She has now been upwards of three years in the world, engaged in useful and active duties, and though she may be liable to extremes, and be too susceptible of the action of exciting causes, yet I have every reason to believe, that experience has taught her the necessity of counteracting and restraining their baneful influence. I am told by her friends, that now collision with the world having smoothed down the peculiarities which her long seclusion had contracted, her character appears much improved.
I might detail many such cases, and prove that cures have apparently been effected by this intellectual and delicate attention, and more especially in some slight and incipient cases. But I may also state, that many cases of the most serious kind have been so treated, and have recovered. I particularly have in view, two cases of the most determined suicidal melancholy, that were so delicately treated and watched, that they were not themselves aware for months, they were even in a place of confinement, or they had an eye of anxiety constantly watching over them. To this watchfulness and constant exertion to amuse and divert them, I principally attribute the gradual diminution of their melancholy, and ultimately their recovery. These cases, No. 412, and 373, have each returned three or four times of their own accord, and have each time, under this system, gradually recovered.
Is it not then of importance that we should do every thing possible to lessen the present feelings of horror associated with such places? then might we expect to find them come of their own accord, have confidence in their medical friend, concur and co-operate in the plan marked out for their cure, and the consequence would be, that we should find them generally recover.
No. 373 came of his own choice,
And was a most distressing case of hypochondria, which had from various causes been increasing upon him for about twenty years; and when he so came, he was in the most depressed and melancholy state possible. His whole mucous membrane had long suffered from chronic inflammation, and was in a state of the greatest irritability. He was, in less than nine months, altogether another being; his habits were altered, and his health greatly re-established; and this person was one whose cure was partly to be attributed to my mode of amusing him. I do not mean to enter into his particular history, or his medical treatment, for it would itself make a volume; but I introduce a brief notice of his cure, for the sake of illustrating the foregoing principles of Classification, and to show that a variety of methods are necessary to accomplish the object we ought ever to have in view, and that it would never answer to apply indiscriminately the same medical or moral treatment to any two cases.
A plan was proposed to spend an hour at least with him every evening, and this hour I devoted to that of detailing to him a history of my own life, always contriving, in the style of the Arabian Nights Entertainments, to break off suddenly at some point of interest; and these conversations, had they been committed to writing, would have formed some very amusing volumes. The great art and merit of the plan consisted not merely in making them amusing, but in contriving to introduce, without appearing intentionally to do so, (that I might not in his over sensitive state offend him), facts and views calculated to counteract the errors and bad habits into which he had fallen.
In all cases it is necessary to know every extreme view and error to which the human mind is liable, and where these exist, as inmost cases of insanity, to endeavour to counteract them by clear and beautiful views of the truth.
What is of the greatest consequence, is that it is still more necessary to know the best mode of making truth admissible and effectual; for it ought never to be forgotten, that in all cases where error and delusion exist, even if we know those views which are best calculated to counteract and remove them, still more depends on the manner, circumstances, and spirit in which we present and apply them. I am anxious to draw attention to this truth, because it appears to me the world at present has no adequate conception of this great and necessary art in its propagation: still less does it appear that mankind, nor even many medical men, have formed any proper estimate of the vast importance of such a system in the treatment of the insane: a system, however, which requires that we should be fully acquainted with the history of man, and be able to perceive the causes and effects of false and perverted views of philosophy, morals, and religion, and above all that we should possess a knowledge of the constitution of the human mind, with all the specific differences of every individual case.
I mention this case with others, to show that there are many instances where something more than common attention is required, and that to such patients we devote ourselves, and have them at our own house for this purpose. These are precisely those who are over excitable. They form a large proportion of the insane, and in their incipient stage, their minds are rather in a state of perversion, than absolutely lost or deranged; whose cure depends on correcting this perversion, and restoring the relative and appropriate share of activity and energy to each function, in the exact measure, proper place, and according to the order of their right distribution.
If then, these houses serve these various purposes, who is best able to judge when such purposes can be best served? The exact moment lost can never be regained! a wrong word, or even look, may unhinge, and bring on a relapse! It is a species of discipline like that of a nursery;—children commit some fault, and are removed from the objects of their affection as their punishment; and no punishment is greater or more effectual. Some of our circle break out into passion, or give way to some strong propensity; they are told it won’t do, and are removed: they soon promise to behave better, and return. The causes are sudden and unexpected, and sometimes trivial; and this mild medicine, instantly administered, has a wonderful influence. Sometimes the attendants will be better suited for some specific cases at one house than at the other; and it may be injustice to other patients to change them, but great justice to change the patient on their account.