EDWARD RUTHERFORD, M.D. Edin., Assistant Medical Officer, Perth District Asylum, Murthly, Dunkeld. James Sadlier, M.D. Edin., Gilmour House Asylum, Liberton, Edinburgh. HEURTLEY H. SANKEY, Esq., M.R.C.S. Eng., Assistant Medical Officer, Oxford County Asylum, Littlemore, Oxford. (Auditor.) W. H. OCTAVIUS SANKEY, M.D., M.R.C.P. Lond., late Resident Physician, Fever Hospital; late Medical Superintendent, Hanwell, Middlesex; Sandywell Park, Cheltenham, and Almond's Hotel, Clifford Street, Bond Street. M.LEGRAND DU SAULLE, M.D., Paris, 9, Boulevard de Sebastopol, Paris. (Hon. Mem.) GEORGE JAMES S. SAUNDERS, M.B. Lond., M.R.C.S. Eng., Medical Superintendent, County Asylum, Exminster, Devon. M. SCHLAGER, M.D., Professor of Psychology, Universitäts, Platz, Vienna. (Honorary Member.) FRANK SCHOFIELD, Esq., M.R.C.S. Eng., Camberwell House, Camberwell. EDGAR SHEPPARD, M.D. St. And., M.R.C.P. London, F.R.C.S. Eng., Medical Superintendent, County Asylum, Colney Hatch, Middlesex. (Auditor.) J. W. SHEILL, M.D. Edin., F.R.C.S. Eng., District Asylum, Maryborough, Ireland. JAMES SHERLOCK, M.D. Edin., M.R.C.P. Lond., F.R.C.S. Edin., Medical Superintendent, County Asylum, Powick, Worcester. DAVID SKAE, M.D. St. And., F.R.C.S. Edin., Medical Superintendent, Royal Asylum, Edinburgh. PRESIDENT, 1863. JOHN SIBBALD, M.D. Edin., M.R.C.S. Eng., Medical Superintendent, District Asylum, Lochgilphead, Argyllshire. JOHN H. SIMPSON, M.D., Assistant Medical Officer, County Asylum, Gloucester. FREDERICK MOORE SMITH, M.D. St. And., M.R.C.S. Eng., late Assistant-Surgeon, 4th Reg.; Hadham Palace, Ware, Herts. GEORGE PYEMONT SMITH, M.D. Edin., M.R.C.S. Eng., The Retreat, Mount Stead, Otley, Yorkshire. ROBERT SMITH, M.D. Aber., L.R.C.S. Edin., Medical Superintendent County Asylum, Sedgefield, Durham. JOHN SMITH, M.D. Edin., F.R.C.P. Edin., late Physician, City Lunatic Asylum; Visiting Physician to Saughton Hall; 20, Charlotte Square, Edinburgh. J. WALBRIDGE SNOOK, Esq., M.R.C.S. Eng., House Surgeon, Infirmary, Bradford, Yorkshire. ROBERT SPENCER, Esq., M.R.C.S. Eng., Assistant Medical Officer, County Asylum, Maidstone, Kent. HANS SLOANE STANLEY, Esq., late Chairman of Visiting Magistrates, County Asylum, Hampshire, Paultons, Romsey. (Honorary Member.) WILLIAM STAMER STANLEY, M.R.C.S. Eng., L.M. Dub., L.K.Q.C.P. Ireland, Orchardstown House, Rathfarnham, Dublin. PETER WOOD STARK, M.D. St. And., L.R.C.P. Edin., County Asylum, Lancaster. HENRY STEVENS, M.D. Lond., M.R.C.P. Lond., M.R.C.S. Eng., late Medical Superintendent, St. Luke's Hospital; 78, Grosvenor Street, London. HENRY OXLEY STEPHENS, M.D. Aber., M.R.C.P. Lond., M.R.C.S. Eng., Medical Superintendent, Boro' Asylum, Stapleton, Bristol. HENRY H. STEWART, M.D. Edin., F.R.C.S. Ireland, Resident Superintendent Physician, Government Asylum, Lucan, Dublin. ROBERT STEWART, M.D. Glas., L.A.H. Dub., Physician Superintendent, District Asylum, Belfast. (Honorary Secretary for Ireland.) HUGH G. STEWART, M.D. Edin., L.R.C.S. Edin., Assistant Medical Officer, Crichton Royal Institution, Dumfries. WILLIAM PHILLIMORE STIFF, M.B. Lond., M.R.C.S. Eng., Medical Superintendent, County Asylum, Nottingham. GEORGE JAMES STILWELL, M.D. Edin., M.R.C.P. Lond., M.R.C.S. Eng.; Moorcroft House, Hillingdon, Middlesex, and 38, Park Street, Grosvenor Square. HENRY STILWELL, M.D. Edin., M.R.C.S. Eng.; Moorcroft House, Hillingdon, Middlesex. ALONZO HENRY STOCKWELL, M.D. St. And., M.R.C.P. Lond., M.R.C.S. Eng., Medical Superintendent, Grove Hall Asylum, Bow. WILLIAM STOCKWELL, Esq., M.R.C.S. Eng., Millholme House, Musselburgh. ALEXANDER J. SUTHERLAND, M.D. Oxon., F.R.C.P. Lond., F.R.S., Censor, 1847, Consulting Physician to St. Luke's Hospital; Blackland's, and Whiteland's House, Chelsea, and 6, Richmond Terrace, Whitehall. PRESIDENT, 1854. § FREDERICK SUTTON, Esq., M.R.C.S. Eng., Assistant Medical Officer, Norfolk Lunatic Asylum, Thorpe. JOSEPH P. SYMES, Esq., M.R.C.S. Eng., L.S.A., Assistant Medical Officer, County WILLIAM BARNEY TATE, M.D. Aber., M.R.C.P. Lond., M.R.C.S. Eng., Medical JOHN THURNAM, M.D. Aber., F.R.C.P. London, late of The Retreat, York; Medical DANIEL HACK TUKE, M.D., Heidel., L.R.C.P. Lond., M.R.C.S. Eng., late Visiting THOMAS HARRINGTON TUKE, M.D. St. And., F.R.C.P. Edin., M.R.C.P. London; M.R.C.S. Eng.; The Manor House, Chiswick, and 37, Albemarle Street, Piccadilly. (Honorary General Secretary.) ALEXANDER TWEEDIE, M.D. Edin., F.R.C.P. London, F.R.S., late Examiner in Medicine, University of London, 17, Pall Mall, and Bute Lodge, Twickenham. (Honorary Member.) EDWARD HART VINEN, M.D. Aber., F.L.S., 6, Chepstow Villas West, Bayswater. FRANCIS DELAVAL WALSH, Esq., M.R.C.S. Edin., Medical Superintendent, Lunatic Hospital, Lincoln. JOHN WARWICK, Esq., F.R.C.S. Eng., 39, Bernard Street, Russell Square, W.C. JOHN FERRA WATSON, Esq., M.R.C.S. Eng., Heigham Hall, Norwich. THOMAS WATSON, President of the Royal College of Physicians, M.D. Cantab., D.C.L. Oxon., F.R.C.P. Lond., F.R.S., Physician Extraordinary to the Queen, 16, Henrietta Street, Cavendish Square. (Honorary Member.) FRANCIS JOHN WEST, Esq., M.R.C.S. Eng., Medical Superintendent, District JAMES WILKES, Esq., F.R.C.S. Eng., Commissioner in Lunacy; 19, Whitehall Place, REV. JOHN WILLSON, D.D., Roman Catholic Bishop of Hobart Town. (Honorary WILLIAM WHITE WILLIAMS, M.D. St. And., M.R.C.P. Lond., Consulting Physician, County Asylum, Gloucester; Whithorne House, Charlton Kings, Cheltenham. (Hon. General Secretary, 1847-1855.) S. W. DUCKWORTH WILLIAMS, M.D. St. And., L.R.C.P. Lond., Assistant Medical Officer, Sussex County Asylum, Hayward's Heath. RHYS WILLIAMS, M.D., and M.R.C.S. Eng., Resident Physician, Bethlehem Hospital, London. FRANCIS WILTON, Esq., M.R.C.S. Eng., Medical Superintendent, Joint Counties Asylum, Carmarthen. WILLIAM WOOD, M.D. St. And., F.R.C.P. Lond., F.R.C.S. Eng., Visiting Physician, St. Luke's Hospital, late Medical Officer, Bethlehem Hospital; Kensington House, Kensington, and 54, Upper Harley Street. (PRESIDENT.) ALFRED JOSHUA WOOD, M.D. St. And., F.R.C.S. Eng., Medical Superintendent, Barnwood House Hospital for the Insane, Gloucester. WILLIAM H. WYATT, Esq., Chairman of Committee, Colney Hatch, 1, Harrington Square. (Honorary Member.) ANDREW WYNTER, M.D. St. And. M.R.C.P. Lond., 76, Addison Road, Kensington. DAVID YELLOWLEES, M.D. Edin., L.R.C.S. Edin., Medical Superintendent, County Asylum, Cardiff, Glamorganshire. Notice of any alteration required in the above List to be sent to the Honorary Secretary, 37, Albemarle Street, W. THE JOURNAL OF MENTAL SCIENCE. No. 59. OCTOBER, 1866. VOL. XII. PART I.---ORIGINAL ARTICLES. Address; on Medico-Psychology. By W. A. F. BROWNE, (Read by the President at the Annual Meeting of the Medico-Psychological Association, held at Edinburgh, July 31st, 1866.) THIS is the first occasion upon which we have assembled under the title of the Medico-Psychological Association. The event appears to me auspicious both as inaugurating a more correct designation, and as pointing to a wider and more legitimate destiny. We can no longer be mistaken for a mere friendly club or a mutual defence society. We may now claim as among our objects the investigation of all subjects bearing upon the science of mind in connection with health and disease, as well as those which affect our personal interests or the interests of those committed to our charge. We claim even a wider, almost a universal range for the science of Medico-Psychology, and we claim for it a distinct position in science. The difficulty is to assign and to restrain it within limits, The multiform phases of actual insanity will be confessed by all to fall legitimately within its province. The still larger and more proteiform affections, unequivocally morbid, but compatible with such an amount of health and work-a-day self-control as neither to violate law, nor decorum nor delicacy, may be tacitly conceded, and, at a certain stage, naturally and inevitably come within the same category. But it is held to be a corollary of the definition of medico-psychology now accepted, that all physical diseases, all changes in structure, have a psychical, and often a morbid psychical side; that to overlook the mental condition of VOL. XII. 21 the fever- or consumption-stricken patient because the disease is corporeal, would be as absurd as to disregard the bodily condition of the melancholic or of the general paralytic because the disease is mental. It would not be enough, according to this estimate, for the psychologist to interpret delirium as an indication of cerebral disturbance, to allay fear or to sympathise with suffering-acts which might be performed by the humane and the uneducated; but it would be incumbent to connect the special mental condition with the particular changes going on in the organisation, to employ the mind as a medium of treatment, or, conversely, to act through the body upon the mind—and, in short, to embrace all the phenomena presented, and precisely in the same manner, as if they were of equal importance or demanded the same consideration. A glance of the idiotic, imbecile, backward, hebete, criminal portions of our population will infallibly suggest the advantages of bringing such views to bear upon the education and training of the young, to such an extent, at least, as that the attempts to impart knowledge should be in harmony with the laws of health, and with the temper and temperament of the individual as affected by structure. For in the errors of education may lurk the poison which grows into insanity or eccentricity, and, in like manner, into sound training may be introduced the preservative against eventual latent mental incapacity. The conservative mission of our science in anticipating, preventing, and modifying mental maladies is hitherto an unworked, and, it is matter for regret, a neglected problem. The laws of hérédité, moral and intellectual degeneration, and of intermarriage, constitute a science in themselves; and, perhaps, contain the basis of the future development and utility of prophylactic medicine. The importance of due attention to transmitted tendencies, not merely in connection with alienation, but with character and conduct, where no open interference of medicine or law could be thought of, and with other affections which are not brought within our cognisance, illustrate the usefulness of such an application of our science. There is a vast class of instances of mental unsoundness, perversity, obliquity, extravagance, which place the sufferer at nearly an equal distance from health and disease, from insanity and crime, and which, undoubtedly, depend upon physical causes, tend to modify other forms of disease, are the sources of incalculable social, domestic, and personal evil, and may originate the pronounced and palpable instances of alienation. The same observation applies when epidemics of mental disease, of theomania, or of suicidal impulse, arise, and even now agitate large communities, in the broad, bright sunshine of modern intelligence, and in what are styled, it may be ironically, the centres of civilisation. It cannot be doubted that the ravages of such moral plagues, although, like cholera or fever, they may select their victims from the predisposed and susceptive, must owe their origin to some common cause or causes, it may be political or religious commotion or excitement, or imitation, or social conditions, or atmospherical changes, which, if they cannot be counteracted, deserve to be studied. Even the mental phases, the panic, the temerity, the fatalism which so often accompany and aggravate the disasters of ordinary epidemics, claim our consideration. We may obtain a better view of the fair proportions of the subject by clearing away the rubbish and obstructions which have gathered around it, and by showing what it is not. The mere custody and care of lunatics certainly do not constitute a man a psychologist. Even where the physical wants and diseases of the class are attended to, and where an intuitive penetration into character imparts a certain suavity and address to the management, there may not be even a remote or indistinct conception that it is the immortal part of our nature, the godlike attributes of reason and imagination, and even of faith itself, and their ultimate destiny in time, which are dealt with, and which are, as the case may be, ignorantly neglected, unconsciously tampered with, or rashly and ruthlessly invaded and disturbed. It is true that, in many well-constituted and well-prepared minds, the experience which grows from mere contact with and observation of the objects of care and solicitude-the actual shortcomings and failures which experimentalisation involves-suggest, obtrude, necessitate the origin and growth of a philosophy, an analysis of the laws of mind as influenced by disease, which, though crude, is invaluable as affording a basis for moral treatment, and for systematising the relations and responsibilities which connect the physician with his patient. It is beginning at the wrong end to learn the physiology from the pathology of mind; but it is better to do this than to stagger and stumble blindly on without a physiology at all. But could we realise the absurdity of a pure metaphysician being entrusted with the study or reconstruction of the mind diseased, the anomaly would be as egregious and disastrous. It would be vain for such an expert to ponder over the states of consciousness as presented in himself, or to form his opinions or his course of practice upon abstract principles or the subjective analysis of intellect, emotion, or impulse; and, though the unwelcome facts might be forced upon his attention that his most delicate crux failed to detect the elements of which a morbid act was constituted, or that a tendency handed down through and by a long line of ancestors— "Through all the blood of all the Howards" perhaps, or that an attack of catarrh, or that a fit of indigestion |