The two illustrations I have cited are faithful and truthful outlines of a type of case that must have come under the notice of those engaged in the treatment of the insane. How keenly cases like these tear the heartstrings asunder and call into active operation all the kindly sympathies of our nature.

The physician cannot too frequently allow his mind to dwell upon the peculiar state of those reduced by insanity to a condition of utter and childish helplessness. In other classes of disease, in which the psychical functions of the brain remain intact, the invalid, even while suffering the most acute and agonizing pain, bodily distress, and physical prostration, is in a state to appreciate his actual relations with those around him—he feels sensitively the exhibition of tender sympathy—he properly estimates the care and attention bestowed upon his case, and recognises the skill of his faithful medical adviser. Alas! how different are the feelings and thoughts of many of the insane! In this class of afl'ections the kindness, sympathy, skill, unremitting assiduity, and attention of the physician are often not outwardly or manifestly appreciated. He has, in many cases, to pursue his holy work without the exhibition of the slightest apparent consciousness, on the part of the patient, of his efforts to assuage his anguish and mitigate his condition of mental disease and bodily suffering. Nevertheless, it is his sacred duty, even where, as is occasionally the case, his actions are greatly misconstrued and perverted by those to whose relief he is administering, to unflaggingly persevere in his efforts to carry out a curative process of treatment. The poor, unhappy invalid may believe that his physician is acting the part of a bitter foe. This ought not to excite any feeling but that of the most profound love and sympathy. If the patient’s


language be offensive and repulsive—if he be guilty of any acts of violence towards those in attendance upon him, the physician should never for a moment lose sight of the fact, that the unhappy afiliction has, to a degree, destroyed the patient’s free will, and that he, for a time, has ceased to be a responsible being. It would be cruel, whilst such a condition of mind exists, to treat him otherwise than as a person deprived by disease of the power of complete self-government and moral control. Let me earnestly and affectionately urge upon all engaged in the treatment of the insane, the importance of never losing sight of the fact, that even in the worst types of mental disease there are some salient and bright spots upon which the physician may act, and against which may be directed‘ his most potent curative agents. How true it is that,

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The more formidable, apparently hopeless and incurable types of mental derangement admit, if not of cure, at least of considerable alleviation and mitigation. It is always in our power to materially add to the physical and social comforts of even the worst class of insane patients. We undoubtedly possess the means of materially modifying (if we cannot entirely re-establish the mental equilibrium) the more unfavourable and distressing forms of insanity, rendering the violent and turbulent tractable and amenable to discipline, the dangerous harmless, the noisy quiet, the dirty cleanly in their habits, and the melancholy to an extent, cheerful and happy. It is possible, by a careful study of the bodily and mental idiosyncrasies of each individual case, and by an unremitting attention to dietetic and hygienic regimen, as well as by a persevering, unflagging, and assiduous admi

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nistration of physical and moral remedies for their relief, to

“ Pluck from the memory a rooted sorrow," &c.

The spirit of love, tender sympathy, Christian benevolence, unwearying kindness, and warm affection should influence every thought, look, and action of those engaged in the responsible treatment of the linsane. It is the special province of the psychological physician to

“ Fetter strong madness in a silken thread,
Charm ache with air, and agony with words."

That a holy, honourable, and sacred occupation is that in which he has the privilege of being engaged! Angelic spirits might well envy him the ennobling and exalted pleasures incidental to his mission of benevolence, love, and charity.



Asscnss, CEREBRAL, accompanied by ver-
tigo, 653
cases of, 672, 673, 674
caused by blows on the head, 654, 671,
672, 673, 674
generally accompanied by headache, 658
importance of inquiring into the ante-
cedents of patient, in cases of sus-
pected, 654
less of speech caused by, 499
often associated with chronic discharge
from the ear, 654
symptoms of, 619, 653
in the left hemisphere of the cerebruln,
formation of, preventable, 675, 672
Abercrombie, Dr., case of loss of memory,
reported by, 406
case of paralysis preceded by aphonia,
reported by, 518
on cephalalgia accompanying inter-cra-
nial disease, 545
on cereme cephalalgia, 654
on dyspeptic symptoms accompanying
cephalalgin, 569
on the impairment of the faculty of
attention, 347
Abernethy, ML, case of injury of the
head affecting the speech, 389
Aberration, incipient, of the intellectual
faculties, 303
of mind affecting moral sense, 320
of sight, 581
Lucretius's Poem written during an
attack of mental, 275
stage of, 303
Abilities, mental, of the insane, 275
Abin-Zoar, dream of, 613
Acuteness, mental, of the insane, 273
of the insane, remarks by Lord Erskine
on the, 280
Advocate, Dr. Johnson’s opinion on the
duty of an, 220
Afl'ections, anomalous and masked, of the
mind, 159
Alchemists, Lord Bacon on the persever-
ing efi'orts of the, 436
Alderson, Dr., case of hallucination,
mentioned by, 311


Amsurosis, dependent upon vascular con-
gestion, 574
early signs of cerebral, 567
from disease of the brain, 571
symptoms of cerebral, 328
Amblyopin a symptom of disease of the
brain, 567
Amnesia, case of, 383
Feuchtersleben on, 372
indicating disorders of the brain, 372
prelude to paralysis, apoplexy, and
insanity, 371
Anaemia, causing cerebral disease, 326
Anaesthesia, connected with certain morbid
cereme states, 546
cutaneous, 547
from pre-oecupntion of mind, 556
of the insane, cases of, 552, 553, 554,
produced by morbid exaltation of the
conscience, 557
symptoms of occasional, often exhibited
by patient, some years prior to the
apparent development of brain dis-
ease, 14
unobserved progress of disease owing
to, 556
Analysing ubtle cases of insanity, art
05 279
Andral, case of oculn spectra, related by,
on affections of vision, 585
on cephalalgia accompanying inter-cra-
nial disease, 545
on connexion between apoplexy and
cardiac disease, 624
on exalted sensibility, 537
on morbid visual phenomena, 576
on the lesions of intelligence accom-
panying diseases of the brain, 329
on vitiatcd sensation, 55S
Andree, Dr., cases of epilepsy detailed
by, 488
Anomalous affections of the mind, 159
Antipheron, deuteroscopy of, related by
Aristotle, 588
Aphonia, case of, related by Dr. Bricrre
de Boismcnt, 533
case of, related by Dr. Copland, 515
case of, reported by Dr. Abercrombie, 518
Aphorisms of Hippocrates, 1
Apoplexy, amnesia often the prelude to,

anticipation of, by Sir Walter Scott, 263
case of, preceded by sensation of cold,
connexion between, and cardiac disease,
corpora striata found rough and jagged
in a person who died of, 623
direct of, on the memory, 405
illusions premonitory of, 307
incipient symptoms of, 326, 473, 547,
interesting case of, related by Dr.
Watson, 506
Itard, Dr., on loss of memory accom-
panying attacks of, 362
loss of speech after, case related by
Dr. Cooke, 412
morbid speech following, 521
preceded by great depression of spirits,
premonitory signs of, 293
softening of the brain, causing, 639
state of mental excitement, precursory
of, 293
vertigo frequently the forerunner of,
vitiated perception, precursory symp-
tom of, 584
treatment of incipient, 668, 669
Arago, singular temporary impaired
vision of, 584
Aristotle, case of Antipheron, related by,
on association of ideas, 450
on memory in youth and age, 427
Articulation, imitative moVements of, 531
involuntary, 532
irregular action of the, 504
morbid, 509
Arsenic in the treatment of afl‘ectious of
the brain, 676
Atkinson, an idiot tried for murder at
the York Assizes in 1858, 217
Attention, Abercrombie, Dr., on the im-
pairment of the faculty of, 347
Chalmers, Dr., on, 334
genius nothing but continued, 333
Hamilton, Sir W., on, 676
heightened and concentrated, 340
impairment of, 335
importance of the faculty of, 333
morbid concentration of, 341
morbid efl'ect of concentrated, 345
morbid phenomena of, 332, 336
treatment in impairment of, 676
opinion of Bufi‘on, Cuvier, and Lord
Chesterfield, that genius is con-
gtiiéuted by continued application of,
suflicient importance not attached to


the cultivation of the faculty of, in
the education of women, 334
Aspasia, dream of, 613
Aura-epilepticr, 483, 486, 541
Autobiography of the insane, 47

Bacon, Lord, extract from “History of
Life and Death,” by, 441
on memory, 680
on the persevering efl'orts of the alche-
mista, 436
Baillie, Dr., curious case of impaired
memory produced by paralysis, re-
lated by the late, 412
Baillie, Joanna, invocation of madness
by, 233
Banks, Sir Joseph, case of sudden pan~
lysis of memory related by, 401
Bathing,Juvenal on the danger of, after a
full meal, 384
Beau, M., on premonitory symptoms of
epilepsy, 4S4
Beddoes, Dr,, case of morbid misuse of
words related by, 51 1
Belhomme, M., on the lomlization of
speech, 497
Bell, Sir Charles, on phenomena resulting
from injury done to the brain, 16
Belladonna in the treatment of insanity,
Bennett, Dr., on the connexion between
apoplexy and cardiac disease, 624
Bertin, Dr., on the connexion between
apoplexy and cardiac disease, 624
Birkett, Dr., case of singular irregularity
of vision related by, 532
Blood, clot of, found in the corpora
striata of a person who died of
apoplexy, 294
Puget, Mr., on the assimilative power
of the, 432
Boerhaave, insomnia of, 604
Bonaparte, memory of, temporarily af-
fected on the retreat from Mower, 400
Borgia, Caesar, description of the madness
of, by Nathaniel Lee, 275
Bouillard, Dr., on the connexion between
apoplexy and cardiac disease, 624
Bracket, Dr., case of morbid exaltat-ion
of vision related by, 577
Brain, amaurosis from disease of the, 571
amnesia indicating preceding disorders
of the, 372
anmmic condition of the, 21
Andral, on the lesions of intelligence
which precede or accompany diseases
of the, 329
anterior lobes of, supposed to preside
War the organ of speech, 49?
Bell, Sir 0., on phenomena raulting
from injury done to the, 16
case of obscure disease of the, 355

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