constant discipline can insure ease of mind in poverty and privation."*

To the physician specially occupied in the investigation of the deranged conditions of the mind, how indispensable is a knowledge of mental philosophy! Unless acquainted with the constitution of the human understanding, we are but ill adapted to unravel or appreciate the intricate phenomena of its disordered action, or to apply for their cure or alleviation those medical and moral agents which advanced science has placed within our reach. Before the morbid mental state can be diagnosed or understood, it is necessary for the physician to be intimately conversant with some normal standard of comparison, otherwise he possesses no test by means of which he can arrive at a safe conclusion. Who would

confide in the judgment of a physician who endeavoured, by means of the stethoscope, to ascertain the nature of any particular disease of the heart and lungs, if he were ignorant of the normal action of those organs! Is not a knowledge of the healthy operations of thought as necessary to the physician who is called upon to pronounce whether, in any given case, an apparently suspicious deviation from the normal condition of the intellect is or is not the effect of disease?

Is it necessary that I should seriously endeavour to establish the importance, not only of a knowledge, but of a profound knowledge, of the human understanding, its affections, propensities, emotions, and its instincts, to those occupied in the study of mental alienation, and specially and personally engaged in the treatment of the insane? Alas! an acquaintance with this section of philosophy is rarely deemed necessary in the education of those intended for psychological' practice. Hitherto, with few exceptions, those engaged in this branch of practical medicine have not only been grossly ignorant of the constitution of the human mind, but unacquainted with the first principles of medical science. It is only in recent times that it has been considered necessary to ascertain whether parties desiring to undertake the care and treatment of the insanet have any other qualification to

* 44 The Original," by Walker.

+ When asylums for the insane are entrusted exclusively to physicians acquainted with the anatomy of the human mind, or, in other words, with the science of medical psychology, they will realize the conception of the great Esquirol, and become "instruments of CURE, and, in the hands of the skilful physician, most powerful therapeutic agents against mental maladies."

recommend them to the office than the possession of a house of certain dimensions, and a sufficient amount of capital to enable them to carry into effect the mere commercial speculation. A surgeon, before he undertakes the performance of an operation, or the treatment of a serious, or even of a trifling injury, is expected to have devoted many years to the study of anatomy and the practice of surgery. A physician is considered to be conversant with the different branches of medical science; to have watched by the bedside the operation of various medicinal agents, exhibited in certain states of disease; and to be thoroughly conversant with the science of therapeutics and the phenomena of morbid action. But a knowledge of the most intricate, complicated, and subtle phenomena with which we have to deal-namely, the faculties of the human mind-is considered to come by intuition, no preparatory psychological education being deemed necessary to those devoted to the treatment of the insane. What would be said of our own mental condition, if we were to place in the hands of a blacksmith a delicate chronometer, for the purpose of having its movements regulated? And should we not expose ourselves to severe animadversion, if we permitted a man ignorant of the anatomical construction of the body, to cut down upon the subclavian artery, for the purpose of applying a ligature to the vessel? Is it less absurd, less destructive to the integrity of the intellectual part of our constitution, to place under the care of persons grossly ignorant of the elements of the science of mind, cases of disease requiring, above all others, for their judicious and successful management, an intimate knowledge of healthy mental phenomena? "Great powers of reason are requisite," says Vogel, "to understand men destitute of reason." To treat the various phases of disordered mind with any hope of a successful issue, requires on the part of the psychological physician qualities of mind rarely seen in combination-tact, presence of mind, judgment, a ready appreciation of intricate morbid mental phenomena, a delicacy of taste, a high morale, a steadiness of purpose, elevation of character, great command of temper, and volitional power and resolute determination not to allow any amount of provocation to interfere with that calmness and serenity so indispensably necessary on the part of those brought into immediate association with the insane. If the mind be the instrument upon which we are to operate in carrying out any systematic plan of moral treatment-if it be the duty of

the physician to perseveringly "combat with delusions and hallu-
cinations, and to substitute for them correct and healthy impres-
sions; to strengthen these impressions by judicious and repeated
repetitions; remove perverted trains of reasoning-replace them
by correct induction, and give them the power and influence of
habit and frequent association:" how, I ask, can he make any
progress in this mode of treatment so long as he is ignorant of the
material with which he is to work-in fact, with the faculties of
the human understanding? If the man who has the advantage
of an ordinary medical education is, on account of his ignorance of
the philosophy of mind, obviously unfitted for the serious duties
of treating its disorders scientifically and successfully, what lan-
guage can convey our impression of the folly, the barbarity and
heartlessness, of entrusting the management of the insane to those
who are not members of the profession at all, and who have
enjoyed no more psychological or general education than that
derived from their having acted as attendants in asylums, or that
which they have received at a village school? Need we feel sur-
prise at the little advancement made in the science of cerebral
pathology, and the amount of public odium which has, alas! for so
many years attached to those specially engaged in this anxious and
important branch of practice, when we consider into whose hands
this class has unhappily fallen? I trust, however, the day is not
very remote, when the psychological physician, engaged in the
treatment of insanity, will take his proper and legitimate position
in the ranks of honourable and scientific men; and the oppro-
brious epithet with which the vulgar and illiterate assail him
will be expunged from the vocabulary. When that epoch arrives,
the public and the profession will esteem, respect, and venerate
those who, at great and heroic personal sacrifices (often of health,
life, and reason), devote their acquirements, energies, and talents,
for the benefit of this section of the afflicted family of man.
am at length rewarded," says Müller,* "since after twenty-six
years' intercourse with the insane, I have not become insane
myself." In a letter to Pinel it is observed, "The labourer in
lead-works is thankful if he escapes lameness, and the medical
attendant of a madhouse, if he does not there leave his reason. A
more deliberate sacrifice to the mightiest good of mankind is not
conceivable."+

Physician to the Julius Hospital, Wurzburg.
"Aspects of Medical Life," by Dr. Mackness.

"I

There is another practical point connected with the study of medical psychology, which comes within the range of our investigation. It has reference to the influence of the will upon the physical organism. It has been maintained that the persistent direction of the volitional power to a particular organ or structure will eventually induce a morbid activity in the part, and give rise to lesions in the organic tissue itself. In many cases of hypochondriasis, a disease often associated with some form of visceral derangement, I have no doubt the sufferings, both mental and physical, are often aggravated by the patient imagining some particular structure or viscus to be the seat of disease; and from that circumstance, the attention being constantly directed to the organ, actual molecular changes in the organic elements of the part are induced. The persistent current of mental impulse, emotion, or volition towards an organ, impels to it an amount of nervous energy and blood sufficient to derange the circulation, and thus interfere with the function of nutrition, and induce organic alterations in the tissue. Does this fact admit of a psychical explanation. Viewing practically the operations of volition, I would ask whether it be not possible to prevent or cure actual physical and mental disease by an effort of the will; and if so, what is the rationale of the process? The will, by a constant exercise of its powers, has been known to acquire an influence over the involuntary organs. The case of Colonel Townsend is familiar to us all. This gentleman, by an effort of the will, could easily suspend the action of the heart, and thus induce, for a period, all the symptoms of apparent death. Celsus refers to a priest who exercised the same power over all the vital functions. In the language of Burton, "he could separate himself from his senses when he list, and lie like a dead man, void of life and sense. "Great expecta

* A Colonel Townsend, residing at Bath, sent for Drs. Bayard and Cheyne, and a Mr. Skrine, to give them some account of an odd sensation, which he had for some time felt, which was, that he could expire when he pleased, and by an effort come to life again. He insisted so much on their seeing the trial made, that they were forced at last to comply. They all three felt his pulse, which was distinct, and had the usual beat. He then composed himself on his back for some time. By the nicest scrutiny, they were unable to discover the least sign of life, and at last were satisfied that he was actually dead; and were just about to leave him, with the idea that the experiment had been carried too far, when they observed a slight motion in the body, and the pulsations of the heart returned, and he quite recovered. In the evening of the same day, however, he composed himself in the same manner, and really died.

tions may be entertained of recovery from an attack of illness, if the patient, with a recognition of his duty of submission to the will of God, resolutely determines not unnecessarily to yield to physical disease. The determination to be well, will, in certain morbid states of the system, do much to facilitate recovery, and will materially aid the physician in the exhibition of his curative agents. The author of The Original relates a curious circumstance connected with his own bodily health, which illustrates the power which the mind exercises over physical disease. He says: "Some months before I was born, my mother lost a favourite child by illness, owing, as she accused herself, to her own temporary absence; and that circumstance preyed upon her spirits and affected her health to such a degree, that I was brought into the world in a very weakly and wretched state. It was supposed I could not survive long, and nothing, I believe, but the greatest maternal care and tenderness preserved my life. During childhood, I was very frequently and seriously ill, often thought to be dying, and once pronounced to be dead. I was ten years old before it was judged safe to trust me from home at all, and my father's wishes to place me at a public school were uniformly opposed by my various medical advisers, on the ground that it would be my certain destruction. Besides continued bilious and inflammatory attacks for several years, I was grievously troubled with an affection of the trachea; and many times, after any excess in diet or exertion, or in particular states of the weather, or where there was new hay or decayed timber, my difficulty of breathing was so great, that life was miserable to me. On one occasion, at Cambridge, I was obliged to send for a surgeon in the middle of the night, and he told me, the next morning, that he thought I should have died before he could have opened a vein. I well recollect the relief it afforded my agony, and I only recovered by living for six weeks in a rigidly abstemious and most careful manner. During these years, and for a long time after, I felt no security of my health. At last, one day, when I had shut myself up in the country, and was reading Cicero's treatise De Oratore, some passage, I forget which, suggested to me the expediency of making the improvement of my health my study. I rose from my book, stood bolt upright, and determined to be well." Mr. Walker then proceeds to narrate, in a number of

'The Original," by Walker.