In the Somerset County Lunatic Asylum, during twenty years, ending 1st March, 1868, sixty-three cases of puerperal insanity came under my care, being 4·6 per cent of females admitted in that period, not including re-admissions. I have drawn up a summary of these cases to lay before the present meeting of the Medico-Psychological Association.

A few weeks∗ ago a gentleman informed the public, through the newspapers, that he had been cured of rheumatism by the fright he had experienced in a railway accident. The remarks which the circumstance has elicited lead me to think that the whole subject of the influence of the mind upon the body deserves more serious and systematic consideration than it has received. It is now some time since I endeavoured to formularise the generally admitted facts of physiology and psychology so far as they bear on this question, and to collect from the sources at my command all authenticated facts illustrative of this influence. Dissatisfied with my work, I laid my cases aside. Judging, however, from the remarks above-mentioned that, imperfect as they are, they may be of some service, I conclude to forward my observations to the Journal of the Association. I must apologise to the reader for treating the subject in so elementary and aphoristic a manner; but I trust the advantage of this method will be apparent as I proceed.

Nothing which has been written of late years so fully demonstrates the fact that Insanity is not regarded by the profession at large as a somatic disease, as the book intituled “The Nomenclature of Diseases, drawn up by a Joint Committee appointed by the Royal College of Physicians of London.” This work has been forwarded to every member of the medical profession in Great Britain and Ireland by the authority of the Registrar-General, and contains a list of some nine hundred diseases, a large assortment of poisons, and fifty-seven pages of accidents and malformations under which the British public is authorised to suffer or die. The mind of the Briton, however, is authorised to suffer from only six “Disorders of the Intellect;” the idea of disease as connected with madness is studiously ignored. On what principle the differentiation between a disease and a disorder is founded, or on what system of pathology the distinction is based, it is difficult to say; still, there the opinion stands expressed by very high authority, that Insanity is not a disease of the body, merely a disorder of the intellect.

C. M., admitted January 17th, 1870, æt. 24. Married; wife of sailor; can read and write; Church of England; from Whitehaven.

Members of Committee: Drs. D. Skae, E. Smith, J. C. Howden, J. Sibbald, J. Batty Tuke, and T. S. Clonston, Secretary.

Many people buy things merely because they are cheap. No actual necessity dictated the purchase of the commodity, but “only 3s. 9d.” was irresistible! “If it is not useful now, it may be by-and-bye, besides Mrs. B—— has one,” is a sufficient argument to set off against that of economy, which would have us, as far as possible, gratify the demands of choice, but not create wants by the existence of supply. Now there is a somewhat similar tendency in mental economy. Subjects “made easy” are the snare of our nineteenth century enlightenment. Table-talk is a sign of our times! These are the days of wide spread but thin spread education. We must all know a little of everything. We must be able to converse rationally upon any subject, land tenure or ladies' gloves! and it consequently becomes a matter of some importance to have subjects “made easy.” We wish to get into the bowels of a science as we do into the bowels of a country, by train! Well, just as three and nine, and the fact that Mrs. B—— has one, tempted the purchase of the useless article, so the “made easy” and the small talk of a neighbour at dinner tempt to the acquisition of some very useless knowledge. And as it is true that purchases which are dictated by vanity and not by need do harm in trade, so do acquisitions of useless table-talk facts do harm in science. If a science is to have fair play, it is well for it if it does not become popular. Goethe somewhere says that when a man does a great thing the world seems to enter into a conspiracy to prevent him doing it again. It dines him and cheers him till he dies. He has only time to bow! So a science that is thought to have done some great thing becomes popular, and it is likely enough to die while the cheering lasts. A popular science, one that is “made easy,” is not likely to have much vitality in it. The intension of a science is in the inverse ratio to the extension.

It will be a matter of grave regret to all interested in the success of the Scotch Lunacy system, and a source of grief to a large circle of warmly attached friends, to learn that Dr. W. A. F. Browne has been compelled—while still in the fall vigour of his mental powers—from grave failure of sight, to resign his office of Commissioner in Lunacy.

At the present time, when several deeply to be lamented abuses in asylums for the insane have come to light, and have produced something like a reaction in favour of the old regime, the following unpublished letter, written by the late Godfrey Higgins, Esq., may serve to prove that the moral tone of our asylums was nearly as low then as now! I would especially commend it to the attention of the past-admiring editor of the “Pall Mall Gazette.”

Godfrey Higgins, in his diary, states that he was in Paris, and visited Pinel. He was very politely received by him, and visited the asylum for French lunatics under his management, and was much pleased with it. He did not think there was anything to learn, except in the employment of the patients. He was rather suspicious that he did not see the whole of the establishment. He was convinced there were many persons placed there who were not and never had been insane, but were placed there, and willing to remain, for the good food, beds, and clothing. The number of patients, 900.

The Report of the Commissioners in Lunacy made upon the cases of Santi Nistri, a patient in Hanwell Asylum, and Rees Price, in the Carmarthen Asylum, who recently died from broken ribs and other injuries, has been printed by order of the House of Commons. With regard to the first-named patient, the Commissioners “are sorry to report that they have failed in obtaining any precise information of how or when the poor man received the injuries of which he died, but our inquiry has served to show various defects in the management of the Hanwell Asylum.” The patient died on the 11th of October; the Commissioners' visit and inquiry took place on the 5th of November. No wonder that they were unable to gain any information, and that “they could place no confidence in the statements of the patients, some of whom impressed us with the idea that they had been tutored.” We believe that the only chance of arriving at the true history of these cases is to institute an inquiry as soon as they occur, an inquiry which, from their experience, the Commissioners in Lunacy would be able to carry out much more effectually than the Coroner, who can only take the evidence which is offered to him. The Report reiterates the Commissioners' complaint of the insufficiency of the medical staff. The Committee of the Asylum, however, in an appended communication, decline to appoint a second medical officer. The Commissioners also recommend an increase in the number of attendants, a matter of equal if not greater importance. To this point we shall presently recur.

In the Annual Report of the Rainhill Asylum, the Medical Superintendent, Dr. Rogers, makes the following excellent remarks in regard to accidents in asylums, and the unjust accusations that have been based upon them:—

Among the various contributions which are appearing on all sides upon the value of the hydrate of chloral, we may quote the opinion of the able superintendent of the Devon Asylum. Dr. Saunders says:—

Dr. Thurnam, in his Report, tells us that comparing the Commissioners, “Returns of Pauper Lunatics” with the Returns of Population for 1861, it will be found that Wiltshire stands in the unenviable position of having a greater proportion of insane paupers than any other county of England and Wales. Those most nearly approaching it are Gloucester, Oxford, Berks, and Dorset, all agricultural counties; while the ratio of pauper insanity is lowest in Durham, Glamorgan, Stafford, Yorkshire, Cornwall, Derby, Chester, and Lancashire, the most influential in the mining, manufacturing and trading enterprise of the kingdom.

The efforts of our Transatlantic brethren to cure chronic drunkards by the establishment of “Inebriate Asylum,” demand our serious attention, for probably no class of persons brings so much perplexity to the readers of this journal. The “Medical Times and Gazette” (April 9th and 16th, 1870) gives an account of the labours of Dr. Albert Day in two asylums of which he has been superintendent. Dr. Day seems to be a remarkable man. The following particulars are gathered from an article in the “Atlantic Monthly,” entitled “Inebriate Asylums, and a Visit to One”:—

Dr. Clouston tells us in the annual report of the Cumberland and Westmoreland Asylum a fact which may be new to some superintendents, viz., that his patients have no beer.