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JULY, 18 69.
ART. I. - La Psychologie Morbide dans ses Rapports avec la Phi
losophie de l'Histoire, ou de l'Influence des Névropathies sur le Dynamisme intellectuel. Par le DOCTEUR I. MOREAU (de Tours), Médecin de l'Hospice de Bicètre. Paris. 1859.
Of all the diseases to which our race is liable, we doubt if there is another that touches our interests at so many different points as insanity. In its attacks it spares no class of men; it meets us every day in our courts, embarrassing the course of justice ; its victims are regarded by every Christian state as entitled to special care and protection; and the kind of management best calculated to reconcile the claims of humanity with those of a proper economy has become one of the great questions of social science. Though none of the results of recent inquiries into this subject will compare with those grand discoveries, the circulation of the blood and vaccination, yet taken in the aggregate, and regarded in their indirect as well as their direct and present effects, it cannot be denied that they amount to a considerable contribution to our knowledge.
The course of inquiry respecting mental disease has been greatly hindered by a class of difficulties over and above those incident to the study of all disease. Besides the organic lesion or disturbance, there is the mental affection springing from causes as yet but little understood. The part borne by each of VOL. CIX. NO. 224.
these elements in producing the ultimate result, their common bond of connection, the laws by which they act and react on each other, — all these are problems compared with which those involved in the study of mere bodily disease are trivial or transparent. Moreover, the student found himself, at the very threshold of his inquiry, face to face with the metaphysician and the theologian, by whom he was warned against entering upon their domains if he would shun the pains and penalties imposed upon materialism, and was thus compelled to receive passively whatever they offered him without examining it too closely or curiously. The idea of a humble inquirer who watched the mental phenomena in the wards of a lunatic hospital, and sought for a key to their mysteries amid the blood and filth of a dissecting-room, questioning the sufficiency of those speculations which the world had been accustomed to regard with an almost sacred awe, implied a sort of presumption that bordered on sacrilege. On this point, there is now little room for complaint. The freest investigation may be pursued without provoking censure, and a man may come to almost any conclusions in such studies without being thought an enemy of religion or morality.
These hindrances to the study of morbid psychology served to prevent much progress in it until within a comparatively recent period. Observers were content with recording the more obvious manifestations of mental and bodily disturbance; they made autopsies, faithfully describing every lesion and change; and they tried new medicines and new appliances. But there came no results worthy of so much labor. It scarcely helped to dissipate the obscurity that hung over the whole domain of mental disease. It furnished no answer to the questions that met the student at the outset of his inquiries. Indeed, people were hardly agreed in considering insanity a legitimate object of physiological inquiry. It was thought by many to be something quite outside of the operation of natural causes, — probably a visitation of God or the Devil. Only fifty years ago, it was declared by a distinguished German writer (Heinroth) to be the unhallowed fruit of copulation between the soul and sin.
Pursued in such a spirit as this, the most diligent study of insanity could reach no very valuable conclusions. Naturally much attention was given to its causes; but it seemed to be enough to ascertain those prominent, special events that preceded it not very remotely, and to recognize the connection, without much care to understand all or any of the conditions. The first step in the investigation' was simply a record of this connection; and thus, whether the attack had been preceded by a blow on the head, a suppressed secretion, a domestic trouble, a religious excitement, or the turn of life, that particular event, singled out from all the other events of life, was to be regarded as its cause. It was no part of the philosophy of these earlier investigators to explain how such dissimilar agencies could be competent to produce similar effects. No mortal had ever undertaken to trace the successive steps of that morbid process which, beginning with a fall on the head or a disappointment in love, ended in an attack of furious mania or melancholy and suicide. The revelations of pathological anatomy were of doubtful significance to men who were unable to go beyond the visible record, and whom the actual lesions before their eyes taught nothing respecting those that had preceded them. They looked for something, they hardly knew what, and what they found left the mystery as deep as ever. The tumor, the abscess, the inflammation, the thickening, the serous effusion, were thoroughly examined and minutely described; but whether they had caused the insanity, or the insanity had caused them, was far from being a settled point. Certain mental phenomena during life had coexisted with certain phenomena discovered after death, and to know this fact seemed to be a positive gain in which they had a right to rejoice. Names and phrases were mistaken for ideas, and a collection of barren facts for a treasury of invaluable knowledge.
It was reserved for a recent generation to see the study of insanity pursued with reference to its proper aims, under the rules and in the spirit of a liberal science. Pinel began the reform by discarding many of the time-honored notions connected with it, and throwing upon its difficulties the light of a broad, sagacious, and disciplined intellect. Esquirol, though very differently endowed, contributed to the same end, by observing and recording a great many cases, with a degree of clearness, precision, and graphic art never exhibited in the same field before. Following the same style of observation, their successors have entered upon a line of inquiry which shows the highest conceptions of the end and aim of their researches. Prepared by a severe professional training, with the objects of their peculiar study thronging around them, they have succeeded in taking that necessary step which consists in the correct appreciation of the relative importance of facts; and, while not despising the results of their predecessors, they seek for something more worthy the name of what Bacon calls the fruit of scientific investigation. Although they think it well enough to know how many patients in a hundred recover and how many do not, how many are over a certain age and how many under, yet they deem it far better to ascertain, if possible, those primordial movements which initiate mental disorder, the conditions under which the integrity of the mind is preserved, and the laws which regulate the transmission of the morbid germ from one generation to another. Among the investigators of this school, none has achieved a more honorable or permanent distinction than the author of the work before us. To the abundant opportunities for observation afforded by the private asylum at Ivry and a long service at the Bicètre, he joins a knowledge of character derived from much intercourse with the world, and that kind of intellectual discernment that can see in a fact something more than what directly meets the eye. He is entitled to all the credit that belongs to an accurate observer, a laborious student, and an original thinker. No one interested in studies of this kind can safely neglect his works, for they indicate, better than those of any other writer of our times, the immense stride which the study of morbid psychology has made since the last century.
The work before us furnishes a new and very original interpretation of the facts of psychological science, well calculated to excite the scorn and derision of all who adhere to the beaten track, and the admiration of those who rejoice in bold inquiry, though they may not accept the conclusions to which it leads. If any apology were needed for bringing it up at this late day, it would be enough to say, that it is but little known in this