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NORTH AMERICAN REVIEW.
JANUARY, 18 4 5.
Art. I. - 1. A Treatise on the Medical Jurisprudence of
Insanity. By I. Ray, M. D., Superintendent of the
490. 2. Report of the Trial of Abner Rogers, Jr., indicted
for the Murder of Charles Lincoln, Jr., late Warden of the Massachusetts State Prison, before the Supreme Judicial Court of Massachusetts holden at Boston, January 30, 1844. By GEORGE TYLER BIGELOW and GEORGE Bemis, Esqrs., Counsel for the Defend
ant. Boston : Little and Brown. 8vo. pp. 286. 3. The Plea of Insanity in Criminal Cases. By FORBES
Winslow, Esq., Member of the Royal College of Surgeons, London. Boston : Little and Brown. 1843. 12mo. pp. 111.
The great prevalence of the disease of insanity, and especially its remarkable apparent increase of late years, which has nowhere been more observable than in this country, have directed much attention towards it, and caused its phenomena, remedies, and consequences to be studied with great zeal and considerable success. We say apparent increase, because it is quite certain, that the progress of science, or a change in the system of classifying diseases, has recently brought very many cases under this category, which were formerly either ranked under a different head, or else not noticed at all ; and because, from the multiplication of public No. 126.
asylums for the treatment of the insane, and from the philanthropic exertions of individuals, many a poor maniac has been rescued from some dark cell in a workhouse or jail, where he raved forgotten except by one or two brutal attendants, and has been brought to swell the number of patients supported at the public charge. Make proper allowance for the recent effect of these circumstances upon the statistics of insanity, and we do not know of any sufficient proof, that the disease is now actually upon the increase, or that it wears a more threatening aspect than in former years. But the facts which have been brought 10 light respecting its prevalence and its consequences are afflicting enough. The vast ranges of buildings which crown one eminence in Worcester, and another in Charlestown, when we consider that they were erected solely for the accommodation of the insane in the single State of Massachusetts, with less than a million of inhabitants, though they may make us proud of the munificent philanthropy of the builders, affect us with far different feelings when we think of the pitiable fate of the multitude within their walls. In a former article, * we laid before our readers the means of estimating the probable number of the insane in this State, and it is not necessary to revise the gloomy computation. Enough was shown of the extent of the calamity to commend the subject to the earnest attention of every reflecting man and sincere philanthropist.
The facts, appalling as they may seem, may not be enough to support the startling theory which has been advanced, that insanity increases with the progress of civilization, and that the number of its victims in any country will be found in exact proportion to the diffusion of knowledge and the general cultivation of the intellectual powers among its inhabitants. Upon this hypothesis, the disease is like a canker, which appears only in the ripening fruit, while it is unseen in the blossom and the germ. Fortunately it is only a hypothesis, and one which it is impossible to substantiate by testimony, from the difficulty of ascertaining the extent to which the disease prevails among half-civilized or barbarous nations. Nor is it supported by a priori considerations; for excessive activity of mind
the undue tension of the intellectual powers - is far from being the only cause of the malady. Moral causes are at least
* N. A. Review, Vol. LVI. p. 172.
equally operative. Intemperance, licentiousness, violent passions, the more gloomy forms of superstitious belief, and many purely physical circumstances, are very active in scattering the seeds of the complaint, and all these may be as frequent and as efficient among savages as with civilized men. Unquestionably, there are certain states of cultivated society - and we sear our own social system is to be ranked among them - which are very favorable to the growth and development of this, terrible disease. Where wealth and distinction pass rapidly from hand to hand, where the prizes of life are held up in glittering profusion in a race open to all comers, and where emulation, avarice, and ambition are consequently stimulated to the utmost ; where the young are most affected by such excitements, and precocity of talent is most observable and most favored; where a general license of speculation exists on all topics, especially on politics and religion, and where advanced systems of education, and the peculiarities of democratic institutions, cause disputes upon these subjects to be carried on among all classes, even the lowest in the community, so that they fill the void in every one's life which is occupied in other countries by less agitating popular amusements; in short, where all the causes of mental anxiety and agitation are so rise, that excitement becomes habitual to the mind, and there is a perpetual longing for it ; – there insanity may be expected to become an epidemic. These circumstances may not operate as immediate and efficient causes of the disease; but they prepare the ground for it, so that every seed which may happen to fall is sure to vegetate.
But it is not our object now to discuss either the statistics or the causes of aberration of mind. The questions of law which grow up out of the existence of insanity are numerous and important, and our present purpose is to consider these legal relations of the disease. Viewed under this aspect, the topic becomes a sort of neutral ground between the professions of law and medicine; and its intrinsic difficulties are not lessened, when the conflicting opinions, principles, and hab'ts of mind of two very different classes of persons are brought to bear upon it. In the publications named at the head
of this article, and in other writings upon the subject, nothing appears more plainly, than the violent contrast between the lawyer's habitual veneration for fixed maxims and long established precedents, and the rather loose empiricism
of the physician, who welcomes every new case as the possible basis of a new principle, and almost every novel theory as affording at least a more accurate method of classifying the various forms of the malady. Each is naturally watchful over his own jurisdiction, and jealous of the other's encroachments; and the uninstructed multitude, belonging to neither party, look on with amazement, wondering who shall decide when doctors and judges disagree. A reviewer may be presumed to be neutral, and is therefore guilty of less arrogance than is usual, when he undertakes to be umpire between two disputants, or to write upon matters in which he has had no professional experience.
Dr. Ray's work is already favorably known to the public, having passed through one edition, and being frequently cited with respect both by lawyers and physicians. The writer is eminently qualified for his task by long professional experience, much study, and an acute and reflecting turn of mind. He has the rare merit of not dogmatizing upon a theme which has occupied so much of his attention, and which he has had so great facilities for studying, that he may reasonably suppose himself to be more able to form a correct judgment upon it than most other members either of the legal or medical fraternity. His conclusions are adopted with care, cautiously expressed, and supported by an abundant array of facts and arguments. He leans, as is natural, towards' his own profession, and manifests some impatience at the pertinacity of the lawyers in applying ancient legal maxims to cases of insanity, which ought rather to be governed by principles derived from the enlarged experience and improved science of the present day. But this preference is not unreasonably indulged, and the writer often shows considerable tact and versatility of mind in contemplating his subject under its exclusively legal relations. If he has any undue bias, it proceeds from the doctrines of phrenology; for although he nowhere expresses his belief in this pretended science, and even cautiously avoids any use of its terminology, we can trace its effects here and there upon the formation of his opinions. And we cannot share the confidence with which he traces all the forms of mania to disease of the brain, and denies that it can ever be attributed solely to an affection of the immaterial principle. Many instances of monomania, unquestionably produced by brooding too long and too anx