Mania is the term applied to that large class of mental disorders in which the functions are in a state of excitement, and their mutual dependence and proportion disturbed. It embraces forms of disease so widely apart from each other, that in treating practically of its diagnosis it will be essential to make some classification. For practical purposes it will be sufficient to distinguish its forms into those of acute mania, comprising cases which present recent and active symptoms; chronic mania, in which acute symptoms have given way to others of a more tranquil and permanent kind; and incomplete mania, corresponding to the “mania raisonante” of the French, and embracing those anomalous and undeveloped forms of mental disorder in which defective power of volition and morbid propensities are prominent symptoms.

The widely differing opinions which have been entertained by the ablest physicians respecting the pathology of insanity, clearly shew that there is some difficulty at the bottom of the question, greater than that which has existed with regard to the nature of other classes of disease. The source of this difficulty is not hard to find. A rational pathology must ever be founded upon the basis of physiology. It is indeed a kind of physiology; it is an account of the abnormalities of organization and of function, which as much depend on the natural laws of our being as do those of health. Fair weather and foul equally depend upon the laws of meteorology; health and disease equally depend upon the laws of animal life. The division of their study into the two departments of pathology and physiology is, therefore, perfectly arbitrary, and useful only for purposes of classification. But the knowledge of the laws of aberration cannot precede, or even be contemporaneous with, the knowledge of the normal laws of action. The high-road of health must be well known before the bye-ways and devious paths which surround it can be investigated.

In the ordinary experience of psychological physicians, whose sphere of observation is largely in private practice and within the walls of an asylum for the middle and higher classes of society, many circumstances arise which do not present themselves, at least with the same distinctness and prominence, to those whose experience may be upon a much more extensive scale, yet almost exclusively among the artisan and pauper classes of the community, in large public institutions. The reports and the disquisitions with which the medical superintendents of these latter establishments enrich, from time to time, the records of psychological medicine need no commendation from individuals; the profession have fixed their value; and it is universally conceded, indeed, that from psychologists and philanthropists alike they justly claim the very highest measure of approval.

Passing from the consideration of the several so-called monomanias, or diseased manifestations of somewhat isolated propensities, we may next consider a more general affection, viz.

In describing the symptoms arising from the derangement of the group of faculties last under consideration, namely, those termed moral, and with which man is specially endowed, as contrasted with the lower animals, it might have seemed natural to detail those morbid mental phenomena, which Prichard and others have so much dwelt upon when treating of moral insanity. But such a perverted condition of the moral sense is so almost invariably indicated, and often only discovered by the activity of the animal propensities, that it is more convenient to treat of it under the third class of mental disorders. It is likewise more consistent with our adopted principle of classification, which consists in referring each mental disorder to that group of faculties, the affection of which is essential to its manifestations. In homicidal mania, the animal propensities are of necessity called into action, whether the homicidal act be the result of their diseased action, in association with a healthy condition of the higher sentiments, or of their normal action when associated with, and therefore uncontrolled by, a state of the moral sense rendered powerless or feeble by disease; be it congenital or acquired, or the result of functional disorder or structural changes. We usually become cognizant of diseased mental conditions by positive, not by negative, symptoms; some overt act or explosion of passion will, in general, be the first proof of such disease of the moral sentiments, as involves their occlusion or inertness, when they ought to be in exercise. Should the disease be of such a nature as to increase the activity of these faculties, then we have an exhibition of religious excitement or ecstasy, a morbid condition already treated of.

The revision of the criminal law which has been so wisely conceived, and thus far so ably executed, has yet left one very important part of the subject untouched; although it is one very nearly affecting the administration of justice and the safety of society. It is to be feared that the unwillingness to meddle with a question avowedly beset with difficulties, as this is, may be, to some extent at least, owing to the fact that such widely different opinions have been expressed by those whose judgment must necessarily guide our lawgivers on the subject of criminal lunacy, as it is called. But the difficulty of the subject, and the differences of opinion among those best informed, offer no sufficient reason why the attempt to apply a remedy should be indefinitely postponed, at the cost of so much accumulated cruelty and injustice.

In my first lecture on the nomenclature of varieties of insanity I dwelt upon those phraseologies which have already been in use. The first of these was the old well known classification, which was grounded on the physical temperament, and conduct of the patient; and which confined itself very much to the question, whether he was violent, low spirited, or silly. Mania, melancholia, and dementia, being applied to these states; monomania and moral insanity, arising in after years as auxiliary to these terms, and being a refinement on the idiosyncracies of various cases. The second phraseology was one which Dr. Noble has developed, if not originated; it dwelt upon the metaphysical position of diseased mind, discarding the consideration of conduct and temperament. It tells us which part or faculty of the mind is diseased; it contains, in short, a geographical sketch of the mind and its diseases, and gives us some ideas of the exact position of each case in the history of diseased mind. Emotional, notional, and intelligential insanity are the chief terms of this vocabulary. I stated my belief that a consideration of both of these histories, the physical and the metaphysical, the state of the conduct and temperament, as well as a history of the part of the mind diseased, were necessary, for a terminology which should represent a fair history of the varieties of diseased mind; and I proposed to compile a nomenclature of the varieties of the disease, constructed from the conjoint consideration of these two histories.

In a former number of this Journal (15) instances where Convulsions had occurredamongst patients, not epileptics, in this asylum were given. Nine cases attended with convulsions have also been recorded. by me in the Edmburql: Medical Journal.” of which three were adults and six infants. Congestion of blood in the brain was found in three of the infants, effusion of blood in one, fluid in the ventricles it) one, and enlarged brain in one; the foramen ovale and ductus arteriosus of the heart were open in one. In the male adult there was general dropsy, and the heart kidneys and liver were enlarged; convulsions preceded death; and in the two female adults convulsions were symptomatic of suppression of urine in one and of Bright's kidneys in the other. Instances of convulsions aye frequent in cases of general paralysis, in cases of melancholia, especially where it is combined with pulmon- ary phthisis; and also, but much Jess frequently, in mania; and these convulsions it is sometimes very difficult to distinguish from epilepsy.

In a former number I was led to draw attention to the distinctive meaning of illusions, hallucinations, and delusions, in consequence of the confusion manifested in the medical evidence given at a late celebrated trial, and from observing a like confusion in most of our works on mental medicine. And without entering into the physiological or psychological nature of these phenomena, I endeavoured to point out the plain, simple, and efficient characteristic, that illusions and hallucinations were the morbid phenomena of perception, the former occurring with, the latter without any external or objective cause; and that delusion was the result of morbid conception. In the following remarks, I wish to point out the distinctive features of those faculties whose morbid phenomena are designated by the above three terms, particularly the distinction between sensation and perception; for the confusion existing relative to the phenomena, healthy or morbid of any faculty does and must result from that faculty in its nature and limits being badly and confusedly apprehended, and therefore requiring a further analysis and more decided definition; a confusion which, relative to our subject, has led some in the present day to locate the faculty of perception, independent of sensation, in the nerves and organs of special sense; (see the Annales Psychulogiques.)

The Forms of insanity hitherto described have been regarded as naturally referrible to the first class, that, namely, of mental disorders involving the intellect. I now pass on to the consideration of those of the second class, that which comprises the disorders of the moral sentiments. I reserve for a future occasion, some remarks on the distinction between this group of diseases, and that comprehended under the third division, or disorders of the animal propensities.

A commodious and conveniently arranged asylum is the first requisite for the skilful care and treatment of the insane. Without this no alienist physician can deal successfully with any number of patients. It is, indeed, the bad workman who complains of his tools; and it will be found in practice that a superintendent fertile in resources, and skilful in their application, will do more with a bad building than another can effect with the newest, the most expensive, and the most commodious asylum that ever was constructed. It is not the bricks and mortar which cure patients, but the living spirit which, as it were, animates them. Nelson, in his old tubs, effected deeds at which the world grew pale; his braggadocio and vituperative successor has exhibited the gigantic masterpieces of naval architecture in an useless and ridiculous parade. In like manner it has happened that some of the worst asylums have been the best conducted, and some of the largest and most costly have. brought more disgrace than honour upon the psychiatric branch of the profession.

Our attention as reviewers has been drawn to the above subject by two papers published in the Journal of Psychological Medicine, the one by the Rev. Joseph Souter, chaplain to the Essex County Asylum; the other by the Rev. J. May, chaplain to the Hanwell County Asylum.