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Materialism In Its Relations To The Causes, Conditions, And Treatment Of Insanity

Creator: H.B. Wilbur (author)
Date: January 1872
Publication: The Journal of Psychological Medicine
Source: Available at selected libraries

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(Again, on p. 399.) He has been speaking of certain phenomena which he asserts are explainable under physiological and pathological laws. "Now, should we stop inquiry here, when insanity results? Can we admit that insanity is any thing more or less than a pathological condition, or that it lies beyond the boundaries of ordinary and legitimate medical study, and beyond the range of clinical observation or pathological investigation? Will not the patient study which elucidates the one be likely to elucidate the other? But in the latter the mind is affected? So is it in delirium, so is it in a degree in its operations in all diseases, when the mind is affected.''. . . Farther on: "We do not treat these mental phenomena; but we regard them simply as exponents of physical states. We hold that it is not necessary, in order to establish the physical origin (that is, producing cause) and nature of insanity, or other cerebral disease, to show that every case is of such origin and nature. If, in a single case, insanity is shown to come on as the result of a well-recognized bodily disease, and the mental disturbance disappears pari passu with the physical restoration, the argument is invincible."

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Running through these extracts, it will be observed, the thread of argument is something like this: Inasmuch as insanity is a physical disease, of which mental derangement is only a symptom, the cause or influence determining it must be a physical one; the ultimate pathological seat must be in the encephalon; the means of cure and hope of relief must lie in remedial agencies based upon such pathology, recourse being had occasionally to the faint, indirect, and strictly reflex influences, of a moral nature.

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Now, let us examine the statistics, to see the origin of insanity; or, in other words, to see what produces this bodily state, for it is upon these statistics that his opinions upon the origin and nature of insanity are professedly based. In Dr. Gray's annual report for 1863, to which he refers, and from which he largely quotes in the present paper, his present views were somewhat foreshadowed, though then less pronounced, and more deferential to those previously held by his professional brethren. He contented himself, then, with expressing the conviction that more careful observation would reveal physical causes as productive of more cases of insanity than moral causes.

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A table of analysis of the causes of insanity was given in that report, covering a period of twenty-one years, in the history of the Utica asylum. This showed a decrease of moral causes from 46 per cent. to 9 per cent., an increase of physical causes from 33 per cent. to 72 per cent. The percentage of unascertained causes did not differ very much at the different intervals. In the paper before us, the table is brought down to 1870, inclusive. The first thing to be done is to exclude the "unascertained causes." They only confuse the lessons to be drawn from the tables, and destroy the proper ratio of percentage of the two classes of causes. For, in analyzing statistics, the value of the induction depends upon the assumption that any ratio established in the known cases will also hold good of the unknown or general population.

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Table showing the Analysis and the Percentage of Moral, Physical, and Unascertained Causes as recorded in the Admission for Twenty-eight Years.

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Analysis of Causes. Percentage of Causes. Revised Table.Percentage.
YEAR. Moral Causes. Physical Causes. Unascertained Causes. Moral Causes. Physical Causes. Unascertained Causes. YEAR. Moral Causes. Physical Causes. Total. Moral Causes. Physical Causes.
1843 28 93 55 46.38 33.70 19.93 1843 128 93 221 58 42
1844 108 93 74 39.27 33.82 26.91 1844 108 93 201 53.7 46.3
1845 106 93 94 36.18 31.74 32.08 1845 106 93 199 53.1 46.9
1846 110 95 132 32.64 28.19 39.17 1846 110 95 205 53.6 46.4
1847 127 139 162 29.67 32.48 37.85 1847 127 139 266 47.7 52.3
1848 116 160 129 28.64 39.51 31.85 1848 116 160 276 42 58
1849 100 141 121 27.62 38.95 33.42 1849 100 141 241 41.4 58.6
1850 88 242 37 23.98 65.94 10.08 1850 88 242 330 26.6 73.4
1851 110 229 27 30.05 62.57 7.37 1851 110 229 339 32.4 67.6
1852 117 261 12 30 66.92 3.08 1852 117 261 378 30.9 69.1
1853 107 292 25 28.07 68.87 5.89 1853 107 292 399 26.9 73.1
1854 96 231 63 24.62 59.23 16.15 1854 96 231 327 28.9 71.1
1855 55 187 33 20 68 12 1855 55 187 242 22.7 77.3
1856 45 158 39 18.60 65.29 16.11 1856 45 158 203 22.1 77.9
1857 31 157 47 13.19 66.81 20 1857 31 157 188 16.5 83.5
1858 63 221 49 18.92 66.37 14.65 1858 63 227 290 21.7 78.3
1859 57 212 43 18.27 67.95 13.78 1859 57 212 269 21.2 78.8
1860 47 237 53 13.95 70.33 15.73 1860 47 237 284 16.5 83.5
1861 40 184 71 13.56 62.37 24.07 1861 40 184 224 17.9 82.1
1862 33 197 57 11.50 68.64 19.86 1862 33 197 230 14.3 85.7
1863 26 208 53 9.06 72.48 18.46 1863 26 208 234 11 89
1864 21 242 56 6.58 75.86 17.55 1864 21 242 263 8 92
1865 19 261 76 5.41 73.35 21.24 1865 19 261 280 6.8 93.2
1866 12 263 113 3.09 67.78 29.12 1866 12 263 275 4.3 95.7
1867 .... 321 80 ... 80.05 19.95 1867 ... ... ... ... 100
1868 ... 296 86 ... 77.49 22.51 1868 ... ... ... ... 100
1869 ... 378 85 ... 81.65 18.35 1869 ... ... ... ... 100
1870 ... 432 49 ... 85.66 11.34 1870 ... ... ... ... 100

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