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Colden's Liquid Beef Tonic
Perfects digestion and nutrition
Supplies normal basis for enduring work
Strengthens nerve forces
Makes sound sleep possible
Enriches the blood
Has a wholesome effect on bile secretion
Aids in discarding blood impurities
And nerve irritants from the system
Is to depressed vital organs

What mother's milk is to a babe.
Sold by druggists generally. Be sure your patient gets the genuine

Colden's Liquid Beef Tonic
SAMPLES

THE CHARLES N. CRITTENTON CO. FREE TO

115-117 Fulton St., New York. PHYSICIANS.

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BROMIDIA 18A

IS REST-MAKER FOR RESTLESSNESS. IT CIVES CONSISTENT NERVE REST, IT DOES NOT LESSEN THE SUPPLY OF BLOOD TO ANY ORCAN OF THE ECONOMY, AS THE BROMIDES ARE SURE TO DO, IT IS A HYPNOTIC.

FORMULA:-- 15 grains each chloral Hydrate

and Purified Brom. Pot, and 1-8 grain
each Cen. Imp. Ext. Cannabis Ind. and
Hyoscyamus to each fld. drachm.

ECTHOL
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BATTLE & CO., COHESELTEM

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The Chicago Medical Times

EDITORS-FINLEY ELLINGWOOD, M. D., ANSON L. CLARK, A. M., M. D.

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The theory which I wish to propound is, that in insanity without cerebral lesion, it is not the intellect which is sick, but the WILL; especially that it is not primarily the intellect that is diseased; it is only by the morbid will that the understanding gets deranged and becomes involved in the insane condition.

Theoretically, or as a doctrine, this theory is only shyly put forward by the Old School. Dr. Bucknill goes so far as to maintain the emotional origin of insanity, but he persists, nevertheless, in the modification that the proximate cause of all mental disease is to be referred solely to an abnormal state of the brain. He states this though without any explanation how this abnormal state, being an effect of the morbid process, can be its cause; but practically, in connection with specific cases, he holds differently, admitting without restriction that it is the will to which, as its real cause, insanity must be referred. In a self-diagnosed case which the said authors relate, the patient says: “I have my reason, but I have not the command of my feelings; circumstances in life create feelings and prejudices which prevent my passing through life smoothly. My intellect is not insane; it is my feelings that I cannot control.” And Dr. Tuke adds that nobody could have described the case more correctly than the patient. Again they relate: "Arago and Baron Humboldt once kindly undertook to convince a patient, a man of science, that perpetual motion, of which he believed himself the discoverer, is impossible. The patient yielded to their arguments, but on leaving them, before he got round the corner of the street, he said: 'For all they say, I must be right.' In this case the lunatic could not have helped yielding to the argument, except for his resisting will which stubbornly clung to the flattering fancy of having accomplished an astounding invention. And all pertinent special remarks of the experts confirm this doctrine of the overweening of the visceral powers over the brain, or of the ganglionic over the cerebral nervous system.

“There are madmen,” says Esquirol, “in whom it is difficult to discover any trace of hallucination, but there are none in whom the passions and moral affections are not disordered, perverted or destroyed. I have, in this particular, met with no exceptions.” If in insanity without cerebral lesion it were the understanding in which the derangement was essentially lodged, it ought to be psychological or generally logical treatment and training which would promise the happiest cures. But the contrary is the case: "Never yet was a madman argued out of any absurd opinion resulting of mental disease."

If it is an argument he gives himself up to, it must be one particularly adapted to the peculiarity of his will. A lunatic imagined his legs made out of glass, and consequently never got up from his easy-chair, for fear of breaking them. The servantgirl, bored by his foolishness, threw a log against them, when cleaning his room. He got in a fury, sprang up to run after her, and from that moment the foolishness was over. But not from a better understanding. It was the obstinacy-—his foolish will to look at his legs in the way he did—which was overcome.

Dr. Tuke relates the case of a lady whose conversation and conduct were perfectly reasonable toward all the world, except toward her husband. In his presence she became a lunatic. Now, then, this was not because the presence of her husband troubled her understanding, but it roused a deep impression in her will, which told on her head.

"Frequently,” the alienists state, “it is found in asylums that the insaņe discover the delusions of the insane more rapidly than others can do." Can this superior sagacity of the understanding indicate unsoundness of the mind? Or is not the cause of this intellectual advance rather in the circumstance, that their mind is clear enough to be aided in their examination of others by their own interior congeniality ? Moreover it is a common observation that insanity without cerebral lesion, starts from all but the brain. "We distinguish,” says Esquirol, "three stages in it. In the first, the disposition and habits are changed, in the second, the affections are perverted and at length in the third, a maniacal excitement appears; or else a weakening of the faculties, more or less rapid

INSANITY WITHOUT CEREBRAL LESION-LINDORM.

155

“It

leads the monomaniac to dementia.” And Griesinger warns: should constantly be borne in mind, that an individual may talk quite rationally and at the same time show by his acts (and even by what he does not do), that he is mentally deranged.”

Sometimes it happens, especially when the will takes a horrifying direction, that the monomaniac himself earnestly strives against the impulse which his reason lacks the power to control. So reports Dr. Skae, of the Royal Edinburgh Asylum (1850), of a female case of homicidal mania without any disorder of the intellect, who "deplored in piteous terms the horrible propensity she was laboring under.” There is a contending will, the one formed in the visceral department, winning it unfailingly over any velleitas of the cerebrum. This follows docile and submittingly the deeper impulse, and the will for the time being is the one to be sure that will command the intellect. “A patient of the writer's,” reports Dr. Tuke, "while admitting that a thousand things she had fancied, from time to time, had never come to pass, and that in these she had been mistaken, would always add in regard to some fresh foreboding: 'I am sure this is true.' Referring to a person who had had similar notions, she would say: 'His were fanciful, mine are real.'”

Moral treatment is a great thing in emotional insanity, but in order to be successful it must aim at the will, not at the understanding. The understanding refers only to modalities, to the peculiar form which it takes in particular cases, but the will refers as it were, to its substance and vital point. The first rule in moral treatment is, therefore, to apply it in a way that the lunatic does not suspect of it; the will must be led off from its mark, without the lunatic ever having a notion of what is being done with him. This maxim was most cunningly observed in the following case, related by Bucknill and Tuke: “One day, at the Retreat, the matron happened to enter a room where she found a male patient on the point of cutting his throat with a razor. The patient was remarkable for his love of order and cleanliness. The matron, unwilling to engage in a personal struggle, with great tact and presence of mind, remonstrated with him on the ground that he would make the room dirty, and begged him to cut his throat—if cut his throat he would-over a basin. To this he at once assented, but when the basin was brought before him, he no longer had the power to do it.” There is in a lunatic, in a curable case, as well as in a healthy mind, a contending will, by which an opposing one can be gained influence over; and this is moral treatment.

Considering these facts of most reliable observation, it is, therefore, surprising that in the literature about insanity, there is a complete omission of all and every mention of any part which the sympathetic nerve plays in mental disease. Is it supposed, when upholding the brain as the seat of insanity, that the ganglionic system is not of the mind? This would be a very curious psychology. It would not only contradict the most verified facts of our lunatic asylums, but also those of physiological research. Embryology teaches that the encephalon is the outgrowth of the spinal cord, and from this fact it follows that the cerebrum is not the focus of our existence, but that this must be referred to the point from which yonder outgrowth started, i. e., the ganglia of the spinal cord. It will probably be never found out microscopically, what part they play as mental factors. But this much may be stated without microscope, that they are action, life, and that there is no hypothesis so thoroughly in accordance with the progress of anatomical investigation, physiological research and pathological observation, as the very one I wish to propose, viz., that all mental disease, and not only that, but also the temper of all and every individual in good health, is conditioned by the proportion which bears the intensity of the ganglionic action in the viscera of the body to the extension of the cerebral endowment. This proportion ties the knot of our psycho-physiological fate; and whatever we be, we are thanks to the proportionate relation of these ganglionic propensities to their cerebral comprehension. And this ganglionic complication is the cause why of all disease insanity is the most hereditary.

If we would apprehend our own understanding, we must look at our intellect as a passive organ; it is altogether impressiveness, and all the more so, the more developed, the richer, it is. The poorer a brain is, the more it is liable to be stubbornly obstinate; and it is sure to be subject to this trait of low-mindness, if the active organs, i. e., our viscera, or rather the ganglionic vital spots in them, are functionating in disharmonious intensity, and there is in our mind a twofold danger of a disturbance of its harmony. There can be a disproportion between the impressiveness of the brain and the degree of force in the impressions of the viscera; and then there can be a disproportion in the intensity of the action in the different viscera, the one against the other. And in either case there will ensue a peculiar bias of the mind, which, if carried to abnormity or monstrosity, represents the more or less pronounced states of mental disease without cerebral lesion we are treating

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