36 On Mental Alienaiion. 
mental alienation in France; enume- 
rating, with boldness and incontrover- 
tible evidence, the serious evils that 
have unhappily accrued from = such 
treatinent. Pointing out prominent 
defects and palpable abuses, whatever 
fast hold they may have taken by long 
continuance, is the first advance to- 
wards effecting any sort of reformation. 
According to this reporter, not only 
in France, but in most other countries, 
the general welfare of the insane was 
for ages neglected ; and that part of 
human nature, secluded from the 
world, was reduced to a degree of 
distress and misery which cannot be 
viewed without detestation. This cha- 
racter, and these most shocking out- 
rages, the author finds and follows up 
to the end of the eighteenth century. 
The sufferers by such failure of the 
constitution, and imbecility of intellect, 
were often stowed in prisons with 
criminals, with no favourable mark of 
distinction and appropriation placed 
upon them in their peculiar situation. 
In hospitals, the captives were confined 
in narrow, infectious quarters, and 
yery often in common dungeons, load- 
ed with irons; if their distemper exhi- 
bited symptoms of violence, they were 
exposed to popular derision. This was 
only exasperating their complaint, and 
rendering it incurable. 
Agreeably to the temper and dispo- 
sition of modern times, men of feeling 
have espoused the cause of these un- 
fortaunates; and the scientific classes, 
and men of medical learning, have 
nade it their business, by a fortunate 
concurrence of improvement and re- 
gulations, to suppress and reform all 
such rigorous interference as they 
deemed unnecessary. From their 
weil-directed efforts, many circum- 
stances of an evil, injurious, and 
immoral, teudency, are expunged, and 
the afflicted experience a more _noble, 
generous, and dignified, sympathy, in 
proportion to that general attention 
which their case excites and deserves. 
Numbers have been hereby restored 
to society, and the condition of the 
incurabies amended in every point of 
view. 
The author, referring to the present 
mode of treatment in France, observes, 
that for those of the higher classes 
Houses of Health are established, 
where every duty of meritorious ser- 
vice is ably executed, and which are 
therefore entitled to every praise; and 
that, generally speaking, means are 
pAug. ly 
employed to much advantage torender 
the poorer part of that community no 
longer subjects of real regret, from the 
sentiments and practices formerly in 
vogue respecting them. Rigorous 
methods are in disuse; and, in most of 
the establishments set apart for them, 
the whole process, as it appears in the 
several characters of diet, regimen, 
and general accommodation, is more 
laboured and complete. 
In all the Paris hospitals, especially, 
the exertions of the managers are pecu- 
liarly calculated to facilitate ameliora- 
tions; of these, the author draws such 
a picture as the spirit of benevolence 
cannot fail to be gratified with. Into 
these have been admitted many insane 
from the other provinces; so that in 
1816, of 1800 insane patients, 545 
were not of the department of the 
Seine. Their numbers have been gra- 
dually augmented in these hospitals. 
On the Ist of January, 1801, they 
amounted to 1070; of whom 40 were 
in Les Petites Maisons, 84 at the Hotel 
Dieu, 337 at Bicetre, and 609 at La 
Saltpetriére. 
Prior to 1805, these patients were 
formed into two divisions; the men at 
Bicetre, and the women at La Salt- 
petriére. On the 31st of December, 
their total number Was 2240; of whom 
764 were in the former, and 1476 in 
the latter, establishment. Hence, in 
the space of twenty years, the number 
had more than doubled. 
The physicians of Bicetre and Salt- 
petriére, when consulted as to the 
causes of this augmentation, varied in 
judging of the principles upon which 
this malady had acquired so many 
subjects. M. Pariset ascribes it to 
the great political events of thirty 
years, the reverses of fortune, the 
exaltation of some successful fishers 
in troubled waters, and the increase of 
population. 
According to M. Esquirol, a great 
number of the insane, prior to the re- 
volution, had been placed in convents, 
or were kept and attended to in their 
families. It was only \maniaes that 
were transferred tu the hospitals. The 
great alterations, so very different in 
character and design from any which 
had appeared at former times, in the 
hospitals, created an interest in their 
favour; and families found no diffi- 
culty, in coincidence with public 
opinion ‘so changed on the subject, 
uniformly to adopt those asylums. 
Formerly, such subjects as were not 
incurable 
