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events, are but rarely affected." Moral | From the returns made of all the Quakers

causes are considered to act more powerfully on women, physical on men.

in England and Scotland, it appears that the number does not exceed 23,000; of these there have not been of late years, on an average, more than 60 confined as lunatics in the Retreat. This, it appears, gives about three insane for every 1000, a proportion much higher than any which

The popular opinion in this country and the continent is, that it is a disease of the mind itself independent of any corporeal malady, but with the scientific men of both countries this is entirely abandoned, the opinion being, that it depends upon diseas-obtains in the general population of the es of the brain and its membranes.

It appears, by the tables which Esquirol has supplied, that more than one-half the entire number of cases admitted under his

care are ascribed to moral causes, which, as they operate more generally in a civilized than in a savage state, account for the prevalence of insanity in the former condition. During the eventful times of the conscription in France, great numbers of insane were driven into the public asylums. "The influence of our political misfortunes," says Esquirol, "has been so great, that I could illustrate the history of our revolution from the taking of the Bastille to the last appearance of Bonaparte, by describing in a series the cases of lunatics whose mental derangement was in connection with the succession of events." There are mad people in whom it is difficult to discover any hallucination, but there are none in whom the moral affections are not disordered; in this particular Esquirol says he never met with an exception.

Though religion has long been considered a fruitful source of insanity, the data upon which this opinion rests are not quite conclusive. Roman Catholics are supposed by some to enjoy an immunity from it. At the Cork Asylum, where the Roman Catholics are to Protestants as 10 to 1, Dr. Hallaran says no instance has occurred to him of religious madness in the former, but that, whenever religious madness did exist, it was always among the Protestant inmates. Guislain makes a similar report as regards the Low Countries. The Prussian provinces on the Rhine afford a good opportunity of testing the accuracy of this. Jacobi has paid considerable attention to this subject, and is inclined to doubt the correctness of the reports which Guislain and others have made. He states, that in a Catholic population the proportion of lu natics compared with those in a Lutheran population is 11 to 10, which gives a pre ponderance to Catholics.

In the Quaker's Retreat, at York, Tuke says, that since 1811 they had but three cases of insanity from religion, and those cases were people of weakly constitutions, and not educated in their society, so that with them religious madness is very rare.

country. In attempting to account for this apparent augmentation among the Quakers, Tuke says,

which the proportion of lunatics in Eng"I should demur to the data upon land rests. I believe the parliamentary returns to be so incorrect as to afford no fair grounds for the estimate which is made; whilst the knowledge of each other which prevails in our society, and the character of the Retreat, brings nearly all the cases which occur among us into the nected with mental peculiarities are more Moral improprieties coneasily and more frequently stamped as insanity amongst us than in the world at large, while the care of our poor prevents any individual of that class from being allowed to roam at large, or remain at home, on account of the expense of maintaining him in our asylum."

calculation.

There is an opinion afloat that insanity is on the increase in this country, and the opinion is in some degree borne out by a comparison of the late registers with those of an older date. Dr. Powel who first directed attention to this particular department, grounded his belief of a positive increase on the apparent augmentation in the London registers for lunatics. These included all lunatics confined in private asylums throughout England, which gave an increase as compared with eight quinquennial periods from 1775 to 1814; the aggregate for the former being 1783, for the latter 3647. This is a conclusion which Dr. Burrows says, is not borne out by facts, as the register does not comprehend lunatics confined in unlicensed houses. Comparing the lunatics with the census of the population for 1800, Dr. Powel arrived at the conclusion, that there was one lunatic to 7300 persons, a conclusion which shows how absurd it was to attempt a statistic account of insanity with means so inadequate. Pinel thought that the increase in the returns of the insane might be accounted for in various ways-irregularity in former returns, and increase of the inmates of asylums, from the better arrangements which now prevail. He says that the greater the liberty in any country, the greater the number of insane is likely to be.

In 1806 a select committee was appointed

to inquire into this subject, and in the report to the population as 1 to 1000, and idiots which they sent in, they gave for England are to lunatics as 2 to 1; while in 7 counand Wales an aggregate of 2248 lunatics. ties of North Wales there are 7 idiots to 1 In 1815 another report was made, which lunatic, and 1 lunatic to 850. gave nearly double the number, but which increase should be ascribed to the inaccuracy of former returns rather than to any positive augmentation in the number of the

insane.

By returns which were made in 1819, Dr. Burrows found the aggregate of lunatics confined in public hospitals and asylums to be 1456, in private asylums, 2585, in all for England and Wales, 4041, to which he added half the number for those confined in private asylums not registered. In this way he raised the whole number to 6000, which he considered the nearest approximation to the total number of lunatics in Great Britain, and which gives us a proportion of about 1 lunatic in 2000 persons. In 1826 Sir A. Halliday made a return of the lunatics confined in public and private asylums in England and Wales, giving as the gross amount 4782, to which he adds those of whom the law takes no notice, as living with their friends, and concludes, from an experience of twenty-five years, that the number confined in England and Wales, in public and private asylums, exceeds 8000; yet, with this apparent augmentation, he is not disposed to believe that insanity is on the increase with us. He estimates the insane of Scotland at 3700. In 1829 he sent in another report, which gave for England and Wales 6806 lunatics, and rates the idiots at 5741, to which he adds for places not returned 1500, in all 14,000. The proportion of insane to the population is, he says-England 1 in 1000; Wales 1 in 800; Scotland 1 in 574. In the gross amount of 14,000, the paupers are estimated at 11,000.

Some very curious returns have been made, showing the influence of different habits and pursuits in life in producing insanity. In twelve English counties where the population is employed in agriculture, the proportion of insane to the general population is 1 in 820, and the lunatics are to idiots as 5 to 7. In twelve counties where the people are differently employed, the insane are to the population as 1 to 1200. People who work in mines are reported to be less liable to insanity than those who work on the surface. It is because they are less exposed to the exciting influences of a busy life, which are ever passing around us in our intercourse with the world, and from which miners are for a great portion of their life withdrawn?

In six maritime counties the lunatics are

In South Wales the proportion of lunatics to the population is 1 to 750, and idiots are to the insane as 1 to 8 1-2. Throughout Wales as in many parts of England, there is a preponderance on the side of female lunatics over males; in Wales the excess is very great. The explanation afforded for this is, that nearly half the population is employed in agriculture. There is a general impression that, in agricultural districts, where people work hard and where females are employed in labour, the violent exertions required in such occupations produce distortion of the body, and mnay very materially affect the growth and developement of the brain, and even the form of the cranium in utero. It is well known that females are obliged to work during the whole of their pregnancy, and there can be no doubt of the injury which such occupations must entail on the offspring.

According to a return made for Scotland in 1821, the proportion of lunatics to the population is 1 to 474, but little reliance can be placed on this as a correct estimate of the state of insanity there.

By the returns which have been made for the French hospitals, from 1801 up to 1823, there is a steady and progressive increase. The first return gave, in 1801, 1070 lunatics, and the last, in 1823, gave 2493. Rating the population at 32 millions, Esquirol estimates the insane as 1 in 1000. In France, as in England, the operating causes vary very much. Of 336 lunatics in his establishment, Esquirol says, there were only three from drunkenness. It, however, prevails as an exciting cause to a great degree in Salpetrière, where women only are admitted, and of whom onetwelfth part are girls of the town. find also, by the reports which Dr. Whally has made on the effect of drunkenness, that it prevails to a great extent in Lancaster infirmary.

We

All the attempts which have hitherto been made to account for insanity by pathological appearances have proved hopeless. In examining the morbid results we are led to consider how the mental diseases could have resulted from them; but here the nature of In cases the subject completely baffles us. of other diseases, of the lungs, whose functions are now well understood, the morbid change accounts for the derangement, but the case is quite different when the mind is affected. We are ignorant of the manner

4

in which it performs its functions, and of the | the government of Norway. In 1825 reconnexion between the organic agents and turns were ordered of the sex, age, situation, the operations commonly referred to it Hence, some are inclined to doubt whether the phenomena of insanity are the result of changes discovered in the brain, and view them as the result of the diseased operations of the mind, believing that hardness of brain and thickening of membranes are only formed after mental disease of long standing, and are altogether wanting in recent cases of insanity; upon these grounds mental disease is considered as a deviation from the healthy state, different from that which anatomy exhibits.

and number of insane. The report was drawn up by Dr. Holst, and published in 1828. The lunatics are to the population as 1 to 551, Here is a marked difference as compared with England and France. The population of Norway is employed much in agriculture and rearing cattle, embosomed in mountains, and without any manufacturing towns. These are to be taken into account in considering the comparative state of insanity there, in comparison with other countries.

From Spain we are without any satisfactory returns, while we find the Italian States giving only 1 in 4879. Here we find that where insanity is scarce, idiotism is always found to predominate, more especially in Spain and Portugal. In New York the insane were as 1 to 721 of the population.

The different states of the intestinal canal have been considered a fruitful source of insanity, both to the rich and the poof to the former, from over-indulgence; to the latter, from very opposite causes-low diet, bad food, cold, constipation. Worms have been viewed as producing it, because in With respect to the treatment of this very some cases, mad people were cured, on the distressing affection, we shall endeavor to expulsion of worms by the intestines. Es-show that our only hopes of cure rest upon quirol records two cases of this kind. It was also a popular belief that it is more intimately connected with disease of the abdominal viscera than the thoracic, but this has been proved not to be the fact. In 168 cases Esquirol found only 2 cases of liver-complaint, whilst in the same number he found 65 cases of disease of the lungs, and he is disposed to believe that insanity is attended by disease of the thoracic viscera in 2 cases out of 8. To this opinion Georget is inclined, who adds, that one half of the lunatics who die at Saltpetrière are cut off by phthisis. In some of those patients it is rather curious that, where large excavations are found to exist after death, no expectoration took place during life. Greding found in 100 maniacs, 40 affected with phthisis; of the whole number, 76 had effusion into one or other cavity of the thorax.

an early application for proper medical advice. The average duration of the complaint under the care of Pinel was from five to six months, but the greatest number of recoveries took place in the first month. This is also the opinion of Esquirol. The greatest amount of recoveries is obtained in the first two years, but the mean duration is less than one, and after the third year, the chance of cure is scarcely 1 in 30. This is a conclusion at which Esquirol arrived, founded on an experience from 1804 to 1813 at Salpetrière. A similar conclusion has been come to at the Gloucester Asylum.

The most favorable age for recoveries is 25 to 30, but women frequently recover after 45; and there are four cases recorded at Charenton of recoveries where each patient was 70 years old. Writers in general admit that recoveries are more frequent in women than men.

Dr. Burrows gives a report of cures in recent cases 91 in 100, and in 64 old cases 19 cures. This is considered by some as much too great, and they account for it by supposing, that many was discharged before a complete cure was effected.

In the Dutch States, the number of insane from 1820 to 1825, was 4520. Guislain is disposed to ascribe the increase of insanity to the positive augmentation which has taken place in the population since the war, by which the number may be augmented in the ratio of the population. He agrees with Sir A. Halliday, that though a temporary Esquirol states that, out of the gross aaugmentation may take place, from the pres-mount of admissions at Bicètre, of 12,592, sure of circumstances, there is no danger of 4968 recovered. its permanently progressive increase.

The returns afforded by the Prussian States, if correct, should necessarily alarm us, but Jacobi, who has had opportunities of judging of their fidelity, attaches but little faith to them. The proportion of lunatics there to the population, is 1 in 666).

Perhaps the best statistics are supplied by

At Bethlem, St. Luke's, and the York asylum, the admissions from 1748 to 1814 were 16,516, of whom 5918 recovered. From this it appears that the cures in England were formerly fewer than in France.

In Lancaster there were admitted, from 1817 to 1832, 1750 lunatics; of these, 597 were cured, a proportion of about 40 in 100.

In the Retreat, near York, from 1812 to 1833 inclusive, 334 were admitted. Of these, 168 were cured, 50 died, 37 removed, 10 improved, 69 remained. Here the probability of recoveries in recent cases is 9 to

1.

Insanity is not reckoned among the diseases injurious to life. In this state the brain, though unfit for intellectual operations, is able to carry on other processes dependent on it, but which are subservient to physical existence.

In 1812 there was at Bicètre 1 who was there 56 years, 3 upwards of 40 years, 21 more than 30 years, 50 upwards of 20 years, and 150 for 10 years.

The dates of entry for 7 cases, at Salpetrière, were from 50 to 57 years, 11 from 50 to 60 years, and 17 from 40 to 50.

The admissions of males to females are, at Charenton, as 3 to 2. At Bicètre the case is reversed, females are to males as 3 to 2. In the South of France there are more females than males in the asylums; the contrary obtains in the North; but throughout France the females are to males as 14 to 11. In Spain there is an excess of females of one-fifth over males. In Italy the males predominate. According to the returns which Guislain has made of Holland and Belgium, females are to males as 34 to 29.

In Great Britain and Ireland the males are to females as 13 to 12, and in the United States the males are to females as 2 to 1.Esquirol shows, from the gross amount of lunatics confined all over Europe, of 76,526, that there were 37,825 male, and 38,701 females, about 37 to 38, without the fraction. Insanity is not limited to any particular age; it may begin as early as two years of age, but does not become common until 15. Georget has collected, from the admissions in France and England, from the age of 10 to 70, 4409 patients, and the average of admissions for every 10 years:

From 10 years to 20

20 46 30

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ence of opinion how far it should be carried.

A system of treatment is adopted at Gheel in Belgium, which if acted on in other countries, would doubtless be productive of great advantages. Gheel is a small country village, where 500 or 600 lunatics are spread among the cottages of the peasants. Each patient is to labor in the fields or gardens for a certain number of hours every day. When not employed they are allowed to walk about without restraint, and are summoned to their homes by a village bell. The peasants are bound to treat them with kindness, and are awarded according to the care they take of them.

A farmer once obtained in Scotland a great reputation for curing insanity. He fastened his patients to his plough, and made them work his grounds, and by degrees brought the most intemperate to reason. Music has been employed with invariable success in the treatment of the insane. There are two states in which it may be useful; first, when the invalid himself plays, his attention is for a time agreeably occupied ; and next, when another person plays, pleasing sensations are thus commonly excited. Frank employed it largely, and found it of great advantage in mania, while Esquirol states, that he found it in similar states to produce raving fits. There is an impression with the majority of the profession, that in mania it is too exciting, but in states of lethargy or apathy it may be used with benefit. Dr. Cox employed it largely in his establishment, but his successor Dr. Bompas, has altogether discontinued it.

The Quakers, in the Retreat at York, were the first who discontinued the use of chains; and the only restraint used there is, seclusion, a straight waist-coat, shower bath, and a few occasional privations. Pinel, who may fairly be considered as the founder of this mild and successful system of cure, gives many cases to prove its good effects.

356 "A lunatic," he says, " in the vigor of his 1106 age, and of great strength, who had been 1416 seized by his family; tied, and brought bound 861 in a carriage, so terrified his conductors, 461 that no one dared to approach him to untie 174 him, and conduct him to his cell. The 35 steward sent the keepers away, talked some time with him, and gained his confidence, and, after being unbound, he permitted himself to be conducted quietly to his new abode. The steward gained every day more influence over his mind, became his confidant, and succeeded in restoring him to reason and to the bosom of his family, of which he constitutes the chief happiness."

4409 There is one leading feature in the management of the insane in which all writers seem to agree-seclusion. Pinel dwells on it as the most rational mode of cure, and considers the separation from friends as indispensable. Willis changed all the servants of George III. Confinement is also necessary; but there is still considerable differ

With respect to the frequency of insanity in the different states and conditions of life,

Esquirol has supplied some interesting re- which is often mistaken for a progressive turns:-For the three years, 1826-1828, augmentation in this painful disease. there were admitted into Charenton 619 patients; of these, 282 were married, 293 never married, and 44 widowed. The number of men was 385, women 253. Of the men 206 were unmarried, and 87 of the women, which shows celibacy to be a fruitful source of insanity.

Another large class composing the inmates of this establishment, is made up of officers and soldiers. For the three years above mentioned, there are 49 officers and 47 soldiers admitted, a proportion exorbitantly great, considering the relative number of each class. Hereditary insanity is here estimated at one seventh of the admissions.

ART. IV. -Historie du Pape Pius VII. Par M. le Chevalier d'Artaud, Ancien Chargé d'Affaires à Rome, à Florence, et à Vienne, de l'Académie des inscriptions et Belles-Lettres, de l'Académie della Crusca et de Gottingen. Paris. 1836. 2 vols. 8 vo.

THE personal and literary character of the author of these volumes is so highly and deservedly esteemed, as to command, at all times, for any production from his pen, a more than ordinary degree of public attention. But at the present moment, when the politico-religious parties in our own country stand opposed to each other in such formidable array, and when every reflecting mind is tremblingly alive to the consequences of victory or defeat, a work which gives so deep au insight into the policy of the Court of Rome, which exposes its weakness and unmasks its power, cannot fail to command for its readers the philosopher, the legislator, and the divine,

Attached to the celebrated diplomatist M. Cacault, in the capacity of private and confidential secretary, and long honored with that gentleman's friendship, M. Artaud pos

From the review which we now have taken of the statistics of insanity in different countries of Europe, we do not think that the opinion advanced by some writers, of a positive and permanent increase in that painful and distressing affection, is at all supported by facts. That there is an apparent increase in the number returned of late, as compared with our older records, is quite clear, but this is only what is manifest in every other department of inquiry, when attention is particularly directed to a subject previously much neglected. The question of insanity was hitherto surrounded by so many delicate and distressing associations, that many cases have altogether escaped notice. And when we consider the system of treatment which then universally obtained, we cannot wonder that the insane are allow-sessed peculiar faculties for his present work ed to drag out a miserable existence in the society of friends, rather than be consigned to the hopeless alternative of chains and a dungeon. The improvements which a mild but decisive system of treatment, first adopted by those quiet unobtrusive men, the Quakers, in the Retreat at York, have at length forced them on general attention. It is now the prevailing system throughout Europe, Once in possession of his materials, two at Charenton, Salpetrière, Bicètre, St. Yon, modes of employing them presented themin France, and in all cur own institutions.- selves to the author's choice. By a clear Those asylums are now so much improved but concise analysis of his documents, a in their internal economy and comforts, and judicious selection of their most striking the chance of cure so great, when attention passages, and a few apt and general reflexis early directed to it, that cases are instantly ions, uniting the whole, he might have efsent thither, which, under the former bad fected what many of those writers have arrangements, would never have reached done, who have transmitted to posterity the them. In this way the apparent increase actions of celebrated characters. Nor, like may be accounted for; besides which, slight the great historians of antiquity, who atshades of mental aberration are now classed tribute to their heroes harangues which are under one or other form of madness, which purely ideal-the creation of the writers' probably, at a period when the subject was vivid imagination, had M. Artaud to depend not so well understood, would not be classed upon the possession of a like talent; the veat all under any form of insanity. These, ry words themselves, as they fell from the with other temporary causes, will occasion-lips of his personages, lay before him, and ally give a slight increase in the returns, he could, therefore, easily undertake to

and of these he has availed himself with great judgment and ability. From an enormous mass of documents, public and private, he has selected nearly two hundred highly interesting and curious papers, all hitherto unpublished, and inserted them according to their respective dates in the body of his work.

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