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0 360. Of perception in cases of total or delirious insanity. We may illustrate the general views of the last section by a reference to the power of perception. It will be recollected that perception involves something more than mere sensation; such as the reference of the sensation to the outward cause, and not unfrequently acts of judgment distinguishing one cause from another. Of course it follows, if the power of relative suggestion or judgment be disordered, as it is in all cases of delirium or total insanity, the disordered condition of the power of perception will be likely to be increased.--This is the case, in particular, in respect to what are called Acquired perceptions. In visual perception, for instance, all objects at first seem to touch the eye. Accordingly, our estimate of distance by the sight is not, properly speaking, original knowledge, but acquired. What we term perception of distance is not a mere act of the eye, a mere visual apprehension, but always presupposes certain preceding acts of the judgment. But in delirious insanity the power of judging is subverted and lost. Hence the delirious man necessarily mistakes in the perception of distance, and it is no uncommon thing to find him attempting to throw himself from the windows of an upper story or down the brink of a precipice. Such attempts can be accounted for on no other supposition than a mistake of sight, founded not so much on a false sensation as on a false or perverted jndgment, involved in the complex act of visual perception. The same causes which perplex his perceptions of distance, also confuse his notions of extension, of the form of bodies, and of the outlines of any object of sight whatever.
Ø 361. Of association in delirious insanity. In the form of insanity which is termed DELIRIOUS, the principle of association is not unfrequently found to be greatly affected. Rapidity of association was given as a characteristic of that form of partial insanity which was termed light-headedness or" demence." But in delirium it often exists in a far more striking degree. In lightheadedness, the direct and indirect influence which is retained and exercised by the will over trains of thought,
is only diminished; in delirium it seems to be wholly annulled. Every new object, every new countenance, every noise heard in the room where the delirious person is, or noises that are heard from without; indeed, everything with which thoughts and feelings have been formerly associated, revives those ancient trains of mental acts. They are poured in upon him like a flood; and it is easier to conceive than describe what a tumultuous chaos the mind in such a condition must be. When we consider that these uncalled-for trains of thought are thrown in upon the maniac when his system is in great nervous excitement, and that he is unable to resist or to regulate the instantaneous transference of the mind from subject to subject, it is no wonder that he should exhibit, as we often find that he does, much external agitation, wildness of countenance, violence of gestures, and outcries.
Ø 362. Illustration of the above section, The following account of the rapid mental transitions of an insane person in the New Bethlem Hospital, London, will go to confirm and illustrate what has been said. Like all characteristic sketches of insanity, it is a melancholy picture. Difficult as it is to conceive that such an endless series of topics should be crowded into the mind in a space so short, it is only what is realized in all cases of delirious insanity, where a derangement of the laws of association is the prominent trait.—“Wholly unlimited by the identities of time, place, or person, he instantly accommodates each to his fancy, and in a moment he is anywhere, and everywhere, and anybody, by turns. At one time he imagines himself to be the Lord Chancellor, or, as he emphatically styles himself, “Young Baggs; and no mortal tongue ever maintained the loquacity of the law, or talked with more incessant volubility, than his imaginary lordship. He would decide ten thousand causes in a day; he would accuse, try, condemn, and execute whole nations in a breath. His language was as wild and far-fetched as his fancy was various; topics of all kinds seemed to come tumbling into his mind without order or connexion. Of every name he heard mentioned he instantly became the personal representative,
and says, 'I am he;' thus he is by turns Bonaparte, the King, the Duke of Wellington, Lord Londonderry, the Persian ambassador, Mr. Pope, Homer, Smollet, Hume, Gibbon, John Bunyan, &c.
“ He is successively a Hottentot, a Lascar, a Spaniard, a Turk, a Jew, a Scotsman. He has been in all situations and occupations of life, according to his own account; a potboy at Hampstead, a shoeblack, a chimneysweeper, an East India Director, a kennel-raker, a goldfinder, an oyster-woman, a Jew cast-clothesman, a police justice, a judge, a keeper of Newgate, and, as he styles it, ‘His Majesty's law iron-monger for the home department:' nay, he has even been Jack Ketch, and has hung hundreds; he has been a soldier, and has killed thousands; a Portuguese, and poniarded scores; a Jew pedlar, and cheated all the world; a member of Parliament for London, and betrayed his constituents; a Lord Mayor, a bishop, an admiral, a dancing-master, a Rabbi, Grimaldi in the pantomime, and ten thousand other occupations, that no tongue or memory but his own could enumerate. The specimen just given may serve as a sample of what is passing in his fancy.”
Ø 363. Of the memory in connexion with delirious insanity. The memory, too, whatever perversions it may suffer in partial insanity, is, as a general thing, still more unfavourably affected in delirium. The memory, it will be recollected, holds nearly the same relation to association that perception does to sensation. That is to say, it embraces something more; and this additional element is an act of the judgment, a process of comparison. If, therefore, the action of the judgment is annulled or greatly perplexed, as it always is in delirium, the malady of the memory, whatever it may happen to be, is unquestionably increased by that circumstance. Under such circumstances, the memory is not only like a ship without a rudder (a comparison which is frequently employed to illustrate its disordered action), but is coasting a shore where there are no buoys or lighthouses. The surrounding beacons of the mind are extinguished; the landmarks which nature had erected in other departments of the
intellectual empire are obliterated ; and there is nothing exterior to itself to indicate either the mistakes or the certainties of its position.
Ø 364. Of the power of reasoning in total or delirious insanity.
If we further examine the subject of total insanity in connexion with the faculty of reasoning, we shall find results somewhat similar, or perhaps even more marked, more onfavourable. In partial insanity, it is true that the reasoning power is sometimes greatly impaired in every respect, whether we consider the mere act of comparison, or the elements which the act of comparison attempts to combine together. But it is not unfrequently the case, that in that form of insanity the deductive power remains essentially sound, so far as the process, or act of comparing and combining, is concerned, and is erroneous in its results merely in consequence of a mistake in the elements which it employs. In other words, the error is not so much in the acts of comparison as in the propositions which are compared together; the superstructure, in itself considered, is well enough, but the foundation is defective.—But in total insanity or delirium, there is, for he most part, neither the one nor the other; neither the basis of the building, nor the materials and requisite powers with which to erect it.
All reasoning, it is obvious, must have something to start from; some amount of knowledge, whether more or less, constituting its beginning, its antecedent position; but in total insanity, still more than in partial, the alienation that pervades the mind has infected and disordered the elements of thought, in addition to the inability of comparing them together. The ability to compare implies a healthy condition of the powers of association and relative suggestion, both of which are disordered in delirium. Of course, the two great conditions of sound reasoning, viz., sound knowledge to begin with and unimpaired powers of comparison, are wanting. Under these circumstances, we leave it to the reader to judge whether we may not reasonably anticipate that a disordered condition of the reasoning power in total insanity will be more aggravated and hopeless than at other times. The
statements which have been made sufficiently indicate, without our going further into the subject, the leading peculiarities of mental action which will be likely to attend a state of delirium or total insanity, in distinction from any
other and lower form of disordered intellect. Ø 365. Of the form of insanity called furor or madness. It is sometimes the case, that insanity of the intellectual powers, whether in whole or in part, is attended with a sort of dull and moping stupidity of the affections. The subject of it is averse to companionship, takes no interest in the ordinary concerns of life, and seems most to enjoy the little happiness which can be supposed to exist in his melancholy situation, when most remote from the observation of others. But sometimes it is otherwise. The fountains of the inner deep are broken up. There are sorrows profound and inextinguishable, sometimes borne and uttered with a degree of calmness, but not unfrequently venting themselves in impassioned expressions and furious acts. All the corporeal powers of the maniac, at such times, are put to the test; he makes war upon his own friends; he attacks his keepers; he assaults the bars and windows of his prison; and even turns, in the height of his uncontrolled vexation and anguish, upon his own person. It is this form of insanity which is commonly termed FUROR or MADNESS, and which we shall probably find occasion to illustrate more particularly when, as in the progress of this work we shall be naturally led to do, we contemplate the subject in connexion with the Sensibilities.
s 366. Of the causes of the different kinds of insanity. In regard to the causes of insanity, which it may
be proper here briefly to refer to, they are generally understood, whether the insanity is partial or delirious, to be of two kinds, viz., MORAL and PHYSICAL.—In the first place, all diseases which violently affect the physical system, such as epilepsy, fevers, and apoplexy, also injuries of the brain, indirectly affect the mind, and may cause permanent insanity. It is worthy of remark also in regard to an insa ne state of the mind, thatit is in some degree hereditary; hence it is often said of particular families that