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As exhibited by the Records of the Bloomingdale Asylum, from June 16th, 1821, to December 31st, 1844: BY PLINY EARLE, M. D., Physician to the Asylum.

It was formerly customary with authors on mental alien-ation, to separate those agents or influences producing, believed to be productive of the disease, into remote and proximate, predisposing and exciting causes. Of' late years, and particularly in the annual reports made out by the physicians of the Institutions for the Insane, that cus-tom has fallen pretty generally into disuse.

In many of the cases of Insanity, it is extremely diffi-cult to fix upon any particular influence which we are satisfied was the origin of the disorder. Sometimes two causes are found, and it is impossible to tell which is the predisposing and which is the exciting. That power which in one case may stand in the relation of a remote cause, may in another, become the proximate.

If, therefore, in regard to many of the causes, the mo-dern writers have adopted the safest, and perhaps the most accurate method, by embodying all the generative influences of the disease into one class, and avoiding the endeavor to make a division where it is impossible to draw an accurate line of demarkation, they have perhaps, in reference to some others, fallen into error.

That constitutional condition of the system, transmit-ted from one generation to another, a condition, which although recondite in its nature, facilitates to a greater or less extent the invasion of mental derangement, and is generally known by the term hereditary predisposition, is invariably a remote or predisposing cause. According to our belief, wherever this natural condition exists, the person will retain the healthy action of his mind until he is subject to some other influence, more immediate, more active, more potent, and the tendency of which is to derange the physical functions of the system, so as to impair the manifestation of the mental powers.

For the reasons stated, we enter upon the subject of hereditary predisposition before proceeding to other causes.

In making up the statistics upon this subject, the rela-tives known to have been insane are given in full, instead of including the whole number of cases under the general term hereditary. Of the fifty-eight males and thirty-nine females placed against that term, in the subjoined tables, the simple fact that an inherited tendency existed, is mentioned upon the records, but the particular ancestor or ancestors who were insane, are not stated

TABLE 1. -- MALES.
Predisposition from direct Ancestors.

TABLE II.
Predisposition, as connected with collateral relatives

Descendants.

TABLE I. -- FEMALES.
Predisposition, from direct Ancestors.

TABLE II.
Predisposition, as connected with collateral Relatives.

Descendants.

Thus, of 1841 patients, 323, of whom 187 were males, and 136 females, are recorded as having one relative or more, insane; this is equivalent to 17 1/2 per cent. The percentage in each sex, taken separately, is as follows: men, 17.16; women, 18.11.

It is not to be presumed, however, that this is even a a -sic- near approximation to the number actually having rela-tives of disordered mental powers. During the first few years of the existence of the Asylum, there appears to have been but little attention paid to this particular sub-ject, and hence the records thereupon are imperfect. There are other important obstacles in the way to a cor-rect knowledge of the full extent of which the heredi-tary predisposition prevails among the patients admitted into a public institution. These obstacles may, by perse-verence, be measurably overcome.

Insanity being a disordered manifestation of the mind, dependant upon some disease of the body, either functional or organic, is subject to the same laws as many or most other maladies to which the human race is subject. Like consumption, gout, diseases of the liver and of the heart, it may attack any person whatever, but is certainly somewhat more likely to prevail among those whose ancestors have suffered from it.

Of the men included in the foregoing table, 118 inheri-ted the predisposition from direct ancestors, and 33 of these had other relatives insane. The remaining 58 had collateral relatives insane, but no direct ancestors. Of the 52 who had insane parents, it was the father in 27 cases, and the mother in 25. In one of these, both father and mother had been deranged. It is also stated, that two of those included under the term hereditary, had ancestors, both paternal and maternal, who were subject to the malady, and one who had a daughter insane.

Of the women, the predisposition was transmitted from direct ancestors in 89; of whom 67 also had other rela-tives insane. In the remaining 42, the disease is stated to have appeared only in persons collaterally connected, and in five cases in their children alone. There are 18 cases in which it is mentioned that the father was insane. In one case the father and mother were both deranged. In the case where it is mentioned that the whole family were insane, it is said that all her father's family, which consisted of twelve children, have been insane, and that their insanity did not in a single instance, make its appear-ance before the age of twenty-one years. Two of her brothers, while insane, committed suicide. None of the third generation have yet been attacked with insanity, although several of them have passed the age at which it made its appearance in the second.

In the following schedule are arranged those instances in which more than one member of a family have been inmates of this institution

In one of the cases of three brothers, their father was insane, and one of their sisters has been admitted as a patient since the period at which these statistics close.

In one of the cases of two brothers, it is stated that they had several other brothers and sisters insane. In one of the other cases of two brothers, the family consisted of but four brothers, and they all laboured under the same disease.

In one case of a woman admitted previously to 1844, her son has been received since that time.

In one instance in which a young man was the only member of the family admitted into the Asylum, it is stated that his father and two of his father's brothers were deranged, and all of them, as well as himself, had hernia.

It is obvious that the foregoing statistics are not sufficiently full or definite to be adopted as accurate data from which to estimate the proportion of the insane in whom an inherent predisposition exists, the comparative number in whom it is transmitted from the father's or the mother's side, or any of the other important questions involved in the subject.

In some persons, although none of their family either in a direct line or an immediately collateral branch may have ever suffered from mental disease, there is a nat-ural idiosyncrasy or peculiarity of constitution which facilitates the invasion of insanity. This peculiarity probably exists in the intimate structure of the nervous sys-tem, although Dr. Rush appears to have thought it to be in the blood. In which system of organs soever it may be, it is probably very similar in its nature to that which constitutes the hereditary predisposition, and in this way the latter springs up in families among whose members it has never before appeared.

This constitutional habit is apparently at all times merely a predisposing cause, and never generates insanity, unless assisted by some more exciting cause. In some of the patients, the existence of this constitutional predisposition is mentioned, but the number is few, and therefore has not been embodied in these statistics.

In idiocy, properly so termed, the mental disease or imperfection exists without the intervention of any external influence, the person being born in that condition. Fourteen of the patients were of this class. Twenty-three more are arranged under the head of imbeci1ity. In some of these also the disease was congenital.

There are one thousand one hundred and eighty-six patients, the causes supposed to have been productive of whose disease are recorded. These are arranged in the following tables, being divided according to the general method, into physical causes or those which act immedi-ately upon the body, and mentalcauses -sic- or those whose influence is primarily exerted upon the mind.

ALLEGED CAUSES OF DISEASE.

1ST -- Physical.

2ND -- Moral Causes

Of the patients whose disease was supposed to have originated from physical causes, there were 664; of whom 379 were males, and 285 females. Of those supposed to have arisen from moral causes, there were 522; 310 males, and 212 females.

Almost all the older authors upon insanity entertained the opinion, that mental causes were more prolific of in-sanity than physical. Within a few years however, the opposite opinion has been gaining ground, -- an opinion which is sustained by these statistics.

It will be perceived that, although a distinct class has been made of all the cases of delirium tremens,* intemperance occupies the highest rank in point of numbers, among the physical causes. So far as this item is concerned, the table may undoubtedly be taken as a criterion by which to judge of the comparative influence of the various causes of insanity in the community.

*There were 322 patients, whose disorder was either delirium tremens or some effect of intemperance other than insanity proper, and who are consequently not included in this article.

Thirteen cases, of which five were men and eight women, resulted from the excessive use of opium. In one of the men, the cause was more fully stated as the "too abundant indulgence in opium, snuff and tobacco." The action of these narcotic substances upon the nervous system is very similar to that of alcoholic liquors, and a recent French writer not only maintains that this action is precisely the same, but asserts that he has proved it to be so. If, therefore, one of the necessary effects of alcohol is to establish in the system a condition which will prevent the healthy action of the mind, -- and we are but too well aware that this is the fact -- it follows that the narcotics in question would produce an identical effect, and cause insanity. No one, it is presumed, will question the truth of this proposition so far as relates to opium. In reference to tobacco, it is possible there may be some doubt. Several modern authors, however, concur in the belief that, when excessively used, it may be the principal cause of mental derangement, and cases thus produced have been reported at a number of institutions. The immediate action of this substance upon the nervous system, in persons of a highly excitable temperament, is so powerful, that when smoking, they feel a peculiar sensation or thrill even to the remotest extremities of the limbs. A constant stimulus of this kind upon a nervous temperament, can hardly be otherwise than deleterious. Tobacco, particularly when used by smoking, tends to disturb the functions of the liver; and disordered action of this organ is not art unfrequent cause of mental disease. It also produces, or assists in producing, a chronic inflammation of the mucous membrane of the alimentary canal. The inflammation of this membrane may become the cause of mental disturbance. Again, particularly in persons in whom it excites an inordinate secretion from the salivary glands, tobacco is likely to produce dyspepsia, a disease which, more than almost any other, by acting sympathetically upon the brain, affects the manifestations of the mind.

Who has not experienced or observed this deleterious influence, producing depression of spirits, dejection, taciturnity, and inability to contend with the cares of life; gloom, despondency, and perhaps a disposition to self-destruction, or actual insanity in the form of melancholia?

How little or how much soever tobacco may act, either immediately or remotely, as a generative cause of insanity, it is a fact well known to all connected with public institutions of this kind, that there is no stimulus or narcotic substance in which the insane are more prone to indulge. If within their reach, those who, previously to becoming insane, have been accustomed to it, will use it to excess and many or most of those who have not before been addicted to the habit, soon become accustomed to it. One man included among the patients remaining in the institution at the time these statistics close, kept constantly in his mouth, both day and night, excepting when at meals, a quid of tobacco frequently as large as an ordinary hen's egg. Whatever saliva it might have produced it was rarely, if ever, ejected from the mouth, but usually swallowed. He had been in the institution during the whole period of its existence, being one of those who were brought from the old Asylum. He had been accustomed to the habit for many years; and it might almost be said of him that, --

"Like to the Pontic monarch of old days,
He fed on poison, and it had no power,
But was a kind of nutriment."

Although as completely insane and incoherent as it is possible for a human being to be, he worked regularly, doing about as much as any ordinary laborer. The tobacco appeared to have a soothing, and controlling effect upon him, enabling him to concentrate his powers upon the labor in which he was employed. If deprived of it for a few hours, he became restless, agitated, excited, talkative, and unable to apply himself to his occupation. In this respect, the narcotic had an opposite effect upon him to that which it produces upon many of the insane. It frequently increases their excitement, and in some in-stances, to a remarkable degree. Its action, upon the whole, is considered so deleterious, that in most of the well conducted establishments for the insane in this coun-try, its use among the patients is prohibited. At this institution it is not permitted, excepting in a few cases, in small quantities, by patients who have resided here many years.

There are sixty-nine cases included under the several causes, the names of which imply an organic lesion of the brain or its membranes. According to our belief, there is always cerebral disease in insanity; and such alone has the power to affect the manifestations of the mind. In some cases this disease is organic; but in the majority merely functional, the healthy action of the brain being disturbed by its intimate sympathy with other organs which are diseased. In many cases it is absolutely impossible for the most experienced and expert observer to decide, in the early stages of insanity, whether the dis-order of the brain be organic or functional. Hence it is possible that the number of cases here attributed to the several diseases of the brain is not sufficiently large.

Thirty-one cases are recorded as having originated from injuries produced by falls. The effect of sudden shocks or concussions of this kind, falls most heavily upon the brain and nervous system. Hence their agency in the production of mental disorder is most obvious.

If the prick of a pin or needle may, as it frequently has done, exert so potent an influence upon the nervous sys-tem as to result in that terrible disorder popularly known as the lock-jaw, it is certainly not remarkable that a punctured or a gun-shot wound should cause insanity. One case arising from each of these causes is mentioned above.

One case is also recorded as the effect of a kick by a horse, upon the region of the stomach. Here the disorder of the brain was undoubtedly secondary, to the immediate effect upon the great central plexus of the sympathetic nerve, in the region receiving the shock.

After the cases of insolation, there is a series of causes, all, or nearly all of which, exhaust the nervous power, occasion debility and probably by this means, destroy the healthy exercise of the brain. The first of these is mas-turbation. Thirty-seven cases are placed against this as their exciting cause. For a long time, this bas been known as one of the many agents tending to destroy the balance of the mind, but it is not until within a few years that its influence was supposed to be so great as it is at present by most physicians to institutions for the insane. Although it is acknowledged to be a very prolific cause, yet there is danger of misapprehension upon this point. The habit is, undoubtedly, in many cases, the effect of the disease.

The important revolution which the system of both males and females undergoes at the time of puberty, sometimes seriously affects the mind, and produces absolute insanity. Thu tendency or this change to operate upon the healthy action of the mental powers, is greatly increased by the simultaneous disposition to rapidity of growth. When the nutritive vessels are acting with such energy, and all parts of the frame are becoming developed with an unwonted rapidity, the texture of the organs is loose, incompact and light, wanting the density, tone and stability, essential to a vigorous performance of their functions, and the nervous fluid can not act with the celerity and vigor requisite to perfect health.

Four cases of men and seven of women are attributed to excessive bodily exertion and loss of sleep.

The renovation of energy by sleep, is absolutely essential to the healthy exercise of both the physical and the mental powers. So important is its position as a preventive to mental derangement, that were we called upon to give advice to all who are predisposed to insanity, are threatened with it, or fearful of it, and were we obliged to give that advice in the briefest possible terms we would concentrate it into an imperative phrase of but two words, "sleep enough."

Nothing exhausts the nervous energies of the system more rapidly than constant and prolonged watching. It subverts a primary law of nature -- a law which can not be seriously infringed with impunity.

Excessive bodily exertion exhausts the frame by its inordinate tax upon the nervous system. The muscles, it is true, are the immediate organs of motion, and consequently of labor, but they are matter merely, inert as the bones or the nails if deprived of the nervous stimulus. If a constant supply of the latter could be continued for an indefinite period, we can perceive no sufficient reason why the muscles should not perform their office with all their energy, unweariedly. At least, the converse of this proposition has never, so far as we are informed, been demonstrated.

Inordinate and prolonged labor reduces the nervous energy, and rest and sleep become necessary to its renewal. But it is frequently reduced to so low a point, that sleep becomes impossible, or, if at length it be attained, it is imperfect, broken, and insufficient to enable the nervous system to rally its wonted forces. Hence, in these cases, it may be not so much the bodily exertion itself, as its secondary effect, the deprivation of sleep, which is the immediate cause of mental disorder.

One case is said to have arisen from "Mesmerism." This was the cause assigned by one of the parents of the patient. The leading features in the history of the case, are as follows. The patient was a young man, about twenty years of age, of a highly nervous temperament, with a brain remarkably developed and corresponding intellectual powers. For several years he had suffered from occasional epileptic fits, which, as yet, had left his mind but little if at all impaired. The skill of many physicians and the virtues of every medical resource, believed to be applicable to such eases, had been exhausted upon him without benefit. As a dernier resort, and at a period when he was in a state of comparative stupor, such as frequently follows a succession of epileptic fits, he was placed under the care of a person professedly practising "Mesmerism" for the cure of disease. To use the expression of this person, "The pa-tient was magnetised daily, for nearly a month" without effect, he remaining in the torpid condition already men-tioned. At length he was suddenly roused, appeared rational for a few hours, and then passed into a state of high excitement and absolute mania. A day or two afterwards he was brought to the Asylum with his arms and legs strongly bound. When admitted he talked but little, and that little was perfectly devoid of meaning. He was highly excited, his face flushed and the veins of his head swollen; the circulation rapid, the pulse being from one hundred and twenty to one hundred and forty per minute, the tongue furred, and the bowels very much constipated. After free catharsis, an inordinate quantity of medicine being required to operate upon his bowels, he was placed upon the use of sedatives. Under this treatment and after the lapse of two days, he began to improve, and in eight days he left the Asylum, restored to his ordinary condition, and without so much of the torpor as existed previously to his excitement.

The general term "ill health," under which thirty-seven cases are arranged, is so vague and indefinite, and it may include so great a variety of diseases, that it is suscepti-ble of but little comment of special application. In general terms, it may be supposed that almost any malady, if sufficiently prolonged, may impair the vigor of the body, act sympathetically on special organs, diminish the quantity or derange the action of the nervous fluid, and thus disorder the manifestations of the intellect.

The next series of causes are those which are arranged under the generic term "fever." Those are placed first whose predominant pathological effects are upon the circulatory and nervous systems; and those which follow, have, as a leading feature, disordered action of the liver.

Pure fever, unallied with a pathological condition of either the nerves or the liver, if, indeed, such a disease exists -- may, from the rapidity and force of the circulation, impair the functions of the brain, or, it may produce the same result sympathetically, through the inflammation of the mucous membrane of the alimentary canal.

If the disease be of the typhus or the typhoid form, in which the nervous system becomes most seriously involved, and delirium is frequently an accompanying symptom, it is easily comprehended that mental disorder of a more permanent character may ensue.

It is probable that of the thirty-one cases included under the general term fever, the disease in many or most of them, was of one of the specific forms afterwards mentioned.

In the bilious fevers, it appears to us, that the disordered action of the liver is the primary cause of insanity, when this disease results. Whether the disordered action of the brain in these cases arise from sympathy with the liver, or be produced by the condition of the blood, modified as that fluid is in its constitution, so far as regards the elements of the bile, is a question which we pretend neither to explain nor to understand.

Twenty-six cases were stated to have arisen from dyspepsia. The remarks already made upon this disease, preclude the necessity of any farther comment

Rheumatism and gout, undoubtedly, as a general rule, cause insanity by a metastasis to the dura-mater, the fi-brous membrane covering the brain.

Phthisis pulmonalis, or the true consumption, is not unfrequently connected with insanity, either as a cause, a concomitant, and possibly, in some instances, an effect. In the whole range of human maladies, there are but few cases more singular or interesting than those in which these two diseases alternate with each other in the same patient. The consumptive person becoming insane, the progress of the pulmonary complaint is arrested until he recovers from his mental disorder, when it resumes its march until stopped by another attack of mental derangement, again to progress, if that malady be cured, and again to be suspended if the patient should become insane. This singular alternation is probably in obedience to a general physiological or pathological law, that two important and active diseases can not simultaneously exist and run their natural course.

The deleterious effects of the sudden suppression of a natural secretion, or an accustomed discharge, whether natural, or artificial, are well known. Accustomed to a constant drain, the body is brought into a condition in which that drain appears necessary for the support of health. If it be suspended, the system becomes plethoric, or laden with matter unqualified to assist in the action of the different organs, and consequently an obstacle to the faithful performance of that action. The brain, in common with other organs, is affected, and consequently the manifestations of the mind disordered.

Some of the eruptive fevers, and particularly measles and scarlatina, are proverbial for the physical defects which follow in their train. Their results being thus unfavourable to the perfection of the body, it is not remarkable that they should, in some instances, disorder the action of the intellect. In the foregoing list, thirteen cases are imputed to them.

That mysterious and peculiar influence of the salts of lead, which, in some cases, produces cholica pictonum, a disease so common among painters as to have derived its name from them, is undoubtedly the same which, in cases, among people who are accustomed to work in those substances, originates insanity.

The case attributed to the inhalation of prussic acid, is that of a man engaged in the manufacture of fancy soap. If that acid were truly the producing cause of the disease, it may be supposed to have effected that result by the depression of the nervous power, its natural physiological effect.

The last ten items in the table of physical causes constitute a series of influences to which the female sex alone is liable. We have long held the opinion that in their sex, these are the predominating causes of mental alienation -- an opinion corroborated by these statistics. It will be perceived that of two hundred and eighty-five cases of females whose disease is attributed to physical causes, no less than one hundred and fifty-five are arranged in the series in question. The nervous system being more fully developed, at least so far as intensity of action is concerned, in females than in males, and the intimacy between the uterus and the other organs of the body being so intimate, so powerful and so controling as the observation of physicians shows it to be, there is lit-tle cause of marvel, that the causes in question should be so prolific of mental alienation. Dr. Rush appears to have correctly estimated the potency of these causes, and alleged the fact as an argument in support of the doctrine that women are more subject to insanity than men.

Connected as this Asylum is with a city almost purely commercial -- a city the majority of whose active adults are subject to the cares, the perplexities, and the fluctua-tions of trade, it is not remarkable that among moral causes, pecuniary difficulties should occupy the most prominent position. Under this head there are one hun-dred and eighteen men, and fifteen women, a total of one hundred and thirty-three; and if, as may be most proper, the eleven cases assigned to "the want of employment" be included, the total will be one hundred and forty-four. There, is perhaps, no mental influence which, if examined in all its bearings and relations, exercises so ex-tensive and controling a power upon man in civilized coun-tries, and more particularly in the U. States, as that arising from his pecuniary condition. Connected with this are many if not all his hopes, and schemes of ambi-tion, preferment and agrandisement -- all his prospects of present and future temporal comfort, and all his affections that are enlisted in the welfare of the persons constituting his domestic circle.

A constant business, moderate in extent and sufficient-ly lucrative to afford a liberal subsistance, can never, in a mind well regulated, operate as an exciting cause of mental disorder. The sources of the evil are, on the one hand, the ambitious views and the endeavours rapidly to accumulate wealth, and, on the other, the extremes of excessive business, of bankruptcy and of poverty, the fluctuations and the unwholesome disposition to speculation. Of the one hundred and eighteen cases of men arranged under the head of pecuniary difficulties, the disease in three was attributed to excess of business; in two, to retiring from business; in four, to a sudden access of fortune; in one, to speculation in stocks, and in two, to speculation in the morus multicaulus.

Moral philosophy requires not, for its illustration, the assistance of the fable of the lion and the gad-fly, when so harmless and apparently impotent a vegetable as the mulberry can overturn the faculties of the human mind.

The moral cause which ranks next in point of numbers among both the men, and women, is the anxiety and other mental influences in reference to religion. The whole number attributed to these is ninety-three; of whom, fifty-one were males, and forty-two females. Although there were more men than women, yet the proportionate num-ber, when compared with the whole number of admissions, is greatest in the latter.

In a country of universal toleration upon religious subjects, and sheltering under this broad banner congregations of almost every sect that has ever appeared in Christendom, it is to be supposed that the religious sentiment would act under its greatest possible variety of phases, and in every diversity of gradation between the extremes of apathy and fanaticism. The accurate observer of the events of the last twenty years, to say nothing of a period more remote, cannot fail to have per-ceived that this is actually the fact. Under these circumstances, and when we consider the whole scope and bearing of this sentiment, and the eternal interests which are its subject, we can not but perceive how important an influence it may exert. It is difficult to believe that "pure religion and undefiled" should overthrow the powers of the mind to which it was intended to yield the composure of a humble hope and the stability of a confiding faith. Nor do facts authorise any conclusion thus hostile to Christianity, for a great majority of the cases of insanity attributed to religious influence, can be traced to the ardor of a zeal untempered with prudence, or a fanaticism as unlike the true religion which it professes, as a grotesque mask is to the face which it conceals. The exciting doctrines of Miller, the self-styled prophet of the immediate destruction of the world, gained but little hold of the public mind in this vicinity, but in those sections of the country where they obtained the most extensive credence, the institutions for the insane became peopled with large numbers, the faculties of whose minds had been overthrown thereby.

The passions or emotions whose activity tends to depress the energies of both body and mind, may he considered, on strictly physiological principles, as powerful agents in the production of mental disease.

Remorse is the first of these mentioned in the table, and eleven cases, of which five weremales -sic- and six females, are attributed to it.

Grief caused by the death of relatives, stands next in position, but first in point of numbers, including as it does forty-three cases, of which sixteen were males, and twenty-seven females. Of the men, the particular rela-tives whose death was followed by so unfortunate an occurrence, is stated to have been the wife in six cases; the wife and child in one; the wife and five children in one; the child in three; the mother in two; the sister in one, and the brother in two.

Of the women, it was the husband in five cases; the child in eight; the father in one; the mother in one; the mother and child in one; the mother and sister in one; the sister in one; the brother in two, and the brother and sister in one.

Forty cases, twelve males and twenty-six females, are recorded as having originated from disappointed affection.

Home-sickness, the maladie du pays, or technically, nostalgia, is assigned as the cause in three cases-two males and one female. The latter was a Swiss girl who had been but a short time in this country, and could not speak English. Separated from her friends, and surrounded by strangers, her spirits were most oppressively borne down by that disease, if disease it may be termed, so proverbial among her countrymen when removed be-yond the sight of their native mountains arid valleys, and beyond the hearing of the Rauz des baches. After a residence at the Asylum, a victim at once to the delusion of insanity, and to the harrowing emotions from which that disease originated, she ended her temporal sufferings by suicide.

Fear is at all times a depressing emotion, whether it be constant and prolonged, or sudden and transient, as more particularly implied by the term "fright." In the latter case it is powerfully so, even to the production, in some instances, of immediate death. Its natural effect, and the power of its action, particularly qualify it as a source of mental disturbance, and hence it should at all times, if possible, be avoided. The tales of horror conjured up to amuse or to subjugate children in the nursery, have not unfrequently been attended with the most deleterious consequences; and persons who, for amusement, attempt to frighten or startle their friends, incur the risk of doing the latter an injury beyond their power of reparation.

During the prevalence of an epidemic, the fatality of the disease is greatly augmented by the panic which seizes upon the mass of the community, the depressing influence of which upon the energies, both physical and mental, prepares the way for an easy invasion of the disease. This influence may also affect the healthy action of the mind. Thus, of the nineteen cases alleged to have been produced by the cause in question, two are attributed to fear of the Asiatic cholera.

In students, whether young or of middle age, if a, proper equilibrium be maintained between the physical powers and the intellectual faculties, the developement and energies of other portions of the body being so promoted and sustained by exercise, that they may preserve their due relations with an enlarging brain, there need be no fear that mental alienation will result from application to study, but unless this precaution be taken, the midnight oil consumed by the student as a beacon light to guide him towards the temple of fame, may become an ignis fatuus leading his mind into the labyrinth of insanity. Even in persons of strong constitution, and of great physical strength, severe and prolonged study exhausts the nervous energy and impairs the functions of the brain. How much greater must be these effects in a frame naturally delicate, and how much more alarming still if the body be debilitated by the want of exercise!

In the table of causes, thirty cases are set down as supposed to have been induced by mental application.

Of the two cases placed against the term, "mental shock," one is represented to have been produced by the hearing of good news.

Domestic trouble ranks high among the moral causes. It includes forty-two men, and twenty-three women; a total of sixty-five.

Under the general and somewhat indefinite term "anxiety," there are twenty two cases, twelve of men, and ten of women. In two of the men the anxiety was on account of a false accusation of seduction, and in five others it was in reference to annoying lawsuits in which they were engaged.

Eight cases are attributed to faulty education and parental indulgence. These are subjects which, during the past few years, have been fully discussed by several able writers on insanity, and hence require no extended comments on the present occasion. Sympathising deeply as we do in the feelings of the young, and entertaining a pleasing and affectionate emotion for all that cross our path who as yet tread but the vestibule of the temple of life, and ardently wishing to promote, by every judicious measure, their welfare, yet we must, and even for those very reasons, subscribe to the doctrine of the prophet of olden time, "It is good for a man that he bear the yoke in his youth." Let not that yoke, however, be placed upon them with despotic hands, but with that prudent combination of kindness and firmness which will render its burden light.

Three cases are attributed to undue indulgence in the reading of novels. Inasmuch as this subject has heretofore often claimed, and undoubtedly will continue to receive the attention of men who "stand in wisdom's sacred stole," we dismiss it without comment.

There are several heads included in the tables, to which especial reference has not been made, but they are either so unimportant or so similar to others which have been noticed, that they do not appear to call for any specific remarks.