and women decidedly insane, although not conscious of the fact, thus administer comfort and consolation to the wounded spirits of those recently admitted as patients within an institution in which they themselves were most unwillingly confined I have heard the insane, with a view of soothing and mitigating the sorrows of those about them, freely admit that they had, like others, been mentally afflicted, but had recovered, or were convalescent from the symptoms of the malady, and although, at the commencement of their illness, they were firmly persuaded that they were perfectly sane, and ought never to have been removed from home to an asylum, they were now fully satisfied of having been deranged, and felt grateful to their friends for recognising the fact, and placing them under moral control and medical treatment. I have had the pleasure of hearing the insane pray by the bedside of other patients when afflicted with severe and dangerous bodily illness, and do so, too, with pious fervour, and great propriety of language, never once making the slightest allusion to their own unhappy and disordered thoughts.”I

. I had a patient under my care who suffered from great dejection of mind, associated with a delusion, that he had committed the unpardonable sin, and was, in consequence, forsaken of God. This gentleman had always been remarkable, previously to his illness, for his orthodox views, and strict attention to religious duties. Before I was consulted, he had made an ineffectual attempt at suicide. This patient took an affectionate interest in another invalid confined like himself in the institution. They were generally engaged several hours during the day in close companionship and conversation. In fact, they were almoat inseparable. This gentleman was seized with an attack of dangerous bodily illness, threatening life. His friend took a deep and kind interest in his case, and was rarely absent from the sick chamber. On one occasion I asked him to offer up a prayer at the bedside of his friend. The request appeared somewhat to stagger him. He was evidently most anxious to comply with my wishes, but was afraid of committing himself. After a little hesitation he fell upon his knees, and prayed with great force of expression, and with touching tenderness. There was not the slightat indication in the prayer (which was extemporury), of his own morbid religions hallucinations. He told me some time after his recovery, when referring to this, circumstance, that he experienced considerable difficulty in

The state of unhealthy feeling, previously described, as often symptomatic of incipient insanity, is occasionally observed in certain anomalous conditions of the nervous system allied to hysteria, and may em'st apart altogether from any actual disorder, or even a tendency to derangement of mind. These distressing nervous symptoms sometimes are seen in young girls, when passing at the age of puberty into womanhood, and occur to females of a mature age at the critical period of life. This morbid exaltution of the nervous and mental functions is generally found associated with visceral complications, easily curable, however, in many cases, by remedial measures. In some patients, these symptoms are the effect of longcontinued and neglected stomach and hepatic derangement. In other instances, the uterine system is the seat of the mischief; and in some types of the malady which have come under my observation, the condition of mind could be traced to irritation and congestion established in the brain itself. In one remarkable case, the patith was tortured by an intense fear of losing his senses, combined with confusion of ideas, strange dislikes to his relatives, and a disposition to conceal himself from his familyHe had for some time suffered from headache, and 9

avoiding (whilst praying on this occasion), alluding to his own unhappy it!“ of mind. The case of Simon Brown, as recorded in “ The Genthmltzlvi Magazine" for 1762, illustrates the point referred to.

Simon Brown was a dissenting minister of great intellectual powers. He became insane. His delusion was that he had fallen under the senfihle 415' pleasure of God, who had caused his rational soul gradually to perish, and left him only, in common with brutes, an animal life; that it was thank“: profane in him to pray, and incongruous to be present at the prayen 0* others. In this opinion he was inflexible. Being once importuned w “Y grace at the table of a friend, he repeatedly excused himself, but the reqvfii being still repeated, and the company kept standing, he discovered evident tokens of distress, and after some irresolute gestures and hesitation, with great fervour this ejaculation: “ Most merciful and Almighty God-l Iet thy spirit which moved upon the face of the water: when there I“ 'n

light, descend upon me, thatfrom this darkness there may rise up 11 9‘” topraise thee I"


general feeling of malaise. This gentleman soon recovered after a few ounces of blood were taken from his head, and two or three active calomel purges administered. In less than three weeks from the time he placed himself under treatment, he was able to resume his ordinary occupations. In the case of a lady, presenting the same symptoms, great congestion was discovered in the neighbourhood of the cervia: uteri. This morbid state of the vessels was removed by the local application of leeches. The blood so abstracted, conjoined with other treatment, entirely relieved the mind of all fear and apprehension of insanity. In another case, the mental disturbance could be clearly traced to engorgement of the liver, consequent upon a long residence in a tropical climate. Calomel, taraxacum, nitro-muriatic acid, internally, combined with a persevering use of the “ nitro-muriatic bath,” as recommended and described by Mr. Ranald Martin, in his able treatise,‘ very speedily dissipated all mental despondency, and morbid anxiety, as to the existence or approach of mental derangement.

Closely allied to the state of conscious insanity of which I have been speaking, or, to use the language of Coleridge, “ the mind’s oum anticipation qf madness," is, what may be designated a morbid presentiment of threatening and approaching alienation of mind. This condition of disordered thought is occasionally recognised in cerebral, as well as in mental diseases. The patient has, in a few instances that have come under my observation, exhibited in the early stage of brain disease, a mysterious prophetic power, a singular presentiment or warning of his cerebral and insane attacks. In one case, the patient assured his friends, for some weeks prior to an apoplectic seizure, that he should soon be the subject of the malady, and that it would be fatal!

' 0: Tropical by J. Ranald Martin, F.R.S. 1859.

Alas ! he proved to be a true prophet! In another case, a patient said that he had received a warning of the advent of insanity, and was positive that he should be attacked. I knew three instances of patients who, for several years, predicted the accession of mental derangement, and who ultimately became insane !

“ We cannot,” says Portal, “hear without astonishment, the remarks sometimes made by those who are threatened with attacks of apoplexy. All their senses appear perfect and entire, but their minds appear to have acquired an inspired and a prophetic power. Their first impression is, that they are about to quit the world. Then they predict the future by the present; and the event justifying the prediction, they are regarded as true prophets. I saw a patient who foretold his death six days previously to its actual occurrence, there being at the time no symptom in connexion with the case that at all justified so unfavourable a prognosis.”

Sir Walter Scott had sad forebodings as to the final close of his active, eventful, and anxious life! He appears to have had a melancholy presentiment of the attack of brain disease of which he died.

His son-in-law and biographer, Mr. Lockhart, says, when referring to the final scene of the great magician’s life, “a more difficult and delicate task never devolved upon any man’s friend, than he had about this time to encounter. He could not watch Scott from hour to hour—above all, he could not write to his dictation— without gradually, slowly, most reluctantly, taking home to his bosom the conviction that the mighty mind, which he had worshipped through more than thirty years of intimacy, had lost something, and was daily losing something more, of its energy. The faculties were there, and each of them was every now and then displaying itself in its full vigour; but the sagacious judgment, the

SIR w. sco'r'r’s ANTICIPATION or BRAIN-Disease. 263

brilliant fancy, the unrivalled memory, were all subject to occasional eclipse.

‘ Along the chords the finger strayed,
And an uncertain warbling made.’

Ever and anon he paused and looked round him, like one half-waking from a dream, mocked with shadows. The sad bewilderment of his gaze showed a momentary consciousness that, like Samson in the lap of the Philistine, ‘ his strength was passing from him, and he was becoming weak like unto other men.’ Then came the strong ell'ort of aroused will—the clouds dispersed as if before an irresistible current of purer air—all was bright and serene as of old, and then it closed again in yet deeper darkness. Under these circumstances, it was no wonder that his medical advisers assured him repeatedly and emphatically that, if he persisted in working his brain, nothing could prevent his malady from recurring with redoubled severity. His answer was, ‘ As for bidding me not work, Molly might as well put the kettle on the fire, and say, Now, don’t boil.’ . . . I foresee distinctly, that if I were to be idle, I should go mad 1' The fate of Swift and Marlborough was also before his eyes; and in his journal there is an entry expressive of his fear lest the anticipated blow should not destroy life, and that he might linger on, a driveller and a show. ‘ I do not think my head is weakened —— (this was a subsequent entry) — yet a strange vacillation makes me suspect. b it not l/uw t/mt men begin lofail-— dreaming, as if were, infirm q/‘purpose?

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And when at the Court-house of Jedburgh he faced the rabble populace, and braved their hootings, the same idea of impending calamity was still present to his mind, as he greeted them on turning away, in the words of

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