nmrder, theft, destructiim of proi)erty, &c. in all these and the like cases the lixitv of the will » a})peai's to extend ecpially over the madman's ideas and over his voluntary actions. Moreover, the understanding appears to be secondarily affectcul, in other cases of madness opposed to the above ; and instead of the mind being fixed, and immovable as it wore, it cannot fix itself tm any one or other contemplation, but is in per})etual motion and rapid change from one idea to another idea, and the man's discourse is altogether inct)herent, or at any rate perfectly unintelligible to others. With this sort of dis- course co-exists a corres})onding sort of other bodily actions : for the most part, he is unstable as water ; he is all in a hurry — runs one way, stops short, then back again ; begins an action, then leaves it off, goes to it again — again to do something else, and so on perpetually. If you can get him to do anything for you, as for instance to j)ut out his tongue, it will be thrust out and drawn back again in a twinkling, and so 11. on for tliroo or tour times ; j^ot him to lio down, and in a moment ho will bb on his Icj^s again, discoursing or acting characteristically as before. 5. What, then, characterises a fit of madness of any sort ? We have to guide us ( 1 ), The irre- sistible hold of consciousness to some object or objects in the mind ; and ('2), in the same, or in other cases, the irresistible impulse in the mind to perform some bodily action or actions : or, and just the opposite of both these, wc have (3), in other cases, the total incapacity of con- sciousness to fix itself to the contemplation of any object ; and (4), the total incapacity in the mind to order the performance of bodily actions to any definite purpose. In ca(;h of these there is an act by or through a faulty organ of the will ; for the will is well defined by Locke •' that power which the mind has to order the con- sideration of any idea, or the forbearing to con- sider it, or to prefer the motion of any part of the body to its rest, and vice versa." Wc conclude that the organ of this power in the madman's fit is in fault ; and this theorv we also reduce to practice in the moral treatment, for we do not endeavour to reason him out of his madness, but we endeavour to act on the will to direct it, by imparting to it an easy compliance, or a requiste fixity, as the case may require.- This theory is also, and justly, acted up to among the most civilised nations ; for he who is mad is not held accountable for those his actions \r, which prorord from msulnoss, for thoso siro sup- posed to arise from an unlioalthy eoiulition of his physical beinjjf, arrivo<l at that dc<^reo of inten- sity, that it acts on and •••ovcu'ns the will ; they are not supposed to arise; from the depravity or purity of his moral [)rincii)les, or fnmi the deli- berate choice t)f evil or of "jfood. And if, as in many cases (the disease sictintr in a determinate way on the mind), the madman is under the influence of a sui)posed divine law, or a law of his own heinjf, requiring him to do an act, which he does — an act which the laws of his country, by the strongest punishments, forbid — he is not held responsible for the act under such influence committed, because he by or through the disease has such volitions forced on him, and is at the time totally unconscious of, or totally unable to keep the true laws of God, find of his country, and of opinion, &c., and thus is deemed for the action amenable to none of these. For all laws, and in each case of their applica- tion, must appeal to principles of action under the command of the man hiniself, without which he is no more to be punished for not keeping them than a blind man is punishable for not seeing, or a paralytic in his limbs for not walking, &c. ; this being so, it is evident thsit a madman in his fit is either altogether removed out of the pale of criminal laws, or if not he must be judged either by those supposed, and to him imperative laws, occasioned by the disease, which determine If) hh net ions in tlic fit — or by tliosc bad bnlnts to wliich In somo cnsos wo cini tnur the first syni))- tonis, jind at'tcr incrc.nso of ilisordor in tlic mind, jis drnnkonncss, dissipation, &c. If bo bo jud<jf<Hl by tbo fornior, bo vvoubl bo dooniod (rul])nblo, bocauso bo had brokon a biw wliicli tbo disoase had rondcTod him for tbo timo totally unablo to fulfil ; if by the othor, thon ho can (mly bo pun- h\u)i\ by those; punisbmonts siwardod to those bad habits which occasioned the disease, and for which the disease itself is considered a suflrtciont punishment. Society, therefore, placing- itself in opposition to the law which in such cases deter- mines the madman's actions, incarcerates him to prevent further mischief ; and not as a criminal, or to deter others from crime, for as an example it would have no force, seein*^ that others could not place themselves in the condition of madness. And hence, if a criminal, after conviction for a capital offence, become a lunatic, he is not executed. 6. All of those causes* which conspire to produce madness and other disorders of the * Ilcroditary niadiioss is a somewhiit coTiiplioatcd subject, and it is not very easy to (liid out its true value, Tliis, atany rate, umy be »iken for granted, — tliat it is illogical to eonclude, because six out of ten individuals, horn of parents who liad been insane, become at certain ages insane, that all these are to be considered as eases of hereditary insanity; unless it can he proved, either that those individuals were not aware o<'the insanity of their parents — or that, being aware of it, they did not regard it as prejudicial to theinselvi's — or that the knowledge of the supposed iiiet (that the insanity of thi' parent increases the eluintes of insanity in the 47 m hid, can only ho contrived of as actin<> on it through tlic inodiuni of its orjran ; and our ideas result from those impressions on this or<;an, which the mind is const ions of. Pure ])o\vers of the udnd, the understaiulin;^' and tlu? will, we lose sioht of, apart from those ohjects which solicit them ; it is accordinjjf to these ohjoets, and to their inlluenee, that a man is learned or ignorant, jiood or had, sam^ or insane. We cannot conceive! of these powers heino' altered in their nature hv disease, nor vet hv anv other • • • • ])hysical causes. 1 hey must he for us that offspring), nnd tJic (Irt'ad which, for the most part, accompanies it, has no sort of inHuciicc in the j)ro(liictioii of insanity — or, that those excitiiif^ causi s wliicii might j)r()tiuct! it in otiicrs, were absent in tliese. Hut this last case can scarcely liappen, because the doctrine of hereditary insanity fosters tlie very strongest of tiiest! exciting caiisi'S. Many of the cases spoken of by authors as liereditary, seem to carry great doubt witii them ; thus, a daughter goes n>ad at the precise age at which lier mother went nuid. And, again, in a largo tiimily, in whicii insanity is supposed to be here- ditary, we ofU'ii fuid, that tlie first individual afflicted is quickly followed by two, tlwce, or live cases more. Again, it is supposed that if the insanity be on liie side t)f tlie mother, the sons escape; and, if on the side of tlie father, the daughters escape. And so we have more daughtirs insane, when their mother has been so; and more sons when the insanity was on the father's side. IJut, does not this look like a popular prejutliee ? We well know how injurious an influence any idea of a melancholy cast fixed in the mind, and reverted to day by day, has over us. And yet physicians give out to the world that the chances are greatly in favour of the children beeoiiiiiig insane, when their parents have been so. Thus, n sanction, and a seiciititie foundation (as it were) is given to their fears of the distase. And so, when one of a liuiiily in which this hereditary disjiDsitiun is siipi>iisi'd lidls mad, «)thers in the same family quickly follow ; for all of them liavo been taught that if is in their blood, and that, it' they tlo not become insane, tlicy are the excepti(>ns to a general nde. D 18 power whirli i> coiiscitms, ami that powrr wliicli (liri'i'ts or wills. IJiit tin- objects wliicli coiiio bct'on' tlu'sc i)owors may oithrr ho such that the mind is rendered unconsciiuia by them, or tht-y may have that appeafance to, and that influence over, the mind, which they have not in a |)ropiM ly workinj,' and sane organ of the min<l. Hv m (u*i •- xions, then, on the brain, not only are tlir powers of the understandni«r and the will drawn into action, but often the brain receives actions which militate a«jfainst, or even de<^^roy percej)tion ; and volitions. Thus, in a fit of epilepsy, the mind is api)arently unconscious. J t is reported of a } oung and learned Englishman, that after his recovery from a fever, he had forgotten all his Latin, which language before the fever he knew per- fectly (at the same time his knowledge of the English language remained unimpaired) ; at the end of the third week, and all at once, his know- ledge of Latin returned. So some idiots have recovered their knowledge during a fever, and when the fever has ended, their idiocy, in many cases, has returned. Other persons have, during a fever, spoken in a language which when children they were familiar with, but which they had appa- rentlv to themsclvo^^ ana to others lonjj since forgotten, and vhki' i. genera ij again forget when the fever declines. And some madmen, when attacked by another disorder, have at once become sane. Again, bodily actions of which we are not immediatelv conscious, alter the mind 19 frorii (lav to (Uv : and in tmr \\;ilk thnmi:li life, fVoiii tlio rnnllc tt) iho ynivi', \mu\\ k>\' our desires, MHSociations, fcflinifs, ploiisuros, >\v., jiit <liiin«;t'dj and others arise by the pliiy ot bodily aetioiis and independently oC any volition or idea on part; for facts like thes<\ we call ^ivo tto otKer n'jison than onr experience that we are mm con- stituted and so traiisrornied. These examples shew that certain species of actions arr and y r. sist in the oriran of the mind, of whirli >t is n'H conscious, which are w»t ideas — therelorc that tliis or^'^an possesses a receptive, different fnWi the mind's perceptive p iwer; the former may not cmly receive an acti<m v\' which the mind is*, hut also (me of wliich it is not conscious ; it may receive an uncons( iwus . ction, which may add jjreatly to the mind's stock of knowledj^e, or which may make the mind almost a blank. Now, is it in certain cases, is re«(ards the orj^an of the mind, as we cxperieiue it to be in other parts of the body ? For insumce, an unsha(;kled limb which docs not move when we will that it should move, is said for the time to be paralysed; or a limb which will not follow our volitions, and keep at rest, but continues to move, by virtue of voluntary muscles, any way as it may happen, is said to be convulsed. Is it also in some disorders of the mind, that the or^jfan by which it works, and of the impr.'ssions on which it is at times conscious, is paralyzed or convulsed, or somethinjjf similar ? Indeed, in insanitv, the 'iO *' I cannot think on a ])articular ihoviglit," or th»' " 1 cannot do a particular action," would a])pcar to approach somewhat to a jiaralysis ; and tho '* I must think on a giton thought," or tho " I must do a given action," wouhl a})pcar in some respects analogous to a convulsion. Thus, in tlie famous and often repeated ex])erinu'nt of Majendie : he cut down on a determinate part of the hrain in a living animal, and forthwith it ran round and round till it was held still or exhausted. In what respect does this action differ from the irresistihle impulse in the madman, to perform Jl particul.ar action ? So in chorea, the mind can- not achieve through voluntarv muscles wonted actions, nor yet can it put a stop to the convul- sions; so, in incoherent insanity, the mind cannot fix itself on any contemplation. Further, the complication of many, the worst cases of mad- ness, with paralysis, epile])sy, and other convulsive disorders, seems to point to the conclusion, that there is between them all an intimate connexion ; and that they are, in all probability, the results of similar disordered actions in different parts of the nervous organs. 7. Again : in our passions different bodily actions, which indirectly solicit consciousness, have ])lay ; which actions, ac((»rding to their peculiar nature, render one man |)rr)ne to anger, another to fear; (me to lust, another to chastitv, tVc. Nor can the angry man, l)y willing it, change places with the pusillanimous man, and 21 become a coward ; nor the coward become coura- j»eous ; nor the chaste man lustful ; nor the histful chaste ; so lonf^ as tliat state of ])ody endurt^s, on which each passion in orcat measure depends. These bodily actions constitute the in^ voluntary part of our ])assions. But we are angry, for some reason, with one or other object present to the mind's consciousness, which we are inclined to hurt or to destroy. In like manner, we fear, for some reason, one or other object, from which wo anticipate injury or destruction. The volun- tary part of our passions arises out of both these ; and the angry man will attack his foe, and the coward will run away, or be fascinated. These and other passions exist both in the sane and in the insane ; for both are angry, fearful, lustful, &c. ; but the sane man can for the most part command his passions, and he is continent or incontinent, temperate or i'ntempe- rate, according to that degree of command which he imposes over them. Whereas, in the mad- man, the bodily action is so int^ense that, while under its influence, he is like one possessed. — Thus, he starts from a sleep or a reverie, or at the sight of a person or thing, or for a trivial remark or circumstance, with his bodv fraught w 1th those actions which are peculiar to him who is angry, fearful, lustful, &c, ; and any object before the mind arrests and fastens on the will, and the impulse to consummate the particular passion becomes irresistible. And the madman '22 perhaps, like Ajax, kills a flock of sheep, taking them for his enemies ; or rushes with rage on his dearest friend, ^c. ; or is horror-struck by some imaginary, that is, brain-real objects ; or is fearfully persuaded that heaven and mankind are leagued against him, &c. ; • he is lost in the fury of a satyriasis or nymphomania, &c. It is not, however, said that the madman is intem- perate on account of these things, because he has no power to be temperate, and no preference for intemperance ; the will is led captive. Doubtless there are many other disorders in which the will is constrained to particular voli- tions. He who is suffering under a severe peri- tonitis, or asthma, or painful ophthalmia, &c., is forced to perform certain actions by voluntary muscles ; and it is just as much out of a man's power in the first of these diseases to walk erect — or, in the second, to breathe at ease — or, in the third, to look at an object in a strong light stedfastly — as it is out of the madman's power, in the fury of the disorder, to think or to act in opposition to that madness which at the time oppresses him : and, as in the bodily disorder, we note as symptoms the results of such volitions; so, in the mental disorder, we note as symptoms the volitions themselves, expressed or acted up to. 8. A madman's actions, then, so far as his madness extends, are involuntarv ; but not in the same sense that a sane and healthv man's actions are sometimes so. For what the sane Q3 man does, lu; does for the most part voluntarily ; but otlier things wliich he cannot command, or is ignorant of, mar the result, — as when a fond parent permanently injures his child by a slight chastisement — as when a man who has under- taken a journey falls and is crippled by the way — as when one taking his accustomed food ia (;hoked thennvilh, &c. But a madman''s actions, in the commencement, and as regards the causes which produce them, are involuntary. Thus, one of them, foreseeing the return of a fit, exhorts his friends to get out of the way or to strap him down, or he straps himself down, in the horrid conviction that otherwise he may k II some of them : thus, another taking himself to be a dead man, acts as if he were so ; and another, being poor, enjoys wealth ; or, being moral and chaste, he is licentious — in his madness. These thoughts and actions, although in the above sense involuntary on the part of the mad- man, are nevertheless often accompanied with pleasure or pain, and he is not in some cases iljnorant of their tendencv, else he could not knowingly accomplish those actions which, in sane men, <md being voluntarily performed, are worthy of praise or blame ; but he is held or driven by those causes which turn his thoughts in a way peculiar to madness into strong deter- minations of action, and which surpass all the efforts of his conscious nature to get rid of. So that the particular action, whatever that may be,. u which ho feels he must acc()m[)lish, is in a manner inevitable, it being, so far as the mind is con- cerned, already determined on and completed. Hence, the difficulty, in some ca>?es, of discover- ing- the madman in his actions, for these ap])ear to be voluntary ; he makes use of voluntary muscles, of proper instruments, with a definite end in view, which he, like other men, may or may not accomplish. Here the circle of volun- tary actions appears complete ; and if we con- sider these tilings merely, he would seem to be a good man, or a bad man ; that is, to have acted from the deliberate choice of evil or of good. But the causes which made these actions invo- luntary, are for the most part sudden, fitful, and obscure. One moment the madness is considered latent, the very next moment it is in full play ; an over excitement — an opportunity — an object of any sort — a mere sound, as of a clock at a given hour — or sight as of a razor — a change of position, &c., has developed it. Contrariwise, it is again made latent by similar slight and, for us, almost inappreciable causes to so great results : the voice of his physician or keeper — the dinner bell — a kind word — the attempt, successful or abortive, to perform an action, &c., has eclipsed it. In such cases, the will would appear as if on the confines of, and oscillating between, two forces — the voluntary and the involuntary : any, the least increment, pn the one hand, making a latent madness evident ; and, on the other hand, •> 25 any, the least decrement, making it again latent; or the bodily disease now incrciises on the mind, so as to force the madness to appear, and now again decreases, so that the madness becomes latent. It often happens, that the impressions on the organ of the mind given by the disease, partake so much of it, that the man's consciousness can make very little out of them ; and they are well termed by the madmen themselves, in their sane intervals, as mere impulses, urging the will to particular actions, such as a roar, a run, a noisy gabble, &c., continued throughout the fit. It is no wonder, then, in these cases, that the madman should do an action whether he will or no, seeing that the disease in the organ is, in great measure^ doing it for him~is acting in lieu, as it were, of his determinations. 9. In conclusion, a fit of madness appears to be a disease of the organ of the mind, arrived at that degree of intensity, that it determines the will. THE END. Preparing for Publication, BY THE SAME AUTHOR, THE STATISTICS OF INSANITY. Preparir^ / r Pvblicatioiu, BY THE SAME AUTHOR, THE STATISTICS OF INSANITY. Y.