Upon motion, the Bureau was closed, and E. Carleton, Jr., M. D., elected chairman for the ensuing year. REPORT OF THE BUREAU OF OBSTETRICS. PRESENTED THROUGH DR. C. A. BACON. 1. After-Pains, Physiologically, Pathologically, and Therapeutically Considered. By A. P. Hollett, M. D. 2. Three Cases of Malformations. By E. Hasbrouck, M. D. Upon motion, the Bureau was closed, and C. A. Bacon, M. D., elected chairman for the ensuing year. 1 THE BUREAU OF GYNECOLOGY Reported 1. Uterine Hæmorrhage. By C. J. Farley, M. D. 2. Use of Hydrastis Canadensis in Diseases of Females. By E. J. Pierce, M. D. Upon motion, the Bureau was closed, and Anna C. Howland, M. D., was elected chairman for ensuing year. THE BUREAU OF VITAL STATISTICS Reported a paper on "Longevity," by the chairman, Dr. A. W. Holden; and upon motion, the Bureau was closed, and Dr. Holden continued as chairman. THE BUREAU OF OPHTHALMOLOGY Reported a paper on "Duboisia," by the chairman, C. Th. Liebold, M. D.; and upon motion, the Bureau was closed, and Dr. Liebold re-elected for ensuing year. DEPARTMENT OF LARYNGOLOGY Reported 1. Laryngitis a Special Disease. By C. E. Jones, Reported DEPARTMENT OF OTOLOGY 1. A Case of Otitis Media Hæmorrhagica. By W. P. Fowler, M. D. Upon motion, Bureau closed, and Dr. Fowler was elected chairman for the ensuing year. BUREAU OF HISTOLOGY Reported a paper by the chairman, Bukk G. Carleton, M. D., entitled "A Pathological Report;" and upon motion, Burean was closed, and Dr. Carleton continued chairman the ensuing year. THE BUREAU OF VACCINATION Dr. H. M. Paine gave notice that, at the next annual meeting, he should move a change in the time of holding the annual meeting to the first Tuesday and Wednesday of February. Upon motion, a set of the Volumes of Transactions of the Society were donated to the Strassbourg Library, at the request of its Librarian. Upon motion, a vote of thanks was tendered the retiring President, for his efforts in behalf of the Society; and also to the Supervisors, for the use of their room on this occasion. Adjourned. ALFRED. K. HILLS, Recording Secretary. MEDICAL ITEMS AND NEWS. THE Connecticut State Medical Society has voted to uphold the County Society in expelling Dr. M. B. Pardee, of South Norwalk. The doctor defended himself nobly, in a long address covering the points at not considered, while that against him was duly exissue, and claims that the evidence in his favor was amined and acted upon. The time will come, and that before very long, too, when these so-called scientists will be ashamed of their actions. In Certis unitas, in dubiis libertas, in Omnibus Charitas," must be our motto, or else we shall degenerate into a mob of bigots unworthy the title we claim. Dr. S. H. TALCOTT delighted the citizens of Middletown in a popular lecture on the "Brain." "He thinks the schooling of the young is begun far too early in this country, and is pushed too rapidly. The real work of education should begin with girls not before the age of eighteen, and with boys earlier. Their days before that time should be spent in acquiring vigorous constitutions, and their nights in refreshing, dreamless sleep. Life, health, body and brain are destroyed by overwork, worry, indulgence, want of sleep and rest, The brain is not only a delicate organ physically, but should be carefully used and protected. The brain is a retentive organ, and parents should take great care that the earliest and most lasting impressions which their children receive should be good. Whoever stamps a bad impression upon the mind of a child commits one of the greatest possible wrongs." TROMMER'S Extract of Malt has been so long favorably known to the profession that it is scarcely necessary for us to call attention to it as an article of diet. The fact that it has nearly superseded the imported Presented no report, and W. B. Kenyon, M. D., was preparation is sufficient evidence of its superiority. elected chairman for the ensuing year. THE BUREAU OF CLIMATOLOGY Presented no report, and upon motion, A. R. Wright, H. D. Paine M. D., was elected Necrologist for the ensuing year. J. W. Dowling, M. D., was appointed to report "On Physical Diagnosis." Drs. Dowling, Hills, Watson, Holden, Talcott, A. R. Wright, Paine, and Hollett were appointed a committee on reception of the American Institute. Upon motion of Dr. H. M. Paine, the following resolution was adopted: Resolved, That we approve the series of experiments instituted by the Milwaukee Academy of Medicine, with a view of determining the scientific and medicinal qualities of the thirtieth Hahnemannian potency, and hereby recommend that a committee of this Society be appointed to co-operate with the committee of the Milwaukee Academy, for the purpose of promoting the proposed investigation; and Drs. Paine, Wildes, and Gardiner were appointed. Upon motion, the Treasurer was authorized to credit Chautauqua Co. Society with $20. CHESTER HILL LADIES' SANITARIUM, Port Chester, N. Y., Dr. Philo Brauns, Physician and Surgeon. Devoted to the treatment of gynecological cases requiring medical or surgical treatment. References: Dr. E. Guernsey, of New York, Dr. C. Hering, of Philadelphia. REMOVALS.-Dr. W. Storm White to 228 West 34th street; Dr. Henry von Musits to 1233 Lexington avenue. DR. J. A. CARMICHAEL has been appointed to the Chair of Anatomy in the U. S. Medical College in this city. Dr. Carmichael's great ability as a teacher will give additional strength to the college. Dr. L. S. ORDWAY, of Hot Springs, Ark., has been elected a member of the local Board of Health. Address C. H. L., office of this JOURNAL, naming WANTED,-A copy of "Lippe's Materia Medica." price. ESSENCE OF MEAT.-Of the numerous extracts of meat before the public we know of none so palatable and nutritious as those of the London Manufacturing Company. The profession are adopting them in preference to all other extracts. The physician finds in them what he so often needs, a concentrated meat stimulant and also an exceedingly pleasant nutrient. THE HOMEOPATHIC A MONTHLY JOURNAL TIMES. Of Medicine, Surgery, and the Collateral Sciences. VOL. VII. NEW YORK, AUGUST, 1879. ORIGINAL ARTICLES. THE RELATION OF PHYSICAL STATES TO BY D.-A. GORTON, M. D., BROOKLYN. The unity of body and mind is still further disclosed in the relation which subsists between physical and psychical disease. The teaching of pathology on this subject is in perfect accord with that of physiology – which has already been considered-the phenomena of disease being due to abnormal or unhealthy conditions and actions of the bodily organs and functions. Sickness presents, in fact, the obverse side of human nature, and comprehends not only bodily deformities and defects and their sequences, aches, pains and disabilities, but also abnormal molecular actions and changes of the bodily substance and tissues in every part, giving rise to nervous and cerebral disorder, and abnormal phenomena of soul, or of psychical life. that 64 No. 5 have we a case of individual disorder- an individual sick, more or less, in every part- and the more finely strung (organized) is such an individual, the more surely does a particular sickness become a general disorder. Hahnemann recognized this fact when he observed Sometimes a man who is patient while in the enjoyment of health, becomes passionate, violent, capricious, and unbearable, or impatient and despairing, while he is ill; or those formerly chaste and modest, ly the case that a sensible man becomes stupid in sickoften become lascivious and shameless. It is frequentness; whereas a weak mind is rendered stronger, and a man of slow temperament acquires great presence of to this remark, they will more often be found in disease mind and resolution." * If there are any exceptions of the higher nerve-centres than in disease of the lower nerve-centres, or bodily organs; for mania of the intellect, as indicated by delusions, may and does sometimes functions; but, on the other hand, it is rarely the case exist with little or no disturbance of the corporeal that a corporeal malady can exist, even the most trifling, without disturbing --sometimes in a manner most marked -- the intellectual as well as the other cerebral functions. This fact should be constantly kept in view. It has been recognized from time immemorial by medical phil-vidual to deal with, whose mechanism, at first perIn all maladies we have, therefore, a unit—an indiosophers, but continually ignored by the medical nov-haps a supposed inconsequential part of it, has become itiate. M. Broussais never uttered a sentiment more disordered, as the hand or the foot, the mucous memtrite than when he wrote that " Man is but half under- brane or the skin, and the being, the living, moving, stood if he is observed only in health." It may be thinking "automaton" is abnormally affected by it in said to be axiomatic. The truth which it involves is every part. So close is the "sympathy" between the quite as significant in its bearings on the doctrine of central and the remote ganglions, so intimate is the the monism of man, or the unity of matter and force, relation of cognition and sensation; so homogeneous, and of the physical and psychical, as any similar axiom in other words, are substance and being throughout the in physiology. Medical psychology, in fact, owes its living organism, that a disorder of a part is an injury existence to pathological phenomena upon which this axiom of Broussais is predicated, and from which it derives all the wealth of meaning with which it is so pregnant. The symptomatology of a sick man does, indeed, reveal his essential monism-oneness, homogeneity, mental and physical, body and soul mistakably that it is difficult to reason one's self out of this conclusion by the most consummate use of wordsymbols which the physiologist has yet been able to devise.. to the whole. dependence of physical and psychical states, we cite As an illustration of the coexistence and mutual the following case, which, though based on observation, shall be supposititious. Let us suppose a delicate, phalangeal joints of the great toe. The swelling is red so un-dark-complexioned man, with a slight swelling of the and hot; sore to touch and to movement; the whole limb, to which the affected member belongs, aches and This is local and particular. Should the condition of pains in evident sympathy with the inflamed joints. the organic functions be inquired into, they would evidently be found deranged, every one, the manner of which every experienced physician could easily foresee however, could not be so easily apprehended, from the -presuppose. The more purely psychical condition, greet complexity of moral symptoms which is often system may be so deeply involved by this little ailment contingent upon such an affection. The sympathetic as to completely unbalance and derange the psychical may in consequence lose the control of his will, and life of the patient for the time being. The individual Griesinger has very wisely remarked, in respect to diseases of the mind, that "nowhere is the disideratum strictly to keep in view the individual of greater importance than in the treatment of insanity; nowhere is the constant consciousness more necessary that it is not a disease, but an individual patient; that it is not mania, but an individual who has become maniacal, that is the object of our treatment." The observa tion is equally applicable to disease of the bodily or gans; for in every instance of so-called physical disease *Revised from the advanced sheets of the National Quarterly Review, for 1 HE HOMEOPATHIC TIMES, by the Author. + Irritation and Insanity. + Mental Pathology und Therapeutics, p. 462. * Organon of Medicine, Sec. 210. fall under the sway or dominion of feeling, preternat- digestion. Nor is this remark inapplicable to certain urally active, and therefore disordered. He faints, children of a larger growth; for criminal statistics possibly, in the attempt to move; is easily excited; is show that crime is largely the effect of derangements anxious and apprehensive without just cause; often caused by strong drink "-in most instances the vicimpatient, quarrelsome, despairing, and complaining. tim being amiable and well disposed until his stomach If he were amiable before, he is quite otherwise now. and sympathetic system were fired". and their funcNothing gives him either pleasure or satisfaction. Life tions perverted by alcohol. When will our theoloitself is a distress--one long sigh of unrest. His con- gians and law-makers realize that only a normally consciousness is overwhelmed with the morbid impres- stituted human being, in a normal condition, is a sions of his disordered body. He has lost his normal | responsible creature and amenable to the criminal taste and relish. The books he used to enjoy have code? The day may not be near when a philosophy become uninteresting and insipid. The friends he of life and its phenomena, moral and physical, so oploved, and whose companionship was a necessity, no posed to that of the present, shall find favor in the longer seem the same to him. He becomes estranged eyes of such classes. But when it does come, as come from persons and things. Their presence is displeas- it must in the natural progress of ideas, we venture to ing, irritating, and provocative of uncontrollable resent- predict, in the management of refractory children, an ment. Instead of being trustful and loving, he is increase in the use of physic and a decrease in that of resentful and suspicious-possibly profane. Ill-nature the rod, or " spanks ;" and, for the cure and reformaand despondency have taken the place of a disposition tion of adult delinquents, the building of fewer jails naturally buoyant and hopeful. A disordered imagina- and penitentiaries and more asylums and hospitals. tion has supervened, conjuring up wild, extravagant, These psychical effects-even to the degree of comand most unnatural horrors, upon one whose fancies plete transformation of the natural disposition-are were full of life-like pictures, and whose conceptions frequently observed in adult life in the progress of were ordinarily pleasing, rational, and enjoyable. This chronic maladies. The vicious become amiable, and patient is full of whims, and needs to be humored as the amiable, vicious; the irritative and combative bemuch as a child during its first'dentition. Psychically, come kind and obliging; the weak-minded become he presents a very common form of mental alienation; strong-minded, and the strong-minded, weak-minded. physically, he is simply gouty. Nor are these peculiar effects of physical disease conSimilar forms of mental alienation are observable fined to any particular class of disorder. There are among children suffering from diseases peculiar to few diseases of either animals* or man with which we childhood. The seat of those diseases is the very citi- are acquainted, which are not accompanied with del of the grand sympathetic, the centre of emotional psychical symptoms of some kind or other-favorable life; and when it is disordered the natural disposition or unfavorable; and sometimes the psychical symptoms suffers in a manner with which parents are but too are more clearly characteristic of the malady than are well acquainted. The period of the first dentition is the so-called physical symptoms. The parts of the one during which the functions of the nerves of organic bodily organism are so intimately related with each life are most easily disturbed, and the consequent per- other, and the influence between each part and the enversion of the disposition is most strongly marked. semble is so reciprocal that an affection of one is imThe presence of worms in the intestines, for example, mediately felt by the others. If there is any class of is indicated by symptoms subjective as well as objec- diseases that does not modify the psychical character tive. In other words, while their presence in the of an individual it is that peculiar to the spinal cord, economy may be suspected from dilated pupils, in- or its meninges. Several cases of spinal irritation, flamed nostrils, offensive breath, constipated and in- some of which presented well-marked symptoms of flated bowels, morbid appetite, convulsions, etc.-fickle- spinal meningitis of the upper half of the cord, of a ness,mulishness," inordinate mischievousness, in- chronic character, accompanied with opisthotonos and somnia, delirious sleep, etc., are indications of their emprosthotonos, have come under our observation, in presence equally characteristic. So, likewise, the which no decided influence of the disease upon the "sour stomach" and constipation of children affect the cerebral functions was discoverable from the beginning disposition far more seriously than they do the purely to the end. The patients were mostly women; and the physical life. While the physical symptoms produced degree of patience under prolonged sickness, and fortiby those causes may be sufficiently distressing, the tude under frightful sufferings, was so noticeable as to psychical symptoms are still more so. A lovable child become the subject of remark by the most casual obmay be transformed by them into one of mental char- server. Their minds were clear and unclouded, brighter, acteristics quite the opposite. Nothing is more com- indeed, if anything, than before or since the attack; mon to childhood, in fact, than these moral transform- and the general balance of all the mental powers, of ations by reasons of disorders of the functions of the the moral perceptions and the intellect, was surprisvegetative," or sympathetic system. The records of1ingly preserved throughout. In two of these cases the the nursery tell a fearful tale, and upon them was pro- sufferers would frequently come out of the most violent bably founded the doctrine of total depravity, which spasms with faces beaming with good nature, and rehas long been such a favorite among Christian theolo-sume their chat with some friendly caller as if they had gians, and which has served the double purpose of a been indulging a frolic, instead of enduring a period of theory of family government and an excuse to practise upon it as old as Solomon. It should be observed, however, that sin and iniquity are often due to disease; and that the rude, wayward impulses of children arise, for the most part, from dis orders having their seat primarily in the physique. A child, possessing a disposition naturally kind and obliging when he is well, becomes cruel and disobliging when he is ill; one with a sweet and amiable disposition, becomes morose and irritable; the bright and industrious lad becomes thriftless and stupid; the generous-minded are perverted into the greedy and covetous. All the forms of sin and wickedness recognized by the law, or known to the theologian, may be due in children too young to have obtained the mastery of their morbid emotions, to derangements incident to agony. Their exemption from the nervous depression and moral deterioration, so frequently observed as the effect of prolonged and tedious chronic disorders, was a subject of profound interest to us. Formerly there was no degree of praise to which, in our estimation, the fortitude of these patients did not entitle them. Since discovering its rationale, however, we are less inclined to admire the self-control of these victims under such circumstances, and more disposed to believe that the credit given them for its exercise, under what *The celebrated horse, Longfellow, is a notable illustration of the difference in point. In his race with Harry Bassett, he met with a serious accident, which disabled him for a time. But, a'though he recovered from the wound and became thoroughly well and sound, his temper was so vicious that it was dangerous for strangers to go near him. Previous to the injury his disposition was amiable. appeared to be trying circumstances, was more easily earned than had been supposed. It is quite otherwise with diseases of the "vegetative system," or disorders of the functions of" organic life' as we have seen. The most inconsequental affection of this part of man's nature disturbs the balance of the emotions; and if actual mental derangement does not follow upon it, a mental state is induced which is closely allied to mental derangement. The psychical phenomiena of gout and dentition have already been referred to; and they afford a very good illustration of the mental effects of diseases affecting the chylo-poietic, or digestive system in general. The moods in such affections are proverbially sullen, fickle, irascible and irritable. The dark side of life comes into undue prominence, and the sufferer is, accordingly, morose and melancholic. The central ganglions of the sympathetic are profoundly depressed; the blood is disordered by functional disturbance of the liver and kidneys, either as a sequence or as a cause of the ganglionic depression; and the latter send disordered messages to the sensorial centres, which, together with the supply of unwholesome blood to the circulation, depress in turn their functions, and thus corrupt all the processes and phenomena of the individual life. An individual may thus, in good health, be a paragon of excellence in all that constitutes a noble man or woman, and be suddenly metamorphosed into a being of quite opposite moral characteristics, when an affection of this nature has come upon him or her. Whereas, in good health he was in possession of lovable characteristics, now he is possessed of characteristics which ally him to that abnormal conception of diseased men of ancient fame-the devil. Even should he be able to maintain his self-control and suppress the expression of his evil thoughts, in act or speech, the morbid whisperings, instigating to mischief, go on in him without abatement; and he finds it most difficult to persuade himself, or to be persuaded, that he is not really tempted of the devil, so thoroughly is he possessed by impulses attributed to that celebrity. An old patient of the writer, a lady whose moral character in health is the most unexceptionable, used to suffer from an occasional attack of icterus. During the attacks, which are sometimes prolonged, her moral char acter undergoes a complete transformation. From being playerful and devout she is inclined to upbraid the Deity. She cannot as usual enjoy her devotions. The heavens are as brass to her. She is capricious and resentful; takes the kindest overtures in bad part; is overbearing, arrogant, and reproachful toward those she once loved best, but from whom she is now alienated. She has repeatedly confided to us her secret thoughts-the morbid impulses to acts of vice, the commission of which would be a grave misdemeanor and inevitably consign her to the ranks of the low and degraded-impulses which, we are confident, are entirely foreign to her normal nature, and confessed, with the utmost consternation of manner, her change of feeling, remarking that she was no longer herselt. Nor was she. Mary Magdalene was not more possessed than was she. During all these periods of profound mental: al agony the intellectual functions were apparently unimpaired. It is interesting to observe that these transformations of the moral character by reason of bodily disorder are often effected without bodily pain or physical discom fort. The sufferings are described by the unhappy patients as of the extremest type, but wholly of a mental character, being caused by reflex influence of the sympathetic upon the higher sensorial functions, Despine remarks this peculiarity of reflex, psychical disorder, and observes: "Elle donne la raison pour laquelle les affections des organes qui reçoivement plus spécialement leurs erfs du grand sympathique réagissent facilement sur le cerveau et sur ses fonctions, au point de changer com plètement le caractère de la personne, de la rendre irritable,'colère, bizarre, violente, ou triste. Ces changements dans la nature instinctive de l'individu, par le fait des affections morbides dans lesquelles le grand sympathique est engagé peuvent avoir lieu sans douleur physique, sans malaise important. La grossesse, l'époque menstruelle, la constipation, la présence des vers dans les intestins, quoique occasionnant à peine un malaise local, peuvent causer les changements les plus graves dans le caractère, et même la volie, chez les personnes dont le cerveau est très-impressionable." *Psychologie Naturelle, Tome I., pp. 440–441. Disease of the heart, particularly that known as angina pectoris, is very generally accompanied with excitable, anxious moods; not unfrequently with illhumor and ungovernable choler, of which we have in history many conspicuous illustrations, notably the case of the celebrated Dr. John Hunter. In people with an apoplectic tendency these moods may be commonly observed; indeed, their liability to fall into a passion is notorious. It is a species of insanity with them, often, in which feelings of irascibility, from very trivial causes, overpower the rational will and compel the individual to acts of violence. These people are never without a grievance. It is a question of" honor" with them to resent a slight or an injury, although the latter may have no foundation except that of undue sensitiveness and a morbid tendency to envy, suspicion, jealousy, revenge, etc. That they sooner or later become paretic is a matter of observation. But paresis and apoplexia are diseases closely allied, being more often associated with disease of the heart and vascular system than with disease of the cerebral substance. The sacred writers of antiquity, therefore, were not so far astray, after all, in ascribing wickedness to "hardness of heart," a "heart of stone," etc., for this is literally true, often, as shown in autopsies of people with hard tempers. But last, though not least, in this category, are disorders of the sexual functions. The abnormal psychical phenomena, having their source in diseases of the womb, ovaries, testes, and spermatic vessels, simulate the symptoms of every form of mental derangement and of moral disease, those of intellectual derangement possibly excepted, even when such derangements are not actually and permanently induced by disease of those organs. In women, inental deterioration from uterine disease is no unfrequent occurrence, even in the absence of brain complications. The strong character becomes weak; fickleness supervenes upon a judgment previously calm and clear; indecision upon resolution; pusillanimity upon fearlessness and courage; deceitfulness upon a frank, open manner. We believe that the habits of truth-telling and fidelity in the social and domestic relations are more frequently destroyed by irritable ovaries than by any native tendency to depravity in the female sex. The affections and disposition are frequently alienated and transformed by such a cause, so that the victim dislikes what she formerly loved, or loves what she formerly disliked. Her life seems to run in morbific channels; her being seems to be inspired by abnormal impulses. It once she were fond of pets, she now dislikes them. She neither caresses nor cares to be caressed. If she formerly loved society, she now prefers solitude. Her relations with the things of time and sense have changed; apathy *This is the reason that the affections of the organs which react easily upon the brain and upon those functions, so much so receive the nerves more especially from the grand sympathetic, as to change the character of the person completely, rendering him irritable, angry, whimsical, violent, or sad. These changes in the instinctive nature of the individual, by means of morbid affections in which the grand sympathetic is involved, may take lace without physical suffering, without serious indisposition. Pregnancy, the menstrual period, constipation, the presence of worms in the intestines, although scarcely occasioning local discomfort, may cause the gravest changes in the character, and even insanity, in persons in whom the brain is very impressionable." has succeeded upon enthusiasm, indifference upon interest, misanthropy upon love and affection. These moral changes may be so radical as to involve the foundation of the moral character and lead her to ignore the affection of children and friends, or even to neglect her duty to him whom she has solemnly vowed to love, even though he prove worse instead of better. For some, to her, strange and unaccountable reason she can no longer endure her husband's presence; his caresses are received with ill-concealed but uncontrollable aversion. Women, whose moral characters are above reproach, have thus, through abnormal impressions on the sympathetic system, been known to play the fiend incarnate during the first months of utero-gestation; exhibiting every species of demoniacal fury which a demoniacal cunning could devise. All the vile passions and abnormal emotions known to the human heart frequently gain the ascendancy over the unhappy being, under such circumstances, and incite in her the desire to indulge in petty violence, obstinacy, malice, and revenge; or to exhibit a spirit of envy, jealousy, quarrelsomeness, resentment, arrogance and selfish ness; or a faithless, lying, reproachful, overbearing, fault-finding, complaining mood; a disposition, often, when worse traits are suppressed, to annoy, tease, hinder, dispute, destroy property and engage in strife and weak contention, ad libitum-conduct altogether foreign to their normal state. Happily for the race and for husbands, these phenomena are not the rule in pregnancy. And it is worthy of note that these unhappy forms of alienation are more frequently observed among the better classes. There seems to be some connection between a life of ease and luxury and moral degeneration. Be that as it may, there can be no doubt that the mode of life of the affluent classes engenders sexual weakness in both men and women, perverting their moral nature and impairing their powers of reproduction, their capacity to produce a healthy, hardy progeny. In men, psychical disorder consequent upon disease of the sexual organs can hardly be less serious than in women. There may not be absolute hysteria in men, as in women, though we do believe that it does sometimes occur; but the moral break-down is as complete and equally common. Take, for example, that weakness known as spermatorrhea. What ravages does it not inflict upon the cerebro-spinal system, as well as upon that of the sympathetic! In destroying the tone of the organic system, so called, it impairs the vigor of the intellect, of volition, and corrupts the centres of emotion and of moral feeling. This disease causes in men of naturally strong mental character the same degree of fickleness and instability, the same want of fidelity in their relations of business, or love, or friendship, which we have ascribed to women suffering from an analagous disease. The courage which peculiarly distinguishes the ideal masculine character, the courage of opinion and conviction; the heroism to brave danger and encounter obstacles; the daring to do what one believes to be right when all the rest of mankind believe it to be wrong; the resolution to work and to persevere, for work and perseverance's sake, these high qualities all crumble into decay in an individual whose sexual system has become enfeebled by disease. The purpose of such a one is weak and vacillating: he is uncertain to promise and still more uncertain of keeping his promise; he has lost the energy of manly loving, manly working and manly daring; he comes to doubt himself, and therefore everything else the existence of truth, fidelity, honor, conviction; he believes all men are miserable dullards; and if he is suspicious of all men, all men, sooner or later, become suspicious of him, and especially all women. He loves nothing long, but everything by turns; now excess of passion, fitful and capricious; then disgust and loathing. He has not the strength to think out new pro cesses, nor the resolution to carry out old ones. His habits of business and enterprise reverse the axiom of business life, for he never does to-day what can conveniently be put off until to-morrow. That independence of thought and action; the manly self-reliance; the strong love of life and the enduring faith in virtue; the calm, clear head in trouble and adversity; the courage to live while he can and to die when he must without fear or reproach of the gods, or complaint or distrust of the providences; all the elements of character, in brief, which make a man a man, and a tower of strength to his race-a refuge for the weak in trouble and adversity-lapse in part, or die out altogether in one who suffers from the graver forms of spermatorrhea; and in their place succeed weakness, irresolution, despondency and despair. Many forms of vice may follow also, but more often, especially in the graver or more settled forms of the weakness, no serious offence against morality is committed. He may, on the contrary, have excess of the pious element and be moral even to prudishness. While he is weak enough to be miserable, he is too weak to be absolutely immoral. More often he is so good as to be absolutely good for nothing. We believe that the influence of sexual disorders of men, as a cause of insanity, has been overrated by medical writers. The clinical records of asylums, of course, show as a matter of fact an almost constant association of the two maladies in the same person; but it is by no means always easy to determine with anything like certainty the relation which the two states sustain to each other. While, on the other hand, we have good reason to believe that medical writers underrate the influence of disorders of the sexual functions on the etiology of the petty vices of men and women so prevalent in civilized life. The insane must have an insane temperament, bias or neurosis, to give direction to a morbid cause. When no such predisposing bias to insanity exists, insane effects from any of the usual exciting causes of insanity cannot be counted on with certainty. Given the predisposing bias or neurosis, and the causes which produce any form of disease may likewise produce insanity. It is a matter of observation that some of the worst forms of sexual disease, both organic and functional, exist both in men and women without exciting any insane tendency. They cannot be found, however, unaccompanied with more or less impairment or demoralization of the psychical character. This, however, while it is in fact an insanity, is so outside the confines of technical interpretation. In respect of the changes in the morale of an individual, through the influence of disease of the corporeal organs, Griesinger very truly observes that they "constitute some of the most fundamental elements of the pathology of insanity.”“They are the key,” he remarks, to a knowledge of a predisposition to mental disease resulting from the most diverse bodily diseases, and of the mode of action of psychical causes.' "The rationale of the effects of functional disease upon mental derangement is perfectly clear to the mind of every medical man. Equally clear is it to him why a grave affection may exist in the cerebral centres, or even in some parts of the spinal system, without perceptibly disturbing the bodily functions or demoralizing the emotional states. If the normal operations of the functions of organic life be preserved, a certain stability of the emotions will be assured, even if emotional insanity, by far the largest variety of insanity, be not an absolute impossibility. Indeed, we must maintain, without fear of contradiction, that the protean forms of emotional insanity, and the disease of the organs of the so-called "vegetative life," sustain the relation of cause and effect, the cause being in the domain of the latter; and that when the relation of cause and effect is inversed and the emotional disturbance precedes the *Mental Pathology and Therapeutics, p. 58. |