THE TRANSYLVANIA 
JOURNAL OP MEDICINE 
AND 
Kixt ttofwtiuit 
FOR JULY, AUGUST AND SEPTEMBER. 
ORIGINAL COMMUNICATIONS. 
ARTICLE I. 
Thoughts on Moral Medicine, being an Introductory Lecture, 
By Charles Caldwell, M. D. Delivered Nov, 4th, 1833. 
INTRODUCTORY. 
Gentlemen:—Considered in one of the lights which present 
themselves, in a liberal examination of it, Medicine might be 
denominated the Science of Vital Impression. From the 
source designated by that expression flow all its effects; and 
from a knowledge of that source only, of the principles on 
which it depends, and the laws which govern it, can those 
be understood and regulated. 
Vital Irnpresrion may be defined the production, more 
strictly speaking, the mode of production, in any portion of the 
living body, of a new condition, by changing, in some way, 
the existing state of action in it. The change thus induced 
consists in an increase or a diminution of action, or in the in- 
troduction of a new form of it, and arises from contact with 
something that is material, or by impulse from something that 
is not. 402 
Caldwell on Moral Medicine. 
The portions of the body, on which impressions can be 
primitively made, are four; the skin, the internal surface of the 
alimentary canal, the internal surface of the respiratory appa- 
ratus including the trachea and nares, and the brain. Accord- 
ing to an anatomical view of this matter, not altogether un- 
fashionable, at present, these four portions of the body might 
be reduced to two; the brain, and the skin; the mucous lining 
of all the open cavities being considered nothing more than 
reflected continuations of the latter organ, in a modified con- 
dition. Impressions on all other parts of the body are secon- 
dary, being communicated to them from one of these four. 
The process through which the communication is made, is call- 
ed sympathy, a term intended merely to express the fact, that 
impression and action in one part of the body give rise to im- 
pression and action in another—sometimes an adjacent part, 
at other times a remote one. In most cases the secondary ac- 
tion is of the same kind with the primary, when the sympathy 
is called direct; but in some instances it is different, when the 
sympathy is called reverse. 
Like all other unsettled subjects, admitting of the free exer- 
cise of the imagination, Medicine has been variously consider- 
ed and treated, according to the varying tastes and tenets of 
inquirers, and the different lights, in which it has been viewed 
by them. It has been correctly enough, perhaps, divided into 
two leading branches, Physical and Moral; the first including 
the three forms of practice, in which the primitive impression 
is made on the skin, the alimentary canal, and the internal 
lining of the nares, trachea, and lungs; the last being that, in 
which the impression is made directly on the brain. 
It has been already remarked, that all medicinal impressions 
are not the immediate product of material agents. This is espe- 
cially the case with those whose seat is in the brain. They 
are made by impulses intellectual and moral, and by a set of 
instinctive feelings, which, with nothing of either morality or 
intellect in them, have received the denomination of animal 
propensities. Hence, on that branch of medicine, in which 
these modes of impression are employed, is bestowed the name Caldwell on Moral Medicine. 
403 
of moral, the class of feelings bearing that denomination being 
of the highest order. It is to a few remarks on this branch, 
that your attention is invited, on the present occasion. 
Nor are you asked to accompany me through a barren waste, 
or a fruitless field. Far from it. We are to pass over a tract 
beauteous to the e}Te, and abundant in products of peculiar 
value. If we do not, therefore, profit, in exploring it, the fault 
will be our own. To drop the metaphor. It would not be 
difficult to show, that, in some respects, the Moral branch of 
Medicine surpasses the Physical, in importance, as well as 
interest. Being much less frequently a subject of notice, es- 
pecially among British and American physicians, it has some 
degree of novelty in it; a consideration not to be disregarded 
in the selection of a subject of inquiry. Far less important, 
however, is that circumstance, than others which are more 
immediately connected with it. Deriving from the brain both 
its existence and character, it is identified with that organ in 
rank and standing. But so perfectly is the brain the master 
organ of the system, and, therefore, the most important, that 
all the others submit to it, and depend on it, if not for life, at 
least'for their activity, energy, and usefulness. Without it, 
they would be as insufficient for all that confers distinction on 
human nature, or renders existence desirable, as azote is for 
respiration, or granite for nourishment. It is as truly and 
immediately the source and arbiter of the higher functions of 
the economy of man, as the sun is of the heat, light, and regu- 
lated movements of the system of planets, over which he pre- 
sides. And what the obscuration, loss of power, or any other 
form of derangement of that master luminary would be to the 
heavenly bodies that move around him, receive his influence, 
and submit to his control—such is a serious affection of the hu- 
man brain to the other portions of the human body. Nor is 
the removal of such an affection dissimilar to what the rekind- 
ling of the fires of the sun would be, after their extinction, and 
the restoration of his other attributes, after they had been lost. 
Such is the pre-eminent rank of the brain, as a portion of 
pur system. And, as already mentioned, from its immediats Caldwell on Moral Medicine. 
404 
connexion with it, Moral Medicine partakes of its standing; a 
consideration that renders the comparative neglect, which that 
branch of the Profession sustains, the more unaccountable, and 
the more to be lamented. But, that the importance of the 
brain may be still more clearly perceived, and its character 
more accurately understood and appreciated, a few farther ob- 
servations on its functions and powers in health, and its phe- 
nomena in disease, appear to be requisite. 
That the brain and not the nerves is the true seat of sensa- 
tion, and also of the animal propensities called instincts, may 
be regarded as an axiom in physiology. No physiologist 
could deny it, but at the expense of his reputation. That it 
is likewise the seat of the intellectual faculties, the rational, no 
less than the perceptive, is acknowledged by all who are ac- 
quainted with the subject. Nor are the entire elevation and 
value of its character yet disclosed. It is as truly the seat of 
morality and religion, (I mean in its capacity as the organ of 
the mind) as it is of sensation and animal passion. In proof 
of this, derange certain portions of the brain, and the moral 
and religious sentiments wall be perverted or extinguished. 
Restore them to soundness, and those sentiments will be re- 
vived. 
I am aware that this latter view of the brain is acquiesced in 
only by the few, while the many reject it; and a portion of 
them even denounce a belief in it as heretical, if not impious. 
This consideration, however, does not shake my confidence in 
its soundness. On the contrary, it would not be very strange, 
were it even to strengthen it. In matters of science, where 
deep and steady research, and calm and deliberate reflection 
are necessary, though the few are not always right, the many, 
until corrected and informed by the few, are almost always 
wrong. The reason is plain. The latter do not think and in- 
quire sufficiently, to penetrate the night of ignorance, and dis- 
pel the clouds of prejudice, that, descending on them, and set- 
tling around them, keep them from knowledge. Over the tur- 
bid and troubled waters of their minds no ministering and 
friendly spirit has moved, to temper and purify their passions, Caldwell on Mural Medicine. 
405 
disenthral them from superstition, and place them under the 
guidance of reflection and reason; nor has a voice gone forth 
to them, commanding that there be light. In simpler language? 
the multitude are incompetent judges of all that deserves the 
name of science. Yet are they the most prompt and determin- 
ed in their condemnation, and the most intolerant and clamor- 
ous in their denunciation of what they least understand. Nor 
is this more strikingly the case, in respect to any topic, than 
that I am considering. 
Are any who listen to me ready to demand of me, perhaps 
in tones of incredulity and surprise, “Is the brain, then, in eve- 
ry case, the source and instrument of all you attribute to it? 
Are we to understand, that the oratory of Demosthenes, which 
even now seems to vibrate in our ears, and the “splendid” 
rhetorical “conflagration” of Cicero, which still dazzles, while 
it fascinates us—are we to believe that these great mental 
manifestations were the products of the brains of those orators, 
and not of their spirits? and is the same true of the eloquence 
of Chatham, Burke, and Canning, Adams, Henry, and Aimes, 
who were scarcely inferior, if inferior at all, to the highest 
models Antiquity can boast? Was it the brain and not the 
spirit, that poured on Alexander and Csesar, Frederick and 
Napoleon a flood of glory, which time, instead of extinguish- 
ing, shall brighten and perpetuate? Did Harvey and Massilon 
draw from the same fountain their pure and fervid sentiments 
of piety and devotion, Aristotle, Bacon, and Newton their in- 
exhaustible stores of learning and philosophy, Watt and Ful- 
ton their inventive powers, so splendid in themselves, and so 
invaluable in their products, and Franklin, Washington and 
Hamilton their profound wisdom and spotless integrity? and 
was it the same mass of organized matter, that immortalized 
Homer, Pindar, and Virgil, Dante, Spencer, Shakspeare, and 
Milton, and other poets of unfading renown? Finally; is it 
the brain and not the mind, that is, in every instance, and ne- 
cessarily, the true and immediate source of the greatness, glory, 
and virtue of our race?” To all these questions I answer, 
tes; the brain is the direct and essential instrument of the Caldwell on Moral Medicine. 
whole, without which they would not have existed. Nor is 
there aught in the reply offensive to morality, dangerous to 
religion, unfriendly to the cultivation of the social virtues, or 
hostile to any of the interests of our race. On the contrary, 
being true, it is in harmony with all, whether in sentiment or 
practice, that is morally, socially, and theologically sound and 
useful. Correctly might I add, that man is indebted to h'.s 
brain for every attribute intellectual and mural, that complete- 
ly distinguishes him from the inferior animals, places him at 
the head of earthly creation, and constitutes him truly a hu- 
man being. And there is no more materialism in this, than 
every enlightened and intelligible writer on mental philosophy 
is'compelled to employ. The dream of abstract spiritual met- 
aphysics is no longer admitted into the Schools, where it w'as 
once deemed heretical to question its truth, or resist its su- 
premacy. Even the cloister of the visionary and fanatical 
recluse, no longer harbours it. 
But all the important uses of the brain are not yet enumerated* 
One remains, which is too closely connected with whatever is 
efficient and valuable in man, to be passed unnoticed. It is 
equally essential to the manifestation of his feelings and 
thoughts, and the execution of his purposes. I allude to the 
function of muscular action. Voluntary motion, in all its mod- 
ifications, has its source in the brain. This fact attaches to 
that organ a degree of importance greatly beyond what it is 
usually supposed to do. As an attribute of our nature, volun- 
tary motion is far from receiving generally its due estimation. 
The cause of this plain. It is a familiar phenomenon which 
every one sees and experiences every moment (and familiarity 
detracts from the weight of all things;) and it is rarely contem- 
plated in the important character that justly belongs to it. 
What, in reality, would man be without it? Unable to minis- 
ter to his own enjoyments, or those of others, or to supply his 
or their wants, he would be fixed to a spot, with no more 
power to move from it, or to act in it, than a plant ora zoo- 
phyte; and, in point of usefulness, he would be inferior to eith- 
er. But, to give even a limited view of the interest and im- Caldwell on Moral Medians, 
407 
portanc© which belong to this subject, a brief analysis of it is 
necessary. 
To voluntary muscular motion man is indebted, in part, for 
respiration, the inlet of life; and, for the power of speech, he 
is indebted to it entirely. Nor could he either provide, pre- 
pare, carry to his mouth, masticate or swallow his food without 
it. Deprived of it, he could not even open his mouth for the 
reception of food. To his very existence, therefore, it is as 
essential, as his aliment itself, or the air he respires. But this 
is not all. The Arts and Inventions of life, in all their variety, 
whether common and useful, or elegant and refined, with their 
innumerable production?, as well the necessary as the ornamen- 
tal, depend entirely on voluntary motion. The brain conceives 
and matures them by its immediate action, and executes them 
indirectly, by the ministry of the muscles. This is as true of 
the arts of writing, printing, engraving, painting, sculpture, 
and land and naval architecture, as of any others. But for 
voluntary muscular action, therefore, the earth would be a 
blank as to recorded knowledge, also as to monumental, medallic, 
and other forms of transmitted remembrance; each nation (could 
nations exist) would be ignorant of every other; the world 
could not profit by ancient or remote example; nor would the 
accumulated wisdom of ages have a name. Even vision, 
hearing, taste, smelling, and touch, are essentially connected 
with muscular motion, and would fail by its extinction. Add 
to this, the entire want of agriculture, navigation, and manu- 
factures, and the earth would be a scene of desolation and 
barrenness. Destroy voluntarily, moreover, in the whole ani- 
mal creation, and the delights of music would cease, all other 
pleasing sounds would be extinct, and sepulchral silence would 
encompass the globe, except when broken by storms and. tem- 
pests, the crash of falling bodies, the gush of cataracts, the 
voice oi the ocean, or the peal from the thunder-cloud. And 
even of these disturbers of silence, the din would fall on im- 
perccptive ears. Nor would grace of motion, or beauty of 
expression—-the smile of pleasure, or the look of affection, 
any longer give delight. They too would perish in the gen- Call well on Moral Medicine, 
eral wreck. So gloomy and vast would be the effect of a 
want or suspension of muscular motion, whose source is in the 
brain! 
Wakefulness and sleep, which are nothing but affections of 
the same organ, concur in demonstrating the importance of its 
functions, and the pre-eminence of its general standing and 
character. When attentively looked into, as subjects of phi- 
losophy, these are found to be among the most curious and 
interesting phenomena of the animal economy. Nor do they 
appear to have been heretofore satisfactorily explained. Per- 
haps they are inexplicable. In the present condition of our 
knowledge, they are certainly so. Wakefulness consists in a 
state of excitement and action of the several portions of the 
brain, produced by the stimuli appropriate to each, and by 
their influence on each other. Sleep is the reverse of this, 
consisting in cerebral inaction, and is the result of the absence 
of stimuli, or of their want of power to produce excitement. 
Here again, the mutual influence of the different portions of 
the brain is an operative cause. The inaction of one portion 
tends to the production of a similar condition in others, espe- 
cially in those more immediately connected with it. Dream- 
ing is partial sleep, some parts of the brain being active, and 
others quiescent. Had I leisure to give a full exposition of the 
influence of sleep and wakefulness on the animal economy, it 
would furnish much and strong additional testimony, in favour 
of the importance of the organ that controls them. On no 
other ground could the supremacy of that organ be more 
clearly demonstrated. 
Though the precise philosophy of wakefulness and sleep is 
concealed from us, we perceive a beautiful fitness between 
their alternation with each other, and the times and circum- 
stances, under which they occur. The relation of the former 
to light, action and sound, and of the latter to darkness, inac- 
tion, and silence, are natural and perfect. The fitness and 
necessity, moreover, of their mutual alternation to the wants 
of the animal economy, are not only learnt by observation Caldwell on Moral Medicine. 
409 
and experience, but are in accordance with reason. Wake, 
fulness is life in full development, with all its functions pre- 
pared for action, or active already. During its continuance, 
man is in a state of aptitude for the discharge of his duties, 
and experiences enjoyment corresponding to his condition. 
But so delicate is the structure, and so high-wrought and ex- 
quisite the sensibility of his brain, that the excitement and ac- 
tion of perpetual wakefulness would exhaust its powers, or 
produce in it some other form of departure from health. Hence 
the necessity of an occasional state of repose, that the losses 
it sustains during wakefulness may be restored, its derange- 
ments repaired, disease prevented, and its aptitude for its im- 
portant functions renewed. As is the case with every other 
portion of the body, the alternation of action and repose con- 
stitutes a fundamental law of its being. And the more perfect 
sleep is, the sooner, more certainly, and more completely is 
the design of it fulfilled. 
If these remarks be true (and it will be difficult to refute 
them, for they are founded in Nature) there is much more of 
poetry and fiction, than of philosophy and truth, in the oft 
repeated assertion, that sleep is a “tendency to death” or that 
there is any positive diminution of vitality in it. Much more 
correctly may it be termed a preventive of death, or a reno- 
vator of life. Such is unquestionably the office it performs. 
Hence the languor and lassitude often felt before sleep, and the 
vigour and elasticity after it. Sleep is the latent condition of 
cerebral or sensitive life. But life, when latent, is as real life, 
as it is when active and open; and it is much less obnoxious to 
injury and destruction. In beans found in Pompeii, life had 
lain latent for seventeen centuries, and for more than thirty cen- 
turies, in wheat discovered in the catacombs of Egypt. Yet, 
that in these cases, the life was genuine, and had suffered nei- 
ther deterioration nor change, appeared from the vegetation of 
those seeds, when subsequently planted. In like manner latent 
cerebral life is still real life. Besides, during sleep, respiration, 
the immediate fountain of life,continues in full vigor. Sodoall 
*he functions of organic life, which is the renovator of cerebral 410 
Caldwell on Moral Medicine. 
or animal life. Hence the salutary and re-invigorating influ* 
ence of sleep on the latter. 
Sleep, then, is not to be considered a diseased or an unnatu- 
ral condition of the brain. Far otherwise. When indulged 
in only under proper circumstances, and to the requisite ex- 
tent, it is as salutary and natural as a state of wakefulness. 
It conforms to a fundamental law of the human constitution, 
as well as of that of other animals, ft is therefore healthful in its 
end, no less than in itself. My reason for indulging in these 
remarks is, that, in their attempts to explain sleep, some wri- 
ters have given a contrary view of it. They have represented 
it as the result of cerebral compression, which would render it 
morbid. They allege that, during sleep, the vessels of the 
brain are surcharged with blood. I need scarcely say, that 
this hypothesis wants proof. Though an effort is made to sus- 
tain it, by analogy, sound analogy discountenances it. True; 
cerebral compression, whether produced by blood, a depressed 
portion of cranium, or by any other means, induces sleep, or a 
condition resembling it. But it is not healthful sleep; it is not 
the sleep, which refreshes ar d invigorates; it is the stupor of dis- 
ease; audits effects are confusion, bewilderment, and debility. 
If a person, exhausted by watching and fatigue, receives a 
blow, which fractures and depresses his scull, and produces a 
torpor of ten or twelve hours, he will not feel invigorated, when 
the bone is elevated, and the torpor relieved. On the contrary, 
his debility will be increased, and he must sleep again the sleep 
of nature, before the balm of refreshment will descend on him. 
Though an insensibility, which, for a time, “knits up the rav- 
elled slieve of care,” may and does arise from pressure on the 
brain, that healthful sleep, which is “sore Nature’s bath, balm 
of hurt minds”—and “tired Nature’s sweet restorer” never can. 
As no salutary result springs directly from a morbific cause, 
but the reverse, refreshing sleep is compatible only with health; 
because the re-invigoration it bestows is the product only of 
natural action. Hence it is not the agitated and feverish sleep 
of disease, but the calm sleep of convalescence that refreshes 
the sick. Caldwell on Moral Medicine. 
411 
I have said that sound analogy is opposed to the hypothesis 
of a preter-natural accumulation of blood in the brain, during 
healthful sleep. My reason for that statement is plain, and 
may be briefly rendered. Conformably to a law of the animal 
economy, which is believed to admit of no exception, excite- 
ment creates a conflux of blood to the part excited, while a 
deficiency of excitement is accompanied by a corresponding 
deficiency of blood. To adduce examples in proof of this 
would be superfluous. No physiologist holds it doubtful. But, 
as already stated, there is a want of excitement in the brain 
duringsleep. Such indeed is the very essence of that condi- 
tion of the brain. Under no other can it be experienced. In 
proof of this, sleep is invited by the abstraction of excitement 
from that organ, and prevented by its presence; especially by 
the presence of an unusual amount of it. When it exists, 
moreover, it is easily removed by the renewal of excitement, 
by touch, sound, light, the sudden application of cold, or any 
other mode of producing sensation. There is no just ground, 
therefore, to believe, that there is a congestion of blood in the 
brain, during sleep. The contrary is by far the more probable 
opinion. It may be pronounced certain, that no congestion of 
arterial blood exists. Such congestion is always accompanied 
by a well marked increase of action and sensibility. Nor is this 
more strikingly the case in any organ, than in the brain. The 
augmented sensibility and action, in inflammation of the brain, 
in which arterial blood is accumulated there, is the chief cause 
of the sleeplessness and distress, that are always experienced 
in that complaint. In ferocious insanity, also, arterial blood 
superabounds in the brain, and, in some instances, months, if 
not years, pass over the sufferers, unmarked by the refresh- 
ment of sleep. Nor is this all. The highest excitement, and 
most vigorous action, of which the brain is susceptible in a 
healthy condition, are always accompanied, and essentially 
promoted, by an augmented conflux of arterial blood to that 
organ. Witness the condition of the brain of the orator, at 
at the moment of his happiest achievements in eloquence. 
The tenseness and throbbing of his carotid and temporal arte- Caldwell on Moral Medicine. 
412 
ries, the deep glow of his countenance, the piercing flashes of 
his eye, the fulness and tension he feels in his head, and the 
alarming vertigo, 'which, at times, invades him, all testify to 
the unusual state of arterial congestion, in the organ of his 
mind. And to the heightened tone of that organ, produced 
by the congestion, is to be attributed the improvement in his 
powers of eloquence. In proportion as his brain becomes 
more fully injected and vivified by blood, are all his mental 
manifestations amended. His perception is clearer, his re- 
collections livelier, and his combinations and inferences more 
prompt and forcible. But this makes only a portion of the 
augmentation of his powers. His imagination becomes more 
brilliant and his conceptions loftier, his pathos deeper and his 
declamation more splendid, his invention readier and more 
fertile, his wit brighter and more pointed, his irony keener, and 
perhaps, bitterer, his sarcasm more caustic, and his bursts of 
invective more indignant and blighting. Nor are all his forms 
of improvement yet enumerated. The fluency, force and fit- 
ness of his language keep pace with the swelling current of 
his thoughts, and even his action and the intonations and com* 
pass of his voice are equally amended, as means to manifest 
the resources of his mind. In fine; the grandeur and lustre oi 
all the highest qualities of eloquence united are but the product 
of the intense excitement and tone of the brain, under a deep 
congestion of arterial blood. So true is this, that neither De- 
mosthenes nor Cicero, nor any other speaker ever played the 
orator fully, until his brain was thus injected. Venous blood, 
having parted from most of its vital qualities, a congestion of 
it never vivifies, but always deranges the part where it occurs. 
Perhaps 1 should rather say, that it is itself the issue of de- 
rangement already existing, and tends to increase it. 
Another effect of arterial congestion in the brain, worthy 
of notice, as being calculated to show the importance of that 
organ in the human system, is its augmentation of muscular 
strength. This effect is most strikingly produced, when the 
congestion occurs in the organs of Combativenes and Destruc- 
tiveness. Evidence in proof of this is abundant. Those organs Caldwell on Moral Medicine. 
413 
are chiefly congested in ferocious madness; and the strength 
of an infuriated maniac is sometimes amazing. Of men ad- 
dicted to broil and battle, when moderately excited by wine, 
or ardent spirits, and intensely so by anger, the same is true. 
Their strength receives a fearful increase, which renders them 
dangerous to those who encounter them. In this provision 
we perceive one of the innumerable aptitudes, which mark 
the faultless economy of nature. The organs of Combative- 
ness and Destructiveness are bestowred on man, that he may 
possess the disposition to defend himself and others from ag- 
gression and wrong, and to inflict injury, or destroy life, if 
necessary, in effecting his purpose. And their excitement, 
and congestion with arterial blood, not only heighten his cour- 
age and resolution to meet danger and set death at defiance, 
but give him greater strength, for defence and attack. 
But, in denying the existence of a congestion of blood in the 
brain during sleep, I do not rely, for evidence to sustain me, on 
analogy alone. Direct observation testifies conclusively to 
the same effect. In persons, whose brain was denuded, and 
open to inspection, in consequence of the removal of a portion 
of the integuments and cranium, that organ has been always 
found in a state of comparative flaccidity and collapse, during 
uninterrupted sleep. Under disturbed and dreamy sleep, it is 
perceived to be somewhat tense and full, but still more so, un- 
der entire wakefulness, and most of all, when excitement is in- 
tense. A remarkable case of this kind occurred in Montpe- 
lier, in France, in 1821, the history of which is given by Dr. 
Pierquin, a physician of distinction; and several of a similar 
character have fallen under the notice of Sir Astley Cooper, 
and other physicians. Indeed I cannot doubt that the phe- 
nomenon shows itself, in every instance, where the trephine 
is applied. And, as a fact in Physiology, useful as well as in- 
teresting, it has a fair claim on the attention of the Profession. 
Most of the foregoing phenomena, indicative of the impor- 
tant character of the brain, belong to the healthy condition of 
that organ. Its morbid affections testify to the same effect. 
with no less directness and force. A concussion of the brain, Caldwell on Moral Medicine. 
414 
by suspending or destroying all the mental faculties, both in- 
tellectual and moral, together with voluntary muscular motion, 
unfits the mind to conceive and arrange schemes of usefulness, 
and the body to execute them, and, if not removed, terminates 
in death. Of compression of the brain, as heretofore intimated, 
by a depressed portion of the scull, the same is true. So is it 
of apoplexy and palsy. These affections, consisting in diseas- 
ed conditions of the brain, destroy indiscriminately all mental 
and corporeal capabilities, and soon extinguish life. Epilepsy, 
St. Vitus’s dance, and other forms of convulsive disease, which, 
for a time, unfit both mind and body for useful action, are the 
product of morbid affections of the brain. I need scarcely 
add, that, unless the system be relieved from them, they usher 
in other complaints highly afflictive, and usually fatal. 
That madness, in all its forms, is exclusively an affection of 
the brain, is now acknowledged by every pathologist. And, 
were it not for the influence of habit, and the power of preju- 
dice and superstition over the mind, it might well excite sur- 
prise, that it was ever considered otherwise. But, of all mala- 
dies, it is one of the most fearful, because it makes a wreck of 
the highest and most valuable attributes of man. This howev- 
er could not be the case, were not the brain, from which mad- 
ness takes its character, the master organ of the system. For, 
as already intimated, the character of the disease must corres- 
pond to that of the part, in which it is situated. But madness 
does not act alone on the brain. Owing to its indirect influ- 
ence on other important parts of the body, it tends to shorten 
human life. The insane rarely attain to an advanced age—Id- 
iotism is likewise an affection of the brain. But the mental 
desolation, in which it consists, need not be mentioned. Nor 
does its deplorable character arise from any other cause, than 
the high rank of the organ it destroys. 
Such are some of the facts demonstrative of the peculiar im- 
portance of the brain. And many others might be added to 
them. But if deleterious impressions made on that organ exer- 
cise an influence so powerful over the other parts of the system, 
it is hardly possible, that salutary ones, well timed, and judi~ Caldwelz. on Moral Medicine. 
ciously directed, can be destitute of power. On the contrary, 
reason and analogy authorize the belief, and experience con- 
firms it, that, in many cases, they are highly efficacious. I need 
scarcely add, that they are peculiarly useful in the complaints 
of females, whose brains far surpass those of males, in delicacy 
and sensitiveness, as well as in their influence on the other 
parts of the body. Male brains, however, possessed of femi- 
nine susceptibility are not wanting. 1 shall now advert to 
some of the principal means of producing salutary and restora- 
tive cerebral action. 
The manners and general character of a physician, more es- 
pecially his deportment in sick-rooms, are a source of moral 
impression on his patients, much more influential than it is 
usually supposed to be. If they are harsh and blustering, or 
marked, in any way, with incivility, or a want of feeling, they 
impress disagreeably and injuriously, and always ought to pro- 
cure, as they often do, the dismissal from employment of him 
who practises them. If, on the contrary, they are mild, affable 
and kind, courteous, attractive and dignified—such, in all res- 
pects, as characterize a gentleman and a man of feeling—they 
cannot fail to do much good. A cheering lenitive to pain and 
distress, they lend directly to assuage irritation and anxiety, 
and minister to hope; and, in doing this, they contribute indi- 
rectly to calm and relieve a throbbing brow and an aching head, 
cool the burning of a fevered hand, and almost occasion, in the 
sufferer, a forgetfulness of his disease. These effects they pro- 
duce on a two-fold ground; the bland and soothing impression 
they immediately make on the patient’s brain, which diffuses its 
benign influence throughout his system; and the confidence 
they beget, and the gratitude and affection toward his physi- 
cian, which they awaken in his mind. They thus put his brain 
into so good a condition, as to enable it to do its duty the bet- 
ter to the other parts of his body. For the true and only 
mode of successful practice is, to restore the controlling organs 
to soundness, and they will produce on the subordinate ones 
a similar effect. These latter considerations are peculiarly 
important. The physician, who possesses the confidence and 416 
Caldwell on Moral Medicine. 
attachment of his patients, can scarcely fail to be successful in 
his practice. Beyond a doubt, other things being alike, he will 
be more successful with such moral aids, than he could be with- 
out them. 
On certain well known principles of human nature, the same 
remedies administered by a favorite practitioner, in whom con- 
fidence is reposed, will prove much more beneficial, than if 
they came from one to whom the sick are indifferent, in whose 
skill they do not confide, or whom they have reason to dislike. 
Nor is disgust of a medicinal article much less prejudicial, than 
antipathy to him, who prescribes and prepares it. Hence the 
propriety of making medicines as grateful as possible to the 
taste. It is the result of experience, as wrell as a fair deduc- 
tion from principle, that, other things being equal, a medicinal 
substance disagreeable to the taste, contributes less toward 
the removal of disease, than one which is pleasing to it. On 
the principles of moral medicine, this may be easily explained. 
As already stated, the brain is the seat of every form of feeling. 
All disagreeable feelings, therefore, (of which an offensive taste 
is not the least operative and repulsive) are irritants to that or- 
gan, produce in it some sort of unnatural action, and not only 
injure it immediately, but the rest of the system indirectly, 
through its influence. Ido not say that I have never known 
pills and powders, potions and boluses, swallowed reluctantly 
and with feelings of disgust, to be productive of good; but I 
do say, that I have known them to do mischief, in cases where 
they w’ere not improper in themselves. For the same reason 
offensive smells, loud, harsh, and disagreeable sounds, and 
strong light are detrimental to the health of the infirm and sen- 
sitive, and more especially to those, who are already suffering 
from a cephalic complaint. By acting immediately and delete- 
riously on the brain, they injure secondarily the rest of the sys- 
tem. Hence the necessity of silence, darkness, and unadulte- 
rated air in the wards and chambers of patients labouring un- 
der cerebral affections, more especially when connected with 
fever. 
On the same ground, all corroding and strongly exciting pas- Caldwell on Moral Medicine. 
417 
siolis, such as grief, fear, anxiety, anger, hatred, and revenge 
are prejudicial to the sick. They consist in excessive and 
therefore deleterious action in the brain, vitiating its influence, 
and unfiting it for the salutary superintendence of the system. 
The victims they consign to the grave are innumerable. This 
is more especially true of fear, during the prevalence of epi- 
demic complaints supposed to be contagious. On such occa- 
sions, that passion is not only a frequent and powerful exciting 
cause of disease, but often swells very appallingly the bills of 
mortality, by deepening the malignity of the complaint, paraly- 
zing hope, one of the chief conservators of life, and weakening 
the recuperative powers of the sick. Yet how rarely is it true 
that epidemics are contagious ! After a course of observation 
and inquiry, pursued attentively for thirty years, mingled with 
no inconsiderable share of experience, my conviction is deci- 
ded, that within that period, epidemic small pox excepted, no 
contagious epidemic has prevailed in the United States. That 
this opinion is opposed to that of a majority, perhaps a very 
large one, of the physicians of our country, I have not now to 
learn. That consideration, however, does not move me. My 
endeavour is, to make my views conform to facts, regardless of 
their discrepancy with the views of others. And, on that 
ground, I have no hesitation in considering a belief in the con- 
tagious nature of yellow fever, plague, cholera, influenza, and 
peripneumonia typhoides, as unfounded as a belief in necro- 
mancy or witchcraft. Nor have I any solid reason to say less 
of a belief in the contagious nature of measles. And, in time' 
to come, when ignorance and prejudice shall have given way 
to a brighter day of knowledge, such, I feel persuaded, will be 
the opinion of the world. But lam not yet done with the in- 
fluence of malign impressions on the brain, in producing par- 
ticular forms of disease. 
Fear, grief, despair, jealousy, rage, ambition, disappointed 
love, and excessive religious enthusiasm are often the produc- 
tive cause of insanity. So are paroxysms of inordinate joy, 
and other forms of strong moral impression; and the same 
causes induce also vertigo, hemorrhagy, fever, epilepSv, paval- 
Vol. 9—(N. S. 1)—No,TIL " 53 418 
Caldwell on Moral Medicine. 
ysis, apoplexy, and sudden death. Of excessive study, long- 
protracted watchfulness, deep anxiety, and every other source 
of high cerebral excitement, the same is true. In persons pre- 
disposed to mental derangement, all such causes, acting as irri- 
tants on the brain, contribute to its development, and should, 
therefore, as far as possible, be avoided. 
Nor, as already suggested, do these causes confine their ac- 
tion to the brain. They often throw it indirectly on the lungs, 
in the form of consumption, and on the chylopoetic organs, pro- 
ducing dyspepsia, gastrodynia, colic, gastritis, and other kinds 
of abdominal derangement. From the same source spring, 
occasionally, jaundice, hepatitis, and intestinal inflammation. 
In females, whose sensibility, as already mentioned, is more 
acute, and their sympathies more active and pervading than 
those of men, cerebral irritation often produces serious uterine 
affections. This is true in a more especial manner, as respects 
the gravid uterus, abortion, and permanent injuries to the foetus 
resulting from the influence of the passions, as a very frequent 
occurrence. Nor, as might be easily shown, do the skin, kid- 
neys, and heart escape mischief from it. Indeed, excessive 
passion, consisting in a state of inordinate and deleterious ce- 
rebral irritation, and the brain being, as already stated, the 
governing organ, it is impossible for any other portion of the 
system to escape. 
So much for the causes which injure the brain. Those 
which act favorably on it shall now receive some further atten- 
tion. In treating of them, I shall speak more definitely than I 
have heretofore done, specifying the diseases in which they 
are salutary. I shall first, however, remark in general terms, 
that, for the removal, no less than the prevention of disease, a 
pleasurable condition of the brain is important. Every painful 
feeling and emotion indicates a malign cerebral impression, and 
may therefore be regarded as a morbid affection, more or less 
injurious to the rest of the system; and the converse. To re- 
move such impressions, then, and substitute grateful and nat- 
ural ones in their places, constitutes an element of moral 
medicine. Caldwell on Moral Medicine. 
419 
To the moral treatment of fever, especially where the brain, 
ss affected or threatened, reference has been made already. 
To speak of it however, more fully, it consists in the exclusion 
of all deep sensations and irritative cerebral impressions. 
Darkness and silence, the mildest kind of food and drink, an 
atmosphere pure, odourless, and pleasant in temperature, and 
perfect cleanliness of skin and clothing are essential. I say the 
atmosphere of sick-rooms should be “odourless;” and to this I at- 
tach much more importance than is usually done by medical 
writers. That the influence of odours on the brain is highly 
exciting and often deleterious, cannot be doubted. Hence the 
sickness and fainting which proceed from it, in some cases, 
and the fierce passions and temporary madness, in others. 
The effect of certain smells on the brains of the inferior animals, 
producing in them, in some instances, the wildest fear, and, in 
others, ungovernable fury, is matter of notoriety to every ob- 
server. 
As respects personal purity, its moral influence is not, in 
general, duly appreciated. On many individuals it is power- 
ful, and acts more or less favourably on all. I once knew a 
lady of excellent intellect and high accomplishments, but unu- 
sually sensitive on the subject of cleanliness, thrown into con- 
vulsions and nearly destroyed, by being maliciously told, that 
her breath and perspiration had an unpleasant odour—an as- 
sertion the more reprehensible, because it was untrue. And a 
conviction of that, kindly but firmly impressed on the patient’s 
mind, proved peculiarly medicinal. 
The attention of the nurse should be so vivid and faithful, as 
to satisfy, on that point, the wishes of the sick; her treatment 
should be kind, and her manners atfectionate, and the deport- 
ment of the physician, as already stated, should embody every 
thing calculated to soothe distress, cherish hope, and inspire 
confidence. With a countenance marked with tempered 
cheerfulness, his manners and conversation should be equally 
remote from mirth and moroseness, gloom and levity, and he 
should do nothing to produce in his patient either alarm and 
despondency, or undue buoyancy and elevation of spirits. In 420 
Caldwell on Moral Medicine. 
fine; his professional ethics being judiciously regulated, and 
his intercourse with the sick grateful and encouraging, are 
measures which enhance not a little the moral of his practice. 
A topic here presents itself, which I am bound to notice; yet 
it is requisite that Ido so with delicacy and caution. I allude 
to the intercourse of the clergy with the sick, and their dispen- 
sing to them the comforts of religion. Is the practice useful, 
(I mean, as relates to the restoration of health,) and therefore 
to be encouraged? or prejudicial, and to be forbidden? A cor- 
rect answer to these questions must be drawn chiefly from two 
sources; the condition of the sick, and the character of the di- 
vine. If the patient be under high febrile excitement, expecial- 
ly excitement of the brain, the intercourse is inadmissible. 
But if there be little or no fever, or cephalic affection accom- 
panied by irritation, or any form of increased sensitiveness, 
the patient desirous of a pastoral visit, and the clergyman mild, 
prudent, and intelligent, the case is different. Under such 
circumstances, the interview may be beneficial, and should 
therefore be permitted. The conversation held should be ad- 
dressed chiefly to the moral and intellectual, especially the re- 
flective organs of the brain; and when they are judiciously im- 
pressed, their influence on the system is soothing and salutary. 
In such a case, however, the divine who is called to “minister 
to a mind,” which, if not “diseased,” is anxious and unsettled, 
should be well qualified for his duty. lie should, in a special 
manner, be so much of a physiologist and true mental philoso- 
pher, as to know that he is to act immediately on the tender 
and irritable matter of the individual; and on his spirit only 
secondarily through that medium; that, in fact, he is to impress 
his brain, for good or evil, according to the substance and tenor 
of his conversation, and his manner of conducting it. He 
should duly appreciate his responsibility, in respect to the 
health of the body of the sick, no less than with regard to the 
welfare of his spirit. He should, therefore, soothe and win, 
with the promises and consolation of the Gospel, not alarm 
and agitate by the terrors of the law. By thus dispelling doubt, 
cheering dejection, assuaging anxiety, and skilfully exciting Caldwell on Moral Medicine. 
421 
hope, veneration, and the other moral organs, whose influence 
on the system is bland and healthful, he may render his visits 
happily medicinal. By thus contributing to ameliorate the 
condition of the brain, he may minister successfully in the res- 
toration of health. But a clergyman, whose religion is intem- 
perate and fanatical, his disposition stern, his dogmas unyield- 
ing, his precepts exclusive and imperative, and his manner hec- 
toring; and who combats with what he deems irreligion or 
heresy, as a dragoon docs with his foe—an agitator like this, 
should never be suffered, in his official capacity, to enter a sick- 
room. As well might a patient laboring under fever, or any 
form of irritative disease, be indulged in the potation of ardent 
spirits, as in the conversation of such a comforter. 
The moral treatment of the insane has never yet been car- 
ried to the useful extent, of which it is susceptible, and which 
it is destined to reach, at a future period, when the science of 
medicine, in its entire compass, shall be better understood. 
The reason is plain. Until the present century was somewhat 
advanced, madness had never been studied on its true princi- 
ples, and was not therefore correctly understood. It is now 
known to consist, like other complaints, exclusively in a de- 
rangement of organized matter. It is nothing but a morbid 
affection of the brain; not indeed of the whole brain (for mad- 
ness is rarely if ever universal, some of the faculties of the 
mind being perhaps always sound) but of one or more of its 
single organs, or groups of organs. And the correct moral 
treatment of the complaint consists in giving the distempered 
organ rest or action, according as it is already inordinately ex- 
cited, or morbidly torpid. Is the excitement of the deranged 
organ preternaturally high, and the faculty belonging to it wild 
and excessive? Bring it to a state of comparative inaction, 
either by general rest, or some other mode of reduction, or by 
transferring the excitement to another organ. To exemplify 
my position. 
Is the inordinate state of action in the organ of Number, or 
that of Tune; and is the individual threatened with madness, 
or is he already mad, in either of the corresponding faculties? 422 
Caldwell on Moral Medicine. 
Restrain him, as much as possible, from calculation and music, 
and engage him in some mechanic art, or in the moderate 
study of geography, history, mineralogy, or chemistry, in 
which the organs chiefly exercised will be Size, Weight, Lo- 
cality, Individuality, Eventuality, Form and Colour; Number 
and Tune being nearly quiescent. Let his study, I say, be 
moderate; for under excessive morbid excitement of any por- 
tion of the brain, severe exercise of any other portion would 
be injurious. This is an attempt to cure the complaint, by 
revulsion; in like manner as we irritate the surface of the body 
by blisters or rubefacients, to remove irritation and congestion 
from some deep-seated part. And, by travelling, change of 
scenery, and various shifting forms of amusement, where most 
of the cerebral organs are exercised, in succession, gently 
and pleasantly, the end in view may be attained, with but little 
effort. For effecting the same purpose, nothing is more effi- 
cacious than well-timed and judicious conversation—that kind 
and degree of it, I mean, which engages and excites lightly and 
agreeably, and maintains chiefly in action other organs than 
the diseased ones. Hence the peculiar benefit derived, by the 
moderately insane, from an intercourse with discreet and intel- 
ligent friends, especially if they are versed in the science of 
Phrenology. I have said ‘moderately deranged;’ for, in insanity 
of high excitement, the presence and conversation of friends 
are inadmissible. They rouse and exacerbate rather than tran- 
quil ize. 
Are one or more of the cerebral organs morbidly inactive? 
Let it be awakened to action, by frequently presenting to it 
its appropriate stimuli, or by blistering, caustics, electricity, 
and galvanism, judiciously employed. Benefit may also be 
derived from the frequent and brisk exercise of adjacent and 
associated organs. One of the great advantages, in the treat- 
ment of madness, derived from Phrenology, arises from its 
furnishing a knowledge ol the immediate seat of the morbid 
affection. And if such knowledge is highly valuable, in the 
treatment of other complaints, it must be equally so in that of 
mental derangement. The usefulness of Phrenology, more- Caldwell on Moral Medicine. 
423 
over, in the treatment of insanity, is the greater, from its not 
only indicating the seat of the complaint, but from its also 
teaching the best mode of exciting torpid organs, and reducing 
those that are acting excessively to a state of rest. It makes 
known the important fact, that different portions of the brain 
have their peculiar and appropriate stimuli, whose influence 
alone they feel and obey, precisely as the eye is stimulated and 
thrown into action by light, but not by sound, the ear by 
sound, but not by sapid bodies, and the tongue by the latter, 
but not odorous ones. And the physician who knows how, 
where, and when to apply cerebral stimuli, will experience no 
difficulty as to the time and mode of withholding, administering 
or suppressing them. Another mode, in which Phrenology 
ministers to the successful treatment of by indica- 
ting not only the deranged organ, but also those most inti- 
mately associated with it, in sympathy as well as locality. 
Hence the phrenological practitioner possesses a twofold ad- 
vantage. He can, with more facility and certainty than other 
physicians, act directly on the seat of disease, and indirectly, 
through the most strongly sympathizing portions of the brain. 
In convalescence from most diseases, especially if it be ac- 
companied by depression of mind, the moral impression pro- 
duced by cheerful society judiciously indulged in, as well as 
that by interesting and pleasant amusements, is highly benefi- 
cial. By exciting the brain, in a salutary manner, and to the 
proper extent, it restores to it its lost strength, and enables it 
to communicate again its invigorating influence to the other 
parts of the system. For the brain is as certainly strengthen- 
ed by suitable exercise, as the muscles of voluntary motion. 
Hence circulation, arterialization, nutrition, secretion, and all 
the other functions of the system are improved in their'character, 
and health and strength are established and confirmed. In those 
who are enfeebled and dis-spirited by disease, the steady main- 
tenance of the hope of recovery is peculiarly important. 
It is highly medicinal to a large and powerful organ of the 
brain, and through that to the system at large. To this point, 
therefore, physicians and nurses should be strictly attentive. 424 
Caldwell on Mural Medicine. 
Neither doubt nor despondency should cloud their counte- 
nances; nor should they express in words, or signify by 
actions, the slightest discouragement. Even to those who are 
in health, hope is much, to confirm them in their resolu- 
tions, and cheer them in their toils. But to the sick and 
enfeebled it is every thing—their sun-light by day, their dream 
of joy and well-being by night, and their balm and consolation 
under all they endure. Their chief life-giver and source of 
enjoyment, to extinguish it would be to destroy. Hence the 
delicate and precarious task a physician has to perform, when 
he is called on to prognosticate the issue of a disease. Should 
he predict recovery, and the complaint prove fatal, his repu- 
tation suffers; and, if his prediction be unfavourable, it may 
aid not a little in its own fulfilment. In diseases of danger, 
therefore, a physician should never prognosticate, except under 
circumstances he cannot resist. 
Another complaint, in which the judicious administration of 
moral remedies is peculiarly useful, is dyspepsia. That that 
affection is often, perhaps generally, induced, by care, anxiety, 
grief, disappointment, mental toil, and other forms of cerebral 
irritation, will not be denied. Nor is it less certain that the 
removal of that irritation is essential to its cure. The victims 
of dyspepsia abound most among the care-worn, the distress- 
ed, and those inordinately devoted to mental labour. Hence 
the importance to them of relaxation from the perplexities and 
annoyance of business, an abandonment of excessive study, 
and the enjoyment of cheerful and agreeable society. The 
relief experienced by dyspeptics from travelling, is attributa- 
ble chiefly to freedom from care, and the grateful and renova- 
ting impressions made on the brain, by interesting scenery 
perpetually changing, pleasing associations, and other salutary 
kinds of cerebral excitement. That muscular exercise, con- 
tributing to the formation of good blood, with wholesome air, 
suitable aliment, and medicinal substances may co-operate 
in the cure, is true. But alone, they are rarely sufficient to 
effect it. The requisite moral remedies must be made to unite 
with them and aid them, else they seldom prove successful. Caldwell on Moral Medicine. 
Yet that the latter means often succeed alone, has been felt 
by thousands. On this subject I speak from experience, the most 
unerring of teachers. Many years ago, I was a sufferer from 
dyspepsia. When at home, and ardently engaged in business 
and study, I was compelled to subsist on selected fare, and 
notwithstanding this, was still an invalid. But, on throwing 
off care, and every other sort of cerebral irritation, burying 
myself a few days in the shades of the country, and joining my 
companions in rural sports, ray health and elasticity returned 
as if by enchantment, and I could eat, with impunity, whatever 
was served up to me. Cases of this description are innumer- 
able. When dyspepsia is relieved, by a resort to watering 
places, the cause is to be looked for, in the moral considerations 
of the occasion, much more than in the virtues of the water. 
The potation of the same waters, in the midst of care, business, 
grief, and intense study, would be unavailing. If one dyspep- 
tic repairs to a watering place, carrying his cares and griev- 
ances along with him, and another, leaving all his troubles be- 
hind him, voyages by sea, or journeys by land, without the aid 
of medicinal waters, the former will experience-but little re- 
lief, while the health of the latter will be soon re-established. 
Animal Magnetism, which is now engrossing so much of 
public attention in Europe, especially in France, produces its 
effects by its action on the brain. Px'ecisely what those effects 
are, I am not prepared to express a belief, because I have not 
positively formed one. If reports be true, however, even to 
half their extent and extraordinariness (and some of the authors 
of them are men, whose veracity, and competency to observe 
and judge, ought not to be inconsiderately questioned) the 
issue of the operation referred to is one of the greatest mar- 
vels of the age. That the individual operated on has his per- 
sonal identity temporarily subverted; that he is changed, 
I mean, into a sensitive and intellectual being entirely different 
from what he was previously, and from what he becomes 
afterwards, forgetful during each change, of his prior existence, 
and that these two distinct conditions of his existence can be 
made to alternate with each other, at the option of the opera- 
Vol. 9—(N. S. 1)—No. 111. 64 426 
Caldwell on Moral Medicine. 
tor—that this extraordinary phenomenon occurs, is asserted 
by physicians, who profess to have witnessed it, and whose 
veracity and judgment, I say, we cannot impugn, without 
detracting from the validity of human testimony, in a manner 
injurious alike to science and history. That the sense of vis- 
ion is so modified and improved by the process, as to enable 
those experimented on to see through bodies considered opake, 
is also gravely pronounced to be a fact. Nor is it less confi- 
dently declared, that so deep is the insensibility, as far feel- 
ing is concerned, in the system generally, that the individual 
under its influence can sustain a severe surgical operation, the 
exsection of a tumour for example, without experiencing pain, 
and even without a consciousness of being in the hands of the 
surgeon. As respects certain other reported effects of this 
process, they partake so much of the marvellous, that I shall 
not recite them. Yet to pronounce them an entire fiction or 
delusion, considering the authority, on which we are called to 
admit their reality, would be at least discourteous, if not dis- 
creditable. That, at any rate, the magnetizing operation, wdrat- 
ever may be the nature of the agent concerned in it, produces 
a powerful effect on the brain, it were unwarrantable scepti- 
cism to doubt. That effect, therefore, may be regarded as a 
moral influence’; and that it may yet be redeemed from any 
empiricism that may now attach to it, and turned by the regu- 
lar Profession, to a profitable account, in the treatment of dis- 
eases, seems not improbable. 
But it is, perhaps, in the preservation of health, and the im- 
provement of the general standing and character of our race, 
that moral means can be most usefully employed. The suprem- 
acy of the brain over the other parts of the system has been 
already noticed, and is universally acknowledged. The im- 
portance, therefore, of the sound constitution, and vigorous 
condition of that organ, to the health, activity, and strength of 
the body, no one will question. Nor is their influence on the 
mind less unequivocal. But organized matter, of every de- 
scription, can be brought to the highest perfection, of which it 
is susceptible, only in one way—by a proper amount of suita- Caldwell on Moral Medicine. 
427 
hie exercise, regulated judiciously, as to time and manner, 
quantity and place. Nor, as already observed, is this less 
true of the brain, than of any other portion of the animal 
frame. Let that organ, therefore, be skilfully trained, from 
infancy to mature age; and let not the process be abandoned 
even then, but be reasonably persevered in until the termina- 
tion of life, and man will be much improved, by the measure, 
in all his powers, both mental and bodily. I speak of the dis- 
cipline of the whole brain, not of that of any class or set of its 
organs, to the exclusion of others. That viscus being divided 
into three leading compartments, the animal, the intellectual, 
and the moral, it is important to its own soundness and com- 
petency, as well as to the health and general efficiency of the 
system, that a well regulated equilibrium between them 
should exist. An undue preponderance of any one of them 
is so far a form of derangement, and may, under certain oc- 
currences, difficult always, and at times, impossible to be 
guarded against, prove a source of actual disease. But such 
preponderance can be prevented only by a well directed 
scheme of cerebral cultivation. Are any organs found to be 
unnaturally feeble? Let them be suitably exercised, in manner 
and degree, and their weakness will be removed. Do any, on 
account of their disproportioned strength, threaten to become 
unruly in their functions, and thus lead to irregularities and 
hurtful intemperance of conduct? Let them be repressed in 
their action, by withholding from them stimulants, and strength- 
ening other organs, and their exbuberant power and energy 
will be diminished. Perhaps the greatest defect in schemes of 
education, as now conducted, consists in a neglect to strength- 
en, in due form, the moral organs, whose influence is most es- 
sential to the soundness ana welfaie of the body, as well as of 
the mind. When children and youth are taught the arts of 
reading and writing, with a knowledge of figures, afew branches 
of physical science, and a smattering of other fashionable ac- 
quisitions, and certain ornamental accomplishments, they are 
thought to be well educated; while principles of sound and 
practical morality, though often gravely talked over to 428 
Caldwell on Moral Medicine. 
them, and perhaps read over by them in text books, have never 
been made a regular element in their education. Pupils, I 
mean, are not disciplined, in the course of their school and 
family-instruction, in the great work of. doing to others, as 
they would that others should do to them, which is the consum- 
mation of morality. No such task as this is prescribed to 
them, as a practical duly, for the strict performance of which 
they are to be held responsible to their teachers. To speak 
more definitely; in our schools of instruction, whether they 
are called academies, colleges, or universities, the pupils are 
not trained, as an exercise, in the important business of doing 
and awarding justice, defending right, protecting the feeble, 
allaying discord, appeasing resentment or removing its cause, 
dispensing charity, promoting harmony and friendly inter- 
course, and actively ministering in all the various branches of 
beneficence and virtue. While reading,writing, ciphering,music, 
painting, dancing, and even swimming, and other gymnastics 
and Jcalisthenics are statedly taught, as branches of education, 
the duties of morality, the highest excellencies and ornaments 
of man, are merely enumerated and recommended, and there the 
matter ends. As if abstract precept could ever be rendered a 
substitute for practice. As well might instructors attempt to 
teach the art of reading, by talking to their pupils about it, or 
by reading in their presence, as the moral and social duties of 
life. As soon shall pupils become painters, without handling 
a pencil, or musicians, without touching a musical instrument, 
as full success attend our present defective schemes of educa- 
tion. 
Thus are the moral organs of the brain permitted to continue, 
for want of due exercise, in a state of comparative debility, to 
the injury of the body, no less than of the mind. No wonder, 
therefore, that the progress of practical morality does not al- 
ways keep pace with the progress of knowledge. For, if the 
intellectual portion of the brain be exercised, and the moral 
allowed to remain inactive, the former will increase in strength 
and resources, while, compared to it, the latter will be feeble 
and barren. This is as certain, as that one arm may increase Caldwell on Moral Medicine. 
429 
in vigor, by constant exercise, and the other grow weaker, by 
habitual confinement to a state of inaction. 
The source of the evil here referred to, consists in one funda- 
mental error, which has brooded, like an incubus, over the mass 
of mankind, since the commencement of our race. The char- 
acter of the human mind, and its dependance on the brain for 
the exercise of all its faculties, have been unknown or misun- 
derstood. In this state of ignorance, the cultivation of one 
mental faculty has been considered tantamount to the cultiva- 
tion of several, if not of all. Indeed it has not been understood, 
as a practical reality, that the mind possesses a plurality of 
faculties capable of being exercised independently of each 
other. In a special manner, it does not appear to have been 
known, (certainly the knowledge has not been fairly reduced 
to practice) that the discipline of the intellectual and that of 
the moral faculties are two processes, distinct from each other, 
and to be executed by means entirely different. In fine; the 
evil, in all its ramifications, is attributable to the want of an 
acquaintance with the anatomy and physiology of the brain; 
to an ignorace of the fact, that that viscus is composed of dif- 
ferent organs, some of them the seats of intellectual, and others 
of moral faculties, each of which can be educated separately, 
and requires to be trained and strengthened by means, and in 
a manner, peculiar to itself. It has not been understood, that 
education is a physiological process, confined exclusively to 
the improvement of material organs, the improvement of spirit, 
or the production of any change in it being beyond its reach. 
But the hour has arrived, when I must close my address. 
Permit me to do so, by earnestly recommending to you the 
study and practice of moral medicine, as the highest and most 
delightful branch of the Profession. And allow me to add, that 
in this you can never succeed, in a degree either useful to 
others or creditable to yourselves, without a previous acquain- 
tance with that system of mental philosophy, which, in its 
principles and details, conforms to the anatomy and physiolo- 
gy of the brain. And however my remarks may have failed 
to convince you of this truth now, be assured, that the obser- 430 
Young on Nutrition and Digestion. 
vation and experience of such of you as may faithfully 
ine the subject will convince you of it hereafter, and thus vin- 
dicate the ground of the effort I have made. 
ARTICLE 11. 
An experimental inquiry, into the Principles of Nutrition, and 
the Digestive Process. By John R. Young, of Maryland; 
Member of the American Linnean and Philadelphia Medical 
Societies. 
“We ought in every instance to submit our reasoning to the test of Experiment, 
and never to search lor truth, but by the natural road of Experiment and Observa- 
tion- ” Layoisieh. 
[ln re-publishing the following paper, in this department of the Jour- 
nal, we deviate from our usual course, for the purpose of laying before 
Dttr readers, at full length, a very ingenious Thesis, submitted to the 
Faculty of the University of Pennsylvania, in 1803, by a young Physi- 
:ian of Maryland, who died a few years after receiving the honors of 
that Institution. The ingenious experiments performed by the author, 
go far towards establishing certain still mooted points concerning the 
important process of Digestion.—Ed,] 
Man is endowed with motion, sensation and thought. These 
are dependent on some internal or inherent principle, and also 
on various external agents; when they are all regularly per- 
formed, they are said to constitute perfect animal life. When 
we contemplate this life, we are struck with motion, as its prin- 
cipal characteristic; and when we take a farther view, we 
must perceive that this motion and its laws, must necessarily 
tend to waste the machine in which they reside. It becomes 
essential therefore to the existence of the living body of man, 
that he be provided with means to counteract his tendency to 
decay. To effect this, he is furnished with an apparatus which 
prepares :pew materials, to supply the waste of the old; and 
these theybeneficent hand of nature has plentifully diffused, over 
every part of the globe. Lest he should neglect them, he is 
furnished with faithful centinels, which seldom fail to admonish