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But again: "It is quite true that when we have referred all he cases of insanity which we can to bodily causes, and grouped them according to their characteristic bodily and mental features, there will remain cases which we cannot refer to any recognizable bodily cause, or connect with any definite bodily disease, and which we must be content to describe as idiopathic. The explanation of these cases we shall probably discover ultimately in the influence of the hereditary neurosis, and in the peculiarities of individual temperament."

Now, what does idiopathic mean in this connection, but an affection of the mind independent of any physical disease, in the way of causation? And again, "peculiarities of the individual temperament" is only another name for the "individual neurosis," or else it means mental idiosyncrasies not necessarily dependent upon any particular neurosis.

My eye has just fallen upon a statement of the argument in favor of the invariably physical basis of insanity, by an American writer, Dr. Earl, of Massachusetts. It is what is sometimes called "an argument in a nutshell." I find it quoted in the annual report of a Western asylum as quite conclusive on the subject. It is as follows:

"Doubtless every observing and reflecting person well knows that mental influences may cause not only bodily disease, but death; and that bodily disease may cause disordered action or manifestation of action of the mind. But there are probably but few who would not give their concurrence in the opinion that, in a person born with both soundness of mind and body, the mind will not become insane so long as the body retains its original health. This proposition granted, the logical consequences must follow, that, the mind being insane, we must seek the cause in corporeal maladies, and to them, in the attempt to cure, we must apply the appropriate remedies. Hence, in each case, the symptoms must be observed, and the medicines prescribed, as in any other bodily disease."

It seems to me that the logic of this argument is, to say the least, lame in one leg. Thus, if mental influences may cause bodily disease, as well as bodily disease produce disordered action of the mind, why may it not also be said that, in a person born with both soundness of mind and soundness of body, the body will not become diseased so long as the mind retains its original health? And then the logical consequence would be that, when the body is diseased, we must seek the cause in mental maladies, and treat them accordingly.

It may be said further, in this connection (and it may help to clear the subject of some confusion), that in the case of insanity, as of consequents generally, it is not dependent upon any single antecedent, but upon the sum of several antecedents. In these days of modern civilization, it is not common to find individuals who do not bear within them an inheritance of constitution, temperament, mental structure, and habits, more or less impaired or vitiated. Besides, in the history of different individuals, the order of succession in the influences culminating in insanity may be quite opposite, and thus their relative force, and the peculiar manner of their working, may differ greatly. So in this matter, as in every other, we single out one of the antecedents, that from its relative importance, or the point of time of its operation, or some other reason, appears to be the inducing agent, and call this the cause, and then speak of the others as conditions or tendencies. In doing this, if it happens that a distinctively moral influence is assigned for the mental derangement, there is nothing, as yet, in the results of physiological or pathological research to allege against it.

When, for cause, the word basis is substituted (as it sometimes is), and it is then said that the basis of insanity is always a physical one, this is a mere begging of the question. It is an assumption, as a fact, of the very point to be proved.

Attention may be called, in passing, to a circumstance that seems somewhat peculiar. Here are two classes of theorists, whose several doctrines and methods have somehow become transposed, so that the method of each is apparently the outcome of the belief of the other. I can think of no better illustration than that decussation of fibres that occurs at the base of the brain, by which impressions originating in one or the other side of the cerebral structure expend their activities in the opposite side of the body. Thus we have one party believing that mind is a mere resultant from physiological action of the brain, and derangement of mind an effect of the pathological condition of the same; and yet believing in the influence of moral causes in the production of insanity, and relying largely on moral treatment in the cure of insanity. On the other hand, we have the author of this paper repudiating zealously these materialistic views of the nature of mind, and at the same time denying the efficiency of moral causes in mental derangement, and professedly putting little faith in the moral treatment of insanity.