stages of cerebral disease, and those of intellectual disorder, clearly belong.

He describes chronic meningitis as a particular and essential disease, entirely distinct from acute meningitis ; but it may, he says, proceed from the latter state, if it be susceptible of putting on this form. The name chronic indicates only the slowness of its progress and its duration, which is ordinarily long, and does not express the mode of its origin.

The physical symptoms which the author describes as ushering in this disorder, or which accompany it throughout, do not materially differ from those of other forms of mania, except a slight embarrassment of speech, a hesitation and slowness in the pronunciation of particular words, and sometimes even a slight degree of stammering; and this is precursory to the mental affection. A difficulty in the motion of the lower extremities is also sometimes remarked.

The mental character of this peculiar form of insanity is a prevalence of ambitious ideas. Bayle conceives he could always discover in the morbid examinations a degree of injection of the pia mater proportionate to the degree of ambitious delirium which the patients evinced.

He further remarks, that there is a striking analogy between drunkenness, in which there exists evident signs of irritation and transient congestions of the brain, with that alienation occasioned by chronic meningitis. Drunken men have their speech embarrassed, and pronounce slowly and with stammering; their walk is unsteady and vacillating, and they describe zigzags in walking; they are ordinarily exalted, and talk without ceasing; their ideas are disturbed and incoherent;-but that which is very remarkable is, that their ideas are always gay and joyous, and constitute very often, though in a much weaker degree than in inflammation of the membranes, a true ambitious delirium.

He concludes, that the kind of mental alienation he has described is the effect of the irritation or inflammation of the gray substance of the brain, which immediately deranges its functions. This irritation and this

inflammation are in their turn direct results of a chronic inflammation of the membranes, which commences on their internal or cerebral face.

Of one hundred dissections of the brain, he did not meet with a single exception, he says, to the diseased appearances which are connected with the symptoms of this form of mental disorder.

Contemporaneous with Bayle's work is another from the same school, by Dr. L. F. Calmeil, on Paralysis, as it appears in lunatics,*

These two pathologists seem to have pursued their inquiries at the same time, in the Royal Lunatic Asylum of Charenton; and though they describe, under different names, the same affection in lunatics, yet as authors appear almost strangers to each other's labours. This is very uncandid and suspicious. Besides, there are some discrepancies in their respective histories which very much shake the credit due to either.+

*De la Paralysie, considéré chez les Aliénés, 1826.

I well remember, when visiting Charenton in 1817, being much surprised to see so great a number of lunatics paralytic, and especially of the lower extremities; nor could I then obtain any satisfactory reason for it. I own I suspected it might arise from some mismanagement, and especially from the effect of damp and cold; to which I thought all the insane patients, both in the public and private establishments in Paris, were too much exposed.

I have since learnt that all the insane military are sent to Charenton. Of those afflicted with chronic meningitis, one-third were military men; and the greatest part of those so affected had served in the campaigns of Buonaparte, and, of course, had been subjected to all the rigours and privations of severe service a fact that satisfactorily accounts for the number of paralytic lunatics, in that especially, and likewise in other French asylums.‹

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When contemporaneous inquirers, even in the same schools, do not generally confirm each other's morbid discoveries; or others, pursuing the same path, pass by them in silence, nay, even positively deny their existence, nothing can be so discouraging to the pursuits of the pathologist.

Nevertheless, the ardour of anatomical researches must not be relaxed on this account. Enough of success has attended to stimulate wider investigation. We owe the great discoveries of a Newton as much to the errors of his predecessors, as to the acuteness and energy of his own innate genius.

The French anatomists will do well in the career of their inquiries to remember the opinion of Pinel, that there is no necessary connexion between the specific characters of insanity and the nature of the existing cause; and that the phenomena in the living and the dead disclose no uniformity or correspondence. Similar causes will produce maladies quite opposite to insanity, yet the morbid phenomena on dissection may correspond in those who have died insane and in those who never were so.

If the lesions and alterations in the brains of the insane do not indicate precisely the proximate cause of insanity, still they are decisive proofs of its seat in that organ.

Unquestionably, the pathology of cerebral affections is greatly indebted to the zealous and scientific researches of modern anatomists. It would therefore be ungenerous to attempt altogether to throw discredit on the ardour which has within these few years been displayed in investigating the morbid anatomy of the insane; yet it is impossible not to suspect that too much enthusiasm and aptitude for theory have influenced the pursuit ; and that extraordinary facilities for morbid examinations sometimes tend more to encourage speculative theories than to advance truth.

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Thus Bayle, in the table he gives of the anatomical characters of one hundred cases of insane persons, finds in the brain of each various morbid phenomena, uniformly corresponding with the mental symptoms which characterise the malady. Many, however, who have carefully dissected the encephalon with similar mental symptoms, can detect no morbid appearance whatever. Because there is sometimes no change of organisation discovered in cases similar to Bayle's, I will not assert that he is mistaken; but the inference is natural and strong, that this ingenious physician has attempted to prove too much, and more than facts warrant. He is, however, supported in his positions by the observations of Falret, who, by the by, lays claim to be the original discoverer of this morbid condition of the membranes with coincident mental symptoms; and likewise by those of Calmeil and Voisin.* I am bound, therefore, though sceptical, to concede, that the evidence is respectable. Enough so, certainly, to stimulate pathologists to ascertain, by further examination, the accuracy of this new doctrine.

Were the views of these pathologists established, a fatal blow would be struck at the phrenological system.†

Dr. Abercrombie, in his able researches into the diseases of the brain, has observed various morbid conditions of its membranes; and has adopted the term meningitis. His labours, however, were not particularly with a view to elucidate the causes of mental derangement. He describes delirium as an attendant symptom

* Des Causes Morales et Physiques des Maladies Mentales, 1826. As the organ of ambition, self-esteem or love of approbation, is said to present but a point on the convexity of the hemispheres, and the manifestations of the functions of this organ depend on a state of health, and the inflammation extends over the whole surface of the membranes, how is the function in such case to be preserved?

Path, and Pract. Researches in Diseases of the Brain and Spinal Cord, 1828.

of meningitis, but not as being characterised by the peculiar ideas mentioned by Bayle, Calmeil, &c. It appears from the remarks of this acute pathologist, that a very slight vascular injection of the pia and arachnoid membranes is sufficient to produce the most fatal consequences.

Nothing seems to abate M. Bayle's ardour. He has more recently published a dissertation, in which he has endeavoured to shew that a chronic inflammation of the mucous membrane of the stomach and bowels influences and modifies the character of the mental aberrations.* The dread of poison, and repugnance to food, are conceived by this author to be the most constant and essential symptoms which attend on a gastro-enteric state of the digestive tube. One of his corollaries is a truism which every pathologist must admit; viz. that this morbid condition of the mucous membrane of the primæ viæ often exists without mental disturbance. And he might have added, that dread of poison and refusal of food have frequently attended in melancholia, where no trace of gastro-enteric disease could be discovered in the patient while alive, or on the most careful dissection.

Doubtless, it was natural to premise a dyspeptic condition of the digestive apparatus in the cases Bayle describes beyond that his inferences are untenable. From his rapid career, I fear a vivid imagination and fondness for theory are leading his judgment astray; and that, like the patients whose bodies he examines, he adopts illusions for realities.

Rouchoux, Rostan, and other modern French pathologists, in their endeavours to unveil the mystery which envelopes the causes of insanity, describe the very frequent occurrence in lunatics of a morbid condition of

Revue Médicale.