In a second memoir (Annales med. psychol., tom. vi., Jan. 1846,*) Morel enters into a full description of the principal asylums of Italy; as for instance, those at Venice, Milan, Genoa, Bologna, Ferrara, Florence, Rome, Naples, and Palermo. This memoir, which evinces great acuteness of observation, and a sound critical spirit, will be read with much interest. Although we learn from M. Morel's report, that the asylums for the insane in Italy do not enjoy the same degree of careful superintendence manifested in the other charitable institutions of that country, a general tendency towards improvement is yet everywhere perceptible. We gather no new facts of practical importance from the results of M. Morel's observation of the mode of treatment adopted by the psychologists of Italy. In the insane asylum for women at Venice, the author found that, of the 1073 patients admitted between the years 1837 and 1843, 215 suffered from pellagra. The institutions at Ferrara and Bologna are very defective. That at Florence is a fine roomy building. Amongst the patients, there were likewise patients with pellagra from districts in the Apennines, where the people do not live on maize. At the fifth meeting of the Congress of Science, in Italy, four subjects were proposed by the Medical Section: 1. A classification of mental diseases: to be based on the facts deduced from clinical observations, and pathological anatomy. 2. Whether, and how far, phrenology is able to further our knowledge of mental diseases? 3. Whether, and how far, pathologico-anatomical changes can be regarded as the cause or effect of mental discases ? 4. What symptoms manifest themselves in different mental diseases, which indicate a prophylactic, therapeutic, moral or physical mode of treatment, and of what value are such symptoms? In a work intended as a reply to these questions,† Professor Carlo Speranza, former President of the Medical Section, enters into an extended disquisition, the purport of which is to prove, that phrenology has not been of use in furthering the study of mental diseases. The third question is left as undecided as it was before; and the fourth is * La Pathologie mentale en Italie: lettre à Mons. le Docteur Ferrus. Coupd'œil sur les principaux établissements d'aliénés. (Ann. Med. Psychol., t. vii. Jan. 1846.) + Riporta al Secondo quesito proposto dalla sezione medica del V. Congresso Scientifico Italiano de Cav. Prof. Carlo Speranza, membro corrispondente di illustri Academie et Società scientifiche, già Presidente della suddetta medica sezione. (Giornale per servire ai Progressi della Pathologia et della Therapeutica, t. x. lev. 2.) treated in accordance with the present condition of psychological science, but without any new views being advanced. Leopold Turk's work demands some notice, from the singular views of the writer, who regards delirium as a purely nervous phenomenon, occasioned by over-excitement of the cutaneous surface with electricity. With the view of curing this affection, Turk recommends the prolonged use of lukewarm baths, continued for days together; having at the same time recourse to venesection, emetics, purgatives, &c. By means of the employment of such baths, the author professes to have cured four-fifths of all his patients. Dr. C. W. Ideler,† directing physician to the insane department of the Charité Hospital at Berlin, attempts, with perhaps too plausible a form of argument, and with too great scepticism, in reference to the special investigations of anatomy, chemistry, and microscopy, to prove that the salvation of psychology, generally and specially, is to be sought. in an anthropology; not such as we are accustomed to regard it, but in the recognition of the influences exercised by all branches of human pursuits combined, as theology, jurisprudence, medicine, and philosophy. This, indeed, is a noble object for the attainment of the psychologist. Engelken's work is distinguished for the unprejudiced, rational views it advances. In opposition to the majority of psychologists, the author regards the prognosis of mental disease as less unfavourable than that of many other chronic affections. We also differ from him in this, and in the favourable character which he attaches to the prognosis of puerperal insanity, which is often extremely difficult of cure, and not unfrequently wholly incurable. As the superintendent of a private institution, the author naturally gives the preference to such establishments over public institutions. He is averse to all coercive measures, and thinks that artifice is preferable to force in inducing the patient to enter an asylum. His remarks on the duties of the physician who undertakes the charge of the insane, are a mere recapitulation of the views now so generally recognised on this subject. We find, however, that his mode of treatment presents several novel features. Thus, for instance, he adopts a modified form of water-cure; enveloping the patient in wet linen sheets, and applying cold moist cataplasms to the abdomen, in different cases of convulsions; and, Mémoire sur la Nature de la Folie, et sur le Traitement à lui opposer. Par Leopold Turk. Paris. 1845. + Ueber das Verhältniss der Seelenheilkunde zu ihren Hülfswissenschaften, von Dr. C. W. Ideler, Prof. der Med. und dirigirender Arzt der Irrenabtheilung au der Charité zu Berlin. (Allgemeine Zeitschrift für Psychiatrie, iii. B. 3 H. s. 394.) Beiträge zur Seelenheilkunde, von Dr. Fried. Engelken, Director der Privat. Heilanstalk zu Oberneuland bei Bremen. Bremen. 1846. lastly, employs electricity, from which he states that he has derived much aid in cases of imbecility, erethism, nervous derangement, and hysteria. Dr. Engelken is a great advocate for the use of opium, not only in melancholia hysterica, but in all instances of extreme irritability of the nervous system where there is erethism, and even in many forms of mania. According to his views, this remedy exercises an invigorating and exhilarating action on the brain and mind. In Dr. Engelken's observations on the psychical treatment of the insane, although we meet with no striking novelties, we are nevertheless forcibly impressed with the proofs of experience and profound thought manifested by the author. Dr. Michéa's work on Hallucinations and Illusions, to which the Royal Academy of Medecine at Paris* awarded its prize in 1846, is so comprehensive, that it may be said to embrace almost all forms of insanity. We do not agree with the author's views of delirium, which he divides into three kinds, viz. delirium of the senses, of the ideas, and of the passions; the difference between delirium and insanity depending mainly, according to his definition, on the longer or shorter time during which either continues-delirium being converted into insanity when the mind loses the power of recognising and controlling its wanderings. In like manner we think that Dr. Michéa, like many other French physicians, gives too wide an extension to the idea of hallucinations, under which it would appear that he comprehends almost every form of ideas and conceptions. Thus, French writers discover this symptom in two-thirds, or in half the whole number of the insane; and Esquirol, even in as many as eighty in the hundred. According to M. Michéa himself, the number is five-eighths. The greater number of these cases occur in monomania and general mania-fewer in dementia, and fewer still in imbecility. We cannot take leave of M. Michéa's work without expressing our opinion of its being the most complete treatise that has as yet appeared on this subject. It bears ample testimony to the extended reading and the industry of the author; and the examples advanced in illustration of his views are so numerous as to be almost wearisome. Next in order of succession comes Effenberger's memoir,† "On the Present Condition of Psychology in England," to which, as our object is here simply to show what has been done abroad during the last two * Du delire des Sensations. Par C. F. Michéa, Dr. en Médecine de la Faculté de Paris. Ouvrage couronnée par l'Academie Royale de Médecine. Paris. 1846. + Der gegenwärtige Zustand des Irrenwesens in England. Geschildert nach Forbes Winslow, von Dr. Joseph Effenberger, K. K. Districts-Physiker zu Bruck an der Leytha in Niederösterreich. (Med. Jahrb. des östr. Staats. Mai.) years, we simply refer, for the purpose of observing, that Dr. Effenberger's work is based on a treatise by the editor of this Journal, entitled, "An Act for the Regulation of the Cure and Treatment of Lunatics. With Explanatory Notes and Comments." The literature of Germany, notwithstanding the political disturbances by which the country is shaken, affords evidence of the good results yielded by the free discussion of the state and condition of the insane at the meetings of the German scientific associations, and the philanthropic opinions, based on scientific principles, which have been advanced in Jessen's paper,* read before the Association at Kiel, offer a pleasing contrast to the views entertained in the generation immediately preceding our own. In turning from general to special psychology, we must in the first place notice the interesting work of Hohnbaum,+ " On Psychical Health and Disease, in their various Transitions." The author follows the almost imperceptible transitions of psychical health, through all the varieties of eccentricities and peculiarities (so often manifested in the every-day life of weak-minded persons and geniuses, in tall and in short men, &c.), to folly or to mania. The author, whose own extensive experience and reading furnish him with numerous illustrations, seeks the cause of mental derangement in some abnormal relations of the body, and is further of opinion that such abnormal somatic relations may be, in the first place, occasioned by a misdirection of the mind, by evil habits, defective education, or the indulgence of the passions. Erlenmeyer, in a recent memoir, enters into the consideration of the question, whether the blood of the insane presents any peculiar abnormal properties; and whether certain diseases tend towards insanity, or afford immunity against it. The conclusions arrived at are only of a negative character. In the next place, the author considers the different abnormal blood-crases in the insane-viz., the fibrinous, the venous, the serous, and the scorbutic. From the result of 304 dissections, made by the author, at the insane asylum at Prague, it would * Ueber die in Beziehung auf Geistes-und Gemüthskranke herrschenden Vorurtheile. (Vorgetragen in der allgemeinen Versammlung der deutschen Naturforscher und Aerzte in Kiel am Montage den 21 Sept. 1846. Von Dr. P. Jessen, (Allgem. Zeitschrift. für Psychiatrie, iv. Bd. 1. H.) + Psychische Gesundheit und Irrensein in ihren Übergängen. Ein Versuch zur näheren Ergründung zweifelhafter Seelenzustände, fur Criminalisten und Gerichtsärzte. (Von Dr. C. Hohnbaum. Berlin, 1845.) Ueber das Blut der Irren. Von Dr. Erlenmeyer, erstem Assistenten au der Irrenheilanstalt zu Siegburg. (Archiv. für Physiologische Medicin, v. Jahrg. s. 436, 684.) appear that the fibrinous (tuberculous) crasis was the most frequent in the insane (134 in 304). Different writers, however, advance such different views regarding this question, that we seem scarcely able, in the present day, to arrive at any very definite conclusion. Fr. Nasse* attempts to define the local and immediate causes of the various forms of mental derangement. According to his definitions, high delirium is a morbidly excited sensibility of the cerebral organs, which serve to give expression to the psychical emotions-low delirium is a morbid obtuseness of the susceptibility of the brain-chronic mania, an abnormal irritability of the brain, generally the result of a morbid character of the blood-madness (fixed delusion), in a diminished susceptibility of the brain-folly (using the word in its original sense of fatuity), is the result of a diminished power of mental activity and vigour—and imbecility, psychical feebleness in its more highly developed form. Nasse's work has been answered by a memoir, bearing the same title,† from the pen of D. Focke, who endeavours, and we think satisfactorily, to refute the views set forth by Nasse. Bergmann, in a treatise on the derangements of mind arising from disappointed affection, makes the observation, that in persons (more especially women) this species of mental alienation has generally been preceded by a derangement in the somatic relations of the body, most frequently by a morbid condition of the tissue of the lungs. He further observes, that the organs of respiration are the first to suffer by the psychical disturbance, and that death from pulmonary consumption is a very frequent termination of such affections. The author, who is distinguished for his profound anatomical researches, is of opinion, that erotomania proceeds especially from the cerebellum, and physical love from the organs of sense. The anatomical results appended at the termination of the work, give evidence of the destructive influence occasioned in the organism by moral agencies. Among the works that have appeared on the Continent, within the period of time included in our considerations, on the physical treatment of the insane, we will in the first place refer to Dr. Weber's memoir, on the effects of certain medicines on the disposition and * Die Entscheidung über die Unheilbarkeit eines Irreseins. Von Fr. Nasse. (Allg. Zeitsch. für Psychiatrie, iii. 4 H. s. 589.) + Die Entscheidung über die Unkeilbarkeit eines Irrenseins. Von D. Focke, zweitem Arzte der Irrenheilanstalt zu Siegburg. (Allgem. Zeitschr. für Psychiatrie, iv. Bd. 2, H.) ¦ Bermerkungen über die durch getäuschte Liebe erzeugte Seelenstörung. Von Dr. G. H. Bergmann, Kgl Medicinaerath und Director der Irrenanstalt. |