a morbid mind. Their mental relation has indeed become that which is expressed by the terms, "ils s'entendent.”

There is much skill required in the manage

ment 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 attack. 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.

Hitherto, I have supposed that the disease is tending towards recovery, and I have contemplated a state of the case in which, as the delirium subsides, a clear and lucid state of the mind is disclosed. It is perhaps favourable to the activity of our exertions, though it involves a want of scientific precision, that we are so little able to speak confidently of results. In the case above alluded to, three years had elapsed; still the patient recovered. In most cases of equal endurance, by that time, evidence of a weakened and paralytic, as well as perverted mind, will have become manifest. With this a failure of bodily health keeps pace. The skin becomes more dry and harsh; the figure more meagre; one of those lesions of brain, which dissection

discloses, will have probably commenced. The patient may, however, still live long, if not exhausted by depletory measures; or if there are not other physical conditions involving extreme nervous excitement or epileptic paroxysms. For, on the other hand, he is no longer subject in the same degree to that excitement, which his intellect and his moral deportment had before supplied him with.

Over this melancholy state art is unavailing as a source of cure, but may go far to alleviate pain, and make existence easy and comfortable.

CHAPTER IX.

Physical treatment of Insanity. - Mental and medical influences produce equivalent physical effects. - Physical treatment referrible to temperament;-in the employment of depletory agents;-of tonics,-of sedatives, of counter-irritants.-These measures considered separately in their application to the three stages of Insanity.

I HAVE hitherto described the mental treatment of a mental disease: and I have been the more desirous of asserting the importance of this view of the subject, because it is always liable to be neglected in favour of physical treatment founded upon physical views.

The treatment, which regards our animal economy in its physical state, operates through agents, if not more potent, at least more definite, more immediate and more easy in their application. A dose of calomel is easily administered;

and if it succeed, is very prompt in its relief of mental uneasiness. A system of mental discipline is of slow operation. Between the two systems, there is however this important difference; that the one has no necessary connection with the formation of a habit of self-control; while the other essentially involves it.

The quaint author of Clarissa Harlowe, puts before us the convertible nature of mental and medical influences even in producing a given physical state, when he represents Lovelace as having recourse to a dose of ipecacuanha in order to obtain the wan and disconsolate appearance of unrequited love. And it would require the pen of Montagne, or of our own Burton, to tell us, without unbecoming levity, in how many cases of escaped madness the regulation of the state of the bowels has at some critical moment been preservative ;-or again, how often this disorder has arisen from the corresponding neglect.

Still the deliberate adoption of precautionary measures, whether of a mental or of a physical kind, against insanity, is somewhat repugnant to our feelings. Men do not like to consider themselves obnoxious to this disorder. The assurance that there is no insanity in a given family is