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important is its position as a preventive to mental derangement, that were we called upon to give advice to all who are predisposed to insanity, are threatened with it, or fearful of it, and were we obliged to give that advice in the briefest possible terms, we would concentrate it into an imperative phrase of but two words, “ sleep enough."
Nothing exhausts the nervous energies of the system more rapidly than constant and prolonged watching. It subverts a primary law of nature—a law which cannot be seriously infringed with impunity
Excessive bodily exertion wearies the frame by its heavy tax upon the nervous system. The muscles, it is true, are the immediate organs of motion, and consequently of labour, but they are inert and incapable of movement if deprived of the nervous stimulus. If a constant supply of the latter could be continued for an indefinite period, we can perceive no sufficient reason why the muscles should not perform their office with all their energy unweariedly. At least, the converse of this proposition has never, so far as we are informed, been demonstrated.
Inordinate and prolonged labour reduces the nervous energy, and rest and sleep become necessary to its renewal. But it is frequently reduced to so low a point that sleep becomes impossible, or if at length it be attained, it is imperfect, broken, and insufficient to enable the nervous system to rally its wonted forces. Hence, in
it may be not so much the bodily exertion itself as its secondary effect, the deprivation of sleep, which is the immediate cause of mental disorder.
One case is said to have arisen from “Mesmerism.” This was the cause assigned by one of the parents of the patient. The leading features in the history of the case are as follows:- The patient was a young man, about twenty years of age, of a highly nervous temperament, with a brain remarkably developed and corresponding intellectual powers. For several years he had suffered from occasional epileptic fits, which as yet had left his mind but little if at all inpaired. The skill of many physicians and the virtues of every medical resource believed to be applicable to such cases had been exhausted upon him without benefit. *As a dernier resort, and at a period when he was in a state of comparative stupor, such as frequently follows a succession of epileptic fits, he was placed under the care of a person professedly practising “Mesmerism” for the cure of disease. To use the expression of this person, “The patient was magnetized daily for nearly a month” without effect, he remaining
in the torpid condition already mentioned. At length, he was sud . denly rouseil, appeared rational for a few hours, and then passed into a state of high excitement and absolute mania. A day or two afterwards he was brought to the asylum, with his arms and legs strongly bound. When admitted he talked but little, and that little was perfectly devoid of meaning. He was highly excited; his face flushed, and the veins of his head swollen; the circulation rapid, the pulse being from one hundred and twenty to one hundred and forty per minute; the tongue furred, and the bowels very much constipated. After free catharsis—an inordinate quantity of medicine being required to operate upon his bowels—he was placed upon the use of sedatives. Under this treatment, and after the lapse of two days, he began to improve, and in eight days he left the asylum, restored to his ordinary condition, and without much of the torpor that existed previously to his excitement.
The general term ill health, under which thirty-seven cases are arranged, is so vague and indefinite, and it may include so great a variety of diseases, that it is susceptible of but little comment of special application. In general terms, it may be supposed that almost any malady, if sufficiently prolonged, may impair the vigour of the body, act sympathetically on particular organs, diminish the quantity or derange the action of the nervous fuid, and thus disorder the manifestation of the intellect.
The next series of cases are those which are arranged under the generic term fever. Those are placed first whose predominaut pathological effects are upon the circulatory and nervous systems; and those which follow have, as a leading feature, disordered action of the liver.
Pure fever, unallied with a pathological condition of either the nerves or the liver—if, indeed, such a disease exist—may, from the rapidity and force of the circulation, impair the functions of the brain, or it may produce the same result sympathetically, through the inflammation of the mucous membrane of the alimentary canal.
If the disease be of the typhus or typhoid form, in which the nervous system becomes most seriously involved, and delirium is frequently an accompanying symptom, it is easily comprehended that mental disorder of a more permanent character may ensue.
It is probable that of the thirty-one cases included under the general term fever, the disease in many or most of them was of one of the specific forms afterwards mentioned.
In the bilious fevers, it appears to us that the disordered action of the liver is the primary cause of insanity when this disease ensues. Whether the disordered action of the brain in these cases, arise from sympathy with the liver, or be produced by the condition of the blood-modified as that fluid is, in its constitution, so far as regards the elements of the bile—is a question which we pretend neither to explain nor to understand.
Twenty-six cases are said to have arisen from dyspepsia. The remarks already made upon this disease preclude the necessity of any further comment.
Rheumatism and gout, undoubtedly, as a general rule, cause insanity by a metastasis to the dura mater, the fibrous membrane covering the brain.
Phthisis pulmonalis, or the true consumption, is not unfrequently connected with insanity, either as a cause, a concomitant, or possibly, in some instances, an effect. In the whole range of human maladies, there are but few cases more singular or interesting than those in which these two diseases alternate with each other in the same patient. The consumptive person becoming insane, the progress of the pulmonary complaint is arrested until he recovers from his mental disorder, when it resumes its march until stopped by another attack of mental derangement, again to progress, if that malady be cured, and again to be suspended if the patient should become insane. This singular alteration is probably in obedience to a general physiological or pathological law, that two important and active diseases cannot simultaneously exist and run their natural course.
The deleterious effects of the sudden suppression of a natural secretion, or an accustomed discharge, whether natural or artificial, are well known. Habituated to a constant drain, the body is brought into a condition in which that drain appears necessary for the support of health. If it be suspended, the system becomes plethoric, or laden with matter unqualified to assist in the action of the different organs, and therefore an obstacle to the faithful performance of that action. The brain, in common with other organs, is affected, and consequently the manifestations of the mind disordered.
Some of the eruptive fevers, particularly measles and scarlatina, are proverbial for the physical defects which follow in their train. Their results being thus unfavourable to the perfection of the body, it is not remarkable that they should, in some instances, disorder the action of the intellect. In the foregoing list, thirteen cases are imputed to them.
That mysterious and peculiar influence of the salts of lead which, in some cases, produces colica pictonum, a disease so common among painters as to have derived its name from them, is undoubtedly the
same which, in other cases, among people who are accustomed to work in those substances, originates insanity.
The case attributed to the inhalation of prussic acid is that of a man engaged in the manufacture of fancy soap. If that acid were truly the producing cause of the disease, it may be supposed to have effected that result by the depression of the nervous power, its natural physiological effect.
The last ten items in the table of physical causes constitute a series of influences to which the female sex alone is liable. We have long held the opinion that in their sex, these are the predominating causes of mental alienation—an opinion corroborated by these statistics. It will be perceived that of two hundred and eighty-five cases of females whose disease is attributed to physical causes, no less than one hundred and fifty-five are arranged in the series in question. The nervous system being more fully developed, at least so far as intensity of action is concerned, in females than in males, and the intimacy between the uterus and the other organs of the body being so intimate, so powerful, and so controlling, as the observation of physicians shows it to be, there is little reason to marvel that the causes in question should be so prolific of mental alienation. Dr. Rush appears to have correctly estimated the potency of these causes, and alleged the fact as an argument in support of the doctrine that women are more subject to insanity than men.
Connected as the Bloomingdale Asylum is with a city almost purely commercial-a city, the majority of whose active adults are subject to the cares, the perplexities, and the fluctuations of trade, it is not remarkable that, among moral causes, pecuniary difficulties should occupy the most prominent position. Under this head there are one hundred and eighteen men and fifteen women, a total of one hundred and thirty-three; and if, as may be most proper, the eleven cases assigned to "the want of employment” be included, the total will be one hundred and forty-four. There is, perhaps, no mental influence which, if examined in all its bearings and relations, exercises so extensive and controlling a power upon man in civilized countries, and more particularly in the United States, as that arising from his pecuniary condition. Connected with this are many if not all his hopes and schemes of ambition, preferment, and aggrandisement--all his prospects of present and future temporal comfort, and all his affections that are enlisted in the welfare of the persons constituting his domestic circle.
A constant business, moderate in extent and sufficiently lucrative to afford a liberal subsistence, can never, in a mind well regulated, operate as an exciting cause of mental disorder. The sources of the evil are, on the one hand, ambitious views and endeavours rapidly to accumulate wealth, and, on the other, the extremes of excessive business, of bankruptcy, and of poverty, the fluctuations and the unwholesome disposition to speculation. Of the one hundred and eighteen cases of men arranged under the head of pecuniary difficulties, the disease in three was attributed to excess of business; in two, to retiring from business; in four, to a sudden access of fortune; in one, to speculation in stocks; and in two, to speculation in morus multicaulis.
Moral philosophy requires not, for its illustration, the assistance of the fable of the lion and the gad-fly, when so harınless and apparently impotent a vegetable as the mulberry can overturn the faculties of the human mind.
The moral cause which ranks next in point of numbers, among both the men and women, is the anxiety and other mental influences in reference to religion. The whole number attributed to these is ninety-three, of whom fifty-one were males and forty-two females. Although there were more men than women, yet the proportionate number, when compared with the whole number of admissions, is greatest in the latter.
In a country like the United States of America, of universal toleration upon religious subjects, and sheltering under this broad banner congregations of almost every sect that has ever appeared in Chris-tendom, it is to be supposed that the religious sentiment would act under its greatest possible variety of phases, and in every diversity of gradation between the extremes of apathy and fanaticism. The accurate observer of the events of the last twenty years, to say nothing of a period more remote, cannot fail to have perceived that this is actually the fact. Under these circumstances, and when we consider the whole scope and bearing of this sentiment, both temporal and eternal, we cannot but perceive how important an influence it may exert. It is difficult to believe that “pure religion and undefiled” should overthrow the powers of the mind, to which it was intended to yield the composure of a humble hope and the stability of a contiding faith. Nor do facts authorize any conclusions thus hostile to Christianity, for a great majority of the cases of insanity attributed to religious influence can be traced to the ardour of a zcal untempered with prudence, or a fanaticism as unlike the true religion which it professes, as a grotesque mask is to the face which it conceals. The exciting doctrines of Miller, the self-styled prophet of the immediate destruction of the world, gained but little hold of the public mind