removed affections of the mind. How these changes are brought about it may be difficult to decide, but I am of opinion that some very important inferences may be drawn from a knowledge of the fact in the treatment of insanity. Perhaps it would be too much to say that every mean employed for the removal of mental diseases, whether moral or medical, when successful, relieves by introducing some important change into the general system; but certain it is, that if any considerable commotion, any violent, new, action can be excited in maniacal complaints, by whatever means, the mental derangement is often considerably relieved if not permanently removed; thus small-pox has dissipated the most obstinate melancholia, and where affections of the intellect have resisted common remedies I should place considerable hopes on inoculation, had the party not previously had small-pox, taking care by proper medicines and management to increase the symptoms that usually attend this disease to such a degree that the whole system should be considerably affected without endangering life.

Itch, too, has been known to bring about the same happy effect, the cure of insanity, but pro

N

bably in a very different way from small-pox; though on a principle of the first importance in the treatment of maniacs, by abstracting attention from the wanderings of deluded imagination, exciting new ideas by the means of strong impressions made on both mind and body: and in the instance of itch, by the irritation excited on the surface, I should therefore have no scruples, in some cases, in communicating this very troublesome disease, especially as it involves no danger, and its removal is always in our power.

As diseases of the intellectual faculties often follow repelled eruptions, drying up of old sores, habitual drains, &c. it is reasonable to expect advantage from the re-establishment of these, and perhaps there is no more manageable or efficacious mode of exciting new eruptions than what is furnished in an unguent formed of some simple ointment, loaded with chrystalized emetic tartar, reduced to an impalpable powder and applied to any part of the surface, though it has succeeded best when rubbed on the newly shaved scalp, where a smaller or larger crop of eruptions, very similar to those of small-pox, may be speedily excited. Blisters, issues, setons, &c. will be proper

substitutes for the old drains. Independent of the other valuable properties of fox-glove, tobacco, and similar medicines, may we not reasonably impute much of their antimaniacal power to the distressing affections they occasion in the stomach? in fact, to their excitement of a species of new disease in the system. After every probable remedy has failed, instances have been known of success following such a mode of management, composed of moral, medical, and physical agents, as ultimately brought about a compleat change of the system, both solids and fluids: on this principle alone we may perhaps explain the frequent cure of maniacs which has been known to take place by a removal from accustomed objects, rigid regularity with respect to diet, &c. and the lengthened employment of some simple alterative.

I have thus compleated my intention of giving a practical Treatise on the subject of Insanity, should the performance, however imperfect, in any degree tend to alleviate the sufferings of humanity, I shall be fully compensated for the labour which it has occasioned me.

7

APPENDIX.

I. On the mode of granting Certificates. II. On Medical Jurisprudence in Cases of Insanity.

ON

N each of these very important subjects, as connected with insanity, a volume might be written, and appears to be necessary; but, consistently with the plan I have laid down, I can only offer some general rules and hints to the consideration of the younger and inexperienced classes of medical men, to direct them not only in their decisions as to the existence of insanity, but also in furnishing a legal instrument for the friends of the party to act upon, and to regulate their conduct in courts of judicature, where the cases involve a suspicion of insanity.