1828.] Insanity. 459 
proximate cauise—so far as we can see and act upon it—is always physi- 
cal—always deranging organs—and anatomy—morbid anatomy and 
physiology—is thus of more importance than philosophy. No mental 
remedies are to be hoped for. We know not how the intellect is gene- 
rated—its ideas furnished, or multiplied, or modified, independent of 
corporeal agency. The disturbance of the brain proceeds from the same 
source. The exciting disease must be attacked in its seat and station— 
what will cure there, will probably cure the insanity, which appears to 
depend upon it. Be the cause moral or physical, the body—the organs 
—the constitution, in whole or in part, is the diseased point, and the sub- 
ject of medical treatment. 
Upon those who are yet sane, and upon those who are the subject of 
hereditary taint, the necessity for caution should be early and perse- 
veringly inculcated ; and the more the cause is understood and felt, surely, 
the more irresistibly will such caution operate. Avoid exciting occa-~ 
sions. The offspring of the insane has double motives for shunning 
them ; and if he must marry, let him match with a sane person, though, 
as Rousseau said, “he be a king, and she be the hangman’s daughter.” 
Useful lessons may be taken from the cattle-breeder—judicious crossing 
will wear out the taint. 
But though nothing is to be done, mentally, with the actually insane, 
moral discipline is as indispensable as medical treatment; for external 
objects, according to circumstances, are all calculated to exacerbate or 
to soothe: and here, accordingly, is an ample field for the employment 
of the best intelligence either of the professional or unprofessional atten- 
dant ; and of course the more sensible and intelligent will be the more 
effective agent. Few rules can be laid down—every case requires its 
_ own treatment. No individuals are precisely alike, and in insanity, less 
than in any other disorder, apparently, are assimilations to be looked for. 
“ Never, however,” says Dr. B., “exercise the mind of the insane in the 
sense of his delirium—never oppose his morbid ideas, affections, or 
_ inclinations—but rather by diversity of impressions, give rise to new 
_ ideas and feelings, and thus, by exciting fresh moral emotions, revive 
_ the dormant faculties—and never commit yourself by promise ; but if, 
inadvertently, a promise be given, adhere to it, unless the fulfilment 
will obviously be attended with worse consequences than the breach 
bof, it.”’ 
The critical period is when the bodily disease is giving way. Gene- 
rally, returning reason follows, as an effect of its cause ; and if it do not, 
the case becomes hopeless. The least glimmer of reason should be 
cherished and encouraged ; but the common mind and the cultivated 
will not bear being treated alike. This is the moment to reason with 
patient—to talk to him as to a rational person—to assist in expel- 
ling fading illusions—to soothe remaining irtitations—to repress his 
impatience for freedom. 
Z the worst cases, the first symptom of returning reason is usually 
some sense of the decencies of life—the dropping of some pertinent 
_ remark, or asking some appropriate question, though hesitatingly, rela- 
tive to his own situation, or that of his family, or giving way to his 
former obstinate defence of delusions. Sometimes convalescence an~ 
 nounces itself by the gradual revival of the moral affections, and the 
_ feelings are often moved to tears. “No augury,” says Dr. B., “is 
more favourable than such emotions ; though feeble and transient, they 
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