upon as immediately and essentially connected with the manifestations of disordered intellect. Jacobi has not expressed his opinion precisely in this manner; but it would appear, from a variety of passages in his works, that he looks upon effects produced upon the sensorium and the mind, through the medium of the stomach, or any of the viscera of physical life, as not less immediately brought about by the action of the material organism on the intellectual or sensitive power, than the impressions produced in the mind by a blow on the head, or by any powerful agency exerted immediately on the brain.* This sequence, as he thinks, is more easily understood, as it is more frequently or more distinctly exemplified in a variety of phenomena, both healthy and morbid, connected with the state of the feelings or moral faculties, and their manifestations. The phenomena of moral insanity, or of a disordered state of the affections and moral feelings, without any corresponding lesion of the understanding, or of the reasoning faculties, furnishes, or appears at least prima facie to furnish, a firm ground whereon to maintain the negative position in regard to the participation, or, at least, the primary influence of the brain, in the development of an extensive series of psychological phenomena. Herein Jacobi assents to the opinion which I ventured some time since to put forth; and which was, at first, thought extremely improbable ;-that a mental disorder exists, fully to be recognised by particular trains of symptoms, in which the moral, not the intellectual, part of the human mind is essentially disturbed. To this I affixed the name of moral insanity; while, to another class of mental disorders, consisting in irregular affections of the will, or in unaccountable voluntary impulses, without motive or rational design, the designation of instinctive impulses, or instinctive insanity, is equally applicable.§ I shall not attempt, at present, to enter into the Zeitschrift, B. 1. S. 78. † Such a position can be maintained only by those who persist in regarding the brain as a single organ.-ED. P. J. The existence of moral insanity was recognised by Pinel and others long before Dr Prichard published his views; indeed, he himself has stated this in the Cyclopædia of Practical Medicine. To phrenologists, moral insanity has long been familiar.—ED. P. J. § This last is the disorder described by Pinel, under the title of " Manie sans delire." It was observed by M. Esquirol, in his last work, that this affection is totally distinct from that which I have described first in the Cyclopædia of Practical Medicine. The term moral insanity is now in common use among the superintendants of lunatic asylums, both in Britain and in the United States, as the distinguishing term for this species of mental disease. It is said that, in some of the United States, nearly one-eighth of the whole number of lunatics committed by the courts belong to this class. rationale of the class of mental disorders to which this writer alludes; or to discuss the question, whether in those cases of insanity in which the primary cause, or the primary morbid change, has its seat in the organs of physical life, there always intervenes a morbid condition of the brain, which last is the immediate antecedent of disturbance of the mental faculties. The most important thing, in a practical point of view, is to establish the fact, that the principal and fundamental cause of insanity is, in many instances, to be sought, not in the brain, but in some other region of the body. Of this, I believe that most persons who have enjoyed many opportunities of observation, and are capable of making a good use of them, are now well convinced. The opinion, however, is yet so far from being the prevailing one, that it is worth while to lay before the public any striking and decided example that may carry strong conviction on the subject; and this precisely is the object of the present communication. A. B-, a lady highly accomplished, and of great mental endowments, pious,'affectionate, and sincere, when about thirtyfive years of age, without any assignable cause, except, perhaps, an over-strained attention to a course of study which, from charitable motives, she had been induced to undertake, and from consequent neglect of exercise and the means of promoting her bodily health, became suddenly low-spirited and hypochondriacal. During the early period of her illness, she fancied herself to labour under a variety of complaints, over which she was ever brooding, and suggesting causes and remedies. Her whole temper and character became changed. Formerly devoted to her duties, and to works of benevolence to others, she now thought only of herself, and her complaints. She was even indifferent about the state of her own person. When her complaints assumed a definite form, they always referred to her stomach and alimentary canal. She thought herself over-filled with food when she had taken a very small quantity; and, under this impression, she almost starved herself. After many months spent under the unremitting attendance of her mother, and her near relations (during which time she made repeated attempts to escape out of the house, in order to elude importunities, and almost compulsion, to take food), it was determined by her friends (who found it impossible, We fully admit the fact in question; the words" principal and fundamental" not here signifying immediate or proximate cause. The subject has been discussed by Dr Combe in a paper on Hypochondriasis, published in this Journal, vol. iii. p. 51. See also his work on Mental Derangement, p. 143.-Ed. P. J. otherwise, to prevent her from sinking under exhaustion) to send her to a lunatic asylum, where she passed the last years of her life. While there, she was induced, though not without great difficulty, and a constant threat of compulsion if she resisted, to take a moderate quantity of the most nutritious and digestible food. Her body, which had been very much emaciated, was then restored to its usual degree of fulness; she had always been of light and slender frame. It was her constant entreaty to be spared the pain occasioned by taking food. She was ever intent upon the means of dissuading her friends from forcing her to eat; and when this was given up as hopeless, she employed her utmost effort to elude their attempts. Every imaginable stratagem was put in practice. Formerly high-minded and upright, she now descended to the meanest tricks, in order to promote this one object, to which her mind was ever directed. At her entreaty, the prescribed quantity of solid food was decreased from time to time, and a milder and more fluid diet substituted for it. On these occasions she became weak and feeble, and emaciated; and it was found necessary, although her complaints of suffering were rendered more distressing and importunate, to return to a fuller quantity; but this was always the smallest quantity that could support her strength. Notwithstanding her complaints, there was no perceptible indication of abdominal disease. After remaining some years nearly in the same state, she was suddenly attacked with diarrhoea, which, in a few days, notwithstanding all ordinary means used to stop it, carried her off. She retained acute intelligence, and all her morbid impressions, to the last hours of her life. The autopsy was made carefully two days afterwards. The following were the most remarkable appearances : The cranium was remarkably light and thin, and permeable to light. Between the layers of the arachnoid was much fluid. This membrane was opaque where it covers the posterior lobes of the cerebrum, and raised by fluid effused between it and the pia mater, separating the convolutions. Ventricles full of perfectly colourless serum. The brain and dura mater were very exsangueous. Altogether, the fluid effused amounted to five ounces. The lungs were extensively beset with tubercles. But the ultimate, if not the primary, cause of the disease was apparent in the intestinal canal. The ileum was beset, through nearly its whole extent, with large, round, or irregularly-shaped patches, occupied by congeries of tubercles.. On these patches were extensive ulcerations, of irregular surface, and with much thickened edges. In many parts these ulcerations occupied the whole circuit of the intestinal tube. The tuberculous matter had been deposited underneath the serous coat, forming a hardened base for the ulcerations which took place on the mucous surface. This dissection afforded proof that the perpetual complaints made by the patient of pain and suffering in the abdomen had an organic cause, and were not unreal, as it had been sometimes suspected. As these complaints had been uniform, and had continued from the commencement of the disease, it may be inferred, as highly probable, that the organic disease in the intestinal canal had been coëval with the mental disorder, and the foundation of the whole train of morbid symptoms. The history of this case furnishes, on this view, an example of insanity mainly dependent on a diseased state of organs very remote from the brain. Serous effusion, indeed, existed within the skull; and this is known to be a very frequent phenomenon in cases of insanity; but it may, perhaps, be regarded rather as an effect than a cause.* Tubercular disease in the lungs is likewise frequently discerned in melancholic patients, as Esquirol has particularly observed; but this rather supervenes upon than occasions melancholia. On comparing all the phenomena which the history of the case displays, I think it, on the whole, manifest, that the abdominal disease was the primary deviation from health; but how this may have operated in giving rise to the complaints which appear to have resulted, I do not pretend to explain. II. Phreno-Magnetic Cases. By Mr T. B. BRINDLEY. STOURBRIDGE, Jan. 6. 1844. SIR,—Should the following facts in Phreno-Mesmerism, attested by respectable witnesses, be deemed worthy of a place * In 120 out of 216 cases, Greding found effusions between the dura and the pia mater. Between the pia mater and the surface of the brain, in 29 out of 100 maniacs. He found the lateral ventricles in 28 very full of serum; in 23 ready to burst; in 10 out of 24 melancholics astonishingly distended. Third ventricle quite full in 57 of 100 maniacs; and in 16 of 24 melancholics. Fourth ventricle ready to burst in 80 out of 100 maniacs, and empty only in 3; completely distended in every one of 24 melancholics. By the same writer it was observed that the skull was remarkably thick in 167 out of 216 cases. In many cases it was remarkably thin, and holes were found in the inner table in 115 out of 216 cases. in your valuable pages, their insertion will oblige, Sir, your obedient servant, T. B. BRINDLEY. CASE I. Lucy Griffin, servant to Mr Granger, Halesowen, was thrown into the mesmeric sleep in a few minutes, at a conversazione given by me on the 22d December last, to John Meredith, Esq., Bellevue, Wm. Moore, Esq., Halesowen House, T. Whitmore, Esq., J. Humphrey, Esq., H. Adkins, Esq., surgeon, and many other gentlemen. The girl knew nothing of Mesmerism, having never seen a person mesmerised; and of Phrenology she did not know even the meaning. After testing her in different ways, to prove that she was really in the mesmeric sleep, I demagnetised Hearing, and excited Language (for she was in a complete state of isolation). We then spoke to her, but she could hear no one but the operator. After cautioning all persons present against naming the organs, I proceeded to excite Self-Esteem by contact; when she immediately raised herself in her chair, tossed her head with much dignity, and informed me, "that she thought herself much too good to associate with me." Moving my finger to Adhesiveness, she clung to me, and exclaimed, "You will not leave me; you shall stop with me." On my finger being applied to Philoprogenitiveness, she talked of children, and of young animals, sometimes nursing the former, and calling the latter. Conscientiousness being excited, led to a sense of duty. "She must attend to her master's business," she said, or it would be defrauding him of her time." Veneration being touched, she rose from her chair and said, "Well, I must go." "Where are you going?" "To church." "What are you going there for?" "Why, to worship God, to be sure." "Oh, I would not go to church if I were you; it's so dull; come and go to a dance." "Ah! you wicked wretch! I would not go for the world." She then began to scold me for my sinfulness, imagining me to be some other person; but, upon placing my finger on Individuality, she knew me instantly. Benevolence excited, produced generosity; Acquisitiveness, an inclination to get hold of what she could, and keep what she had; Ideality, to talk about the moon, groves, and poetry; Wit, to laugh and say funny things; Firmness, to refuse to do any thing when she had made up her mind, though repeatedly solicited; and Secretiveness, to refuse to tell me anything I asked her, remarking," that she kept her own secrets." On the whole, thirty organs, as marked on the bust, were excited (the rest we had not time to 2 |