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Again, it is hardly necessary to call attention to the negative and unreliable character of statistics, in the mass, collected as these must necessarily have been. With your experience, I only need to allude to some of the difficulties in the way of getting any considerable or accurate history of cases. The persons who bring the patients to an asylum are often ignorant; and, when not ignorant, with very little real knowledge of the case. The access of the disease is often so gradual; the occurrences happened so long ago; the mental and physical symptoms are so slightly deviated from the normal standard, or run so nearly parallel, that there would be a liability of mistake in assigning causes in the case of an intelligent, unprejudiced, and careful observer. By general acknowledgment, too, in many cases the insanity is the result of a combination of influences. Even when the opportunity is afforded of obtaining medical testimony, the party giving it may either be ill prepared to discriminate properly in the matter of causation, or takes the cue for his answers from the questions sent him from the asylum. But with intelligent friends and an educated physician to observe, in any case, you then have the fact that, in regard to all subjective symptoms of mind or body, the insane person's own testimony is of little value, even when he is disposed to give it. What he should feel, he is not conscious of; and his supposed feelings are morbid or imaginary.

Dr. Brigham, who originated the tables of statistics of causation at the Utica Asylum, in his first report, thus expresses his opinion as to the proper estimate to be placed upon them: "The causes of many diseases are obscure; those of insanity are often peculiarly so. Hence, we find few authorities attempt to give any thing but the supposed or probable cause. We have endeavored to be as accurate as possible in investigating the cause of insanity in each individual admitted. We have interrogated relatives, neighbors, and physicians (so far as we have had opportunity), who were knowing to the cases sent to us, and have neglected no means in our power for ascertaining the exact causes of the attack. In many cases the evidence thus obtained has been satisfactory, and we feel but little doubt of the correctness of the causes assigned, but in many others we have not obtained such evidence as to enable us to state them with confidence."

After six years' experience at Utica, Dr. Brigham reiterates the same opinions, in similar language; adding, "we have given a table of supposed causes, but do not attach any great value to it." In his administration, the ratio of unascertained causes was an increasing one; that is to say, he was less and less satisfied with the evidence furnished in the matter of causation. After his death, the percentage of unascertained causes fell from 33 to 10 per cent; that is to say, his successors had more faith in the correctness of assigned causes.

We may now examine the table of causes, as upon this the argument of the paper is based. As I have before mentioned, it starts with an error. It includes, in the percentage-table, the cases where the causes are unascertained. Any one familiar with statistical tables will see that this confuses the comparison made, and vitiates the ratio or percentage. I have therefore revised the table, leaving out the unascertained causes. I also give a revised table of percentage of cases from religious excitement during the six years that Dr. Brigham was in charge at Utica.

Of the table, it is said in the paper: "Here we have a gradual and marked decrease in moral and increase in physical causes. This is neither accident nor design. It results from experience and recorded facts." And again, speaking of the number of cases attributed to religious excitement, excessive study, etc.: "These and kindred causes were recognized less and less as efficient influences in the production of disease, in the lifetime of Dr. Brigham, under the light of experience."

Let me mention a few circumstances that will modify these statements somewhat. In the first place, the year 1843 was an exceptional year. It was the year when the Miller excitement in regard to the end of the world was producing a widespread anxiety among the ignorant and excitable portion of the community. Thousands believed in the approaching day of doom, gave up all attention to worldly matters; in some cases even distributed their property and spent their time in watching and prayer. Other multitudes, without positively believing, shared the anxiety in a greater or less degree. That and the two or three succeeding years was a time of more than ordinary attention to religious matters among sects less fanatical -- a period of "protracted meetings" and "revivals." After allowing for these special causes, the percentage of moral and religious causes varies no more during Dr. Brigham's connection with the asylum than might well happen without imputing to him a change in his views of causation.