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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.