Part 2

_Page_ On the buildings, grounds, situation, and system, necessary 1 for all purposes of an efficient classification Illustrated by an interesting case of recovery, No. 106. 5 Do. do. do. No. 195. 12 On the common division of Insanity into Mania and 15 Melancholia, not necessarily being separate classes of cases, but generally, _merely variable states of the same case_, requiring corresponding changes and modes of moral treatment This view of these cases is confirmed, and their danger 18 forewarned, by an examination of the natural constitution of mind and previous habits of those subject to these states The delicate treatment which such cases often require, 25 renders a separate house, where the medical proprietor and superintendant and family reside, of great importance, as well for them as for milder and convalescent cases That cases under this system, are induced, when they know 28 it from experience, or have it faithfully explained to them, to come and return without fear or reluctance The great importance of this first step; and of making 29 _truth the basis_. The manner of doing this explained, and its beneficial influence stated Illustrated by an interesting case of recovery, No. 335. 36 Ditto do. do. No. 373. 45 Further observations on such cases and the above principles 47 That suitable classification and association is better than 49 entire seclusion Illustrated by cases, No. 425 and No. 429 51 On the beneficial influence of their being accustomed to 53 the usual habits, manners, and privileges of civilized life On the propriety of diminishing the prejudices which exist 59 against the mere residence at an Asylum, if for the purpose of restoration The evils of considering diseases of the brain as a greater 61 disgrace, and as an indication of greater criminality than other diseases That our aim in all our moral treatment should be, to call 65 forth self-control, and all the better principles and feelings of the human mind; and that this important subject will be resumed Illustrated by a case, No. 372. 69 Do. do. No. 395. 71 That often we have only a choice of evils, and must choose 73 the least Illustrated by a case, No. 421. 75 Do. do. No. 396. 77 On the use of exercise, and a retired situation for the 78 purpose An account of a system of cure, by being made to work, 81 related by Dr. Gregory Regular work always useful, when willingly undertaken, but 82 not otherwise; easily managed with the labouring, but as difficult with a higher, class of patients The danger of irritation, illustrated by a case 83 The contrary system of soothing, illustrated by a case 84 Further remarks and quotations on this subject 86 The talents and sacrifices all this requires, and their 89 influence, Notwithstanding all this apparent extra trouble, it is, 100 when done from right motives, the safest and easiest in the end That these views are based on the firm ground of Christian 108 philosophy CONTENTS OF APPENDIX. EXPLANATION of the object of this Appendix; which is, by 111 giving a correct description of the state and character of a fair average number of old insane cases, to counteract the usual misconceptions and prejudices existing against them Case No. 1.—His eccentricity, and exaggeration of his 113 natural character and that of his family. Has seasons of excitement Observation 1st.—That the fluctuations of the animal 115 spirits of the old insane often depend on causes which equally act on the sane; but, that from differences of state and circumstances, the effects are very different Case No. 2.—Though in a very torpid state, yet he has (as 116 every case has) his distinguishing peculiarities _Illustrated by a Portrait_ 116 Observation 2nd.—That mind is a garden which we must 116 cultivate—a fire which requires stirring and feeding Case No. 3.—An example, which indeed every one is, more or 118 less, of the correspondence, as far as the remnants of mind exist, between his present and original character and organization. His habits of employment, and its happy influence _Illustrated by a Portrait_ 118 Observation 3rd.—On the use of employment, and its easy 119 application Case No. 4.—That of an idiot. Odd displays of an increase 120 of animation _Illustrated by a Portrait_ 120 Case No. 5.—Torpid lethargy. His natural character amiable 121 Case No. 6.—Though in a very singularly deranged state, 122 evinced by the most extravagant fancies and exploits, which he delights to detail to every one, yet he is constantly employed, useful, and happy _Illustrated by a Portrait_ 122 Observation 4th.—The explanation of the peculiarity of his 124 character, proves that, in all cases, truth should never be violated in our conduct towards them Case No. 7.—A very singular case of periodical violence and 125 sleep. His habit of gyration described Observation 5th.—His habit of gyration explained. How far 127 the generally alternate states of excitement and depression of the insane is the return of their primary disease, or for the most part, merely the habits acquired of irregularly expending their nervous energy, which fluctuations are further increased by the usual atmospheric causes of excitement and depression The influence of temperature, moisture, climate, seasons, 129 diurnal periods, atmospheric changes, and different years, on our health and spirits, and the type of our diseases, (and that this subject will be resumed), and how all this is modified by the states, habits, and circumstances of the insane Why they are less subject to the prevailing diseases 133 The mental condition must, in all diseases, be considered 134 Illustrated by cases 135 How the state of mind and circumstances of the insane must 136 modify these physical influences Why this is differently exhibited by the insane, than it is 137 by those who retain the power over their own spirits That this view is proved to be correct, by the fact that 139 these causes produce different effects by their being under different modes of treatment That the various character of insanity is but the same 143 excitement of the vital energies operating on different parts of the mind, according to previous or present habits and states Hence, the insane are often caracatures of their own, as 146 well as of family habits and character The truth of this reasoning proved by the fact, that the 147 greatest number of insane cases occur when mental conflicts and worldly struggles are greatest, and among those whose minds are ill regulated or miserably circumstanced; but still it does not necessarily and always follow that those whose minds are most wicked are soonest overthrown, but sometimes the reverse The practical object of these observations 150 Case No. 8.—One of the extreme cases of furious mania, with 151 a leprous eruption of the skin Observation 6th.—Whether cutaneous disorders are common to 153 the insane? The treatment of this case Case No. 9.—One proof, out of many, which proves, that the 154 last strongest impression of their sane state continues prominent, even when their minds seem for ever lost to themselves and all passing objects around them Case No. 10.—In which an injury on the head produced 155 symptoms in correspondence with the phrenological office of the part injured Case No. 11.—Apparently perfect dementia, and yet he is 156 always employed Observation 7th.—An excellent illustration that there is 157 scarcely any insane person’s mind so much lost, but that still, provided labour has been their early common habit, they may with ease be brought into habits of useful employment, and which with such a class, should, both for their cure and comfort, be adopted, and arrangements made for the purpose Case No. 12.—A female instance of scolding and kindness by 158 turns Case No. 13.—Constantly talking to imaginary objects, but 159 still perseveres in his habits of usefulness Case No. 14.—A beautiful exhibition of female kindness and 159 love of children, as well as of many other symptoms which indicate that her former habits and general natural character and disposition have been amiable _Illustrated by a Portrait_ 159 Case No. 15.—Like a passionate and proud man in a constant 161 state of inebriation Observation 8th.—A striking instance of the correspondence 162 between cause and effect Case No. 16.—Vanity turned into stone 163 _Illustrated by a Portrait_ 116 Case No. 17.—An unmarried female, useful as a laundress, 163 and distinguished by her affection for cats and kittens Case No. 18.—An extreme instance of the most furious 164 excitement of the vindictive and destructive passions, and the habits and states to which his treatment had reduced him Observation 9th.—The mistake of calling those facts, which 166 are the effects of improper treatment, symptoms of insanity Case No. 19.—Constantly like one muttering in his dreams. 167 Very good-natured Observation 10th.—Perhaps his reason might have been 168 re-awakened by constant judicious treatment and attention Case No. 20.—An ideot, but employed 168 _Illustrated by a Portrait_ 168 Case No. 21.—Was formerly in states of furious revenge, now 169 gradually diminished in frequency and degree, by kindness Observation 9th.—A happy illustration of the effects of 170 kindness Case No. 22.—Mind a perfect wreck—the effect of 170 disappointed love Case No. 23.—A very interesting caricature of political 171 mania of a person of family and title. He fancies himself constantly employed in making calculations and in doing many strange acts, all necessary parts of _his mighty_ task of paying the national debt, which abstracts him from all external objects, and from all consciousness to his own bodily sensations Observation 12th.—That the correspondence between the 175 present and previous habits of mind, are, in most cases, and certainly in this, most striking On the effects of heat and cold, and the changes of 175 temperature in the insane That we are not to mistake, which is often done, the mind, 175 in a state of abstraction, being insensible to the external changes of temperature, for the physical system being unaffected by their action That the changes and unequal diffusion of heat correspond 176 with the general and particular state of the mind, and that in cases of pure intellectual abstraction, and in those excited by the bad passions, it is very different, and in cases of gradual decay of mind, it is altogether defective To discriminate those differences is necessary to regulate 179 our treatment according to the exigencies of the case Observation 13th.—On the effects of intense study and 180 general intemperance of the mind That when study is blamed, I have often found that the 180 intemperate feelings, wicked and irregular habits, were the real causes That proper mental exercise is as essential to the health 181 as bodily exercise That it is a great error to suppose such exercise injurious 182 or discountenanced by religion, provided always the mind is under the influence of right motives Case No. 25.—A dignified exhibition of all the mental 190 energies arranging and concentrating themselves under his self esteem _Illustrated by a Portrait_ 190 Case No. 26.—A caricature of a masculine female 193 Case No. 27.—One of extreme torpor and debility 193 Observation 14th.—That the character of all hereditary 194 cases retains something of a family resemblance Case No. 28.—A caricature of Johanna Southcott’s followers 195 _Illustrated by a Portrait_ 195 Case No. 29.—A most horrible object of demoniacal violence 197 suspended twice by a physical accident and disease Observation 18th. {26}—On the doctrine of demons, and that 198 the subject will be resumed in an after part of this work Case No. 30.—A very interesting demonstration of the misery 199 of ill-assorted marriages, and that the painful and powerful association of the original cause of the disease produced its frequent recurrence Observation 19th.—On the evils of such marriages, and that 202 the consideration of this important subject will be resumed in an after part of this work Case No. 31.—A singular and most interesting case of an 203 active, excitable, and overworked mind being overthrown by family afflictions, his power of personating various celebrated characters of different periods of the world, which he believes himself for the while to be. His splendid eloquence and conversations with imaginary beings, &c. Still, there were encouraging symptoms, that by proper and laborious methods of mental occupation, he might possibly have had the balance of his mind restored _Illustrated by a Portrait_ 203 General explanation of the peculiar complexion of this 207 work, and of the Appendix in particular Concluding observations, that the object of this Essay, and 209 especially of the Appendix, has been to lessen the prejudices against and better the treatment of, the insane

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LIST OF DR. ALLEN’S PUBLICATIONS.

CASES OF INSANITY, with Medical, Moral, and Philosophical Observations and Essays upon them. 1 vol. 8vo. price 8s.

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MEDICAL, MORAL, AND PHILOSOPHICAL ESSAYS AND OBSERVATIONS UPON INSANITY.

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OUTLINES OF A COURSE OF LECTURES ON CHEMICAL PHILOSOPHY.

ESSAYS OX CHEMICAL PHILOSOPHY.

IN the Annual Review of Medicine and Collateral Science for 1818, of the London Medical Repository, the following notice is taken of these Essays.—

“In the Philosophical Magazine the reader will find a series of Essays by Mr. Allen; rich in ingenuity of argument, and abounding in masterly views on the great subject of chemical agency, as affecting changes in the modes of existing of physical matter. These essays all go upon the principle, that in every change of existence that matter is capable of undergoing, caloric is given out or absorbed in the form of either electricity, of galvanism, of caloric, or of light. Respecting the important question which has recently agitated the philosophical world, and which has been proposed as a prize in one of the Societies abroad; viz. In what does the difference consist between galvanism and electricity? Mr. Allen observes, ‘In electricity we contrive, by mechanical means, to collect the loose and uncombined quantity from the earth and surrounding medium; and this we do in circumstances in which it has nothing to act upon, as free from moisture of any kind as possible; in fact, from every thing readily soluble in heat or in this power. I would therefore, he says, define electricity to be the object of science which treats of the mechanical and natural means of separating this _grand agent_ from some of its combinations, and of ascertaining its actions in this state.’ ‘In galvanism, on the other hand, this solvent power, this electric fire, is produced in circumstances in which it has _substances_ to act upon; substances which are most readily dissolved in it; substances, in fact, which seem to form the grand medium between this _power and passive substances_, and which are partially dissolved in it. And hence I define galvanism as the electric fire, or _grand agent_, only _partially_ separated from its combinations; by which I refer principally to oxygen and hydrogen.’ After illustrating this principle, by referring to the circumstances in which the chemical agency of galvanism appears more conspicuous than that of electricity, he adds, ‘thus we perceive, that when _the grand agent of nature_ is _more perfectly_ separated from its combinations it is ELECTRICITY; when partially separated, GALVANISM.’ Of these views and principles we have a more ample illustration and defence as the author proceeds in his investigation; and the whole inquiry is conducted with much philosophical acumen. Hypothetical, of course, part of it must be: but how different are the hypotheses of the present from those of former times, when science was a sort of poetry, and dealt in abstractions and inventions!”

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ESSAY ON CLASSIFICATION.

THE better to explain and illustrate my ideas and views on the important subject of Classification, I shall, in the first instance, give a brief description of the present plans, arrangement, and manner of proceeding, in my own establishment.

Fair Mead House, Leopard’s Hill Lodge, and Springfield, with appendages to each, constitute my present establishment at High Beach; and I wish to have it most distinctly and most fully understood, that they are simply for classification, of a more general or more specific nature; and consequently, besides the advantages derived from having three houses, I have (as far as I could) made arrangements in each for this purpose. Leopard’s Hill Lodge, where I have more especially made arrangements for the purpose of classification, consists of a front, or what may be called the family portion of the house, and galleries behind, with appropriate rooms for patients requiring more restraint.

To show that these houses are merely for the purposes of classification, I may mention, that there is no sort of difference in the three houses, excepting that in the one generally and latterly inhabited by ourselves, we prefer having those to whom our individual and more immediate attention may be useful. The same patients are even sometimes at one house, and sometimes at another, according to their state; and sometimes for the mere purpose of change. In fact, the greater part of our first class of patients have been occasionally at Leopard’s Hill, and this with the knowledge and approval of their friends.

As I have published some hints on this point, and addressed them to the Commissioners in Lunacy, I may be permitted, in order to show I have long entertained the same views, to quote two or three passages.

I there state, “that two establishments on the same grounds should be allowed and encouraged for the purpose of Classification. My reason for this alteration, in the Act relative to such places, is, that large and crowded houses are decidedly objectionable, from the greater chance of noise and disturbance, from their being less healthy, and from their assuming more of a prison-like appearance, than of a family mansion. With two, we can adopt a better and more complete method of classification; and it is a consideration of very great importance, that in one of them the proprietor and his family should reside, and devote themselves to recent, partial, slight, or convalescent cases.”

As I conceive this plan of two establishments for the purposes of classification, to be of the highest importance, and essential to the moral regulation, as well as to the cure of the insane, so far from avoiding any investigation of either the principle of their adoption, or their mode of management, I wish the most exact knowledge to be obtained of the one, and invite the fullest scrutiny of the other.

I would have not only two establishments in the same grounds, but these sufficiently separated so as to prevent annoyance; and, not only this separation, but I would have one to consist of a male and female part, sufficiently separated from each other. This arrangement I have at my own establishments, which consist of Fair Mead House, and of Leopard’s Hill Lodge, for males, and Springfield for females, with appendages, and separate cottages; and more especially, I would have each house divided into a front and back part, and this front part so contrived, that in appearance it should be sufficiently distinct from the other, so that patients might feel, on recovery, that removal to this part withdrew them from the more painful associations of their past state, and afforded them solace and encouragement; thus might their recovery be expedited, and the chances of relapse lessened. In the domestic part of the establishment, the proprietor and his family should reside.