be clearly shown that it might aid as a stepping-stone to further research. Dr. Bouchut's work cannot be looked upon in such a light. To accept his generalization would be to adopt an expression calculated to cast a false light upon a class of phenomena, than which we know nothing that presents so interesting a field for, and which so well repays accurate observation and research.

It may be thought that we are giving more attention to Dr. Bouchut's work than is necessary, but truly to some persons newly-invented technical words have an irresistible charm, as if they possessed an occult property. Dr. Bouchut has well suggested, as we have already seen, the harmful influence which words exert at times upon science, and we wish, as far as in us lies, to guard his new word nervosism, from having like injurious results. We do not think that our neighbours require the word, and for those among ourselves who are not content to clothe their ideas concerning the phenomena of which we have been writing, in language which would neither fall short of nor exceed the knowledge they possess of them, the time-honoured word nervousness ought to suffice.

ART. VIII.—DR. B. A. MOREL ON MENTAL DISORDERS.*

DR. B. A. MOREL, who is perhaps best known to our readers by his Traité des Dégénerescences Physiques, Intellectuelles et Morales de l'espèce humaine, has very recently given to the world a treatise on mental maladies. Any work emanating from so highly competent a source would command attention, but this work merits particular notice for two reasons; first, because the author has specially destined it for the use of physicians not alienists; and second, because it is based upon a new classification of mental disorders.

The present work may be fittingly termed a complement to the treatise on degenerations already referred to. In that work, Dr. Morel endeavoured to show that, the psychical and moral as well as the physical deterioration observed in degenerated conditions of the human race, had fixed and definite characters in immediate relation with the causes which gave rise to these conditions. In the work before us he seeks to establish an intimate and constant relation between the form of mental alienation and the cause in which it originates, a natural extension of the idea just mentioned, and he proposes a classification based upon the etiology of mental disorders.

*

Traité des Maladies Mentales. Par le Dr. B. A. Morel, Médecin-en-Chef de l'Asile des Aléinés de Sainte-Yon (Seine Inférieure). Paris. 1860.

We purpose to lay before our readers some account of the nature and mode of formation of this classification, and an estimate of the effect it will probably exercise on the study of mental disorders, if it be accepted by the profession.

In the first place it is needful clearly to distinguish between the necessary and conditional causes of insanity. Thus, for example, meringitis, phthisis, pneumonia, typhoid fever, hypertrophy of the heart, &c., moral impressions, such as fear, love, exaltation of religious sentiment, all the passions, in short, can occasion insanity, but not necessarily so. All who are exposed to these causes do not become insane, or not even threatened with insanity. It is only on condition of a predisposition which determines the action of a particular cause in a special direction, that any of the so-called determining or occasional causes give rise to insanity. The causes called specific, for example, alcohol, opium, &c., and certain idiopathic cerebral affections, alone have the power of producing necessarily permanent disturbance of the intellectual faculties under certain given circumstances.

Now it is requisite that divers elements, which participate equally of the physical and the moral nature of man, be called into action under the influence of the predisposition, and should concur with the occasional cause in order that a new morbid type or a particular form of alienation be formed, which shall stamp all the insane which are attached to this form with a common character.

When, therefore, Dr. Morel lays down the law that an intimate and necessary relation exists between the form of alienation and the nature of the cause which gives rise to it, he is not to be understood as implying that this relation is established under the influence of the least cause, which in inducing the elements of delirium, may ultimately lead to alienation. He holds that the cause cannot be separated either from the individual predisposition, or from the functional disorder, or from the lesion that the cause determines in the organism. Three elements are indeed necessary for the realization of a particular form of insanity, to wit, the predisposition, the occasional cause, and the functional disorder or lesion.

The further development of Dr. Morel's theory of causation will scarcely bear abstraction, therefore we give it in full :—

"If the predisposition does not exist, the occasional cause may certainly induce a disturbance of the intellectual functions, a general or systematic delirium, durable or transitory, an alienation in short, but rarely will this delirium have the character which is observed in particular or essential forms of insanity. Moreover, the prognosis will be all the more favourable because no predisposition exists, and because the state of the patient presents generally conditions of acuteness.

"If the cause communicates to the organism but a passing impres

sion, the delirium which may be occasioned by it will be transitory and fugacious. It is only on condition of originating a durable disorder in the organism, of determining a special lesion of the nervous centres, that the delirium, at first transitory and ephemeral, advances presently to proportions which give it an entirely different character, and which constitute a special form of insanity.

"It is then permanent or durable, general or systematic. It is developed according to laws fixed and invariable; it derives the elements of its activity, of its mode of production, both in the nature of the cause, and in the spontaneity of the intelligence, and in the gravity and progress of the functional disorder or of the organic lesion; it begets insensate determinations, acts of a fatal and irresistible character. It is in short the index of insanity, so called, of that state which, in a psychological point of view, is not only the expression of the general sufferings of the organism, but of this or that suffering in relation with the nature of the cause and that of the lesion. It is in this point of view only that I am able to say that intimate and necessary relations are established between the nature of the cause and this or that form of alienation.

"If it were otherwise, and the forms of insanity were developed in an invariable manner under the influence of the least determining or occasional cause, these forms would be innumerable, and every attempt at classification would become impossible in presence of the multitude of causes which would have the fatal privilege of creating forms of alienation in relation with the specific nature of their action.

"It remains then but to designate the form of insanity by the name of the determining or occasional cause, and we shall immediately see how many errors of diagnosis and prognosis would be occasioned. Does not experience prove to us daily that we are almost invariably induced to attribute to the determining cause the part of final cause, and to neglect thus the real point of departure of the evil; in other words, the real point of departure of that cause which gives to insanity its particular form, which does not permit us to confound one variety of alienation with another, and the insane appertaining to one class with the insane belonging to another?

"It is then indispensable that the cause which conducts to insanity, to that exceptional state which makes man different from himself, it is indispensable, I say, that this cause should derive the elements of its activity in an order of facts or of phenomena which are engendered and which dominate in such a fashion, that if nothing is opposed to this generation and to this reciprocal dependency, there will result from it determined, fixed, and invariable effects, which must necessarily produce not only insanity with all its consequences, but such a variety of insanity rather than such another.”—(pp. 250-2.)

The facts upon which this theory is founded are duly recapitulated by Dr. Morel, and upon the principles contained in it he has framed a classification of mental maladies, in which these affections are no longer characterized by the greater or less degree of exaltation which accompanies the delirium, as is observed in

the states usually named mania, melancholia, monomania, stripidity. These phenomena are but symptoms which may be found in every variety of insanity :

My object," writes Dr. Morel," is to seek in each form the characters which distinguish it from any other form, in such a manner, that the fundamental aspects once being given, we shall be able to recognise to what nosological variety in alienation belongs the individual who betrays either delirium of ideas or acts, or diverse lesions or disorders of the nervous functions."—(p. 258.)

Upon the etiological basis set forth, Dr. Morel divides mental disorders into six principal groups, each of which has several subdivisions. The following is a summary of this classifi

cation.

1st GROUP.-Hereditary alienations.-This group is subdivided into four classes.

(a) The first class includes those in whom the nervous temperament is a congenital fact, in virtue of hereditary transmissions. excessively varied. These individuals are more apt than others to be attacked with insanity.

(b) The second class contains those in whom hereditary transmission is revealed by psychical and physical phenomena, which approximate the insane of this category to a type that may be recognised by the following characters:

"In the course of their existence, insanity is manifested among them much more by delirium of acts than words. They are distinguished by their eccentricities, by incoherence, singularity, and often even by the profound immorality of their actions. Certain remarkable intellectual qualities do not exonerate them from the impossibility of directing simultaneously their faculties towards a wise and useful end. Their creations are rare and commonly their inventions do not fructify. They are partial geniuses, and notwithstanding certain brilliant manifestations, they are struck with intellectual and sometimes even physical sterility.

"In this class are placed a multitude of individuals who indulge in chimerical projects, reformers of the human species, Utopianists of every kind, inventors whose discoveries are impossibilities, or who pursue the verification of insoluble problems (monomanias of certain authors).

"The dangerous acts which they commit in the paroxysms of their insanity, their instinctively bad tendencies, necessitate often the intervention of authority, and their sequestration. Their accessions of mania are of short duration, and in the remissions they manifest to observation the essential characters of their disease: systematic delirium, with haughty tendencies, without general paralysis. They astonish those who notice them but superficially by the apparent lucidity of their reason (mania raissonnante of authors, moral insanity of the English.")-(p. 259.)

(c) The third class forms a transition series between the indi❤ viduals of the second and fourth classes.

In this, the third class, the signs of hereditary taint show themselves at a very early period, even at the most tender ages, by intellectual inertia, and excessive depravity of the moral dis position :

"Their innate tendencies to evil have caused them to be characterized as instinctive maniacs. Incendiarism, robbery, vagabondage, preco◄ cious propensities for debauchery of all sorts, form the sad balancesheet of their moral existence, and these unfortunates, who most commonly have not been fecundated either in respect to physical or moral well being in humanity, and who are in consequence the most direct representatives of hereditary transmissions of an evil nature, people in the greatest proportion our prisons and penitentiary insti tutions from their earliest childhood."—(p. 260.)

(d) The fourth class includes innocents, imbeciles, idiots.

2nd GROUP.-Mental alienations from intoxication.-The intimate relation which exists between the form of insanity and the nature of the cause is, perhaps, more clearly seen in the alienations produced by intoxicating substances than in any other varieties. As in the instance of the inordinate use of alcoholic liquors, certain toxic agents exercise a determinate effect upon the system, each giving rise to peculiar psychical disturbances. Whether man seeks to procure factitious sensations with alcohol, opium, or other inebriating substances; whether he be the victim of working in lead, mercury, phosphorus, or other metals; or he suffer from the use of diseased nutriment, as spurred rye; or from the air he respires being polluted, as in marshy districts; or from the geological character of the soil, as in cretinism, we may look upon him as exposed to the influence of an intoxicating cause, and anticipate that the lesions of the nervous system will be in relation with the nature of the cause.

It may be said that these agents may cause rapid death preceded by more or less furious delirium, escaping from all classification in reference to insanity. This is true, but it is only in the chronic state that we shall have to study the different deliriums produced by these substances. The term chronic alcoholism, employed now to specify poisoning by alcohol, indicates in what manner this question ought to be posited.

Dr. Morel divides into three classes the morbid varieties included in the group of alienations caused by intoxication.

(a) The first class contains the varieties produced by narcotic substances employed to procure factitious sensations, and by the deadly influence of certain forms of industry. This class includes the effects of alcohol, opium, and other narcotics; also the morbid effects of working in lead, mercury, phosphorus, &c.