Page:Popular Science Monthly Volume 6.djvu/524

508 Dr. Maudsley, and Dr. Tourtellot admits that, however great may be the want of evidence to establish the theory, it is at least a consistent position. Dr. Maudsley says, "To write as if sanity is a thing of the immaterial, and insanity a thing of the material world, is to infer that men are furnished with brains only that they may become insane." Yet it seems that some physicians find it convenient to entertain both theories; and we are informed in this discourse that Dr. John P. Gray, Superintendent of the State Lunatic Asylum at Utica, in a paper read before the New York State Medical Society, on "The Dependence of Insanity on Physical Disease," takes the ground that mental aberration is due to bodily disorder; but, being "no materialist, he does not regard sound mental action as the result of a sound and healthy brain, and denounces such a notion" as "an attempt to revive the exploded vagaries of the French materialism of the encyclopedists and the Revolution." Obviously the superintendent is a politician as well as a doctor.

But, even assuming that insanity is a bodily disease, Dr. Tourtellot maintains that it is impossible to find the indications of it in the bodily structures. He quotes Leidersdorf as declaring any such demonstration "outside the realm of possibility;" while Griesinger, the celebrated German authority, ridicules the "belief that every mental disorder must correspond to a palpable cerebral lesion." The practical evil of the extreme theory, that insanity is in all cases essentially a bodily disease, Dr. Tourtellot thinks to be an undue reliance upon medication for a cure. This leads to the appeal for legislative aid upon an enormous scale, to provide medical establishments for the treatment of the insane. Upon this point Dr. Tourtellot remarks:

Dr. Gray makes the statement in his last report to the Legislature, that "a recovery of four-fifths" (of insane persons) "might reasonably be expected, if treated within three months of the first attack; while, if twelve months are allowed to elapse, the same proportion may be considered as incurable." Dr. Tourtellot replies that this is a fallacy, and states that, in a large number of the cases, the outbreak is sudden and transient, and that "it is quite certain that four-fifths of such patients will recover even without special treatment.... But, on the other hand, patients brought to the asylum a year or more after their attack, are of a wholly different class. Their insanity was chronic, not only in its fully-developed stage, but in the stage of invasion. It was never possible to bring them to an asylum within three months of the date of their attack. Their insanity came on imperceptibly, and opinions might differ months or even years as to the time of its beginning."

In regard to the vexed question of the definition of insanity, the author remarks: