The insanity which accompanies epilepsy, known as epileptic insanity, has been studied with care, and many important conclusions have been reached. In this form the acts of the subjects are extremely sudden and independent of the will, and are of a strong homicidal tendency, and after the attack has passed away they are unable to remember anything that has transpired. The pathology of insanity is an exceedingly interesting study. There is often, in addition to evidences of cerebral and membraneous congestion, thickening of the bones of the cranium, and adhesion and thickening of the dura, mater. Blood cysts are often found in the arachnid cavity, and there is great wast ing of the cerebral substance, the brains of the insane weighing less than those of per sons dying of other diseases.
The treatment of the insane is often difficult, requiring an intricate knowledge of various diseases, and great experience antong insane patients; but the most important element of success, under all circumstances, may be embraced in one word—humanity.
The wretch who neglects or maltreats the unfortunate subject of mental derangement intrusted to his care, if not himself insane and irresponsible, should be regarded with universal contempt.
According to the census of 1870—the latest official authority at present obtainable— the total number of insane persons in the United States (besides idiots, 24,477) was 37,382, in a population of 38.555,983. In England the total number of insane, includ ing idiots, was, in 1870, 54,713, in a population of 22,090,000; in Scotland, 7.571, in a population of 3,222,837; and in Ireland, 17,194, not including idiots, in a population of 5,195,236. In France, in a population of 37.988,905, there were in 1866, of insane per sons, 50,726. It may be estimated that the number of insane in Europe, in 1866, was about 270,000. The following table includes a list of the public and many of the private insane asylums in the United States, with the number of patients: