INSANITY. 
©? the patient, and to ascertain wherein and on what 
points his infanity confifts: it is alio important to learn 
the hiftory of his diforder from his relatives and friends, 
and to enquire particularly refpefting any violence he 
may have attempted towards himfejf or others. 
« la holding conferences with patients in order to dif- 
cover their infanity, no advantage .has, ever been derived 
from affirming a magifterial importance, or by endea¬ 
vouring to Itare them out of countenance c. mildnefs of 
manner and expreflion, an attention to their narrative, 
ana feemjng .acquiefcence in its truth, fucceed much bet¬ 
ter. By 1'uch confirm they acquire confidence in the 
■praftitiouer; and, if he .will have patience, and not too 
frequently interrupt them, they will foon iatisfy his mind 
as to the derangement of their intellects. 
“ When a patient is admitted into Bethlem Hofoiial, if 
he be iufficiently rational to profit by fuch tuition, it is 
•explained to him, by the keepers and convalefcents, that 
he is to be obedient to the officers of the houfe, and efpe- 
cially to myfelf, with whom he will have daily inter- 
courfe ; they point out.to him, that all proper indul¬ 
gences will be allowed to good behaviour, and that feclu- 
ffon and coercion inftantly fucceed to fiifobedience and 
revolt. As nemo repente turpijfimus, fonoone in an inftant, 
from a date of tranquillity, becomes furioufly mad ; the 
precurfory fymptoras are manifold and fucceffi.v.e, and 
allow or* fulficient time to lecure the patient before 
milchief enfues ; it is principally by taking thefe precau¬ 
tions that our patients are obferved to be fa orderly and 
obedient. The examples of thofe who are .under drift 
coercion, being conftantly in view, operate more forcibly 
on their minds than any precepts which the moft conl'um- 
mate wifdom could fugged. In this moral management, 
the co-operation of the convalefcents is particularly Ser¬ 
viceable ; they confider themfelves in a ftate of probation, 
and, in order to be liberated, are anxious,’by every atten¬ 
tion and afllftance, to convince the fuperintendants of 
their reftoration to fanity of mind. From mildnefs of 
treatment, and confidence repofed in them, they become 
attached, and are always difpofed to give information con¬ 
cerning any projected milchief.” 
To apply our principles of moral treatment, with undif- 
criminating uniformity, to maniacs of every character and 
condition in fociety, would be equally ridiculous and un- 
advifable. A Ruffian peafant, or a (lave of Jamaica, ought 
evidently to be managed by other maxims than thofe which 
would exclufively apply to the cafe of a well-bred gentle¬ 
man, unufed to coercion and impatient of tyranny. It is 
well known that the late Dr. Willis proceeded in themildeft 
manner in the treatment of his majefty’s diforder in 1789 5 
and the prefent mode we hope is the fame. 
As the patient Ihould be taught to view the medical 
fuperintendant as a Superior perfon, the latter fliould be 
particularly cautious never to deceive him. Madmen are 
generally more hurt at deception than punilhment ; and, 
whenever they deleft the impofition, never fail to ] 0 f e 
that confidence and refpeft which they ought to enter¬ 
tain for the perfon who governs them. In the moral ma¬ 
nagement of the infane, this circumftance cannot be too 
jftrongly impreffed on the mind of the praftitioner; and 
thofe^perfons, who have had the greateft experience in 
this department of medical fcience, concur in that opi- 
nion. The late Dr. John Monro exprefsly lays, “The 
phyfician Ihould never deceive them in any thing, but 
more efpecially with regard to their diltemper; for, as they 
are generally confcious of it themfelves, they acquire a 
kind of reverence for thofe who know it; and, by lettino- 
t’nem fee that he is thoroughly acquainted with their com° 
plaint, he may very often gain fuch an afcendant over 
them, that they will readily follow his direftions.” 
We are informed by Dr. Gregory, that a farmer, in the 
north of Scotland, a man of Herculean ltdture, acquired 
snuch fame in that quarter, by his fuccefs in the cure of 
infanity. The great fecret of his practice confifted in 
giving full employment to the remaining faculties.of the 
m 
lunatic. With that vrew, he compelled all his patients to 
work on his farm. He varied them occupations, divided 
their labour, and afiigned to each the poll which he was 
belt qualified to fill. Some were employed as beafts of 
draught or burden, and others as Servants of various or¬ 
ders and provinces. 
This mode of treatment is highly approved by M. Fi¬ 
ne!. “ It is no longer,” he fays, “ a problem to be halved, 
but the refult of the moft conffant and unanimous expe¬ 
rience,, that in all public afylums, as well as in prifons and 
hofpitals, the fureft and perhaps the only method of fe- 
cv.ring health, good order, and good manners, is to carry 
11-0 decided and habitual execution the natural law of 
bodily laiour , jo contributive and effential to human hap- 
pinefs. This truth is efpecially applicable to lunatic afy¬ 
lums ; and I am convinced, that no ufeful and durable 
eftabiifinnents of that kind can be Founded excepting on. 
the bafis of interefting and laborious employment. I anv 
very fare that few lunatics, even in their molt furious 
ftate, ought to be without fome aftive occupation. The 
fcer.e which is prefented in our national eftabiifinnents, by 
the infane of all defcriptions and characters expending 
their eftervefceiit excitement in antics and motions of va¬ 
rious kinds, without utility or objeft, or plunged in pro¬ 
found melancholy, inertia, and ftupor, is equally affect¬ 
ing, pifturefque, and pitiable. Such unreftrained indul¬ 
gence of the natural propenfities to indolence, to unpro- 
duftive activity, or to depreffing meditations, mult in a 
high degree contribute to aggravate the exilting evil. 
Laborious employment, on the other hand, is not a lit¬ 
tle calculated to divert the thoughts of lunatics from their 
ufual morbid channel, to fix theiijg attention upon more 
pleafing objefts, and by exercife to ltrengthen the func¬ 
tions of the underltanding. Where this method is. adopt¬ 
ed, little difficulty is experienced in the maintenance-of 
order, and in the conduft and diftribution of lunatics, 
even independent of many minute and often ineffeftual 
regulations, which at other places are deemed indifpenfa- 
bly neceflary. The return of convalefcents to their pri¬ 
mitive taftes, purfuits, and habits, has always been by me 
confidered as a happy omen of their final complete re-- 
eftablifhment. To difcover thofe promifing inclinations, 
a phylician can never be too vigilant; nor, to encourage 
them, too ftudious of the means of indulgence. An en¬ 
viable example is prefented to us in this refpeft by 
a neighbouring nation. In a city of Spain, Saragofia, 
there is an afylum, which is open to the difeafed, and ef- 
pecially to lunatics, of all nations, governments, and reli¬ 
gions, with this fimple infcription, Urbis et Orbis. 
Manual labour has not been the foie objeft of folicitude 
on the part of its founders. They have likewife fought an 
antidote to the wanderings of the difeafed imagination 
in the charms of agriculture, a tafte for which is io gene¬ 
ral, that it is commonly confidered as an inftinftive prin¬ 
ciple of the human bread. In the morning may be feen 
the numerous tenants of that great inftitution, diftributed 
into different claffes and awarded their refpeftive employ¬ 
ments. Some are kept in the houfe as domeftics of va¬ 
rious orders and provinces ; others work at different trades ■ 
in (hops provided for the purpofe. The greateft number 
fet out in different divifions, under the guidance of intel¬ 
ligent overlookers, l'pread themfelves over the extenfive 
inclofure belonging to the hofpital, and engage, with a 
degree of emulation, in the foothing and delightful pur¬ 
fuits of agriculture and horticulture. Having fpent the 
day in preparing the ground for feed, propping, or other- 
wile nurfing, the rifing crop, or gathering the fruits of the 
olive, the harveft, or the vintage, according to the feafon, 
they return in the evening calm and contented, and pal's 
the night in folitary tranquillity and deep. Experience 
has uniformly attelfed the fuperiority of this method of 
managing the infane. The Spanifh nobles, on the con¬ 
trary, vvhofe pride of birth and family prefents unfur- 
mountable obftacles to a degradation fo bleffed and faiu- 
tary, feldom recover.”' 
M, Find 
3 
