N.Y., in an admirable article on Mental Hygiene, may, perhaps, serve to throw some light on the peculiar psychical phenomena indicated by the murderous instances which we have briefly recorded. After speaking strongly of the too prevalent weakening in the States of domestic ties between parents and children, and the unhappy effects which this exercises upon the moral tone of the latter, he makes the following observations :—

"We proceed to speak of the theory and practice of our boasted republican civilization, whereby the healthy rule in regard to the influence of parental and other example, upon the formation and development of mental and moral character, though recognised theoretically, is, in numberless instances, nullified in all its practical operations. In this connexion we would call especial attention to the importance of faith as an element of mental and moral health and power; faith in the good and true in man; faith in the goodness, truth, justice, and daily guidance of a Heavenly parent, to whom we owe reverence and obedience. The great minds that have arisen in the world's history; that have influenced and controlled the destinies of untold millions of their fellow-men; given form to their social, political, and religious institutions; contributed in the highest degree to the development of the arts and sciences, and to the progressive welfare of the human race, have derived no inconsiderable portion of their power and influence over other minds, from the faith which infused their own. If such a faith be an important element in strong and healthy character, it follows that a social life, which scatters widely the seeds of distrust and doubt, which develops precocious ideas of independence and freedom, instead of dependence and obedience, and allows the youthful mind to become familiar with evil in some of its most alluring forms before it is prepared to judge intelligently, cannot exert other than a vicious, unhealthy influence upon the physical, moral, and intellectual well-being of the present and future generations. That very many of our youth are exposed to such malign influences, at a period of their lives when they should be most carefully shielded from them by parental example and care, is but too plainly exemplified in the prominent traits of character peculiar to young America,' and in the steadily increasing stream of youthful depravity, crime, and disease. Later in life we may trace the evil through our whole social fabric, everywhere a prolific source of unhappiness, suffering, wrong-doing, and disease, both physical and mental.

"There are some, but they compose a small and scattered minority in many communities, who correctly appreciate the importance of a stable foundation, on which to rear the superstructure of physical, moral, and intellectual manhood. They are worthy of all honour for their steadfastness of purpose and adherence to the right, in the midst of the general laxity which so universally prevails."

Before terminating our Retrospect, we cannot avoid directing attention to a case which occurred early in the quarter, in the Westminster Police Court, and which is a singular illustration of popular information concerning lunacy.

A middle-aged man, who believed that he was Oliver Cromwell, occupied lodgings in Westminster. He was supposed to be under a sort of surveillance by the landlord, although it appeared that he had

3 American Journal of Insanity, January, 1859.

almost uncontrolled command of his actions in going in and out of the house. It further appeared that the lunatic had certain warlike propensities, and that he was permitted, in the indulgence of these propensities, to arm himself with sundry murderous steel weapons, made and even ornamented to his own pattern. One morning he quietly entered the room where his landlord was seated, and, going behind him, felled him to the earth with a tremendous blow, given by a heavy steel bar, one of the warlike implements referred to. The landlord was much hurt, but fortunately for him the blow did not prove fatal. In due time the lunatic was arraigned before the magistrate for assault, and the instructive portion of the business was this; the landlord asserted that until he was struck down he had never for a moment thought that the lunatic was dangerous. Notwithstanding that the lunatic had a fancy for offensive weapons, and expected every moment to be called upon to defend his rights or assail the rights of others, still it had not occurred to his keeper that he was dangerous!

This was an exceedingly narrow escape from another horrible butchery by a homicidal maniac at large, and it ought to teach the press, who are too apt to cavil with the alienist who is desirous of placing lunatics of this species under durance or strict watch, that it is only by sequestration or constant surveillance that the public can be protected from their dangerous tendencies.

THE JOURNAL

OF

PSYCHOLOGICAL MEDICINE

AND

MENTAL PATHOLOGY.

APRIL 1, 1860.

ART. I.-ON HABITS OF INTOXICATION AS CAUSING A TYPE OF DISEASE.

"DOCTOR, I will give you a wrinkle," said a friend to us not long ago, as we were gossiping concerning wine, and an attendant was directed to descend into the cellar, and bring from a particular bin a bottle of champagne. It may be as well, perhaps, to remark, lest the uninitiated should stumble over the term, that a wrinkle, in the refined slang of the day, signifies a little bit of practical wisdom. The phrase is highly metaphorical. Worldly wisdom increases with years; so also do the furrows which indent the forehead. Therefore an increase of wrinkles on the brow may be regarded as an index of increasing sapience, and a wrinkle may legitimately stand as a figurative synonym for an item of practical wisdom. This by the way. The champagne was in due time placed upon the table, and the sparkling fluid had a most agreeable taste and refreshing effect, for the evening was hot and stifling. "Well, how do you like the wine?" inquired our friend. "A pleasant drink for a scorching day," we replied. "Read that," he said, putting into our hands the cork which had just been extracted from the bottle, and pointing to the inner extremity-that which had been in proximity to the wine. There we saw and read, not a little to our astonishment, the formidable word MORT, printed in clear bold letters. "That," said our friend, "is a trade-mark, and when you see it affixed to the cork of a champagne bottle, you may rest assured that no grapes ever contributed towards the formation of the wine."

This was the wrinkle; but the singularity of the trade-mark awoke other thoughts than those immediately connected with the utility of knowing it. Should there have been a full stop after

the different letters-each having a specific signification, the formation of the word being merely accidental? Or was the trademark such as we read it, Mort-Death-and if so, was its adoption a Mephistophelian satire of the wine-merchant on the wine vended? Truly, a reversed cork so stamped and placed upon the plates of the guests at a feast might well serve the purpose of the puppet-mummy introduced during the course of an ancient Egyptian banquet; or might convey as homely but as forcible a lesson as that taught in Holbein's drawing of the toper in the Dance of Death, in which Death is represented as officiously pouring the inebriating drink into the mouth of one of the carousers. Or may we regard this trade mark as a foreshadowing of that time, which Dr. Magnus Huss tells us, in his work on chronic alcoholism, he doubts not will sooner or later arrive, when alcohol will no longer be known as aqua vitæ but aqua mortis.

And, indeed, as we become more and more familiar with the remote effects of alcohol upon the system, in whatever form the potent spirit be consumed, we cannot resist the conclusion that, as too commonly used, it would be more correctly termed aqua mortis than aqua vite. It will be well briefly to recal a few of the reasons which justify this inference, as in so doing we shall best pave the way to the subject-matter of this article.

Mr. Neison, in his researches on the "Rate of Mortality among Persons of Intemperate Habits," shows that in the instances he investigated, at the term of life 21-30 the mortality was upwards of five times that of the general community; and that in the succeeding twenty years of life it was about four times as great, the difference becoming less and less as age advanced. "If there be anything, therefore," he adds, "in the usages of society calculated to destroy life, the most powerful is certainly the inordinate use of strong drink."*

Again. of the immediate causes of death among the intemperate, Head diseases (Nervous system) ranked most prominent, while diseases of the Digestive organs and dropsy, and diseases of the Respiratory organs were about on a par, although showing a comparative difference of very considerable importance. Now the deaths from Head diseases among the population of England and Wales, aged twenty and upwards, constitute only 9.710 per cent. of the deaths from all causes at those ages; but Mr. Neison tells us that among the intemperate classes they constitute 27.100 per cent., being nearly three times as great. With other diseases," continues this gentleman, " similar differences will be found. In the general community, the deaths from diseases of the respiratory organs, at the same period of life, amount to 33-150 per cent. of the * Vital Statistics, 2nd edit. p. 205.

deaths from all causes; while among the intemperate group they are only 22.980 per cent. of all the deaths."* Of the Head diseases among the intemperate, upwards of 50 per cent. were recorded as "delirium tremens."

Further, while the mortality from the two groups of Head diseases and of the Digestive organs forms 15 950 per cent. of the deaths from all causes, at corresponding ages, the mortality from the same groups of diseases among the intemperate forms 50:40 per cent. of all the deaths that take place, or more than three times

the general average. These may, therefore," writes Mr. Neison, "be regarded as the distinctive type of the causes of death among intemperate persons; and the predominance of deaths assigned to such causes in any particular collection of facts, may fairly, in the absence of other and more direct evidence, add to the inference of irregularity of habits having prevailed to an unusual extent."+

If, then, the inordinate use of alcoholic beverages exercises so lethiferous an influence, it must be conceded on this ground alone, that the subject is one of sufficient gravity to claim the most careful attention of the practical physician. In our systems of medicine it is, however, customary chiefly to direct notice to the more immediate results of excessive indulgence, and these alone find a place in our nosological arrangements and mortality records. Not that the more remote effects of intemperance have been, or are overlooked or forgotten. Far from it; for the subject is one having such important bearings upon the moral, intellectual, and physical deterioration of individuals and of nations, and even upon the extinction of families and races, that much research has been and still is being devoted to it. And yet with all this the more remote morbific results of intemperance have not been so fully appreciated as to receive a legitimate position in systematic medicine, and until this requirement be fulfilled several evils must be perpetuated. First, the records of mortality and of sickness being thus far imperfect, from them no satisfactory measure can be obtained of the lethal or deteriorating influence of intemperance on the whole population. The nosological system adopted by the Registrar-General marks in two instances only-intemperance and delirium tremens-death as a result of excessive indulgence in strong drink. It is manifest that these examples can embrace but a small amount of the mortality arising directly from intoxication. The nosology of the Registrar-General is that, however, which principally governs the systematic teaching of physic in our schools of medicine. Hence a second evil, to wit, that the attention being fixed mainly upon the immediate ills arising from intemperance, we are apt to -* Op. cit., p. 221. + Op. cit., p. 222.