5o<3 



THE POPULAR SCIENCE MONTHLY. 



ist Dr. Maudsley, and Dr. Tourtellot admits 

 that, however great may be the want of evi- 

 dence to establish the theory, it is at least 

 a consistent position. Dr. Maudsley says, 

 " To write as if sanity is a thing of the im- 

 material, and insanity a thing of the mate- 

 rial world, is to infer that men are furnished 

 with brains only that they may become in- 

 sane." Yet it seems that some physicians 

 find it convenient to entertain both theoiies ; 

 and we are informed in this discourse that 

 Dr. John P. Gray, Superintendent of the 

 State Lunatic Asylum at Utica, in a paper 

 read before the New York State Medical 

 Society, on " The Dependence of Insanity on 

 Physical Disease," takes the ground that 

 mental aberration is due to bodily disor- 

 der ; but, being " no materialist, he does not 

 regard sound mental action as the result of 

 a sound and healthy brain, and denounces 

 such a notion " as " an attempt to revive 

 the exploded vagaries of the French mate- 

 rialism of the encyclopedists and the Revo- 

 lution." Obviously the superintendent is a 

 politician as well as a doctor. 



But, even assuming that insanity is a 

 bodily disease, Dr. Tourtellot maintains that 

 it is impossible to find the indications of it 

 in the bodily structures. He quotes Lei- 

 dersdorf as declaring any such demonstra- 

 tion " outside the realm of possibility ; " 

 while Griesinger, the celebrated German au- 

 thority, ridicules the " belief that every men- 

 tal disorder must correspond to a palpable 

 cerebral lesion." The practical evil of the 

 extreme theory, that insanity is in all cases 

 essentially a bodily disease, Dr. Tourtellot 

 thinks to be an undue reliance upon medi- 

 cation for a cure. This leads to the appeal 

 for legislative aid upon an enormous scale, 

 to provide medical establishments for the 

 treatment of the insane. Upon this point 

 Dr. Tourtellot remarks : 



" I must point you to one other evil, of 

 perhaps greater magnitude, which is directly 

 due to Dr. Gray's false theory and vicious 

 reasoning. You are doubtless aware that 

 the demand for new hospital-asylums, to 

 provide for all the insane of the State, has 

 been based mainly upon the doctrine that 

 insanity is a bodily disease, easily curable in 

 its early stages. At length, the Legislature 

 of this State was prevailed upon to authorize 

 the building of two such asylums. And, as 

 they were in the end to save vast sums of 



money through the speedy cure of those who 

 must otherwise, as incurable, become a pub- 

 lic charge for life, it was not necessary to 

 spare expense upon them. These asylums, 

 in fact, were planned to reqinre an outlay of 

 from $8,000,000 to $10,000,000 for a total ca- 

 pacity of 800 patients. Now, I need not stop 

 to prove to you how even more absurd is the 

 plan of ' stamping out ' insanity by medical 

 treatment than that of exterminating cancer 

 and scrofula would be. The serious proposal 

 of such a scheme by a medical man in any part 

 of Europe would be enough to brand him as 

 a visionary or a quack. That it should not 

 only have been proposed, but apparently ac- 

 cepted as the basis of a policy of provision 

 for the insane in this country, seems hardly 

 credible. But, as you know, the policy is 

 still urged upon our State Legislatures, and 

 the argument for it is repeated in nearly all 

 our asylum-reports, year after year." 



Dr. Gray makes the statement in his last 

 report to the Legislature, that " a recovery 

 of four-fifths " (of insane persons) " might 

 reasonably be expected, if treated within 

 three months of the first attack ; while, if 

 twelve months are allowed to elapse, the same 

 proportion may be considered as incurable." 

 Dr. Tourtellot replies that this is a fallacy, 

 and states that, in a large number of the 

 cases, the outbreak is sudden and transient, 

 and that " it is quite certain that four-fifths 

 of such patients will recover even without 

 special treatment. . . . But, on the other 

 hand, patients brought to the asylum a year 

 or more after their attack, are of a wholly 

 different class. Their insanity was chronic, 

 not only in its fully-developed stage, but in 

 the stage of invasion. It was never possible 

 to bring them to an asylum within three 

 months of the date of their attack. Their 

 insanity came on imperceptibly, and opin- 

 ions might differ months or even years as to 

 the time of its beginning." 



In regard to the vexed question of 

 the definition of insanity, the author re- 

 marks : 



" After what has been said, you will not 

 expect me, in closing, to present you with a 

 definition of insanity as a physical fact. The 

 term is a purely metaphysical one, and can- 

 not be translated into the language of natu- 

 ral science. To say that insanity is morbid 

 energy of the nervous element, is to state 

 what we all admit to be a legitimate scien- 

 tific hypothesis, but at the same time know 

 to be worthless as a definition. On the other 



