The last mental cause of madness which we shall men tion is the principle of involuntary imitation, operating by the frequent sight of persons in similar circumstances. That this has some influence we may infer from the dread which many individuals nave of entering a madhouse. That principle which leads us, even against our inclination, to adopt feelings, and repeat motions, which make a strong impression on our senses, is very strong in all men. The same principle which makes a panic, (when once begun,) to spread rapidly through an army, which gives the pathos of the orator, and the performances of the tragedian, a si multaneous power over the whole of their respective and: ences, and which has sometimes spread convulsions and enthusiastic visions among large congregations, exerts a similar influence in the production of nervous diseases. In hysteria and epilepsy, the effect is well known. It is not, indeed, so frequently nor so quickly produced in cases of insanity, because this disease, in its decided forms, is more distant front the ordinary state of any sane mind than these casual motions.
On this principle, assisting the hereditary disposition, the repetition of mania in the same family may he partly accounted for. People think with particular frequency and seriousness of any glaring mental aberrations that af fect their near connections. It has sometimes happened that the parent of a person who has become deranged has acknowledged that he felt an apprehension of falling im mediately into a similar state. When the mind is weaken ed by sorrow, it is more easily operated on by sympathe tic imitation ; and the influence of this principle would be more frequently seen than it is, were it not counterbalanc ed by those efforts to maintain fortitude, which are dictated by a sense of the necessity of exertion for diminishing the evils with which a family is afflicted. Even those who have had relations whom they had never seen, who were subject to mania, especially if they died under the disease, must, if they know the fact, be led to think at times of that part of their family history, and certain expressions of coun tenance and manner, arising from such circumstances, may be communicated from one relation to another, and may thus contribute to cherish a diseased train of feeling tend ing to mania. We often find two or more individuals in a family becoming deranged at the same time. This we can attribute only to the influence which the progress of the morbid feelings of each has produced upon the other.
Physicians sometimes differ in their treatment of mania, according to their opinions regarding the comparative in fluence of bodily and of mental causes. Those who have supposed that some sort of organic fault is always the cause of mania, and that the apparent causes of it are merely oc currences slightly contributing to develope the disease, place their chief dependence on the resources of the Ma teria Medica ; they trust to blood-letting, blistering, purg ing, antispasmodics, and the application of cold. This
branch of the subject must be allowed to be of great im portance ; but for the details we refer to our article MEDI eiNE.
We confine ourselves under the present article to the moral treatment, or general management. It is well known that, even after the diseased state has been corrected, and the symptoms alleviated by the judicious use of medicine, a slight occurrence tending to irritate the mind is sufficient to destroy in one moment all the benefit produced, and to fs rise to an immediate increase of violence in the symp toms. Moral circumstances must be attended to from the very beginning. The first and most important step is, to remove the patient from his own home, and from all the objects which he has been accustomed to see. His false notions and harassing impressions are associated in his mind with the objects exposed to his senses during the ap proach of the disease. His relations have become to him, in the first place, stale and uninteresting, and afterwards causes of angry irritation. The places where he has been accustomed to feel perplexity of thought cannot be seen without in some measure reviving it. It can seldom be expected, that in a private family individuals are to be found qualified for so difficult a charge as the care of a maniac. The most favourable situation is a retirement, where the patient will be surrounded by objects which have a composing influence. It is seldom, and only in the most violent form of the disease, that confinement in a dark room is advisable. In ordinary cases, the darkness of night brings with it an increase in the symptoms. The patient should, even for some time after he is apparently well, be kept at a distance from his friends. His impor tunities, and those of his connections, for a premature res toration to his family, ought to be firmly resisted till his recovery is well established. From the too frequent neg lect of this precaution, many violent relapses take place. Dr. Cullen judiciously recommends that, 'where the pa tient cannot be removed, the furniture of his room should be changed. In the Bic'etre at Paris, religious mania was often increased by the presence of the emblems of the Ca tholic worship, and it was made a serious question, whe ther or not all such emblems ought to be removed from the hospital. The propriety of removing all such objects ought not to be doubted. A patient might be hurt by an insult offered to his opinions, but not by a step purely ne gative in its nature.