150 



INSANITY. 



Ctuttt of 

 nudnen. 



Hereditary. 



Marks of a 

 predisposi- 

 tion. 



Occasional 



ou-u. 



Whether is 

 madness 

 owing most 

 to tlie mind 

 or the 

 body? 



ticms, patients who have laboured under it for a year, 

 are put in the list of incurable, and curative measures 

 are not in such cases kept in view. In others, two 

 years are allowed for this species of probation, 

 predictions, however, must not be absolute. Recovery 

 has in many cases taken place, after the patient had 

 laboured under his complaint for several years. 



Mania has always been considered as an hereditary 

 disease. This opinion is certainly founded in truth. 

 When we find the features and expression of the coun- 

 tenance so often exactly copied from the parents, we 

 have good reason to conclude that the conformation 

 and character which predispose the constitution to 

 mania are communicated in the same manner. The 

 fact is also well confirmed in this particular disease by 

 the experience of mankind, We cannot, however, as- 

 cribe so much influence to this cause as is generally 

 done. Other causes contribute to (he repetition of 

 it in the same family, independently of communica- 

 tion from the parents. It has been sometimes main- 

 tained, that the present frequency of mania in this 

 country has proceeded from the intermarriages of per- 

 sons of sound constitutions with those who have labour- 

 ed under this hereditary disposition : but we have no rea- 

 son to suppose that, at the time when mania became so 

 prevalent, such intermarriages were more frequent than 

 formerly, or that these are now more common in pro- 

 portion to the cases of mania that exist. Where both 

 parents are predisposed to mania, the predisposition 

 has a chance of being communicated with greater cer- 

 tainty to the children ; but, where a sound constitution 

 is married to one of an opposite character, there is as 

 great a chance of the offspring being improved as of its 

 being deteriorated, unless other causes of general ope- 

 ration tend to increase the frequency of the disease. 



The predisposition to mania is marked by peculiar 

 sensibility, accompanied with a disposition in the per- 

 son to conceal the manner in which he is affected ; and 

 sometimes by absence of mind. A determination to the 

 head, which predisposes to apoplexy, is also a predispo- 

 sing cause of mania, and probably terminates in the one 

 disease or in the other, according to the conjoined ope- 

 ration of other causes. The same thing may be said of 

 that tendency to inflammation in the brain, which is 

 the predisposing cause of phrenitis. Madness is well 

 known to be sometimes occasioned by organic injuries 

 in the head. 



Excessive sensuality, and intemperance in the use of 

 intoxicating liquors, or other narcotics, are frequent 

 causes of this disease. Their immediate operation is, 

 to produce a temporary state nearly allied to it ; and, 

 where this is frequently repeated, the tendency be- 

 comes at last rivetted in the system. The suppression 

 of various secretions is numbered among the causes of 

 mania, as obstructions of the menses, checks given to 

 the perspiration, and the drying up of a long continued 

 discharge from scrophulous sores. That disturbance 

 of all the functions which is incident to the puerperal 

 state, is a very frequent cause of mania. When we con- 

 sider the extreme delicacy of many females in the high- 

 er and middling rank of society, we cannot be surpri- 

 sed at any effect that follows the shock which all their 

 sensations must sustain in childbirth. 



One question has been agitated as of the greatest im- 

 portance ; whether the disease is ever strictly mental, or 

 is always dependent on faults or peculiarities or injuries 

 of organization ? The degree of importance attached to 

 this question is in some measure to be regulated by the 



meaning which we attach to terms. It is evident that it Mania. 

 might be so managed as to involve the whole doctrines V *""Y"^" 

 which relate to the nature T>f matter and of wind, and 

 might thus lead us into the most unsatisfactory regions 

 of metaphysical discussion. This must be avoided when 

 we are in quest of real information. In so far as the 

 question is practically useful, it may be resolved into 

 this, Whether is insanity, supervening from the appli- 

 cation of a mental cause, without any apparent bodily 

 defect or ailment, always the effect of this cause only, or 

 in conjunction with some fixed and very particular pre- 

 disposition in the organs by which the powers of the 

 mind operate ? We do not adopt the latter part of this 

 alternative. We grant, indeed, that insanity owes its 

 origin to certain relations which the external cause has 

 with the state of the subject operated on. But we con- 

 tend that the predisposition is most commonly founded 

 in a delicacy which is very general among men ; that the 

 increase of this delicacy in any individual is chiefly 

 owing to a series of external impressions, and that even 

 the organic peculiarities which are the most strongly 

 marked are the consequences of such impressions, either 

 communicated to the individual or to his progenitors. 

 This susceptibility, which in one nation produces insani- 

 ty, may in another appear to be absent, from being ope- 

 rated on in such a form as prevents variety of mental ex- 

 ercise, and renders the individual entirely the creature of 

 a limited set of habits ; and it is questionable whether any 

 abrupt attempts to change the habits of an individual 

 thus situated would not readily induce insanity. They 

 would certainly occasion unhappiness, or probably death. 

 If insanity were not the effect, he would probably owe 

 this exemption to the want of that sort of mental em- 

 ployment which exists in those tribes among which that 

 malady is common. Very few persons, perhaps none, 

 are exempt from the symptoms of madness during par- 

 ticular moments of their lives. Dreaming is a state of 

 madness. Reverie, or vague musing, is nearly allied to it. 

 The irregularity and imbecility of thought so often ex- 

 perienced while a person disposes himself for sleep is 

 a state which every one understands, and which, if it 

 were perpetual, would constitute madness. The uni- 

 versal liableness of mankind to this state shows that 

 the weaknesses which lead to madness may be regard- 

 ed as radically universal, and that external circumstan- 

 ces operating on the senses and intellectual powers, and 

 through these on the material organs which lie hid 

 from our view, are by far the most efficient causes of 

 the appearance of this malady. 



The mental causes which evidently occasion mad- Mental 

 ness are, restless ambition, jealous love, and frequent causes, 

 or severe disappointments. Harassing changes are well 

 known to be unfavourable to soundness of mind. It 

 has been said that a sudden change of fortune from 

 low to high has occasioned madness i more frequently 

 than a change from high to low. This was remarked 

 in the mental effects of the celebrated mercantile specu- 

 lation called the South Sea scheme, which gave occa- 

 sion to numerous sudden changes of both kinds. Re- 

 verses of fortune are particularly apt to affect persons 

 destitute of all taste for rational occupation, to whom 

 wealth and its attendant honours form the whole interest 

 of existence. The dreadful reverses which took place 

 in France in the course of the revolution, formed a 

 fruitful source of madness ; some interesting cases of 

 this' sort are described in the treatise of l j inel. 



The effect of affronts is often to produce mania in Affronts. 

 persons acutely sensible to the treatment which they 



