the treatment of maniacal patients. To supply this desideratum, in some degree, is the principal object of the present work, in which all abstract reasoning is purposely avoided, the result of my own observation and experience stated, and an attempt made to point out a rational and successful method of treating diseases of the intellect. Much still remains to be effected, and I fear ever will, while our knowledge is so limited respecting the parts of the animal economy more immediately connected with the reasoning faculties. I would advise my brethren of the profession to adopt every mode calculated to improve the treatment of insanity, and experience has taught me, that nothing is more important and useful than a judicious, well conducted case book, in which the history of every maniac subjected to our care should be minutely detailed, every symptom and peculiarity accurately noticed, as well as the methodus medendi.

While we deplore the unsuccessful result of so many excellent investigations, established for the express purpose of increasing our knowledge of mental diseases, we have particularly to lament that those of our anatomists have been attended

with so little advantage.* We are not only disappointed, but have been furnished from this source with extraordinary and unaccountable facts, which might induce us to believe the brain in some instances had little to do with the intellect; thus the contents of the cranium of some madmen, and even idiots, have appeared on dissection free from disease, while the same parts in other individuals, who retained their intellectual faculties unimpaired to the last hour of existence, have been found universally diseased: and, indeed where certain peculiarities have been detected in and about the encephalon, it is impossible to determine whether they were the cause or effect of the disease. Infants have been born without

Reasoning a priori it might have been expected that much useful information would have accrued from such researches. Both ancients and moderns have diligently investigated the brains of maniacs, and the celebrated Haller (See Halleri Elem. Physiolog. Lib. xvii. Sect. 1. Tom. 5. p. 571.) collected a great variety of histories of such dissections, hoping to procure some valuable information respecting the functions of the encephelon, from the appearance of its different parts after death, in subjects who had laboured under mental diseases during life, but he candidly acknowledges his disappointment,

brain,* and adults almost compleatly deprived of it by disease; the cranium of some animals has been found filled with bone, and that of others compleatly emptied of their contents, &c. yet the faculties said to depend on the integrity of this organ did not appear to suffer. From such singular facts we can account for some authors having assigned the seat of the soul to the stomach, plexus solaris, &c. but waving any discussion of such subjects, as being more curious than useful, I shall take it for granted that the brain and its emanation, the nervous system, are the parts most intimately connected with the intellect, and that some morbid changes of these exist in every case of insanity.

*See New Abridgment of the Philosophical Transactions, Vol. IV. p. 149, and p. 372.

PRACTICAL OBSERVATIONS

ON

INSANITY, &c.

WITHOUT any laboured Introduction, I shall immediately proceed to the

HISTORY OF A MANIACAL ATTACK.

The approach of insanity is generally very gradual, at first only observable in a change of habits, disposition, taste, and pursuits, generally succeeded by hurried movements, a rapid succession of ideas, high spirits, acute sensibility, mental irritation, unusual suspicion, listening to fancied whispers or obscure noises, pride, impatience of controul, peevishness, restlessness, inordinate mirth or depression, (according to the temperament) occasional abstraction: dreams of the most grotesque and unnatural description deprive the patient of refreshing slumbers, and frequently whole nights B