Chapter I: Part 1

[Picture: Book cover made from title page]

ESSAY
ON
THE CLASSIFICATION OF
THE
INSANE.

BY

M. ALLEN, M.D.

MEMBER OF THE ROYAL MEDICAL SOCIETY OF EDINBURGH, AND OF THE
MEDICO-CHIRURGICAL SOCIETY OF LONDON; CORRESPONDING MEMBER OF THE
METEOROLOGICAL SOCIETY OF LONDON, AND OF THE PHRENOLOGICAL SOCIETIES
OF LONDON AND EDINBURGH; HONORARY MEMBER OF THE LITERARY
AND PHILOSOPHICAL SOCIETIES OF LEEDS, HULL, AND WAKEFIELD, &C.

* * * * *

“Thou shalt not break the bruised reed.”—_Is._

“The care of the human mind is the most noble branch of
medicine.”—_Grotius_.

* * * * *

LONDON:
JOHN TAYLOR, UPPER GOWER-STREET.

PREFACE.

IT appears necessary to explain the somewhat abrupt commencement of this Essay on Classification. It was written, and even a great part of it printed, as a continuation of my defence in the case of Allen _v._ Dutton; but during the progress of printing, I soon became weary of this defensive attitude; and I also soon discovered, that so far from the ex-parte and perfectly false statements which were reported of the trial having any injurious influence, they rapidly expedited my success. Thanks to the zeal and exertion of all those friends who were anxious to counteract the effect which these falsehoods were calculated to make against me; they spoke from personal experience, and with all the ardour which gratitude and justice could inspire.

The design, therefore, of publishing it as a part and continuation of my defence, was gladly abandoned. Many of the first sheets, however, containing no improper allusion to this case, remain: I mention this, because it accounts for that which might otherwise appear an abrupt commencement, especially to those who have not previously read that defence. On this account, I shall bind up that defence, (without additional expense) at the end of this Essay, for those who may wish to have this connexion before them. It is necessary, also, to inform the reader of the origin of this Essay, for another reason, in order that he may understand (and I trust, also, under such circumstances, he will excuse) why there is so much personal minuteness in describing our system of procedure and exertions, which could not, and would not, otherwise, have been obtruded on the public.

But if, after being thus justified and compelled to come forth in my defence, the matter should be found useful, either to myself or mankind, it would be foolish affectation to seem to feel shame and regret by too anxiously apologising and explaining the origin and consequent peculiar complexion of this publication, or of those which may follow in regular succession. And it is a truth, that it has increased my zeal and strengthened my resolve to prosecute that most useful of all studies, the study of mind,—its errors and diseases, with, I trust, so ardent a love of the truth, that I earnestly pray I may be enabled to trace every error to its source; for so much does the ground appear to me to be untrodden, that I pray also, that opportunity, life, health, and encouragement may be given me to complete the work I have to do, that, however slender my talents may be, I may yet feel that they have not been given me altogether in vain.

In explaining in this Essay all the plans necessary to the moral and physical purposes of an efficient system of Classification, I have had slightly to introduce many cases and subjects to illustrate my present purpose; and feeling that I had not done them or myself justice, I have said, on these occasions, I shall hereafter treat this case or subject more amply in that part of the work in which they will be more directly and specifically introduced.

Having thus incidently introduced many subjects without their being under any specific head or title, I shall, to enable the reader to form some conception of the matter, give in the contents something like a minute dissection of the whole.

From all this, and also from what I say in my former work on Insanity, as well as in Allen _v._ Dutton, it will be seen that I have been induced to give pledge after pledge so repeatedly, that it becomes a serious matter, “partaking of the nature of a solemn obligation;” if, therefore, I fail to exert myself to redeem these pledges, I cannot have the excuse of those who promise without even intending to perform.

In the preliminary remarks of Allen _v._ Dutton, I say at the conclusion, “I find I must do even more than this, (meaning the defence); for my defence would still be imperfect without a short statement of my views on the insane. For this purpose, I propose to write the following Essays:

1st.—On Classification, and Tables in Illustration. {vi}

2nd.—The different Divisions, into which I divide the Insane.

3rd.—Their General and Specific Character.

4th.—The Correspondence between Causes and Effects.

5th.—That the Study of Mind will evolve the Principle of Universal
Generalization.

6th.—Their Moral and Medical Treatment.

7th.—A Selection of Cases in Illustration.

By this I shall be able to give a more full and perfect understanding of the peculiar character and proper treatment of this particular case; and by which will be seen, though imperfectly, something of those principles, and of that spirit which has pervaded the whole of our conduct to all those entrusted to our care.

“To do all this, in connexion with the above case, would not be right, were I influenced by any improper spirit; but as my conviction is confirmed by experience, that these unjust persecutions, provided we use them rightly, are for our good, I feel in no danger of indulging in any spirit, but a spirit of gratitude and forgiveness.”

From all this, (whatever variation I may make in the plan as I proceed) as well as from what I say in my first work on Insanity, where the same principle and mode of procedure is adopted, it will be seen that my task is not a slight one. In the preface to that work, I say,

“Many subjects, not usually included in works of this kind, will be
introduced; but as my reasons for doing so will best explain
themselves in due course, and as one subject will be introductory to
another, it is unnecessary to mention them now, particularly as it
might excite critical objections, which I would rather wish to disarm
than pretend to brave.

“Without presuming on the experience, knowledge, or the materials I
may possess, of this I am confident, that so long as I am conscious
that the love of truth is my pole-star, so long will my faith
continue firm in this, that with patience and perseverance, and the
love of truth for our guide, scarcely any man’s powers are so limited
but he may hope to acquire some clearer views, or perhaps make some
discoveries in the matters he has undertaken to investigate.

“The objects of my enquiries are very numerous, and involve so many
either undiscovered or unadmitted truths, which are so closely
connected with subjects of inquiry the most interesting, that I have
adopted this slow and humble plan of proceeding for the present, and
have suspended, for a while, my first purpose of publishing a
systematic treatise on insanity.”

It is intended that each publication shall contain one subject, at least, in some measure complete, so that each part may have its distinctive title, and be had separately.

The study of mental philosophy, of which insanity is a very important part, is, of all studies, provided we are on the road where truth is the guide, the most useful to our moral state. This belief was the first motive which induced me, now more than thirty years ago, to direct my medical attention to this most radically-important, though hitherto-neglected branch of the profession, as well as to whatever seemed best calculated to make me understand the sources of all erroneous and extreme views, and which a series of painful circumstances through life have excited and continually strengthened; but it is not necessary to state them: I may, however, mention that, as early as 1807, I visited lunatic asylums _con __amoré_, and that in 1816, 1817, 1818, and 1819, I was engaged in lecturing on Mind and its Diseases. Before this time, I had no conception that I should ever be exclusively devoted to this department of the profession, which _circumstances_ at that period forced upon me. I trust, however, that I have endeavoured to profit by the opportunities which this new situation afforded me of more fully comprehending the nature of mind, its connection with life and organization, its diseased manifestations, and of ascertaining the best modes of co-operating with nature in the removal of them; and, at any rate, it is certain that, for the purpose of lessening the miseries and increasing the comforts of those under my care, I, for the most part, have sacrificed every personal consideration.

From 1819 to 1824, I continued medical resident and superintendant of York Asylum; and on leaving it, it was voted unanimously, “That I deserved the thanks of the Governors, for my constant and successful efforts in establishing and perfecting the mild system of treatment there.” I was again engaged in lecturing, at the request of several institutions, on Mind and its Diseases; soon afterwards, in 1825, I fixed on this situation, as the best adapted of any part of the country about London which I saw, (and I spent several weeks in the examination; nor have I since that time seen any I like better) to carry into effect my views of the treatment of the insane, either as respects the recovery or the comfort of recent or confirmed cases; for here, together with domestic comfort, diversity of occupations and amusements suited to their various states, the retirement, pure air, and sweet scenery around, afford ample scope for walks, without annoyance, and apparently without restraint; which, with judicious moral and medical management, combine many acknowledged requisites to assist the disturbed and diseased mind to regain its tranquillity, and in many cases to resume its healthy tone of action.

I shall only add, that all these views have been amply justified by the beneficial results on those entrusted to my care; so much so, that these results and my success have greatly exceeded my most sanguine anticipations.

I here gladly close these personal remarks, which have been forced from me, for self is a subject which it is seldom wise and always dangerous to introduce.

It only remains to notice another peculiarity in this essay, which is, that of having introduced some animadversions on legislators whose minds are not sufficiently pure or comprehensive to enable them to avoid the common error of overlooking general principles, and not to presume to judge and draw conclusions from the hasty, partial, and erroneous views they have acquired on the subject on which they legislate. This has often led to, or been combined with, that great selfish view of making themselves and their property the chief good, not considering the real objects of legislative care, nor “that life is more than meat, and the body more than raiment.” This it is which has corrupted all our laws, especially our criminal code, which was a system of legal murder, not justice, and a perfect scandal to the nation.

The same faults are visible in all they have done for the poor insane. They have given an undue and exclusive consideration to property and to the few extreme and violent cases; treating them and _all who have the care of them as criminals_. To live amongst them, appears to be deemed a crime, for which neither goodness nor talent can atone. All which must, in various ways, have an injurious influence. To banish these errors is to better the treatment of the insane. This conviction is my excuse for introducing the subject, and which makes me anxious to prove, from experience, that such extreme cases hardly have any existence at all under a proper system of treatment; and, that at all events, this liberal treatment materially lessens the horror and danger usually conceived to attend these places.

Insanity is, no doubt, a terrible visitation; but why should we allow a false and unreasonable horror to increase it? and why should we thus sever our sympathy from a disease which more than any other requires it? The medicinal virtues of the fruits of charity are best proved amongst them. Grant that the disease arises from some remote or proximate ill-directed mental states. Why should we have more horror of insanity, than many other consequences of ill-regulated minds? To me, the foul ward of some large public Hospital, is incomparably more horrible and loathsome. Such direct consequences of wickedness present the object before us in an aspect that makes it difficult for us to exercise any feelings of commiseration towards them. Not so the insane. But these are views, however, into the consideration of which I shall not enter in this place; but I mention or rather hint at the diseases of other organs, for the purpose of asserting that the reality and appearance of the miserable state of the insane is not so shocking as people imagine; but that still I allow it is an awful visitation.

When the gloom and horror at present thrown around establishments for the insane shall be cleared away, Dante’s inscription over the gates of Hell, will be no longer applicable to them,

“Lasciate ogni speranza, voi, ch’entrate;” {xiii}

this, or perhaps another passage from Euripides, has been imitated by our Milton,

“Here hope never comes, which comes to all.”

They will be considered houses of cure, or hospitals for the insane.

The erroneous and false impressions concerning the character and state of the insane, will be corrected. The popular impression, that they are all violent and vociferous, destructive and dangerous, will be removed. Hitherto medical writers, by selecting the most striking cases, have contributed their share to this popular error. They have been led to do this, partly because they are cases, which more naturally arrest their own observation; but chiefly, because they are more easily described, make a more interesting picture, and are the most curable. A statement of the recovery of such patients, though it may serve to exalt the writer in public estimation, is wrong in itself, and very injurious in its influence; for it increases the unreasonable horrors and false impressions entertained about the insane, and propagates and perpetuates the evils of which the public and legislature complain. They receive impressions from extreme cases, which average about five per cent. then speak and act just as if all the insane were in a similar condition.

It would seem that these prejudices and horrors of the insane exist in a much greater degree in this part of the kingdom than they do in Yorkshire. There I was in the constant habit of taking convalescent patients with me into family parties of the first respectability; and members of these families were also in the constant habit of visiting them as friends and acquaintances, and of inviting them to tea and to spend the evening at their own homes; and this practice, in most instances, had a very pleasing and beneficial influence. This was the case with other institutions; but I have not found, neither have some others found, any such faith in, and sympathy for, the insane in this part of the kingdom, but quite otherwise; and yet I am certain, it is an example they cannot too soon imitate—its beneficial influence will bring satisfaction to themselves, will remove their prejudices, destroy their painful fears, and lessen the chances of the calamity invading themselves. There is a protection around those who are striving to alleviate the distresses of others.

This difference, which I and others have experienced, makes me more anxious “to impress these views on others, and especially on those around me, in order that I may not be obliged, from too great a deference to the fears and prejudices of those I most anxiously wish to conciliate, to abridge the exercise and lessen the happy effects of a system which theory and feeling have suggested and compelled me to pursue; and which nearly twenty years’ experience and increased knowledge have confirmed and justified.” {xv}

So important have I considered just views of the insane, that I have added an Appendix for the express purpose of exhibiting a fair average of the general appearance of the insane. With the same view, I have given a few portraits of such of these cases as are now, either themselves, or their friends, dead, or little known. I had the same principle in view in my first publication, which induced me to give cases in regular rotation, “rather,” as I there say, “than the common mode of making a selection of extreme ones, that I might not give a distorted picture of the insane, nor add to the unreasonable horrors and false impressions on their state, as this has, I am convinced, been one cause of an improper spirit and conduct towards them.”

It is scarcely necessary, after what I have already said in the Appendix, again to guard the reader against the mistake of supposing that the cases and treatment described in that Appendix form any data or criterion for judging of the kind of cases and treatment in my own private establishment. The medical swing, for instance, is stated as having been useful, in some violent cases of mania; but this was even then soon laid aside as objectionable; but it would be worse than useless now, because, under a system which does not cultivate the habitual exercise of the vindictive passions, cases in which it was of use, no longer exist. In fact, to have recourse to any means which operates so much on the fears, whatever medical virtues it may appear to possess, is adopting a principal which philosophy and Christianity equally condemn. It ought ever to be the aim of all persons IN POWER to call in no principle but that of the OMNIPOTENCE of SYMPATHY and BENEVOLENCE; and this PRINCIPLE is not to be excluded even from those whose spirits are imprisoned in bodily evils and diseases.

CONTENTS.

_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

* * * * *

LIST OF DR. ALLEN’S PUBLICATIONS.

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

“Thou shalt not break the bruised reed.”—_Isaiah_.

“The care of the _human mind_ is the most noble branch of
Medicine,”—_Grutius_.

_Extracts from the Reviews_.

“We consider Dr. Allen’s Work one of great interest.”—_London Medical
Journal_.

“Dr. Allen’s work is well worthy the attention, not only of the
Faculty, but of all persons who have relatives or friends afflicted
with that fearful malady.”—_Periodical Review_.

“Strong, perspicuous, and concise; this work is deserving the highest
estimation.”—_Periodical Review_.

“Our limits prevent our doing such justice as we could wish to this
very able book.”—_Union Monthly Magazine_.

LECTURES on the _Temper and Spirit of the Christian Religion_; on the _Preliminary Principles of Early Education_; on _Christian Forbearance_. Written for the use of Families, Schools, and _other Institutions_.—Price 10_s._

_Extract from the Reviews_.

“We hope this excellent book will find its way, not only into the
hands of all heads of families, but also into the hands of all
persons engaged in the education of youth. The tendency of the
discourses is elevating and good; they are evidently written from a
heart warm in the cause of humanity, Christian toleration, and for
the improvement of the human mind.”—_Monthly Magazine_.

OUTLINES OF A COURSE OF LECTURES ON CHEMICAL PHILOSOPHY. Price 5_s._

_Extracts from the Reviews_.

“A Series of Essays, rich in ingenuity of argument, and abounding in
masterly views on the great subject of Chemical Agency, as effecting
changes in the modes of existence of physical matter: the whole
enquiry is conducted with much philosophical acumen.”—_London Medical
Repository_.

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

ESSAY ON CLASSIFICATION, Illustrated by Cases.

ALLEN _versus_ DUTTON, consisting of Preliminary Remarks: Affidavits in Reply, and Affidavits in General; and General History of Mrs. Dutton’s Case, as they appeared on this trial.—Price 3_s._

“A series of Facts very material to all having care of the Insane.”

* * * * *

The above Works may be had of JOHN TAYLOR, Upper Gower-street; or through the medium of any country bookseller.

* * * * *

_Also_, _by the same Author_.

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.

In many cases, an entirely separate house is required. I have known cases, the cure of which would have been apparently blighted and blasted for ever, if they could not have been wholly removed from, not merely the real, but the apparent, association of former scenes and circumstances, and this without any change in their servants and medical treatment and attendance, which is also essential. Yet it is perfectly true, that in other cases this association is not so injurious as most people would imagine; the dawnings of the light of the understanding are, for the most part, so gradual, and the mists of delusion so gently steal away, that there would be a greater shock given by a sudden transfer to rational scenes and real life, than by their continuance in the place where they might be at the time.

I have often, with feelings of wonder and admiration, had occasion to observe these occurrences. I have seen a convalescent patient very much attracted by, and perfectly delighted with, the strange remarks, speeches, and conduct of another inmate, sometimes fancying it was meant purposely for his amusement and diversion; and on whom, refined wit would have been lost, while the incongruous combinations of unguided thought, which no wit or ingenuity can equal, appears, and is the very essence of wit to him. Notwithstanding the truth of all this, there are other cases,—cases of more sudden convalescence, where all this would shock and horrify, and produce a revulsion of feeling, most dangerous to them in their delicate and fragile state, and perhaps permanently fatal to their recovery. This is more particularly the danger in the incipient stage of convalescence in some violent cases of mania, {5} and where I am quite certain delicate and judicious attention have been essential; and where first, perhaps, removal to the family part of the house, then removal altogether to our own house, was apparently their salvation.

_No._ 106, _admitted April_ 11_th_, 1820, _aged_ 65.

This was one of the cases apparently saved by such timely attention, and which I intend hereafter to describe more particularly, for the purpose of illustrating both the medical and moral treatment of many similar cases of insanity. I shall, however, state so much of the case now, as will be sufficient to show, that there is not only a critical period of the disease, when judicious medical and intellectual attention arrests and prevents its transition into another and equally dangerous form of over-excitation, so dangerous, that if allowed to take its course, it not unfrequently ends in dementia, but also, and more especially to show, that in all cases our moral treatment must have in view the nature of the existing causes, in order that we may be able to adopt the most suitable methods of counteracting their effects,—a part of treatment which has hitherto been either wholly overlooked, or else exercised without much knowledge and discretion; although I am certain it is of great importance in the treatment of all curable cases of insanity, and in many cases so important, that by such methods we may ultimately succeed in removing these causes altogether; and removing them, remove also the fear of their again (at any future time) being allowed to have any baneful operation.

This person, who was a dissenting minister, had always been reckoned by all parties, one who entertained gloomy views in religion, and pushed these into extremes; his zeal was equally violent and vindictive, and he besides possessed a mind with every opposite quality in excess, and which had always, as far as I could ascertain, been in a state of irregular and discordant excitation; it is quite certain that during many years past, it had been habitually kept in a very painful and irritable state, by several causes, and one more especially deserving notice. He lived unhappily with his wife and her friends,—instead of union and harmony, all was dislike and contradiction, perpetual storms and altercations, which had just before terminated in a separation between himself and them.

Thus, from the condition of his own unsettled and ill-constituted mind, his gloomy and vindictive views in religion, his variable and irritable temper, and from the nature of the domestic excitement under which he had suffered most severely, it was easy to trace the distressing and awful form of his derangement to the causes which had produced it.

He was in a state of the most furious mania;—his was one of the most violent and distressing cases I had ever seen. It is impossible to convey any adequate conception of its appalling nature. His language was obscene and vulgar, and his horrible oaths and blasphemous speeches were poured forth for some weeks without ceasing, and without sleep, with a volubility, rapidity, and a voice so loud, and so foaming with passion, and with such a frightful expression of countenance, that even those most accustomed to such scenes, and of the strongest nerves, trembled before him. He had a demoniac energy and eloquence, which was, indeed, of the most harrowing and awful kind. It was truly terrific! for even at a distance, his voice sounded like a river escaping from some narrowed part, and rushing with impetuosity over every thing that would impede its course.

Had a short-hand writer taken down his ravings, it would have proved that this picture is far from being an overcharged one. One principle subject of his furious raving, was his favourite doctrine of Election; or rather, perhaps, I ought to say, his blasphemous doctrine of Reprobation. He was constantly denouncing every one (and against myself he was peculiarly severe) as lost, whose belief on this point was not, even in phraseology, the same as his own;—calling on God to execute vengeance upon them;—then blaspheming God, that his prayers and commands were neither heard nor obeyed;—taunting and cursing Him with a contempt which no language can describe;—calling his clemency weakness, and his not executing his decrees a proof he did not possess the power he pretended to have. In fact no one could hear and see him without feeling shocked, and without having a conviction forced upon him that there must be something wrong—some perversion of truth in those doctrines, as well as in his own mental system, out of which all this dreadful spirit, and all these terrific extremes originated, and of which this case appeared a Satanic caricature. It is a truth, that there is no error or perversion of truth that we may not perceive in reviewing the history of mind caricatured, and perhaps in a still more striking manner among those who are in confinement from being _directly_ denounced insane.

On the subsidence of his excitement, he was overwhelmed with the perfect recollection of all he had uttered during the utmost fury of his dreadful ravings, and his state was truly miserable and deplorable. In this state I took great pains with him, treated him with every possible kindness, and endeavoured to show him every possible mark of my confidence: one instance of which may be mentioned.—I gave him, at a very early period of his convalescence, a set of manuscript sermons, all in loose slips, and which he read with great pleasure, and preserved with great care. They were affectionate moral discourses, strictly, I believe, in agreement with the spirit of Christianity, though not on any peculiar doctrines; for in these I had purposely avoided all doctrinal points, although doctrinal views may, when properly presented, be the best preventives, and in some cases the best medicines, in the cure of insanity; but the circumstances in which I was at that time placed, appeared to forbid even their most cautious introduction, and were scarcely admissible to an audience consisting of some of almost all denominations. However, he said, the spirit of these discourses just suited his altered state of mind, for he himself felt horror-struck at the views which had led to such awful consequences.

Though no one can feel more than I do, the necessity of not busily trying to proselyte or unhinge unnecessarily any one’s settled opinions, yet this was an extreme case, and in such cases, where cure seems to depend on the proper administration of counteractive views, every other feeling should give way to this conviction; but at the same time, every thing depends on the judicious mode of stating these sounder views. This case was a remarkable instance of the necessity of such management; and where such views were apparently of the utmost importance to his comfort and peace. But it would require a separate Essay to defend what I conceive those sounder views; and even were I to give this striking case as a specimen of their happy influence, I still might lay myself open to cavils and objections. I shall, therefore, in a separate Essay, bring forth all the arguments, and exert all the power I possess in their defence.

Though his furious state was so unusually violent, yet it was of long duration, and after it had left him, it was some time before he was able to overcome the painful reflections which came over him; he however recovered, and returned home in the September following, since which period I have received many, and almost constant proofs of his great gratitude and attachment to me, one of which is worthy of being stated.

In the autumn of 1824, he walked about a hundred miles to see me, and not finding my place of residence, he called on a medical acquaintance, to whom his description of my kindness and attention, and their happy influence upon himself, were so powerful and eloquent, that this new and accidental medical acquaintance, became from that time to the present, my first and warmest medical friend in encouraging me to establish myself in my present residence, and to whom I have to attribute the origin of all my success; so that this recovered patient’s gratitude, who followed me unexpectedly, was the first step in my progress, and was the _sole_ foundation of every thing which I have done or exists in this place. It was my only introduction. I may be permitted, therefore, to acknowledge my great obligations to the warm-heart friendship of the person, of whose melancholy state I have just given a general description, as well as, the medical friend to whom I have alluded.

_No._ 195, _admitted October_ 27_th_, 1821.

This case, I shall hereafter show, was apparently saved by this separation from former associates, at this critical period of convalescence, and he was one who required very superior and intellectual attention.

He was a young man of some talents, and of various pursuits and acquirements, by far too many to be perfect in any one. Born with a large proportion of the family failing, his vanity had been fed by flattery and example, so much so, that it might be said he was bred in vanity’s hot-house; and ultimately, from over excitation, and too little collision with the world, he fancied himself a second Crichton. Of course with such an estimate of himself, it could not be otherwise but that he was constantly meeting with disappointments and mortifications, on his entrance into his profession, and the real business of life. From these causes, as well as from an increase at this time, of parental embarrassments and mortifications, (and home had always been an atmosphere of perpetual storms), from an hereditary scrofulous habit, and from his self-made morbid state, his mind was at last overwhelmed. But it is not my intention to enter into all the details of his history, further than to prove that the causes which produced his disease, and the form his insanity assumed, perfectly corresponded with each other.

On his arrival he was in a very exalted state of over-excitation; he was the greatest of men in every mental capacity and acquirement; all Philosophers, Poets, Painters, and Linguists, that had been, or were in existence, were nothing in comparison with himself, nor were their works to be compared with those he intended to execute, and the basis of which he had already formed in his own conception. Nothing could exceed the vain and pompous displays of his talents and acquirements; and it is impossible to conceive, from the difficulty he had to support his pretensions, with the defects under which he then laboured, what a very painful and ridiculous exhibition it produced. Still his vanity and exaggerated estimate of himself, combined with his ineffable contempt for others, remained unchecked. One feature was very striking; he possessed considerable powers of imitation, in the exercise of which he took great delight, and in pouring forth his contempt against others, he did it with the attitude and voice of Kemble; it was almost impossible not to feel the force of his manner, and against myself he was particularly severe, and his poignant expressions of contempt and indignity were most provoking and overwhelming. When, however, a change of state occurred, I felt so interested for his trembling and doubtful situation, that I had even a bed put up for him in my own room. I had always some case of this kind about me, and no one can conceive the sacrifice of health and comfort it cost me.

This case, as well as the last described, may perhaps be detailed more particularly in their proper place, to illustrate a general principle, of far more importance than even moral treatment. And even in moral treatment it will appear how important this general principle is, to enable us to perceive how we may best counteract the effects which may have arisen from the operation of baneful causes: for by it we shall be able to trace errors to their source, and without this, we can never counteract and cure them. And this we can only do with certainty, by possessing correct views of the origin, nature, and constitution of the human mind, and of the correspondence which exists between physical effects, and mental or spiritual causes: out of which views this general principle will be educed, and it will be found to be of universal application.