This Report includes the transactions which occured during the year 1844. It was presented on the 31st of March, and the public who are interested in lunacy matters, have reason to feel obliged to the Commissioners for the promptness of its preparation and publication.

A philosophic and sufficient nomenclature for the various forms of Insanity is still a desideratum, and must, I fear, remain so, until the physiology and pathology of the brain are better understood, and the relationship of mental with cerebral phenomena more accurately determined. A perfect nomenclature for disease, one which could not well be improved, is a rare thing; for to be perfect it should not only indicate the exact seat of the disease, but should also bear upon its face a description of the malady from which the organ or tissue is suffering.

The term spasm was applied by Dr. Cullen, to a state of muscular contraction more violent in degree than is usual in health. Where the contraction is succeeded by relaxation, and immediately repeated without the concurrence of the will, or from natural causes, he applies the term convulsion. Dr. Copland, in his Dictionary, has given a fuller definition, to distinguish convulsions from allied and specific diseases, as tetanus, &c. Andral's definition is similar to Copland's, with this addition, that there is or is not loss of consciousness. When there is loss of consciousness the disease is termed eclampsia, always without foaming at the mouth; by which eclampsia is distinguished from epilepsy.

The extreme distortion of face produced by acute mania, or melancholia in its higher degree, is easily recognised. It may, however, be needful to distinguish it from the expression of cerebral inflammation, or of fever. The distinguishing characteristics of cerebral inflammation attended by maniacal symptoms are, a greater suffusion of countenance, a firm knitting of the brows expressive of intense pain, and a fierce, prominent, and blood-shot eye. It is in meningitis rather than in mania that it may be truly said—“And each strained ball of sight seemed bursting from his head.” The patient suffering from cerebral inflammation has a motiveless ferocity of aspect, rarely met with in pure mania. The stage of effusion in meningitis, and all the stages of some forms of deep-seated cerebral inflammation, in which the meninges are not affected, require to be distinguished from dementia, rather than from mania. The history of the case, however, and the affection of the muscular system, will generally render the diagnosis easy.

As it is my intention to present a faithful description of the various forms of mental disorder, it is necessary in the first place, to draw attention very briefly, to the classification of diseases of the mind. Very different arrangements have been made by different writers on the symptoms manifested by the insane, and they have grouped them under somewhat opposite heads, guided in some instances by the most prominent symptoms, and in others, by the supposed seat of the malady. Before that attention had been paid to psychological affections, which they now happily have obtained, Cullen's nosology was regarded as clear and natural; and doubtless, it promised advantages over the systems of Sauvages, Vogel, and Linnæus. Cullen placed mental disorders in the class, Neuroses, and under the order, Vesaniæ, which included those disorders in which the judgment is impaired, without coma or pyrexia. These he referred to four great divisions, viz., amentia, melancholia, mania, and oneirodynia. Amentia, might be either congenital, senile, or acquired; melancholia exhibited itself in eight principal varieties, some involving hallucinations of a painful, others of a pleasurable nature; mania, he defined as a false judgment arising from perversions of the imagination, or from false recollection, and commonly producing disproportionate emotions (assuming the person to be awake and free from pyrexia and coma); oneirodynia, the last of Cullen's divisions, included, somnambulism and night-mare.

In a former number of this Journal (No. 11) attention was drawn in a leading article to the breaking up of the Military Lunatic Hospital at Yarmouth, Norfolk, and in the next number I was led to make one or two remarks on the question, actuated by a natural sympathy with the present sad state of my former patients.

In Dr. Conolly's early treatise on the Indications of Insanity, there is a charming chapter, on the “Modifications of intellectual power and activity, by various stimuli.” It abounds in anecdote, is very suggestive and full of instruction. If any reader of the Asylum Journal is unacquainted with the volume, he will obtain a rich treat by the perusal of its classic pages. Its facts will instruct him, even if he may demur to the theory which is based upon them. It has suggested to one mind, an hypothesis transient, it may be, as an April sunbeam, but which nevertheless seeks a written utterance in the Asylum Journal; and if meriting no better name, let it pass under the title of psychological gossip—for the writer has a strong suspicion, that this is its correct definition, more especially as in its elucidation some facts -will be reiterated, and some statements made, which have been used for other, if not for higher purposes elsewhere. The hypothesis consists in the supposition that the science of Phrenology, if not the art of Craniology is based upon truth, but that the special faculties of the mind are not produced simply and exclusively by an inherent power or impulse, but require for their education some appeal from the external senses; that Locke was not right in regarding the mind as a ‘tabula rasa’ until written upon by the senses; or Cabanis, Gall, and their successors, in supposing that the manifestation of special genius in individuals was dependent solely upon a particular cerebral organization, and altogether independent for its action of external incidents. In other words, that the faculties of the mind are evoked by an appeal from the senses, each mind responding to some peculiar excitement, as the highly toned instrument echoes back the note which is struck from without, provided it is in accordance with its own pitch or tensity. There is a dual action between the organs of sense and the brain, in the first awakening of the mind to a special pursuit; thus the genius of Ebenezer Elliott, the stern and powerful “Corn Law Rhymer,” appears ever to have required some such appeal from without, for in his autobiography he tells us, that “time has developed in me not genius, but powers which exist in all men, and lie dormant in most. I cannot, like Byron and Montgomery, pour poetry from my heart as from an unfailing fountain; and of my inability to indentify myself, like Shakespeare and Scott, with the characters of other men, my abortive ‘Kerhonah,’ ‘Taurepeds' and similar rejected failures are melancholy instances. My thoughts are all exterior. My mind is the mind of my own eyes. A primrose is to me a primrose and nothing more. I love it because it is nothing more. There is not in my writings one good idea that has not been suggested to me by some real occurrence, or by some object actually before my eyes, or by some remembered object or occurrence, or by the thoughts of other men heard or read. If I possess any power at all allied to genius, it is that of making other men's thoughts suggest thoughts to me, which, whether original or not, are to me new. Some years ago, my late excellent neighbour John Heppenstel, after showing me the plates of Audubon's “Birds of America,” requested me to address a few verses to the author. With this request I was anxious to comply, but I was unable to write a line, until a sentence in Rousseau suggested a whole poem, and coloured all its language. Now in this case I was not like a clergyman seeking a text, that he may write a sermon; for the text was not sought but found, or it would have been to me a lying and barren spirit.” This experience of Elliott would be regarded by some as an apt illustration of the sensational theory of mind, while the phrenologist might consider it as an example of the development of the perceptive faculties equalling if not dominating over the organ of ideality. It appears to the writer, generic and typical of all mental arousings to a specific pursuit; certain is it, that Byron is no exception, as the Corn Law Rhymer would have us believe, for the bright world around him with its ever varying incidents was the inspiration of his muse. It was on the lake of Geneva, that he composed the most beautiful portions of Childe Harold. The stillness and the loveliness of the place, seemed to imbue his mind with corresponding placidity, for in the eighty fifth verse of the third canto, he thus writes:—

The treatment of insanity may be said to resemble more a long-continued siege than a vigorous warfare. It is not by action and measures, and certainly not by certain formulæ of medicinal agents that we can hope to make any progress against the disease; not that it is less the province of the medical practitioner to direct the treatment, whatever the means adopted: the progress of the malady has to be watched, and the means of cure varied as circumstances arise. But it is not a well-furnished dispensary, or a large assortment of drugs with which he has to be supplied, his agents are rather careful nursing, wholesome diet, regular employments, diversified amusements, cheerful dwelling, personal cleanliness, and such like; these constitute his materia medica, and these he should have at his command at all times.

Our knowledge of the causes of mental diseases, in spite of the conflicting statements of morbid anatomy, has of late years had a tendency to remove from our minds, many doubts we might have been disposed to retain, as to the important part which the body takes, as an organic system, in the production of those diseases; and the ample results of a persistent and judicious application of therapeutic means, justifies the belief, that as the science of animal chemistry advances, and our knowledge, not merely of ultimate analysis, but of organic synthesis, is enlarged, we may have the gratification of seeing this protean malady deprived of many of its most painful and most formidable symptoms.