From an interesting Report on Lunatic Asylums in Ireland, issued in 1862, we find that the moral Causes of Insanity predominate in females, the physical causes to a larger extent in males, particularly intemperance and irregularity of life. The cause of disease was ascertained in 2186 cases: in 323 it was intemperance and irregularity; in 183, religious excitement; in 115, love, jealousy, and seduction. Thirty-seven per cent. of the cases were ascribable to hereditary transmission and intemperance combined. With regard to the hereditary character of insanity, it is observed that mental, like bodily affections, gradually wear out from the intermixture of blood. There was no case found in Ireland in unbroken descent to the fourth generation. On the important question whether insanity is on the increase, there is no certain proof furnished. We know that, with fresh accommodation for the insane, fresh, though long-existing cases, are presented for admission into asylums, creating an apparent increase of lunacy; and we know that improved treatment and care have tended materially to the prolongation of life among lunatics, and to their consequent accumulation. We know also that science, and even public opinion, now accept as indicative of lunacy affections formerly classed under a different category. Lunacy, also, is now less concealed as a discreditable visitation. Emigration has not taken its proportion of lunatics. But, insanity being in great measure a disease of intellect—one connected with the development of the human mind—it is highly presumable that, in this age of excitement and rapid advancement in arts and sciences, mental affections may be more prevalent than before. In a northern district of Ireland, during the two months of religious revivalism, there were more cases of insanity than in the whole preceding year.
Brain-Disease.
Dr. Forbes Winslow, whose professional life has been devoted to the study of Insanity, in his work On Obscure Diseases of the Brain, and Disorders of the Mind, attaches much importance to premonitory ailments, as indicative not only of the fatal mischief which will inevitably succeed them if neglected, but of the only period when remedies can be applied with a fair chance of cure. This period it is difficult even to the medical expert to detect, for the aversion to own any affection of the mind or weakness of the head is so strong, that both patient and friends will often repudiate and ignore it altogether; yet there are unmistakeable signs, such as “headache attributed to derangement of the stomach, vacillation of temper, feebleness of purpose, flightiness of manner, irritability, inaptitude for business, depression and exaltation of spirits; and even weakness of sight, when the optician has been consulted rather than the physician.” None of these signs, if caused by Brain Disease, can exist, says Dr. Winslow, for any length of time without seriously perilling the reason and endangering life: yet “it is a well-established fact that seventy, if not eighty, per cent. of cases of insanity admit of easy and speedy cure if treated in the early stage, provided there be no strong constitutional predisposition to cerebral and mental affections, or existing cranial malformation. And, even when an hereditary taint exists, derangement of mind generally yields to the steady and persevering administration of remedies, combined with judicious moral measures, provided the first inclinations of the malady are fully recognised, and without loss of time grappled with. A vast and frightful amount of chronic and incurable insanity exists at this moment in our county and private asylums, which can be clearly traced to the criminal neglect of the disease in the first or incipient stage.”
Dr. Winslow insists upon the great importance of self-control as a preventive. He says: “This power is in many instances weakened or altogether lost by a voluntary and criminal indulgence in a train of thought which it was the duty of the individual in the first instance resolutely to battle with, control, and subdue. Nervous disorders, as well as insane, delusive thoughts, are thus often self-created. The morbid soon becomes a deranged mind—the insanity manifesting itself in an exaggerated, extravagant, and perverted conception of a notion which had originally some semblance of truth for its foundation. The self-created, delusive idea may thus obtain a fearful influence over the mind, and eventually lead to the commission of criminal acts.” The forced education of youth frequently leads to mental alienation. “It is,” says Dr. Winslow, “undoubtedly an important element in education to carefully, steadily invigorate and discipline the memory in early life; but, in effecting this most desirable object, it is our duty to avoid mistaking natural mental dulness for culpable idleness, and organic cerebral incapacity for criminal indifference to intellectual culture and educational advancement.” Again, the tremendous strain that now taxes the brain-power of society in every direction, is an additional reason why the voice of this minister to the mind diseased should be listened to in time: in the statistics of insanity the terrible fact is admitted, that there is an absolute increase of madness throughout Europe and America.
Dr. Winslow has assembled some very interesting instances of retention of the vigour of the mind in old age, and arrived at, inter alia, these conclusions: “1. That an active and vigorous condition of the mental faculties is compatible with old age. 2. That a continuous and often laborious exercise of the mind is not only consistent with a state of mental health, but is apparently productive of longevity.” It is indeed particularly satisfactory to be told that even in the worst types of mental disease there are some salient and bright spots upon which the physician may act; and that formidable and apparently hopeless and incurable cases of derangement admit, if not of cure, at least of considerable alleviation and mitigation.
The Half-mad.
The Commissioners in Lunacy have reason to know that there are many, not insane, but who, being conscious of a want of power of self-control, or of addiction to intemperate habits, or fearing an attack or a recurrence of mental malady, but being in all respects free agents, may be desirous of residing as voluntary boarders in an institution for the care and treatment of persons of unsound mind, submitting to a modified control, and conforming to the general regulations of the hospital. There is not in the statutes for the regulation of registered hospitals any prohibition on such persons being admitted as inmates on the terms above suggested; provided they contract alone, or jointly with others, to conform to certain regulations expressed or referred to.
Motives for Suicide.
In the Westminster Review, New Series, No. 23, we find this suggestive return: