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      S S H
      o ©

 
DISEASES
or THE
NERVOUS   SYSTEM;
OR,
Pathology  of  (tie  Nerves and  Nervous Maladies.
A TREATISE OF
PSYCHOLOGICAL   MEDICINE.
                              BY


               ALBERT H. HAYES,  M. D.,


AUTHOR OF " SCIENCE OF LIFE," " PHYSIOLOGY OF WOMAN AND HER DISEASES," " A
       TREATISE ON THE DISEASES  OF THE THROAT AND LUNGS," CHIEF
               CONSULTING PHYSICIAN OF PEAB>DY MEDICAL
                   INSTITUTE, LATE SURGEON OF THE
                       U. 8. ARMY, IIC, ETC.
" Canst thou not minister to a mind diseased,
 Raze out the written troubles of the brain,
 And with some sweet oblivions antidote
 Cleanse the stuffed bosom of that perilous stuff
 Which weighs upon the heart? " — Shakespeare.
                  BOSTON,  MASS.:

PUBLISHED BY THE  PEABODY  MEDICAL INSTITUTE,

                 No. 4 Bulfinch Street.

                          1878. 
WM
  l?7?
Entered according to Act of Congress, in the year 1873, by
               ALBERT H. HAYES,
 In the Office of the Librarian of Congress at Washington. 
PREFACE.
   The author has long entertained the opinion that a, popular work
on " Nervousness,  or the Pathology of the Nerves, and Nervous
Maladies," is  a desideratum.  Of  technical works on this subject,
intended for the medical profession, the name is legion   But he
knows of no  popular treatise for  the general and  unprofessional
reader.  In the following pages he  has endeavored to furnish such a
work to the public.   Having made the cure of Nervousness a  spe-
cialty throughout his entire  professional course, and having had an
enviable success in this specialty,  he has, of course, drawn largely
from his own experience in writing the following chapters.  But
he has  had no hesitation in drawing on  the experience of other
practitioners as detailed in their writings, whether in the form of
independent treatises, or as  contributions to jom-nals of psycholog-
ical medicine, whether published in English, French, or German.
Tt has always been  his maxim to  supplement and fortify his own
experience by that  of others.   Never was psychology, or the sci-
ence of mind, pursued with  more fruitful results than it now is,  in
connection with physiology.   The Nerves and Brain, which are the
organs of the  mind, demand as much study as the mind itself.
   Psychology and Physiology now go hand in hand, and shed mu-
tual light on each other.  The subject of the Nerves, and their Dis-
eases and Derangements, the writer unhesitatingly pronounces to be
at this fast  and eventful epoch, when'life is condensed, as it were,
the most important  in the whole range of medical pathology. Mind
and body are such intimate companions, that  they sympathize, so
to speak, with each  other perfectly.  If  one is sound and buoyant,
the other is ordinarily in the same condition, and vice versa.  If
the nerves, which are the organs  of the mind,  are  healthy and vig-
5SZIXY 
iv                        PREFACE.
orous,  the  mind is bright and hopeful.   On  the  contrary,  if the
nerves are jaded,  diseased, and unstrung, the mind is in the same
state.  Mental pathology  is necessarily  a sad record  of human
wretchedness and woe ;  for what torments are like those caused by
" a mind diseased " ?  It has been the writer's  aim to make his work
interesting, as well as instructive.   He has dealt with nervous dis-
ease in all its thousandfold and most perplexing forms and man-
ifestations, and should know whereof he writes.  Under the dread
name of Nervous Disease, what an awful  category of human ills is
included !  Insanity ; suicide ; narcotism ; alcoholism ; epilepsy ; pa-
ralysis ;  softening of the brain; soul-crushing  mental anxiety;
" that strange melancholy,"  " which rejoiceth exceedingly, and is
glad when it can find the grave," to quote from the Hebrew  Scrip-
tures ; that utter  wreck of the will and helplessness, which is the
result of self-abuse, and which is a cause of a  majority of the cases
of nervousness and general debility; all these  momentous subjects,
of course, are full}'' and popularly discussed in the following pages.
   One word  before closing on the subject of special medical prac-
tice.  The special medical practitioner, who, confident in his power
of  dealing successfully with the  particular  class of diseases  to
which   he devotes himself, seeks,  by all legitimate and proper
means, to bring himself and his skill to public notice, must calcu-
late beforehand on incurring the occasional sneers and unkindly
criticism of jealous professional brethren.   If  such things can even
annoy him for a moment, he has mistaken his calling.   A  profes-
sional man is either a public man, or he is nobody. If a physician
has especial skill in treating, say, the diseases of the nervous  sys-
tem, the public want to know the fact, and ought to know it.  In
such a case, it is a duty  to seek publicity,  for it is a means of doino-
good.   The skilful, special practitioner will have triumphs enough,
in  the long run, over  those  who  sneer.   He will  oftentimes find
such reluctantly compelled to avail themselves, and their patieuts
in extreme cases,  of his superior  skill  in his own particular prov-
ince.  In such cases  he gets his revenge by affording the desired
relief.
   Peabody Medical Institute,
         July 30, 1873. 
PRESCRIPTIONS.
  The following Prescriptions have proved, by the most extensive experience,
to be thoroughly  efficacious in the treatment of  the  diseases the names of
which are appended to them. They are written in English, Latin names and
scientific terms being purposely avoided, and they can be obtained at all reliable
drug-stores  throughout the  country.   While the  following formulae  are  of
established merit,  the  reader should bear well in  mind that it is important
that they be only applied for the dise»ses  for which  they are  recommended,
hence the importance  of a correct  knowledge of their complaint before using
tbem.
        Prescription No. 1.
  R  Tinct. Musk, 5i.
     Tinct. Hops, Siii.
     Liq. Potassae, 3ii.
     lufus. Buchu, Svi.
Mix: Three tablespoonfuls after meals.
  Very useful in  Indigestion  attended
   with Nervousness and Flatulence.

        Prescription No. 2.
  R  Gum Arabic, 5i.
     Water, Oiss.
     Simple Syrup, 5ii.
Mix: A wineglass frequently.
  In Stranyuary and Irritant Poisoning.

        Prescription No. 3.
  R  Gum Arabic mixture, 5iss.
     Water, Siiiss.
      Syrup, 5ss.
Mix: A tablespoonful frequently.
     In Bronchial Catarrh of Children.

        Prescription No. 4*
  R  Gum Arabic mixture, 5ii.
     Water, Si v.
      Syrup Tolou.
     Orange Flower  Water, aa3i.
Mix: A tablespoonful every two hours.
             Excellent in Slight Colds.

        Prescription No. 5.
  R Vinegar, 3i.
     Water, 5xv.
      Sugar, 3ss.
Mix: To be taken as a common drink.
   Very useful in Fevers to allay thirst.

        Prescription No. 6.
  R  Distilled Vinegar,  3 ii.
      Syrup, 3ss.
      Water,  gii.
Mix:  A fourth part every three hours.
  In Scarlatina  (for  a child  of  three
    years).
        Prescription No. 7.
  R  Dilute Acetic Acid, 3i.
     Tinct. Jalap, ITlxv.
     Tinct. Orange Peel, 3i.
     Mix; ure Camphor, 3x.
Mix: Make a draught to be taken 2 or
  3 times a day.
  In Rheumatism in debilitated persons.
        Prescription No. 8.
  R  Vinegar, 3ii- *'
     Ammonia Muriate, 3i.
     Honey, Siss.
     Water, gxii.
Mix: Use as a gargle 3or 4 times daily.
              Good for a Sore Throat.
        Prescription No. 9.
  R  Lemon Juice, 5n.
     Camphor Mixture, 5i.
Mix: Make a draught, to be taken 3
  times a day.
              In Acute Rheumatism.
       Prescription No. 10.
  R  Recent Lemon Juice,  5i.
     Oil Sweet Almonds,  5iss
     Syrup Marshmallow,  3ss.
Mix: A teaspoonful every 3 hours.
              In Obstinate Diarrhoea.
R
  Prescription No. 11.
Camphor Mixture, 5i.
      Spts. Ether Com p., S ii.
      Tinct. Cardamon Comp., 3iv.
      Spts. Anise,  3vi.
      Oil Carroway, Vt[x\\.
      Syr. Ginger,  3ii.
      Peppermint Water, Svss.
Mix:  Take two tablespoonfuls.
          For Troublesome Flatulence. 
PRESCRIPTIONS.
       Prescription No. 12.
  R  Sulph. Morphia, grs. ii.
     Sulph. Soda, 3ii.     •
     Syrup Simple, 3ii.
Mix: Dose, i a small teaspoonful to an
  adult after each discharge.
             Invaluable in Dysentery.

       Prescription No. 13.
  R  Liquid Tar.
     Powd. Alum, aa3v.
     Powd. Liquorice, q. s.
Mix: Divide into 100 pills. Take from
  6 to 10 every day.
              Excellent in Gonorrhoea.

       Prescription No. 14.
  R  Camphor Mixture, Siss.
     Liquid.Acetate Ammonia, 3iv.
     Wine Antimony et Potassia Tart.
       drops xl.
     Tinct. Opium, drops xx.
Mix: Take half of the  quantity on
  retiring.
   Very beneficial in Acute Rheumatism.

       Prescription No. 15.
  R Antimony Potassia Tart., 1 gr.
     Saltpetre,  3ii.
     Almon I Mixture, Sxii.
     Tinct. Camphor Comp., 3ss.
Mix: Dose, a tablespoonful every hour.
             Excellent Cough Mixture.

       Prescription No. 16.
  R Horse-radish Root.
      Contused Mustard Seed,  aajiii.
      Warm Water, 01.
Macerate for an hour, and strain.
      Colaturas, Svii.
      Spts. Ammonia Arom., 3iss.
       Spts. Pimentse, Siii.
Mix: Two tablespoonfuls 3 times daily.
              Very useful in Paralysis.

        Prescription No. 17.
   R  Tinct. Arnica.
      Tinct. Capsicum, aaSi.
       Chloroform, pure, 3ii.
      Tinct. Sapo et Opii, 3ii.
   Mix: and mark external use.
       Excellent in Bruises and Sprains.

        Prescription No. 18.
   R  Ungt. Belladonna, Si.
       Powd. Camp., 3i.
 Mix:  Mark external use.
            In Painful Cords or Piles.

        Prescription No. 19.
   R   Bromide Potassa, 3iii.
       Ciunamon Water, Si.
 Mix:  Dose, a teaspoonful as occasion
   may require.
 Useful in Headache, or to produce Sleep.
       Prescription No. 20.
  R  Infusion Buchu, 5 vii.
     Tinct. Buchu.
     Tinct. Cubebs, aa 3iv.
Mix: Dose. 2 tablespoonfuls  3 t raes a
  day.
         Useful in Kidney Difficulties.


       Prescription No. 21.
  R  Fresh Milk, Oss.
     Lime Water, 3 i.
Mix: Four tablespoonfuls is  a dose.
              Useful in Sour Stomach.
       Prescription No. 22.
  R  Tinct. Spanish Flies, drops ii.
     Tinct. Henbane, lTlv.
     Water, 3x.
Mix: *Dose,tablespoonful every 2 hours.
  Useful in Inability to hold Urine, or
   Paralysis of the Bladder.


       Prescription No. 23.
  R  Tinct. Spanish Flies.
     Tinct. Camphor Comp., aa 3i.
     Tinct. Cinchona Comp., 3x.
Mix: Dose, thirty drops, gradually in-
  creased to a  teaspoonful, 3 times a
  day.
        Beneficial in Whooping Cough.


       Prescription No. 24.
  R  Acet. Spanish Flies, Sss.
     Aqua Cologne, Si.
     Aqua Rosae, Si.
Mix: Make a wash.  Rub on the head
  when the hair falls out.
       Prescription No. 25.
  R  Powd. Red Pepper, 3 ii.
     Boiling Water, Oss.
Mix: Strain, and when cool take a tea-
  spoonful 3 times a day.
     Useful in Malignant Sore Throat.


       Prescription No. 26.
  R  Elix.Peruvian Bark with Protox.
       Iron, Sxii.
Dose, a dessert-spoonful after meals.
                 An Agreeable Tonic.


       Prescription No. 27.
  R  Liquid Acetate Ammon., 3ii.
     Sweet Spirits Nitre, 3 Hi.
     Aqua Camphor, 3ss.
     Syr. Simplex, 3iv.
Mix: Dose, a teaspoonful every 3 hours.
  Very beneficial at the commencement
   of Fevers. 
PRESCRIPTIONS.
        Prescription No. 28.
  R  Powd. Peruvian Bark.
      Powd. Rhubarb, Turkish, aaSss.
      Carbonate Magnesia, 9i.
      Conf'ect. Aromat. 9ss.    No. 1.
      Cinnamon Water, Siss.
Mix:  Make a draught.  To be taken
  twice a day.
                  Excellent Cathartic.


        Prescription No. 29.
  R  Sulphate Magnesia, 3ii.  No. 2.
      Fluid Ext. Senna, 3vii.
      Simple Syrup,  Sii.
Mix:  Take all at one draught.
                 An Excellent Physic.


        Prescription No. 30.
  R  Bals. Copaiba.
      Liquid Potassae, aa3iii.
      Mucil.  Gum Arabic, Si.
      Peppermint Water, Svi.
Mix: A tablespoonful before meals.
 Excellent in first stages of Gonorrhoea.


        Prescription No. 31.
  R  Ammoniated Tartrate of Iron, 3i.
      Water, Svss.
      Simple Syrup, Sss.
Mix:  Dose, tablespoonful 3 times a day.
         Beneficial in Bright's Disease.


        Prescription No. 32.
  R  Ext. Henbane, 3ss.
      Valerianate Ferri, 3i.
Mix:  Divide  in  30 pills; dose, 1 after
  meals.
               Excellent in Neuralgia.

        Prescription No. 33.
  R  Bromide Ferri, 3i.
      Syrup Orange,  Sss.
      Orange Water, Siss.
Mix:  Dose, teaspoonful every 6  hours.
          Useful in Secondary Syphilis.


        Prescription No. 34.
  R  Sulph.  Ferri,  Si.
      Distilled Water, 3xvi.
Mix:  Make wash, apply on linen every
  2 or 3 hours.
              Excellent in Erysipelas.

        Prescription No. 35.
  R  Powd. Galls, 3i.
      Sulphate Copper, Bi.
      Lard, 3i.
Mix:  Make  ointment, apply  to   the-
  affected part 3 times a day.
                     For Ringworm.
       Prescription No. 36.
  R  Extract Gentian.
      Sesquicarbonate  Ammonia
       aa3i.
Mix: Divide into 30 pills; dose two, 2
  or 3 times daily.
             In Obstinate Heartburn.

       Prescription No. 37.
  R  Glycerine.
      Rose Water, aaSii.
      Powd. Borax, V)ii.
Mix: Apply at bedtime.
  An excellent application for Chapped
    Hands, Chilblains, and Sore Nipples.

       Prescription No. 38.
  R  Ext. Henbane.
      Camphor.
      Ext. Hops, aa, grs. iii.
Mix: Make 2 pills; take at bedtime.
               In simple Wakefulness.

       Prescription No. 39.
  R  Tinct. Iodine Comp , 3i.
Make external use; apply with a brush
  thrice daily.
Excellent Application to Swollen Joints.

       Prescription No. 40.
  R  Powd. Peruvian Bark, Red. Si.
      Lard, 3ii.
Mix: Make ointment; use 3 times a
  day on linpn.
    The best Salve for Sores and Ulcers.

       Prescription No. 41.
  R  Powd. Dovers, grs. xl.
      Hyd. Sub. Murias., grs. viii.
Mix: Divide into 8 powders; 1 in every
  3 hours if awake.
Excellent in Pneumonia or Lung Fever.

       Prescription No. 42.
  R  Powd. Ipecac Root, grs.iv.
      Mucilage Gum Arabic.
      Simple Syrup, aa3ii.
      Distilled Water, 3i.
      Saltpetre, grs. xv.
Mix: Two teaspoonsfuls every 4 hours.
               In Measles of Infants.

       Prescription No. 43.
  R  Dover's Powd.
      Hyd. Cum Creta, aa  grs.i.
Mix: To  be taken at bedtime.
  Excellent in the Diarrhoza of Teething
    Infants.

       Prescription No. 44.
  R  Ground Flaxseed, Siv.
      Ground Poppy Flowers,  Si.
Mix:  Divide in 8 poultices; use a fresh
  one morning and evening.
       Excellent Poultice for a Felon. 
PRESCRIPTIONS.
     Prescription No. 45.

R  Tinct. Lobelia, Sss.
   Orange Water, 3H.
   Distilled Water, 3iv.
   Dose, a tablespoonful 3 times a
Mix
  day,
Beneficial in Asthma.
R
       Prescription No. 46.

     Carbonate Magnesia, 9i.
     Tinct. Cardamon Comp., 3ii.
     Orange Water, Sss.
     Syrup, 3ii.
Mix: Dose, a teaspoonful frequently
  during the day.
         Excellent in Colic of Infants.
       Prescription No. 47.

  R  Cod Liver Oil, Siv.
     Emulsion Almonds, Si.
     Whiskey, 3 ii.
Mix: Dose, a tablespoonful after meals.
      Very Beneficial in Consumption.
       Prescription No. 48.
  R  Sweet Oil, Sviii.
     Arom. Spts. Ammonia, 3ii.
Mix: Dose, 3 teaspoonfuls night and
  morning.
    Good to Expel and Destroy Worms.

       Prescription No. 49.
  R  Citrate Iron et Quinine, 3 Hi.
     Sherry Wine, 3 vii.
Mix: Dose, a teaspoonful before meals.
                  An Excellent Tonic.

       Prescription No. 50.
  R  Tinct. Peruvian Bark.
     Tinct. Gentian.
     Tinct. Cardamon,  aaji.
     Essence Checkerberry, gtts.xxx.
Mix: Dose, a teaspoonful before meals.
    Excellent in a Capricious Appetite.

       Prescription No. 51.
  R  Wine of Ipecac, Si.
Dose, a teaspoonful to children in con-
  vulsions.  This is an invaluable rem-
  edy,  and always  safe  to administer,
  care  being taken  not  to strangulate
  the patient from inability to swallow.
  The reader must bear in mind that the use of the foregoing remedies is only
for adults, and that the author has purposely refrained from giving any formulas
for the diseases mentioned chiefly  in this treatise, from the fact that nervous
diseases are the most insidious, painful, and destructive that afflict the popula-
tion  of the  earth, and the  remedies therefore are  most potential, and might
 Eroperly be classed as edge-tools in ,medicine.  Apropos to this subject, I would
 ere quote the statement of the  eminent Professor of Anatomy and Physiology
at Harvard Medical College to the Fellows of the Massachusetts Medical Society,
"that medicine as they practised it (that is, the physicians in general or family
practice) did more harm than good; and if all the drugs they used were thrown
into the sea, it would be all the better for their patients, but all the worse for the
fishes."  From the daily observations of the author he can fully corroborate the
sentiments of this  outspoken,  truthful, and  learned gentleman.  Myriads of
broken-down,  wretched invalids are constantly crowding upon his attention,
whose misery and wretchedness are owing whoily or in part to the ignorance of
previous medical advisers, and he feels constrained to admonish invalids of this
class to confide the treatment of their case to none except those who devote their
whole energy and abilities to the treatment of nervous diseases, and who give
undoubted evidence of their superior qualifications. 
CONTENTS.
Chapter.                                                   Page.
     I.  The Nerves and the Brain......1
    II.  Nervous Disorders and the Temperaments .   .    .   11
   III.  A Chief Cause of  Nervous Derangement  ...   24
   IV.  Patients with the Nervous Temperament  ...   31
    V.  Convivial  Habits and Nervousness   ....   39
   VI.  Anxiety of Mind    ........   43
  VII.  Nervousness and Religious Excitement    .    .     .   48
 VIII.  Illusions and Hallucinations......52
   IX.  Sleep and Sleeplessness .......66
    X.  Epilepsy..........74
   XL  The Suicidal Propensity.......78
  XII.  Treatment of the Insane.......89
 XIII.  Urinary Analysis, as a Detective of Disease  .    .   101
 XIV.  Various Urinary Deposits......114
  XV.  Pathology of the Nerves and Nervous  Maladies    .   124
 XVI.  A Few Hygienic Observations on Nervous Affections   132
 XVII.  A Curious Case of Supposed Demoniacal Possession .   140
XVIII.  Hope and Confidence as Therapeutic Agents  .     .   146
 XIX.  Alcohol, Tobacco, Opium,  Hacshish   .    .   .    .150
  XX.  Body vs. Mind.........158
 XXI.  General Paralysis........167
 XXII.  Dipsomania, or Drunken Insanity.....178
XXIII.  Late  Suppers and  Dreams......1S3
XXIV.  The Uses and  Abuses of the Popular Nervines .    .   189 
» 
    THE  NERVES AND THE  BRAIN.



                  CHAPTER I.

          INTRODUCTORY AND GENERAL REMARKS.

  The barbarian, and the rude, ignorant European peasant,
scarcely know that they have nerves.  But civilization, cul-
ture, and refined artificial modes of life bring the nerves into
almost fearful prominence.   Few who live in cities, or come
in any way within the vortex of our social life, have escaped
occasional attacks of nervousness.*  Is nervousness, then,
asks a distinguished English writer on the physiology and
pathology of the  nerves, an inevitable condition of civiliza-
tion, a tax we must be content to pay for our advantages ;
or can we free ourselves from its assaults without paying too
great a price  for the immunity ?  What is the  malady and
its cause, that we may know what the cure must be?   And,
first, have the nerves  really anything to do with it, or have
they borne the blame while other portions of our organiza-
tion have been at fault?  When we are in that  excitable,
tremulous condition, in which there  is a morbid anxiety to
labor, with diminished power of performance ; when, without
any definite ailment, wrc seem deadened in every faculty, while
yet the least vexation is felt  as an intolerable annoyance,
— are  we right in saying  that it is especially the nervous

  * Vide Ilinton's works, whose admirable account of the nervous system
has been summarized in the  following chapter, — our limits forbidding
extended and scientific details, which are always tedious and often unin-
telligible to the general reader, for whom we write. 
2
THE  NERVES  AND THE BRAIN.
system that breaks down?  In order to answer this question,
we must get some definite idea of that complex machine, the
Nervous System, as it exists in man.  Beautiful and myste-
rious as are its operations and results, its mode of action has
been well ascertained, and is exceedingly simple.  The ner-
vous system is one of the chief characteristics of animal life,
especially of the  higher animals.   By its means the various
organs,  which make up the body of an  animal, arc blended
into  a whole;  and thus the animal is a unit or individual,
while the plant  always  remains a  mere bundle  of more or
less  similar parts.
   Through the nerves the body is acted upon by, and  can
react upon, objects that affect it from without, not only by a
motion of the part immediately affected, but by the combined
movement of many, and, it may be, distant organs.  In this
lies the  primary  need of a nervous system.  It is in its  sim-
plest aspect merely a channel by which  the affections of  one
portion  of the body are  enabled to call out  the activity of
another.  Keeping this  idea in  mind, we shall find there is
no difficulty in following, in  their general  principles,  the
structure  or functions of the nervous  system,  even in  its
most highly developed and complicated forms.   If we look
at the human brain, we find that it consists mainly of a vast
mass of fibres.   Their number, tenuity,  and variety of direc-
tion  are so great that no skill has  hitherto availed to trace
them in detail, though their course has been pretty gener-
ally well made out.  Emanating from the  brain  and spinal
cord, long lines of fibres pass to each region of the body, and
distribute themselves in a minute net-work, that, if we could
see it by itself, would appear before us a  perfect image of
the body, all  pure nerve.   The fibres which constitute the
chief mass of  the nervous system  are simple in their struc-
ture, so far as the microscope can reveal  it, and  present a
very curious analogy to a telegraphic ware.   Like the latter, 
INTRODUCTORY.
3
each  nervous fibre  consists of a small central thread (or
tube, perhaps, in  the  case of the nerve, though the  tubular
structure cannot be demonstrated), surrounded by  a  layer
of a different substance.  The central thread (or axis) is of
a grayish  color;  the surrounding  material  is  of a glassy
appearance, soon becoming an opaque white after death, and
giving then the characteristic white appearance to the  nerves.
The fibre,  consisting of these two portions, is included in a
sheath, which isolates it.  If we roll up a  wax candle in
paper, that will give  us  a rough illustration of the nerve
fibre.  The paper is the  external " sheath " ;  the wrax is the
intermediate white matter; the wick is the central axis.  It
is most natural to believe that the analogy suggested by this
structure is a true one, and that the white substance acts the
part of the gutta-percha  round the electric wire, as an insu-
lating medium for the currents which travel along the cen-
tral portion.   But this is not proved.  Probably,  owing to
the minuteness of the parts,  it is beyond  the possibility of
experimental proof.   For in  man two or three thousand of
these fibres would occupy but  an inch in their largest  part.
  There is another kind of nervous matter, besides the fibres,
and that consists of cells.  The  nerve fibres  spmetimes run
into them; sometimes they pass among them  without ap-
pearing  to communicate.  Cells  of  this kind  form a thin
layer over the surface of the brain,  and its fibres  for the
most part  have their  origin  from or among them.   They
also exist in  large numbers in certain spots in the substance
of the brain,  and they  are found within the spinal cord in its
whole length.  Wherever they are found they go  by the
name of gray matter, the nerve fibres  being called the white
matter.  The fibres which constitute the nerves, strictly so
called, are conductors, and they conduct to and  from the
cells.  What, then,  is  the part played by the  latter? But
before answering  this  question, it is worth while to  peruse 
4
THE  NERVES AND THE BRAIN.
 and note the extreme  simplicity of form exhibited by this
 element of the nervous system.  In the  gray matter of the
 brain, wre have arrived at the very highest organic structure,
 the great achievement of the vital force, the texture  in which
 bodily life culminates, and for the sake of which, we  might
 almost say, all the other organs exist. And we find a structure
 of the very lowest form.  Mere cells and granules —Nature's
 first and roughest work, her very starting-point in the organic
 kingdom — strewn in a mere mass, with no appreciable order,
 over the ends of a multitude of fibres, and loosely folded up,
 as it seems, for convenient storage !   This is what meets the
 eye.  Is this the laboratory of  reason,  the  birthplace  of
 thought, the  home of genius and imagination, the palace of
 the soul?  Nay, is this even the source and spring of bodily
 order, the seat of government and control for the disorderly
 rabble of the muscles?  Should we not have expected, when
 we came thus to the inmost shrine of life, and penetrated to
 the council-chamber of the mind, to find  all that had before
 appeared of skilful  architecture  and  elaborate  machinery
 surpassed and thrown into the shade?   But it  is  all cast
 away.  Mechanical contrivances for mechanical  effects !  Skil-
 ful grouping and  complex organization there may be for the
 hand,  eye,  the  tongue;  for all  parts  and every  function
 where the mind is not.  But where the spirit comes, take all
 that scaffolding away !   The gray matter of the brain is very
 abundantly supplied with blood.  What is the office of  the
 cells or gray matter ?  The spinal cord of man is a series of
groups of cells, giving off nerves on each side, and connected
by communicating fibres with each other, and with the larger
groups in the brain, which also  give off nerves to the nose
and eye, the  skin and muscles  of the face,  and other parts.
Thus, in man and all animals  alike, masses of gray matter
the cells, are placed at the centre, and nerve fibres  connect
them with the organs of the body.  It has been proved also 
INTRODUCTORY.
5
by the  beautiful experiments  of  Sir Charles Bell that the
nerve fibres are of  two kinds :  some conveying an influence
from the organs to the centres,  where the nerve cells are
placed ; and others carrying back an influence from them to
the  organs.   So these groups of cells evidently answer to
the stations of the  electric telegraph.   They are the points
at which the messages are received from one line and passed
on along another.   They are called ganglia in  scientific lan-
guage.   But besides this the cells are the generators of the
nervous power.  For the living telegraph flashes  along  its
wrires not only  messages, but  the force also which ensures
them fulfilment.  A nerve bears  inward, say from  the  hand
or foot, an impression, it may  be of the slightest kind; but
the cells are thrown into active change  by  this slight stimu-
lus,  and are thus able to send  out a force  along the nerves
leading to large groups of muscles, and excite  them all to
vigorous motion.
   In the above we have merely aimed at giving a general
account of the Nervous System.   The nerves are the special
vehicles of will and feeling, hence  their derangement is  most
calamitous.   By them we see,  taste, smell, hear, and  feel.
By them we command  our limbs with the aid of the muscles.
Hence the terrible character of nervous disease and derange-
ment, which strikes at the very source of all our  pleasurable
activity, enjoyment, and conscious life.    Diseases  of the
brain, of the spinal cord, of the nerve cells and of the facial
nerves,  and cerebro-spinal disease, compose in general terms
the  terrible bead-roll  of nervous disorders.   Under these
heads come insanity, softening  of the brain, epilepsy, hydro-
phobia, all kinds of paralysis, neuralgia ; in short, all morbid
affections, which are  specially characterized  by pain  and
dethronement of the  mind.  Fortunately  for suffering hu-
manity, Dr. Hammond, in his great work on Diseases of the
JScivous System, is  strictly correct when he says, that " in no 
6
THE  NERVES  AND THE BRAIN.
department of  medical science has progress been more de-
cided during the  last decade, than in nervous  affections."
The writer of this  treatise, with a most ample and gratifying
experience in the treatment and cure of nervous disorders, is
able fully to indorse the above assertion.   Whether or not
he himself has  in  his professional career contributed to this
progress in the means of  ameliorating  the acutest  human
suffering, it is for his multitudinous patients to say.  At any
rate, he is willing  to abide by their verdict.
  Derangements of the nervous system are seen in the par-
oxysms of  asthma and the seizures of epilepsy, in both  of
which affections the muscles are thrown  into excessive con-
traction through a morbid condition of the spinal cord.   Of
a different order are the  languor and feeling of utter  disa-
bility for muscular exertion which  creep over us  at times.
These  feelings  show  that the nerve  centres which preside
over muscular exertion have become oppressed and sluggish,
likely enough through want of proper exercise.  Of a differ-
ent kind, again, are tremblings of the muscles, or involuntary
jerks and twitchings, and, in brief, all that condition known
by the expressive name of "fidgets."  What is the source  of
this irritability, which renders it  impossible to  keep the
muscles still?  We  can answer in general that irritability
means weakness.   A physician of  eminence compares  it  to
the whirling motion of the hands of  a watch of Avhich the
mainspring is  broken. In our physical,  as in our moral
nature, strength is calm, patient, orderly ; weakness hurries,
cannot  be  at rest, attempts  too  much.   Strength  in the
living body is maintained  by the full but natural exercise of
each organ.
  The full access  of all healthful  stimuli  to the  skin, and
through it  to the  nerves of sensation, is the first and  chief
condition of the healthful vigor of the nervous system.
  Among  these invigorating  influences, fresh air  and  puie 
INTRODUCTORY.
7
water hold the  first place.  The great and even wonderful
advantages of cleanliness are  partly  referable  to  a  skin
healthily active, open to  all the natural stimuli, and  free
from morbid irritation upon  the  nerve  centres of which it is
the appointed excitant.
  The state  of general vigor which wre  call " Tone "  also
depends upon the  healthy action of these nervous centres.
It consists  in an habitual  moderate contraction of the mus-
cles, due to  a constant stimulus exerted upon them  by the
spinal cord, and is  valuable less for itself  than as a sign of a
sound nervous  balance.   Tone  is maintained, partly by
healthful impressions radiated upon the spinal cord, through
the nerves from all  parts of the body, and partly by  the
stimulus poured down upon it from the brain.   So it is dis-
turbed  by  whatever conveys irritating or depressing influ-
ences in  either direction.  A  single injudicious meal,  a
single sleepless  night, a single passion  or piece of bad news,
will destroy  it.   On the other hand, a vivid hope, a cheerful
resolve, an absorbing interest, will restore it as if by magic.
For in  man  these  lower  officers in the  nervous hierarchy
draw their very  breath according to  the bidding of the higher
powers.
  A chief condition of keeping  the  nerves and brain healthy
is to keep  them in full vigor and in natural  alternations of
activity and  repose.   Muscular exercise  has  a most bene-
ficial  effect on a depressed or irritable  state of mind.   The
bodily movement, by affording  an outlet  to  the activity of
the spinal  cord, withdraws  a source of irritation from the
brain, or it may relieve excitement of that organ by'carrying
off its energy into a safe channel.
  We see evidence of the same law in the delightful effect
of a cheerful walk, and in the demand for violent exertion,
which is so frequent in insanity.   The power of  the brain
over the vital  condition  of  the  body is  exerted through  a 
0             THE NERVES AND  THE BRAIN. .

particular set of nerves, which have been called "the sympa-
thetic system."  They  are  somewhat smaller  and  simpler
than the  nerves of  sensation and motion, with which, how-
ever, they are intimately connected.  They are distributed
to the organs on which life depends (the lungs, heart, stom-
ach, etc.), and to the blood-vessels all over the body.  Thus
the condition of the brain is necessarily the key to that of the
wrhole body, and its influence is universally paramount, both
directly by its power over the heart and breathing, and still
more profoundly by its indirect control  over the supply of
blood.
   There is no mystery on the  effects produced on  health by
excess  of mental  labor, or by long-continued cares,  nor in
the bodily torpor  which attends a merely inactive mind.
" Nervousness" naturally results from an overtaxed brain.
The wonder is, not that it occurs so  often, but that, amid the
rude shock to which our life is subject, it is not more fre-
quently experienced.   If we would  have our bodies healthy,
our brains must be  used, and  used in orderly and vigorous
ways.  The torpid, unhealthy frame and languid circulation
of the idiot  are but an exaggerated instance of the  unnat-
ural torpor to* which he condemns  himself, who wastes  his
life  in indolence, or consumes it in  dissipation.   To  him
Nature, indeed, has been kinder than she has to the idiot
— he does but abuse  her bounty to become a worse enemy
to himself.
   The perfect health of a man is not the same as that of an
ox or horse.  The  preponderating  capacity of his nervous
part demands a corresponding life.  But  the  very  causes
which  make  the  proper  exercise  of the  brain  especially
needful,  render its  excess  especially baneful.    The sicns
of this excess, or excess combined with misdirection me  t
us  on  all hands: in weariness,  despondency,  disgust  or
causeless  anger;  in racking  neuralgic  pains,  or  o-radual 
INTRODUCTORY.
9,
 decay of vital power,  or in the insidious threatenings of
 serious  disease.    How  could  these  results  be  guarded
 against,  we ask.   The answer can  be but one.   Health can
 no more be  obtained without its price than  anything else.
 Nature has  forever forbidden  it.    The flame of  life  can
 neither be fed nor renewed with stolen fire.
   The condition of rescue from overwork is rest and change,
 — fresh air,  and the soothing influence of natural scenery, if
 they can be obtained.
   One word, before closing  these  somewhat general intro-
 ductory  remarks,  on the subject of cities, as our modern life
 is more and more concentrated in  cities, which develop and
 intensify the nervous energy wonderfully, and by  their man-
 ifold and  constant excitements  fearfully  multiply  nervous
 disease in all its  forms.  A distinguished author observes,
 that " the invention of towns were  a pure gain to humanity,
 if due admixture of the country life can bo secured."   And to
 obtain this advantage for  our laboring populations is one of
 the great tasks of our age, and one of the great problems for
 managers of railroad corporations in particular.   Our physi-
 ology teaches us that the  vice and misery of our great towns
 can never be successfully  combated in the strongholds which
 they have made their own, and fortified for generations,—the
 courts and alleys where the  poisonous atmosphere combines
 with all hateful sights and sounds at  once to deaden  and
 irritate the nervous sensibility.   From the continued breath-
 ing of a vitiated atmosphere inevitably arises either apathy
 or a craving for intoxicating drinks ; in all probability, each
 in turn.
   On the other hand, the splendor and  allurements of city
 life constantly acting  upon  the senses, especially of  the
 young and susceptible, ar3  calculated to produce nervous
derangement, and  prematurely use up those exposed to them.
Indeed, modern civilization,  with its splendid material  tri- 
10
THE  NERVES AND THE  BRAIN.
*umphs  and manifold devices for comfort, luxury, and sen-
 sual enjoyment, grows ever more and more trying to the
 nerves, and has rendered completely unfashionable the plain,
 frugal,  ascetic life  of our ancestors.  Hence it is  that the
 medical practitioner, who contributes by his  skill and inge-
 nuity to restore a jaded and disordered nervous system, and
 check  the  spread  of  nervous affections, is emphatically a
 Public Benefactor. 
CHAPTER  II.
       NERVOUS DISORDER AND THE TEMPERAMENTS.

   A careful examination of numerous cases of nervous dis-
order has  satisfied me that the study of the temperaments is
absolutely necessary on  the part of the physician who aims
at even ordinary success in the  treatment of disease.  For
instance, were we to treat four different persons, all suffering
alike from the same nervous disorder, but all of them having
different temperaments, writh precisely  the same  remedies,
without taking into account  the peculiarities of each, or  the
effect of these upon the constitution, as well as the nature of
the disease,— we should be as little likely to succeed in effect-
ing a cure as would the mariner in reaching his destination,
who steered  in  a direct right  line by compass for the point
which he wished to reach, totally regardless of, nor making the
slightest allowance for,  leeway, current, or any other disturb-
ing causes.  It is therefore as indispensably necessary that
the physician take into account, not merely the general nature
and character of the disease, but also the various  concomi-
tant circumstances, before  he incur either risk  or responsibil-
ity.  It is the study of these circumstances, and the paying
due attention to them, that constitute the accomplished and
trustworthy  physician;  and those traits alone can ensure
him success  in  practice.   In the study of all disorders, we
must take  into account and carefully review both the history 
12     NKRVOUS DISORDER AND THE TEMPERAMENTS.

of the disease and the history of the case.   The first makes
us acquainted with all the general phenomena and tendencies
of the disorder, while the second brings us into relation with
all those specialties which require peculiar  modifications of
treatment.
  In  the Nervous  Temperament we find that the brain is
large and well developed, and its energies  and those of  the
nervous  system are  the most  predominant,  and take  the
lead over those of all the other organs.   The features  are
Fig. 1. Nervous Temperament.
sharp and prominent, the eye  large and  expressive • the
mouth betokens  intelligence, and frequently there  is a full
and  intellectual forehead;  the  skin thin and transparent
with flossy, silky hair;  the  muscles small but well marked
with quick and active motions;  the face generally pale, and
frequently expressive of anxiety ; the brain and whole of the
nervous system in a high state of activity.  Such persons are
for the most part quick and intelligent, and  highly  sensitive 
       NERVOUS DISORDER AND  THE  TEMPERAMENTS.     13

to every kind  of impression;  and they are readily excited
and easily depressed.  At one time  you may find  them en-
joying themselves to the fullest extent, and  in  a very short
time after,  perhaps in tears.  The dispositions of persons in
whom this temperament predominates, arc much modified by
the circumstances in which they may happen to be placed.
Confinement, especially if the occupation be sedentary, never
fails to produce evil effects upon the  constitution.  Individ-
uals of this temperament arc highly sensitive  to  all those
agents which act upon the nervous sj^stem.  Such persons
require to be treated writh great care and delicacy.
Fig. 2. Lymphatic Temperament.
  But in the Lymphatic Temperament, in which the abdomen
is  remarkably large  and prominent; the brain dull and in-
active ;  the body  round and  soft; action slow and heavy ;
skin muddy and flabby ; circulation weak and languid; mus-
cles  soft, flaccid, and  feeble,  with great aversion  to either 
14     NERVOUS DISORDER AND THE  TEMPERAMENTS.

mental  or  bodily exercise, — we find the energies of  ever}'
kind  Arcry  feeble,  indeed   almost   dormant.    Thus  we
see that persons of  this temperament  differ materially in
these particulars from  persons of the former.   Indeed, so
little excitable are people of the purely lymphatic tempera-
ment, that it is not without the greatest difficulty they can
be aroused, or  induced to exert themselves  in  the smallest
degree,  while they are quickly exhausted when  aroused to
exertion.   It is  obvious that  this inert temperament  is not
so liable to nervous  derangement as the former, and when
thus disordered, that  it does  not  require  the same delicate
treatment as the other.
  Persons  of  the Sanguineous Temperament differ widely
Fig. 3. Sanguineous Temperament.
from  those  of the Lymphatic.   In the former, the luno-s
and heart are large, and the power of the latter oro-an is con- 
       NERVOUS DISORDER AND THE  TEMPERAMENTS.     15

spicuous, predominating over all other systems.   The  pulse
is strong and regular;  the veins turgid, full, and blue;  the
chest large ;  the complexion  fair and florid ;  muscles firm;
hair reddish, chestnut, or auburn.   Impressions made on  the
nervous  system are vivid;  imagination luxuriant;  temper
passionate, but not vindictive ; and individuals of this  class,
though readily excited, are still easily appeased.   Now were
we  to treat a patient of the sanguineous temperament,  in  the
same wray that we  should treat one of the lymphatic, suffering
from the same disease under  exactly  similar circumstances,
the consequences would  be  most deplorable.  For instance,
wine, spirits,  and  such stimulants would be wholly inadmis-
sible in treating a patient  of the  sanguineous temperament,
because in such an one the heart and arteries are already  too
prone to over-action.  The use of stimulants by a patient of
sanguineous  temperament would almost to a certainty bring
on inflammation ;  or wre  should by such means incur the risk
of doing some violent injury to the  heart or some other part
of the  nervous system.
  The Biliary Temperament,  again,  differs from  the fore-
going, thus  briefly  noticed.   In persons of  this tempera-
ment,  the liver  is large, and  its functions are readily  called
into activity,  and  there  is a  great  tendency to a redundant
secretion of bile.   The pulse is stronger and more frequent
than in  the  purely sanguineous; the veins are prominent,
the  sensibility acute,  and  there  is  great  constitutional
energy.   The  skin   is  generally   dark  or sallow, with
occasionally  a yellow tinge;  hair  black or  dark brown,
and often short and crisp ; the muscles firm, and well  devel-
oped ;  temper abrupt, but not liable to such extremes  of
excitement  as in  those  of the purely nervous ;  the concep-
tions are bold, while  they themselves are inflexible  in  the
pursuit of a  project, nor are  they so readily exhausted as
persons of the nervous or other temperaments.  In attaining 
16     NERVOUS  DISORDER AND  THE TEMPERAMENTS.

the object they  wish, individuals of this  temperament  are
dauntless and persevering to  the last.   In treating persons
of biliary  temperament, suffering  from nervous affections,
Fig. 4. Biliary Temperament.
and  m  wnom the  secretion  of  bile  is  somehow  faulty,
we  must not  turn our  attention  exclusively to  the  con-
dition  of the  stomach  and bowels,  as the only  cause of
such disorders.   It is true that too much food, or food of an
indigestible nature, taken  into the stomach may affect  the
liver, derange its functions, and  so vitiate its secretion, and
thus bring on a train of nervous symptoms.   Still, such are
not the  sole causes of  deranged  bile ;  and as the  morbid
effects cannot  be relieved till we have  ascertained and re-
moved  the cause, we must  endeavor to  discover  this by
inquiring most minutely into the history and all the circum-
stances of the case as already explained. 
       NERVOUS DISORDER AND THE  TEMPERAMENTS.     17

  The various passions, whether of a depressing or exhilarat-
ing character, have great influence in inducing nervous  dis-
order.  Sudden emotions, too, have  the same  effect;  and
the more  sudden and violent, the greater their  pernicious
effects, not only upon the system at large, but upon the  ner-
vous  portion in particular, — ranging  from mere temporary
trepidation or excitement, to the most inveterate mania or
confirmed insanity.  Thus jealousy, abused confidence, fear,
sudden alarm, prolonged or continued apprehension, anxiety,
grief,  joy, unexpected good fortune, and similar emotions,
exert, very frequently, a most dangerous  influence.   Such
effects will violent emotions of this kind produce upon the
nervous  system, that  the functions of different and distant
parts become not only sensibly, but deeply implicated.  Thus
very strong impressions upon the mind with the concomitant
conflict in the nervous  system  have so acted, even  upon
young persons, as  to turn the hair gray in a single night;
while in other cases the skin, instead of exuding the  ordinary
perspiration, has  sweated  blood.   These results  sometimes
supervene so rapidly, and  come on  so, suddenly, as to
wholly exempt them  from  any  interference, and  place
them  beyond all   possible attempts  at  prevention or ar-
rest.   I am frequently called upon to prescribe for patients
of biliary temperament suffering  severely from nervous dis-
order, which I have traced to deranged state of the stomach
and  bowels ; and  these conditions were  clearly referable to
the abuse of purgative and mercurial medicines.   Costive-
ness  by  no means invariably indicates the necessity of re-
course to opening or purgative medicines.  Many persons
live almost entirely upon food, nearly the whole of  which is
not only convertible, but actually converted into nutriment
and  completely assimilated, thus leaving little, or rather no
residue, to pass off through the bowels.   If,  then, in  such
            2 
18     NERVOUS DISORDER AXD THE  TEMPERAMENTS.

circumstances, it should be deemed  advisable to move the
bowels, the more rational plan wTould be to alter the nature
of the diet, and substitute more of a  vegetable, while we
reduce in a corresponding degree  the amount of the more
concentrated  and nutritious food.  Vegetables contain less
of the nutrient principles, and consequently  leave  a  larger
amount of residue,  upon the expulsion of which superfluous
material the action  of the bowels may be more naturally and
far more legitimately and advantageously employed, than in
responding to the irritating influence of drastic purgatives.
"It is in cases of this description," says  Cowle, in his excel-
lent work on the Physiology of Digestion, "that the  physi-
cian is more frequently consulted, and that he has  the best
opportunity of showing his discrimination and judgment.  If
he and the patient are satisfied with simply procuring relief,
he has ready means  at hand in any of the ordinary purgatives ;
but if a  cure is their object, they must go back to  the root
of the  evil,  and begin by restoring the digestive organs
to health."   Nervous  disorder  in biliary temperament is
clearly traceable to  the secretion of bile being vitiated  or
otherwise deranged.  In laying down plans for locating such
affections, wre must not only  determine their nature, but
inquire into and ascertain the cause,  and remove this if pos-
sible.   If, for example, we should  find,  upon careful  exam-
ination, irregularity in  diet to  be  the fundamental cause of
the evil, which is frequently the case, we should most per-
emptorily interdict  all those kinds of food which either expe-
rience or science has taught  us  tend to vitiate  or derange
the secretion of bile; such, for instance, as a  too free use of
porter, sugar, cream, butter, rich, fatty meats, ardent spirits
wine, etc.   These,  it is well known,  and chemistry  confirms
our  experience, increase the quantity of bile to an amount
far beyond  what is required  for  the purposes  of healthy 
NERVOUS DISORDER AND THE TEMPERAMENTS.
19
digestion;   and,  further,  the  most moderate  experience
has repeatedly shown that the superfluity often lays the foun-
dation of some nervous disorder.
  I have also had many opportunities of witnessing the ill
effects, on  particular cases, of meat suppers taken  late at
night.  This proves very injurious to persons of biliary tem-
perament,  by the formation of a large quantity of bile during
the night,  the individual frequently sleeping in a close, con-
fined, ill-ventilated chamber, while at the same time respira-
tory  and circulating processes are slow and  inactive.   The
quantity of oxygen  necessary to enable  the  lungs to  burn
off the carbon being withheld through impurity and a defi-
cient supply of air, as well as from  other causes, the liver is
called upon to assist in secreting the superfluous carbon under
the form of bile.   The person in consequence awakes stupid,
unrefreshed,  and for the most part with^a bad, oppressive
headache.  Indeed, so liable  are  biliary  persons  suffering
from this  form of nervous disorder to the consequences above
 stated, that I  have repeatedly seen a severe  attack of  head-
 ache brought on by the patient retiring  to repose in an ill-
ventilated apartment, after taking a full  meal.  As a means
 of immediate relief under such circumstances, a saline purge
 is one of  the most effectual, as it will drain the liver of its
 redundant bile,  and thus afford instantaneous, but still only
 temporary relief.   Permanent benefit must be sought for in
 avoiding the  exciting cause,  by the  inhalation of pure, fresh
 air,  friction and cleanliness  of the  skin,, and warm bathing,
 which will facilitate the exit of carbon and other impurities
 through the  other channels, the  lungs and  skin.  By such
 means,  and avoiding late suppers, the liver will be relieved
 from the  necessity of over-activity, and  of forming a super-
 fluous quantity of bile ; and thus, the real cause of the dis-
 order bein^ removed, the morbid effects will naturally cease.
    Another fertile source of nervous diseases in bilious tern- 
20     NERVOUS DISORDER AND THE TEMPERAMENTS.

peraments, which formerly came under my observation more
than at present, was the taking  large  quantities  of  Cod
Liver Oil.   It is well, before we indiscriminately prescribe
fashionable remedies, to consider how they are likely to act.
The Laplander, dwelling  in the  arctic  regions, where it is
intensely cold, and the atmosphere  in an equal bulk contains
a large quantity of oxygen, lives principally upon  carbona-
ceous  substances, as train oil, blubber,  and fat.   But  the
Indian, who lives in the  torrid zone, "where the  atmosphere
is  rarefied,  and for equal bulk contains but  little oxygen,
selects rice, vegetables, and other  diet  containing but little
carbon, and it is found  that such are best suited to the cir-
cumstances  under which  he lives.  For the  same reason,
Cod Liver Oil administered in summer, when it is  hot and
oppressive,  more especially if given to  a patient of  a biliary
temperament, will seldom fail to aggravate the disease it was
given  to  cure.   Nature  evidently intended  that  the  liver
should free  the  blood from those principles which form the
radical or constituents of  the bile, and apply them,  so elimi-
nated, to perfect or complete the function of digestion. But if
more bile is formed than  is necessary to this end, the excess
acts as an irritant to the bowels, and occasions what is com-
monly called "bilious diarrhoea."   If, however, on the other
hand, the bile be  scanty in quantity, as often  occurs  with
persons who have resided long in  tropical  climates ; or suf-
fered  frequently and  severely from  agues;  or who   have
indulged to a  pernicious extent in  a too free use of  alcoholic
liquors, in consequence of which the liver pours out fibrin
which, acting as a ligature upon the portal vessels, impedes
the flow of bile, —the consequence is that the bowels become
constipated ; the stools clay-colored ;  the powers of digestion
greatly weakened,  and otherwise  impaired, attended  with
great loss of  strength  and flesh.   The  skin becomes rouo-h
hard, and dry;  the countenance assumes a sallow aspect, or 
       NERVOUS DISORDER AND THE TEMPERAMENTS.     21

a general yellowness pervades the skin, and true or confirmed
jaundice is the result.   This is  not unfrequently attended
with the formation of gall-stones, which greatly aggravates
the evil, and leads to very unfortunate  consequences,  an
instance of which, of remarkable  severity, lately fell  under
                           Fig. 5.

my observation.   In this case, upon dissection after death,
the gall-bladder felt like  an uniformly hard, solid mass, giv-
ing the impression that its cavity was wholly occupied by a
single calculus.   Upon opening it, however, the  cavity was
found filled with a number of distinct small calculi, the  sur-
faces so moulded and fitted to each other as to appear to the
touch a single solid mass.  The appearance of the gall-blad-
der (in this case) laid open and the calculi exposed is  well
shown in Figure  5.  This patient used to suffer, at intervals,
the most excruciating pain; especially during the passage of
gall-stones into the intestines, which occasionally took place,
and  was usually attended with jaundice  and  other hepatic
disorders.
  In such cases,  strict  attention to  regimen and diet should 
22     NERVOUS DISORDER AND THE TEMPERAMENTS.
 be enjoined;  the food should be  light but  nutritious ; the
 patient should abstain from all  rich  and fat  meats, pastry,
 doughy puddings,  and, as  far as  possible, from  spirituous
 and fermented liquors.  By carefully  observing  and abiding
 by these rules, a person may live for many years,  though he
 may have but little liver remaining.   But if persons afflicted
 with serious disease of the liver will still persist  in indulging
 in  the pleasures of the table, and will continue  to violate
 those rules laid down for their guidance,  they will speedily
 bring existence to an end, and perish in the extreme of ema-
 ciation and misery.
   A gentleman  consulted me four years ago,  suffering very
 severely from  an affection of the liver,  and for which, for sev-
 eral years, he  had been taking almost every kind  of medicine,
 without much benefit.  I had every reason to believe that the
 patient would  never perfectly regain his health ; yet I felt sure
 that much relief might be derived from the proper use of warm
 baths with dry cupping, and the external use of nitro-muriatic
 acid; frictions to excite the skin : light, nutritious, unirritat-
 ing diet;  the occasional use of a pill composed of aloes and
 rhubarb;  horse exercise ;  and a residence  in  a dry pure air,
— were the means which seemed best suited to prolong life.
 He pursued the proposed plan for about five months ; and in
 a note which I received from him, in the interval, he states :
" The action of my bowels is now regular and nearly natural
and I very rarely experience the  sickness  after food; I <rain
 strength every day, and I can sleep the whole night without
being troubled with either sickness or nausea; I am o-aininc
flesh; can walk a long distance without feeling fatigued and
I am not without hopes that I shall soon  be quite well and
able to resume practice."  This gentleman continued still  to
 improve ;  but a few months after this period,  beino- attorney
and counsel for several railway companies, he dined at  sev-
eral public dinners, and, indulging rather freely in the pleas- 
        NERVOUS DISORDER AND THE TEMPERAMENTS.     23

 ures of the table, drank too liberally of wine and spirits, and
 died,  after a  six weeks'  severe  illness, greatly emaciated.
 Upon  the  post-mortem examination,  the  liver  was  found
 much  atrophied, and indeed very little was left.  Although
 I felt  satisfied that this patient would never have reached a
 mature old age, yet I am convinced  he might have lived
 for  many  years, had he  but conformed to the dictates  of
 common-sense, and abided by the rules laid down for his
 guidance.
   I have  at this moment  a patient under my care, suffering
 severely from nervousness, lowness of  spirits, and great de-
 spondency, which the yellow  tinge of the  conjunctiva, the
 harsh, hard, dry state of the skin, the  feeling of uneasiness
 after food, frequently attended with vomiting,  and the clay-
 colored stools, enable me  at once to refer to  congestion of
 the liver as the cause.  This gentleman had been under the
 care of his  medical adviser for a considerable time, and had
 consulted some of the most eminent  men in the profession,
 who all prescribed a variety of means ;  yet, strange as it may
 seem,  notwithstanding  the dry, hard, harsh,  and inactive
 state of the skin, the use of the warm bath — so powerful a
 means of promoting the action  of this  organ — had never
 been even once suggested  to him.  He has  resorted now to
the warm bath, and his  health is steadily progressing; and I
feel  satisfied that to  its  use, and dry cupping, we are chiefly
indebted for the improvement in the health of  this patient,
which  has recently taken place, and I have reason to  believe
that he will perfectly recover. 
CHAPTER  III.
       A  CHIEF CAUSE  OF NERVOUS DERANGEMENT.

  In another now well-known work of the writer, he has
gone at length into  the subject  of the abuse  of the repro-
ductive organs.   I allude  to  the work entitled " Science of
Life."  Therefore there  is no necessity for  more than a sin-
gle chapter of a general character in the present volume on
this subject.   But in a work on Nervous Affections and Mal-
adies, it was impossible to avoid allusion  to  this  subject,
because of  the  mysterious  psychological influence  of the
organs in question on the health, and especially on the ner-
vous system, and through that on the mind.  There is a close
connection between  genital psychology and physiology and
pathology.  Speaking  of self-abuse and involuntary  losses
of vitality through  the  reproductive organs, the  " London
Lancet " said many years ago : " It is a subject not less in-
teresting to the moralist than to the  medical practitioner;
and it really  is  surprising  to see that  nothing worthy of
notice  is to be found on a matter so important in the vari-
ous writings of standard authors."  This was written in 1841,
several years before the appearance of the great work of M.
Lallemand, entitled " Des Pertes Seminalcs Involontaires.'"
"This  circumstance," continues the "Lancet," "appears re-
markable  and unaccountable, when experience convinces us
that sexual weaknesses and imperfections, either hereditary
                                        [24] 
        A CHIEF  CAUSE OF NERVOUS DERANGEMENT.      25

or acquired, constitute  the  great majority, perhaps  nine
tenths, of the causes of nervousness, mental  imbecility, and
derangement.   How, then, are we  to account for a fact like
this — a fact  of   such frequent occurrence,  and so highly
philosophic and  instructive  as it  undoubtedly is — having
obtained so little attention?  Can a general feeling of  ill—
exercised tenderness towards the depraved habits of most of
the pitiable sufferers have operated in preventing the matter
from having been duly investigated, and candidly avowed and
discussed,  or  has it  resulted from ignorance?  The former
we are disposed to think can scarcely have been the case ;  for
with the medical practitioner, less  frequently, perhaps, than
with any other professionalist, from  the confidence  so read-
ily reposed in his calling,  does delicacy or prudery supersede
utility." Thus far the "London Lancet."  Everybody of any
experience  in  the world  knows that  there  is extant much
mrwholesome morality;  there is much substitution of wrords
for things; much false  delicacy which is  miscalled virtue ;
much traffic in
              "The false commerce of truth unfelt ";

much conventional  lying; much  conventional dissimulation.
For want  of the reverse of all this, many fine minds  are
overthrown.
   There is nothing which  t.s, which has actuality of existence,
that should not  be  fathomed, and whose  rocks and quick-
sands should not  be placed, as in an unfolded map, conspicu-
ously in sight.   Upon subjects on  which neither Religion  nor
Science  disdains  to  treat, correct  information should be  dif-
fused.   It lies within the scope of our Avill to shun  many of
the  first approaches  of   insanity; nay,  even although  the
first steps into error are those wdiich are most easily retraced,
to extricate others  and ourselves from its  labyrinths when
deeply involved  in them.   Into these  labyrinths we are usu- 
26      A CHIEF CAUSE OF NERVOUS DERANGEMENT.

ally misled by some of those passions and temptations which,
not peculiar to a few, are common to our whole species.
We cannot know too much; and minds may be capable and
yet unenlightened, hearts human and yet unawakened.   The
subject of which  we  are  speaking. is  one  on which even
sane minds are apt to entertain many misconceptions.  There
are psychological mysteries which  it lies within  the  power
of pathology to elucidate, and which would without its  aid
remain obscure.    There  have frequently been   witnessed
deviations from the perfectly correct in conduct and amiable
in manners ;  exhibitions of petulance  of temper  and tres-
passes against the minor  moralities ;  to account for which,
upon a post-mortem examination, there have been discovered
traces of painful and perhaps previously unsuspected organic
disease.
   Among our currently  nomenclatured diseases  are  some
wThich peculiarly tend to generate gloom, and even, in severe
or long  protracted cases,  to  incite to  suicide.   There  are
forms of gastric, hepatic, and cerebral diseases, which display
these  or like  tendencies.  Sometimes it is rather  ill-temper
that is induced, as  by attacks  of the gout.  Anxiety  of ex-
pression in the countenance is  a symptom of enteritis, which,
although  having a physical origin,  has  not a physical only,
but implicates the condition of the  mind.  The mind in each
of the varied forms of febrile  excitement takes the peculiar
course of wandering, and surrounds itself with those peculiar
groups of hallucinations, which characterize the existing state
of the brain and sensory system.   At the same time it may
be observed, that the mind of the patient individually deter-
mines the mode in wrhich various morbid states of the brain
are manifested ; and will be found in a greater or less degree,
unless when torpor and incapacity are  superinduced, to vin-
dicate its own idiosyncrasy.   While under excitement  it fre-
quently throws off such gigantic shadows of portions  of its 
       A CHIEF CAUSE OF NERVOUS  DERANGEMENT.      27

being, as the microscope brings into view of the minuter tex-
tures of  natural objects.   We  obtain glimpses of the very
infusoria, so to speak, which are engendered in the reason
and  imagination  of the patient.  There are,  on the  other
hand, diseases, and these  of a  fatal character, which, during
the most part of their course, do not disturb the temper or
trouble  the mind.   Consumption, not  always, indeed, but
frequently and commonly, deals in these respects very gently
with her victims.   Investing them as with  the  hues of per-
petual youth, she leads them to the altar crowned Avith gar-
lands.  Not  till their  near approach  to the  sacrificial  flame
does the bright eye lose its lustre, the hectic flush give place
to paleness,— do the hues fade, the garlands wither.   They
gradually, though still and evermore attended by Hope,  be-
come less and less tenacious of existence ; they are gently
weaned  from the things of time and sense,  and from the
love of life;  their hopes in life are displaced by hopes of the
life  beyond  this life.  We  regard  their  fate almost  with
envy.
   After  bereaved relatives have passed through the first bit-
terness of sorrow for  their loss, their reminiscences of those
near and dear to them, who have died of this disease, become
almost pleasurable.
   The patience of sufferers under a long-sustained mortal
affliction, is  naturally regarded in the most amiable  light.
But we  must not  forget, as  psychologists,  that, in com-
parison  with many of the ills which  flesh is  heir  to, this
complaint occasions less of bodily suffering, and less severely
tests the powers of endurance.  We should remember this,
not that wc  may cast  a  shadow of disparagement upon the
characters of those who, having had something — probably
much__to endure, have endured it patiently, and left behind
them a  pleasing image of tranquil resignation to the will of
heaven  in the memories of  survivors ;  but that wc  may be 
28      A CHIEF CAUSE OF NERVOUS DERANGEMENT.

just to such as, having had more to suffer, have naturally,
and almost inevitably, displayed  more of irritability and im-
patience.
  Yvre have  noticed how bowel disease induces cerebral dis-
turbance ;  how,  through the  medium  of  physical  organ-
ization,  the mind is  made  a party in  the  struggle.   We
thus see  clearly instanced the influence of  the body on the
mind.   The  intense  agony attendant  upon the passage of
the gall-stones, or upon a paroxysm of tic-doloreux, are too
great to be borne by any human being with tranquillity.   Wc
remember having heard some severe and unkind comments
passed upon a clergyman wrho could not refrain from mani-
festations of impatience under extreme suffering  from the
former mentioned cause.  It was inferred that he came short
of his duty as a Christian minister in not setting his flock a
better example.  There is no degree of strength of mind wdiich
disease and pain may not master.   The influence of  the mind
on the body is manifold. There are the various passions which
inspire, exalt, and debase humanity.   There are painful or
agreeable surrounding  circumstances.   These take each  its
part in influencing health ;  these constitute some of  the links
which  unite physiology and pathology with psychology.
There is also  to  be considered  the  influence of one  mind
upon another, which  is great; likewise its power,  as exer-
cised within or upon itself, as well as upon the body. There
is what is of a loftier order than intellectual, — there is moral
powrer ;  there is strength of will, of an inferior ordqr to both,
but  capable of greater  ostensible  achievements than  cither.
There are none who have not observed the effect of hope as
a cordial, of  fear as a depressant,  upon invalids.  Health
and longevity depend much upon circumstances, much upon
the duo management of the mind.  A man who upon a sick
bed is  disturbed by the reflection that he has not succeeded
in making a due provision for his family, may be inclined to 
        A CHIEF CAUSE OF NERVOUS  DERANGEMENT.      29

give himself up to despair, and actually suffer himself to die ;
or his want of resignation to his  fate, his  cherished designs
for the future, his  sanguine determinations to carry out  his
views upon his recovery, may conduce to his convalescence.
The subject is one not only of great, but of universal interest.
To pursue it further would be to expatiate over too wide a field.
It has been shown how close an affinity subsists between cer-
tain physical and psychological phenomena ;  and while it has
to be conceded that  there are diseases which act but slightly
and inappreciably as disturbing forces upon the mind, it will
be  perceived that this  concession can least of all be held to
apply to  organic  disease or functional disorder of the  gen-
erative system; not genital disease  indeed, only, but the
ordinarily fulfilled functions of the reproductive organs while
in their  normal state,  much influencing the mind, and pro-
ducing, as the status of puberty  becomes  established, abso-
lute and plainly perceptible changes  in its character.  The
same truths  admit of being expressed in the blunt language
of science, which have given vitality to the poetry of every
language.   Science,  Philosophy, and  Song concur in telling
the same  tale, only that what  the  latter generalizes, science
expounds and specifies: they speak of the Master-Passion,
and hymn its eulogy or lament its pangs  of discomfiture ;
science, of its more gross and corporal elements.
       "Love lives; Thought dies not; the heart's music still
          Prolongs its  cadences from age to age;
        Perpetuates its melodies, which thrill
          Through each voluptuous leaf of Nature's page."
Man perishes;  but the passions  common  to human  nature
will endure as long as the world exists ; hence the interest in
them never ceases, never becomes  obsolete ; hence our  sym-
pathy with the joys and sorrows of the long since dead,  as if
they were yet among the living.   The passions, and among
these the master-passion especially, supply us with countless
examples  of the  agency of the body on  the mind, of the 
30      A CHIEF CAUSE OF NERVOUS DERANGEMENT.

mind on the body, — of the  reagency of  each on the other.
With the advance of life their development becomes more
complete, their tendency and objects more clearly  under-
stood.   As in the female sex the frame becomes more wom-
anly, and a thousand new graces come into view ; so the mind
itself, in becoming more mature, becomes more feminine.   In
both sexes, the distinctions of sex become more marked and
definite ; in the male sex, not the aspect and voice only, but
the mind undergoes a change.  Those changes in persons  of
both sexes which are of a psychological character are matters
of as plain recognition as those which are physical; and  so
also are any pauses in  the march of nature towards perfec-
tion of  frame and maturity of mind, which disease or other
obstacles to its progress occasion; and, as we may add also,
any  forced or  unnatural acceleration  of its pace.   The
acclivity from childhood to adolescence may be ascended too
rapidly; the ascent itself is  not without  its perils and diffi-
culties ; it  extends  indeed over  one  of the most dangerous
tracts  of  country which  we have to  pass  in our journey
through life.  Upon our safe  conduct through it, the health
of body and vigor of mind of all after life greatly depend.
Through educational neglect, there  may be hardy but wild
and worthless plants; and a hot-house cultivation may pro-
duce such as are  only calculated for useless and  idle show.
There  may be, in fact, an extreme cultivation of the mind,
which  shall tend  eventually  to incapacitate rather than  to
strengthen it;  causing it to lose in sensitiveness, more than
it gains in power; 'prematurely exhausting  those  energies
which are requisite to wage the battle of life successfully.
During a requisite course of  study, habits of abstraction of
mind may be formed, which renders persons as members of
society  useless, because  isolated  and unsocial; and which,
removing   them from  the ordinary  temptations  of man's
worldly condition, leave  them but a more certain and easy
temptation from within. 
CHAPTER
IV.
         PATIENTS WITH A NERVOUS TEMPERAMENT.

  The  nervous temperament, as previously stated,  is to be
distinguished by a quick, active brain;  and the nervous sys-
tem takes the lead over all the others.   The eyes arc large,
and generally piercing;  the features prominent and  usually
sharp;  the  forehead clear; the  hair black, but  silky,  not
crisp, as in the biliary temperament.   The muscles, though
small, are still  round and well marked; the motions quick
and active, and the step firm; the features generally  expres-
sive of  anxiety.  Such persons  are for the most part intelli-
gent, and alive to every kind  of nervous impression; being
easily excited and as readily depressed.  The disposition as
well as  the mind is frequently modified by associations ;  but
a sedentary and indolent life never fails to create morbid im-
pressions ; the persons themselves being best suited for occupa-
tions requiring activity and quickness. We very seldom, how-
ever, meet with  the  neryous  temperament, or, indeed,  any
of the  others,  perfectly pure and unmixed; but they  run
into, and arc blended with, each other.   Thus, we have  the
bilio-nervous,  the nervo-lymphatic, the  nervo-sanguineous
temperaments.   It requires some discrimination, and consid-
erable  practice  and experience,  to thoroughly comprehend
the  various temperaments, and  modifications they are con-
stantly presenting in practice to our observation.   The indi-
                                            [31] 
32      PATIENTS WITH A NERVOUS TEMPERAMENT.

viduals  themselves  often seem complete  enigmas.   Thus,
some  that  arc  intelligent and courageous, will  often faint
even at  the sight of a drop of blood.'  I am acquainted with
a gentleman of highly nervous temperament, who is timid
and fearful  on  trivial  occasions ; yet when suddenly placed
in real danger, has been known to be bold,  decisive, and self-
possessed.   But all attempts at describing the various phases
and shades assumed by this temperament must fail and prove
abortive.  I have seen some hundred cases  of the  nervous
temperament, but have never yet met two  precisely alike in
all respects.  Climate, associations,  hereditary  tendencies,
and  other  innumerable  circumstances, as  grief, disappoint-
ment, etc., so far  change, alter, and  otherwise modify  this
class  of persons, as to render them  one  and all dissimilar,
■—the same causes not being applied  or not operating in all.
What I wish more particularly to insist  on is,  that when
the nervous temperament is  present and in activity, or when
it is intermixed with others, it is of the greatest possible im-
portance that it be attentively and thoroughly studied; for
no treatment of disease can be  permanently successful if
these  conditions be not taken into account.   Redness, swell-
ing, heat, pain,  and throbbing, are laid down, in the syste-
matic works upon medicine  and surgery, as the characteristic
or distinctive signs of inflammation;  and  in  other tempera-
ments such signs may  be relied on with safety ; but I would
recommend practitioners, not much accustomed to the man-
agement of nervous cases, that patients of  this temperament
simulate not only inflammation, but  also many of the incu-
rable  diseases in which inflammation frequently terminates.
I am  satisfied,  after having strictly  watched and carefully
attended to  a large number of cases of purely nervous disor-
der, that all the phenomena indicative of acute inflammatory
action may 1)6  present, and yet no  inflammation whatever
exist. 
        PATIENTS WITH  A NERVOUS TEMPERAMENT.       33

  I shall briefly notice the following interesting and instruc-
tive  case, which will, perhaps, more clearly illustrate what
I wish to inculcate.   I wras called, about three  years ago, to
visit a young lady  of highly nervous  temperament.    She
was an only child, and had been brought up in all the luxury
and delicacy that affluence could procure.  She suddenly com-
plained of very severe pain in the knee, attended with all the
symptoms of inflammation in the joint.   The pain was so in-
tense, that it was not without difficulty she could be prevailed
upon to allow even a superficial examination.   The pain was
very speedily followed by swelling, heat, throbbing, and all
the usual symptoms of inflammation.  The medical gentleman
who previously attended  the  case had  applied  leeches in
abundance,  had tried cold and astringent lotions, purgatives,
and such  other  remedies,  and  had persevered most steadily
in the antiphlogistic plan of  treatment  for a  considerable
time, — still the pain was in no way relieved, or even abated in
the slightest degree.   The obstinacy and the general appear-
ance of the joint led to the belief that the young lady was
threatened wdth white swelling, and it was under these cir-
cumstances  that I w*as called upon to visit the case.
   When I first saw the patient, I was assured  that the same
state of things as I then witnessed had existed without amelio-
ration, or, indeed, the slightest change, for a period of nearly
three months ;  and  this, too, notwithstanding the  most ap-
proved means of subduing inflammation had been  adopted,
and most strictly persevered in, ever since she had been first
taken ill.  I had  before  seen several cases of a  similar de-
scription.   Therefore, after a minute and careful examination
of the joint, I expressed my doubts of the existence of any
real or true  inflammation.  Upon this I was the more de-
cided, because I had in the course of my inquiries ascertained
that the symptoms had  neither increased nor decreased, but
had continued steady and stationary; in fact, precisely as at 
«
34      PATIENTS  WITH A NERVOUS TEMPERAMENT.

the very first day.  Now, it  is in accordance with my expe-
rience, that real inflammation, more especially when acute,
if not subdued, must certainly proceed to abscess or ulcera-
tion, or symptoms indicating the destruction of the joint
either supervene  or threaten before the lapse of  so  long a
period.  These considerations, with the admitted irregularity
in the periodical health, the  high degree of nervous  excite-
ment, the acute sensibility, greatly increased by a luxuriant
and indolent  mode of living,—induced me firmly to an-
nounce it as my opinion that  the patient was suffering from a
purely nervous affection of the joint, and clearly and decidedly
the result of morbid irritability.
   In accordance with these views, I recommended that the
limb, which had  been  hitherto  confined  in one position,
should be greatly exercised ;  that the patient should remove
from the heated apartment to which she had been so closely
and strictly confined, and  take carriage exercise in the open
air.  It Avas at the same  time strongly advised that external
applications  to the limb  should  be discontinued ; for it Avas
very evident that the only  effects  of the  lotions Avere to
attract her attention to the state of the limb, and create great
anxiety and alarm from the apprehension of being obliged to
suffer the  loss of the leg;  for she had unfortunately been
told that the disease might end in Avhite swelling.   With the
vieAV of restoring the  periodical  action of  the uterus, Avhich
had been for some time  suppressed, the bowels  were kept
regular, and the patient AAras directed to use  warm, salt water
baths frequently ;  and to  give energy and tone to the general
system, Avhich had been  enfeebled, she was directed  to  take
the Tinct. Ferri, Acet. ^/Ether, in regular doses three or  four
times a day.  It Avas indeed  extremely gratifying to Avitness
the great improvement in her health, even  in the  course of
a feAV Aveeks, after the alteration in the treatment  had been
adopted.  'Pure air, regular  exercise, Avith plain,  simple, but 
        PATIENTS WITH A NERVOUS  TEMPERAMENT.      35

nutritious diet, and  the  mind being  set at ease, I am satis-
fied had much to do in effecting the cure Avhich speedily fol-
lowed the adoption of the plan aboAre stated.  Although an
advocate for great simplicity of means in such cases, I am
far from Avishing it  to be understood  that the treatment of
them is ahvays as simple or equally successful.  We  have
often to contend Avith prejudice, — patients and their friends
haA'ing been, in  most instances in which  the  case has  been
prolonged, informed that there is danger of the disease turn-
ing to Avhite swelling, and that exercise, or indeed motion
of any kind, is  prejudicial and attended with  the  greatest
danger.   Thus, under the influence of first impressions, they
rebel against any advice to the contrary,  and persist in con-
fining the patient either to the bed or to the couch; and this,
too, not  unfrequently in a hot  and ill-ventilated apartment.
   These nervous affections of the  joint are not ahvays to be
easily distinguished from organic diseases of  the same struc-
tures ; for it is not unusual to find that the  natural appear-
ance of the  joint has been completely altered by the effects
of  repeated leeching, blistering,  cupping,  issues, setons,
etc., so that it is often extremely  difficult to decide whether
the appearances be really in consequence  of the remedies or
of  the disease.  The practitioner, therefore, avIio  has  not
paid special attention to these diseases, should be very  care-
ful before deciding positively upon the nature of such affec-
tions, but  more  especially if the  patient be a lady of the
nervous or bilio-nervous temperament.  It is  not  long since
a very eminent surgeon at one  of  our great hospitals ampu-
tated above the  knee, under  the notion of the existence of
white swelling of the joint.  But, to his great surprise, upon
dissection after the operation, the joint Avas  found in a per-
fectly sound and healthy state, and  it turned out that the
disorder was purely nervous and nothing more.
   To fortify myself by eminent authority, I quote Sir Benja- 
36      PATIENTS WITH A NERVOUS  TEMPERAMENT.

min Brodie, who says, " Among the local hysterical affections,
one of the most frequent is  acute  pain in  the  knee-joint.
Indeed, the affection is marked  by almost every  sign of
structural disease, save that it  is more diffused.   Yet  this
is true neuralgia." And Sir Benjamin concludes his sentence
thus : " I do not hesitate  to declare that among the higher
classes of society, at  least four fifths of the female  patients
who are commonly supposed to  labor under diseases of the
joints, labor under hysteria and nothing else."
  These  nervous  affections are not confined  solely to the
joints, for I  am  often called upon  to prescribe for similar
affections  of  the breast.   Patients  of this  kind  invariably
apprehend and suspect the beginning  of cancer.  The dis-
crimination of such cases is frequently  a matter of considera-
ble difficulty.   And,  indeed, there  are  many instances of
breasts having been removed under the belief of the presence
of cancer, Avhen really no such disease existed.  While this
sheet is passing through the press,  I  have been called upon
to prescribe for a hard and painful tumor hi the left breast,
Avhich, upon examination, presented many of the symptoms
of cancer.  This person was of a highly  nervous  tempera-
ment, and, on her first visit,  gave  me the  impression  that
she was under the influence of wine;  but, upon  more strict
inquiry, I found  it was laudanum,  to the habitual  use of
which she had been addicted.   I declined giving an opinion,
when I Avas informed that the  amputation  of the breast had
been already resolved upon; and that  she had  called for my
advice before submitting to the operation.   I advised her to
go into the country, and try the effects of a pure, wholesome
atmosphere, for a fortnight at least; to leave off the use of
opium; to take warm, sea-water baths ; to use the  plainest
and simplest, but still mild and nutritious diet; to live prin-
cipally upon  milk, and  thus remove any cause of constitu-
tional irritability.   During  the first ten days her sufferino-s 
        PATIENTS WITH A NERVOUS TEMPERAMENT.      37

were  most  intense, in consequence  of being debarred her
habitual doses of opium.  Her firmness and strength of mind
were  put to the severest proof in altogether renouncing the
narcotic;  and, as  she  informed me, it was only the hope of
being able to save her  breast, that could have induced her to
forego its use.  Upon her return to Boston, after someAvhat
more than three Aveeks' sojourn  in the country, the irritation
Avas greatly reduced by change of air, bathing, and mild diet;
and now a thorough examination could be endured Avithout
apprehension, and Avas therefore readily submitted to.  It at
once became evident that the tumor was the result of irrita-
tion,  in an  extremely sensitive  and excitable system;  and
that the care-Avorn, anxious, peculiar  expression of counte-
nance, Avhich Ave observe so constantly in true cancer, was, in
this instance, entirely occasioned by mental anxiety, greatly
increased and aggravated by the opium she was taking.  She
Avas  advised to continue the  plan of living which had proved
so beneficial,  and she  faithfully promised me that she Avould
not again have recourse to  opium,  and I have every reason
to believe that  she will  perfectly recover.   I  cannot  too
strongly denounce the immoderate use  of  opium in these
cases.  If ever used at all, it should be given with the great-
est caution aud circumspection  to  persons of nervous tem-
perament, and still more if the  patient be young.  Opium
renders the nervous system highly susceptible, and alive to
all sorts  of nervous impressions.
   Nervous affections of the spine are still more common than
those  of the  breast, and they are but too often treated as
really organic diseases.  It is by no means uncommon to meet
Avith such instances ;  they  are  constantly presenting them-
selves in practice.  I  have seen many who  have been con-
fined to the  couch for months, or stretched for a like period
upon the inclined plane.  Had the cause of the disorder been
traced out and removed, instead of attending to and treating 
38      PATIENTS  AVITH A  NERVONS TEMPERAMENT.

effects, much present suffering and subsequent misery might
have been  avoided.  The history of the folloAving case may
perhaps prove not uninteresting:  A young  lady, of highly
nervous temperament, Avas  subjected to the inconvenience of
confinement upon the inclined plane, for nearly nine months.
This severity of discipline  had its origin in  the notion that
this unfortunate patient was laboring under severe disease of
the spine, and which, it Avas imagined, was the primary cause
of the disordered state  of her health, which had been declin-
ing for  some years.  Her symptoms were watchfulness  and
Avakefulness, so that there Avas a total inability to sleep more
than about  four or five hours during the night, all the rest of
Avhich she remained awake.   In  consequence, her health had
become delicate, which was referred to disease of the spine
as the cause, as she complained of a good deal of pain in the
back.  A careful  inquiry into  her history satisfied me that
the Avakefulness was hereditary.  From childhood she  had
not slept as much as other persons.  For years previous to
her birth her father had forced himself to very great mental
application.  Being  the architect of his own  fortune, he had
not for a length of  time allowed  to  himself more time for
repose than Avas imperatively required by exhausted nature.
Had, then,  the history of this case been carefully investigated
at the commencement, I think very different results would
have been  arrived at, and  it would not  have been  thought
necessary to confine  her to  the  inclined  plane.   The above
cases are  cited to show Iioav the cause  of disease  may be
overlooked  by  eminent  physicians, and to   shoAv that the
study of the temperaments, a more strict inquiry into the
nature of nervous affections, and a more rigid investigation
into  the causes  of disease,  Avould tend much to relieve many
of those distressing cases of nervous disorder Avhich so con-
stantly come under the care of the physician. 
CHAPTER  V.
     CONVIVIAL  HABITS AS A CAUSE OF NERVOUSNESS.

  Of course the prompt and effective remedies for nervous-
ness, which the  writer has  ready at hand, are frequently
demanded  to  quell the  nervousness  of persons  suffering
from convivial habits  and good cheer,  and occasional or
habitual abuse of wines and alcoholic drinks.  The depression
of the nervous system, induced by such indulgence, is some-
times called alcoholism or alcoholic melancholy.   There is in
every class of society a number of persons who, although they
do not become intoxicated, suffer from chronic alcoholism,
from drinking more spirits, wine, or ale than agrees with their
health.  Most of these persons lead a useful and active life, and
apply for medical advice, being quite unaware of the cause
of their illness.   The  habit  of indulging freely  in wine at
frequent dinner parties, of drinking Avine, ale, or whiskey at
times, of taking occasionally a glass of wine between meals,
or of sipping every evening  two or three glasses of  ale, or
punch, or wliiskey and water, is quite sufficient to bring on
an attack of alcoholism.  Drinking  is not  usually in these
cases an indomitable  habit, and accordingly the patient will
gladly give it  up, if he feels certain that by so  doing his
health will be improved.   Sleep disturbed by dreams, some-
times sleeplessness, diminution of the appetite and evacua-
tions, vomiting of mucus in  the  morning, trembling of the
                                              [39] 
40   CONVIVIAL HABITS AS A CAUSE OF NERVEOUSNESS.

hands and arms more marked in the mornings, etc., are con-
sequences of these convivial habits.  The chief symptoms of
chronic alcoholism are trembling of the feet and hands ;  in-
creasing weakness; the sleep is much disturbed by fright-
ful dreams, or it  cannot be  obtained  either on  account of
neuralgic pains in the limbs, or extreme restlessness.   In the
more advanced stages of the disease, the night  not  unfre-
quently becomes a period of horrible suffering.  The patient
in vain seeks to place  his limbs in  a position which would
afford relief to the uneasy sensations or burning pains  Avhich
affect them;  and if  sleep or drowsiness steals upon him,
it is presently driven away by convulsive startings.   The
neuralgic pains which  at first haunt solely the night, begin
to affect the patient, and increase upon him by day.  Vertigo
often happens, and at times the vision is  clouded.   Halluci-
nations are of common occurrence.  They mostly affect the
organs of sight and hearing.  For instance, one of my patients,
when Avalking in  the street, had seen ropes dangling  about
his head ; to another, objects appeared as if they were double ;
some occasionally perceived  insects  creeping about, — the
various  visions often  disappearing  as soon as the attention
was directed to them.
  These factitious perceptions of the sight appear sometimes
so real that the individual moves aside to avoid an imaginary
object  standing in his way.  A hackman I was treating for
chronic alcoholism told me he frequently pulled up his horse
suddenly, or drove to one side of the street, lest  he should
run over some obstacle he distinctly saw in frout«of his horse,
and which he  aftenvards found not to exist in reality.   In
most cases the patient is occasionally, or perhaps constantly,
troubled with  shadows or  black mist,  or fly in or specks
passing rapidly before his eyes, and causing  a dimness of
sight, especially when he is looking attentively at something;
in the act  of reading, for example, the  book is  suddenly 
           CONVIVIAL  HABITS AND  NERVOUSNESS.         41

darkened, and a state  of  almost complete blindness ensues,
lasting a few minutes.  During the long and sleepless nights,
aberrations  of  the  sight frequently happen.  The wife of a
patient  I was treating for chronic  alcoholism, told me her
husband often fancied, Avhilst lying  aAvake, that he  saAV rats
and cats, and various  other descriptions  of animals, on the
bedclothes ; he used to doze at intervals,  and in the morning
could not remember anything of the nightly visions.   The
aberrations  of  the sense of hearing are not so frequent, but
I  have  met Avith  patients  who  occasionally heard  voices
addressing them when nobody Avas present.  " Doctor, I will
give you a wrinkle" said a friend to us, not long  ago, as Ave
were  gossiping concerning Avine ;  and an attendant was di-
rected to descend into the cellar, and bring from a particular
bin a bottle of champagne.   It may be as well, perhaps, to
remark, lest the uninitiated should stumble over the term,
that a wrinkle, in  the refined slang of the day,  signifies a
little  bit of practical Avisdom.  The phrase is highly meta-
phorical.  Worldly Avisdom iucreases with years ;  so also do
the furrows which indent the forehead.   Therefore an increase
of Avrinkles in  the forehead may be regarded as an index of
increasing Avisdom, and a Avrinkle may stand well  enough for
an item of practical wisdom.  This by the Avay.   The  cham-
pagne was in due time placed upon the table, and the spark-
ling fluid had a most  agreeable taste  and refreshing  effect,
for the evening was  hot and stifling.  " Well, how do you
like the wrine ? " inquired  our friend.   " A pleasant drink for
a scorching day," we replied.   "Read that," he said, putting
into our hands  the  cork Avhich had just been extracted from
the bottle, and  pointing to the inner extremity, — that which
had been next the wine.  There  we saw and read, not a
little to our astonishment, the formidable  Avord mort (French
death) printed  in  clear,  bold  letters.    "That," said our
friend, " is a trade-mark; and when you  see it affixed to the 
42         CONVIVIAL HABITS AND NERVOUSNESS.
cork of a champagne bottle, you may rest  assured that no
grapes ever contributed towards the formation of the  Avine."
  This was the  wrinkle; but  the  singularity of the  trade-
mark awoke other thoughts than those immediately connected
with the utility  of knowing it.   Should there have been  a
full stop  after the different letters, — each having a specific
signification, the formation of the word being merely acci-
dental ?  Or was the trade-mark such  as we read it — Mort
(Death) ; and if so, was it a piece of satire of the wine mer-
chant on the Avine?  Truly,  a  reversed cork so stamped and
placed upon the plates of the guests at a feast  might well
serve the  purpose of  the mummy  introduced at the  old
Egyptian banquets ; or might convey as homely but as forci-
ble a lesson as that taught in Holbein's drawing of the toper
in the Dance  of Death, in  which death  is  represented as
officiously pouring the  inebriating drink into the mouth of
one  of the carousers.   Or may we regard  this trade-mark
as a foreshadowing of that time when alcohol will no  longer
be known  as  aqua vitm, but aqua mortis.   And, indeed, as
we become more and more familiar with the remote  effects
of alcohol  upon the  system, in whatever form  the  potent
spirit be consumed, we cannot resist the conclusion that, as
too  commonly used,  it would  be more  correctly  termed
water of death,  than aqua vitoe,  or  water of life.
  The Avriter can quiet  the nerves shattered by vinous and
alcoholic excess, and drive from his  pillow the ugly visions
which  disturb the sleep of  the victim  of alcoholism.  But
total abstinence, as  it  is  called, is better  even than  his
remedies. 
CHAPTER  VI.
                    ANXIETY OF MIND.

  Anxiety !  Is there a human breast in which this awful word
fails to produce an echo ? — from the youth,  Avho fears to be
superseded in the affections of the object of his love ; from the
parent, AArho Avatches Avith alarm the flush in the cheek of his
child, lest its vividness indicate latent consumption, — to the
old man worn down Avith years and sorroAv, who tries to esti-
mate the commercial convulsions that threaten to swallow up
the hard earnings of a long life of privation, and reduce him
to beggary.  To specify the objects  of this  corroding  care
Avould be to enumerate all the classes of society.  The  man
of poetical imagination might give a series of individual pic-
tures Avhose  vividness would  excite universal despair, like
the single captive of Sterne; he might so harrow up the feel-
ings of the reader by the representation of social misery indi-
vidualized, that the whole Avorld should seem a charnel-house
of wretchedness, unworthy of the benevolence of  the great
Being Avho called it into existence.  It is hard to believe it
in times of despondency and alarm; but the man who stands
aloof from the turmoil' of the Avorld, and occupies the higher
station of independence, knows that all things work together
for good ; that God does not leave to a future state flie expia-
tion of  many of our errors and sins, but that even in this
world they work their own punishment.   If we suffer for the
                                               [43] 
44
ANXIETY OF MIND.
faults and crimes of others when acquitted by our own con-
science,  we  must endeavor  to  consider  the misfortunes
inflicted on us as a part of the moral discipline by Avhich it
is His  purpose to Avork out our improvement, and fit us for
final happiness.   This view of the case, however, is appro-
priately left to the clergyman.  It is in the capacity of phy-
sician  and man  of the world  that I put myself forward, in
the conviction that it is in my power to offer alleviation to
the afflicted, to  show hoAV  misfortune  may  be best borne,
— hoAV its physical and moral consequences  may  haAre  their
force turned aside, and be rendered comparatively harmless ;
Iioav inevitable bodily ailments  may be  modified  or cured;
how some  admit  of  great alleviation,  and  some of  entire
removal;  that even by acting on the body we may render
important service to  the mind, and enable it to rise elastic
from the pressure that, if left alone, would  have  crushed it
to the earth.
  It is not that I would evade  the consideration of other
forms  of  unhappiness; on the contrary, I  hope, sincerely
and confidently, to render a service to  my fellow-creatures
by showing that  in all cases we may anticipate and prevent,
or give considerable  relief to, the ailments,  disorders, and
diseases produced by mental causes, even when it is obviously
impossible to alleviate and remove their source and origin.
The mind, that is, the aggregate of the functions of the brain
(for Ave are not here speaking  of the soul), can only  produce
disease by some  sort of action on the physical structure and
functions of the  body.  We see,  however, that as accidental
injury  to the body (an extensive burn or scald for example)
can produce a very serious  effect on the mind, so  also the
diseased or disordered state of body, directly caused  by men-
tal  emotion,  acts reflexly on the functions of the  brain and
very often paralyzes all the efforts of the sufferer, and render
him incapable of using in its full power the intellect which 
ANXIETY OF MIND.
4.5
would have otherwise shown him a mode of extrication from
his embarrassment.
   Men who have  weighty care  on their mind, — statesmen
whose confidence  of  retaining  their  position,  and  ambi-
tious  hopes of further advancement, depend on the slender
and  fragile thread of popular  favor;  or where patriotism
looks forward with honorable fear to the result of a  deep-laid
scheme for the advancement of their country's Avelfare, liable
at every moment  to  be defeated by malevolent rivals, and
the unexecuted  purposes rendered  suspicious to those Avho
judge by results  alone ;  merchants who  have  staked vast
sums on the issue of an uncertain  speculation; gentlemen
of fortune who  have* perilled their whole possessions  and
their honor on the result of a horse-race, — such  men will,
perhaps, look down Avith  contempt on the petty  details of
the cares of humble life, but
               Little things are great to little men.

   The medical philosopher looks with as mucn  interest on
the anxiety of the petty tradesman, as on a great leviathan
of the stock exchange or gold board, whose vast speculations
involve the fate of nations.   There is as  much real dignity
in the sufferings of the one as of the other, except in so far
as the wish for wealth is modified by the desire to possess
the  means  of benevolent  poAver, and the exercise  of an
enlightened beneficence (such as actuated the late  Mr. Pea-
body, the  patron  of the Peabody Medical  Institute), —the
hopes, fears, motives, sentiments, and  feelings of the differ-
ent classes, as well as their mental and corporeal sufferings,
are essentially the same; and, if regarded from  the heights
of pure reason and philosophy, are equally deserving of honor
or contempt.
   It requires  no  argument to   prove  that anxiety  affects
the health ; it is an object of  daily experience ;  our libraries 
46
ANXIETY OF MIND.
are full of books of  counsel on the subject; medical works,
in  the enumeration  of causes of  lingering  disease,  are
crammed with cases arising from this source alone ; and there
is scarcely  a disorder wherein this state  of  brain  is  not
assigned as one  of the most  prominent  agents  in disturbing
the bodily health, and establishing disease.  Fevers, jaun-
dice, gout, consumption, insanity, dyspepsia, and a hundred
other diseases are  so often thus created,  that it would  almost
appear to be the  sole agent in their production.  And yet,
with all this profusion of advice and description, I  cannot
call to mind a  single writer who has attempted to  explain
the mode in which these innumerable effects  are produced;
yet, till this be clearly understood, we are not  in possession
of half the available means of modifying or removing them.
The distress brought on by this inability to guide the thought,
— a frequent consequence of great anxiety,— this inability to
use the two brains concurrently, that  is,  to exercise attention
or study, is  one  of the most  pitiable  states of mind that can
be conceived.  Happy those who have never had experience
of the infliction,—the utility of Avorks of imagination is thor-
oughly appreciated in  such cases, and the sufferer would be
always reading.   In following the ideas of another man, he
can generally leave his own intellectual  organs in quiet;  the
discordant action of the tAvo brains  may thus  subside  per-
haps into repose,  and on resuming  their  duties they  may
have re-established  the  unison  and  consentaneity which is
necessary to the tranquil exercise of  the mind.  On such
occasions, if there be no object of tender fondness,  Avhose
soothing blandishments can turn the current of the thoughts,
— if a man look only with terror to the time when

            " Shall dawn the dreary morrow;  and the toils,
             The cares, the ills of life, with scarcely hope
             To brighten the involving gloom, and save
             The fainting spirit," 
                    ANXIETY  OF MIND.                 47

on  these  occasions, we feel  acutely  the  value of such a
writer as Charles Dickens, — a man whose medical services,
if I may so term them, would have been cheaply purchased
by the nation  at the price of the largest fortune  ever pos-
sessed by  an  individual.   Hoav many a harassed  brain has
been soothed by his delightful fictions ;  hoAV many a lingering
disease has been rendered endurable ; from how many has he
not directed the dismal prospect of inevitable death ; to how
many an aching heart has he brought consolation and comfort
and the temporary oblivion of sorrow ; how many a suicide has
he prevented; and  how many a bewildered brain placed  in
repose!
  Such men have  their mission, — they are  sent  into the
Avorld by a benevolent Deity for  a specific purpose, and they
may be  compared to  the  blessed remedies which have been
created  for the relief of sufferers.  I do not hesitate  to say
that I attribute the recovery  of  many a nervous patient to
the mental  composure produced by reading  his admirable
stories,  in which there is  nothing to detract from the entire
satisfaction and assent of a virtuous mind. 
CHAPTER  VII.
        RELIGIOUS EXCITEMENT AND NERVOUSNESS.

  The writer has had many cases of nervous depression and
melancholy resulting from religious excitement, and what are
knoAvn as revivals, although these  cases  are not so common
as they formerly were.  Occasionally a nervous patient, Avho
believes himself or herself to have committed the unpardon-
able sin, and to be,  therefore,  destined to everlasting perdi-
tion, is brought to  the writer for treatment; but cases of
what  may be  called religious  insanity are not so common
now as formerly, owing to the fact of  a softening of the
creeds, and  the elimination of the terrible penal articles of
faith, Avhich once  were insisted on  more  than  all the rest.
Hysteria in  connection Avith religious revivals  is  a  well-
known medical phenomenon. When the nerves, especially of
uneducated people, of women in particular, Avho are unaccus-
tomed to self-control, are powerfully wrought upon by the rude
but powerful appeals and eloquence of a revivalist preacher,
paroxysms,  convulsions, and outcries are the natural  enough
expressions  of the  overwrought feelings of the  auditors.
Hysteria seizes upon some  extremely susceptible female, and
becomes straightway contagious.   In fact, several  leading
nervous disorders, such as catalepsy,  ecstasy, chorea or St.
Vitus' dance,  and hysteria are historically associated Avith
religious excitements.   Dr. Hammond truly says : " Most of
         [48] 
         RELIGIOUS EXCITEMENT  AND NERVOUSNESS.      49

the  religious impostors, who  have at various times made
their appearance, and many very sincere and devout persons,
have been ecstatics." "In ecstasy," he says, "the eyes are open,
the  lips parted; the face is  turned  upward, the hands are
often outstretched ; the body is erect and raised to its utmost
height.  A peculiar radiant smile  illumes the  countenance,
and the Avhole aspect is  that  of intense mental exaltation.
In  its  combination Avith catalepsy, chorea, and  hysteria,
ecstasy has played an important part  in the history of the
ciAilized world, — at one time leading to  a belief in Avitch-
craft; at another,  to  demoniac  and  angelic possession; at
another, to mesmerism  and clairvoyance ;  and, in  our day,
to  spiritualism.  Ecstasy,  though  not  entirely confined to
the female sex, is very much  more common in women than
in men.   It appears to be produced in those who are of deli-
cate and sensitive  nervous organizations by intense mental
concentration on some  one particular subject, — generally
one connected Avith religion.   It Avas formerly quite common
among the inmates of convents, and is now not unfrequently
met Avith  at  camp-meetings  and  spiritualistic gatherings."
Chorea,  or St. Vitus' dance, is another well-known form of
disease having religious associations.   Hence its name.  The
coiiA-ulsions and paroxysms of this nervous affection are often
of  the most extraordinary character.   " This  affection," Ave
again  quote  from Dr. Hammond's  admirable work entitled
"Diseases  of the Nervous  System,"  "has often  prevailed
epidemically.  The first authentic visitation of the kind A\Tas
one which  occurred at Aix-la-Chapelle, in 1374.   This was
in the form of a dancing mania.   It was named St. John's
Dance.
  " The men and women subject to  it  met in the streets and
churches, Avhere they formed circles hand in hand,  and, ap-
pearing to have lost  all  control, continued dancing, regard-
less of the by-standers, for hours together, in Ayild  delirium, 
50      RELIGIJUS  EXCITEMENT AND  NERVOUSNERS.

until at length they fell to the ground in a state of exhaustion.
. .  .  While  dancing, they  neither  saw nor  heard, being
insensible  to  external impressions through the senses, but
Avere haunted  by visions, — their fancies conjuring up spirits,
whose names they shrieked out.  Some  of them afterwards
asserted that  they felt as  if they had been immersed in a
stream of blood, which obliged them to leap so  high; others,
during the paroxysm, saw the heavens open and the Saviour
enthroned with the Virgin Mary, — according as the religious
notions of the age were  strangely or variously reflected in
their imaginations. . .  .
  " Some  religious  monomaniacs are never safe.   Pinel re-
lates the case  of a  fanatic who conceived the idea that man-
kind  should be regenerated by the baptism of blood; and
under  this delusion he  cut the throats  of all  his children,
and  would have  murdered his wife,  had  she not effected
her escape.   Sixteen years afterwards, Avhen a  patient in the
Bicetre, he murdered two  of his felloAV-patients, and  would
have killed all the  inmates in the hospital, if  his homicidal
propensity had not been restrained.
  " In our own  country *we have had the Jumpers and the
Shakers."
  In  these  practical, matter-of-fact  days,  the subjects  of
these nervo-religious excitements, paroxysms, and convulsions
are  cured  of their disorders by an administration of the bro-
mide of potassium, or some of the other bromides, combined
with the oxide or sulphate of ziuc  and strychnia and other
tonics, reinforced by a proper hygiene of  exercise in the air
and nutritious diet.
  The physical phenomena of  " the revival" can be  sIioavh
to present, in their predisposing and exciting causes, in their
progress and  in their results, a precise resemblance  to the
hysteria commonly seen  in medical practice, and  produced
either  by secular terrors or by  amatory reverie.   We are 
        RELIGIOUS EXCITEMENT AND NERVOUSNESS.      51

clearly entitled  to  consider  them as belonging to the same
family, and as being in fact very striking instances of morbid
action.  Without trespassing upon the domain of the theolo-
gian, yet Ave may regard these phenomena in  their patholog-
ical relations, and may point out the methods by which they
may be prevented, and the manner in which they may be over-
come.  Itis incontestible that love to God, founded upon an
assurance of God's love to man, is the only possible basis of
Christian faith and duty ; and it is inconceivable that love to
God  can be kindled at the flames of a literal hell.   Denun-
ciations of  the  Avrath to come,  and frantic  appeals  to the
terrors of a congregation, produce either hysteria or indif-
ference,— either shake the physical frame, by posith^e dread
of impending torture,  and mere selfish fears  for personal
safety, or else harden the listeners by the natural reaction of
the human  spirit against threats.  " HoAvling about hell-fire
in bad grammar," as Thackeray says, very  frequently ex-
presses nothing  but the longing of the preacher to persecute.
I hold, therefore, that  these  denunciations of the wrath to
come, made prominent as the leading and essential feature
of scriptural teaching,  are without any shadow of justifica-
tion  or excuse.   Hysteria, originating in  terror, maintained
for effect, terminating in profligacy or insanity, is a sad con-
trast to the peace that passeth understanding.  But, as I have
said,, in these days of science and rational views, instances
of religious  melancholy and insanity are becoming fewer and
fewer; as those physicians,  who, like the writer, make the
treatment of nervous affections a specialty, can  testify;  al-
though such cases  are by no  means rare.   Interesting cases
of this kind might be cited from the author's OAvn professional
experience,  and described  at length,  but  it is,  perhaps,
unnecessary.  More or less  of such cases can be found in
every lunatic asylum.   Most of them are curable by the pow-
erful  remedies for nervous affections, which have been added
to the Materia Medica within  the last decade. 
CHAPTER  VIII.
             ILLUSIONS AND HALLUCINATIONS.

  It is said that hallucinations of the senses arise from some
defect  in the organs of sense, or from some unusual circum-
stance attending the object.   Hallucinations  are sometimes
symptoms  of general disease, as in fevers.   The  extent  to
which we  are  subject to  illusions  and hallucinations shows
that we  are fearfully and wonderfully  made.  The  most
aggravated murders are frequently committed  by persons
who are the victims of fixed ideas and hallucinations.   They
are often  aAvare  of the  fact that they are  laboring  under
mental disease, and yet they cannot  hold themselves back
from the perpetration of the dreadful crime to Avhich they
are irresistibly  impelled.  The subject of hallucination is a
most important and interesting one.  The various religions
OAve to the hallucinations of their so-called holy personages
all  their  accounts  of supernatural  beings   and  incidents.
When a person actually insists  that he sees, hears, or feels
what no one near  him  can see, hear, or feel, the question
arises, Are the senses which convey these impressions to the
brain in a sound condition, or is his mind delirious ?   Is  the
cause of the hallucination external or  internal ?  In order to
ansAver this question, wc must first inquire Iioav far the senses
arc capable of  misleading the reason and urging the  imagi-
nation to unconnected dreams.  We know that the nervous
              [52] 
ILLUSIONS AND HALLUCINATIONS.
53
system is influenced by the condition of the body.  Privation
of food, for  instance,  indulgence in  alcoholic stimulants,
habits of narcotism, and congestion of the brain will power-
fully affect the nervous system, and through it produce  illu-
sions and hallucinations  of the senses.   In fact, the history
of mankind, and the experience of those who have had the
opportunity of studying the ills to which flesh is heir, prove
that the manifold  causes which give  rise  to hallucinations
can be  referred to  innumerable  sources, which oftentimes
escape the  curiosity of the  most watchful and intelligent
observer.  The power  of the  imagination is proverbial.
Shakespeare says the poet, the loArer, and the madman are of
imagination all compact.   The latter he represents as seeing
more devils  than vast  hell can hold.  Whatever a person
firmly believes, that to him is a reality.  So that an  illusion
or hallucination, no matter how wild and  irrational it  may
be, has  all the effect of a reality on the subject of it.   There
is no limit to the force  of a morbid imagination, and the
mad pranks  and delusions to which it will  reduce  its unfor-
tunate A'ictims.  Burton asks,  "What will  not a fearful  man
conceive  in  the dark?  What strange forms of bugbears,
devils, Avitches, goblins?  Melancholy and sick men, he says,
conceive  so  many  fantastical  visions, apparitions  to them-
selves, and have so many absurd  apparitions, as that they
are kings, lords, cocks, bears, apes, owls."
  Burton furnishes perhaps as many and as striking instances
of illusions, delusions, and hallucinations  as any other Avriter.
He gives the case of a baker, who thought he was composed
of butter, and  did not dare to sit in the sun or come  near
the fire  for  fear  of  being  melted.   Another  hallucinant
thought  he  Avas a  nightingale,  and  sang  all  night;  and
another that  he  Avas a  glass pitcher, and would let nobody
approach  him, lest he  should be broken.   Recorded delu-
sions of a  similar nature are innumerable.  Old writers on 
54
ILLUSIONS AND HALLUCINATIONS.
the subject of melancholy  and insanity  furnish  as varied
instances as the most recent  authorities, and apparently en-
tertain as  correct notions of the causes  of such delusions.
Wierus, an  old  author, illustrates  the  force of  a diseased
imagination by saying that persons  suffering from hydropho-
bia seem  to see the picture of a  dog  still in their water.
And apropos  of hydrophobia,  Dr.  D.  H. Tuke has  lately
published a work on the Influence  of the " Mind upon the
Body," and in it supports the proposition that hydrophobia
is  produced solely  by the  action of the  imagination.  The
author cites cases  where, beyond all  doubt,  hydrophobic
symptoms were developed  without  inoculation.   A notable
instance  is  that of  a physician of Lyons (France), named
Chormel, who, having aided in the  dissection of several vic-
tims of  the disorder, imagined  that he  had been inoculated
Avith the virus.  On attempting to drink he was seized with
spasm of  the  pharynx, and in  this condition roamed  about
the streets for three days.  At length his  friends succeeded
in convincing him  of the groundlessness  of his apprehen-
sions, and  he  at once recovered.  Bush also tells of sponta-
neous cases of hydrophobia from no other  cause but fear and
association of ideas.  A German physician, too,  Dr. Marx,
of Gottingen, is disposed to  take this view of hydrophobia,
and to regard it as a psychical affection,  the result of morbid
excitement of the imagination.  This view is  confirmed by
the fact that young children, who are not acquainted with the
common  belief as  to hydrophobia, may be bitten by  mad
dogs and escape spasms and madness.   We are indebted to
the " Popular Science Monthly " for the  above statements in
reference to hydrophobia.   Certain it is  that this awful affec-
tion leaves no traces of itself on the brain and nerves of its
victim.  But as for  young children being  bitten with impu-
nity by rabid  dogs, we doubt.   Indeed, we know  of cases
proving as fatal to children as to adults. 
ILLUSIONS AND HALLUCINATIONS.
55
  In  countries Avith superstitious forms of religious  belief,
which nobody questions, the most intelligent  traveller feels
the influence of the universal superstition stealing upon him.
The curse of  a  priest in the SandAvich Islands, in the old
days of barbarism, would take visible effect upon its object,
and destroy him.   A superstition gets entire  possession of
the soul, so to speak, of the  ignorant portion of a commu-
nity,  and it  takes generations of culture to rid them of it.
Their imaginations arc possessed by it.   Hence the strength
of old religions, after they have been  proved to be false.
   The hallucinations of the sense  of hearing are the most
frequent.  Amongst  those Avho  are  decidedly insane, this
species of false  perception is infinitely more common  than
that of any other of the senses;  it is not only  one voice that
is heard, but  many;  it is not only the less instructed, but
the intellectual;  it is among  men of  great  imagination and
deep  learning.  It haunts the mind in the form of a demon,
as in  the case  of the poet Tasso, or as Satan Avrangling upon
divinity, as it did with the disputant  Luther  (Avho actually
hurled  his inkstand at the Devil), or as a Deity revealing
his will, with the contemplative  Swedenborg,  Avho gives the
date and circumstances of his first intervieAV  with the Lord
in the most matter-of-fact, off-hand way.  The most  simple
of  the hallucinations  is  that of noises in the car, such  as
sounds made  during  the night  in the chimney.   I have
known an invalid complain of  a perfectly sleepless  night
occurring for Aveeks,  in consequence of the idea that dwelt
upon  her mind that some swallows were building  a nest in
her chimney.  She had  lately returned from the country.
At the end of a few weeks she had  an intermittent fever,
after  which the noises ceased.   A singular case is recorded
in the books as having occurred in Paris in 1831, during one
of those bloody emeutes Avhich have for so long a time been
characteristic of that gay but ill-starred city.  A female saw 
56           ILLUSIONS AND HALLUCINATIONS.
her  husband, a workman, fill dead at her feet, struck by a
ball.   A month after this event she was safely delhrered of a
child ; but the tenth day after her accouchement, delirium came
on.   At its commencement she  heard the noise of cannon,
the firing of pickets, the Avhistling of balls.  She ran  into
the country,  hoping,  in  getting  out  of the city, to escape
from the noises by which she was pursued.  She wTas arrested
and  conducted to the Salpetriere (the insane asylum).   At
the  end of a month she Avas completely restored.  During
ten years, six similar paroxysms took place, and the delirium
ahvays commenced with hallucination of sound.  Ahvays did
this  patient  run into the country to  escape from  ideal dis-
charges of cannon, from firing of guns.  Frequently,  in the
precipitation of her flight, she fell into the water;  tAvice she
threw herself into it to escape the horror of  the sounds that
reminded her of the death of her husband, and recalled the
miseries sha  endured.  Single voices are seldom so common
as tAvo voices, and the subject is oftentimes accompanied and
caused by some emotion in the mind.
   A young  girl heard a voice constantly calling her thief,
and  reproaching her Avith the object stolen.   At length she
returned  the  article,  and the  hallucination soon ceased.
This Avas a  case of conscience as wTell as of hallucination.
Conscience let loose the Furies, hideous hags, upon the mm-
derer in ancient times, giving him no rest, chasing him from
land to land.   Some  females, who haAre led the  most irre-
. proachable lives, have heard voices calling them by the Avorst
epithets.   One of the most singular hallucinations to Avhich
the sense of  hearing lends itself is, to the carrying on a lon°-,
uninterrupted  conversation,  during  Avhich the individual
 speaks, addresses a third party, and Avaits to listen to the
 reply, Avhich seems to be  perfectly neAV to the apparent lis-
 tener, Avho gives every attention.   Who that reads the life of
 Tasso, the great Italian poet  already alluded to, as given by 
ILLUSIONS AND HALLUCINATIONS.
57
his friend and biographer, Manso, does not remember to have
either himself met with a patient Avho has reminded him of
the description, or has heard from a medical friend some tale
Avhich has carried the same marvellous air Avith it ?   Any  one
accustomed to Avhat occurs within lunatic establishments must
have seen patients Avalking up and down, holding an imag-
inary conversation, or must have heard during the night, in
some  cell  or  other,  an  earnest,  long-continued  dialogue.
During the hallucinations  produced  by taking  the Indian
hemp, the intensity of the  sense of sound is most startling.
The celebrated Theodore Gaultier related to Dr. Moreau, in
poetic language, Avhich it is hopeless to attempt to translate
so as to give an idea of the style of the imaginative author,
the sensations produced.  He says that " his sense of hearing
was prodigiously developed.  I heard the noise of colors, —
green, red,  blue, yelloAv sounds, reached me in  Avaves per-
fectly distinct;  a glass  overthroAvn, the  creaking of a foot-
stool, a Avord pronounced low, vibrated  and shook  me like
peals of thunder ; my oavii voice appeared to me so loud that
I dared not speak, for fear of shattering the walls around me,
or of making me burst  like an explosive shell;  more than
five hundred clocks rang out the hour Avith  an harmonious,
silvery sound;  every sonorous object  sounded like the note
of an harmonica  or the reolian harp : I SAvam or floated in an
ocean of sound."
  The imagination is engaged in  a Arery different  manner
Avhere the sight  is in fault, than Avhere hearing is disordered ;
it does not paint  such  exciting scenes; it does not bring
the reason  into action,  as Ave  have seen it  during the dis-
turbance of the latter organ, Avhen conversations sometimes
of  an intellectual character  occur,  AAThere  the  individual
has to listen to the advice, the reproaches, or the threats of
a supposed  stranger.  It  is generally one object alone that
attracts the attention, or that is complained of;  it may appear
under various shapes, but it is more generally connected Avith 
58
ILLUSIONS AND HALLUCINATIONS.
 some idea that has previously struck with great intensity on
 the mind;  thus a person, after being in danger of his life at
 a bridge, saw afterwards  a precipice with a fearful^ibyss at
 his feet.
   Those whose minds  are  strongly  bent  on devotion, and
 have yielded up their thoughts to religion, see  angels and
 the Virgin Mary.  I was once in a church where the clergy-
 man,  who had for some time betrayed symptoms bordering on
 alienation of mind, but Avho never had evinced its actual
 presence, broke off his discourse, pointing to the presence of
 the Holy Ghost.  He was fortunately prevented, by timely
 attention, from becoming insane, but he was considered eArer
 afterwards incapable of resuming his  duties.
   It is not generally known  that the  first Bonaparte was, in
 the early part of his career, subject to an hallucination of sight
 in consequence of the vivid impression made upon his  mind
 by one  of  the occurrences of his eventful life.   In the heat
 of one of the many battles in Avhich he was  engaged, he Avas
 carried, by the ardor of his courage, into the very midst of
 the slaughter. His immediate followers fled ;  he was left alone,
 surrounded on all sides by fierce assailants.   Howr he escaped
 from death unhurt no one was ever able to  ascertain; it Avas
 one of those miracles  which  seemed to be worked by his
guardian genius.  The  deep impression, hoAvever, of the dan-
ger which he had run, was not effaced when he mounted the
throne ; at certain intervals a striking hallucination occurred.
Suddenly, in the midst  of the  silence of  the palace, loud
cries Avere occasionally heard; the  emperor was seen fightinc
with the utmost desperation amongst  his visionar}r foes.  It
lasted but a very short period, but during that time the bat-
tle seemed to be a tremendous one.  This gave  rise to the
report that he was subject to epileptic fits.  These  visions
will not unfrequently  cease  upon shutting the  eyes :  they
more  generally, hoAvever, are permanent.
  Starvation  will  cause  hallucinations of  the sight.  The 
             ILLUSIONS AND HALLUCINATIONS.           59

narratives  of ships Avrecked at sea abound Avith  singular
phenomena;  the famished victims have seen not only beings
before them  luring them on  Avith promised food, but they
have had painted before them the most beautiful scenes which
the imagination can display,— gardens abounding with Hes-
perian fruit, crystal streams,  delicious rills, ever-blooming
flowers, and  all  the fascinations that the poet and the painter
give to the Elysian fields.   Sometimes  angels minister to
them, robed  in celestial garbs, and their last hours are  ren-
dered happy by  the delusions to which the senses gladly lend
themselves.  There are  certain tonics Avhich also have  an
effect someAvhat extraordinary;  of this nature  are the prep-
arations of  iron,  more  especially  Avhen  administered to
delicate females, but neither in my oavii practice  nor in that
of  the many friends with whom I have communicated,  have
I learned any particulars springing from actual experience.
   Hallucinations affecting  the sense of smell are not  unfre-
quent;  but  they seldom  attract  much attention,  and  unless
they exist in unison Avith some more striking derangement of
the sensorial system, afford but  little scope for observation.
It is very generally associated Avith a deranged state  of the
sense of taste ;  but this docs  not necessarily occur.  An in-
sane person  believed firmly that he could  detect the exist-
ence  of cholera by the odor Avhich followed it everywhere.
He Avas first struck Avith it, he  said,  while dining; it came
upon him like  the smell of a dead  body;  he recognized  its
existence  in a  city,  directly he entered it.   Esquirol had
under his  care a female who fancied that she had  a most dis-
agreeable odor about her ; and on being asked to go into the
garden, she refused, on the plea that she Avas Avell aware that
she should kill  all  the vegetables there, by the scent Avhich
she bore.  A certain person insisted that his wife exhaled at
all  times a most ambrosial smell, which captivated all who
approached  her; when  the fact was she was very unsavory 
60           ILLUSIONS AND HALLUCINATIONS.

and untidy, and remarkable for anything rather than clean-
liness.  I have knoAvn patients who  believed  that every
object round them Avas impregnated with some disagreeable
odor.  This is  not at all  uncommon toAvards the termination
of fever.  Those Avho enjoy religious ecstasies among maniacs
speak of the delicious perfumes, of the divine exhalations,
of the  camphor, the myrrh, the frankincense;  the food is
holy manna, and the blood  is that of the lamb,  SAveet and
savory.   The language used by  the poor beings is generally
that  of  happiness, and they are frequently made partakers
of some delicious repasts,  Avhich  ordinary mortals know
not of.
  The hallucination  of touch varies exceedingly.   It is sin-
gular enough to find, in an establishment where an individual
has been  admitted Avho believes  that  he has  rats  craAvling
over him, that spiders infest him, that he recehres occasional
1)1oavs from an unknoAvn hand, hoAV A'ery soon several others
of the confined persons take up the same notion;  and if by
any chance suspicion  falls  upon any  attendant that he has
been  accessory  to  a bloAV, all  the  others Avho  complain,
Avhether from cunning or from the Avish to obtain the com-
passion  Avhich  is generally shown, load the  servant Avith
charges  of being the person who annoys them.   Some inva-
lids will insist on it that cold water has been thrown on their
heads; others that corrosive substances and poisonous pow-
ders have been thrown upon them ; that hence their bodies are
metamorphosed;  that they are  unlike Avhat they were, and
that they are grossly maltreated.   Some of them cannot bear
the  slightest breath of air to Woav upon their bodies ;  those
who have witnessed the horror expressed by patients labor-
ing under hydrophobia Avhen the least air falls upon them,
can judge  of the horror which some  experience  when they
fancy that they  are blown upon.
  An actress who had become melancholy, after expatiating 
ILLUSIONS AND HALLUCINATIONS.
61
Avith considerable  energy upon the miseries which were in-
flicted upon her  by unknown hands, added, " They are not
satisfied  with these  cruelties, but they are  employed blow-
ing, night  and day,  ingredients Avhich destroy me,  upon my
skin, Avhich is  as pure  and unsullied  as  my heart."  Many
patients believe that they have swallowed animals, reptiles,
insects ;  and even those Avho have no other indication of the
slightest alteration of  intellect,  cannot  be induced  to lay
aside the impression.   Sometimes they beat the stomach and
bowels with  great  Anolence, often wounding  and severely
hurting  themselves.  They assert that the internal  organs
have disappeared; they knoAV it  by the sense  of emptiness,
by the hollowness  of  sound.   They occasionally accuse a
friend of being the cause, or they lay it at the door of  some
one to whom they have  taken,  without apparent cause, a
violent aversion.  Spiders and  mice are frequently charged
with being the cause of the mischief, and of having entered
into  the stomach.   Sometimes  the head  is  very light, at
others it is enormously heavy;  sometimes one arm is longer
than another; there may be three arms, — in fact, Avhen the
sense of touch and the general sensibility  are disordered,
hallucination  appears  in  a  thousand  indescribable  forms,
altering every day, and  exhibiting itself under the  most
extravagant guises.  Sleep vanishes under their influence;
day and night, for a series of years, are the unfortunate indi-
viduals haunted and persecuted ;  devils take them by the feet
durino* the night, strike them  constantly upon the back at
the moment when they most require repose; they  are seized
by  vampires,  Avho  during the  night suck the blood  from
their veins till atrophy and deformity  of their organs  take
place.   Invisible  agency  is constantly at work.   In   such
morbid  phenomena  as  these, undoubtedly Salem Avitchcraft
had  its  rise.   The  bewitched people  were the subjects of
hallucinations of hearing, sight, and touch.  There are  cases 
62
ILLUSIONS AND HALLUCINATIONS.
— especially in diseased states, such as delirium tremens —
in which the senses  all partake of the hallucination alike;
the eye, the touch, the hearing, the smell, and the taste are
so disordered as  to convey unhealthy  impressions  to the
brain.   Most generally one of the organs so predominates
over the other,  that its deviations only are complained of;
it is  only  by examination  of  the invalid, and  by repeated
conversation, however,  that this is perceptible.  At a  lead-
ing insane asylum there is at present a female, about sixty-
five years of age, who has now  been of unsound mind for five
or six years; she makes daily complaints  of the frightful
sufferings she has to endure, and which are consequent  upon
the hallucinations in which all her senses  are wrapt.   At
night she sees  forms  that  menace her, — heads of bodies
which  frighten  her.  Sometimes  it is  her  oavu image, her
oavii portrait, that is represented to her.  Once she saAV her
mother, Avho has been some time dead, crawl towards her
on four paAvs. She constantly hears voices which insult her;
oftentimes  they  tell her  melancholy tales, — for instance,
they repeat that  her mother is dead.   They send the bodies
of putrefying children to her.    She has  sometimes the  com-
plete  odor  of arsenic.   This  Avoman  Avill eat  nothing but
bread, because both flesh and  vegetables taste  of  arsenic.
Besides all this, she receives blows upon the head—upon
the limbs.   They give  her cramps  in the legs, icy  sweats,
colds ; they take away her breath,  and drive the blood to her
head.
  Sometimes an individual gets a fixed idea,  which remains
knoAvn only to himself.   He struggles Avith it  perhaps  for
years, nor reveals the  contest  going on within  him.  This
" fixed idea "  may be either to destroy himself,  or to kill  some
near and dear relative, a Avife or mother, for instance.  It is
only when the madness  bursts  out Avith uncontrollable vehe-
mence in  the perpetration  of the terrible act, that  it  is 
ILLUSIONS AND HALLUCINATIONS.            63
known.  The suicide has long fought Avith himself, before
he has  rushed to the fatal extreme; the homicidal maniac
conceals for an immense length of time the horrors by which
he is pursued; and it is  only Avhen he can bear his fate no
longer, that  he divulges his  long-kept  secret.  There  are
cases recorded  Avhere men  laboring  under the murderous
mania have had themselves bound hand  and foot, notifying
the persons Avhom they felt irresistibly impelled to  kill, of
the state of  mind in which they were.   Sometimes the pas-
sion of fear will take  complete possession of a person.   He
has a dread of the most overAvhelming kind, which gradually
groAvs into a most complete oppression, weighing doAvn all
the other faculties of mind.   It  is utterly in vain that he
endeavors  to drive aAvay the fixed idea; it remains rooted
to the very inmost part of his being; the very circumstance
of his attempting to  drive it from  him only roots it deeper.
At length, completely overwhelmed with the intensity of the
suffering, he yields  himself up  to  that  sole  persecuting
thought; there is a  complete personal  inertia, Avhich for-
bids him to mingle further Avith the world ; the consciousness
of surrounding objects is lost, as well as that internal  con-
science Avhich governs  the  internal actions  of man.   The
result of this state of mind is quickly conveyed to the body,
Avhich not  only sympathizes  with it, but  is completely gov-
erned by it;  it is not only that the appetite fails, the poAver
of enjoyment, and the desire for  locomotion,  but the nutri-
tion of the  body ceases, the  secretions  are  not duly  per-
formed, the circulation becomes  languid, and all the organs
are in a state of torpor; this proceeds, gradually increasing,
till there is an almost complete suspension of all the powers
by Avhich life is carried on ; the blood, no  longer oxygenized,
is full of carbon ; it sloAvly meanders through the liver, Avhere
the A-cins stagnate wTith their fluid; the brain  is after  some
time surcharged Avith this venous blood, and that state Avhich 
64           ILLUSIONS AND HALLUCINATIONS.
approaches  the  third  stage  of intoxication  supervenes.
During this crisis there is, as iu ordinary insanity, a sudden
change  for the better where relief is  obtained;  but where
it  has not been watched and prepared for, there is a violent
paroxysm, Avhose intensity bears proportion to the previous
depression.   This action and  reaction, so  strongly marked
iu intermittent fever, affecting that  portion of the nervous
system which is contained Avithiu the spinal column, produc-
ing  the  phenomenon in  its greatest  extent, of  universal
tremor, acting upon the brain, evidently causes a large por-
tion of that Avhich is displayed in the insane, under the guise
of alternate depression  and  excitement.
   The sudden crisis,  Avhich leads to  sudden, impulsive acts,
in the insane that had previously exhibited the form only of
imbecility and stupidity, most probably depends upon some
altered  state  of  the  arterial circulation, some  momentary
determination to  the  brain;  and, Avere we  folloAvers  of the
doctrines of Gall and Spurzheim to their fullest extent, we
should be naturally led to inquire whether the organ upon
which they  assert that homicide depends, was the seat of
some instantaneous action.   When Ave find that there exists
in nature vegetable substances Avhich produce this effect, or
which suddenly call into action the desire for spilling  blood,
we must grant that this is OAving to some condition  of the
brain, produced by a physical agent.
   It is not brandy or Avhiskey alone that Avill, in  some con-
stitutions, cause a fearful ferocity (vide the daily accounts of
crime in NeAV York city among  the thugs  of that metrop-
olis), but there is a vegetable, a species of mushroom, called
Ornanita  muscovia, whose effects are of the most striking
                                                        o
character.  Some of  the Cossack tribes never go to  battle
without adding a portion to the spirituous liquors which they
take, and they become inspired Avith a blood-thirstiness which
nothing can resist.  Even the  Cannabis indica has been known 
             ILLUSIONS AND HALLUCINATIONS.           65

to inspire  even a reflecting and humane individual with  a
desire for destruction ; it? often fills the mind with an impulse
that cannot be resisted.  On one occasion, Avhen Dr. Moreau
had himself  taken it, by Avay  of  experiment, he  piteously
entreated that the Avindow should be immediately shut, as he
felt coming over him an irresistible propensity to throAV him-
self out. 
CHAPTER IX.
                SLEEP AND SLEEPLESSNESS.

  What refreshment and reinvigoration good  sound sleep
brings to jaded, deranged nerves !  Sancho Panza blessed the
man who invented sleep.  It is, indeed, the best medicine of
nervous disease, and it is precisely the most difficult thing for
the nervous patient  to obtain,— that is, good, sound, natural
sleep.   People may sleep too little or  too much, too early
or too late.   OA^ermuch sleep leads to corpulence, sluggish-
ness of the general functions, congestions of the chief viscera,
especially of  the head, endangering attacks of apoplexy and
death.   It is the bon vivant who is disposed to sleep ; a doze
in his easy-chair after dinner, and an inclination to nod over
the newspaper or during a prolonged discourse.  The Avell-
nourished require more sleep than the lean, and the phleg-
matic more than the irritable.   But in the present day som-
nolent obesity is a rare phenomenon.  The evil that we have
to complain  of,  is  an  incapability  of  sleeping  enough.
There  is no  fixed  duration for sleep.   "The  world roars
around  us  like a torrent of events.   Everything is rapid;
and Ave are whirled Avith velocity in the midst of a vortex as
vast as it is incessant.  Repose there is none;  and instead
of sleeping on a pillow of down, we stand continually on the
tiptoe of expectation, awaiting  the coming on of to-morrow,
big, as it were, with the  doom  of some  great  hereafter.   It
         [66] 
SLEEP AND SLEEPLESSNESS.              67
is impossible to sleep ;  nay, it is scarcely possible to survive.
This morbid excitement, fictitious though it be, is in reality
the pregnant source of a  large family of ailments, of which
mania  is  neither  the  youngest nor  the most insignificant
child.
  A sleepless night cannot be recovered from by any sub-
sequent siesta snatched out of the business of the day.   We
must wait for the following night, go to bed early, and sleep
soundly, if  Ave hope to awake refreshed  the next morning.
Nor can exhaustion from the want of sleep be relieved by
stimulants,  either in the shape of food or  medicine, although
the late hours of the modern world, which induce a perpetual
lassitude both of mind and body,  are alleged as one of the
chief reasons, if not of the poor excuses, for  indulging in
Avine and hot condiments.   There is a  form of conditional
drunkenness to which people in  good society are addicted,
without being aware of it, that produces effects quite as per-
nicious as dram-drinking among the loAver orders : Ave mean
the free use of Avine at  the dinner-table.    Such persons with-
out  suffering in appearance,  or losing flesh, get  into  a
chronic state of disturbed  health, manifested by impaired'
digestion and irritable  nerves.  Deprived of his usual mod-
icum, the gentleman is unable to sleep,  and becomes in  a
certain degree  delirious,  unless  allowed  to  return to his
ordinary habits.  There is likewise a chronic sleeplessness,
chiefly among  the  better classes, Avhere individuals  suffer
from an almost total want of rest for  months together, Avith-
out any loss of  flesh, or visible  impairment of the constitu-
tion.   Such cases get  well of themselves, after a  shorter or
longer period,  and  do not  require any medical treatment.
  The evil  consequences of  not sleeping enough are clearly
manifested  iu the  features,  which become  pale, lank, and
sharp ; the eye cold, blanched, and watery ;  the hair shabby,
straight, and long ;  the deportment wan, and the feelings Ian- 
68              SLEEP AND SLEEPLESSNESS.
guid.  The palms  of the  hands are hot, the lips  dry and
peeling, and the  utterance feeble or tremulous, while a Ioav
fever feeds upon the vitals.  If the  want of sleep  is volun-
tary, as in the pursuit of some necessary or interesting occu-
pation, or in consequence of fashionable engagements, it saps
the strength at an early period;  men become old  at thirt}'-
fh'e  or forty;  and women, wasted in their prime, suffer from
difficult childbirth,  or die in consequence of it.  A city life
is most baneful in this  respect, and may be  considered  as
limiting the average of longevity to forty-five or fifty years.
   Those Avho go to bed late rise early, and early risers are
for the most part forced to retire equally early.  Students,
who require more  sleep than  others, usually rise too early,
and  sit up too late.   Modern fine children, who are taught
to mimic their elders, are exotics, flowering in an  artificial
atmosphere, but withering Avithout fruit long before  the
morning of their  days  has  passed over their debilitated
heads.  Nor learning nor fame nor money  nor power  is
equivalent to an  elastic, Arigorous constitution; nor are the
lesser virtues usually styled accomplishments, pleasing and
'graceful as they may be, of any value in comparison with the
decrepit nerves,  and the  still more decrepit morals, Avith
which they have been purchased.
   The older physicians  paid much more attention to  this
inquiry than modern  physicians and physiologists are accus-
tomed to do.  Hippocrates long ago pointed out the impor-
tance of denoting the kind of sleep, the nature of the dreams,
and  the particular posture of the sleeper in bed, as  an acces-
sory means  of  forming a correct diagnosis  of his  disease.
Allowing for some  puerilities  peculiar to the remote  epoch
in Avhich he flourished, the fourth book of his treatise, entitled
"Regimen," is a much more practical essay on this subject
than anything else of the sort that has yet been put forth by
later pathologists.   Although  Dr.   Marshall  Hall  observes 
SLEEP AND SLEEPLESSNESS.              69
that sleep is a cerebral affection, and that the spinal and gan-
glionic systems  never sleep, yet  our notions are, Ave cannot
help aAroAving, somewhat different from  his on this subject.
It seems to us that the poAver of  sleeping is much more inti-
mately  connected Avith the  medulla oblongata  and  spinal
cord, than with the cerebrum aud  superior portions  of the
hemispheres.   The whole ner\"ous system is a unit or entity,
in its essence compounded of distinct parts, entirely  united
in their different, but by no means separate functions.   The
intellectual powers would seem to  belong  to the cerebra,
perhaps  to the  cortical substance, or gray matter alone,  as
some suppose; the  several senses Avould appear  to have
their origin or root at the base of the brain ;  the  faculties of
the mere animal organs are apparently governed by the cer-
ebellum, Avliile those of locomotion, speech, respiration, etc.,
are  evidently connected Avith the pons variolii, the medulla
oblongata, and  the  spinal cord.   Noav sleep  is  an absolute
suspension of sense and  motion ; but then  these tAvo func-
tions, or sets of functions, are under the  rule of the  spinal
cord;  so that the  spinal cord Avould  seem to be the  imme-
diate locality, if not the true centre, both of rest and action,-
progression and repose, locomotion and inertia,  or, in other
words, of  waking and sleeping.
   There are  several  physiological as  well as pathological-
phenomena confirmath'c of this view of the case.  It has been
proved that the pupil of the eye is closed almost to a point
not larger than a pin-hole during sleep ;  that the eyeball like-
wise is turned upAvards, and that the upper eyelid falls down.
These phenomena are also the symptoms set down as indicat-
ing disturbance at the base of the  brain among the diseases
of that organ.   For a very contracted pupil is almost ahvays
a fatal sign, by shoAving  loss of power at  the  origin of the
respiratory nerves, Avhether from  effusion  or  injury  or  4
natural  dissolution.    The turning upwards of the eyeball 
70             SLEEP AND  SLEEPLESSNESS.
  is a common symptom of convulsive affections proceeding
  from spinal irritation, or mechanical mischief of that  part.
  And the drooping of the eyelid is  indicative of incipient
  paralysis, or loss of power, in the cord and medulla oblong-
  ata, often forerunning paraplegia, loss of speech, and failure
  of the locomotive poAver in general.  These signs, wrhich are,
  physiologically speaking, in  one sense the phenomena of
  ordinary sleep, become,  in another, leading symptoms  in
  the natural history of disease of the  brain; and both the
  symptoms  on the  one  hand, and the  phenomena  on the
  other, point  directly to one  part of the grand  system of
  nerves,  namely, the medulla oblongata and the spinal  cord.
     That sleep should be less connected with the cerebrum than
  with the spinal cord is not so unlikely, if Ave consider the
  nature of each part of tlie nervous system respectively; for
  we shall be enabled to remark, that sleep, Avhich is the sus-
  pension of action, belongs to the spinal portion rather than
  to the brain or cerebrum, which, as the focus  of Avill and
  intelligence, only  exerts itself in governing  the rest of the
  frame, and ceases from exertion as  soon as  the rest  of its
  parts cease to require governing.  Disturbance of the  supe-
  rior hemispheres will of course  hinder the  cord from sleep-
  ing quite as effectually as  irritation of any other  part  of
  the body Avould do;  but Ave mean  that, in  health,  sleep
  belongs  to the  cord rather than to  the brain.  Wakeful-
  ness is  one of the most  vexatious symptoms of  spinal dis-
  ease ; of spinal exhaustion from venery, or excessive pedes-
  trianism; of spinal irritation produced by a sort of  reflex
  action  from acid  indigestion accompanied with  cramps  of
  the legs, and of profuse diarrhoea,  exhausting  the  spinal
  cord  so  greatly as to give  rise to incurable  paraplegia.
  All these signs, symptoms, and  phenomena lead to one and
► the  same conclusion, — that  the spinal cord,  rather than
  brain,  is chiefly concerned  in sleep and sleeplessness.  But 
                SLEEP AND SLEEPLESSNESS.              71

the ablest psychologist must  admit that it  is  beyond his
poAver to  explain the nature of sleep.   The  best Avorks on
physiology offer us nothing more  satisfactory than probable
opinions,  curious conjectures, and interesting theories, Avhile
pretending to solve a problem which still remains, as it has
hitherto remained, the monitor of the end of all things, —the
daily  rehearsal of our death.  There are'some curious in-
stances on record of sleeping and Avaking.  In Turkey, if a
person happens to fall asleep in the neighborhood of a poppy-
field,  and the  wind blows over toAA^ards  him, he becomes
gradually narcotized, and Avould  die, if the country  people,
Avho are Avell acquainted with the circumstance, did not bring
him to  the next Avell or  stream,  and  empty pitcher after
pitcher on his face and body.  There is a  reported case of a
gentleman,  thirty years of  age,  Avho, from  long-continued
sleeplessness, Avas  reduced  to a  complete living skeleton,
unable to  stand on his  legs.  It was partly owing to disease,
but chiefly to the abuse of mercury and opium, until at last,
unable to pursue his business, he sank into  abject poverty
and avoc.
   The poAver of Avill may obtain  or dissipate  sleep.   Some
persons have the power of Avilling themselves asleep  as soon
as they lie doAvn.   There is  no doubt that the habit of doing
so may be easily acquired.   Some people require vastly more
sleep  than others.   There are cases recorded of people sleep-
ing seventeen or eighteen  hours a day for years, or taking a
solid  nap a month or  six Aveeks in length,  while in  other
cases  four or five hours' sleep in the twenty-four was  all that
Avas taken or needed by persons remarkable for their  activity
and influence over mankind.  According to Wilkinson, the
ancient  Egyptians, who, as  everybody knows, shaved their
scalps, slept Avith their heads resting on an iron prong, like
that of  a  pitchfork, welted Avith  something soft.  This they
did for the sake of keeping their heads  cool, Avhich they sup-
posed strengthened their Avits. 
72
SLEEP  AND SLEEPLESSNESS.
  The sentinel will sleep at his  post;  an entire battalion
of  cavalry have  been  known to  sleep  on the  march.   It
is  about three  or four o'clock in the morning that this pro-
pensity to sleep  is the most overpowering,—the moment
seized upon by troops for driving in the enemy's  outposts,
and taking the bivouac by surprise.  Maniacs are  reported,
particularly in the eastern hemisphere, to become furiously
wakeful during the full of the moon, more especially when
the deteriorating ray of its polarized light is permitted to fall
into their apartments, —hence the name lunatics.  Sleeping
directly in the  moon's rays is said to be at all times preju-
dicial.
  There is certainly a greater pronenesT to disease dur-
ing sleep than in the waking state;  for those  Avho pass
the night in  malarious districts inevitably become infected
with the noxious  air, while  travellers who go through Avith-
out stopping  escape the miasma.   Intense  cold induces
sleep, and  they Avho perish  in the  snow sleep on till they
sleep  the  sleep of  death.   Children sleep  a great  deal;
infants much more irregularly;  while the old man scarcely
slumbers at all, watching, as it were, his  end approaching
The bromides  of  potassium, etc., are now greatly used  to
drug  the posset of repose in disease  and nervous attacks.
Allowing  the patient to get up and Avash  himself  and walk
about his room, making his bed afresh, giving him a glass of
cold water, or Avine and Avater, avlII often succeed in procur-
ing refreshing sleep Avhen all other means have failed.   These
are practical points  calling for experience  and judgment  in
their application.  In these instances of Avakefulness, which
are frequently observed towards the close of acute diseases, it
is always necessary to repeat the soporific or opiate for some
time after the first symptoms have been checked.   The same
practice is likewise pre-eminently useful in the first stage  of
delirium tremens, in its  congestive onset, before the sub- 
SLEEP AND SLEEPLESSNESS.
73
acute inflammation and milky effusion  have ensued.  The
irritability, watchfulness, and phantasmagoria of this peculiar
malady are best treated by a combination of bitters, alkalis,
and opiates, or else Avith tonics and opiates at the  same time.
Sometimes hot sponges applied to the head will cause sleep,
and  sometimes  cold.   Nothing Avill relieve the wakefulness
of old age ;  nor should soporifics, particularly opium, ever
be tried, since the dose that is  sufficient to procure sleep,
may end in death. 
CHAPTER X.
                        EPILEPSY.

  Those who have attended the lectures of Brown-Sequard,
the greatest living neurologist, well remember how he pro-
duced the convulsions of epilepsy in a guinea-pig.   This will
illustrate the insight wdiich is being obtained into the physi-
ology and pathology of the ner\Tous system.  Epilepsy is the
most celebrated  of the  neuroses.  " It  is," says Hammond,
"characterized  by paroxysms  of more or  less frequency
and severity, during which consciousness is  lost, and  Avhich
may or may not  be marked by slight spasm, or partial or gen-
eral .convulsions, or mental aberration, or by all these circum-
stances  collectively.   The essential element of the  epileptic
spasm  is  loss of consciousness."   Some  very famous men
have been  epileptics.    There  are  slight  paroxysms and
severe.
  "The respiration  is  forced and irregular,  froth   issues
from the  mouth, and, if the tongue has been bitten, it is
covered with blood."  During the seizure the epilept is liable
to make the most outrageous  and furious demonstrations.
Some of the greatest writers have been epileptics.   One of
the greatest living British poets is said  to be.  Dr.  Ham-
mond gives  as causes of epilepsy in one hundred and two of
his  cases, fright, anxiety, grief, over mental exertion,  denti-
tion, indigestion, venereal excesses, menstrual derangement,
                [74] 
EPILEPSY.
75
bloAVs on  the  head, falls, sunstroke,  scarlet fever, measles,
diphtheria, pregnancy, syphilis.  The starting-point  of epi-
lepsy, according to Brown-Sequard, is often the sympathetic
nerve ;  but generally the  seat of primary  derangement  is,
according  to  Reynolds, the medulla oblongata  and  upper
portion  of the spinal cord.   The derangement consists in a
perverted  readiness of  action in  these  organs,  the  result
of such action  being the induction of spasm in the  contractile
fibres of the vessels supplying the brain, and in  those of the
muscles of the face, pharynx, larynx, respiratory  apparatus,
and limbs generally.  By contraction of the vessels the brain
is deprhTed of blood, and consciousness is arrested; the face
is or may be deprived of blood, and there is pallor; by con-
traction of the. vessels,  which haAre  been mentioned,  there
is arrest  of  respiration,  the chest  walls  are   fixed,  and
the other  phenomena of the  first stage of the  attack are
brought on.   The arrest of breathing leads  to the  special
convulsions of asphyxia.  The subsequent phenomena are
those of blood poisoned by the retention of carbonic acid,
and altered by the absence of  a due  amount of oxygen.   It
may be induced by conditions acting upon the nervous centres
directly, such as  mechanical injuries, overwork, insolation
(sunstroke),  emotional  disturbances, excessive venery, etc.
The  bromides of potassium, lithium, and sodium, and the
oxide of zinc,  are invaluable remedial  agents in the treatment
of epilepsy.   It  was anciently called the  falling sickness.
The importance of hygiene in this neurose is considered equal
if not superior to that of medicine.   There are some  prac-
titioners,  even, who look upon medicine as utterly useless in
such  cases, and place their sole reliance on  such measures as
serve to guard the  patients against the causes Avhich induce
the fits, and  favor the  action  of such natural agents as are
capable of changing the constitution.  Hippocrates recom-
mended a change  of climate. 
76
EPILEPSY.
  Epileptic fits are much more common  in extremes of heat
and  cold  than in  a climate  little  subject to  atmospheric
changes.  Excess in quantity or  quality of  food or drink
Avill  prove  injurious.   More  vegetable  than  animal food
should  be taken,  and  cooling fruits  may  also  be used.
Complete abstinence from wine, or at any rate the use  of
the least stimulant Avines, is recommended, and  such should
only be taken in moderation.   Those patients who are liable
to be  attacked during  the night, should make  but a light
supper, to avoid increasing the cerebral plethora, which is
always  greater during  sleep.   Cleanliness, baths, frictions,
and Avarm clothing are requisite.   The  hair  should be cut
short; in bed the patient should lie with his head high, to
assist the  circulation of the blood  through the brain.   Con-
stipation should be avoided.   Continence is  essentially the
virtue  of the epileptic; sexual intercourse produces a ner-
vous shock, which too closely resembles the  emotion which
occasions the epileptic attack, not to be  attended with great
danger.   Those who practise onanism have  in  general the
greatest number of fits.   A peaceable and quiet  life suits the
epileptics best.   Exercise is  very salutary;  an inactive,
sedentary life increases  the morbid  predisposition, and ren-
ders  the consequences of the fits more deplorable.
  Gardening, horse exercise,  the gymnasium, swimming,
etc., are recommended.  But out-door work, such as  agri-
culture  and  gardening,  are the best exercises.   Variety of
occupation,  intermingled  with amusing  relaxations, will
prove  serviceable in cases of epilepsy.  Intellectual em-
ployment  requiring  deep thought  is injurious.   Reading,
draAving,  music,  light  compositions, and the  elements  of
chemistry, botany,  physics, etc., afford great   satisfaction,
and sustain  the  moral poAvers  instead of exhausting them.
With respect to the treatment during  the fit, it resolves
itself almost entirely to the prevention of bodily danger by 
EPILEPSY.
77
falls or otherwise.  The patient should generally be placed
on his back in bed, all  tight articles of  clothing removed,
the head a little raised by pillows, in order to diminish the
determination of blood  to the head,  and  the body placed a
little on one side, in order to favor the discharge of saliva,
Avhich collects in  quantity in the mouth, and might otherwise
prevent the  passage of air into the lungs.   Some patients,
Avhen attacked during the  night, have an unfortunate  ten-
dency to turn on the face, and unless carefully watched, and
their position changed, may die asphyxiated.   Another acci-
dent, which occurs in  some instances, is the laceration, or
even the amputation, of the  tongue during the fit.  To pre-
vent this, a piece of  wood, or a linen roll, may be placed
between the teeth, when the fit is coming on. 
CHAPTER  XL
               THE SUICIDAL  PROPENSITY.

  It is said that as long as the most instant and efficient
agents of self-destruction are openly sold  in every street, at
little or no price, and to  any purchaser, Avithout either let or
hinderance, so long will suicides  be  frequent, and even in-
crease.  The victim of the more extreme forms of nervous
disorder, from Avhatever  cause  arising, undoubtedly feels at
times a propensity to suicide, even the valley of the shadow
of death seeming to him a refuge from the ills of a deranged
nervous system.  The inventor of the revolver has probably
furnished to the suicidally given the most efficient means of
self-destruction.  The Avriter was once talking, in his office,
with a patient suffering from nervousness, who was detailing
his  misery and  Avretchedness, Avhen, in the midst of his ac-
count of his condition, he suddenly dreAV a revolver, and put-
ting the muzzle to his head, said he had a mind to bloAV his
brains  out on the spot.  He had cocked the weapon, and the
least motion  of his tremulous forefinger would  have been
fatal.  Here was a dilemma.  With the utmost sang froid,
the  writer pretended to be struck by some peculiarity of the
weapon, and quietly requested of his patient permission to ex-
amine it, at the  same time expressing a Avish to compare it with
a revolver belonging to himself, which was in a neighboring
closet.  The Aveapon Avas politely handed over for examina-
             [78] 
THE  SUICIDAL PROPENSITY.              79
tion, AA'hich of course terminated the possibility of a tragedy
at that consultation.  It is a fact that suicides are increasing
to an alarming extent in this  country.   The most influential
causes of  suicide in a free,  enterprising, commercial com-
munity like ours are the  range given to the social passions ;
the hazard and losses in mercantile and joint-stock specula-
tions  and  companies; habits of dissipation ;  the  indolence
and  ennui  consequent  upon  Avealth and  sated  enjoyment;
the importance attaching to  public  opinion, and  the insta-
bility of that opinion;  the violent shocks and collisions  of
opposing parties, and the details of crime and suicide which
constitute  a principal part of  the daily reading of all  classes
of the community.   The history of  all nations  has demon-
strated the prevalence  of this  act, both as a disease and a
psychological  phenomenon,  during  periods  of  surpassing
luxury, of criminal  debasement, of public commotion, and
of the decline of public and private spirit and virtue.
   A French Avriter remarks  that  the high civilization and
refinement, the luxury, the clash of interests, the  repeated
political changes, combine to keep the moral feelings of the
Parisians in a state  of tension.   Life .does not roll on in a
peaceful and steady current, but rushes onward  Avith  the
force and  precipitation of a  torrent.  The drama of life is
full of miscalculations,  disappointments,  disgusts, and  de-
spair ; hence the  numerous  suicides.
   When a person labors under a suicidal mania, Ave believe
it may  generally be recognized by other signs; as deep
melancholy, eccentricity of  conduct, etc.   Most  of those
suicidally  inclined  labor under a  constant  depression  of
spirits, presaging  nothing'but ev;l;  imagining  that they
l«wc  committed some heinous offence; that their  friends
have  forsaken  them,  and ate  Avatching their movements;
that they are hated and  despised  by the world; they com-
plain  of  neglect; become morose and taciturn;  utter bitter 
80
THE  SUICIDAL  PROPENSITY.
complaints; weep;  say  they  have committed  the  unpar-
donable sin; that their damnation is inevitable, etc.   More
or  less  bodily  derangement  is usually present  in these
cases,  as  a  weak  and irritable  nervous system, quickened
circulation,  imperfect  digestion,  and  especially  derange-
ment  of  the  liver  or hepatic  function.   After this  state
has continued for some time, the mental derangement be-
comes  more  prominent,  and the Avretched victim  begins
to see visions and to hear strange voices, and believes that
he  has communications  from   superior beings.  At this
time the  idea of self-destruction is frequently if  not con-
stantly before the mind, and unless  the patient be  narrowly
watched, he will finally  succeed, after  A^arious attempts, in
accomplishing  his purpose.   Suicides  are most  frequent
among persons of the melancholy temperament and  bilious
constitution, Avith a pale or sallow or yellowish complexion,
and hard or sharp features.  But  the  suicidal  act  is  not
infrequently committed by the  nervous  and irritable,  and
even by the sanguine and plethoric.  Females of this latter
constitution occasionally attempt or perpetrate  self-murder
just before  or during the catamenia, or from some  irregu-
larity of this evacuation.  M. Esquirol states, that the scrof-
ulous diathesis  is remarkable  in the number of  suicides.
Both sexes display the suicidal tendency, but the  male sex
most frequently.  M. Esquirol  considers the proportion of
males  to  females to  be three to one; but  there are differ-
ences according  to countries, arising from the greater or less
influence of many of the  circumstances  shoAvn to favor this
act.   Thus in France there are more suicides among  women
than in Germany.   It has been .observed, both in England
and on the continent, that nearly t\vo thirds of suicides were
unmarried.  This  state, therefore,  is much more  favorable
to self-destruction than the married  condition.   Suicides in
states of mania  or delirium occur either from some involun- 
THE  SUICIDAL PROPENSITY.
81
tary or blind impulse, or from some delusion, hallucination,
or false perception.  A patient  for whom I was  consulted
during an attack of mania, from Avhich he recovered, expe-
rienced after a time similar symptoms to those Avhich ushered
in the former attack.  His friends Avere directed to take the
necessary precautions  regarding  him;  but these he eluded,
and committed suicide.  In melancholia, and other states of
partial insanity, or even previously to any symptoms of in-
sanity being sufficiently prominent to attract notice, or  in
consequence of some mental  shock or perturbation, the pa-
tient may conceive that an  internal voice calls upon him  to
commit suicide, and may sometime act in  conformity Avith
it.   A lady consulted me on  account of headache, during
which she could not look upon a knife without experiencing
a strong desire to use it against her  own life ; but her reason
had always resisted the  impulse, which  disappeared  after
treatment.  Among persons wTho have  been but little accus-
tomed to self-control, or to listen to  the  dictates  of moral
principles, such impulses  are  often soon acted upon.  M.
Esquirol furnishes  several instances.
   A  monomaniac,  he  states, heard  a voice within  him  say,
" Kill thyself! kill  thyself! " and he immediately obeyed the
injunction.   This writer remarks, that he has never known
an  instance of suicide from an irresistible impulse, without
some secret grievances, real or imaginary, serving as motives
to the suicidal propensity.   There  are few states of partial
insanity that may not  be attended  or followed by this pro-
pensity.   Of the delusions which characterize melancholia,
there are none more productive of self-destruction, as  Dr.
Darwin has remarked, than the fear  of future damnation
and of present poverty, although the former apprehension
otoavs less and less operative from the softening of the penal
parts of religious creeds.  Reverses, mortified pride, impa-
tience under misfortune, and  disappointments, are frequent
causes of  suicide,  especially in commercial countries  and 
»
82              THE SUICIDAL PROPENSITY.

under free governments, Avhere there is a constant straining,
among almost all classes, after Avealth, office, and other direct
or indirect  means  of power.  Instances  of self-destruction
from mortified pride, consequent upon the failure of attempts
at becoming conspicuous at  public meetings, in the senate,
or at the bar, or even upon the boards  of a theatre, are not
rare in modern  times.   Self-murder has been often perpe-
trated in  order  to  escape exposure and  punishment conse-
quent upon detected crimes.   Indeed, this is one of the most
common moral causes of suicide  in this and  other  civilized
countries, and instances of it are of  daily occurrence.  The
desire of  escaping from moral or physical pain, or from an-
ticipated or  impending \vant, is not unfrequently productive
of self-destruction.    Under this head may be  comprehended
seduction, and despair however produced.  Physical pain  is
much less frequently a cause of suicide than moral suffering.
Man}*, however, of the ancient stoics put an  end to pain by
terminating  their Ih^cs.   I have been told by several persons
that, Avhile suffering the  pangs of neuralgia, it required the
utmost efforts of their moral principles to restrain them from
perpetrating self-murder.  Numerous instances are on record
of persons who, having believed themselves suffering incur-
able maladies, have had recourse  to suicide as a more pleas-
ant  mode of dying, the act  being committed under the
impression that  a natural death is more painful than that  in-
flicted by themselves.  But this is  a mistake.  Death  from
disease, even when the mental faculties are retained to nearly
the last, is attended by a gradual abolition of  the sensibility
that is by no means painful or distressing; the patient ceas-
ing  to exist  as hopefully and calmly as  Avhen  fallino- asleep
unless under peculiar circumstances.  Suicide is often com-
mitted in  sjtates of irritation and chagrin, particularly by per-
sons of a morose, splenetic, or irritable  temper.   It  is some-
times suggested to such persons by a desire to excite regrets 
                THE  SUICIDAL PROPENSITY.              83

or self-reproach in the minds of those Avho  have offended
them by a  feeling of revenge.  Most of the suicides  com-
mitted by children  are  caused by a desire of this  kind, par-
ticularly Avhen  they folloAV punishment  of any description.
Suicide arising from  jealousy also depends chiefly upon the
promptings of  this feeling in connection with anger, and  is
most apt to  occur in hysterical, nervous, or weak-minded
females.
  Some years ago I Avas present at an evening party, Avhere
a young lady, engaged  to  a gentleman  present, was seized
Avith hysterical convulsions in consequence of his attentions
to another.   The following day she Avas taken out of a  canal
in her full dress, she having gone upwards of a mile in  order
to carry her design  into  execution.  A lady on  a similar
occasion took  a large quantity  of laudanum.   The  usual
means of restoration producing  no effect, I was  ultimately
sent for.   She Avas finally recovered by the effusion of cold
water on her  head.    Domestic  contrarieties and  misery;
the  frequent recurrence of petty vexations; the tyranny of
intimate connections, and the positive  ill-usage  of others ;
suits in courts  (misnamed) of justice may from their continu-
ance, severity,  and repetition, especially under aggravating
circumstances,  and in  states of high  susceptibility in the
unhappy sufferer, drive even the strong-minded and the Avell-
principled into a state of temporary despair and desperation,
— may  fire the brain to madness, during which self-destruc-
tion may be attempted.  A most talented  and awejomplished
young lady, suffering from a  combination of the above cir-
cumstances, took, upon retiring to rest, a very large quantity
of laudanum,  more  than is  usually productive  of a  fatal
effect.   She wakened late the. following day Avith a most dis-
tracting headache and  general disorder, recollected the act
of the  previous night, regretted  the  attempt, and  sent for
medical aid, determined, hoAvever, to conceal the cause.  Her 
 84             THE SUICIDAL PROPENSITY.

 health from this, and other circumstances alluded to, con-
 tinued greatly impaired for many years, and several  physi-
 cians were consulted.   She came under my care, and at last
 mentioned the  suicidal attempt,  which was never  further
 divulged.   She now continues in good health,  to ornament
 the society in which she moves.  The state of desperation
 into which a person inflamed by the passion  of  love may be
 thrown by  disappointment, is actually that of insanity, at
 least moral insanity.   A gentleman  endeavored  to  obtain
 the  favorable notice of a  lady, of whom he  had become
 enamored, but had not succeeded.   He committed suicide by
 opening a vein in his arm, and, while the blood  was flowing,
 he wrote a note with it, acquainting her Avith his act.   She
 was soon after  attacked by nervous  fever,  which Avas  fol-
 loAved by insanity, during Avhich she fancied that she heard a
 voice commanding  her to  commit suicide.    Instances of
 associated suicide are not rare, particularly in recent times.
   A wide publicity was not long  ago given to the mutual
 suicide of tAvo young girls at Lewiston, Maine, by drowmino-.
 Not unfrequently one  of the parties  who have  agreed to
 commit suicide, only pretends to do it,  with the  intention of
 getting rid of an object  no longer one of endearment.   Mur-
 der is often committed first, and suicide afterward, prompted
 by jealousy.  Suicide is often feigned or simulated with a vieAV
 of obtaining a desired end; the lover threatens or seems to
 attempt it, to induce a return of affection ; the spoiled  child
 to obtain a compliance with his wishes;  and the indulged
 wife, submission to her  caprices.  In such cases but a small
portion of  laudanum is  usually procured, and this is diluted
Avith some fluid, to  increase  the apparent quantity, or a laro-e
quantity is taken when seen by some person, or Avhen instant
relief may be obtained.  Females have resorted to this plan
to try the affection, or to  compel the  fulfilment of the  en-
gagement of their  lovers;  but in cases of this kind little 
THE  SUICIDAL PROPENSITY.
85
more is necessary to be knoAvn than that such acts are some-
times resorted to ; and that a poisonous dose may be actually
taken,  in order to appear the  more in earnest, knowing that
assistance is near, and that it Avill be successfully employed.
  Drowning even may be feigned in similar  circumstances.
I have, hoAvever, seen two cases in Avhich fatal results very
nearly followed this experiment upon the endurance of affec-
tion.  Circumstances predisposing to suicide are hereditary
predisposition (Dr. Gall has  observed  the suicidal predis-
position in several successive generations, I  have known it
in three generations)  ; the melancholic, bilious, and irritable
temperaments ;  the  middle  period of life;  the unmarried
state;   masturbation  and sexual  excesses;   drunkenness;
immoral amusements  and exhibitions ;  the  perusal  of loose
productions and of  criminal  and  suicidal details ;  idleness
and indolence ; habitual recourse to powerful mental excite-
ment ; states of the air or of the weather, occasioning depres-
sion of the nervous  energy;  disappointed love ; jealousy;
gambling ; poverty ;  fanaticism ; debt and domestic trouble ;
disgust of life ;  religious excitement;  matrimonial  strife ;
disease and pain ; crime and remorse.   It is Avell known that
many philosophers and distinguished Avriters have attempted
to defend suicide under  certain circumstances, on the ground
that he to AAmom life  has become a misery and burden, has a
right to rid himself of it.
   A French Avriter on the subject of suicide, dogmatically
announces that " Suicide is the last, term, the highest expres-
sions of man's  liberty!  Why have not animals ever con-
ceived suicide ? " he asks.  " Because  their nature  is every
way passive.  They have not the choice and the preference.
Man, on  the  contrary, eminently active and free, has been
able to push his activity even to the destruction of himself."
But this is an old idea of the Roman writer Pliny.   " Indeed,"
says Pliny, "this constitutes the great comfort in this imper- 
86
THE  SUICIDAL PROPENSITY.
feet state of  man, that even the Deity cannot do everything.
For he cannot procure death for himself, even if he Avished it,
Avhich, so numerous are the evils of life, has been granted to
man as a chief good."  Let us lurve a care.  Wo have apolo-
gists for suicide even hoav, and upholders of it,  and the pre-
scriptions of  both the Liav and the  gospel in reference to it
are in a great measure unheeded.   This is not a bad starting-
point  and groundwork in favor of  a  reactionary movement,
sympathetic of suicide ;  and if Ave do not take heed, we shall
have our young men and  maidens  looking upon the deed as
a matter of feeling, and not of morality, while sympathy for
the self-destroyer would find an outlet in song.   Would you
have an example of the song ?

             " Then hie thee to the rope-yard, boy,
                And purchase me a cord;
               Ride slowly home and give it me,
                But do not speak a word."

  The frequency of suicides varies  at different  ages.  Dur-
ing the early epochs of existence, the sanguine expectations,
which are generally indulged, and Avhich soon take the place
of temporary despondency and distraction occasioned by dis-
appointments and losses, tend to diminish the number of sui-
cides.
  In the middle and more advanced period of life, sensibility
becomes  exhausted or blunted,  Avhile  cares and  anxieties
increase  in number and intensity; and  the  attachment to
life is much impaired.  The desire of life afterward increases
and frequently in  proportion as old  age advances.   It  is
from thirty-five  to forty-five that the greatest number of sui-
cides occur.  After forty-five suicide becomes more and more
rare ;  and above seventy there are scarcely any instances of it
  It is difficult to obtain the actual statistics  of suicide in a
given city or community,  as  many cases  are  undoubtedly
reported under other heads, as  "sudden,"  "apoplexy " etc 
THE  SUICIDAL PROPENSITY.             87
  In a work on Nervous Affections and Nervous Disorders,
it was impossible to overlook the  momentous subject of sui-
cide, as nervous  depression, and  general  or  partial or mo-
mentary insanity,  always precede the  dread act of self-
destruction.   There is usually cerebral disorder  connected
Avith it.  The increasing  frequency of suicide, as Avell as of
manifest insanity, forces  it upon the attention of  all  practi-
tioners  Avho  make  nervous diseases  a specialty and  study.
Of course, so far as suicide is a product of vicious states of
society, it is beyond the  power of the  physician.  But the
nervous condition which  leads  to it  is  curable by the pow-
erful remedial agents which  have been  added to the Materia
Medica Avithin the last decade, and which enable  the skilful
special practitioner to minister to a mind diseased, and  restore
the equilibrium of  the most  disordered and demoralized ner-
vous system.   In a young and hopeful community like our
own, Avhere "there  is no shadow,  no antiquity, no mystery,
no picturesque and  gloomy Avrong, nor  anything but a com-
monplace  prosperity," suicide ought  to  be rare.  But it
unfortunately is not.   Our  people are  beyond  all others a
nervous, and therefore, under the pressure of great  mental
excitement, a desperate people.   NoAvhere else is  there such
a desperate  and reckless pursuit of gain.  It is to the ner-
vousness of our people that the frequency of suicide Avith us
is to be attributed.   Of the hopeless and appalling poverty
AA'hich characterizes the dense communities of the Old World
Ave knoAV but little.  But our morbid passion for excitement,
our disposition  to stake everything upon a single th/OAV, the
frequency of  our contested  elections, and the personal  and
exciting character of our political  contests, all contribute to
demoralize the nervous system, and overturn the equilibrium
of the  brain.   Add to this the  variety  of  foods, and the
hurry of eating, Avhich lead to dyspepsia, — a disease Avhich at
middle  age causes Ioav spirits, listlessness, and  tedium vitoe, 
88
THE  SUICIDAL PROPENSITY.
or disgust of life, the very disposition of mind which leads
directly to suicide.   The suicidal propensity is almost always
the result and accompaniment of nervous disorder and cere-
bral disease.  If the medical adviser of one suicidally given
has the medical  means of dealing effectively and promptly
with nervous disease in all its manifold gloomy and despair-
ing forms, he can restore his patient to  cheerfulness and
health, and  to  that  love  of life  which is so natural  to the
healthy man or woman in  a normal condition.   It is  need-
less  for the writer  to  say that in his markedly successful
combats with nervous disease in all its forms and in thousands
of patients he has utterly ignored the old-fashioned treatment,
Avhich  consisted of local vascular depletion  (bleeding), dry
cupping, setons, blisters, repeated blood-lettings  in the im-
mediate Aucinity of  the brain, etc.   He  cures mental and
nervous maladies by a different mothod, and by a remedy the
result  of  a  more advanced medical knoAvledge, than that
which dictates such  coarse and sanguinary attempts at heal-
ing a disordered mind and unstrung nerves.  That his rem-
edy Avhile simple  is sure, prompt, and decisive in its action,
hosts of those who,owe their restoration to  health, business,
and society  will testify. 
CHAPTER  XII.
                TREATMENT OF THE  INSANE.

  The  most important question in  psychological medicine
and  mental  pathology, is  concerning  the treatment of the
insane.   Volumes have within a few years been written on
this  subject in all the languages of  the civilized world, and
the discussion still goes on.  A writer on this subject says :
" I doubt if ever the history of the world, or  the experience
of past ages, would show a larger amount of insanity than
that of  the present day.  It seems,  indeed, as  if the world
Avas  moAring at an advanced rate of speed proportioned to its
approaching end; as though in this  rapid race  of time, in-
creasing Avith each revolving century, a higher pressure is
engendered in the minds of men, and Avith this there appears
a tendency among  all classes  constantly to demand  higher
standards of intellectual attainment,  a faster  speed of intel-
lectual  travelling, greater forces, and larger means than are
consistent with reason and health."  It is a matter of no slight
difficulty  to determine, in all  cases, the primary or  predis-
posing  cause of mental disorders, apart from an hereditary
taint existing in the constitution, and Avhere there is no posi-
tive  mental deficiency from birth ; for it is only too probable
that  from a much earlier period than  the actual manifestation
of disease, the fuel has been  laid; and it therefore becomes a
matter  of grave consideration for those who may have the
                                        [89] 
 90             TREATMENT  OF THE INSANE.

 poAver vested in their  hands, not so much for the cure, but,
 Avhich is of far greater  import, the prevention of disease, that
 many carry  about Avith them unsuspected, perhaps, through
 a long life-time the seeds  of insanity.   There  is  a fearful
 balance of minds wholly free from  inherited taint or consti-
 tutional infirmity, and yet  doomed to  break down in the
 terrible struggle of the age.
   Insanity visits all  classes of society alike, Avith an impar-
 tiality like  that  of  death.   The  amplest means of earthly
 enjoyment will not  purchase exemption from it.   Indeed, it
 often happens that an  hereditary mental taint descends as a
 curse with hereditary wTealth and high social position.   Fail-
 ure  of health, pecuniary embarrassments, over  anxiety, too
 great application to business, etc.-,  are among the ordinary
 recruiting  sergeants, so to  speak,  of the  ranks of mental
 darkness and imbecility.   Causes of insanity are not far to
 seek among those, for instance, Avho earn their bread by the
 sweat  of their broAv; Avhose lives are a continual struggle,
 whose daily toils are unmitigated by pleasure, to wdiom each
 morroAv brings fresh cares, and night scarce brings repose.
 The hard-worked professional man,  Avho  spends his days in
 painful efforts to make  tAvo  ends  meet;  the avaricious man
 of commerce, only aiming to double his gains and grind fresh
 profits from his Avares;  the  speculating  capitalist, ea°-er to
 lay out his treasure in the best market; the adventurous mer-
 chant, Avhose temple is the counting-house.   What a restless
 sea !   What troubled Avaves of thought and care rise  up even
 within this  single  catalogue  of  callings!   But look  Ave
 further;  observe the young of all  classes, Avith Avhat sui-
 cidal frenzy they commit themselves to  sorroAv.  Whether
 in obedience to the  promptings of high ambition, Aveavino-
an entanglement of thought,  and straining the sinews of  the
mind in attempting to achieve the  gain of riper years, and to
wrest the victory ere  the battle  has begun;  or else  led 
TREATMENT  OF THE INSANE.
91
spell-bound by passion, the powers and  resources of youth
arc squandered in the bed of  the voluptuary;  sin  sinking
into the heart with all its accursed stains, polluting the foun-
tains of reason at their source, and embittering  the  springs
of life.  Do we not find here predisposing causes Avith a ven-
geance, borne it may be long, but only waiting for the spark
to fall?
   The tendency of dissolute habits toAvards inducing aberra-
tion of mind need  not be dwelt upon.  If prolonged habits
of  dissipation  frequently predispose  toAvards insanity,  fits
of intemperance  prove  not seldom the  immediate  exciting
cause.  Intemperance is indeed a fertile  source  of insanity.
The prevailing superstitions  of the day — spirit-rapping,
table-turning, etc. — exercise their baneful influence on sus-
ceptible minds.  These  are rocks  in  the fathomless  sea of
mysticism, on  Avhich  many an empty head  has split, and
many a shalloAv mind been stranded.
   But to our more immediate subject, the treatment of the in-
sane.   Among the multitudinous Avorks and periodical essays
on this momentous subject, with Avhich the press has labored
of late, the Avriter is happy to refer to an American book, Avith
the significant title, "Behind the Bars," as  containing, upon
the AA'hole, not only the latest Ifut the best word upon the ques-
tion under consideration.  The author of this most searching
and interesting exposition of the faults of the present system
of treatment of the insane, apparently writes from his or her
own experience as a patient.  But the criticism  of a vicious
system is tinctured Avith no harshness for that reason.  In-
deed, I understand that this little book has already produced
a decided amelioration and revolution in  the mode of treat-
ment in our OAvn immediate asylums.  I cannot do better than
to make several extracts in extenso from this work.  Says this
writer: " If these nervous diseases must  be treated by some
systematic form, surely no suitable progress has yet been 
92
TREATMENT OF THE INSANE.
made toAvards it, and no steps  taken Avhich are  sufficient in
conformity with all that it seems to require.  Many afflicted
with nervous  diseases would shrink from the very name of
an insane asylum,  or  any retreat  with so professional  and
formidable a sound, yet Avho would  gladly avail themselves
of some  sort  of refuge, some temporary home  (which asy-
lums are not), where they might escape for a time the cares
and toils of business, the excitements of society and pleasure,
or the  trials of domestic life.
  In England, insanity is regarded  in a very different light
from the way it is looked upon in  this country.   There it is
made to  appear as a disgrace or stigma of  society or fami-
lies,  and thought next to crime itself.  There is  an evidence
of inborn ignorance of the  subject out of which all  should
be educated.  Here, we believe,  there is  no  crime (hap-
pily  for  us)  in  misfortune, and it is only where it  can be
traced to absolute  vicious  courses that there can exist  any
disgrace.  It is easy to understand how persons may shrink
from  the very suggestion  of asylums, either for friends or
kindred, for there is natural horror  in  removing a beloved
friend  or relative from the home, from  family  or society,
from independent  situations,  free to  act and  do as they
please, and subjecting them like  children to the rule  and
government of  strangers,  and depriving them  of nature's
dearest boon — liberty." .  . . " As regards  the patient him-
self,  except  in extreme cases of violent mania,  never ouo-ht
the asylum to be experimented with."   That is good, sound
doctrine.
  The Avriter proceeds : " There is  nothing more  sincerely to
be desired than the establishment of  some proper sort  of
home or retreat,  or whatever it may be called, for the con-
cern and care, if not for any deliberate course of treatment,
of nervous diseases."  (The writer seems not to have been
aware of the existence of the Peabody Medical Institute, an 
TREATMENT OF THE INSANE.
93
establishment, one  of whose specialties is  the  treatment of
nervous diseases, not by any crushing system of restraint and
utter seclusion, but by methods and remedies, kindly, sooth-
ing, and efficient.)  The  Institute, indeed,  is exactly the
" place " Avhich the Avriter of " Behind the Bars " desiderates,
"Avhere the patient might  act himself, and Avithout opposi-
tion to  natural tastes or positive restraint; wdiere he might
be indirectly Avatched and cared for ; where the development
of the disease may  go on, or Avhere it may be gently checked
by some suitable regimen."
   Well ma}- this writer say that " although much has  been
done of late years  towards  the amelioration of the treatment
of the insane, yet  it has not yet reached that  perfection to
Avhich modern science,  cultivation, and good  sense  should
eleA^ate it."  This  is too true in the case of the management
of public asylums, Avhich are the chief and great receptacles
of the unhappy A'ictims of nervous disease  and  insanity; but
there are solitary practitioners here and there, as in the  case
of the managers of  the Peabody Institute, Avho have sum-
moned to the treatment of  nervous derangement, of all de-
grees and names,  all the  resources of " modern science,
cultivation, and good sense," Avith  a grand result of cures,
Avhich show Avhat can be done for the amelioration  of the
Avoes of humanity,  Avhen the ruts  of vicious usage and  rou-
tine are  abandoned, and reason and common-sense are left
free to act.
   " That  the plan  adopted for years  past in our  insane
asylums is Avrong," says the Avriter  from Avhom I am quoting,
" cannot be doubted by any intelligent  being Avho has  seen
the victims of such a system, and Avitnessed the very instru-
ments of  torture applied to the  persons  of the patients,
brought to operate, as they  are, upon the harmless and  gen-
tle, as well as  the  most violent."   "Are the patients of the
insane asylums treated kindly ? "   " The interest Avhich sur- 
94
TREATMENT OF THE INSANE.
 rounds this question," says the Avriter of "Behind the Bars,"
 "and the anxiety to  learn something definite of a  subject
 which the regulations of a system keep hid from their eyes,
 often  lead  persons  to take long journeys to see some un-
 known patient released  from an asylum,  or are the  impetus
 to  some confidential  correspondence,  often  full of  anxious
 misgiving or bitter experiences."  "That  the upholders of a
 course  of personal restraints do not mean to be cruel, and
 that they believe their way the best for the patient, may be
 charitably believed.   .   .   .  They believe in tying up the
 body, that  they may disenthral the mind.   Are they not
 slugs iu an  age of universal activity and  progression, wdiile
 they cling fast to  the old theories, and refuse  to adopt the
 neAv ?  Were the non-restraint system established throughout
 our asylums, Ave should  behold those patients who are so for-
 tunate  as to  obtain their release  in a far different  aspect.
 They Avould not  still bear the marks about the world of the
 fetters they had Avorn.   Young girls Avho  had entered there
 at the age of development would not return changed in form,
 bent, shrunken, and  sometimes crippled.   It is fearful to Avit-
 ness the shapes of these young persons in asylums, who are
 subjected, if not  daily, always nightly, to the rough strait-
 Avaistcoats, tightly pressed against the chest, so as to prevent
 all  expansion, and giving to them the figures of very infirm
 old Avomen, rather than the fulness and shapeliness of youth
 and health.   .   .   .  Why is it that the  non-restraint sys-
 tem has not been adopted  in our best asylums ?   WliA' is it
 that the  experiment is not made  of doing away Avith these
 implements  of torture?   The ansAver from medical  science
 Avill be, that they are done aAvay Avith ; that the chains and
 irons and rings and  fetters, belonging to past treatment of
 the  insane,  have  disappeared.*    But  are  not  the  strait-
  *  Ransack history: the insane anciently were objects of buffoonery, or
burnt as being guilty of sorcery. Later, they were abandoned, and they 
TREATMENT OF THE INSANE.
95
Avaistcoats,  the  bed-straps,  the leathers, the  buckles, the
chairs, all  in  common use?  Are not ladies fitted to these
Avaistcoats  month after month, as though it Avere a legitimate
night-dress ?  Whoever has  passed any time in the asylum
Avill see plainly why these  appliances  are still  kept  up.
They save  trouble.   They save  the employment of more at-
tendants, and they save  trouble to those already employed.
Thus, the physicians say, they save attendants.  The attend-
ant says, they save my time.  How simple, upon looking at a
prospective project of reform in asylum life, seems to be the
alternative, — to do away with the troublesome accessories,
conjured up by force, and to  rely upon moral safeguards
and persuasive strongholds, Avhich come from and aim at the
heart and  human sympathy, Avhich the  patient though dis-
eased is still supposed to possess,  and be capable of aAvaken-
ing to  and profiting  by !  No non-restraint system  can be
adopted Avithout a vast  change in the  machinery of the old
management, and by breaking down the tyranny, and substi-
tuting a species  of imaginary absolute freedom."   This Avriter
gives a  bad account of the attendants in our  lunatic asylums,
of the  jeering  and cruel manner  in Avhich  they treat  their
unfortunate  charges.  Indeed, she defines a lunatic asylum
to be a  place Avhere insanity is  made, manufactories of mad-
ness rather than healers.   "Take an instance," she says ; "a
young Avoman from one  of our country toAvns appears  on a
certain  day upon one of the best  galleries.   She is bright,
intelligent, and active, suggesting always the idea to the mind
of the beholder, that if educated she Avould have been rather
an uncommon person.  She is lively, brisk, amusing, busies
herself at her needle or the care of her room, in which she is

perished for want of care in hideous prisons.  The  Turks still maltreat
their insane.  In 1790 a law Avas passed in France, providing for the con-
finement of furious lunatics, and mischievous and ferocious wild beasts,
classing the insane  with brutes. 
96             TREATMENT  OF THE  INSANE.

scrupulously neat.  She not only performs these acts for her-
self, but she visits the rooms of the  other patients, and  im-
provises little reforms to be made in their clothing, offering
to mend or make garments for them, and 'fix them up' gen-
erally.  Of course this sort of interference does not fall to
her requirement in the asylum.  She must not direct, but be
directed.   She is an intruder,  agitating the patients Avith
outside influences and the like.  Moreover she is very lively,
and talks a great deal, — so the attendants say ; too much, say
the physicians ; and so she must be moved to a less quiet and
comfortable gallery.   They take her away. But Avhere ?  To a
wing of the building so different, that there is not even  one
patient AA7ith Avhom she canhaAre a sympathetic look.  They are
idiotic,apathetic, cataleptic :  all far, far wide of reason, incapa-
ble of talking, excepting babble, or even of apprehension.  Let
the reader imagine for himself, let his own opinion determine
Avhat the  sanitary influence  of society like  this might have
upon a person of lively mind, hoAvever disturbed, during the
course of Aveeks and months.  A year afterwards,  the Avriter
again had  an opportunity of beholding this patient, for Avhom
much interest  had been felt.   But what an object !  What a
contradiction of her former self was the  unfortunate changed
to !  Her face looked  as though stamped by imbecility. Her
lips moved to utter only incoherent jargon.  Her eyes, Avhich
had been  bright and intelligently lighted, were  like dead
eyes, and  she  was in no respect unfit for  the gallery to
Avhich  they had confined her." .  . .  What a  system that
would  be  to practise, if, instead of this, patients  Avere  by
some charm of cunning made to feel that they Avere  roam-
ing quite at large ; that they were not in a place of deten-
tion ; that  they were  free to go and  come;  and yet all the
Avhile,   physicians  and  attendants,  under  these  illusory
devices, were having it all their own way, though impercep-
tibly to their patients  ! 
               TREATMENT OF  THE INSANE.             97

  "A  system of  this sort Avould be Avorth inventing, and
Avould bring honor to the inventor, because depending upon
moral and higher elements than  anklets for the feet and straps
for  the discontented body.   For it is certain, that  just for
the reason that these  patients know that they are confined,
knoAV they cannot go home, knoAV they may not see  a friend
or relative,  it is that they are so miserable.  ... It  is amaz-
ing hoAV the sense of  liberty  and  the right of  volition  can
affect violent insane  patients.   Under bonds and restrictions
they conjure up  all sorts of desperate and terrible things
Avhich they Avould do Avere liberty alloAved  them.  .  . . But
untie their hands, take them  out, unbar  the door, tell them
they  are free,— and  Avhat then?  Are  they  ATery quick to
cut off by Ariolent acts the apprehension and  enjoyment of
this new-born blessing — liberty ?  Not  one of them would
do an act of harm to himself.  . . . One patient who Avore day
and night the strait-waistcoat, was  perpetually  imploring
that she  might just be  allowed  (a delicate favor)  to fling
herself upon the railway track, and end all by the  coming
train.   When  she Avas  permitted to go out unbound,  her
chief fear of the Avorld  outside seemed  to be, the  danger
suggested by the sight of a locomotive."  I Avould gladly
quote more from this most interesting writer, because his or
her statements are those of  an expert, Avho has fortunately
recovered the full sovereignty of reason, as the book from
Avhich I haA^e been  quoting amply testifies on  CArery page.
Such testimony is invaluable.   I  wTill boldly affirm that  the
test of the  civilization of a  given community is the degree
of science, and  even  of charity,  with AArhich the insane  are
treated in that community.   Notwithstanding that statistics
show, during  the  last ten years,  an increase in the  number
of the insane, still I affirm that in proportion as true civil-
ization  shall advance, insanity will diminish its ravages in
society. 
98
TREATMENT  OF THE INSANE.
  Our principal lunatic asylums arc on too monstrous a scale,
and there is such a host of patients  in them as to render it
impossible that each particular case can receive proper atten-
tion.   Were the Avriter to establish a lunatic asylum strictly
so called, he should by all means establish it  in the country,
because  it is there only that  the family life can be realized
suitably for the insane, Avho need  air and space to act with-
out danger  to any one, and  especially to be removed from
the circumstances which surrounded the onset of this disease.
Such an establishment would be a therapeutical centre, which
would  have a farm as  a subsidiary establishment.  The rich
Avould  find diversion, and the poor Avork in the fields.  The
air of the fields, as says  one of the princes  of science, Hum-
boldt,  is the first and best therapeutical  agent.   The simple
contact of man with nature, that influence of open air, — or
in a more beautiful expression, of free air, — exert a sooth-
ing power.  They soften  pain, and they allay the passions,
Avhen the soul is agitated in  its utmost depths.  At Gheel,
in the  northeastern portion of Belgium, the  insane  are col-
onized.  In this  place is the church of  St. Dympna, whose
intercession in the  Middle Ages was  supposed to cure luna-
tics, Avho AArere brought hither in great numbers.   The taber-
nacle  containing  the  saint's  bones  stands  on four stone
pillars behind the altar, so as  thus to form a passage about
three feet in height, through Avhich lunatics, brought here for
cure, Avere accustomed to pass on their knees.
  The insane colony of  Gheel cannot be here  described  at
length.  Some idea of it can be  obtained from the  account
of a visitor : "When perambulating the  various hamlets vis-
ited," he  writes,  " often  through  pretty but devious path-
ways, Ave frequently noticed lunatics occupied, as agricultural
laborers in adjoining fields ; whilst some were quietly walk-
ing to or from neighboring cottages, quite  as  tranquilly as
ourselves.   Being  all acquainted  Avith  the inspecting phy- 
TREATMENT  OF THE INSANE.
99
sician, these  parties  saluted  him  respectfully,  and often
conversed with us  familiarly ;  in short, they behaved like
ordinary peasants, or any rational person.   Wc saw others
sitting at the cottage doors, and some looking out of win-
doAVS ; Avhile several Avere amusing themselves Avith children
of the family, in adjoining gardens or enclosures.   In one
of the public roads we met a maniac Avho lived in a cottage
at some distance, then carrying an infant in his arms like
any nurse.   He seemed to take great care  of  his  innocent
charge ;  and the physician remarked that such an occupation
constituted this lunatic's chief  enjoyment.   Afterwards  we
encountered another insane resident — a young man —amus-
ing  himself Avith  three little children, romping with them,
and at the  same time taking care that they did no  harm.
In a  solitary lane, we next came  up Avith a  patient, Avho
was. being  conducted  homeward to dinner  by  the juvenile
daughter of his host, after laboring in an adjacent field.  In
various other instances, we observed insane persons saunter-
ino- about, and  some  also going toAvards or returning from
neio-hborino- farm-houses.   In  truth, had it not been for  the
vacant-looking countenances noticed in most cases, and occa-
sionally that their legs were loosely tied together by leathern
thono-s,  so  as  to prevent  the wearers from  running  fast
or o-oing  to any  distance,  I should scarcely  have  recog-
nized many of the parties  then enjoying  themselves, while
breathing the pure and open  air of heaven, as real lunatics
residing in the Gheelois commune.   Within the  houses  and
 cottages Ave inspected, many insane residents were occupied
 as ordinary servants; some superintending  coavs, churning,
laboring in the barn, cooking food, cleaning the house, rock-
ino- the cradle, and taking care of  the cradle;  in short,  em-
ployed in much the  same Avay as  they might have been at
home, or out at service.  Various male patients,  again, were
laboring in the gardens or fields ; others working in carpen- 
100
TREATMENT OF THE  INSANE.
ters' shops, also smithies, stable and farm yards;  besides
being engaged in such out-door employments as are common
amongst any agricultural population; these occupations hav-
ing this very great advantage for lunatics, that whilst under-
going physical exertion — often  so beneficial for their mental
malady — they, at the same time, are much  in  the open air,
breathe a purer and more salubrious  atmosphere than  most
inmates of wrards, day-rooms,  or frequently  too  confined
workshops, can enjoy  in northern  asylums.    In several
houses, we also observed female lunatics comfortably sitting
with their hostess at table, knitting, sewing, making clothes,
and conversing as  if equals, friends on a visit, Or relatives.
Such spectacles were  truly pleasing;  and when looking out
of the cottage windoAVS, near such  parties, upon sometimes
a pretty flower-garden, or towTards open  green  fields, stran-
gers could hence  scarcely suppose, from outward  appear-
ances and surrounding circumstances, they were then visitino-
the  chamber of an  insane  occupant, afflicted  most likely
with incurable  mental alienation."  What a contrast  have
we here to the hideous, strait-Avaistcoat, close-confinement,
restrictive system of our great, crowded lunatic asylums ! 
CHAPTER  XIII.
     URINARY ANALYSIS, AS  A DETECTIVE OF DISEASE.

  As a means of facilitating diagnosis or discrimination  of
disease, I Avish most strongly to inculcate  the necessity of
analyzing urine;  and  I  feel  satisfied from very extensive
experience,  that if this Avere more generally attended to, that
diversity of opinion Avhich now so unhappily prevails Avould
no  longer exist, nor should Ave be so  frequently taunted by
our patients Avith  the reproach,  " When  doctors  differ, who
is to decide?"  As I  have  already  observed, the clammy
tongue, dry skin, pain in the back, and failure of the strength
may exist in so many different  diseases, that avc should  be
unable, relying on symptoms alone, to  decide Avith any degree
of certainty the real nature of disease.   But an examination
of the urine will often lead us to the true interpretation,
and under all circumstances will  facilitate  our inquiries into
the causes  of  morbid phenomena.   For instance, a single
property from  Avhich much may  be determined, I need only
mention that the specific gravity of the urine  in  health may
be averaged at about one thousand  and tAventy, but if the
urinometer  should indicate  a  density of one thousand  and
fifty,  the  urinary pathologist Avould  immediately infer the
presence of a  large quantity of  sugar, and  the existence of
diabetes  in  an aggravated degree.  He  Avould still further
confirm his  notions upon this point, by setting a portion aside
                                          [101] 
102
URINARY ANALYSIS.
under the proper circumstances, and  inducing those fungoid
vegetations, the appearance of Avhich, under the microscope,
is  shown in the subjoined diagram, Figure  6.   Thus  we
               Figure 6.

should be enabled by one examination
to decide the nature of the disease,
without  the  possibility  of mistake.
For  theypurpose  of speedily taking
the specific gravity, Ave make  use of
a little instrument,  contrived by  the
late  and much  to be lamented Dr.
Prout, called "the  uriuometer."  It         Figure7.
consists  of a hollow globe or glass,
or  thin  metal,  from the upper  part of  which  projects  a
scale graduated from 0 to 60;  in the  opposite direction
there is  a Aveight  to keep the stem upright.  Immersed in
the  urine,  it sinks  and indicates the gravity of the  urine
by the figure on the stem, which coincides, or is  on  a level
Avith the surface of the  urine.   Reference to  Figure  7
will explain  the use and  nature of this  instrument better
than any description.  The value of this instrument in detect-
 
URINARY ANALYSIS.
103
ing disease will at once be apparent, by mentioning the fol-
lowing  case.
   A  feAv days  ago, a gentleman, a perfect stranger, whom
I  had never seen  before, called upon me for my  advice.
I requested him to furnish me with a specimen of the urine,
the specific gravity of which  I  immediately ascertained to
be 1038.   I boiled a small  quantity in a test tube, Avith
a  solution of potass, over the  spirit-lamp, which speedily
changed to a dark-brown color.   This led me at once to make
the following inquiries :   If the thirst was not most urgent;
if his appetite Avas unusually good ; if the skin was not unusu-
ally hard and dry ; if the quantity of urine passed in twenty-
four hours did not greatly exceed what was  natural, and if he
had not  lost flesh.  He had  as yet hardly given me  any
account of  himself,  and appeared much  surprised  at  my
inquiries, and looked steadfastly at  a microscope that Avas
standing upon my  table ; and  I  afterwards learned  that he
attributed some extraordinary  influence  to   the polished
reflector attached to the instrument.  It appeared that he had
been  suffering for  some time from all  the  symptoms  I  had
mentioned, and felt at a loss Iioav I could, in so short  a time,
get to knoAV so much about him,  for I Avas not more than five
minutes in making the examination.  To  the urinary pathol-
ogist this could occasion  no surprise, if it Avould be at once
apparent that I had tested for diabetes.  Feeling satisfied of
its presence, it was then of course easy enough to enumerate
symptoms.   I have found diabetes to occur  between the ages
of twenty-two and thirty-six.   I  have seldom met with it in
advanced age;  a form of  it sometimes ocQurs in young chil-
dren.   It is of the utmost importance that this disease should
be detected in its earliest stages, for  it is  only then that it
can be  kept in check,   or  possibly subdued.   Instances,
indeed,  are not wanting of perfect cure.   If food containing
sugar or saccharine principles  be allowed, even as luxuries, 
104
URINARY ANALYSIS.
it is the opinion of most urinary pathologists that no plan of
treatment can prove  serviceable.   " Even its  occasional in-
fringement," says Dr.  Prout, " cannot be indulged in Avith
impunity.   Thus I  have knoAvn,"  he  continues,  " a  feAV
saccharine pears undo  in a feAv hours all that I had  been
laboring for months to  accomplish."  With the ArieAV of still
further impressing on the mind the necessity and  importance
of urinary analysis, I shall briefly mention another case  of
diabetes that came under my notice.
  The patient, a cooper, had been, working for six or seven
years  in  a very damp cellar.  He  applied to  me  in  1866,
complaining  of intense  thirst.   He  had become greatly
emaciated, with a voracious appetite  and other symptoms
usually present in diabetes.  Examination of the urine fully
proved the existence of the disease.  I explained to him the
nature of his disorder, and the necessity of at once procuring
a more  suitable Avorkshop,—one dry and  properly venti-
lated.  I also inculcated the necessity of strict attention to
diet, and explained  some other  necessary precautions calcu-
lated to  improve  his health, and the necessity  of strictly
conforming to dietetic rules for some  considerable time.   I
Avas, hoAveA-cr, soon supplanted by a medical gentleman, aaIio
asserted  that all the symptoms  originated  in  a  disordered
state of  the liver, at the same  time undertaking to set all
right in  a month.   To accomplish his purpose he directed
blue-pills to be  taken, which Avas continued for the space of
ten days ; but the  unfortunate patient, instead of beino- per-
fectly Avell at the end of the month, as promised, had become
worse, the symptoms much more severe,  and he died a short
time afterAvards of  confirmed  diabetes.   FeAv persons  not
accustomed to  the  treatment of these affections  Avould  be-
lieATe the deleterious effects of even a dose or two of mercury.
Indeed, the mildest  form of the  disease may be  speedily
converted, by the use of  calomel or blue-pill, into the most 
URINARY ANALYSIS.                 105
confirmed  and aggravated  diabetes.  From  several  years'
experience in the treatment of diabetes, I am decidedly of
the opinion, that  if early detected the disease may be re-
moved ; but generally cases of this kind seldom terminate so
favorably as Ave could wish, or indeed as Ave  have a right to
expect, and I am satisfied this is  OAving to the disease not
having  been detected  in its early stages.   Most  of the pa-
tients whom I have seen suffering from diabetes have been
more or less of the phlegmatic temperament;  not so, hoAv-
ever, the class I am to enter upon.  We often find the urine
depositing certain sediments, the nature and variety of Avhich
are  often  intimately connected Avith both  the  temperament
and the peculiar  affection under which the patient may be
laboring.   Oxalate  of lime, correct delineations  of which I
here  subjoin  (Fig. 8),  most  frequently occurs,  according
                          Figure 8.

to my experience, in the  nervous and biliary temperaments,
and  not unfrequentlv in  the  sanguine.   When it  occurs  in
this last, it is often  associated Avith an eruption of  the  skin,
and attended Avith great mental and bodily irritation.
  Not long  since, I was consulted by a gentleman laboring 
106
URINARY ANALYSIS.
under this diathesis,  oxalate of lime constantly appearing in
the urine.   This patient Avas  treated  simply for a cutaneous
disorder,  an  eruption having  appeared  upon   the  skin.
Astringents in the form of ointments, applied to the surface,
succeeded  in  suppressing  the cutaneous disorder;  but  the
nervous  excitement  and  mental distress  increased to  an
alarming extent.  So severe Avere  the  symptoms, that  the
patient found  it quite  impossible to  remain at rest, but  felt
obliged, as it were, to shift about from place to place.   .He
assured me he had suffered so much, that he often felt as if
he should  lose  his  senses,  were not the  symptoms soon
relieved.   Sulphur baths  Avith diaphoretics, and irritating
frictions to the skin, soon brought out the  eruptions again,
with immediate relief to  the  patient.  I have found  almost
invariably that affections of the skin, Avhen accompanied Avith
an unnatural or disordered state of  the urine,  must not  be
rashly interfered with, nor suppressed by external applica-
tions, till the disordered state of the urine has been corrected,
and the kidneys restored to  the healthy discharge of their
functions.   When oxalate of lime is constantly present in the
urine, Avhich in my opinion is  much more frequently the case
than is usually imagined, —the difficulty of  detecting the na-
ture of these crystals enabling them to escape observation, —
there  is  frequently a feeling  of  distension  in the stomach,
more  especially when that viscus is  empty.   This feeling
frequently prevails to  so  great a degree, that the patient is
compelled to have his dress made very loose, and to adopt
every means of preventing pressure.   This distension some-
times extends over the Avhole region of the stomach, Avhich
bulges out, occasioning great irritation and distress.
  The heart, or at least its  motions, frequently become  in-
volved.   I have seem many instances of Avhat may be named
nervous palpitation of the heart.   Patients, from such palpita-
tions, often imagine themselves the victims of real disease  of 
URINARY ANALYSIS.
107
the heart;  and this notion appears to be more strongly con-
firmed by the irregularity of pulse which prevails in these
circumstances, and indeed not unfrequently it intermits.  A
medical gentleman consulted me some little time since for a
feeling of severe  nervous depression, greatly aggravated by
a firm belief that he should die suddenly from an affection of
the heart.   About two years before he  consulted mc,  he had
endeavored to effect an insurance upon his  life, which Avas
refused, however, under the impression of his suffering  from
disease x)f the heart.  Certainly palpitation Avas evident, and
there was irregularity of pulse, great difficulty in breathing,
with habitual  coldness of the feet.   On examining the urine
I found it loaded Avith octohedral crystals of oxalate of lime,
and remarkably so after  dinner; which, perhaps, might be
attributed to an habitual indulgence in sweets,  etc.,  at this
meal.   The digestive functions were  deeply involved, and
yet the tongue was perfectly clean. The  general circumstances
induced me to suspect a gouty tendency, and, on  inquiry, I
learned that gout prevailed in his family.  By regulating the
treatment upon these views, and paying due  attention to the
digestive organs, the patient recovered, and is now attending
to a very extensive practice, Avhich he had  been  forced  to
relinquish.   Disease of the heart  is  usually inferred Avhen
there is habitual  palpitation,  Avith irregularity  of  pulse,
difficulty  of  breathing, coldness  of  the extremities,  and
the pulsations of the heart audible over the Avhole  extent
of the chest.  It will  be avcII, however, to  remember that
all  these  symptoms may  be  present, and  yet  the heart
itself be perfectly free  from disease.    I feel reluctant  to
refer to  the  numerous  instances  I have seen  of persons
Avhose existence  has been  embittered,  and   their  prospects
blighted,  in consequence  of functional irregularity being
mistaken for organic disease of the heart.   I have  already
mentioned a case of gout lurking in the system giving rise 
108
URINARY ANALYSIS.
to all the  phenomena of diseased heart, and  shall conclude
the subject by calling the  attention of the  profession to one
other remarkable instance.
  A young gentleman, Avho consulted me, gave  me the fol-
loAving preliminary history of himself: "I enjoyed," he said,
" excellent health until I Avent to Harvard University; there
I studied very  hard.   A friend gave  an entertainment in
celebration of my success in gaining a prize for a literary
essay.  After the entertainment Ave went  upon a rowing ex-
cursion, and I exerted myself beyond AArhat was  usual.  On
our return I became giddy, and  at length fainted.  I soon,
hoAvever,  recovered my  recollection, but  became ill,  and
was confined  to bed six Aveeks.   My digestion at this period
Avas  much disordered, the pulse irregular, with a constant
feeling  of uneasiness  about  the heart.   I was advised to
return home; to aA'oid all kinds of  mental exertion or ex-
citement,  and all  sorts of active exercise, especially upon
ascents ;  and  to restrict myself to a very Ioav and  poor  diet.
I took foxglove  for a considerable  time, in order, as it was
stated, to loAver the heart's action.   My health Avas not suf-
ficiently restored to admit of my return to Cambridge the
folloAving term.   I remained at home for twelve months ;
and not being alloAved to read,  nor to take much exercise,
time hung heavily upon my hands, and at the end of that time
the symptoms were as  severe as at first.   I was compelled to
give up my studies, and  have remained quite an  idle man
ever since.  I have taken a great deal of medicine, of one
kind  and another, and I hoav begin  quite  to despair of
recovering my health."
  Upon analyzing this patient's urine, I  found  the  oxa-
late   of  lime in  great   abundance.   The poAvers of the
digestive  organs Avere greatly impaired, Avhich  I attributed
principally to the kind  of  diet  to which  he  had  been
restricted, he having lived mostly upon slops  and ve«-eta- 
URINARY ANALYSIS.                 109
 bles, fearing that otherwise he would make too much blood,
 and disturb the action of the heart.   After hearing the his-
 tory of the case,  and giving due attention to all the circum-
 stances, I came to the conclusion that the patient had greatly
 impaired his health by too close application to study.   After
 severe literary exertion, the  indulgence in the pleasures  of
 the table, followed by the laborious exercise of roAAring, acted
 as  the exciting cause ;  and  in  his excitable,  but still ener-
 vated condition, proved quite sufficient  to bring on fainting,
 and the  disordered state  of frame  Avhich succeeded;  that
 the bleedings to which he  had been  subjected, and the  digi-
 talis only served to  keep up a degree of irritation  in the
 system; and on his return home, being debarred from bodily
 exercise, and deprived of all mental  occupation, he had too
 much time  to think upon his disease  and to chvell upon  mel-
 ancholy forebodings, Avhich at length brought on a permanent
 state of irritation in  the system   Acting upon these views,
 I recomme. ded that he should resume his studies, of course
 under due restrictions as to intensity  of application; that he
 should-take horse exercise  and adopt  a more liberal and  gen-
 erous  scale of diet.   I also recommended means for restorino-
 the vigor of the digestive  organs; and advised him, during
 his  stay in Boston,  to divert his mind by visiting the differ-
 ent places  of  amusement  and  objects of curiosity.  His
 health and spirits Avere greatly improved;  but  still  I  fear
 that the impression that his  heart is  seriously diseased, Avill
 not be easily eradicated from his mind, notwithstanding that
 he  has been assured by the most eminent  of the  profession
 hereabouts, that no such diseased state  exists.
  In the treatment of the oxalate .of lime diathesis, great  care
 must be taken to  order that kind of food which can be easily
 reduced by the stomach ; therefore, oily substances, as butter,
cream, fat meats, should be wholly interdicted.  Great atten-
tion should  also be paid to the nature  and kind of fluids used 
110                URINARY ANALYSIS.
as drink ;  and Avater  impregnated with  carbonate of lime
should be  carefully avoided.   It  is generally admitted that
the appearance of oxalate of lime, as a deposit in the urine, is
closely connected Avith the condition of the digestive organs ;
as it readily disappears  and reappears  under certain altera-
tions in the diet.   The dyspeptic symptoms under these cir-
cumstances  are often referred to  acidity of the stomach as
their  cause.   While  upon this subject,  therefore, I Avould
strongly impress upon  the mind  of  the practitioner  the
necessity of well weighing all the circumstances of the case
before he recommends that incessant resort to  carbonate of
soda,  so  much in vogue.   Acidity of  stomach is now  de-
nounced as one of the most common and constant accompa-
niments of nervous disorder;  and carbonate  of  soda and
liquor potassae, among the most favorite  remedies.  Many
cases  of nervous disorder have fallen under  my care,  to
remove Avhich was a work not  only of time, but of extreme
difficulty, in consequence of the injurious  effects  of an im-
moderate and daily use of alkalies.
  A gentleman of nervous temperament, engaged in a NeAV
York  Avarehouse,  a tall,  powerful  man, applied -to  me  in
consequence  of suffering  from  pain in  the  region  of  the
stomach.   The pain Avas confined  to a spot which he could
cover Avith the tip of his  finger.  He suffered invariably after
dinner from a painful feeling of distension and  fulness, with
an almost  incessant desire of haAvking up phlegm, Avhich
seemed  as  if  agglutinated in the  throat, causing great irri-
tation, Avith  an  uncontrollable desire  of getting  rid of it.
The skin Avas dry, hard, and harsh.   There Avere severe peri-
odical pains in the head, and, in fact, all  the  general symp-
toms  characteristic of confirmed  dyspepsia.   He informed
me  that  having  suffered for a considerable time, he had,
upon advice, been in the habit, for the last six years, of mix-
ing a quantity of carbonate of soda with  the  ale  which he 
                    URINARY ANALYSIS.                I' l

used.  He commenced wTith Avhat he called " a small pinch,
or as much as Avould lie  on  a shilling."  This quantity was
gradually increased, till  it amounted to a teaspoonful.  The
soda generally rclieA'ed  his distress, in some degree, for  an
hour or two, when the uneasiness  returned, and recourse to
t'io soda again  became necessary.
  The urine passed  in my presence had a specific gravity  of
one  thousand and  twenty-two, with a very  faint acidulous
reaction; deposited  a sediment  consisting of  mucous and
epithelium, and  abounding  in  crystals of oxalate of lime.
After  standing at  rest  for  above tAventy hours,  the sur-
face became covered wdth a pellicle, Avhich pixwcd to  be
the triple  phosphate, and  the  sediment  Avas  found  inter-
mixed with the same.    The  reaction  Avas uoav  alkaline.
From  the  history  and general  circumstances  of the case,
I  felt firmly convinced  that  the greater part, if  not  the
whole, of the misery and distress endured by  this patient,
was caused by the  inordinate  daily quantity  of carbonate
of  soda Avhich  he  daily  took.   I therefore  recommended
the gradual discontinuance of the medicine,  substituting for
it,  first, the hydrochloric acid, and  afterwards the  nitro-
muriatic, beginning Avith very small doses, Avhich Avere after-
Avards gradually increased. Frequent recourse Avas had to the
warm  bath; while  a plain,  simple, but  nutritious  diet was
adopted.   This plan he continued for  some time  and with
great  benefit, as he  became very much better; but still  he
Avas far from  being  relieved.   He became, however,  rather
impatient  of restraint and rule, and  gave Avay  to a longing
alter his  firvorite dose of soda-Avater;  and as  I Avould  not
sanction this, he got tired, and consulted another physician.
I have heard from  a friend of his  Avho is a patient of mine,
that he is constantly changing his medical attendant, and that
he is at  present in very bad health.  When  patients, under
false notions, habituate themselves to the daily use of soda, 
112
URINARY ANALYSIS.
they may be  placed  in  the same category Avith the  habitual
opium-eater or the dram-drinker.   Such endure the greatest
misery, till they indulge in the accustomed dose ;  and feAV
there are Avho possess firmness enough to  resist the tempta-
tion, or fortitude enough to  abandon  its use.   And here
again I must beg not to  be  misunderstood.  I by no means
urge that the alkalies are ahvays injurious in nervous affec-
tions ;  on the contrary, I have met Avith a great number of
patients Avho have derived very great benefit from a judicious
and avell-regulated course of these  remedies, as Avill be seen
in the folloAving example : —
   A gentleman of the nervo-bilious temperament, connected
extensively with the public  press, applied to  me, complain-
ing of many of the symptoms just enumerated.  In this case
the pain in the region of the stomach was by far more severe
than in  any instance I  remember to have preA'iously met
with;  Avhich may, perhaps, be explained by the great ner-
vous excitement and mental anxiety to which he Avas almost
constantly exposed, in consequence of the great responsibil-
ity imposed on him by his connection Avith an influential daily
journal.  Great irregularity  of habit was a necessary result;
dining very  irregularly, and at all  hours.  He sat up, too,
almost  all  night, resorting to stimulants to keep aAvake and
active.   Indulgence  of this kind generally ended  in  great
depression and nervous exhaustion, Avhich commonly lasted
till recourse to the usual beverage  aroused the energies and
raised  the spirits.  I was called upon very suddenly by one
of his friends to visit this gentleman, Avhom I found  sufferino-
                                                        ©
from a very  severe attack  of nervous  fever.   It appeared
that upon a recent occasion he  had  been confined for several
hours,  in a  close and  overheated  apartment, being at the
same time exposed to  intense mental anxiety;  he very in-
cautiously  and  most injudiciously exposed himself under
these circumstances, unsuitably clad, to the open air, on  a 
URINARY ANALYSIS.
113
raw, cold, damp morning in the month of November.  The
attack of nervous fever above mentioned Avas the conse-
quence.  In this case, the perspiration and other secretions,
generally, indicated a great tendency to excessive acidity,
which justified a resort to a judicious  and Avell-regulated use
of the alkalies ; and, indeed, I feel that the patient is" mainly
indebted to their influence for his recovery.   But CAren at
the present moment, Avhen he  is  in  the  enjoyment of his
usual good  health, he is obliged to avoid green Aregetables,
oranges, light  acescent Avines, sugar,  and other fermentable
articles, experience having taught him that, in his case, acid-
ity may be  speedily and Arery easily induced by the slightest
deviation from rule ; and  this  acidity, Avhen brought on, is
ahvays  attended  Avith severe  pain in the stomach,  intense
headache, and nervous  trepidation,—effects Avhich speedily
supervene, but wdiich require considerable time to  subside.
Figure 0. 
I
                 CHAPTER  XIV.

               VARIOUS URINARY DEPOSITS.

  Nervous patients, with the oxalate of lime  diathesis,  I
find  derive  very great benefit from the exhibition of nitro-
muriatic acid  Avith  tincture  of  cinchona.   It is, however,
necessary to caution against  the too long-continued use of
the acids.   Oxalate of lime  is  found in urine  depositing
urate of ammonia, a diagram of which (Fig. 11) is subjoined,
Figure 11.
and even uric acid in the crystallized form, under which cir-
cumstances an incautious use of the acids might lead to great
inconvenience.   In regulating the treatment, therefore, when
oxalate of lime appears in the urine, it ought to be analyzed
         [114] 
VARIOUS URINARY DEPOSITS.
115
every third day, and immediately when either urate of am-
monia, or crystallized uric acid appears, the use of acids should
be suspended.   Sulphate of quinine, oxide of silver, or tris-
nitrate of bismuth, may be given with great advantage, till the
time arrives when Ave may resume the  acids.   I have, at this
moment,  a patient under my care who  has. suffered for many
years from this diathesis,  and Avhose  health  has been much
injured by  an empirical resort to  alkalies, but Avho is now
deriving very great benefit from the cautious administration
of nitro-muriatic  acid and cold baths.
   Urea — a diagram of Avhich (Fig. 12), crystallized from its>
solution in spirit, is here subjoined — is a urinary principle,
                          Figure 12.

excess or deficiency of Avhich in the urine is often  connected
with important nervous disorders.  When urea is in excess, it
often causes a great deal of irritation; there is a dull, heavy,
dragging pain  in the lower part of the back, Avhich is much
increased by exertion.   A  very  constant  symptom, more
especially in certain forms of excess of urea, is  a frequent
voiding of  the urine.   There is  often  a  greater quantity
voided than is  consistent Avith health; but from the frequent
calls, the quantity passed seems  to the patient  greatly to 
116
VARIOUS URINARY DEPOSITS.
exceed  Avhat  is natural.   Hence  this  affection is, and has
often been, confounded with diabetes, a disease  of  a very
different nature.
  In speaking of the treatment of this affection, Dr.  Prout
very justly obserAres, and in practice  I find  his ArieAvs con-
firmed,  "That calomel,  black doses, and saline purgatives are
calculated to do infinite mischief, and will probably render a
manageable disease perfectly  unmanageable,"—hence  the
necessity of at once ascertaining the  true  nature of the dis-
order.
  A patient lately  consulted me, whose urine had for some
time contained an  excess  of  urea.  He had been taking cal-
                                                     ©
Figure 13.
omel, Avhich, however, had not relieved him, and he Avas rec-
ommended the daily use of fluid magnesia.
  Upon examining the urine under the microscope, I discov-
ered crystals in beautiful tufts, which Avere at once copied by
the artist, and the delineations (Fig. 13) are here subjoined
Upon further inquiry, I found them  to consist of urate of
magnesia.   This patient Avas much relieved by discontinuing
the medicine,—paying  strict attention to diet, and  takino-
small doses of oxide of silver. 
               VARIOUS URINARY DEPOSITS.            H<

  In certain forms of degeneration of the kidney — granular,
for instance — the serum of the blood passes off by the kid-
neys.  Such urine  is albuminous, coagulating by heat, more
especially  if a feAv  drops of nitric acid be  added.   When
albuminous urine depends upon granular kidney, it  may be
regarded as a fatal  symptom.   We must, hoAvever,  be cau-
tious in pronouncing such an unfavorable opinion.  Not very
long  since I Avas called upon  to visit a gentleman Avho Avas
studying for the bar.   For some time he had been suffering
from scArerc nervous, aching pain in the back and loins.  A
medical  gentleman, a friend of his, having discovered albu-
men in the urine, pronounced him suffering from organic dis-
ease of the kidneys.  His friends  became  greatly alarmed,
especially  Avhen informed that nothing could be done to save
the patient.   At this juncture I saAV the case.
   The general  appearance  Avas not such as to excite in my
mind the  notion of organic disease.   All  those symptoms,
— the swollen face  and eyelids, the harsh,  dry state of skin,
the dull, stupid look and tendency to droAVsiness, —Avere not
present in the slightest degree, nor Avas there the least  indi-
cation of  any tendency to  dropsy.   I Avas, in  consequence,
induced to doubt that the kidneys  had anything to  do Avith
the  diseased condition of the urine.   I therefore  Avashed
out  the bladder Avith distilled Avater, by means of a double
catheter;  and then  made him drink, in my presence, tAVo or
three  tumblers of  filtered Avater.  He Avas placed,  on his
bare feet,  upon a cold marble slab,  and  in less  than ten min-
utes  passed  a considerable quantity of urine,  Avhich, on ex-
amination, afforded not a trace of albumen.   This sufficiently
proved that the kidneys Avere not the source of the albumen.
Upon stricter inquiry it Avas found that the albumen Avas de-
rived from the  mucous coat of  the  bladder.  It disappeared
very shortly under the influence of the tincture  of sesqui-
chloride of iron, iu doses of tAvcnty drops three times a day. 
118            VARIOUS URINARY DEPOSITS.

I mention this case to show the necessity of caution, and the
inconvenience Avhich may result from inferring  degeneration
of the kidneys merely because of a  little albumen  in  the
urine.
  Lithic or uric acid, of Avhich there is a diagram (Fig.  14)
attached, is likewise a principle  by Avhich the  urine is des-
tined to carry out certain effete matters from the system.   It
howTcver sometimes happens that more lithic acid is formed
than is  evacuated with  the urine.    The superabundance
Figure 14.
either is retained in the kidney, giving rise to  the formation
of renal  calculi, or it remains  in  the blood,  and occasions
various forms of nervous  disorder.   It is Avell knoAvn that
in rheumatism  the  blood  comparatively  abounds  in lithic
acid.   Occasionally this acid,  after remaining for some time
in the kidney, passes  into and  remains in the bladder, form-
ing a nucleus for further deposition, and vesical  calculus is
the result.
   One of my patients requested my attention to a poor man,
a shoemaker, Avho had been suffering for thirteen years from
a  nervous  affection, Avhich  latterly  had  increased so much,
and occasioned so great a degree of distress,  that he  could 
VARIOUS URINARY DEPOSITS.
119
hardly attend to his Avork.  He had tried a variety of reme-
dies,  and  consulted numerous  practitioners,  and  various
vieAvs Avere taken of the nature of the case.
  Having obtained several specimens of the urine, I found,
upon examination, that it abounded in lithic acid, which Avas
deposited in the crystalline form.   The appearance of the
acid, Avith the general circumstances of the case, induced me
to suspect the existence of stone in the bladder, as the cause
of the nervous symptoms from which he suffered.  He came
to Boston, and, on sounding, the  existence of calculus was
clearly and decidedly proved.
   There Avere  a great  number  of  very small  calculi of the
lithic kind,  many  of Avhich I succeeded  in crushing.   lie
became impatient, hoAvever, it being inconvenient to him to
be so much in Boston.  He therefore determined upon going
into the Boston Hospital to  be cut for stone.  The opera-
tion Avas very  skilfully performed, and the stones adroitly
extracted from the bladder; but inflammation  set in on the
third day, of which the patient unfortunately died.
   When lithic acid deposits in the joints in the form named
"chalk stones," there is much nervous irritation set up in the
system; and patients of this class  suffer so much from ner-
vous derangement, that the most trifling incidents Avill throw
them into a nervous paroxysm.   These gouty concretions do
not consist of chalk, but of urate  of soda; and the diagram
(Fig. 15) sIioavs the form of crystallization assumed by the
uric acid Avhen liberated from its combination with the  soda.
   When the  lithic acid diathesis preArails, the digestive func-
tions arc usually much out of order, and the patient complains
of flatulence and  great acidity of stomach, much increased
by acescent  fruits and vegetables, and indulgence  in port
wine.
   It is of the utmost importance that such derangements of
the system should be speedily recognized.  A few grains of 
120            VARIOUS URINARY DEPOSITS.

carbonate of potass  taken three  or four  hours after dinner,
and perseA'ered in for a short time, will remove a great deal
Figure 15.
of mischief, and prevent the formation of stone in the bladder,
which cost the patient, Avhose case I have  just mentioned,
his life.
  Cystine, or Cystic oxide (see diagram, Fig.  16), is very
                          Figure 16.

rare,  but Avhen it occurs  is attended  with severe  nervous
derangement.  It Avas first described by Dr. Wollaston, and 
VARIOUS  URINARY  DEPOSITS.
121
afterwards by Marcet;  and a very excellent account of the
substance itself, and of the state of the urine in which cystine
prevails, Avas published by my friend, Dr. Venables, some
years ago, in  the " American Journal of Medicine."  Little
or nothing has  been added to Dr. Venables' excellent detail.
  Liebig  has   lately announced the  existence of  hippuric
acid (Fig. 17), as a constituent of human urine.   It is occa-
Figure 17.
sionally present in quantity in the urine  of hysterical and
nervous females, and in the urine of persons who have been
compelled to live for some time  upon a poor, low, and bad
diet.   Change  of air,  and good  nutritious food, with  tran-
quillity of mind, will be found among the most effectual rem-
edies.
  The earthy phosphates are constantly deposited from the
urine of nervous patients, and many of  the symptoms in
such cases, are analogous to those Avhich occur in the  lithic
acid diathesis.   The triple or ammonio-magnesian phosphate
is delineated  in Fig. 18.
  The deposition of the  prismatic phosphate  is generally 
122
VARIOUS URINARY DEPOSITS.
accompanied Avith severe pain in the back, much increased
by any kind of exertion, especially if the lumbar and dorsal
muscles are much or actively employed.
  We frequently find  cutaneous eruptions  upon  different
parts  of the body  associated,  or in  some  way  connected,
with the deposition of the triple salt.  " That tendency to a
deposition  of these earthy salts  in the  urine," says Dr.
Prout, " is sometimes hereditary, there  can be  no doubt.
Moreover, this tendency often assumes different forms in dif-
Figure 18.
ferent members  of the same family, and  even in the  same
individual at  different periods of his life.   Thus, Avhen one
individual of a family has  suffered from a deposition of the
phosphates, another has suffered from  gout,  a second from
asthma, a third from cutaneous disease.
  I have for some time attended a gentleman Avho has been
suffering for many years from spasmodic asthma.   The urine
deposits  the  phosphates  in great abundance.   I  have also
attended the brother of this gentleman, likeAvise his nephew,
and three of his children, all suffering  from Avhat they name
nervousness, which it is said runs in the  family.  No two, 
VARIOUS URINARY DEPOSITS.
123
hoAvever, suffer alike.   The gentleman told me  that  he
thought he should have lost his life in consequence of having.
gone, on the recommendation of a physician, to a watering-
place,  and  drank largely of an  alkaline spring.   He was
reduced to such a degree, and his health so very much shat-
tered, that many months elapsed before it was restored to its
ordinary state.  One can hardly reconcile the probability of
such an error, had there been even but an imperfect  analysis
of the urine.
  There is scarcely a day passes that I have not applications
from  members of the profession  requesting me to examine
the uriue of their patients.   This is very often accompanied
Avith another, —that I Avould be  so good as to forward,  by
return of post, a report,  Avith a full account of the analysis.
Perhaps the little  attention bestowed  upon  inquiries of this
sort, by gentlemen in general practice, will account for their
not being aAvare that days are often necessary before the  in-
vestigation can be completed, and the  analysis perfected. 
CHAPTER XV.
   PATHOLOGY OF  THE NERVES AND NERVOUS MALADIES.

  The dominion of the nerves over the mental and physical
actions of man is unbounded.  The various workings of in-
tellect,  sensation,  volition,  motion, secretion, nutrition, —
the essence  of all  these  is nervous influence.  There  is no
animal without nerves, but myriads without  circulation of
the blood.  Blood and  nerve  are, hoAvever,  about equally
implicated in the phenomena of health and disease.   When
the nerves are powerfully affected, how quickly the heart is
affected also !  Alarm and terror are mental impressions ; but
hoAV instantaneously the  heart is affected by  undue enerva-
tion is  evidenced  by palpitation,  increase or arrest of cir-
culation,  by  blush  or pallor.   The phenomena of mental
disorders, or of a  class of them, at least, are dependent on
an  abnormal supply of carbonized or  oxygenized blood on
the brain, or a deficiency of phosphorus.   Excess of arterial
or-venous blood will equally induce  a  train of morbid phe-
nomena in the nerve, as  in any  other organic tissues of the
body.   There is indeed a marvellous connection betAveen the
nervous and vascular  systems throughout  the animal frame.
Too great action  in the minute arteries, congestion in the
veins, an  ansemious or bloodless state of  the vascular sys-
tem of the brain, alike induce morbidly exalted and impaired
conditions of the  mental and cerebral functions; spectres,
              [124] 
PATHOLOGY  OF THE NERVES.            125
delirium, insomnia or sleeplessness, amaurosis, stupor, coma ;
violent  involuntary  actions,  or  paralysis  of  the  volun-
tary motions, etc.  The  higher the nervous  energy, or the
more vigorous the circulation  of the blood, the  greater the
poAver of  the A'ital  tissues to  resist contagious  diseases.
Hope AA'ill  preserve the energy of the body under the most
depressing influences, the most laborious exertions. The body
cannot have rest or health till the mind  be  satisfied.  The
nerves are valuable servants, but  they are despotic masters.
Let them once get the  Avhip-hand, and Avoe betide their slave.
Noav, have we not an  apology to make to them?   We either
coax and pet and  indulge them as Ave do spoiled children, or
Avork them to the utmost; and then Ave  wonder that their
evil qualities turn  the tables on ourselves, and render us slaves
to the tempter.   Let us take  a brief glance at those excited
conditions  of the  mind Avhich are  so often the spring of ner-
vous  maladies, real and  imaginary.   It is true  we cannot
always
              " Minister to a mind diseased,
               Pluck from the memory a rooted sorrow; "

but, by a little self-denial, a sound mind  (mens sana), to  a
degree at least, may be preserved to us.  If, in the effort,
even  self-interest  or self-gratification be sacrificed, the tran-
sient  tears of regret will, we may hope, be consecrated, and
turned to those of joy and thankfulness, when the struggle
is over.
  Intense impression on the mind is a subject full of  inter-
est.   The illusions so often induced by it are contrasted in
their influence o\ov the  system.   They may be consolatory,
an agreeable  and happy deception,- and should in some cases
be even  encouraged.   We Avill  glance at a  story  told by
Kotzebue, the poet, in illustration.   It was of a young lady
Avhose lover  died.  His  harp, on  which he  Ava's  wont  to 
126            PATHOLOGY OF THE NERVES.
accompany her, hung in her chamber.   After a period  of
melancholy and grief, she touched the cords of her  instru-
ment ;  the harp, tuned  in accordance, responded.   Surprise
and  terror Avere  at first the consequences ;  but these iioav
yielded to a  romantic  melancholy, Avith a  conA'iction that
the spirit  of her loA'-er swept the strings of the harp.  Her
music  became  her only consolation, until  a  scientific friend
explained to her the principle  of phonic harmonies.   From
that moment  the  illusion  vanished,  and she  drooped  and
died.  But  if the  impression  be foreboding of misfortune,
of course  it should be removed  if possible.   We could cite
many cases  of those  unhappy  prognostics from dreams, and
the prophecy or  dread  of  the fortune-teller, regarding the
termination of operations or of childbirth.  Anxiety is pros-
pective sorroAv, — its subjects A^arious.  In  that Avhich may
be termed moral  anxiety, as that of a Avife or a mother for
the safety of her husband and her child, there is  a  sacred-
ness Avhich excites our  deepest  sympathy.  Others  have a
more unholy spring; a  heart  tainted with pride or avarice,
those besetting sins Avhich  so deform human nature,  and to
the pains  of Avhich there is no end, —for  pride and  avarice
are never satisfied, — there is no  real meaning but a negative
one  in  the Avord enough.  These passions  are the very bane
of existence.  Yet Iioav many, even of those wdio decry them,
cherish the serpents in  their  bosom, trusting to  honor or
riches for sublunary happiness, forgetting the monitory lines
of Yroung, —

        " Why all this toil  for triumphs of an hour?
          What though we wade in wealth or soar in fame ?
          Earth's highest station ends in ' Here he lies ';
          And dust to dust concludes her noblest song."

   The feeling of anxiety is  one  continued  heart-ache; it is
the dread "of something worse tbmi the  present.   It  is pro- 
               PATHOLOGY OF  THE NERVES.            *■**

gressive in its degree, and therefore more poignant than real
sorrow  or grief, Avhich is the pain of  memory, and Avhich so
constantly, from the mere elasticity  of the mind, gradually
fftdes and disappears.   For  the  anxious heart there is  often
no relief,  save from the eloquent lips of sympathetic friend-
ship, or the consolation of religion.   If it be not relieved,
Ioav  nervous  fever Avill  be the consequence, with remora of
the  circulation, inducing local  congestions ; then, not only
are  the secretions diminished,  but those which are  formed
are depraved and  unhealthy.   For so surely  as the enliven-
ing  passions  oxygenize the blood, do the depressing  emo-
tions accumulate carbon.  By this poison a constant morbid
and ineffective reaction is going on, Avhich wofully aggravates
the  original affection.   Thus is established a train  of ner-
vous maladies, — neuralgia, hypochondriasis,  melancholy, —
inducing  that corroding action in the brain, which, in  the
Avords  of the son of Sirarh, "consumeth marroAV  and bone."
In the end, if the brain be long oppressed by  its  poison-
blood,  taidium vitce, or Aveariness of life, must be the result,
the  climax of which may be suicide.  During this progress
the  system is  in a state of universal malady, — all is  going
 wrong.  Circulation, digestion,  assimilation,  nutrition,  the
 nurses of life, fail;  absorption  of fat succeeds, and  atrophy
 is the result.  In  the  anxious   mother, the secretion of the
 milk is checked or depraved,  by Avhich half-poisonous fluid
 the numerous convulsive and gastric diseases of  infancy are
 brought on.
   The influence  of anxiety also constantly lights up  those
 latent  germs  of constitutional disease, which might  never
 otherwise have been  developed.  The miliary tubercle  of
 phthisis is thus excited to action, and youth and beauty, till
 then in seemingly blooming health,  are  at once  doomed to
 decay  and perish.
   But  the great source of anxiety and  its train of ills is to 
128
PATHOLOGY  OF THE  NERVES.
be sought in those  ardent longings for Avorldly possessions,
Avhich  are  the especial debasement of this age.   But even
the fullest measure  of success in the insane struggle for opu-
lence soon palls  on the sense.   When all earthly grandeur
and  power  are at length attained, the  proud  and  anxious
possessor stalks  through his  gorgeously furnished halls,
counts over his millions, and Avonders  and deplores (that is,
if he can moralize)  that his heart "is not sufficiently capacious
to enjoy all the splendor, and opportunities of  gratification,
Avhich it commands.  We cannot
                  " Through the loop-hole of retreat
               Look out upon the world,"

agitated as  it is at this  moment with the intense desire of
gain, Avith the eager haste to be rich, without a thrill of pity
and sympathy for the  blind votaries of Mammon,  Avho daily
and  hourly prostrate  themselves before the golden image
they have  themselves  set up !   Tranquillity of mind !   It
Avere a miracle indeed if such a condition of  brain could be
preserved amid the tumult of a stock  and share market and
gold-board, in the face of desperate ventures, in Avhich mil-
lions may be involved, and  families reduced to irretrievable
ruin, in the twinkling  of an eye, as it  Avere.   And it Avere  a
vain effort to check the headlong course of one  on  Avhom the
monomania of gaming has taken so deep a hold.   Yet while
Mammon thus reigns in every alley, the  health of the body
is sapped, the intellect is impaired and perverted, the condi-
tion of  its organ  gradually destroyed, the earthly  climax of
AA'hich  may be  drivelling or  raving insanity, or death, self-
inflicted from the muzzle of the revolver in the  grasp of des-
peration.   On the  slaves of  pleasure,  anxiety is  ever  an
attendant demon.   True, the orgies of  Bacchus and Yenus,
during their intense excitement, droAvn  the heart  and mind
in one voluptuous flood, Avhile the cup  of Nepenthe  or the lips 
      >         PATHOLOGY OF  THE NERVES.           129

and arms of beauty throAv their spell over the senses ;  but the
deep  anxiety of after-thought and feeling  can never be com-
pensated by a thousand-fold of such enjoyment.  And is the
penalty merely transient?  Alas, it lasts  a life-time !  It is
deeply painful to reflect on the prolific springs  of  disorder
from   these slavish passions;  the brain  and heart  are the
especial  organs  into which their poison is infused.  Either
the intellect or the senses are reduced to a brutal apathy,  or
the sensitiveness (hyperesthesia) of the  nervous system is
so morbidly increased, that, on the slightest disappointment,
or social competition even, the Avhole  system is deranged,
and there  is no philosophy, no piety, to tranquillize a mind
so subdued, for irreligion  must be the predominant  prin-
ciple  of such a life.
   Grief and its  prototypes is  another fertile  source  of deep
or protracted  neiwous maladies.  The intense degree  of grief
is all-absorbing.  The mind broods  over  the one subject  of
its  Avoe, and  so reluctant  is it to admit  another, that it is
often annoyed by conversation of friends, or even impression
on the senses.   Hence, the deep mourner retires into lonely
seclusion,  and soon may be lighted a train of feelings as dis-
tressing  as they  are  obnoxious to remedy — melancholy.
  When this  sad  condition is the result of bodily causes, Ave
can cure it; but Avhen it springs from moral causes, time, of
course, is  an element  in  the cure.  But the maladie imagi-
naire is mostly the result of mere corporal derangement and
break-down.  We will conclude our remarks on the pathol-
ogy of nervous maladies by glancing  at the hygiene  best
adapted  to remedy them.   (As for their medical treatment,
Ave  can  best administer that directly and  personally, rather
than through the medium of  a wrork on Nervous Affections.
As  has  already been said, the  resources  of  the   Materia
Medica for nervous maladies has been powerfully reinforced
within the last ten years, by an entirely neA^ class of reme- 
130
PATHOLOGY  OF THE NERVES.
 dies, based on our greater knoAvledge of the nervous system
 and its  action.  The Avriter himself  has  introduced a new
 and most potent remedy.)
   If Ave believe in the irritation or disturbance of mind as a
 fertile source of the neuroses,  or nervous  affections, Ave may
 also belieA'o  that the inducing a different  state of mind Avill
 proATe a curative  or preventive oftentimes,—at any rate, a
 great help to a cure.   This state of mind Avould be the oppo-
 site of pride, envy, hatred, and sordid greed of gain,  Avhich
 passions, as  a great moralist remarks, have no  holidays, —
 that  Avhich  we term  repose, — contentment,  tranquillity,
 happiness.   By mental repose Ave do not mean the apathetic
 state of the thoughtless or the  slothful; the dolce far niente
 of the useless do-nothing, is the mere scum on the surface of
 the  cup  of idleness Avhich contains a poisonous bitter in  its
 dregs.   Under the placid condition of mind, not only is the
 vis medicatrix alloAved to exert its potent  influence, but the
 various functions of the body are almost ensured, or restored
 to their former integrity.   " To  laugh and grow fat" has
 become  a piwerb.  Yet, to ensure this  happy mood, how
 manifold arc the precepts, —amusements and moderate occu-
 pation, and  those most congenial to  the  disposition.  But
 this mental  election  must not be  negative ; the mind must
 be brought  not only to  forego those perilous  pleasures of
 sense and of sensibility, to Avhich luxury and  sloth are so
 naturally prone, but also to act on the  subject of its thoughts,
 not  with fatigue and labor, but Avith  that degree of energy
 which will  afford food for immediate reflection, and the
 memory  of  which will be  the constant  spring of tranquil
 satisfaction.   "We should  live pleasant,"  and regard  cheer-
fulness as a duty.  To ensure this  requires  often  a high
 degree of self-control, as Avell as the sympathy of friendship.
 The greatest caution in conversation is sometimes essential ;
 allusions to  subjects Avhich are  agreeable,  congenial, and 
PATHOLOGY  OF THE NERVES.
131
   consolatory to the invalid, should  be adopted, both in con-
   versation and reading ;  and objects of beauty and of interest
   should as much as possible be presented to the mind ; for it
   has been observed Iioav influential are  odor and  color  and
   form in mitigation of more decided maladies.  Of the antipa-
   thies of smell and taste Ave have known very curious instances
   in nervous  patients.  The olfactory nerves may become so
   acutely sensitive  as to be oppressed  by even grateful odors,
•  so that the poet scarcely exaggerates Avhen he says, —
                " And quick effluvia darting  to the brain,
                 Die of a rose in aromatic pain."

   The morbid eccentricities of  touch or feeling are among the
   most painful maladies of the  neuroses.   They are eminently
   characteristic of hysteria.    A lady, Avho Avas for several
   years under the writer's care for phthisis, Avas occasionally
   affected with intense hyperesthesia (excessive sensitiveness)
   of the skin.  During this state, a feather dropped on  her
   person  Avould instantly produce such intense agony  as to
 •  draAV forth a shrill  and prolonged  scream.   But to resume
   our remarks on  the  hygiene for shattered  nerves.   We fear
   that the lesson which we are  endeavoring to inculcate  is not
   so easy in this excited,  artificial age.  We have, in truth, so
   multiplied our Avants, that we become restless, if we do  not
   accomplish  all the mind can conceive.  Like Ariel, Ave wTould
   put a girdle round the globe in forty minutes or seconds.
   The age is  a nervous one, and hence  the desirability — to
   the Avorld-worn, jaded man — of repose, and the  exceeding
   need of procuring it. 
CHAPTER XVI.
  A FEW HYGIENIC OBSERVATIONS ON  NERVOUS AFFECTIONS.

   In regard to nervous patients, Brown-Sequard insists that
" A serious aim in the daily occupations is  of the greatest
value, and for many persons, quite essential to prevent or to
check nervous disturbances.  The applications of this princi-
ple are, of course, he says, very difficult, and often impossi-
ble, in certain neuroses;  but in those  cases  in which any
kind of serious work, either mental or physical, but not too
fatiguing  or  exciting, is liked  by the patient, he should be
induced to do it.   In cases of hypochondria, of hysteria, of
chorea, or even of epilepsy, a great  benefit can be derived
from a serious employment of the mental and physical activ-
ity of the sufferer.  How often have I not seen young epilep-
tics kept in idleness (alas ! by medical advice), and  having
gained more or less of the vices  it leads to, improve rapidly
from having their minds occupied at regular hours,  in nearly
the same way as  healthy people of their age.  The  second
principle of moral  treatment is, that we must, in the interest
of our nervous patients, as much as, if not more than in our
own, give them confidence and hope in the treatment we rec-
ommend.  In hysterical and  all nervous  complaints allied
with it, and also in hypochondria, a great hope of  cure will
do  much to work out the cure.   No doubt you Avill say, But
how can vou give hope ?   I answer that the best means for
         " ■      [132] 
OBSERArATIONS ON NERVOUS AFFECTIONS.      l133
 that purpose is to have  hope  ourselves, and to express our
 hope Avith the accent of conviction.  And, as you Avould ask
 hoAV can Ave command hope  in ourselves ? I ansAver that the
 very knoAvledge of  the truth of the  principle I am now
 speaking of, is enough to render  one  hopeful.   I need not
 now repeat  that I am noAV only speaking of those nervous
 diseases in AArhich the power  of the mind upon the body is so
 great,  that  under the  influence of an  emotion,  or another
 moral  cause, a sudden  or almost sudden cure  is  not very
 rare." *   It has repeatedly occurred to  me to see  patients
 who stated that they had been  for years in the habit of taking
 large quantities of opening  medicines  to keep  up  the due
 action of the bowels, but still without the slightest advantage
 or even effecting the purpose ;  yet have I seen these persons
 derive  infinitely more benefit, in a few weeks, from  a few
 "globules," and strictly attending  to the admirable dietetic
 rules prescribed by Hahnemann, viz. giving up the use of
 wine, spirits,  and all  such stimulants,  than  could  possibly
 have been derived from the adoption of  all the routine  disci-
 pline so commonly insisted on.  It may be said, and I have
 no doubt Avith  a great deal of truth, that the abstaining from
 the use  of Avine and  ardent  spirits, with the strict .attention
 to  diet, etc., were really the means  of cure; and  that the
 minute doses of medicine in the globules were merely incen-
 tives to  regimen, but  in  every  other particular wholly inert.
 Upon this, however,  as a purely practical  man, I  need only
 observe, that it matters but very little to the patient by what
 means his health has  been  restored,  so that he perfectly
 regain it; nor can it interest  him much  what particular plan
 of treatment has been  the truly efficacious one in curing his
 disorder.  But if patients will  not  be satisfied Avithout tak-
 ing large quantities of medicine, they may as Avell be grati-
  * Lectures on the Diagnosis and Treatment of Functional Nervous  Affec-
tions.  By C. E. Brown-Sequard. 
 134       OBSERVATIONS  ON NERVOUS AFFECTIONS.

 fied and amused Avith globules, or something at least equally
 harmless, so that they may sustain no injury, Avhile pursuing
 a  rational mode of  living,  and one  conducive  to  health.
 Again, I have seen  similar benefit, in habitual and obstinate
 constipation of the bowels, and indeed confirmed ill health,
 from  a  feAV months' Avell-regulatcd  hydropathic  treatment;
 and such patients have really obtained inconceiArably more
 advantage  from strict observance of  these rules, and due
 attention to diet, air, and exercise, than had accrued from the
 prolonged adoption of the plans recommended by the most
 judicious and skilful allopathic practitioners.  In such cases,
 regimen  seems to have been an important element of  suc-
 cess.  It has  been already  observed that  the dietetic  and
 sanitary measures inculcated by homoeopathy ; the invigorat-
 ing influence  of hydropathy;  and the various means at the
. disposal of and resorted to by the allopathist, may,  Avhen prop-
 erly applied, prove  of the greatest benefit; but  on the con-
 trary, if indiscriminately adopted or injudiciously used, they
 may prove not only inert, but  often Arery injurious.  It must
 therefore be apparent  that,  as already  observed, before Ave
 can determine  Avith any prospect of success  on the treatment
 of disease, Ave must diligently inquire into  the nature of the
 case, so  as  to ascertain the cause and remove it;  for if this
 be alloAved to continue in operation, it will  be vain to expect
 that the  effects will cease,—still less  be   permanently re-
 moved.
   But let us suppose  that we  should  prove  successful in
 checking or suppressing the effects, as  may sometimes hap-
 pen, Avithout subduing the cause,  Ave should only aggravate
 the mischief, and induce confirmed derangement  in the sys-
 tem, the cause of which perhaps no subsequent  efforts would
 be sufficient  thoroughly to   eradicate.   Possibly this  may
 be rendered more intelligible by  the folioAving illustration.
 Purging, for instance,  may  be  occasioned  by  cold applied 
          OBSERVATIONS ON NERVOUS AFFECTIONS.      135

to the skin while it  is hot and perspiring;  the perspiration
being suddenly and over-precipitately checked, purging is
set up  on the part of nature to compensate  the suppressed
action of  the skin, and thereby relieve, at least in part, the
system  by the removal of noxious  principles.   Any similar
derangement of the boAvels may arise from taking too much
food into  the  stomach.   Here, then, Ave find the same effect
— relaxation of the  boAvels — produced by two causes differ-
ing altogether in their nature and mode of action.  Were we
to treat the disorder of the boAvels, so  occasioned, by the
same means, Ave should most assuredly fail  of success,
the  causes  in each  being so Arery  different; and therefore
the  treatment should be varied, and suited  to  the peculiar
circumstances of each case.   Instead of checking the purging
in the  first instance, by administering astringents,  absorb-
ents, etc., the AA'arm bath and the administration of* medi-
cines, calculated to restore the suppressed or suspended action
of the skin, Avill  be more in accordance Avith the true princi-
ples of treatment.   But, in the second  case, in which too
much food, or of an indigestible nature, has been the cause
of the  derangement, the appropriate treatment Avill be its
immediate evacuation by  an emetic or a suitable laxative.  A
very frequent cause of nervous affections is, intense or unsea-
sonable application  of  the mind, as in reading Avhile at din-
ner.  By this untimely  exercise of the brain, the blood is
diverted from its proper course — viz. the  stomach — at  a
time when it 'is particularly required there to enable  the vis-
cus to secrete and supply a sufficiency of gastric juice.  Such
patients cannot be benefited except they  alter their habits,
because so  long  as  they  force  the current of blood towards
the brain, Avhen the vital fluid  is required elseAvhere for the
purpose of digestion, this function Avill be impaired, and but
very imperfectly performed, and nervous derangement will
continue to result. 
 136      OBSERVATIONS OX NERVOUS  AFFECTIONS.

  Another and very common cause of nervous disorder I have
 found to prevail much amongst gentlemen engaged the AAdiole
 day in  the city,  and Avho seldom  take any food till they
 return home to a six-o'clock dinner.   They then indulge too
 freely in the pleasures of the table, and burden the stomach
 Avith more food than  there is  gastric juice to dissohre ; con-
 sequently a considerable portion  of the food remains  undi-
 gested, and,  undergoing spontaneous decomposition, gives
 rise to the evolution  of different gases in  large quantities in
 the stomach,  painfully  distending  the organ, and  causing
 belching, acidity, acrid eructations, hiccup, etc.   Unless Ave
 remove the cause  by a more suitable mode of living, the
 effects Avill not cease.  Medicines may relieve, but Avill  not
 cure the patient.
  Nervous disorder proceeding from another and very differ-
 ent cause, frequently falls  under  my  notice.   The affection
 is  attended Avith Auolent nervous headache,  severe palpita-
 tions of the heart, Avith a sense of sinking and exhaustion.
 It occurs in persons who are engaged for many hours during
 the day in active exercise of both mind and  body, and Avho
 at certain seasons  cannot  spare  time  for  refreshment till a
 very late hour, when  the energies of the frame have become,
 as   it  Avere, completely  exhausted.   But  even at this late
period they are frequently disturbed and called aAvay, before
 they have had time to finish their repast.   Under such cir-
 cumstances, the frame is enfeebled and  overpoAvered before
any opportunity for refreshment presents itself, the stomach
 naturally participates  in the general debility, and  in conse-
quence becomes unequal to healthy digestion.   Hence, such
 individuals emaciate, become feeble, and ultimately are pros-
trated both in mind and body.  In such cases medicine is of
 little or no use; nothing but a more rational  mode of livino-
can restore such persons to health and strength.   Indeed  it
 is  surprising  to see  hoAV  speedily they recoArer,  Avhen, by 
OBSERVATIONS ON NERVOUS AFFECTIONS.
137
altering their mode  of life, the  cause  of disorder has been
removed.
  Analogies  draAvn  from the  inferior animals often  lead us
to the knowledge of the true principles of cure.  Experience
has taught the groom the evil consequences that result from
feeding the horse immediately after severe exercise ; and phys-
iology unfolds to us the  rationale.   The  blood requisite  to
enable the stomach  to form and secrete a sufficient quantity
of gastric juice for the  purpose of digestion, has  not yet
reverted from the muscles, whither the current of blood had
been more  abundantly directed, to increase the muscular
energies and activity, and proportion them to the exertions
they were called upon to make while under the stimulus of
severe exercise.  Hence it  is necessary to alloAv the animal
sufficient time  for  repose, that the muscular system  may
relapse into its  ordinary state of quiescence.  The animal
may then be fed, not only with  safety, but with advantage ;
the stimulus which the food creates brings an increased afflux
of  blood  to the, stomach;  gastric  juice  is  secreted more
copiously, and  poured in sufficient quantity  into the cavity
of  the viscus, and,  acting with energy  upon  the food,  it is
readily dissolved, and  prepared for its final  formation  into
nourishment.  The  same laws hold  good  Avith respect  to
man;  and thus  it is that  analogies often lead to the adoption
of true principles, as well as to their explanation.
   "Nervousness," says Dr. Trail, "is as much distinguished
from all  other  maladies by  mental perversity, as  it is by
bodily infirmity.  Without being criminal or addicted to any
particular vices, nervous persons are  ill-tempered, peevish,
jealous,  passionate, and always  unreliable.  They are un-
trustworthy, not because of dishonest  motives, but because
of uuo-overnable impulses.  They are unreliable, not because
of intentional Avrong, but because of fickleness of disposition
and feebleness  of will power.  They are very  selfish, and 
138       OBSERVATIONS  ON NERVOUS AFFECTIONS.

sometimes mean, not because they lack benevolent emotions
and  a  right conscience, but because  their outward conduct
expresses their internal conditions.  Cure them of their ner-
vousness, and they may become  agreeable, generous, truth-
ful, and faithful, as they have been before.   But  everything
has a cause, and so has  nervousness.   It has many causes,
as many as individuals have unhygienic habits.  All personal
habits  that are unwholesome conduce to it.  But in all cases
there is some local point of irritation" or obstruction, perhaps
trivial  in  itself, from which the whole  trouble proceeds.   A
person may be  very weak, as in cholera  or paralysis, with-
out being nervous."
   "He maybe dangerously sick, as of  fever, and  no one
accuse him of nervousness.  But if the  blood is congested
in some  part or  organ, no matter  where  nor  from what
cause,  to the extent of disturbing the  equilibrium  of the
circulation, yet not sufficient  to occasion  acute  disease,
the person so  affected  will inevitably have a more  or less
aggravated form of nervousness.   And this fact explains why
so many  persons are more or less nervous,  and why this
ailment is peculiar to high  civilization."
   Among the more prominent special causes are too much
night work, wTant of sleep, great mental anxiety, indigestible
viands, narcotic stimulants, as alcohol and tobacco, late sup-
pers, and sedentary  habits.  Any  cause, also, that impairs
the vitality and drains the vital fluids, as  running sores, fre-
quent bleedings, chronic  diarrhoea, will result in nervousness.
A very torpid liver, a  very inactive skin,  and  prolonged
constipation,  never  fail  to occasion severe  and  obstinate
forms  of  nervousness.   Obstruction,  therefore,  beino- the
primary and predisposing cause,  and unbalanced  circulation
the proximate condition, the remedial plan  is self-evident.
Promote  circulation to the Avhole  surface as much as possible
by occasional bathing, and daily frictions with  dry towels ; 
          OBSERVATIONS ON NERVOUS  AFFECTIONS.      139

use only plain and simple viands, so that the internal viscera
may be unloaded; and exercise as much as possible, within
the limits of fatigue.   Sleep all you can, avoid  all convert
sation concerning your manifold miseries, and in due time
this nervousness will disappear.   Great numbers of men  in
the vortex of  city life seem to suppose that they can indulge
constantly  and  with  impunity  in   sensual  excesses, and
especially the abuse of Avines and liquors, of good cheer,  of
venereal  pleasures,  and  intellectual  excesses, represented
particularly by prolonged watchings and preoccupations with
business  enterprises,  works,  etc.   But sooner or  later all
such find their mistake in shattered and disordered nervous
systems.  The writer has by his remedies enabled hundreds
of persons guilty of such habitual excesses and violation of
the plainest hygienic laws to escape the consequences of their
folly.   But he has done  it by his  insisting, when his reme-
dies had  done their perfect Avork in restoring  the nerves  to
their wonted  healthful action, upon  an entire abandonment
of previous bad habits and practices, so that the effects of
his medicine  might be reinforced  by a proper regimen and
life. 
CHAPTER  XVII.
   A  CURIOUS CASE OF SUPPOSED  DEMONIAC POSSESSION.

  I could very easily fill a  dozen chapters with interesting
narratives of the manifold illusions, delusions, and hallucina-
tions AAdiich I have had to deal with in treating a vast num-
ber of  nervous  cases.   These  various  instances  of  the
maladie imaginaire have been, of course, the results of a
disturbed condition of the functions of the brain and nervous
system.  Several years  ago  a patient was  under my treat-
ment, who  Avas thoroughly convinced that he was possessed
by unclean or evil spirits.  This person was a gentleman of
uncommon intellectual  power and culture, and on all other
subjects, except that of his own demoniacal possession,  was
sensible, rational, and intelligent.   On  his  first visit at my
office, he placed in my hands  a lengthy account of his sup-
posed affliction.  It was addressed  to me, and Avas in the
form of a letter.  It is too long for the limits of this volume
entire, but  I will give  the most  interesting  portions of it,
merely prefacing it with the remark that the writer Avas ulti-
mately cured of his most uncomfortable monomania,  and now
looks back upon it with almost the  curiosity of  a  disinter-
ested third person.   The epistle is subjoined.

" Dear  Doctor :
  "It was  my intention, some  time since, to have Avritten
you a short account of the sufferings I have experienced for
              [140] 
SUPPOSED DEMONIAC POSSESSION.          141
several  years  past, from the possession of  evil spirits;  but
in consequence of having been  constantly pitied and smiled
at, and  having met with no one Avho would  sympathize with
me, Avhenever I have broached  such a notion, and instanced
myself  as a proof of  the  existence of  such  spirits, I  had
almost come to the conclusion  not to Avrite at all.  Unac-
quainted as I am with theological discussion, and  Avholly
unused  to argumentative composition, I am at a loss in Avhat
manner to set about an explanation on the subject required."
(Here the writer gives a sketch  of his life.   It seems that he
was  living Avith his wife and several fine children in the  city
of New York,  engaged in professional pursuits, Avhich yielded
him a lucrative  income at  the  time he was attacked by the
singular monomania.)   "The profits from my profession,"
he writes, " still continuing on  the increase, I at this period
entered into  some money speculations, which caused me a
little  anxiety  and some  pecuniary  embarrassment,  but I
retained all my usual buoyancy  of spirit.  It was then Avhile
taking  a quiet walk one evening, far from the  busy hum of
men, I  heard  the sound of voices  near me, speaking  of  me.
I looked in every direction, but  could not discover any one.
I got over  some banks, thinking that, probably, the persons
might have  been  concealed from vieAv by them;  but  no
human  creatures were there.  I Avalked away from the spot,
still  the voices pursued me.  I mixed Avith the  thickest of
the throng  in the  metropolis;  the voices still continued to
haunt me,  and the words then  uttered Avere 'Who is he? —
do you knoAV who he is?'  The response was,  ' He is Satan's
oavii.'   These  words seemed continuously to proceed from
the persons I passed.   I crossed and re-crossed the streets ;
still  the same voices followed me.  Every  one appeared to
ask the  same  or a like question,  and  there  Avas a similar
reply.  Other queries  and  ansAvers succeeded to these relat-
ing to  my  walking,—for  my  pace was  very  rapid, as  I 
142          SUPPOSED DEMONIAC POSSESSION.
trusted to escape the notice or recognition of the passers-by;
but the " Devil's  Own " was either whispered or shouted to
me, apparently by almost every one; and those from whom
the sounds did not emanate, appeared hastily to get out of
my way, or, in my imagination, shrunk from me Avith looks
expressive of surprise.   No doubt, hoAvever, that my strides
were those of  a possessed person, and caused those I met or
overtook to make  ample space for me.
  "The whole  night did I thus perambulate NeAv York and
its environs, occasionally dozing, as  I stood still for a few
minutes;  and  in  this manner I  tAvice accomplished the cir-
cuit of the great city, vainly hoping that daylight Avould end
my illusion.  Such hope was indeed vain, and I must  men-
tion, that  not merely the " Devil's Own " was sounded in  my
ears, but observations and conversations relating to me inces-
santly occurred.  Yet was I perfec^y in my senses.  I Avent
to the place in which the sounds  first reached me, and exam-
ined it  and the neighborhood minutely;  of course I could
not discover any human power to account  for them.  I then
began to think of spiritualism, on which I had thought little
before,  as  an  explanation of the strange  phenomena.  .  .  .
The voices loudly and clamorously spoke of all my misdeeds,
and taxed me with sins of which I had not  been guilty.  And
I Avas dared to meet  the parties Avho charged me Avith such
and Avith other  crimes.   I did accordingly go to a friend of
mine, Avho is now dead, and  told him  I had been  affected,
and that I wished him to be present to hear the  voices, if he
could, and the charges to be made against me, Avhich I Avas
to deny, or to admit, as the  circumstances might be.  Sev-
eral voices then made various accusations against me, and I
appeared to be put  on a regular trial.   I replied to  the,
charges by my thoughts, without speaking,  but occasionally
my tongue could not refrain from moving  Avithin my lips, to
express my thoughts Avithout, hoAvever, giving  utterance  to
them. 
             SUPPOSED DEMONIAC POSSESSION.          143

  " One of the voices Avas remarkably clear  and loud.  It
appeared to be that of a being of authority in conversation
with another, and although slightly favorable  in his expres-
sions of my good conduct  throughout life, yet  strong and
severe Avere  his  animadversions  on  my  bad thoughts  and
actions.  And here everything I had said or done, or omitted,
Avas elucidated instantly ;  hidden motives and thoughts and
actions Ave re unravelled, to my great astonishment, and my
heart and  brain  seemed completely laid  open.   All  Avas
written doAvn or directed  so  to  be,  and  the next day Avas
appointed  for  a  further examination.   I asked my  friend
repeatedly during this trial if  he  heard any  voices.   He told
me he did not.  I mentioned Avhat Avas now and then said to
me, and of me.  I smiled at  myself, for I  kneAV I Avas only
in a room, and that it Avas impossible for any Avorldly being
to  speak or communicate  Avith  me  except my friend.   I
looked  at  him — he Avas  deeply  engaged in Avriting; could
there be  any ventriloquism in the case ?   I  knew that my
friend Avas  not thus  gifted;  besides, the voices Avere Avith
me before I saAV him that day.  What could have occasioned
the sensation of sound I had experienced ; the direct appeal to
my heart and brain ? I Avas entirely in my senses, and reasoned
on the absurdity of my harboring any opinion contrary to my
own received notion of the ordinary laws of nature.  I began
to think of spiritualism—of clairvoyance.  . . . The  more I
thought, the less could I account for the extraordinary ordeal
to which I Avas subjected.   I did not  believe in  evil spirits.
... I did not believe in the commonly received notions of
hell-fire, and flames had  no terrors  for me, nor have  they
noAV. .   .  .  The  next day I Avent  prepared  for  another
examination, but I Avas not  again put on trial.  The  parties
seemed partly satisfied Avith my mental engagement of com-
pensation, as far as I had the ability,  of any persons I might
have injured in thought, word, or deed.  ...  I returned; 
144
SUPPOSED DEMONIAC POSSESSION.
still the voices folioAved me.  .   .  .  In the day-time I did
not feel the annoyance so much, but in the stillness of night,
the torments I endured Avere unutterable — indescribable.
The hellish sounds, the dreadful impieties  that were  spoken
of, that Avere foisted  on me.  .   .  .  When  I  attempted to
pray, I could not, for the jeering and laughter. .  . .  For
change of scene,  and  hoping I could get rid of the voices, I
Avent  tAvice abroad.   I tried all  kinds  of  amusements, and
also the effect of living very Avell, thinking my nerves might
be  improved by a still more  generous  regimen than I  had
ever been  accustomed  to.   These having no  effect, I  had
myself cupped, and entirely altered my diet, living  chiefly
on vegetables, and avoiding all vinous or spirituous liquors.
Nothing, hoAvever,  made any difference  in  my  sensations.
The sounds accompanied me everywhere, and I still  contin-
ued the prey of evil spirits.  I could plainly  distinguish
about seven voices : two of them struck me as  the voices of
females ; one of them sometimes spoke in over-soothing,
complaisant accents to me,  but these Ave re  generally used to
turn me into  ridicule afteiwards. .   .  .  It is now  lhre
years and  four months that I have had this  singular Arisita-
tion from God, and although I have no faith in dreams, yet
most  singularly I dreamt  of  my father's death about the
time it occurred,  and  I have not dreamt of him  since,  until
the beginning  of  this  month  of  September, Avhen I  dreamt
that I saAV him  interceding with  God for the suspension of
my sufferings from evil spirits, and, strange to say, I expe-
rienced for a time relief  from  their  presence  and  perse-
cutions.  .  .  .  Suffice  it  to say that the  Avriter  finally
became a firm believer in evil or unclean  spirits, and their
power to haunt or possess man.   He concluded his singular
communication to me, Avhich  is  very long, in the foliowinor
words :  " It  strikes  me that many persons, Avho  are  consid-
ered and pronounced deranged, are, really, instead, possessed 
SUPPOSED DEMONIAC POSSESSION.
145
by evil  spirits.  It may be said that I may myself be in a
state of derangement.  To this I Avould oppose these; facts —
that I do not pretend to having had any ocular demonstration
of any spirit, nor have I had  any distorted visions or ideas.
I haAre not spoken incoherently, nor have I acted contrary to
rationality ; but I have ahvays been blessed Avith my senses,
notAvithstanding this heavy calamity of evil possession Avith
which it has pleased God to visit me.  .  .  .
              " I am, sir, your obedient servant,
  When the Avriter of the above singular account came under
my treatment, he had only occasional  and greatly mitigated
attacks from his imaginary infernal tormentors.   In fact, the
case had ceased to be very distressing, notwithstanding the
patient had become a firm believer in demoniacal influences.
He Avas a sceptic, in the height of his monomania and suffer-
ing.  It perhaps should be remarked that the gentleman Avas
the son of Avhat  is called  an Eurasian;  that is, his grand-
father Avas English and his grandmother an East Indian lady,
Avhich fact  accounted for certain  psychological peculiarities
as Avell as peculiarities of temperament.  I easily reinforced
the happy effects Avhich the lapse of years had begun to have
on this patient's most delicate and excitable nervous system,
with a class  of remedies specially adapted  to  such a case,
which Avas  marked by a morbid condition of the auricular
nerve.  The  patient was completely cured under my treat-
ment, and  I  finally succeeded in demonstrating to him that
demoniacal possession  was nothing more nor less than one
of the forms of nervous malady.  The belief in possession by
unclean spirits Avas natural enough in ages of ignorance and
superstition,  when  the mysteries and  peculiarities of the
nervous system Avere not in the least understood, and  per-
sonal agencies Avere supposed to account for  everything. 
CHAPTER  XVIII.
    HOPE AND  CONFIDENCE  AS THERAPEUTICAL  AGENTS.

  The physician who  cannot inspire hope and confidence in
his patient, might as well understand that he has  mistaken his
calling; and just in proportion as the medical man is able to
excite these two exhilarating, buoyant, and curative emotions
in the breasts of those Avhom  he treats, just in  that propor-
tion ordinarily Avill be his success.  In treating diseases of the
melancholic-nerArous class, especially, the physician Avithout
self-reliance cannot hope to beget reliance in his patient. A
third thing, says old Burton, in his famous book on Melan-
choly,  to be required in a patient, is confidence, to  be of
good cheer, and have sure hope that his physician can help
him.   Galen, the old Greek physician, holds confidence and
hope to be more good than physic.  He cures most, in Avhom
most are confident.  The great success of another old  Greek
physician,  Hippocrates,  was  accounted for on  the ground
that  the common people  had  a most strong conceit  of his
worth.   The young student of medicine is told in Faust,

                 " If you on yourself rely,
               Others on you will place reliance."

  It is Avonderful the healing  effect which a hopeful, confi-
dent state of mind in the patient has  upon his disease.   But
when  one considers the  intimate  connection  of  mind and
               [146] 
    HOPE AND CONFIDENCE AS THERAPEUTICAL AGENTS.   147

body, the mystery is  solved.  Reputation  and wide-spread
notoriety are valuable to a physician, because  they give  him
a power and sort of magical  influence over the mind of his
patient.  This influence, too, may be given by personal qual-
ities, such as appearance, etc.  There is a certain genius for
the cure of disease, and an intuitive insight into the ills to
which flesh is  heir, which some men possess, and wdiich are
more valuable than the fruits of the profoundest  study.  A
perusal of the lives  of  eminent physicians Avill convince one
of the fact, or an acquaintance with one of these natural  con-
querors of disease.   Their  presence inspires a certain  con-
fidence in  the  patient, a sort  of magnetic influence, which
reinforces the medicines administered, and causes the happi-
est effects. Professional jealousy and rivalry may cause these
born physicians to be denounced  as quacks and empirics, but
the public cannot be diverted  from recourse to such.   Per-
sonal power, a  strong will,  is as necessary in  a conqueror
of disease, as of armies.  In nervous-melancholic maladies,
the first  thing Avhich the physician  has to contend against in
his patient,  is  a fearful depression and downheartedness.
Out of this abyss of despair he  must be able by his will to
lift the victim of nervous malady who has recourse to him.
For the  victims  of nervous disease dwell, as it Avere, "in a
land of  darkness, as darkness itself; and of  the shadow of
death .  . . and Avhere the  light is as darkness."
   To quote from quaint old Burton again : " Of those diverse
gifts which our  Apostle Paul  saith God hath bestoAved on
man, this of physic is not the least, but most  necessary, and
especially conducing to the good of mankind.   Next, there-
fore, to God, in all our extremities ('for of  the most  high
cometh healing'), we must seek  to  and rely upon the physi-
cian, who is ManusDei (the hand of God), and to whom he
hath given knowledge, that  he might be glorified in his
wondrous works.  With such  doth he heal men, and  take 
148  HOPE AND CONFIDENCE AS THERAPEUTICAL AGENTS.

away their pains.   When thou hast need  of him, let  him
not go from thee.   When Ave have  now  got  a skilful, an
honest physician to our mind, if his patient will not be con-
formable, and content  to be  ruled by him, all his endeavors
wall come to no good end.   Many things are necessarily to
be observed and continued on the patient's behalf:  first, that
he be  not too niggardly miserable  of his purse, or think  it
too much  he bestows upon himself, and, to save charges,
endanger his  health.  The Abderites,  Avhen they sent for
Hippocrates, promised him what reward he Avould, "all the
gold they had, if all the city  were gold he  should have it."
Naaman  the  Syrian, Avhen he Avent into Israel to Eiisha to
be cured of his leprosy, took with him ten talents of silver,
six thousand pieces of gold, and ten changes  of raiment."
We are not sure but that Burton's  Anatomy of Melancholy
is not even yet the best treatise on Nervousness and Nervous
Maladies, quaint as it is.   "Melancholy," he says, "is either
in disposition or habit.  In disposition is that transitory mel-
ancholy, which goes and comes  upon  every small occasion
of sorrow, need,  sickness, trouble,  fear, grief, passion, or
perturbation of  the mind; any manner of  care, discontent,
or thought Avhich causeth anguish, dulness, heaviness, and
vexation  of spirit;  any  ways  opposite  to pleasure, mirth,
joy, delight,  causing  frowardness  in us,  or a  dislike.  In
which  equivocal  and  improper sense,  Ave  call  him melan-
choly,  that is, dull, sad, sour, lumpish, ill-disposed, solitary,
any  way moved,  or displeased.   And from  these melan-
choly dispositions, no  man living is free;  no stoic, none so
wise, none so happy, none so patient, so generous, so godly,
so divine, that can vindicate himself.  Melancholy in this
sense is  the  character of mortality.  The  name is imposed
from the  matter, and  the disease denominated from the ma-
terial cause, Ariz. black bile."  Among the  causes of melan-
choly he  includes the  imagination, which, he  says, as  it is 
  HOPE AND  CONFIDENCE AS THERAPEUTICAL AGENTS.  149

eminent in  all,  so  most especially it  rageth  in melancholy
persons.   .   .  .   This Ave  see verified in sleepers, AArho by
reason of humors  and concourse  of vapors  troubling the
phantasy, Avill  give   many  times  absurd and prodigious
things, and in  such  as are  troubled with incubus  (night-
mare), if they lie  on their backs, they suppose a hag rides
and sits hard upon  them,  that they are  almost stifled  for
Avant of breath.   .   .  .  This is also, evident in such as walk
at night in  their sleep and do strange feats.   .  .   .  All
ecstacies  are referable to this force of imagination, such  as
lie  Avhole days  together in  a trance ;  as  that priest Avhom
Celsus speaks of, that could separate himself from his senses
when he list, and lie  like a dead  man void of life and sense.
.  .  .  Many times such men, Avhen they come to themselves,
tell strange things  of heaven and  hell, what visions they
have seen.  .   .  .  The like effects, almost, are seen in such
as  are  aAvake;  hoAV  many  chimeras, antics, golden  moun-
tains,  and  castles in the  air, do they build unto them-
selves ? " 
CHAPTER XIX.
       ALCOnOL,  TOBACCO, OPIUM,  HACSHISH, LEAD.

   It is through the nerves that the five dread agents enu-
merated at the head  of this  chapter have their fearful hold
upon humanity.   These five  agents are continually making
war upon  the  healthy equilibrium  of the  nervous system,
and through that deteriorating the  race.  The symptoms of
alcoholic poisoning  are those of alternate  excitement and
depression.   Partial paralyses are but  the  precursors  of
more grave affections, which  terminate finally in general
paralysis, deterioration, and  ultimate loss of  intelligence.
A. French Avriter  maintains that  insanity is merely the last
degree  of  degeneracy.  In the  first generation  you  have
immorality, depravity, alcoholic excess, brutish disposition ;
in the  second, hereditary drunkenness, maniacal accessions,
and general paralysis ; in the third,  sobriety,  hypochondriac
and maniacal tendencies,  systematic ideas  of persecutions
and homicidal  impulses;  in the fourth, Aveak intelligence
originally,  access of mania,  stupor, transition  to idiocy;
finally, extinction  of  the race.   M.  Morel,  the French
writer,  already alluded to, asks, in  his work on  the " De-
generacy of the Human Race," what may be the part which
tobacco plays  in the production  of degeneration?   And
admitting even  that  its degenerative  action is  an ascer-
tained  fact, how  far Avould it be good medical  hygiene to
             [150] 
       ALCOHOL, TOBACCO, OPIUM, HACSHISH, LEAD.    151

attack the usage of tobacco, which has become for all nations
not only a habit but an  imperious  necessity, to be satisfied
at any risk?   I have no intention,  he says, of  attacking its
use, and this for many motives : first, it is  far from being
proved that the habit of smoking,  in moderation, is in atiy
Avay injurious; and, secondly, it would not  be without dan-
ger to iiwoke the force of an  absolute legislation against a
habit passed  into  such an irresistible necessity.  Medical
men engaged in the investigation and treatment  of the dis-
eases of the  brain and disorders of the  mind, occasionally
have brought under their notice cases of severe nervous dis-
order and  mental  impairment, clearly traceable to an exces-
sive and  immoderate use of  tobacco.   Shattered nervous
system, premature  loss  of mental vigor,  impaired memory,
mental alienation,  arc too often the Avell-defined result of
excessive tobacco-smoking.   These  are facts that cannot be
ignored when considering the question.
   If society  Avere in a more natural  condition, or one more
in accordance Avith  the most obvious rules of hygiene, it  is
highly probable that no  poisonous agent, whether narcotic
or stimulant, would be habitually desirable or alloAvable.   It
would not be easy to define accurately what is a natural state
of society ; but it is easy to  say what is not.  For instance,
it is not natural for man to pass his  life underground, as  in
mines ; to be exposed, in addition to the ordinary atmospheric
changes, to those  of moisture and cold,  in  connection with
sieges  and the life  of armies in active service, and to migra-
tions from mild to extreme  climates and new conditions of
existence ; to be immersed perpetually in  poisonous or irri-
tating vapors, as in various branches  of art or  industry; to
be suffering  the extremes of misery, privation, and  heredi-
tary disease.   It does not appear improbable that  in the war-
fare Avith evil influences Avhich  man is constantly called upon
to AA^age, that within moderation the use of tobacco may have 
152    ALCOHOL, TOBACCO,  OPIUM, HACSHISII,  LEAD.

as beneficial effect in enabling him to resist successfully some
of these  influences,  as  any other prophylactic agency may
have in other cases.   It may be injurious to the normal con-
stitution  normally treated, but  may it not avert or resist the
abnormal consequences of  a different condition ?  In  other
words, the use of tobacco in moderation, and under circum-
stances of great hardship and privation, is upheld by many
men of high scientific attainments and  sound judgment,  as
not only  not injurious, but beneficial.   Then, again, it is said
by high authorities, that cases of general paralysis and soft-
ening of  the brain are fearfully multiplied by tobacco-smok-
ing.   As for opium, that is an agent whose effect upon the
nervous  system  is of an  appalling character.   The  use  of
this  seductive  drug  is  enormous.   The  Indian  hemp   or
Hacshish forms the  basis  of most of the intoxicating prepa-
rations in Egypt, Syria, and most Oriental countries.  The
leaArcs  arc smoked alone or mixed Avith tobacco.  Besides
the habitual hallucinations Avhich the extract of Indian hemp
produces  in some individuals, its prolonged  usage induces
incurable dementia.   There  is  reason to belkwe that such is
the case  in many persons met Avith in the  cities  of Egypt,
who are  venerated as holy men (santons) by the people, but
who are  merely fallen into a state of dementia from the use
of hacshish.   To return to  tobacco for  a moment.  A dis-
tinguished English physician avers his  belief that cases  of
general paralysis are more  frequent  in  England  than they
used to be, and  he suspects that  smoking  tobacco is one  of
the causes  of that increase.   He further believes that  if the
habit of  smoking advances in England as it has done for the
last ten  years, that the  English character will lose that com-
bination  of energy and  solidity that  has hitherto distin-
guished it, and that England will sink in the scale of nations.
Tobacco  is reprobated because it produces insanity, paralysis,
consumption, laryngitis, tonsillitis, short sight, emaciation, 
       ALCOHOL, TOBACCO, OPIUM,  HACSHISH, LEAD.    153

dyspepsia, and an infinity of minor disorders.   It is upheld
because it is pleasant; because it is  a valuable therapeutic
and hygienic  agent, a preservative against  cold and starva-
tion, a substitute for food, a solace to  the Aveary, Avhether of
mind or body.   One Avriter attempts to settle its value by an
appeal to  final causes,  asking, "Why was tobacco created, if
not to be smoked ? " perhaps  overlooking  the fact that the
Same trenchant argument applies to every vice.   Another
writer says, if the evil  ended  with the individual Avho, by
the indulgence of a pernicious custom, injures his own health
and impairs his faculties of mind and  body, he might be left
to his enjoyment, his fool's paradise unmolested.   This, how-
ever, is not the case.   In no instance  is the sin of the father
more strikingly visited upon the children than in the sin of
tobacco-smoking.   The enervation, the hypochondriasis, the
hysteria,  the  insanity, the  dwarfish  deformities, the  con-
sumption, the suffering lives and early deaths of the children
of inveterate smokers, bear ample testimony to the feebleness
and unsoundness of the constitution transmitted by this per-
nicious habit.   This is the age  of  narcotics and narcotism,
and they undoubtedly have much to do Avith the marked in-
crease  in  the number of  cases of disease  of the brain and
nervous system.   We think the fact  is indisputable.   Phy-
sicians  Avho  have  favorable  opportunities  of investigating
this subject, not only agree in opinion that such diseases are
of more frequent occurrence, but that a  certain unfavorable
(but in its incipient  stage  certainly  not incurable) type of
cerebral disorganization develops itself  in  the  present age
at a much earlier period than  formerly.   Softening of the
brain,  for  example, now manifests itself  at the early age of
thirty  and thirty-five!  It is indeed lamentable that the
brain and mind  should yield to the  influence of certain nox-
ious  moral and physical agents, at a  time  of life when the
intellect ought to be in an active and  vigorous condition of
exercise and health. 
154    ALCOHOL,  TOBACCO, OPIUM,  HACSHISH, LEAD.

  Speaking of the immense use of narcotics, let  us  take
China, Avhose  habit of opium-smoking has invaded  Europe
and our  Pacific slope.   Neither  tobacco  nor Indian  hemp
(norperhaps alcohol) compares Avith opiums either in the con-
stitutional result, or in  the difficulty of breaking the habit.
China presents a curious spectacle of moral disease.   Three
hundred  millions of individuals united under  one  absolute
government, speaking the same language and having • identi-
cal  religious notions, present  to  us the sad spectacle of a
people menaced, as to its dearest interests, by the most fatal
and degrading  habit that it is  possible to conceive — that of
smoking opium.   The  effects of this habit, immediate  and
remote, are thus described:  "The first impression is  a feel-
ing of content  and slight excitement, manifested by loquacity
and  involuntary laughter.    Sometimes  there  are  fits  of
anger.  Soon  the eyes become brilliant, and the respiration
and circulation are quickened and excited.   At this stage of
the nervous exaltation,  the smoker  feels a peculiar comfort,
and the  temperature is augmented.   The  impressions are
lively, and the imagination wanders  into strange illusions.
Now we observe a phenomenon frequently remarked in men-
tal  alienation.  Facts  and ideas,  long  forgotten,  present
themselves to the mind in all  their original freshness.  The
future appears all  bright, and every happiness ever AArished
for appears realized by  the smoker.   If he  continues smok-
ing, exaltation gives place to  depression and utter prostra-
tion.  The action of the senses is  suspended.   He hears
nothing ; he becomes silent; his face becomes pale, his  tongue
hangs out; a  cold sweat inundates  the  Avhole body ;  and
insensibility supervenes, often lasting for several hours. The
awakening is what might be expected after such a debauch."
Except some  feAv smokers, who, thanks  to an exceptional
organization, can restrain themselves Avithin  the bounds of
moderation, all the others attain rapidly a fatal termination, 
       ALCOHOL, TOBACCO, OPIUM, HACSHISH,  LEAD.    155

having passed in quick succession the stages  of idleness,
debauch, misery, the ruin  of their physical strength, and the
utter degradation of their moral and  intellectual faculties.
Nothing can  cure an advanced smoker  of opium.
  Another poisonous agent  Avhich Avages Avar  upon human-
ity and conduces to  degeneracy, is lead.  There are  analo-
gies  betAveen lead  colic,  and  partial  lead  paralysis, and
alcoholic poisoning.  There is, in the commencement, trem-
bling,  Aveakness,  and paralysis  of the  loAver  extremities,
and  diminution  of  the general sensibility.   Soon there are
twitchings and  cramps, dizziness, fantastic dreams and hal-
lucinations ;  and  these  are  exactly the symptoms  of the
anaesthetic form of alcoholic  poisoning.   These are the
symptoms inseparable from  all chronic poisonings;  and
more than that,  they are the  essential signs which announce,
by their duration and their constant progress,  that the indi-
vidual is  smitten  in the  most  important  functions,  and  is
tending to degenerate transformation  more and more radi-
cal.   Those A\rho present the first signs  of the action of the
poison of lead,  as the blue line in the gums, and the yellow
tinge of skin, appear for a time to be quite Avell; all the func-
tions are correctly performed ; the subject  complains of no
pain, and folio avs his  employment as usual.   The nervous
lesions which ultimately occur assume all forms of delirium,
coma, epilepsy,  etc., sometimes after several attacks of colic,
sometimes unpreceded by  it.  After the occurrence of these,
especially  the epileptic  seizure, the reason is never sound
again.  In lead poisoning, the  individuals affected are too
feAv, comparatively, and the fatal termination too sudden,  to
permit any Arery definite  calculation as to  the effect  finally
upon the race.   But  the  effects which  the  use  of alcohol,
tobacco, and opium, Avide-spread as  it is and  has been, has
had  upon the Nervous  System of the Race, both directly
and  by transmission, must defy calculation.  What a sum- 
156    ALCOHOL,  TOBACCO, OPIUM, HACSHISH, LEAD.

total of degeneracy and degradation, both moral and physi-
cal,  have these  mighty agents  of nervous  elevation  and
depression caused!   What wonder  that  general  paralysis
and softening of  the brain are becoming the  most frequent
diseases  mentioned in the death-list!  No one is ignorant
that many organic dispositions in the human race  are trans-
missible  from one generation to another; but it is not gen-
erally known hoAV far this principle extends.   It is believed
in general that form and appearance are transmissible, but it
goes much further than this.   It is ascertained that all mor-
bid dispositions, all pathological predispositions, are inherit-
able from parents to children, as avc.11  those belonging to
the organs of vegetative as of animal life.  The predisposi-
tion to nervous maladies, to epilepsy, to mania, is transmissi-
ble as well as that of gout, rheumatism, scrofula, etc.   Now
the predispositions have not constantly existed in all preced-
ing generations, but have been acquired by some part of the
ancestry, and  handed down to  the descendants, the morbid
taint becoming moro and  more pronounced in every genera-
tion. Whatever may be the form of the physical degradation,
and Avhatever  the nature of the lesions  experienced by the
individual, Avhether  arising from alcohol, opium,  or other
causes, it is not necessarily the same typical form, nor the
same lesions, Avhich are to be  expected in his descendants.
The deviation from  the normal type of humanity sIioavs
itself in succeeding generations, by internal and external signs
perhaps  much more alarming:  since they represent enfee-
bled faculties, an addiction to the Avorst  tendencies, and the
limitation of intellectual life to a certain period, beyond Avhich
the individual is no longer in condition to fulfil the functions
of humanity.  In  contemplating successive  generations under
these unhappy conditions, Ave observe a  series of manifold
nervous phenomena having in general a convulsive type ; and
forming  those  pallid, suffering, and morbid  temperaments, 
       ALCOHOL, TOBACCO, OPIUM,  HACSHISH, LEAD.    157

as  well  as  those  incredible  moral perversities  and intel-
lectual aberrations,  which, by  their nature and  frequency,
justly astonish those Avho have not watched intently the for-
mation of such  degenerate races.   As long ago  as the last
part of the eighteenth century, the abuse of alcoholic liquors
in SAveden had produced a degeneracy in stature and physi-
cal strength  among the people  of that  country.   In this
country, at the present time, the annual list of  the victims
of alcoholism  is enormous.  The moral effect of the use of
opium in China is marked.   It is almost impossible to imag-
ine, says Hue, the  readiness Avith Avhich the Chinese commit
suicide.   The merest trifle, or a Avord, induces them to hang
or droAvn themselves, the favorite  modes of suicide.  Mental
aberration,  serious as it is in any point of view, in this light
becomes doubly so, when it is not merely an individual affec-
tion, but the fatal climax, and as it were resume of a long line
of individual  and hereditary affections.   It is easy to con-
ceive how,  from one generation to another, the  moral and
physical condition  is greatly deteriorated, when what was
the habit merely of one generation, became an instinct and
impulse  in the next;  when, added to the hereditary taint, was
the force of example positively, and negatively the absence of
all  instruction and useful education; when to the disease of
the mind already  existing, either actually or  potentially,
was systematically  denied  the  exercise  of  the   commonest
rules of hygiene or therapeutics, and the ordinary restraints of
morals and  religion.  In cases representing so deplorable an
ancestry as  this, medicine will do little in altering the condi-
tion of the individual,  Avhich may be   considered virtually
beyond  cure ; but  there remains a noble part to  play in the
enunciation of principles Avhich, when carried out, wall tend
to the removal of those causes to which so many of  these
evils are attributable. 
CHAPTER XX.
                     BODY VS.  MIND.

  It is a curious and interesting study to trace the variety of
opinions Avhich  have been held concerning the  respective
existence and the mutual relations of the Body and the Mind,
— opinions which  have, in turn, taken  up every position
between the absolute non-existence  of Mind, save as a form
or function of Matter, on the one hand;  and, on the  other,
the merely phenomenal existence of Matter dependent upon
the variations of a sentient or thinking immaterial existence,
— the Mind.
  The scientists now generally maintain that Mind is a result
of organization.  But for ages the belief has been that man
is a compound being, consisting of a material man, the Body,
and  an  immaterial active principle, the  intelligent  Mind.
Those that maintain this  doctrine are now called animists,
from anima, the soul.   In the old gentile nations the body
was  carefully trained along with the mind.   But under the
peculiar vieAvs of Christianity, Avhen it Avas  introduced into
the world, the body became gradually neglected and despised,
though  this result was naturally of tardy growth.   Chris-
tianity was not  at the  start muscular, as the  phrase noAv
is.  The Christian doctrine of immortality, though  a belief
in immortality Avas  not peculiar to Christianity, gaAre to the
mind, or spirit, which was supposed to be the deathless prin-
             [158] 
BODY VS.  MIND.
159
ciple  in  man, a supremacy over the body in  the  estimation
of believers  Body and Mind began henceforth to be held, by
philosopher and Christian, to have separate and antagonistic
interests.  To the former, the  body was a clog,  an impedi-
ment to the acquisition of knoAAdedge, a something perpetu-
ally interfering, by its pains, its sorrows, and its imperfections,
with the clear vieAvs of truth Avhich he supposed the unencum-
bered soul Avould obtain,—constantly distracting the atten-
tion by its material relations and requirements, — ever of the
earth, earthly,—tending to its own source, bending and drag-
ging the soul along Avith it.   To the Christian, the body Avas
sin incarnate, the source of all  evil and temptation, the bar-
rier betAveen the soul and heaven.   In the early centuries of
our era, the body seemed to be of ever less and less estima-
tion.  There is  something even amusing  in the excess of
contempt in Avhich it Avas held and the abuse heaped upon it.
A prison-house, a cage, aweary load of mortality, — these
were by comparison  complimentary terms.   One old ascetic
 Christian writer, a saint of course, calls the body " an ill-sav-
 ored sink," " a begrimed, pestiferous Avorkshop,"  " a lump of
flesh, Avhioh mouldereth away and draweth near to corruption
while Ave speak of  it. "   The  torments  of  the  body  Avere
 so utterly despised  as to be  scarcely considered personal
matters.  In fine, the body Avas considered the source of all
 evil, and, as such, Avorthy  of no consideration.   The saints
 and philosophers held that these our mortal members do pro-
duce the effect of fear, desire, joy, and sorroAv, in our bodies ;
 from Avhich four  passions  the whole inundation of man's
 enormities have  their  source and spring.  One  old  sect
 of religionists held  that the body Avas so evil, that its crea-
 tion cannot be ascribed to the same author as that of the soul.
 They held all flesh the  Avork of the Devil.   In their opinion
 the oreat  object of the government of the God of light was
 to deliver the captive souls of men  from  their corporeal 
160
BODY VS. MIND.
prisons.   Of course these folks must have regarded a skilful
physician as a servant of the Evil One, because he cured the
body of disease, and prolonged its existence.
  Thus did  theology cause  an antagonism, a  division of in-
terests, so to speak, between the material and  the immaterial
elements of  man's nature,—one Avhich in various forms, in
accordance Avith the spirit of the times, has been propagated
even until the present;  iioav one  and  noAV the other being
held in paramount  esteem,  in accordance with the demands
necessary to be made upon their functions.  Here, brain has
been had in  honor; there, thews and sineAvs.   But the pres-
ent is  essentially an iron and a practical age ; both strong
limbs  and thoughtful  minds are  in  requisition;  and the
spirit of the age  is in nothing more manifest than in the
manifold attempts, by the spread  of national  education  and
the increased  attention   to the sanitary condition of the
masses, to balance the interests of these hitherto conflicting
elements.  The present prime minister of Great Britain, Mr.
Gladstone, about half a generation ago, said,  "There  still
remains in some quarters a vulgar notion that there is a nat-
ural antagonism betAveen corporeal and mental excellence.  I
trust  that corporal  education will never be forgotten ;  that
the pursuit  of manly sports Avill ahvays  receive the  counte-
nance and encouragement, not only of the boys Avho engage in
them, but of the masters who are responsible  for the welfare
of those boys."  These Avere memorable words  at the time they
were uttered, and produced an effect which is perceptible on
both  sides  of the water,  especially in  our colleges  and
schools.
  Noav, our leading clergymen  are foremost  as hunters and
fishers and rovers of the forest and lake.   Fifteen years  ao-o,
before the revolution in regard to gymnastics in our institu-
tions of learning had fully taken place, the " London Times "
said, " It Avas a great point in ancient philosophy, the value it 
                      BODY VS. MIND.                   iDl

attached to the body, and the proper training of it, the pres-
ervation of its  health, strength, and all its proper poAvers.
Ancient philosophy did not despise the body, did not regard
it as a mere husk and outside of human nature, or treat it as a
despicable and absolutely vile thing; it regarded the body as
a true part of human nature, deserving of proper deference,
for the failure of Avhich it Avas sure to retaliate upon the Avhole
man.
   Hence the gymnastics of the Greeks,  which were not only
fostered by the boxers and Avrestlers, but went on under  the
solemn sanction of sages.   There  is a distinction betAveen
ancient and modern thought on this subject, and the ancient
has certainly the advantage over the modern in this particu-
lar point — at least  over the  modern before the latest  im-
provements.  It has been too much the fashion Avith us to
decry the body, to talk it doAvn, to speak scornfully of it in
every possible Avay, to be always comparing it Avith the mind
for the sole purpose of showing how vile and Avorthless it is
in comparison, — a mode of speaking Avhich if it be abstractly
true, may be indulged in such a degree as to involve a prac-
tical untruth.  . .  .  After all our sublime abuse of the body,
a body man has, and that body is part of himself;  and if he
is not fair to it, he himself Avill be the  sufferer.  The Avhole
man will be the sufferer, — not the corporeal man only, but
the intellectual  man as Avell.   If the body is thoroughly out
of condition,  the  mind will suffer.   It may sIioav a  morbid
enlargement of one  faculty  or another,  but  the  direct-
ing principle — that  Avhich alone can apply any faculty or
knowledge to  a good purpose,  can regulate its use and check
its extravagances — is Aveakened and reduced.  Hoav  miser-
able is the spectacle of  morbid learning,  with  its buried
hoards, and its voracious, insatiable appetite for  acquisition,
united Avith the judgment of a child ! Such study  does, hi
short,  leave men  children  with remarkable memories and 
162
BODY VS. MIND.
acquisitive poAvers, who knoAV as much history, philosophy,
and poetry as Avould make a learned man, but Avho are not a
bit nearer being men in consequence, because  they simply
knoAV by rote  Avhat they know, — they do  not understand
their  oavii knoAvledge.  This is to a considerable  extent the
case with all morbid learning, where the general intelligence
has not been cultivated, — Avhich general intelligence depends
on the soundness and health of the whole  man, body  and
mind too.  The picture of a Kirke White  dying  at the  age
of tAventy-one of nocturnal study, Avet towels round heated
temples,  Avant  of sleep, Avant of exorcise, want  of air, want
of everything Avhich  Nature intended for the body, is  not
only melancholy because it is connected Avith  an early death :
it is melancholy, also, on account of the  certain effect which
Avould have followed such a course unchecked if he had lived.
We see,  Avhen Ave look down the A'ista of such a life, an en-
feebled and a prostrated man, very fit to be  made a lion of,
like a clever  child, and to be patted on the head by patrons
and patronesses of genius, but  Avithout  the proper  intellect
and judgment of a man. Hoav sad even is  the spectacle of that
giant  of  German learning, Neander, lying his Avhole length
on the floor among his books, absorbing recondite  matter till
the stupor of repletion comes over him, forgetful of time and
place, not knoAving Avhere he is,  on earth  or in the  moon, led
like a child by his sister to the lecture-room when the lecture
hour  came, and led away home  again, Avhen it is  over.   Is
this humanity, we ask, as Providence designed us to be ?   Is
it legitimate,  rational human nature?  It can hardly be called
so.  We must not let the mind feed itself by the ruin of the
body.  The mind has no right to this indulgence,  this dissi-
pation and whole-length abandonment to  its cravings, any
more  than the body has to sensual indulgence.   This mental
drain, the noxious stimulant Avhich produces this overgroAvth
of mind, is  as  contrary to  nature as  the  coarser stimulant 
BODY VS. MIND.
163
 which unduly excites the body.  The mind should be a good,
 strong, healthy feeder, but not a glutton.   We have no right
 to despise the body, or to  speak of it only and exclusively as
 something which is Aule in comparison Avith the mind.   This
 language Avill  lead astray; it will  make ardent, ambitious
 student  youth neglect health,  and abandon themselves to the
 process of acquisition at the cost of  body, and ultimately of
 mind too.  Do not use too unsparingly the  motive of  ambi-
 tion in dealing with youth.  It is a motive Avhich  is perfectly
 honest and natural Avithin proper limits, but when pushed to
 excess it produces a feeble, sickly, unmanly groAvth of char-
 acter; it creates that  whole brood of fantastic theorists,
 sentimentalists, and  speculators, which in art, science, and
 theology alike, are the  seducers and the corrupters of man-
 kind.   Nowadays there is happily no  danger of neglect of
 the body.   The mind is iioav studied in connection Avith the
 nervous system.  Brain and mind are now used convertibly.
 The brain proper is the one organ which  increases from the
 fish to man in proportion to the intelligence.  It  is iioav rec-
 ognized  that without  a healthy  body  the mind cannot be
 healthy or sane.  Within'a feAv years past we have seen the
 students of our oldest university contending with those of
 an English  university, not in  scholarship', but in  the purely
 physical art of rowing.  It is scarcely necessary to allude
 even slightly to the proof that the brain is the material
 organ  (and the only one) through which the mind acts, and
 communicates  with the external world,—this is generally
 aeknoAvledged.
  It is less understood that the brain, as an organ, is subject
 to precisely the same laAvs, chemical, dynamic, and automatic,
 as other organs and tissues.  It is also  not disputed that every
action  of the body is  attended by the phenomenon of nutri-
tion, including the decomposition of  some of the'  old tissue,
and  the  supply of its place by new particles; and that the 
164
BODY VS.  MIND.
 evidences of such decompositions in the blood and the excre-
 tions are in exact  ratio to the energy and and continuity of
 such actions.   But although the  laws of nutrition are in as
 active operation in the brain as in any part of the system, Ave
 find it at first difficult to realize the fact so well established by
 undisputed physiological testimony, that these acts of nutrition
 are in their essence the necessary conditions of every act of
 intelligence, perception, or volition ;  that,  like all other tissues
 actively concerned  in the vital operations, nervous  matter is
 subject to a waste or disintegration, Avhich bears an exact pro-
 portion to the  activity of its  operations ;  or,  in other Avords,
 that every act  of the nervous system involves the death and
 decay of a certain amount of nervous matter, the replacement
 of Avhich Avill be requisite in order to  maintain the system in a
 fit state for action ;* in short, that every idea, every emotion,
 every act of volition, and every perception, however passive
 or fleeting, is  necessarily attended by a waste and decay of a
 certain portion of brain tissue.  Carpenter says, " In the healthy
 state of the body, when the  exertion of the nervous system
 by day does not exceed  that which the repose of the night
 may compensate, it is maintained in  a condition which fits it
 for moderate  constant exercise ;  but unusual demands upon
 its powers —  whether by the long-continued and severe ex-
 ercise of the intellect, by excitement of the  emotions, or by
the combination of both in that state  of anxiety  which
the circumstances  of man's  condition too frequently induce
— produce  an unusual  waste, which requires  for  the  res-
toration of  its powers prolonged repose."  It is certainly
inexplicable how   matter  and  mind can  act  and react
one upon  another; the  mystery is  acknowledged by all  to
be past finding out, and will probably ever  remain so ; the
co-ordinate  phenomena, however,  are  open to investio-ation,
and  it is clearly ascertained  that to certain mental condi-
                        * Carpenter. 
BODY VS.  MIND.
165
tions  a  certain  state of  the  material organ  is  attached;
and for certain mental acts, certain chemical changes in this
organ are requisite.   A German  physiologist says, " With-
out phosphorus, Avithout thought.  A due supply of arterial
blood is requisite for the  proper  action of the  mind.  Loss
of consciousness folio avs abstraction  of this stimulus.  The
quality of the blood  circulating through the brain also influ-
ences the development of ideas ; if it be  deficient  in oxy-
gen, delirium of course  follows.  The  digestion of food
introduces a quantity of imperfectly assimilated material into
the circulation;  until this new material  has undergone  the
necessary changes, and  while certain matters,  altogether
unfit for nutrition, are mingled with  it, it is not adapted to
excite  those states of the brain which are necessary for the
proper manifestation of mind; and as  it  is conveyed to that
organ by the circulation, it produces an injurious change in it,
and  impedes or destroys the mental  functions.  Hence  the
indisposition to mental  labor experienced by  some persons
after meals."*   The  same  effects are produced in a more
marked  degree by  Avine,  spirituous liquids, narcotics,  and
the presence of bile or urea in the blood.   The organic affec-
tions of the brain necessarily and obviously modify the men-
tal conditions, not only by destroying the efficiency of a certain
portion  of  the tissue, but by interfering Avith the due per-
formance of the organic changes in the other parts. 'All this
is sufficiently comprehensible, that the organ being deranged
is no longer capable of performing the behests of the mind.
It is much less  so how the derangement  of the immaterial
essence can effect the organic structure; yet the fact is indis-
putable-.  The simplest illustration may be dnvwn from an
occurrence  not unfrequent  in ordinary experience.   A per-
son in perfect health receives a letter containing, perhaps, some
fatal neAVs; he drops down, smitten with appolexy, and after
                          *  Miiller, 
166
BODY VS. MIND.
death it  is found  that the cerebral tissue is torn by an effu-
sion of blood into its substance.   Joyous emotion may jaro-
duce the same or analogous result.  A young  Frenchman
recehred a complimentary letter from the Directory; he wTas
struck motionless, and his head immediately became affected
in a manner from AAdiich he never recovered.   The  paleness
of the skin, and Aveakness of the circulation accompanying the
depressing  emotions ; blushing,  and other determination of
blood ; excitement of the arterial action, under the influence
of anger and the allied passions, — all illustrate powerfully
and sufficiently the force of mind.   Enough has been said to
show the powerful influence which states of mind have upon
the body. 
                 CHAPTER  XXI.

                   GENERAL PARALYSIS.

  A preliminary idea of the nature of the affection of which
we speak may be obtained by a glance over the various names
by Avhich it  has been known.  It has been called  general
paralysis of the insane, paralytic insanity.  Incomplete and
progressive paralysis, from  its symptoms and its connection
Avith mental disorder, from its usual pathological characteris-
tics it has been termed sIoav or chronic meningitis, and men-
ingo-cerebritis.   It is a disease which  may be briefly said to
be characterized by disorder of the intellectual and volitional
poAvers, —not ahvays, or even generally, in strict proportion
one  to the other.  The mental affection  is usually  of  the
expansive character, attended  by exaggerated notions of  the
Avealth, position, or personal  qualifications of the  subject,
terminating in dementia, or total eclipse of the mind.   The
physical disorder consists in a progressive Aveakness and  un-
certainty of action of the voluntary muscular system gener-
ally ; in a majority of cases, beginning Avith the muscles of
the tongue, and those  connected with articulation,  so that
stammering is very often the first  symptom  of  the  invasion
of this affection.  In a patient who has evinced any tendency
to mental derangement,  there can be few symptoms  of more
serious import than this, —a tendency  to stammer, or a diffi-
culty of pronunciation  of certain words;  it may be appre-
              [167] 
168                GENERAL PARALYSIS.

hended with a great amount of certainty that general paral-
ysis is imminent, and that death, soon or late, wall folloAV as
the almost necessary result, let the physical health have been
up to that time ever so good.   It may be expected that very
soon the tongue and the muscles of the face Avill act irregu-
larly and  tremulously, and that  this  feebleness  and uncer-
tainty of function Avill extend to the entire locomotive system,
sometimes attacking first the inferior and sometimes the supe-
rior extremities.   The term " general paralysis " is, hoAvever,
someAvhat deceptive, as not indicative of the absolute phe-
nomena of the disease in its progress.  It is not  until the
latest stages that the paralysis becomes truly general, and no
voluntary power is left, not even of the sphincters.   But  it
is in so fir general that it is not  hemiplegian or  paraplegia,
nor local paralysis, differing from all these essentially, inas-
much as all the muscles of the body are indiscriminately liable
to be attacked,  and sooner or later are so affected.  It is rather
singular that a disease so well marked in its phenomena, and
so serious in its results, should only have attracted  attention
in so comparatively late a period of medical history.  Many
of our hospitals  for the  insane  simply refuse admission to
patients affected with  paralysis, as being incurable.  This is
a highly important subject, and why ? it is getting to be, even
numerically, very prominent in the causes of death affecting
our bills of  mortality, much more so than has hitherto been
suspected.  There are forcible reasons, in a scientific point of
vieAv, Avhy it is deserving  of special attention.  The physical
causes of insanity are hitherto involved in great uncertainty.
   Some pathologists go so far as to assert that in a majority of
changes cases of simple derangement of intellect, no morbid
condition of the nervous centres  can be detected, and that in
a majority of the remainder, such changes are too  unimportant
and too undefined and unspecific to be considered as causes.
Others aver that  they have never examined the brain of a 
                   GENERAL PARALYSIS.                169

patient avIio has died insane., without detecting some morbid
alteration of the brain or its membranes ; and these authorities
are certainly amongst those Avho have had opportunities, not
by units  or  tens, but by hundreds of cases.  Again, others
affirm that  the Ausible  and palpable changes are  certainly
in many cases  deficient, but would,  doubtless, be revealed
were our means  of investigation  by the microscope and by
chemical analysis more  perfect.   And, in addition to all this
variety of opinion, it has to be taken into account that Avhat-
ever may have  been the proximate cause of the mental affec-
tion,  certain additional, physical changes must have  taken
place in  order to cause death; and there is the  superadded
difficulty of deciding what has dethroned reason, and  Avhat
has destroyed life.   In short, we  are still ignorant of Avhat
may cause mental aberration, and what is its essential, mate-
rial element; nor have  we as yet obtained any certain start-
ing-point,  any  positive data  Avhereon  to found a clearly
inductive system of research.   One  of  the principally con-
tested points concerning this affection is, whether it is essen-
tially connected or not with  mental disorder, for it appears
to occur  sometimes entirely independent  of mental affection ;
sometimes to supervene upon it;  and  sometimes to precede it
by months, or perhaps years.  The causes of general paralysis
are immediate and predisposing.  The former are such in gen-
eral as produced  prolonged over-excitement of the  brain, —
sensual excesses, especially the abuse of intoxicating drinks,
over-feeding, sexual  indulgence,  and intellectual excesses,
accompanied by  prolonged vigil.  The predisposing causes
may be considered to be such as belong to insanity and brain
affection  generally ; the disease moreover attacks men  much
more  frequently than Avomen, and both chiefly between  the
ages of thirty and  forty-five years.   The symptoms of gen-
eral paralysis (of the insane) consist of a non-febrile lesion
of the intelligence,  the sensibility, and voluntary  motion. 
170
GENERAL PARALYSIS.
The  intelligence  is constantly affected from the commence-
ment of the malady.  Sometimes only observed as a feeble-
ness of memory or judgment;  and most frequently, as mania
with the  delirium  of grandeur and  poAver; sometimes  as
melancholia, and sometimes again, as simple  dementia  from
the outset, a condition into which all the previous forms have
a tendency to merge, as the disease makes progress.  What-
ever may be the original specific type of the mental affection,
the faculties are observed to be enfeebled progressively even
during the excitement of the opening delirium ; and this goes
on until the last phase is characterized by the utter extinction
of all  intelligence.  The  alteration  consists in progressh'-e
weakness of the  voluntary movements, commencing by trem-
bling of the muscles of the tongue and mouth, by a more  or
less  marked difficulty in the pronunciation  of Avords,  and
afterwards by hesitation in  walking and uncertainty in stand-
ing,  with  trembling and weakness of  the hands  and arms.
The  loss of muscular power extends often, and especially  in
the later stages, to the  sphincters of the bladder and anus.
When arrived at the extreme, the loss of power condemns the
sufferer to  absolute immobility and muteness.  The loss of
sensibility has not been studied with the s,ame amount of care
and attention as  has been bestowed  on that of motion and
intelligence.  Yet it is ascertained that the general sensibil-
ity  is  notably diminished, and the sense of touch  greatly
deteriorated.  The sight and  hearing partake in some meas-
ure in the  general dulness of  sense.  The seat of the malady
is in the cortical layer of the cerebral hemispheres.   The
progress  of the  development of  this affection has  certain
characters which are special* to it, as relating to the connec-
tion and succession of the symptoms, and the termination  of
the disease.  Impairment of  the  memory and  judgment  is
evident from the first, and continues always increasing  until
their entire abolition. One of the most special and distinctive 
GENERAL PARALYSIS.
171
as well as most serious characters of general paralysis is that
it terminates constantly by death.   As we proceed, we may
find some exceptions to this in the general paralysis occurring
independent of mental disease, but most observers agree,
that  Avhen once general paralysis has appeared, even slightly,
in an  insane person,  there may possibly be  a remission of
symptoms even for a considerable period, but there can be or
rather has been hitherto no cure, — death is  imminent and
certain, although at a very uncertain  period.   Perhaps the
average  duration  may be  from two to  three  years.  It  is
very common before the close of life to observe gangrenous
sloughs in all parts of the body that are exposed to pressure ;
the  phenomena of life are merely  vegetative for some time
before dissolution.  It is very common to see  patients  who
have gradually fallen into dementia without presenting any
of the symptoms  of reaction or delirium, or in whom these
have been extremely slight and  subordinate.   As this decay
of the intelligence is established, Ave notice at first slight, and
then more  marked signs  of paralysis;  and shortly we have
developed a paralytic insanity so marked,  that none can  mis-
take it.   By the side of this numerous group there is another
Avhich is yet more so, especially amongst men.   The patient
beo-ins by presenting the signs of an excitement more or less
lively ; he moves about  perpetually, and cannot remain  still
for  a moment.   At the same  time he  forms large  projects,
buys  all manner of objects, gets angry when opposed, and
cannot sleep.  To this state succeeds a complete  maniacal
 delirium, Avith predominance of ambitious ideas, and a special
muscular agitation quite distinct from that of ordinary name.
At the same time, if Ave are in the habit of attentively observ-
ing  such patients, Ave shall detect a little hesitation in the
pronunciation of certain words.  Such are in the two groups
which  are  at present designated  under one name, that of
insane paralysis.   These symptoms are  assuredly very much 
172
GENERAL PARALYSIS.
opposed.  In the one case we see debility, inaction, and the
slow extinction of the cerebral functions ;  in the other, force,
violence, and an increase of physical and intellectual activity.
Authors have related a few cases of recovery, even after the
patients had presented the gravest symptoms of paralysis;
and that although these facts may be considered exceptional,
they are doubtless  of the highest significance.   Observation
1st,—Mania for some months,  Avith  predominance of ambi-
tious  delirium;  very  marked symptoms  of paralysis, with
difficulty of walking and standing.  Stammering not present,
but some hesitation occasionally before a word.   Formation
of gangrenous sloughs, followed by recovery, Avhich lasted
twenty-five years.  Observation  2d, — M----, aged forty-
one, had some insane relations,  and became melancholic him-
self after some  domestic  trouble.   He had  some epileptic
attacks;  the  speech  became imperfect, and  one arm Aveak.
After his entry into the asylum, he was in continual agitation
and had the delirium of  grandeur and riches fully developed.
Pupils unequal, tongue  furred,  pulse accelerated.  The sen-
sibility became  very much diminished,  and  the paralysis
extended to sphincters.   He could  not Avalk nor write  his
name ; there appeared a great number of sloughs on the body,
some apparently Avithout cause,  some where his agitation had
bruised the skin.  After attaining almost the  lowest state of
paralysis, he began to recover, — as it is stated not by means
of therapeutic agency, — and both his reason and his bodily
poAvers returned.  He was alive  and Avell when  the  account
was Avritten, ten years afterAvards.
   (From the " American Journal of Medical Science.")  Ob-
servation 3d,—General paralysis, apparently  of the worst
kind; symptoms of the last period.   Acute oedema of one
leg, with gangrene.  Rapid recovery which is known to have
lasted six years.  Observation 4th, — Acute mania, with ten-
dency to ambitious ideas; feebleness of the memory, uncer- 
GENERAL PARALYSE.
173
tain walk.   Eruption of  boils Avith  abundant suppuration,
embarrassment of speech ;  recovery.  Duration of the malady,
one year.  Duration of the recovery, five years.  Sudden
death from cerebral haemorrhage.   The fifth case recovered
after an abscess  of the liver ; the sixth after a purulent dis-
charge  from the ears ; and  the eighth after an amputation, fol-
lowed by profuse suppuration. In all these cases the paralysis
was so  far advanced as to be unmistakable ; the authorities
from Avhom they are quoted are unimpeachable.   We  must
therefore admit  the possibility of paralytic ambitious mania
being  cured.  As for remedies :  moderate  local  bleedings,
says Pinel, at the outset only, and when  there are signs of
congestion, — issues at the base of brain, repeated vesications
over the scalp — general affusions, and ' revulsives  from the
intestines and extremities, are the principal means to be used.
There   are  well authenticated  cases  of recovery.   I am
convinced, says Pinel, that general paralysis is not a disease
especially appertaining to the insane ;  that it is not a form of
insanity ; that it does not necessarily and fatally induce it;
that it is an affection independent of this latter, so long as the
alteration which produces  it does not extend to that portion
of the molecular structure of the brain, which presides over
intelligence ;  and I believe that this portion of the brain may
escape  lesion during the whole period of life.
  The question of the  essential nature of general paralysis
has perhaps been  complicated more than by any other con-
sideration, by that of the Arariety of manners in Avhich it makes
its first appearance.  We Avill briefly sketch three.  General
paralysis presents  itself in four  forms, two  of Avhich are
marked by bodily  disorder, and tAvo by mental.  1.  The
paralytic variety. This is the most insidious  of all the forms
in Avhich this fearful disease appears, and has perhaps given
rise to  more contest as to its  nature than any other.   For
some time the only disorder appears to the ordinary observer 
174
GENERAL PARALYSIS.
to be one of the motor functions exclusively.  The patient
himself perceives that his actions become irregular, trembling,
and Avanting in precision.  He lets fall objects which he holds
in his hands, and  cannot perform  any acts which  require
delicacy of manipulation ; writing, drawing, or playing on any
instrument becomes difficult.    He  stumbles  against  the
slightest obstacle, and Avalks with a jerk ; he is  more  quickly
fatigued than formerly, and all his motions lack  co-ordina-
tion. All this, which comes on very slowly and impercepti-
bly, is accompanied from the outset by a peculiar hesitation
and embarrassment of the articulation, or stammering. Ordi-
narily there  is  a slight pain in  the head, and dizziness, an
unequal dilatation of the pupils and not unfrequently genital
impotence, with occasional incontinence  of urine.   During
this period the patient is conscious of his failing strength, and
troubles himself about  it.  He appears at first to enjoy the
full exercise of his faculties ; but although in some rare cases it
is not possible to detect any intellectual Aveakness,  in general
the  practised observer will recognize some indication  of this.
There is an undefined  alteration  of character or disposition,
a mobility of temperament that  scarcely admits of  descrip-
 tion, the performance  of odd,  bizarre  acts  that pass for
 eccentricity, a tendency to make  mistake in his usual employ-
 ment, a slight  weakness of memory for  recent events, and,
 what is  the most  serious symptom of all, a combination of
 a marked hypochondriac  tendency, with a general  feeling
 and expression  of satisfaction and pleasure, the sure  forerun-
 ner  to  an outbreak of  the  expansive  ambitious  maniacal
 delirium, Avhich is not then long  delayed.  2.  The congestive
 variety in this  form,  the  physical symptoms again predomi-
 nate over the psychical. The predominant character is one of
 transient and recurrent congestion of the brain with  or Avith-
 out loss of  consciousness, ordinarily slight, though some-
 times very  severe, simulating  apoplexy or  epilepsy,  and 
GENERAL PARALYSIS.
175
giving rise to the opinion that the subsequent  paralysis has
been caused by one of these affections.  This form of conges-
tion is distinguished from the ordinary apoplectic form, by
leaving more serious  and persistent traces in the moral and
physical nature.  The speech remains for a longtime disor-
dered, the movements of the limbs  become  difficult, and
sometimes there is even incomplete hemiplegia, which dimin-
ishes and disappears sloAvly, to return perhaps after the next
congestion.  The intelligence is  affected after each attack,
as Avell as the motive poAvers ; but if there be any consider-
able interval, both orders of phenomena partially disappear,
and the patient is restored to a comparatively  healthy condi-
tion;  apparently, immediately   after the attack  Ave  may
detect a  considerable feebleness  of memory  and the other
faculties ;  but in time the intellect appears to resume its ac-
tivity.  After several attacks, hoAvever, both the physical and
intellectual nature is found to be  unmistakably deteriorated,
and dementia, accompanied  by various  forms of delirium,
supervenes. In short, like the last form, the malady assumes
the ordinary aspect of " general paralysis  of the insane."
   Melancholic Variety. —In this  form the psychical disorder
first attracts the  attention.   It is only in  comparatively rare
instances that the physician sees the first stage  of the malady ;
but in inquiring into the history of paralytics, he Avill not
unfrequently find that the first phenomenon  that attracted
attention Avas a  state of marked  moral and physical Aveak-
ness or depression, Avith lowness of spirits, and incapacity,
real or supposed, for  any form of action; presenting every
appearance  of hypochondriacal melancholia.  Even  at this
period there may sometimes be detected  slight disorders of
mobility, as stammering or hesitation in speech, or feebleness
 and trembling of the limbs.   But these symptoms are over-
looked, the  melancholia absorbing  the  Avhole attention.
The  melancholic period may be  very  short, or it may have 
176
GENERAL PARALYSIS.
lasted some time ;  but in all cases that are paralytic it disap-
pears gradually, to give place to the normal condition.   But
this is very transitory;  almost  as soon as the  signs of mel-
ancholia  begin  to  disappear,  the  attentive  observer may
detect  frequently  the  symptoms of  an opposed  condition.
The patient experiences a sensation of exaggerated comfort;
he Avas never so well in his life, body or mind ;  he begins to
be unnaturally active, moving incessantly ;  he forms projects
of Avhich he Avould never  have  thought before, perhaps  not
absurd, and altogether out of accordance Avith  his fortune or
profession, but still quite  opposed to his previous habits  and
tastes.  He then either passes gradually into the true expan-
sive  delirium, or a fierce mania Avith predominance of am-
bitious ideas  breaks out suddenly,  after Avhich his history is
the same as that of the next variety.
   The expansive Variety. —This is the most frequent form
of the debut of general paralysis ; and from the marked char-
acter of the symptoms clearly requiring immediate attention,
it is more frequently noticed in its  earlier stages than any of
the others, and on this account has been erroneously supposed
absolutely essential to the character  of general  paralysis.
Those paralytics who  present  themselves  from the  outset
with the expansive form of delirium, have been ordinarily
men of active minds and habits, enterprising, rash, and gen-
erally of irritable, violent character, with much generosity.
The expansive delirium is an exaggeration of this character;
and  so gradually does it sometimes* sweep on, that the  mo-
ment  of  actual outbreak  is  difficult  of  detection.    The
patient appears at  first to be simply more  active, more rash,
more irritable, and  by fits and starts more  generous  and
lavish in his expenditure than before.  By and by all  this
passes clearly beyond  the normal state.   The subject is in
perpetual motion, takes no rest, cannot sleep,  feels an exag-
gerated sense of poAver and general well-being, and conceives 
GENERAL PARALYSIS.
177
projects of the most stupendous  character, that must be at
once  carried  out,  all of Avhich, if not  quite irrational, are
opposed utterly to his previous habits and tastes.  He adopts
excesses which are  not habitual to him, passes  an irregular
and disorderly life, and  commits acts which greatly astonish
his friends, such as undressing in  society, sleeping  in  the
fields, and out of his own  house, and  perhaps committing
petty thefts without any motive.   He is possessed of bound-
less Avealth or poAver with Avhich  he  will perform the most
unheard-of deeds.  He Avill give away his property, and if he
has none  he will profess  to  do so.  He is endoAved with
supernatural attributes, he  is God's  vicegerent upon  earth,
he is some mighty potentate.  Acting upon some  of these
convictions, he commits an offence against society, himself, or
property,  which demands his seclusion, when the true nature
of the case is readily recognized. 
CHAPTER XXII.
           DIPSOMANIA, OR DRUNKEN INSANITY.

  This is  a learned word Avhich signifies an  insane  thirst, a
moral insanity in regard to Avines and liquors.  A man is a
drunkard who gets drunk at the festive board, who  seeks
occasions for getting conveniently drunk without interfering
with his ordinary occupation, who takes a feAv days drinking
at a time when he has plenty of money, and returns to his
duties and employments when he has finished his superfluous
cash and  his  "bender"  or "spree," as it is  called.   Some
men, on  the  other hand, get systematically and  regularly
drunk every day after dinner, some every night before going
to bed, and will perform their daily duties Avith propriety
and efficiency.  Obviously they do not come under the head of
insane drinkers, for they exercise a certain amount of self-
control, a sufficient amount of restraint upon their appetites,
not to alloAV the  quantity Avhich they drink  to affect their
aptitude for business, or driving a good bargain.  The prin-
cipal feature of this disease — that  of insane drinking, or
dipsomania — is, on the other hand, the absence or loss of the
poAver of  self-control or self-regulation.   Persons affected
Avith this form of moral insanity do not drink from  the pleas-
ure which the social board  affords, but, on the contrary, will
not unfrequently  preserve a  certain amount of decorum
while  in  company.  Neither  do they drink for the pleasure
               [178] 
           DIPSOMANIA, OR DRUNKEN INSANITY.        179

which the Avine gives them ; they will drink any kind of intox-
icating  stuff.   Nor do they drink at  a convenient time and
place, and only occasionally ; they drink as often as they can,
and as much as they can ; their craving for stimulants is inces-
sant and uncontrollable; no considerations of self-respect,  no
regard to public opinion, or common decency, or domestic
ties, or religion, or the certainty of impending ruin, degra-
dation,  or even the fear of death, can  prevent their drinking
till they  can drink  no  longer.   Such persons  Avill often
deplore their fatuity, their inability to  control their appetites,
and  will  say with  tears  in their eyes, as  some have done,
that if  hell Avere yawning at one  side of them, and a bottle
of brandy standing at the other, they  would drink, although
the next moment they Avere to  be  thrown into the bottomless
abyss.   In a word, such persons drink because they cannot
help it,  and if they  really cannot help  it,  they must  be
reo-arded  as  no longer responsible agents, — as, therefore,
insane,  and proper objects for being restrained and protected
against themselves.  The loss of self-control is, indeed, the
most essential condition of  almost all cases   of  insanity.
The most constant symptoms  of  insanity are those referable
to altered affections,  perverted desires,  and morbid propen-
sities.   In almost all cases  of this variety of moral insanity
there is a total disregard for truth.  Such persons are singu-
larly mendacious.  They Avill resort to every possible device
to procure stimulants, to excuse their conduct, to deceive
their friends and medical attendant, will display an ingenuity
and  fertility in  deceit which  is  truly marvellous.   They
Avill become faint, or  be in agony with the  toothache, or tic,
or cramp in the stomach, or colic, etc.,  and represent them-
selves at death's door in order  to get brandy, wine, or opium
administered.  They  will pawn  every  available article  of
dress or  furniture or jewelry.  They will  borrow from  all
and  sundry.   They will get whiskey  smuggled home Avith 
 180        DIPSOMANIA, OR DRUNKEN INSANITY.

 their clothes from the tailor or laundress.  They will evade
 the most vigilant surveillance, and  tell the most deliber-
 ate falsehoods in their attempts to deceive, solemnly appeal-
 ing to God  for their truth.   When shut off  from the ordi-
 nary sources of stimulation, they will  sometimes resort to
 almost anything to relieve their craving.   I  have known
 a young and delicate lady, after being  prevented getting
 Avine  or  spirits, and  deprived  of   lavender  wTater and
 eau de  Cologne, take creosote, vinegar,  tobacco.  Again,
 such persons will insist on a total  denial of their habits of
 over-indulgence.  They  wall very frequently disavow most
 solemnly having ever exceeded the bounds  of strict tem-
 perance  in  their use  of stimulants ; and,  if admitting  at
 all that they have ever been the worse for drink, they will
 blame some other person or  circumstance as the cause of it.
 Accompanying this disregard of truth,  there are often other
 indications of moral perversion in the insane drunkard, such
 as extreme licentiousness, or a  propensity to  theft.   The
 disease  is frequently hereditary; and it will  be found,  on
 inquiry, that a grandfather,  or  father or mother, or one or
 more brothers, have died of delirium tremens, orhaveother-
 Avise shoAvn the fatal propensity.  The constancy with which
 the hereditary predisposition to this  disease is transmitted is
 most remarkable, and, in a  vast majority  of cases, can be
 traced either  through the the maternal or paternal side of the
 family.   To illustrate the truth of these remarks, I have ana-
lyzed the records of eighty-six of the cases of  this form of
moral insanity which  I have had under  my  care, of AA7hich
tAventy were  females and sixty-six males. Of the former one
half presented natural peculiarities  in their mental constitu-
tion, being either of Aveak minds, of very violent and uncon-
trollable  passions, or subject to hysterical attacks of great
violence,  combined in some  instances  with  great  moral
depravity.   Of the males, thirty, or nearly one half,  were 
           DIPSOMANIA, OR DRUNKEN INSANITY.         181

naturally of Aveak mind, or presented some mental peculiar-
ity, such as  silly vanity, general depravity of  disposition,
and, in some cases, considerable talent, but combined Avith
eccentricity.   In  regard to  hereditary predisposition, it is
difficult generally to trace this in a public hospital, partly
because many cases come in without any information regard-
ing them at all, and partly because the friends, Avhen they
have friends, are generally very solicitous to deny or conceal
the existence  of an  hereditary taint in the family.   Of  this
malady there are three divisions, the acute, the periodic, and
the chronic.   Under the head of acute, I would include all
those cases of uncontrollable drinking Avhich occur to persons
of previously temperate or regular habits, but in Avhom this
insane craving  has been generated under the influence of
some accidental cause, — such as the noArelty and excitement
of a  new sphere of duty,  and the temptations of neAV asso-
ciates and habits, all combining to lead to intemperance ;  or
the depressing effects  of some overAvhelming calamity, or of
some debilitating accident, or disease, or other agency.  It
is Avell known that the use  of stimulants, begun or indulged
in under any of these circumstances, has gradually merged
in many instances  into an  inordinate  and uncontrollable
craAano-, and an insatiable and destructive  use of them.
Cases of this kind, if taken in time and treated judiciously
and firmly, are generally curable Avithout recourse to any step
for depriving the patient of his personal freedom.   Periodic
or recurrent attacks of this disease are generally dependent
upon some  constitutional  or  hereditary peculiarity.   Some-
times they occur at the critical age in  females, and preserve
a periodic form coinciding with the menstrual period. Some-
times  they  arise  from injuries of the  head.  Cases of  this
kind are less  easily  treated than the acute,  particularly
Avhere there  is  a hereditary predisposition.  They hardly
 justify confinement.  The uncontrollable impulse will come at 
182         DIPSOMANIA, OR  DRUNKEN  INSANITY.

its accustomed time. Nor does this form of the disease inter-
fere  materially,  in  many  cases,  with the  duties of life.
Many individuals have distinguished themselves in literature
or in professional  or mercantile  life, who have been known
for a long  term of years  to  retire periodically into the pri-
vacy of their oavii chamber, and,  after indulging this morbid
appetite  to satiety for a  week  or two, in  their  voluntary
seclusion, to reappear again on  the  stage of life, and  pur-
sue their usual avocations with   credit  and  success.  Such
cases are  perhaps rare, and  more frequently it happens that
the periodic or recurrent form gradually degenerates into the
chronicWariety of the disease, the intervals becoming shorter
and the attacks longer, until the intervals cease altogether,
and a  chronic disease  or* a fatal  issue ensues.   It is  the
chronic form of this disease which is the  least curable and
most troublesome  to manage.  Hero the craving  for stimu-
lants, brought on perhaps by indulgence and irregular habits
operating  upon  a  constitution  hereditarily predisposed,
becomes constant,  insatiable, and incontrollable  ; and  the
daily or hourly indulgence suffers only now and then a tem-
porary check by illness caused by it,  by attacks of delirium
tremens, or outbursts of mania.   I believe it is agreed by all
parties, that this  form of the disease   can  only  be treated
effectually by prolonged and complete  abstinence  from all
stimulants. 
CHAPTER  XXIII.
               LATE SUPPERS AND DREAMS.

  We have alluded to the subject of the effect of late suppers
on the nervous system already.   A late supper is an unwhole-
some meal  from whatever point looked at.   The influence
both of food and drink on the mind is acknowledged.  A man
may be said to think according as he eats and drinks.  Every-
thing Avhich affects the circulation of the blood, or which in-
creases or diminishes the nervous force, may and does interfere
Avith, modify, or stimulate the action of the mental faculties.
Dreams merely indicate a disturbed condition of the stomach
or brain.   I can best illustrate this subject by relating  some
curious  dreams in point,  dreams Avhich have been occasioned
by food Avhich has  disagreed Avith the digestive organs, or
Avhich have exercised a peculiar influence upon the nervous
system, or Avhich have been induced  by food taken at an
improper time, or which have happened when sleep has been
indulged in immediately  after taking food.
  It  is  a curious fact that not only the kind of food may
determine the events of a dream, but often, also, that the pur-
suits of the dreamer will tend to give his dreams some  spec-
ialty.   For example, we knew  a medical man who  after
attending a lecture  Avas  very hungry, and, contrary to his
usual practice, ate a hearty supper of rich fish with a stuffino-
composed  of liver mixed Avith savory herbs and spices, and
                                        [183J 
184            LATE SUPPERS AND DREAMS.

some stimulating sauce.  When he Avent to bed  he had a
rather dry and feverish skin, but he  soon fell asleep  and
dreamt the following curious adventure :   He said, "that he
thought  he AA^as  travelling  in  a  very hot  country, Avhich
abounded with a number of  poisonous  serpents, particularly
the ' cobra di  capella,'  and  that, having the opportunity to
dissect some of them,  he seemingly  did so Avithout harm
to himself, until he proposed shoAving the structure of the
secretory glands, Avhich generated the  poison.   These  he
traced to  the loAver surface of  the tbngue, and when in the
act of carefully pressing these glands to ascertain the color
of the deadly fluid, a little of it  squirted into his face and
caused him great pain.  The sense of his dangerous position
awToke-kun,and he was highly gratified  to find merely a little
eruption  on his nose and face, evidently caused by the rich
food of which he had partaken the previous  night," and he
added that indigestion  Avas iiwariably relieved in his  own
case by eruptions on the skin.
   We select another  instance  to prove that  particular food
not only gives  the.  specialty of the dream, but also  iu  this
case  revived impressions of the  past, and  gave them  all
the vividness of reality.   The person said, " The other liio-ht
I Avas very hungry and Avas induced to  eat supper, and added
to the outrage of partaking of  cold roast beef, the folly of
eating about a dozen pickled onions. But as I felt very com-
fortable and had a  long  Avay to walk, there was not any mis-
giving that for  so doing any great punishment Avould result.
By the time I reached home it Avas at  least two if not three
hours after taking  the  uiiAvholesome  meal, and  soon after-
wards I went to bed.  I felt  someAvhat  uneasy, but it Avas not
long before I fell asleep.  Soon  afterwards I dreamt that for
some offence of etiquette I was doomed to eat ' sour-crout.'
Noav  it  so happened that  this  kind of pickled  cabbage
ahvays caused me most painful nausea even Avhen smellino- it 
LATE  SUPPERS AND DREAMS.            185
so that I had never been prevailed upon to taste k.  Never-
theless, in the vision, it seemed that great pains and penal-
ties aAvaited me, unless I abided by the unchangeable fiat of
the judges.   'I  fancied  myself brought into a large room
in the centre of Avhich Avas  the reeking crout, and Avhat with
its acid fumes and its fatty smell I was almost overpowered,
and I experienced a sense of nausea and disgust.   Still I made
the effort to  eat, but every mouthful which I endeavored to
swallow was immediately rejected, and the painful and  sick-
ening  sensation increased at every attempt  to  retain the
abominable  stuff.  My situation was  indeed pitiable;  and
the perspiration trickled doAvn me, from the agony I experi-
enced.  It Avas a battle betAveen sour-crout and the  stomach,
and the struggle Avas desperate; but the stomach conquered,
and I aAvoke.  My  mouth was  filled Avith  acidity and the
disagreeable taste of the onions, which  together  rendered
my sensations most unpleasant.  This condition of the mouth
had evidently suggested the  dream, and an early* antipathy
for fermented sour  cabbage was reproduced with  as  much
vividness as if the crout had been positively served up, and
coercion had  been used to enforce it being eaten."   This
individual was advanced in life  and had  not seen or smelt
the sour-crout since his boyhood, yet its odor appeared as
disagreeble  to him in his dreams as it would have been in
his wakeful  moments.  Here  is a  somewhat funny dream
which occurred during not a late supper, but an after-dinner
nap.  A gentleman  fond of good living, aat1io invariably did
justice to his meals, one day  had dined at  home Avith his
family,  aud being very hungry, he had despatched slice  after
slice of some roast or boiled mutton, declaring that he had
never eaten a more delicious, juicy, tender specimen of mutton ;
and as a proof of his sincerity, he  refused  all the  et-ceteras
of a wealthy citizen's  dinner meal.  After dinner he took his
usual short siesta.   He had been  but a short time asleep, 
186
LATE  SUPPERS AND DREAMS.
 when he began to laugh, and that so heartily, that it was con-
 tagious, and  the risible  chorus  soon awoke  him.   Imme-
 diately all asked him Avhat he had dreampt  about that had
 so tickled his fancy.  " Well," he replied, " I thought that I
 was at a public dining-table, at which there were many stran-
 gers.  The tables  Avere Avell supplied Avith fish, meats, and
 vegetables of all kinds in season, and I myself only partook
 of mutton.   But what tickled my fancy in the first  instance
 was, that I oArerheard the Avaiters speak of the different vis-
 itors, giving each  the name of the ' dainty dish ' he or she
 had preferred. There were Mr. Fish, Mrs. Steak, Miss SteAv,
 Lady Cabbage, Mr. Rice, Miss Duck, Old Squire Bread, and
 numerous others distinguished by what they most enjoyed.
 I thought it curious that I had not been mentioned, and prob-
 ably I should not have been, had  not one of the ladies asked
 my name, ' O, ' said  the domestic  addressed, ' you mean
 Old Mutton.'  This audible reply was not considered rude,
 as he had feigned  deafness.  He thus became the topic of
 conversation.  ' Old Mutton is a curious, eccentric person-
 age,' observed a sly fellow, who with  a most beAvitching lisp
 proposed Old Mutton's health and ' let him know our  admira-
 tion is  excited,'said the speaker, 'because he  sticks so loAr-
 ingly to his family connections, and gives them the preference,
 as Ave  all have  witnessed.'   All the company rose simul-
 taneously, and  turned towards me, then Avith mock  gravity
 boAA^ed,  saying, ' Old Mutton's good health.'   Whilst a feAv,
 not improved in their manners   by  Avhat they  had  drunk,
 shouted out, ' Here's to jolly Old Mutton.'   Then I opened
my eyes and stared at them, and thus addressed the com-
pany:  'Thank you, my innocent  lambs, but you  bleat most
discordantly.'  The surprise that  Avas depicted on every face
 looked most ridiculous,  and I continued in a strain of badi-
 nage.  * Well, you  pretty innocent, Avool-covered  creatures,
 I am very glad you  are  not foxes,  or else " Old Mutton," 
               LATE SUPPERS  AND DREAMS.            187

" Jolly Old Mutton," would have had little chance of saving
himself from your chops ! "  All this and much more had
taken  place  during a doze  of  a  few  minutes.   Here  is
another amusing  dream, suggested by the nerves  of  taste
Avhich  occurred to a lady, a friend of  the writer, and which
furnishes  some speculative thoughts  to   the  psychologist.
Mrs. —had a slight cough,  and one of her daughters brought
her some barley-sugar to suck when in the act of lying dovai,
or in case the cough disturbed  her during the night.  She had
on the occasion avc are about  to relate, taken a piece of this
SAveet  medicine into her mouth, and  soon afterwards fell
asleep AAdth the confection undissolved.  She dreamt that she
Avas a very little girl,  and that she  Avas  spending the  even-
ing in a juvenile  party, at which, besides tarts  and jellies,
there was added an abundance of sweet-meats of the most
delicious  kinds.   She felt superlatively happy,  and, Avhat
contributed to ensure this satisfactory  state,  all her early
associates wrere  present.   These friends of  her childhood
appeared the same laughing girls  and  boys, and  Avere appar-
ently undisturbed by  care  or annoyance  of any kind.  Yet
she  seemed  to have  some undercurrent of misgiving, for
many of these  spectra had been  dead for years, and others
she had not  seen since their school days, Avhen she herself
Avas but a little girl. But these reflections did not affect her;
for she fancied herself entering  into all kinds of childish
sports and pastimes wdth  all  the glee  imaginable, and  so
she continued to laugh Avith those around  her until she aAvoke
with  a smile  on  her  features ; and so  brief Avas the Avhole
period of the dream that her daughter had not left  the bed-
side, for she had not been asleep more than a few moments.
The explanation is, that as she Avas going  to sleep the passing
idea occurred : "lam like a little child, to go to bed with
SAveet-meats."  This  suggested to  her  mind  the   train of
pleasing thoughts.  For when  the world was closed on her 
188            LATE SUPPERS AND  DREAMS.

unconscious senses, the  soul  thus untrammelled revived  the
scenes of  her juvenile  days,  and called  forth  from  the
shadowy past  her former  associates,  companions who had
been  forgotten  during  her  maturity, with its hopes and
fears. 
CHAPTER  XXIV.
    THE USES AND ABUSES  OF THE POPULAR NERAaNES.

  Particular  kinds of remedies and medici • s, like other
things, are at particular times all the rage, and are supposed
during their brief period of popularity to be absolute cura-
tives for the particular class of  affections and  ailments for
which  they are  designed.   Of course in this high-pressure
age, wahen  nervous  affections and nervous diseases  of  all
descriptions  arc the preAralcnt  ills  of the flesh,  at  least
among  all those  classes  Avho employ head-Avork, Avhether
professional, literary, or mercantile, nervous  remedies are
in especial demand.
  The danger is that Avhen a particular remedy becomes thus
popular, it Avill be  used  in  excess, and so, in the end, prove
detrimental.  For  instance, there Avas a time Avhen prepara-
tions of mercury were all the rage, and when it Avas supposed
that such  preparations  were actual panaceas or  cure-alls.
The consequence Avas that mercury was not  only used prop-
erly, but misused and abused, until it has become a synonyme
of  all  that  is deadly as  a medical  prescription.  So with
bleeding, it was regarded as such a sovereign remedy at one
time, that  a physician who  visited a patient without his lan-
cet, Avas thought to be Avithout the means at  his command to
properly practise his profession.   And cupping Avas practised
to such an  extent, that the last  dregs of the cup of human
                                         [189J 
190      USES AND  ABUSES OF  POPULAR NERVINES.

life Avere in danger of being drained.  So hydropathy had its
run,  andAvas esteemed at one time a sovereign remedy.  So
at the present time, which may be called the era of nervous
diseases, there are certain fashionable nervines which are mis-
used and which are abused to full as great if not to a greater
extent than calomel, phlebotomy, and the  cold-water pack
used to  be.   The Avriter has recently had a nervous  patient
Avho, by the excessive use of belladonna (deadly nightshade)
injudiciously prescribed by a friend, evidently Avith the best
intentions, became so  addicted to the  inordinate  use of the
drug, as a nervous remedy, as  to induce amaurosis and come
near a total loss  of  eyesight.   It is well known that chloral
is a poAverful hypnotic (or sleep  producer), and wakefulness
being one of the most  distressing  symptoms  and incidents
of nervous  diseases, this remedy Avas naturally  hailed  as
almost a benison from  heaven, and became in literary and
fashionable circles, in all cases Avhere, either through ill health
or over-indulgence,  the nerves  Avere  unstrung, a universal
resort  as a prescription.   The consequence  was that  the
patients using this powerful remedy, not  taking into  consid-
eration  the  reaction Avhich inevitably  follows, became inca-
pable of  any  but an  unnatural, artificially induced  sleep,
AA'hich  only continued  during  the  effect  of  the  druo\   Iu
short, healthful, ordinary slumber became an utter stranger
to their  pilloAvs,  while phantasies and  disturbing visions  of
all kinds  continually haunted their nocturnal hours.    There
is another class of nervines, which have come into great use
and  celebrity Avithin the past ten years, Avhich deserve espe-
cial mention and consideration.  I allude to the  multitudi-
nous salts of potassium, prominent amongst Avhich  are the
bromides  and iodides.   This  class of  nervine  remedies has
of late been considered the great resource in the treatment of
nervous affections, particularly  in cases  of cerebral congestion
or irritation of the base  of the brain and spinal column, 
         USES AND ABUSES  OF POPULAR NERVINES.      191

and in gastralgia ana dyspepsia or inflammation of the stom-
ach, either acute or chronic.  Every patient suffering from
hysteria,  alcoholism or delirium tremens,  melancholy,  de-
spondency,  or venereal excesses, has been liberally dosed
with  bromide of potassium.  While I do not wish it to be
inferred that I entirely ignore this class of nervous remedies,
or  deny their  utility and beneficial effects Avhen  judiciously
administered, I still must insist that  these  remedies should
never be administered alone, or in quantities Avhich  may be
well termed  excessive, as the  invariable  result  of such im-
proper administration is a depression  of the nervous system,
from AArhich the patient seldom if ever rallies.  Furthermore,
it is a well-known therapeutical fact  that bromide of potas-
sium produces a permanent aneemia  (or absence of blood)
in  the brain throughout the Avhole capillary and  arterial cir-
culation.  Consequently, as must be evident eYen to  the un-
professional  reader, if its  use be  continued the result is con-
tinued until the brain, deprived of nutrition, loses  its tonicity,
and softening is the inevitable consequence.  No more terrible
affliction, of course, can  befall a human  being than this.
Henceforth he Avanders about a lack-lustre idiot, until death
comes to his relief, much, also, to the relief of  his  friends.
In  1812 aconite was introduced as  a nervous  sedative by
Sir Benjamin Brodie.  The peculiar action of this drug upon
the nervous  fibre is due to  the alkaloid, Avhich does produce
a very  rapid and tranquillizing effect on the brain, at the
same time  also producing a very depressing effect on the
heart and circulation.  In  other words, the brief beneficial
effect of the administration of  the drug in quieting the brain
is secured at the expense of the permanent depression of the
nervous  system.   The administration of  this  drug, when
persisted in, is almost sure to produce  apoplexy.  Where
there is too much tone, excessive tension of the nerves is a
result, and when  there is too much depression, effusion is 
 192     USES AND ABUSES  OF POPULAR NERVINES.

pretty sure  to  follow.  Even the  small doses of this  drug
prescribed  by  homoeopathic physicians finally  induce the
same  results as in a  more heroic practice.   I wall close this
cursory discussion of  the merits and demerits of some of
the popular  nervines by a word  or two about  the most  com-
mon and popular of all the nervines (for  a nervine  it is to
all  intents  and purposes, and not  by any means  perfectly
harmless),  to wit:  Tea, one of the chief constituents of
this beverage "which cheers but not inebriates," is  tannin, a
substance so poAverfully astringent as to produce derangement
of the liver  and all the excretory organs.   Hence the exces-
sive use of  tea is oftentimes at  the bottom of the  complete
derangement of these organs.  As a result, come  spleen,
melancholia, and nervous derangement.   As for the other
nervines, such  as  valerian,  morphine, lactucarium, hyoscy-
amus,  etc.,  they  all have their  devotees,  and are  too well
known, both in their curative and pernicious effects, to need
special  notice.  Suffice it to say that  all the nervines are
necessarily perilous agents, except  in the hands of a skilful
practitioner, who  has made nervous affections  a  life-lono-
study and specialty of treatment. 
INSTRUCTIONS  TO  PATIENTS.
   Dr. Hayes, having for many years devoted his attention to the treatment
 and cure of diseases of the Nervous System described in the preceding
 pages, may be personally consulted, together with Dr. Parker, his assistant
 and former pupil, from nine in the morning until six  in the evening, daily,
 Sundays excepted, at his office, No. 4 Bulflnch St., Boston, Mass.
   Cases can be treated by correspondence when a personal interview is im-
 possible, providing the patients will minutely detail all of their bodily infir-
 mities and mental disturbances, written in a simple and natural style, and in
 accordance with the unerring dictates of their own feelings.  One personal
 interview,  however, even with patients resident at a distance, is highly de-
 sirable Avhen practicable, and will more than repay the patient the expense
 and trouble  of a visit  to Boston.  The  advantages of such a visit are
 apparent and manifold.   A single visit in most cases will enable the Doctor
 to form an accurate opinion and note particulars which might be lost sight
 of in mere correspondence, particularly when a microscopic  and chemical
 examination of the urine is absolutely necessary.


         Patients  not  Resident in "the  City,

 Who wish to transact their business through the mail, or by express, can
 have their necessary remedies sent  to any address,  or left at any railway
 station or coach office in the United States or Canadas until called for, care-
 fully packed and securely sealed.
  All communications must contain the usual consultation fee of five dol-
 lars ; otherwise no  notice will be  taken of their application.  A  distinct
 name and address is necessary.   Money can be forwarded  by enclosing
bank notes in a registered letter, to ensure their safety, by  Postal order,
 drafts on New York or Boston banks, or by express.
  The entire correspondence of the Institution comes under  the personal
inspection of Dr. Hayes, whether addressed to the Peabody Medical Insti-
tute Dr. "W. H. Parker, his assistant, or himself.
                                                  [193] 
 
TESTIMONIALS.
  By way of conclusion to this volume, the  author  is gratified to
be able to place before his multitudinous readers a number of  cer-
tificates and testimonials of his success  in the  cure of nervous
diseases from grateful  patients residing in  different  parts of the
country.   These testimonials have been unsolicited, and are  such
tributes as would be flattering even to the most distinguished mem-
bers of the medical profession.  Naturally enough, patients  who
have been cured of the most depressive class of ailments and ills
to which flesh is heir, are somewhat warm  in their expressions of
gratitude towards their medical benefactor.   The writer could fill
a volume with authentic testimonials of a similar nature.  Man}-
of these testimonials are from  prominent and  influential persons
in the various localities in which they reside, — from persons, in
short, in all avocations of life.
AN  ALMOST HOPELESS  CASE OF NERVOUS DISEASE.
Perfect Cure. — A  Grateful Testimonial.
                                            Boston, May, 1873.
  In June of the year 1865 the undersigned went to California and took
charge of a large mining interest, in which his  own fortunes, as well as
those of several friends,  were largely involved.  The interest was in litiga-
tion, and for a year and  a  half was under the  constant strain of intense
mental  anxiety, to say nothing of incessant bodily activity.  My manage-
ment was successful; but at the end of a year and a half I found myself
               [195] 
196
TESTIMONIALS.
completely prostrated and broken down by excessive mental  and bodily
exertion.  I was, in fact, the subject of one of the most  serious forms  of
nervous disease, caused, I was told by the medical authorities, by conges-
tion of the base of the brain.
  To be thus suddenly arrested in the very midst of a  lucrative and most
promising enterprise, just when I had reached blue water, as it were, and
all difficulties had been overcome, and doubts of success had been dispelled,
— to be arrested, I say, at such an interesting juncture by an alarming ner-
vous affection, which completely incapacitated me for any mental or bodily
exertion whatever, was sufficiently discouraging and disheartening.  It was
like drowning, not only in sight of land, but with one's  clutch on the shore..
It was useless to struggle.   I was obliged  to succumb; and, by advice  of
my friends, I went reluctantly east to  Philadelphia, where I was  placed
under the care of a  most prominent physician.  At this time my memory
failed me, and I had lost the perceptions of taste, touch, and smell. My left
side was paralyzed.  I  was constantly tormented by hallucinations and
gloomy forebodings as well as by incessant pain, so that a nurse at my side
was a necessity that could not be dispensed with by night or day.
  As I showed no symptoms of recovery, I was  taken  to  Saratoga, that a
physician resident there, who was somewhat celebrated for his treatment
of nervous affections, might be consulted. Perhaps also it was thought that
the mineral waters might be  beneficial.  I remained six months at Saratoga,
not only without amendment of my health, but I had grown worse instead
of better.
  Matters had now become so serious that immediate recourse  to the best
medical advice and ability to be found in the city of New York was deemed
the best step.  I was soon under the care of the most  noted specialist  in
nervous disease in the commercial metropolis.  After a course of treatment
in which electricity formed  a  prominent feature, my friends were notified
that my case was hopeless.  There was  life left in  me, it is true, but the
verdict was that there was no hope.  Henceforth I was to be a burden  to
myself and my friends, until death came to my relief.
  At this critical point an eastern gentleman, who had business with one
of my friends in New York,  happened to be informed of my hopeless con-
dition.  He called to see me, and strongly advised that I should be taken to
Boston for a personal interview with  Dr. Hayes, the consulting physician
of the Peabody Medical Institute in that city.  He was told that I had been
taken from place to place for medical treatment several times already with-
out receiving the least advantage, and that another removal to a distant
point would probably result  in another  failure to obtain relief, and would
therefore be worse  than useless.   But the eastern  gentleman,  being of a
sanguine temperament, would not give my case up so, and finally prevailed
upon those who had me in charge to take me to Boston. 
TESTIMONIALS.
197
Alexander E. Raitt. 
198
TESTIMONIALS.
  After a careful examination of my case, Dr. Hayes said that he could
afford me partial relief, but he did not speak encouragingly in regard to a
permanent cure.   Under no circumstances the doctor informed me could I
expect much mitigation of my sufferings from his treatment in a less time
than at the end of six weeks.  Even partial relief was worth more  than a
six months' stay in Boston, to say nothing of six weeks.  Suffice it to say
that I found myself at  once subjected  to a new treatment, entirely different
from anything which I had experienced at the hands of my previous med-
ical advisers.  It began to tell on my shattered nerves at once, working like
a charm.
  At the end of two weeks the gentleman, who  had originally advised my
recourse to the doctor, called to see me in my new quarters, and under my
new treatment.   Sensation had already begun to return to my left side.  I
was  recovering the use  of my lost senses, and warmth and  motion were
taking the place  of partial paralysis.  The gentleman gave me a  L>ak,
which said louder than words — "I told you there was  hope and cure for
you."  In fact I felt health dawning anew in me.  AA'ith returning strength
came hope and confidence, which reinforced the treatment  and medicine
wonderfully.  The doctor acknowledged that he had underestimated the
recuperative power of my system.
  At the end of the six weeks, Avhich he had mentioned as the earliest date
of even a partial recovery, he assured me of a perfect cure.  His  assur-
ances were made good by the event.   I am  at the  date of this writing a
well man, and have been for several years.   Indeed my present occupation
requires vigorous health, and I am fully equal to it.' I frequently indulge
in gymnastic exercises, and am noted for muscular strength.  During my
illness my weight, which is now from 175 to 200, fell to 120 pounds.   I am
induced to write this letter by a sense of duty to others  who are suffering
as I suffered.  It was this sense of duty, combined with a feeling of intense
personal  regard  for my healer  and benefactor, Dr.  Hayes,  which has
prompted me unsolicited to pen these lines as a guide to all prostrated with
severe  nervous  disease.   I  refer to Adjutant-General  Cunningham and
Judge Abbott, who are personal acquaintances.
                                             Alexander E. Raitt.
Suffolk, ss.
                                                  August 1G, 1873.
  Then  personally appeared the above-named Alexander  E.  Raitt, and
made oath that the above statement by him subscribed is true.
                             Before me,
                                          T. P. Nuttek,
                                                 Justice of the Peace. 
TESTIMONIALS.                      199
                           East Woodstock, Conn., March 8, 1873.
  To whom it may concern: In the year 1871, my nervous system and phys-
ical powers became so reduced by an unnatural drain, and my mind so dis-
eased, that my people deemed it necessary, for my protection as well as
their own, to send me to the Insane Asylum at AVorcester.  I was admitted
Edward L. Morse.
to the asylum Sept. 12, 1871, and  during the many weeks I was confined
there, I grew worse, day by day, until it seemed as though I should become
a raving maniac, unless I could get relief, which I was sure I could never
obtain in that institution.
  The  last of November I managed to escape, and  by some mysterious
providence I was led to the Peabody Medical Institute, Boston. Dr. Hayes, 
200
TESTIMONIALS.
the chief consulting physician, and his assistant, Dr. Parker, immediately
interested themselves in my case;  and after a most thorough and rigid ex-
amination, they pronounced my case curable.  This I could not realize or
believe, my mind being so much diseased;  but my father was subsequently
convinced of Dr. Hayes's great skill in such cases as mine, and also of the
honorable business principles that governed the management of the Pea-
body Medical Institute in every particular.   He, therefore, at once placed
me under the treatment of Dr.  Hayes and his assistant.  The proper rem-
edies were furnished me, and I returned home with my father, where I have
remained in safety ever since, visiting the doctor occasionally.  The results
have been an astonishing change in my condition for the  better.   I  have
now been taking Dr. Hayes's remedies for a little more than a year, and con-
sider the good results but little less than miraculous.  I do not  take  med-
icine now, nor do I need any.  When I was forced, or rather  entrapped,
into the insane asylum, the doctors there pronounced me incurable, — and
I think I was incurable at their hands.
  If this testimonial, which I feel it is my duty to give, should fall under the
notice of any sufferer from nervous disease in any shape  or form,  or  from
the diseases described in Dr. Hayes's  " Science of Life ";  or should this be
seen by the friends of such a sufferer,  I would conscientiously and earnestly
recommend them to the author of  this book, Dr. Hayes, as a skilful physi-
cian and an  honorable gentleman.   Nor can I do less ; and should any poor,
suffering fellow-being wish to make further inquiry, I will with delight give
them all the information in my power<
                                                 Edward L. Morse.

Suffolk, ss.                                         March 8,  1873.
   Subscribed and sworn to before me,
                                         Joseph  Bennett,
                                                  Justice of the Peace.
                               Sprlngfield, Illinois,  May  9, 1873.
Dr. Hayes :
  Having been under your treatment for the past three months for epilepsy,
I take pleasure in saying, in gratitude for kind and skilful attention, that I
have derived such essential and marked benefit from your skilful practice
as to make me certain that  I am cured;  at any  rate the symptoms of the
disease have entirely disappeared, I feel confident not to return.
                                                           J. S.  K.
  When a person is cured of a disease which, though not generally deemed
incurable, is yet manageable only by the most skilful treatment and pecu-
liar remedies, it is his duty to those similarly affected to make  it known. 
TESTIMONIALS.
201
For a long period I suffered from chorea or St. Vitus' dance. The action of
my brain was disordered and my mind was decidedly impaired.  My feel-
ings were easily excited and my temper was fretful and irritable.  Hallu-
nications of sight and* hearing also troubled me.  My sleep was disturbed
by disagreeable dreams.  These mental troubles were accompanied by the
usual  disorderly muscular contractions.  Acting on the advice of a friend
who some years  ago was cured  by your treatment of a like disease, I too
placed myself under your care, and after two weeks of constant treatment
was radically cured, and the constitutional disturbances entirely disap-
peared.
  I am  confident that  others similiarly affected with myself,  by  placing
themselves under your care, and following your advice, will be rewarded
with like benefit.
                                                          G. W. P.
  Richmond, Va., March 3, 1873.
Dr. Hayes :
  Dear Sir: — Gratitude to you for a perfect restoration to health, society,
and business, leads me to write you this letter, hoping that you will make
it public, so that others similarly affected with myself may know to whom
to have recourse for relief.   Owing to youthful indiscretions and excesses,
I was a sufferer from constant depression of spirits and mental anxiety of the
most disheartening nature.   Life was a burden and I found myself the vic-
tim of hypochondriasis in the very prime of manhood.  I found myself also
contemplating death as the  only refuge from the deep gloom which clouded
my  life and prospects.   At this critical time I was directed to you, and in
a few weeks, under your advice and remedies, I  became well again, with the
buoyancy of spirits natural  to health and mental and bodily vigor.
                                                          J.  T. S.
  Hartford,  Conn., Jan. 27,  1873.
                                           Fitchburg, Dec. 29, 1872.
To the Public:
  For the good of those affected with paralysis agitatus, or shaking palsy,
I am pleased to state that Dr. Hayes radically cured this affection in myself,
it being the result of an exhausting disease from which I had suffered.
                                                           F. N. B.
                                    Springfikld, Mass., June 7, 1872.
Dr.  Hayes:
  Dear Sir: — Under your skilful treatment and  remedies, and by strictly
conforming to your advice, and the hygiene recommended by you, I was
completely rescued from the horrors of a shattered nervous  system, and 
202
TESTIMONIALS.
made once more capable of complete self-control, so far. as the accursed
habits are concerned which drove me almost to suicide.
                          Gratefully yours,
                                                             A. P.
                              Toronto, Canada West, April 3, 1873.
Dr.  Hayes:
  Dear Sir: — I was attacked with what was undoubtedly incipient soften-
ing of the brain.  Good luck led me to have recourse to you.  The terrible
infliction was arrested by your remedies,  and I am now enjoying  good
health, and have the use of my mental faculties.  It is due to you and the
public that I should thus signalize your skilful  and successful treatment of
my case.
                                                             R.  D.
                                      Buffalo, N. Y., Feb. 12, 1872.
Friend Hayes :
  Arduous and unremitted professional labors for a course of years, almost
Without recreation, had reduced me to such a state of nervous depression
that I was rapidly nearing the dread goal of insanity and complete mental
imbecility when I put myself under your treatment.   That I have escaped
the calamity of a permanently deranged mind, I owe to your remedies, and
to the regimen which you advised.
                          Gratefully yours,
                                                          C E. L.
                                      Worcester, Mass., June, 1873.
Dr. Hayes:
  It is with feelings of intense gratitude that I find myself, through the use
of your remedies, once more capable of sound, natural sleep.   Previously
to my application to  you for relief, my memory had become  impaired.  I
could not sleep;  or if I did, I awoke in a state of excitement and alarm,
sometimes in horror.   I could not get any sleep for hours after I went to
bed.  At length  this constant  insomnia, or wakefulness,  reached  a point
where relief had become an absolute necessity.  I could no longer endure
the dreadful illusions, hallucinations, and nocturnal visions which haunted
what should  have been hours of repose, but were not.   Learning of your
skill and success  in the treatment of nervous affections, I  had recourse to
you, feeling that  your advice was a last resort.  Nor did it fail me.  A few
weeks of conformity  to your directions, with the use of your prescriptions,
have restored me to perfect health.
                                                         E. W.  B. 
TESTIMONIALS.
203
Dr. Hayes :
  Dear Sir: — I take great pleasure in saying that your professional efforts
in my case of paralysis of the left arm resulted in  a permanent cure, and
were in the highest degree satisfactory.
                        I am yours, very truly,
                                                          R. H. W.
  Syracuse, N. Y.
Dr. A. H.  Hayes :
  Dear Sir: — For several years I was the victim of alcoholism, which had
been originally induced by convivial habits, and the temptations set before
me by the society of numerous  and hospitable friends.  Almost  before  I
was aware  of it, owing to a singularly sensitive  and impressible nervous
system, I found  myself  tormented by all  the distressing and appalling
symptoms and incidents of the above disease.  I would have  given  all  I
possessed on earth to be relieved from the sufferings aud nervous agitation
which  ensued.   I feel that it is  to you I owe my final extrication  from
the gulf of despair, in which a disposition naturally social and too easily
yielding to convivial temptations had involved me.  Please accept my grate-
ful acknowledgments for the thorough relief which your skill has afforded
me.
                                                           S. R.  C.
  Haverhill, N. H.
Dear Doctor:
  After having been  extricacted from a  gulf, into which  one has been
plunged by his own youthful follies, and the excessive indulgence of his
passions and appetites, it is not pleasant to recur to the misery and despair
which you have alleviated in my case.  But I should be wanting to myself,
to you, and to society, if I was altogether silent after having been the sub-
ject of your skill and care, until I have been relieved of the consequences
of my follies.  You have given me back the manhood which I had lost and
forfeited. Why should I indulge in the gloomy details of my case with which
you are so well acquainted, and which others reduced  to a a like strait can
readily imagine ?  Suffice it to say that I am  cured, and sit  clothed and in
my right mind.
          With the utmost esteem I subscribe myself,
                                             Yours ever,
                                                         J. W. W.
  Boston, July 15, 1873.
                                  West Chelmsford, Feb. 25, 1873.
Doctor Hayes:
  Dear Sir: — Yours of yesterday is at hand and with pleasure I would has-
ten to reply.  When I first visited you one year ago last January (1872), I 
204
TESTIMONIALS.
 was a used-up man, both mentally and physically, and it was with much
 pain and suffering that I performed my daily labor, and my nervous system
 was in a very bad  condition.  It was with much difficulty that I could sit
 still and read a paper in the evening, and it was a common occurrence to lie
 awake in bed until eleven, twelve, one, and  two o'clock in the morning,
 and then I would sometimes get up  and stand  on a stone doorstep, or go
 out into the snow barefooted and get chilled so  that my nerves would get
 quieted down so that I could sleep.  My head also troubled me very much.
  But now, by the blessing of God and your very skilful treatment, I feel like
 a new man.  I can now sit and read without suffering from nervousness, and
 to use an  old saying, "I can sleep like a pig."  I often say to my wife
 that I never enjoyed sleep so well in all my  life as  at the present time.
 And in every respect I can truthfully say I am a hundred per cent better than I
 was one year ago, and a more healthy man than I was fifteen years age.
  I  would most earnestly recommend you to  all suffering from  nervous
 disease as a true gentleman and a skilful physician.
                       Most respectfully subscribed,
                                                A. W. Parkhurst.

 Commonwealth of Massachusetts. )
          Middlesex, ss.           $
                                        Chelmsford, April 7, 1873.
  Personally appeared A. W. Parkhurst and made oath to the within state-
ment.
                 Before me,
                                Jonas J.  Hoyt,, Justice of the Peace.
                                           Foxboro', July 14, 1873.
Dr. Hayes:
  Dear Sir: — Words will never express my gratitude to you for the help
you have rendered.  I feel as though I was a new man.  I did not gain
flesh while in the shop; have been out a week and gained four pounds, and
am in most excellent spirits.  I have medicine enough to last four davs,
please send another supply on receipt of this.
                            Yours truly,
                                                       Fred N. B. 
 
 
 
					
					
					
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