PUERPERAL MARIA comprehends many forms and degrees of mental derangement. In the experience of Esquirol, these forms presented the following proportions: of 92 cases, 49 exhibited symptoms of mania; 85, those of monomania; and 8, those of dementia. The points of agreement between these widely-differing moral phenomena are, that they occur during some stage of child-bearing, and that they can be traced to physical, but not necessarily common physical causes. Insanity is developed either pregnancy, shortly after parturition, or during nursing. Under whatever eir malady may arise, it is one of exhaustion, debility, and prostration; and this is nearly equally true, whether it be characterized by depression, languor, and pass• iveness, or by extreme excitement and violence. The latter are the features by which it is generally recognized, and which have justified the name by which it is generally known. The similarity to ordinary frenzy is great: there is the same watchfulness, fury, inco herence, the same vitiation of the secretions, and emaciation; and the chief differences between these affections consist in puerperal insanity being invariably traceable to dis turbance of the circulation, or to animal poisoning, and in the short duration of the great majority of cases. The prognosis is in fact, so favorable, recourse to seclusion in an asylum so painful, that'it has been proposed to treat all such cases at home, or that a distinct hospital or sanatorium should be established exclusively for them. When it is
stated that a physical cause may be detected in the puerperal condition, this must not be construed as excluding the psychical elements which enter into the production of all such affections. Thus, it was found by Macdonald, that of 66 cases, only 6 could be attrib uted to a purely physical origin; and that iu the majority, fright, or anxiety, or anger had formed the last or principal of that series of conditions which culminated in alienation. It not merely affects feeble and hysterical females more than others, but in a marked manner those belonging to tainted families. Of 66 patients in the Blooming dale asylum, 17 labored under a hereditary tendency to mental disease. As connected with this point, it may be mentioned that unmarried are more liable to the disease than married women, in the proportion of 11 to 2. This great disparity may partly be explained by the fact that the fallen and unfortunate are, more than any other class of females, compelled to seek shelter in those institutions from which such statistics are obtained.—Reed on Symptoms, Causes, and Treatment of Puerperal _Insanity; Nara, Fag des l'onfrnes Enceintes, des Nouvelles Accouelthes et des KM prices.