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and the inspection of Visitors forbids the supposition of the existence of cruelty or neglect.

But we maintain that for the cure of the disease they are inadequate; there is no scope for recreation, no amusement to withdraw the mind from the contemplation of its affliction, no occupation to fix the wanderings of the fancy. Neither are the funds at the disposal of these establishments adequate to secure the highest standard of professional skill; the inducements, both financial and experimental, too small to withdraw from lucrative practice the heads of a profession. The physician to the insane should be a daily companion, a friend in council, a soother of sorrows.

There is a mass of human misery jumbled together without order, regularity, or system. The raving maniac; the harmless imbecile ; the cretin morbidly careful of his interests but unable to master a sum of arithmetic; the idiot, with a mind darkened to external objectsenclose a variety of affliction within the walls of a madhouse, painful to contemplate, difficult to relieve. It is impossible amidst such confusion to single out isolated cases, and apply to each the remedy it demands.

An experiment attended with marked success was adopted in Scotland. Idiot children were entrusted to the care of insane women; they were made the sole charge, the maternal instinct was called out; the devotion which they lavished upon the object of their adoption touched the right chord; that feeling in woman so often dormant in the light of prosperity, but which kindles up in the shade of adversity, was aroused; the vacancy in the mind was filled up with the sense of 'something to do'; the intellect became invigorated by the brain effort, and cures were effected which baffled the resources of skill.

But experiments, however successful as tests of the value of attention to individual cases, prove that these private asylums are too large for minute inspection, too small for the general welfare of their inmates.

Thirty and forty years enclosed within the walls of these retreats, with perhaps in the first instance slight symptoms of mental aberration, but which have hardened into concrete, baffling the efforts of science, the mind depressed by the torpor of idleness, the physical powers enervated by enforced inaction-these private asylums should be looked upon as refuges for temporary derangement of the intellect, not as sanatoriums for the cure of the disease.

We discover in them nothing to relieve the monotony of existence, nothing to enliven the dull routine of daily life.

If we turn from the dead-alive aspects of these abodes of misery to large establishments such as Caterham or Hanwell, we are struck with the contrast; there is an air of vitality about them-so much so as to elicit the question of a visitor, 'But where are the madmen?' The essence of the system is occupation, and the area is so extensive

as to provide employment, congenial to the tastes and habits of the individual. No compulsion is required, but a moral restraint is exercised in withdrawing the mind from the contemplation of its woes, and fixing it upon industrial pursuits; for whilst the intellect in a healthy condition may not be required to devote undivided attention upon the object it prosecutes, it is the characteristic of insanity to concentrate its faculties upon the work which engrosses it and in the oblivion of its griefs the mind may recover the equilibrium which has been upset by false and erroneous impressions. But the main advantage to be derived from these large establishments is their capacity for classification, the being able to deal with the various stages of the malady.

Pinel cites, as an example, a man in a state of mental convalescence who relapsed into the condition of incurable madness from intercourse with a maniac. It is an outrage upon humanity to compel the religious zealot to listen to the oaths of the blasphemer. The mind which might be gradually recovering its powers under the sedative influence of care and of repose is liable to be unhinged by the distraction of noise or the ravings of impiety.

It should never be forgotten that rarely are the whole faculties of the individual impaired; one idea may be predominant to the exclusion of reasoning powers, but the feelings and affections may be as acute as ever, as susceptible to kindness or asperity. There is then one healthy spot on which the physician may work, to combat delusion or soothe irritation.

That, then, is the moment when science is required to adapt itself to the treatment of mental pathology-to trace the thought that may have led up to crime, the paroxysm that may have goaded to action, those wanderings of the will that lie buried in the inmost recesses of the mind.

Phrenologists assert that the head of Palmer was so deficient in the bump of conscience that he was unable to place a check upon his actions. Without subscribing to the tenets of such dangerous fatalism, as that the absence or presence of some protuberance in the head should be made an excuse for crime, we may imagine a weakness in some department of the brain which renders a man powerless to resist the stimulus of ungovernable impulse.

As for hereditary insanity, we disbelieve in it. There may be a disorganisation in the brain, as there may be physical defects in the frame; but with the mind in a healthy state, we no more admit the possibility of transmitting insanity to a descendant than that a wooden leg should be the cause of a stiff joint. Were the evil traced to its source, it would probably be discovered to spring from a defective education, or moral and physical ill-treatment.

The registers of the Bicêtre recorded that the insane consisted almost entirely of priests, painters, artists, sculptors, poets and

musicians. In no case, of naturalists, physicians, geometricians, or chemists. Whatever value we may attach to such returns, it points to the advantage of sound education in youth, and consequently to the benefit of engrossing occupation to a weakened or disordered intellect.

We are living in times when the malady is increasing both in volume and in virulence; as sure as the nettle follows the steps of the white man, or the thorn-apple marks the track of the gipsy, does insanity march in the wake of civilisation-the penalty a nation pays for its advance in luxury and wealth. Rarely to be found in barbarous tribes, it rises in the barometer of national prosperity.

A national disease demands a national remedy; as the malady originates in overpressure of the brain to supply our national wants, it is a public duty to restore to society those members who have fallen out of its ranks through the cares and anxieties of life.

To stamp out a moral as we could a physical plague is impossible; to mitigate the evil is all that can be hoped for. The remedy will not be discovered in the seclusion of private asylums; it must be the province of science to elucidate the mysteries of insanity.

As for statistics, they may prove anything or nothing. There is no attempt at classification of the various shades of the disease, no line is drawn between the temporary effects of excess or the deepseated root of the malady. We can draw no conclusion from these returns of the attempts at cure in different establishments; they teach us nothing of the effects of climate or situation, nothing of the effects of changes of society in disordering the intellect. We are treated with figures as if they represented bales of merchandise, satisfactory to the eye, useless as a means for scientific investigation. In diseases of the mind we are confronted with the difficulty that there is nothing tangible to go upon, no data to guide us in tracing cause and effect, from the flights of imagination to the stroke which paralyses the intellect. In the ailments of the body, slight difficulty will be experienced in meeting with the antidote; in the mind their variety confuses us.

It is the ordinary cases of mental aberration which tax the talent of the physician. Comparisons with the habits of daily life cease to be a guide for his treatment of the man, he must get an insight into character, into the motives which influence conduct. To imprison a man to allay the apprehension of relatives alarmed at the waywardness of eccentricity is injustice, to allow unchecked the depression of melancholia which may terminate in suicide or the excitement of feelings which may swell into mania is a danger to the community; those intricate workings of the mind are not to be elucidated by the common practitioner ; it requires the highest order of talent to discover the agency which confines and controls the intellect.

But when we see the wonderful progress in the science of medicine,

in its mastery of disease, its alleviation of pain, in the numberless cases withdrawn from the list of incurable to the rolls of recovery, we cannot but rely with some degree of confidence that the genius which has modified the ailments of the frame will shed its rays upon the passions and affections of the mind. If it is a fact that to inflammatory diseases it is impossible to assign a limit, tenfold must be the difficulty of gauging the volition of the senses. We have the maniac impelled with the demoniacal possession which urges to violence; its spirit may be exorcised by care and kindness. The imbecile may be taught the rudiments of learning, the false impression of the delusionist may be corrected; there is, at all events, in these cases a glimmer of intellect which may expand under the light of science.

But how are we to regard those cases of idiocy where everything that can dignify human nature has left the man; where progress in virtue, which ought to be the object of life and may be the forecast of a perfection of a hereafter, is brought to a standstill; while the mind, obscured by a cloud which it has not power to penetrate, leaves the object without even the instinct of an animal to guide or direct his actions, existing solely by the power of digestion-a lump of stagnant idleness, blank, boundless, mute, and motionless.

Why a being so useless to others is allowed to live is not for us to inquire. Probably in the inscrutable designs of Providence he is where he ought to be, fulfilling in some mysterious manner his part in the work of creation. To our finite capacity it is unintelligible. But there he is, and we are bound by every principle of duty to support and, if possible, to relieve him. An eminent physician relinquished a practice of thirty years with the remark, 'I am weary of guessing a conclusion no doubt satisfactory to the elastic conscience of the individual, but a nation is not so easily absolved from its responsibilities. We have a plague spot in our system to eradicate, embracing in ever-expanding folds a class whose absence is a loss to the community; our object is to call it back.' The question how to do it may not be so easy to answer. To pronounce a man mad is simple enough; to exclude him from society there exists unfortunately too great a facility; but to get an insight into the cause of the malady and to apply to it its remedy, is a problem that can only be solved by the aid of science and the test of experience.

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Many persons have risen to eminence by the successful treatment of mental disease, but their efforts have been spasmodic and the results uncertain. We have made these unhappy beings the subject of haphazard experiments, and have handed them over to the care of dependents, who have treated them as outcasts of society, too often with harshness and contempt.

It is out of the question for any person who has not made mental pathology an object of study to pronounce a trustworthy opinion

upon so complex a subject as insanity; but an outsider may perceive causes which militate against the success of our present system. First and foremost are the lunatic asylums, those huge excrescences on the soil, offensive to the eye, revolting to the senses; their long corridors, their bolts and bars, the high walls which enclose them convey the impression of the discomforts of a workhouse, the confinement of a prison. They cannot fail to create an irritation of the feelings destructive to the repose which it is the object to secure.

The very first principle of dealing with the insane is lost sight of -the absence of visible restraint.

Less onerous to the ratepayer, far better for the cure of the disease, would be the grouping of small cottages in the vicinity of places allotted to the reception of the patients, where a system of classification could be adopted, individual attention drawn to particular cases, where the semblance of home life could be realised, and, when convalescence returns, the transition should be gradual from the irksomeness of restraint to the freedom of the outer world.

One more reform is needed: a system of parole--the higher feelings of the man should be encouraged. Confidence in his honour that he will conform to the rules and regulations of the establishment which supports him, a sense of responsibility should be imposed upon him, to control his words, his thoughts, and his actions. And when the moment of liberation arrives, it may not be as that of a culprit at the expiration of a sentence, but that of a man returning into that place of society he may have left from the effects of physical or social misfortune.

Of the mystery of madness we know nothing, and in ignorance we shall remain until great public establishments supply the material for its study, where a branch of the medical profession, especially devoted to probe to its source the origin of the evil, to note its peculiarities, to ascertain whether it springs from over-indulgence of luxury, or in the keen struggle for existence incident to the dense population of a highly civilised country, and, by applying the resources of science, to elucidate the character of an occult, insidious disease.

The treatment demands skill, discretion, knowledge, and experience-a combination of qualities not often to be met with in the limited area of private asylums.

DE MAULEY.

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