force of each re-action, as commensurate, not with its reasonableness, but with the strength of the impulse, under which he had previously acted or resolved to act." 96.

When actual delirium supervenes, separation becomes indispensable. Nor need we dwell on its advantages. With the third stage come, observes our author, the tempora fandi; the opportunities of an effectiver emark, must be observed with watchful attention. Suggestions vividly and pointedly made of incongruities of thought and conduct often appear to rouse the patient into a consciousness of his state. His mind perhaps darkens again, but the vestiges of an impression thus made are often observable in his subsequent conduct. Many such alternations of light and darkness occur during convalescence.

Dr. M. thinks that a valuable influence may be obtained from the operation of sympathy. It has occurred to him, in many instances, to observe the effect of a well-regulated mind upon the convalescent insane, when that mind is furnished with the curious tenacula of sympathy, which seize and hold under their influence the minds of others. Instances, however, have occurred, in which the influence has been reciprocal. Dr. M. relates a case in point. An anxious and attached wife had maintained a long-continued intercourse by letter and conversation with her insane busband, who resided at a private establishment. This gentleman had passed into the third stage of his complaint; and there continued. He required but little surveillance, and united in a remarkable degree his original capacity for clear thought and sagacious reflection with the rapid and erratic associations of insanity. The lady herself, though nervous by temperament, had a sound and strong understanding. In talking with her, however, it is easy to see, that the sequence of her thoughts, and the links by which they are connected, have been influenced by the habitual contemplation of a morbid mind. Their mental relation has indeed become that which is expressed by the terms "ils s'entendent."

"There is much skill," continues Dr. Mayo, "required in the management of the insane, in observing a distinction between those ideas, which belong to his disease, and those, in regard to which his mind is at the time not insane. The power of control over the train of thought sometimes returns very suddenly: and it is of immense importance, that the chain thus recovered should not escape the patient's grasp. Now, whatever modes of thought receive the sanction of a judicious medical attendant, are by this circumstance in some degree recommended to the attention of the patient, provided his sympathies have been secured. Thus his recovery becomes valid in his own eyes, when countersigned, as it were, by the opinion of his friend.

A patient, who had been insane for three years, and had spent a large portion of that time at the establishment at Ticehurst, had passed into a state of alternate lucid intervals and paroxysms, each of these states successively lasting for some weeks. At the commencement of one of these, he announced to Mr. Newington, the proprietor of the establishment, that he should never have another attach. On learning this, as well as that he had never before made any similar remarks, I went over to Ticehurst; and formally stated to the patient, that I accepted with pleasure his announcement of his recovery; that I believed he was correct in his supposition that it had taken place; that nothing more remained, than that he should give himself and me some proof of the soundness of his own impression by spending a portion of time, which I named, at the establishment. This patient never relapsed. 103.

Dr. Mayo's sentiments on the physical treatment of insanity are judicious. They apply to the use of depletory agents-of tonics-of sedatives—and of counter-irritants. He joins in reprobating that extreme depletion, which, we fear, is too often practised in mania. He relates a striking instance of the possible bad effects of even a small loss of blood. It was the case of a middle-aged lady residing at an establishment, in whom the disease had continued for some time in its first stage; the application of a few leeches to the temples, which her dull and oppressed look and robust figure seemed to indicate, as, at least, a safe measure, gave a very mischievous development to the disease. She became instantly very delirious, laughing and chattering incessantly, and in this state, Dr. M. found her about four months afterwards. He relates another case in the patient's own words as a sample of one in which depletion would probably have been injurious.

A lady had, by Dr. M.'s direction, taken some mild alterative aperients, and a cordial mixture for six days. "I still feel," she says, "a whirl about my head. I should describe it as if it felt too tight; and express the feeling, as if air got in and made a whistling or rushing about my ears; or I could fancy it voices talking to me. I feel a reluctance to apply to anything; to work a sum with my children seems too great a strain on the forehead; and I forget as soon as I have read a page, or indeed any conversation; even, if I desire it to make an impression. I once, many years ago in 1818, had a slight illness in Paris, and possibly from over-excitement a tendency to imagine things different from what they really were. This always made me most anxious during my confinement, and at other times, to keep myself as tranquil as possible. I never had any return. But have for some time felt unwilling to attempt mental exertion. I remember, once at, taking some bark and cayenne pepper; and it seemed to clear my ideas and to make my mind more collected." The lady was a fine person, aged about thirtyfive, of a full but flaccid figure, her temperament leucophlegmatic and nervous; but, living in a very bracing air, she kept herself in a state of fulness, which might easily simulate the robust sanguine constitution. She had had several children; and her mind was kept on a stretch by domestic cares. The catamenia were free in quantity and regular. Now in this case, the lancet, if used for the above congestive symptoms, would have had a very mischievous effect on her powers of self-control.

Moderate depletion is well borne by the melancholic. But free venesection may convert quiet melancholia into delirium.

In the case of a young lady, the accidental taking of a drachm of nitrate of potass by mistake for a scruple three times a day for a fortnight, which produced bloody evacuations and obstinate vomiting, appeared to operate most beneficially in the disease. It subsided with going into its second stage, and has never recurred.

Dr. Mayo considers tonics valuable in the first stage of insanity, in the serous and the nervous temperaments, mischievous in the bilious and sanguineous.

In the second stage tonics are inapplicable, whatever may be the temperament of the patient.

In the third stage, they are valuable in every temperament, with this reservation, that their use in each should be cautious or bold, in the same No. LX.

LL

proportion, as it may be noxious or salutary in the first stage of the disorder under that temperament.

Of course Dr. M. speaks well of purgatives. And he concurs with the best practitioners in extolling sedatives.

"The intention of sedatives is in every stage of the disease a wise one. By soothing the insane patient, we at once give him wholesome strength, and reduce morbid action. Of all the medicines which possess this virtue, opium has been in my experience the least valuable, and digitalis the most so. The following recipe I have found very useful in the second stage of the sanguine or sanguineonervous temperament. Mixturæ camphoræ 3xij.; potassæ nitrat. j.; tincturæ digitalis mxv. M. fiat haust. ter quotidie sumend." 117.

Dr. M. speaks disparagingly of opium-commends the extracts of henbane and lettuce, combined with camphor in small doses, and with the compound extract of colocynth-lauds the infusion and tincture of hop-and leans dubiously to counter-irritation, particularly in the bilious, leuco-phlegmatic, and sanguine temperaments.

The Tenth Chapter is occupied with Brutality. This was the subject of a former essay by the same author. The name is retained-the thing is described as before-but the view in which it is regarded is altered; for he did look on it as a form of insanity, while he does regard it as destitution of principle. We must say that if brutality is to be deemed insanity, there is no crime so monstrous, no deviation from the path of natural feeling so wide, as not to claim the privilege of the same plea. Tiberius, Caracalla, would cease to disgust-they would become objects of pity. The executioner might burn his halter, our criminal courts might be turned into lunatic asylums, for the great criminals, the Thurtells and the Greenacres, would no longer be the victims of offended justice. Our penal code would be almost limited to petty larceny and shop-lifting, and with the progress of science, even these would be found at last to be only forms of madness. Take Dr. Mayo's description of brutality, and see if it be not what is usually deemed a vicious tendency unchecked by proper education, or ripened by indulgence. "We have a class of persons, differing from the majority of mankind in their incapacity for moral distinctions, differing from the insane, in not labouring under any suspension of the power of will. On the first of these grounds they have a right to a place in our system of mental pathology. On the last, they must constitute a distinct head from insanity. I am not at present considering this class generally; I exclude indeed that section of persons, in whom the absence of principle is obviated by the harmlessness of their tendencies. I am speaking of persons destitute of the moral faculty, and also vicious in their propensities. For these I have borrowed the designation given to them by Aristotle; and I call them brutal.

In regard to the principles on which this morbid condition may be treated, the law, it may be observed, greedily takes advantage of its co-existence with insanity, whenever this occurs, and it readily does occur, to control the unsound habit of mind, but has not hitherto been able to grasp it in its own form. Although in truth, the state which we term brutality spreads as wide devastation as insanity would, if insanity were left uncontrolled; and is, according to the above view, equally a disease of mind." 128.

If it be difficult to determine the existence of insanity in its usual forms, how impossible it would be in practice to draw a line between "brutality" and vice or crime. The latter is punishable in a sane man, because the

brute" this power of reflection and If he has, he is a responsible agent

exercise of reason enables him to perceive that it is culpable, and that the laws of society denounce it. Has the " of estimation of consequences, or not? —if he has not, that can be proved by aberrations of reason.

Dr. Mayo seems to hint that the law might reach brutality. But if brutality be rational how can any law reach it? The law cannot punish tendencies. How are they to be determined? Only, we presume, by acts. But if acts be culpable they are already punishable by as strict a code as the circumstances of society permit. If they are not culpable, we do not see how the law can grapple with them. Law must define, must say what it will and what it will not suffer. If it did not say this, none would be safe; the powerful would escape-the weak would be hunted down. No doubt there are acts without the scope of law which are offences against our moral sense, and even injurious to society. But there are punishments, as well as crimes, independently of those with which law deals-acts which entail retribution in a thousand ways—which make the tyrannous father suffer from the disobedience of his child: the harsh husband from the indifference, the drunkenness, or the infidelity of his wife: the proud or the imperious man from the desertion of his friends. We are sure that it is impracticable for law to deal with anything but facts, or to regulate society and repress vicious tendencies, connate or acquired, by any other means than by the punishment of those acts which she denounces.

Dr. Mayo adds :

"It is indeed time, that the disgraceful scenes should terminate, which are now occasionally enacted at the public offices in London; where a father is heard requesting that an ignominious punishment should be inflicted upon his son, as the only moral expedient which can reach him; and thus finds no other mode of obviating the deficiency of principle, than the penal inflictions of the law. But it is yet more painful, that the offender should be allowed to wander on through crimes and inflicted misery, until he reach this goal. An instance of such a termination to the course of the brutal person is afforded by the unhappy Lord Ferrers. That nobleman was not insane in any customary use of the word; his intellectual facultics were good; and they were directed by a powerful will towards definite objects; neither did he exhibit that moral incoherency, which we have described among the earliest phenomena of the insane state. The business-like talents, indeed, which he displayed in his own defence, indisposed his judges to allow him the advantage of that plea. But his brutality made him unfit for social existence: the laws of this country did not reach him as a subject for confinement. Therefore he was hanged. This procedure was unavoidable under the circumstances of the case, and in the present state of our laws; but it constitutes a painful fact, considering, that education at present affords no preventive to such criminality." 132.

We do not think that Dr. Mayo proves his case. Brutality, such as he describes it, does not seem to us to require, on the part of society, the shield of insanity against legal consequences, nor to merit it on the part of the individual. If "brutality" were allowed that defence, it must be extended to almost all the ramifications of violence, of passion indulged, and of evil propensities uncontrolled. The case to which Dr. Mayo refers-that of the father and son at the police-office-is frequent enough no doubt. But it shews no more than that the father has educated that son amiss, and that

bad associates, and corrupt habits, have completed what parental mismanagement began.

Unless it can be shewn that vice is attended with deficiency or alteration of the reasoning faculty, it must, and, for the interests of mankind, it ought, to be held responsible for its mis-deeds. Education tends to prevent it. But moral education is a private affair. The state cannot take each child from the cradle, and regulate the nursery or parlour. That must be left to parent and preceptor. If they fail to pluck out the seeds of wrong doing, and allow them to germinate and ripen, woe to the unhappy being in whom they have been let grow, for his only safeguard against himself is his terror of the strong arm of insulted law. This, indeed, is admitted by Dr. Mayo, and, making that admission, he withdraws "brutality" from the pale of irresponsible mental infirmity, and places it, where it ought to be placed, within the catalogue of guilty things.

The Eleventh Chapter, on Idiocy, congenital or acquired, presents nothing of moment. It is more easy of appreciation than some other forms of insanity. The degree of deficiency of intellect which constitutes it can only be determined by special examination in each particular case.

The Twelfth Chapter is intended to supply some omissions in its predecessors. They cannot be considered by our author great, for it is extremely brief. The only passage that we think it necessary to introduce is the following:

"In describing medical treatment I have to regret a very important omission; namely, the use of nauseating remedies in this disease. The large doses in which ipecacuanha and the tartrate of antimony are borne by the patient, without exciting the effort to vomit, and the decisive effect which they produce in shortening and mitigating the second stage of the disease, entitle them to the highest attention. In recommending measures that may tranquillise the insane mind, I have omitted the important topic of employment. This, indeed, if cautiously managed, conduces to tranquillity. Gentle manual employment is of great avail in diverting mental irritation: and in this point the habits of females give them a valuable advantage. Of the intellectual faculties, that of observation may be cultivated with the greatest advantage; it does not imply the continuity of action, which easily runs on into incoherent thought in the insane intellect; and it tends gradually to wean such an intellect from false perceptions." 152.

We take our leave of Dr. Mayo. His little work will repay perusal. It cannot be considered an elementary treatise, but it contains many judicious reflections, and the reader will probably rise from its perusal better qualified and more disposed to study the mental phenomena of insanity, and to regulate the insane.

II. ON HALLUCINATIONS.

These form the subject of the second essay of M. Esquirol, and occupy forty-three of his pages.

There is a certain form of insanity in which the individual believes in the reality of impressions, sometimes transmitted by one sense, sometimes by another, at a time when no external object really exists to give rise to them. One person hears voices, questions, replies, keeps up a connected conversa