RELATION OF EDUCATION TO INSANITY.

By education is here intended any training of the mind by which its facilities are drawn out, its powers disciplined, and knowledge is acquired. This includes the study of books, of the thoughts, principles, and facts that have been prepared, digested, and printed by others. Usually this is done in the schools, from the infant school to the university, or it is done in private life, with or without teachers. Besides these means there is the education of the outer world in social intercourse, in business, in the management of affairs, public and private, political, of State or town, in commerce, manufactures, agriculture, &c.

THE BRAIN AND MENTAL ACTION.

Whatever stimulates the mind to observe, to study, or reflect, whether it be things present to the eye, or abstract ideas in books; whatever demands thought, compari son, or deduction, whether it be arithmetic, grammar, geography, or the profoundest problems in science and philosophy, whether it be the relations of values in business, the combination of materials and succession of processes to obtain definite ends in me chanics, or the observation and pursuit of the laws of nature to obtain crops of grain, and other products in agriculture, they all demand mental action; they develop and train the mind; they discipline the perceptive and the reasoning faculties, and all lay burdens of various weight upon the brain. There is no work of the mind without

cerebral action.

These burdens are extremely light upon the savage, who only thinks enough to find a cavern to shelter himself from the storm, or to search for wild fruits, or to catch a fish or an animal for food. They are heavier on the farmer who develops the riches of the soil, and raises grains, fruits, and vegetables for his nutriment, or on the mechanic who plans and builds a comfortable dwelling, adapted to the wants and health of a family, and still heavier upon the manager of a manufacturing establishment, or the conductor of a commercial enterprise, or the affairs of state; and in the technical education of the schools, the burden increases from the lightest upon the child who en deavors to grasp the relations of sounds to the form of letters, to the philosopher who solves the most abstruse problem of mathematics; whatever this burden may be, its first demand is for action of the brain.

Now the question arises, whether this action of the brain has any disturbing influ ence upon its health; and if so, in what manner and to what extent is insanity or mental unsoundness increased by education, and, if so, how much? And, lastly, is this a necessary condition of educating the people, of raising them from a savage and rude state to the civilized and the cultivated?

LITTLE OR NO INSANITY AMONG SAVAGES.

Without means of demonstration, there is an almost universal opinion that there is little or no insanity in savage nations, or even among barbarians. This is the opinion of almost all travelers of every kind-the curiosity hunters, the commercial, the phi losopher-all concur in reporting that they found no lunatics, and heard of none among the rudest people.

This is admitted by writers on insanity-Esquirol, Halliday, Prichard, Bucknil, Tuke, and others-men of the greatest research, and of the most cautious habits of deduction, the profoundest thinkers, the most reliable philosophers.

Insanity is manifest in all countries above the state of barbarism, from half-civilized Egypt and Turkey to the most cultivated and refined. It exists in various preportions to the population, but there are no means of determining these ratios. Although from all these countries there are reports of insanity, from most they are vague and ill-founded. Some include only those who are in hospitals for lunatics, as Egypt: others report such as are in public institutions, as hospitals, alms-houses, and prisons England reports those who are in these establishments, and also those who are under guardianship.

Some governments, at their periodical censuses, inquire as to the insane in the fam ilies, and publish their numbers, with some statements of their condition.

EVERY CENSUS OF THE INSANE IMPERFECT.

It is not an easy matter to obtain the number of the insane in any community. In early times they were supposed to be possessed by the evil spirit; and later, eve now, they are considered by some people more than a misfortune, even a disgrace to their families, and many were, and some are now, concealed, known only to their rela tives and a few friends. Many still are unwilling to speak of the insane of their

households as they do of others whose sickness is of the body, fever, consumption, pneumonia, &c.; still more do they shrink from speaking of this domestic calamity to strangers.

Governments find this difficulty in this inquiry, and fail, in great degree, to overcome it. When their agents ask at the houses whether any of the family is a lunatic, the question is often evaded, or met by a direct denial. This is a source of mortification that the sensitive, the agonized or proud parent, child, or brother is not willing to expose to a public officer who asks that he may publish it; and therefore the information is withheld. Hence even these official enumerations fall short of the probable fact.

TRUE PERCENTAGE OF THE INSANE POPULATION.

The report of the insane of Massachusetts in 1854 makes the nearest approximation to completeness. The commissioners appointed to make that survey requested every physician to give the name of every lunatic within his knowledge, with a description as to thirteen specified points. The name enabled the commission to avoid duplication, and exclude all repetition of the same persons. Every physician except four reported. As in any established community, like Massachusetts, there are few or no families whose domestic condition is not known to some physician, it was presumed that few or none could fail to be reported. The result was that one person in every four hundred and twenty-one of the living was found to be insane.

The average of the reports of two State censuses, 1855 and 1865, and of three national censuses, 1850, 1860, and 1870, in Massachusetts, was one lunatic in five hundred and seventy-one of the living. The commissioners' report was 2,375 in 1,000,000, and the censuses reported 1,750 in the same number of people. The commissioners found 28.14 per cent. more than the families revealed to the enumerating officials of State and nation.

In the absence of other standards of comparison, this may be assumed as a correct one, and that the State or national reports of results of inquiries made in the ordinary way fall short of the truth in a similar degree, and the 28.14 per cent. should be added for the incompleteness of the returns.

It is safe, at least, then, to add this proportion to the number of the insane reported by the census of any civilized country.

The enumeration of the people by actual family and personal inquiry and counting is a modern improvement. Few of them go back even into the last century. Most statements of population a hundred and more years ago are based upon indirect inquiry-upon calculations, inference, estimates, which at least are but approximations to the facts. The inquiries into the number of the insane are still more recent, mostly within less than half a century, or even a quarter of a century. The first of the United States was in 1840, and again in 1850, 1860, and 1870. Those for 1850 and 1860, as already shown, were manifestly incomplete as to Massachusetts, and probably for other States.

APPARENT INCREASE OF THE INSANE.

In whatever way the number of the insane have been ascertained, calculated, or estimated, there has been a constant increase reported-more and more have been revealed and known with the progress of years.

The successive reports, upon whatever source or means of information procured, all tend to show an increasing number of the insane.

In the United States, Great Britain, Ireland, and other civilized nations, so far as known, there has been a great increase of provision for the insane within forty years, and a very rapid increase within twenty years. Hospitals have been built, seemingly sufficient to accommodate all the lunatics within their respective States, counties, or districts. These have been soon filled, and then crowded and pressed to admit still more. They have been successively enlarged, and then other institutions created, and filled and crowded as the earlier houses were.

This increase of lunatics presented to the hospitals has been and is much greater than the increase of population, and seemed to indicate an increase of insanity in proportion to the numbers of the people.

CAUSES OF APPARENT INCREASE.

At first sight this seems to be evidence of so much actual increase of lunacy in the world. But further examination shows that it is not so much the development of new cases of insanity as the development of the persons insane-not so much a manifestation of increased lunacy as an increase of the world's knowledge of its presence among them.

In former times lunatics were objects of terror and disgust. They were considered as unpleasant blots on families, sources of shame and mortification. Hence they were concealed and their existence known to as few as possible. Their disease being thought remediless, they were allowed a bare existence, but not to be numbered as among men.

INSANITY A CURABLE DISEASE.

But in later times a better knowledge of pathology shows that insanity is primarily a disease of the physical organs, and is generally remediable. The means of restoration are now provided in hospitals fitted for them. Patients, such as in another age would have been given up as forever lost to their friends and the state, are now sent to these institutions and again brought back in their sound mind, and again assume the burdens and bear the responsibilities of healthy life at home.

Society now seldom attaches dishonor to this disease. They respect it and regard it as tenderly as the disorder of any other organs, the lungs, the stomach, &c.; conse quently the insane are more and more brought out. The more the means of healing are provided and made known to the people and brought within the reach of families, the more are they moved to take advantage of them and intrust their mentally-disordered friends to their care. This is remarkably illustrated by the growth and increase of hospitals in most of the States of the Union and in the nations of Europe.

In a State where perhaps a hundred patients are known, the Government builds a hospital for them; but, looking providently to the future, plans it large enough to accommodate one hundred and fifty. Soon after its doors are opened the hundred appear, and in a short time the other fifty, and still more, apply for admission. The State builds wings for another hundred with the same far-seeing prudence; but in a short time the new rooms are filled; again there is a crowd and a new demand for expansion.

THE EXPERIENCE OF MASSACHUSETTS.

The history of Massachusetts is a type of the experience of other States in this respect. In 1832 the State built the lunatic hospital at Worcester for one hundred and twenty patients, which was as many as the legislature thought would be offered for several years. In their first report, at the end of the first year, the trustees said: "The hospital is now in a very crowded condition," and proposed that additional a commodations should be provided. In the next year, 1834, the superintendent, Dr. Woodward, reported that the hospital was crowded, and that he had been obliged to reject half the applications for want of room. In 1837 two wings were added, for one hundred and sixteen patients. One hundred and seventy-seven patients were admitted in 1838, and one hundred and seventy-nine in 1839. There were two hundred and thirty present at the end of 1842, and two hundred and fifty-five at the end of 1843, In 1844 two more wings were added, for one hundred and twenty-five patients. In 1843 two hundred and ninety-three were admitted. In 1853 the average number was five hundred and twenty, through the year; and at one time there were five hundred and sixty-seven in the house.

In 1854 the State opened the new hospital at Taunton, for two hundred and fifty patients. At the end of September, 1857, there were three hundred and twenty-seven patients in this institution, and three hundred and eighty-seven in that at Worcester, In 1858 the State opened the third hospital, at Northampton, for two hundred and fifty patients. In 1862 it contained three hundred and thirty-two lunatics, while there were four hundred and one at Worcester, and four hundred and twenty-one at Taunton. Within two years the State has built an establishment for lunatics at Tewksbury, In 1870 there were two hundred and sixty-seven inmates in this house; and at the same time eleven hundred and ninety-three in the three State hospitals, two hundred and thirty-three in the Boston city hospital, and one hundred and, seventy-eight in the McLean asylum; in all the public institutions of Massachusetts, eighteen hundred and seventy-one insane patients.

It cannot be supposed that so many persons were suddenly attacked with insanity when these successive establishments were opened or enlarged for their healing-that an epidemic mania fell upon the people so contemporaneously with the new opportunities of relief. But rather there was an increase of intelligence of the nature of the malady and of its curability, and of confidence in the management of these hospitals, and in their power to restore the mentally disordered to health. From this cause, so many more of the insane were brought out from their homes and revealed to the authorities and to the world.

The more these means of healing were prepared, the wider the knowledge of their worth spread among the people, and the more the number of the insane seemed to increase. Yet, however we may qualify this apparent increase of lunatics by this explanation of increased interest in them, and of the means of cure, within the last fifty years, there has unquestionably been a very great real increase of the malady in the progress of the world from the savage to the civilized state. Without asserting that these two great facts, the development of mental disorder and the growth of hu man culture, stand as cause and effect, still all the known evidence goes to show that these have marched side by side, and disease of the brain has grown up in connection with the increased mental activity and culture, if not out of them. We may then rea sonably ask, whether this connection is more than accidental, and, if so, to what extent?

CONNECTION OF INSANITY WITH CIVILIZATION.

The savage is apathetic, and his mind is torpid. He has but little more than the animal instincts, cunning and appetite. He neither learns nor thinks, nor loves nor hates as cultivated people do; so his brain bears little or no burden. The barbarian has somewhat more mental action. He is somewhat more emotional, and his brain has more to do, but far less than the civilized races.

As man emerges from this low estate, his brain begins its destined work; new wants present themselves, and compel thought to satisfy them; new gratifications tempt him to devise means of obtaining them. He seeks variety; he co-operates with his fellows in business; mechanic arts exercise his mental faculties; public affairs require his attention; education in schools, with books, quicken the cerebral energies; and thus burdens are laid upon the brain, and its labors increase as civilization passes from the lower to the higher, admitting more and more culture.

The brain is the seat or organ of thought and emotions. By this, or with this, certainly in connection with this, we conduct all the mental operations; we study, learn, think, plan. By it, or with it, we love or hate; we feel joy or sorrow, exhilaration or depression. All that constitutes life and its movements is connected with the brain and its actions.

It is natural to suppose that any machine or structure is in more danger of getting out of order when it is put in motion and used than when it is entirely dormant. The active brain is in more danger of disturbance than one that is ever at rest.

CAUSES OF MENTAL DISORDER.

When patients are admitted into insane hospitals the officers obtain the best information they can from friends and previous medical attendants, in respect to their history, habits, exposures, and conditions, and the events, circumstances, and influences that might be supposed to be causes of the disorder. All this is put on record, and if afterward any new facts are discovered that should modify the opinions first formed the record is altered correspondingly. These causes are digested into systems, arranged in tables, and published in the periodical reports of the hospitals. By means of these the psychological student is enabled to trace insanity back to its probable or assumed causes, in most civilized nations, through periods varying with the experience of the hospitals.

In a part of the cases the causes are self-evident and manifest equally to the common and scientific observer, to the friends, the physician, and the specialist, who is familiar with the diseases of the brain. Of these there is no doubt. But, in regard to many others, it is difficult to determine the origin. There may be several causes combined. Some which seem to be causes may have been merely co-existing conditions or events. Sometimes habits or conditions which are apparently causes are really a part of the disorder or its early symptoms. A man, ordinarily very cautious, may go out of his usual track of business and enter into hazardous speculations and grow more and more venturesome, and at last he becomes excited, absorbed, loses his wonted balance and at length becomes manifestly insane. His speculations are, by most persons, supposed to be the cause of his mental disease; but, in reality, the disease had its origin before the speculation, and first prompted him to go out of his habitual course of life into this uncertain and dangerous business. This was the first open stage of his malady.

Beside the classes of cases whose origin is certain and those which are doubtful, there is a large class of which nothing can be learned, and some whose history, although fully known and faithfully reported, reveals nothing as to the source of the mental disturbance. This class of the unknown figures largely in the tables of most, if not all, hospitals.

CLASSIFICATION OF CAUSES.

The causes of insanity which are certain and accepted are usually divided into two classes: 1. Physical, those which affect the body and brain primarily; as apoplexy, palsy, epilepsy, fever, blows on the head, and many other diseases or injuries. 2. Moral, those which first affect the mind and the emotions; as excess of study, all sorts of overaction of the brain in business, excitements, mental disturbances, disappointments, griefs.

In some of the hospital reports there are ninety-three of the physical and eighty of the moral causes given. In all the reports the number of imputed or stated causes is much greater. They include most of the diseases, disturbances, exposures, mistakes, misappropriation of mental power or emotion that happen among men.

Among these are comparatively few that are directly chargeable to education, yet it is equally clear that comparatively few of these causes exist in the savage state, nor are common in an ignorant age. They have mostly grown up with civilization and are is contemporaries, if not its results, immediately or remotely.

INFLUENCE OF EDUCATION.

Education causes directly but little insanity. In a table of seventeen hundred and forty-one cases, whose causes are given, from sixteen hospitals, only two hundred and five are from excess of study, two hundred and six from mental struggles and anxiety, and sixty-one from excitements. Eleven hundred and thirty-four were from business trials and disappointments.

But education lays the foundation of a large portion of the causes of mental disorder. It unlooses the brain from its bondage of torpor, and encourages mental activity in the numberless paths of life. It opens the fields of enterprise; it adds intelligence and reason to the power of the muscles, and makes them more available for every purpose. It stimulates energy and bold adventure. It offers temptations for the assumptions of mental burdens in business. It holds out rewards to ambition, for the strife for knowl edge, wealth, honor, political success. These and other motives act in various degrees on civilized communities, and few people completely escape their influence; and among nearly all there is more mental activity, more cerebral labor, in thought, anxiety, more exhilaration from hope and success, and more depression from anxiety and disappointment, than is found among people that are untaught. All these have their dangers, and among those thus engaged some lose their mental balance, and some become insane.

There are other causes that only appear in a cultivated age, yet they may affect mostly uncultivated people. Education and civilization produce machines and other means of labor. In the hands of uneducated men these cause accidents to their ignor ant operators, who are thereby made insane.

In the hospital reports the largest class of causes is included in the comprehensive term "ill health." This was the presumed origin of 21 per cent. of the cases. Under this head are the manifold depressions of life, or disturbances of the physical powers, Dyspepsia is the most prominent. With the general failure of health the brain and nervous system suffer and falter in their functions.

INTEMPERANCE A CAUSE.

Intemperance is another cause of much insanity. About 10 per cent. of all stated are said to arise from this vice. This happens more among the poor and the ignorant in a civilized society. Savages are protected from this cause of insanity simply by their want of opportunity; but in cultivated communities the means of intoxication are more accessible and obtainable; few are so poor as to be unable to obtain them, and it is noticeable that the poor are the most addicted to this indulgence, and furnish thereby a very great portion of the victims of lunacy.

It is a melancholy yet unavoidable conclusion that some or many of these causes of insanity are peculiarly abundant in this country and in this age, and some of them are increasing in frequency and disturbing force. Almost the whole class of accidents, injuries, and exposures has increased. With the new improvements in the mechanic arts, the multiplication of machinery, the new and sometimes uncontrolled, if not uncontrolable, motive powers, and with the new modes of travel, more accidents hap pen, more injuries are inflicted, and in their way they multiply the causes and the cases of insanity.

In course of the same progress of improvement, there are more chemical agents dis covered, and numberless new applications of this science, and its discoveries to practical use, in the common arts and business of life. Men are, therefore, more exposed to minerals, acids, gases, paints, dye-stuffs, and combustibles, and explosive elements and mixtures, which are sometimes more or less injurious to health, or cause accidents daɛgerous to those who are connected with them, and consequently multiply the caused and the cases of lunacy.

COMPLEX NATURE OF MODERN CIVILIZATION A CAUSE.

The causes connected with mental labor in its manifold applications have increased and are increasing continually. In the progress of the age, education has made rapid advance both in reaching a wider circle of persons, and in multiplying the subjects f study. The improvements in the education of children and youth have increased their mental labors, and imposed more burdens upon their brains in the present than in the preceding ages. The proportion of children who are taught in schools increases every year in the United States, and in most civilized nations. There are more and more of those whose knowledge, whose sense of duty, whose desire of gratifying friends, and whose ambition, impel them to make their utmost exertion to become good scholars. Thus they task their minds unduly, and sometimes exhaust their cerebral ener gies, and leave their brains a prey to other causes which may derange them afterwards The new sciences which have been lately discovered, or the old sciences that were formerly confined to the learned, but are now simplified and popularized, and offered to the young as a part of their education, multiply the subjects of study, and increase the mental labor of almost all schools.