« PreviousContinue »
the late Dr. Adams, on the subject of hereditary distempers, in which the apprehension of perpetuating diseases by a general admixture of society is combated with a good deal of force and effect. This admixture, Dr. Adams maintains, so far from having the influence which is usually ascribed to it, produces the very reverse effect, and ultimately becomes a cause of the extinction, instead of an increase of the evil. If this view be correct, one imaginary source of the regular increase of mental disorder may be fairly placed out of the general calculation; and we may add, as an incidental remark, that public feeling need not be so anxiously alive to the hereditary perpetuation of particular disorders, as we find for the most part to be the case. 'May we not trace (he says) a provision against that deterioration of the race which the great apprehension of hereditary maladies supposes, in that revealed law by which any sexual intercourse between near relations is forbidden? This prohibition, as far as we can judge, proves sufficient to prevent the too great influence of such an hereditary cause, since the number of maniacs does not increase in proportion to our increased population, and the great exciting causes of madness, namely, increased wealth, and other sources of ambition. Seeing, then, how little is left in so important a concern to the operation of human institutions, have we not reason to be satisfied with the provisions of nature, and with the divine commands? Yet in the most serious of all hereditary peculiarities, the great susceptibility to madness, celibacy has been recommended as a duty. Before we venture to propose measures contrary to one of the first impulses of nature, and to the first blessing which the Almighty fiat bestowed on man, it becomes us seriously to weigh the consequences. These restrictions, Dr. Adams goes on to maintain, are not only unnecessary, but inefficient; for the first appearance of the several maladies deemed hereditary, must, unquestionably, in all cases, have been independent of parental communication; and we see these maladies every day occurring without being able to trace them back to progenitors, unless we proceed too far, even for the most credulous on the subject of lineal descent. It is only where the principle of seclusion is acted on, that Dr. Adams conceives the perpetuation in question is effected. ( Goitre and cretinism (he says) are endemical in certain places, from no other causes than hereditary propensity commencing in certain individuals, and continued by sequestration, and constant intermarriages,' implying, that had the first sufferers from this complaint not been expelled from society, but suffered to marry such as were free from it, the disease would in no long time have vanished. The idiotcy attendant upon the complaint, he traces to the same cause, since, (as he pointedly observes,) the unhappy sufferers
VOL. XXIV. NO. XLVII.
sufferers have been deprived, by this expulsion, of the advantages of progressive civilization, and have thus become cretins. Dr. Adams presses this argument, which is a favourite with him, somewhat too far, in our opinion; but whether we allow that the circumstances of cretinism, (which have never yet been fully explained,) make any thing for or against his principles on the propagation and perpetuation of disease, we fully agree with him that the restrictions against union, on the score of hereditary complaints, have been in many instances unnecessarily severe. Were madness, gout, scrophula, as absolutely hereditary as has been supposed, the world by this time must have presented nothing but one vast lunatic asylum or universal lazar house.
That a disposition to disease is communicated from parents to progeny can only be denied by a determined spirit of opposition to fact; but this very disposition may be often turned to good account, by occasioning more caution in respect of exciting causes: and here we may slightly observe on the power of art in conquering those evils which are themselves the produce of art. It has been suggested that if the development of intellect had not kept pace with structural complexity and consequent increase of physical excitability which are the results of social refinement, and had not this development of intellect furnished a principle of counteraction proportioned to the increase of danger, man instead of commanding upon the face of the earth, would have been the first species in the order of nature to disappear from its surface.' This assumption partakes too much of the organic creed, and is one either of system or enthusiasm; but in a certain sense we believe it to contain the ingredients of truth: for although there is an increase of susceptibility to external impression in proportion to the progress and development of intellect, the very source of the evil manifestly becomes a remedy for it, and thus the indefinite progress of both moral and physical disorder is providentially provided against.
But why, it will be said, adduce arguments, and seek for principles, in order to determine a question which is palpably one of fact? Does it, or does it not, appear, by a comparative examination of records, whether instances of insanity are more numerous now than they were formerly? There is however no datum extant by which the relative proportion of lunatics of the present with past periods may be satisfactorily estimated; for the London Bills of mortality are so proverbially deficient, both in science and accuracy, as to defy the deduction of any correct inference from their statements. Here we must permit Dr. Burrows to speak for himself.
Finding,' he says, no decisive evidence on the important point, whether insanity is actually on the increase, and being anxious to throw all
possible light upon it, I obtained the number of pauper lunatics annually applying to the parish of St. Mary-le-bone. The population of this parish is equal to that of most cities (above 80,000); and is most rapidly augmenting; and as this district constitutes an integral part of this great metropolis, it naturally participates in all its vices, and consequent incentives to mental derangement. As the absolute number of admissions may be relied upon, and as the returns are open to none of the objections to the Commissioners' register, I conceive this account to be of much weight. It certainly is the best extant upon the subject under. consideration. I have therefore copied and annexed it.
Account of the number of PAUPER LUNATICS of the parish of St. Maryle-bone, London, from 1804 to 1819.
The number of lunatics admitted shews, that no increase of insanity has taken place in this parish since 1808. It was then doubled; this fact however does not imply an increase of the malady; but simply and further confirms my conclusion, that the great increase of entries in the Commissioners' register (a document before referred to) which is nearly contemporaneous with that in the St. Mary-le-bone, was derived from the operation of Mr. Wynne's act, with the passing of which the increase was synchronous.* Although it be not obligatory to make returns of pauper lunatics, yet in the London district, it is common; for all such patients in the licensed houses are very properly and humanely constant objects of the visiting Commissioners' notice, and largely contribute to the entries in their record. Further, there is another coincidence; the number of entries in both registers declined after the year 1813. Were we seeking for proof of the decrease, instead of the non-increase of insanity, a more appropriate one could not have presented than the fore
* The immediate effect of this act was an increase in the number of registered lunatics. Rev. M 2
going return. For when the scale of the annual admission of lunaticsis compared with that of the immensely increased population of Maryle-bone parish, and the still greater of increased pauperism within the last sixteen years, a very opposite result might have been justly anticipated. This return of lunatics, although having relation to a considerable population, yet, I admit, is too local and limited to be decisive either of the general increment or decrement of mental derangement. But the unprejudiced must concede, that it forcibly corroborates the justness of the inferences I have deduced.
The late Dr. Willan conceived, that there were not sufficient grounds for the opinion prevailing in 1800 that insanity was increasing. He computed, that in Bethlem and St. Luke's, and the twenty five licensed houses within the London district, there were then two thousand lunatics. Since, the licensed houses have augmented to thirty. Yet notwithstanding the increase of receptacles, we have the authentic evidence of the parliamentary returns, that in all the hospitals and houses within that circle there were in May 1819, but 2005 lunatics, being an increase of only five in the space of twenty years; though the population has augmented some hundreds of thousands! Dr. Bateman, who follows the track of Dr. Willan, seems to have contented himself with adopting all his predecessor's data on this interesting subject, without adding any new fact or observation; though the parliamentary reports of 1815 and 1816, offered abundant information. He, however, concludes, that insanity has not increased within the last half century. Dr. Heberden, whose authority is always to be respected, seems to entertain the same opinion. Such concurrent testimony surely amounts almost to demonstration.'
In apparent contradiction to these statements and opinions, the recent increase of deaths from lunacy in the London bills, and the addition of the Commissioners' register for the few last years may be adduced; but Dr. Burrows contends, that in neither case is an actual increase thereby indicated, since the powerful interest which the subject of mental derangement has lately excited, compels a performance of duties before neglected; and in this way may be easily explained the augmentation both in the register of admissions and deaths; and he concludes the section of his book devoted to the inquiry under consideration in the following terms.
Whether the question respecting the increase of insanity in England, be judged by the aggregate entries in the Commissioners' register; the account of the lunatics, received by St. Mary-le-bone parish; the records of English lunatic asylums; a comparison of the number at present in the London district with the computation in 1800; with the deaths of lunatics entered in the London bills of mortality; or even with the progress of the population; the more clear is the demonstration that it is not an increasing malady.'
* Reports on the diseases of London, p. 326. By Robert Willan, M. D. 1801. + Reports on the diseases of London pp. 24, 25. By Thomas Bateman, M. D. 1819. Observations on the increase and decrease of different diseases. By W. Heberden.
The above calculations and deductions apply, it will be seen, ́exclusively to our own country; but in corroboration of his statement we are further referred by Dr. Burrows to the registers of La Salpetrière and the Bicètre, both of them large Parisian institutions, and from which it appears that the disorder has not recently increased, except in the year 1817, which was in France a year of great national distress and scarcity. Neither in Germany, except locally, where the ravages and horrors of war were particularly exasperated, has this malady gained ground during the present century.' Sorry are we to add that the reports from Ireland are of a far less consolatory kind. We have lately seen a letter from Dr. Hallaran (the able and excellent physician of the Cork asylum, and author of one of the best treatises extant on mental diseases,) in which a frightful picture is pourtrayed of the present condition of some districts of Ireland as to the prevalence of mental disorder. In his interesting publication, too, we find it remarked that 'the late unhappy disturbances of Ireland have augmented in a remarkable degree the insane lists ;' and there is another cause,' he says, 'of a more general nature which seems likely to add more permanently to the growing number, I mean the unrestrained use of ardent spirits, that alarming vice, so inimical to domestic peace, to every moral virtue, and to political security.'
But the unfavourable reports from either a Cork or a Dublin physician cannot be considered as an absolute test that the disease is on the increase. Ireland not being regulated by the same poor laws as England, there are no houses in which pauper lunatics are confined, and the circumstance of their being at large must augment the apparent number; but besides this, a general and just impression has obtained, that both in Dublin and Cork the treatment of lunacy is far more successful than in many other parts of the island, and therefore the asylums of these cities have lately been thronged 'precisely for the same reason that the Paris hospitals are stated to have overflowed,' the success in them being beyond measure superior to that of the provincial establishments:—a fact, by the way, which proves that the proportion of recoveries from mental diseases, is greatly dependent upon the means employed for restoration.
In pursuing the inquiry relative to the comparative prevalence of the malady in this and other countries, Dr. Burrows is led into a series of investigations, the results of which must be highly gratifying to those who feel interested for the happiness, and jealous of the character, of their countrymen. Insanity is considered by foreigners in general as the opprobrium of England, and it has long been a practice with Frenchmen, in particular, to reproach us for