in the vicinity of the Bloomingdale Asylum, but in those sections of the country where they obtained the most extensive credence, the institutions for the insane became peopled with large numbers, the faculties of whose mind had been overthrown thereby.

The passions or emotions whose activity tends to depress the energies of both mind and body, may be considered, on strictly physiological principles, as powerful agents in the production of mental disease.

Remorse is the first of these mentioned in the table, and eleven cases, of which five were males and six females, are attributed to it. Grief, caused by the death of relatives, stands next in position, but first in point of numbers, including, as it does, forty-three cases, of which sixteen were males, and twenty-seven females. Of the men, the particular relatives whose death was followed by so unfortunate an occurrence, is stated to have been the wife in six cases; the wife and child in one; the wife and five children in one; the child in three; the mother in two; the sister in one; and the brother in two.

Of the women, it was the husband in five cases; the child in eight; the father in one; the mother in one; the mother and child in one; the mother and sister in one; the sister in one; the brother in two; and the brother and sister in one.

Forty cases, twelve males and twenty-six females, are recorded as having originated from disappointed affection.

Home-sickness, or, technically, nostalgia, is assigned as the cause in three cases-two males and one female. The latter was a Swiss girl who had been but a short time in this country, and could not speak English. Separated from her friends and surrounded by strangers, her spirits were most oppressively borne down by that disease-if disease it may be termed-so proverbial among her countrymen when removed from the sight of their native mountains and valleys, and beyond the hearing of the rans des vaches. After a residence of a few days at the asylum, a victim at once to the delusions of insanity, and to the harrowing emotions from which that disease originated, she ended her temporal sufferings by suicide.

Fear is at all times a depressing emotion, whether it be constant and prolonged, or sudden and transient, as more particularly implied by the term fright. In the latter case, it is powerfully so, even to the production, in some instances, of immediate death. Its natural effect, and the power of its action, particularly qualify it as a source of mental disturbance, and hence it should at all times, if possible, be avoided. The tales of horror conjured up to amuse or to subju

gate children in the nursery, have not unfrequently been attended with the most deleterious consequences; and persons who, for amusement, attempt to frighten or startle their friends, incur the risk of doing the latter an injury beyond their power of reparation.

During the prevalence of an epidemic, the fatality of the disease is greatly augmented by the panic that seizes upon the mass of the community, the depressing influence of which upon the energies, both physical and mental, prepares the way for an easy invasion of the disorder. This influence may also affect the healthy action of the mind. Thus, of the nineteen cases alleged to have been produced by this general cause, two are attributed to the fear of the Asiatic cholera.

With students, whether young or of middle age, if a proper equilibrium be maintained between the physical powers and the intellectual faculties, the development and energies of other portions of the body being so promoted and sustained by exercise, that they may preserve their due relations with an enlarging brain, there need be no fear that mental alienation will result from application to study; but unless this precaution be taken, the midnight oil consumed as a beacon light to guide towards the temple of truth, may become an ignis fatuus leading the mind into the labyrinth of insanity. Even in persons of strong constitution and of great physical strength, severe and prolonged study exhausts the nervous energy and impairs the functions of the brain. How much greater must be these effects in a frame naturally delicate, and how much more alarming still, if the body be debilitated by the want of exercise!

In the table of causes, thirty cases are set down as supposed to have been induced by mental application.

Of the two cases placed against the term mental shock, one is represented to have been produced by the hearing of good news. Domestic trouble ranks high among the moral causes. cludes 42 men and 23 women—a total of 65.

It in

Under the general and somewhat indefinite term anxiety, there are 22 cases-12 of men, and 10 of women. In two of the men, the anxiety was on account of a false accusation of seduction; and in five others, it was in reference to annoying law-suits in which they were engaged.

Eight cases are attributed to faulty education and parental indulgence. These are subjects which, during the past few years, have been fully discussed by several able writers on insanity, and hence require no extended comments on the present occasion. Although

sympathizing deeply in the feelings of the young, and entertaining a pleasing and affectionate emotion for all that cross our path who as yet tread but the vestibule of the temple of life, and ardently wishing to promote, by every judicious measure, their welfare, yet we must, and even for those very reasons, subscribe to the doctrine of the prophet of olden time, "It is good for a man that he bear the yoke in his youth." Let not that yoke, however, be imposed with despotic hands, but with that prudent combination of kindness and firmness which will render its burden light.

Three cases are attributed to undue indulgence in the reading of novels. Inasmuch as this subject has heretofore often received, and undoubtedly will continue to receive the attention of men who "stand in wisdom's sacred stole," we dismiss it without comment.

There are several heads included in the tables, to which especial reference has not been made, but they are either so unimportant, or so similar to others which have been noticed, that they do not appear to call for any specific remarks.

In speaking of the form of disease, the writer observes :

"Mania occupies the first rank in point of numbers, in either sex, as well as in the aggregate. There were nine hundred and five of this form of disease, which is equivalent to fifty-two and one half per cent. of the whole number.

"The second in rank among the men, and in the total of the two sexes, is Dementia. Of this, there were two hundred and thirty-five cases, or thirteen and sixty five hundredths per cent. of the whole.

Monomania occupies the third position in the men, and in the total; but the second in women. There were two hundred and thirty-two cases, or thirteen and fifty-nine hundredths per cent.

66

Melancholia is the fourth in men, and in the total, but the third in the women. Of this there were one hundred and eighty-five cases, or nearly ten and three quarters per cent.

"Epilepsy holds the fifth rank, there being thirty-five cases, or two and three hundredths per cent.

"The nosology of mental diseases is still so imperfect, that it is difficult to make an arrangement of cases which would be of any material value, either practical or theoretical. Indeed, there are scarcely two physicians who would classify a series of cases, such as are admitted into any institution, in precisely the same manner. The forms of disease, in the cases included in the foregoing table, were recorded, in part, by several physicians, whose views upon the subject may have differed, and hence the classification is undoubtedly different from what it would have been, had it been made entirely by A case called Partial Insanity by one person, might be termed Monomania by another. That which one records as Monomania,

one.

another would place under the head of Melancholia. There being no definite line between Mania and Dementia, a given case might be placed under the former by one physician, and under the latter by another.

"A perfect nomenclature of Insanity is a great desideratum."

"With regard to previous attacks of insanity, it would appear that 208 patients were known to have previously suffered from the disorder. This is equivalent to eleven and twenty-nine hundredths per cent. of the whole number admitted. The per centage of men is a small fraction more than ten; that of women, a little more than thirteen."

"It would appear that 57 men and 52 women, a total of 109, had actually attempted to destroy themselves. The number who had attempted to do it more than once was thirty-eight, of whom 19 were men and 19 women."

Persons who are intimately acquainted with the insane, will recognise an important difference between the terms disposed to, on the one hand, and, on the other, talks of, or threatens to commit suicide. Patients in whom the propensity to self-destruction is the strongest, and who are most likely to be urged onwards by it to a fatal execution of their designs, never, or rarely, in any manner allude to that propensity, but, on the contrary, use every precautionary measure to conceal it. I have never known but one person accustomed to talk of the propensity, who afterwards committed suicide. This was a woman whose case offers an exception not only to this, but to another general rule. The suicidal rarely-so very rarely that, it might almost be said, never-put their intentions into execution in the presence of another person. This patient hung herself within five feet of another female, a fellow-patient, who, however, it is possible she supposed to have been sleeping, as the act was committed in the night.

Patients who threaten to commit suicide, almost invariably do so for the purpose of frightening the people around them, rather than from any propensity in that direction. I do not recollect ever to have met with a single exception to this.

One of the most remarkable characteristics of the really suicidal, is their fearfulness of being injured by others. A man will shrink from those by whom he is surrounded, lest they should do him harm, in the slightest degree, and the next moment take his life with his own hand.

The following table will give our readers an idea of the patients who manifested the homicidal propensity:

"Of the five actual homicides, one killed a child; one his motherin-law; and one, his wife's brother. Of the remaining two, it is merely stated that one killed a person; and the other killed a man with a knife, was tried, and acquitted on the ground of insanity.

"Of the men who attempted to kill, that attempt was made on a wife, by five; on a wife and child, by one; on a father, by two; on a brother, by one; on a sister, by one; and on a constable, by two. "Of the men who threatened to kill, the threat was against a wife in two cases, his friend in eight, and family in one.

"The attempts to kill, by women, were in five cases upon a child, in one case upon a sister, and in one upon a sister and step-mother. "The threats to kill, by women, were against a husband in two cases, against her children in one, her friends in one, and in one the particular persons are not mentioned.

"It may be observed that many of the insane, particularly when excited, threaten to kill those around them, without any intention, certainly any permanent intention to put their threats into execution."

Relative to the condition of the patients when discharged from the Asylum, it would appear that :

"One thousand seven hundred and sixty-two patients were discharged-of whom 1046 were men, and 716 women. Of these, 408 men and 264 women were cured, making a total of 672.

"There were 42 of the foregoing patients-23 men and 19 women -who, after a short residence in the Institution, were discharged, as follows:

but, after a brief absence, were re-admitted, and finally discharged cured. These cases should be added to the cures in the former table."

Physicians to Institutions for the Insane are frequently questioned in reference to the time necessary to effect a restoration, in cases of insanity. The following table shows the term of residence in the Asylum, of all the patients who were discharged cured on their first admission: