148 



INSANITY. 



UiotUm. ganization. This has be declared to be universally 

 < -~Y~ the case with idiots whose heads either exhibited this 

 particular shape, or were preternaturally large. These 

 observations have not yet been sufficiently extensive, 

 and attested by a sufficient number of observers, to form 

 a part of the ascertained doctrines of science. This is 

 no derogation from the credit due to the enterprize of 

 those who have undertaken them ; who, though they 

 may not be trusted as superior to the influence which 

 enthusiasm sometimes exercises over the power of ob- 

 servation, deserve praise for their devotedness to the 

 object, and will be entitled to more lasting honour if 

 even a few of their positions shall be ultimately esta- 

 blished. Casts of the heads of idiots whose cases are 

 minutely described, and whose brains have been dis- 

 sected after death, if multiplied and well authenticated 

 indifferent countries, cannot, fail ultimately to throw 

 much light on the nervous system, and its connection 

 with the manifestations of the mind? Yet it is possible 

 that the conclusions obtained may widely differ from 

 any that have been hitherto anticipated. 



The chief characteristic about the head that is strict. 

 ]y universal, consists in the manner of holding and mov- 

 ing it, and thus, like other points of pure physiognomy, 

 resolves itself into the habits of the moving powers. Yet 

 we cannot deny that there is a deficiency of organiza- 

 tion more strictly radical than this, which careful in- 

 quiry may be afterwards able in some measure to trace, 

 though we should not indulge the hope that the sub- 

 ject is capable of being thoroughly explored. 



The treatment of idiots is not a matter of great dif- 

 ficulty. The duties of humanity are generally in these 

 cases simple, and the events to be expected either from 

 the course of nature, from accident, or from any treat- 

 ment, admit of very little variety. 



The case is far otherwise with those forms of insani- 

 ty which are not congenital. To such forms of it, 

 therefore, our chief attention is due. 



Here, again, science finds herself cramped and em- 

 barrassed wherever the love of an easy and brief accu- 

 racy calls on her for a definition, or demands mention 

 to be made of any universal characteristic which is es- 

 sential to insanity. 

 McUncholy. Insanity, as thus applied,includeS7e/anc/eo/yand mad- 

 ness. The symptoms of melancholy, however, often al- 

 ternate with those ascribed to madness, and madness of- 

 ten ends in settled melancholy. When melancholy ex- 

 ists separately, it is found in various degrees. Few 

 persons are at all times exempt from it. It is that state 

 which disappointment and external disadvantages have 

 a uniform tendency to produce. It is when compara- 

 tively permanent, and affecting a man's feelings towards 

 every object, that we call the disease hypochondria, or, in 

 common language, " habitual discouragement." " Low 

 spirits," and the subsequent " indifference" tending to 

 that abolition of feeling and of interest which we call me- 

 lancholia, are greater degrees of the same mental disease. 

 When symptoms of melancholy exist separately from 

 those of mania, the individual is disposed to decline 

 the common affairs of life in a greater degree than he 

 appears to be unfitted for them ; no coercion or con- 

 finement is called for; no mischief is to be dreaded, 

 excepting that in some cases a tendency to suicide may 

 be suspected to be present, or that mania may be ap- 

 prehended as its ultimate consequence. 



Mania. Our further delineations and remarks shall be confin- 



ed to mania, by far the most important branch of the 

 fcubject of insanity. 



It is in cases of jnania, that the perplexities to which 



Insai.ity ! 

 pcrvcning 

 in the 

 course of 

 lite. 



we have already alluded in forming our decisions prin- 

 cipally occur. 



The difference between the state of the thoughts in 

 maniacs and in others is not ensily descried or defined ; 

 but it is judiciously observed by Cullen, that " it always 

 implies hurry.'' It appears in the form of false judg- 

 ments, and irresistible actions ; sometimes conjoined, 

 sometimes separate. Aberration of any sensation or 

 intellectual power is so incident to all men, that it can- 

 not constitute insanity. Hence some have made this 

 distinction, that in the insane the aberrations are to- 

 tally unperceived. Even this, however, fails to afford 

 us a sure diagnostic. Maniacal aberrations of judgment 

 seem only a greater degree, and a more unaccounta- 

 ble form of that ignorance of ourselves, our* motives, 

 our character, and the relations in which we stand to 

 others, which abounds among mankind And with re- 

 gard to the irresistible aberrations of feeling of the ma- 

 niac, he is in many cases very far from being uncon- 

 scious of their existence and influence. Perhaps the 

 following definition, although it does not present to the 

 mind the striking image of madness, will more nearly 

 designate all cases of this malady than any other that 

 has been given : " A continued impetuosity of thought, 

 which totally unfits a man for judging and acting with 

 the composure requisite for the maintenance of the so- 

 cial relations of life." Yet this definition will only apply 

 with propriety,in consequence of the emphasis to be laid 

 on the word " totally.'' We must profess our dissa- 

 tisfaction with all definitions. Words are only aids to 

 our minds in giving precision to our observations on 

 phenomena which must be presented to our actual view 

 before a conception of them can be formed ; and this 

 is one of those subjects, on which the words must be 

 numerous, and extend to the length of a historical de- 

 scription, before they can communicate precise informa- 

 tion. Even then their deficiency is apparent; and, 

 when we are limited to a short compass, as in the present 

 article, we rather hope to present instructive sketches, 

 than an entire view of this important subject, the study 

 of which is worthy of being much better cultivated. 



The impetuosity of mania appears under two leading 

 forms, furor and delirium. Furor consists in an ex- 

 treme irascibility, and an invincible propensity to com- 

 mit indecent or atrocious actions. It is considered as a 

 disease of the will. Delirium consists in an extreme 

 hurry of imagination, sometimes attended with a false 

 perception of objects as present which are not, and al- 

 ways depriving the patient of those just notions of 

 the relations of things around him which he entertains 

 in a state of health. It is, therefore, considered as a 

 symptom of disease in the intellectual powers. Impe- 

 tuosity, however, is a characteristic in which it agrees 

 with furor. A diseased inclination attaches the pa- 

 tient to those rambling thoughts which derange the 

 operations of his judgment. 



Mania has seldom been known to attack any person 

 before the age of puberty, after which period all ages 

 are subject to it. It is sometimes preceded by deep 

 melancholy, or by a slight lowness of spirits. In per- 

 sons addicted to intemperate drinking, the approach is 

 sometimes indicated by an increase in the extravagance 

 of conduct attending their excesses. The most general 

 mark of decided mania is a total change of feeling to- 

 wards connections and acquaintances, indicated by a 

 suspieiousness, and a violent hatred towards those per- 

 sons who at other times are objects of affection and 

 confidence. Very often the patient shews remarkable 

 proofs of penetrating sagacity, brilliant wit, and an inv 



Mania. 



Two laiU 

 ing symp- 

 toms. 



Modes of 

 attack. 



Its general 

 features. 



