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ART. II. -- Materialism in its Relations to the Causes, Conditions, and Treatment of Insanity. (1) By H. B. Wilbur, M. D., Superintendent of the New York Asylum for Idiots.

THE drift of modern science, judged by its surface, is toward materialism. The term is used in its philosophic and not in its theological sense. Not to discuss the general doctrine, I desire to make a few suggestions upon certain special aspects of the subject, that would seem to come within the scope of this occasion and this assembly. I would call your attention, then, to the effects of the practical application of modern materialistic views, in estimating the causes, conditions, and treatment of insanity.

As I am addressing an audience of practical alienists, familiar with the literature of their specialty, I will, to save time and narrow the discussion, take for my text a paper that has just fallen under my observation, in the April number of the American Journal of Insanity.

I say to limit the discussion, for I purpose, in the main, to refer only to opinions, the materialistic basis, or tendencies, or consequences of which are not always perceived by those who hold them. Still running quite parallel with these, in some aspects, are certain other dogmas, the direct outcome of an acknowledged materialism, that may be referred to incidentally.

The paper meant is one entitled "The Dependence of Insanity on Physical Disease." It was read before the Medical Society of the State of New York, at its last meeting. Its author, an ex-president of the Society, was known to that body as the Superintendent of the State Lunatic Asylum, as the principal editor of the American Journal of Insanity -- a man of large experience in the study and treatment of insanity, a frequent medical witness in our highest courts, and accustomed to expressing his views upon the subject. From such a source, it might well be regarded as the clear and authoritative exposition of the well-settled opinions of your special profession.

That no injustice may be done the author, it may be said here that he is no materialist. He would disclaim the charge at once. In the January number of the Journal of Insanity, there is an article, apparently from the same pen, in which the views of Dr. Hammond, in the JOURNAL OF PSYCHOLOGICAL MEDICINE are stigmatized as "flat materialism," and then denounced in no measured terms. The paper in question is entitled "The Dependence of Insanity on Physical Disease." It may be remarked that hardly any medical man in these days would object to the general statement or proposition that insanity is frequently, or perhaps even generally, dependent upon or associated with physical disease, functional or organic; but this paper, if it proves anything, proves that insanity is invariably the result of physical causes, is invariably dependent upon physical conditions. In other words, the prime condition, the essential element, is a pathological state.

The two are quite distinct propositions, and with practical consequences that differ still more widely. First, then, as to the doctrine of the paper. You have doubtless all read it, but I quote a few passages (p. 397): "The true and only method by which insanity can be studied is that followed in all other diseases. The physical lesions are the subjects of primary importance. These must be studied through physiology and pathology. The mental manifestations are here secondary and dependent. . . . We say that insanity is a bodily disorder; that it is a disease of the brain. This does not imply that there is something to be thrown off in the character of some morbid entity. It simply means that certain changes have taken place in the brain or its investing membranes, which imply a departure from healthy physiological action, and that, in consequence of these changes, there is more or less prolonged disturbance of the mind. The physician recognizes the delirium of fever, and refers its origin to the brain." This extract, if it means any thing, means that insanity is always caused by cerebral disease, or rather it ways is cerebral disease, of an organic character.

(Again, on p. 385): "In insanity, therefore, we have the dominating organ always deranged in function, if not further. Whatever the cause may be, physical or mental, or whether the brain is primarily or secondarily affected, the condition in insanity is cerebral disease. Disease is what we have to deal with. Not disease of mind, for the mind, the spiritual principle, the immortal being, cannot be the subject of disease. The manifestations of the mind are disturbed and disordered when the brain, which is its organ, suffers. . . . The expression 'disease of mind' should have a place, in the nomenclature of modern medical science, with witchcraft and demonomania. They are alike the offspring of metaphysical speculation, alike misinterpretations of phenomena."