ART. X. Practical Obfervations on Infanity, in which fome -Suggestions are offered towards an improved Mode of treat ing Difeafes of the Mind, and fome Rules propofed which it is hoped may lead to a more humane and fuccefsful Method of Cure: to which are fubjoined Remarks on Medical Furifprudence, as connected with difeafed Intellect. By Jofeph Mafon Cox, M. D. 8vo. 166 pp. 5s. Murray. 1804. MA ANIACAL cafes are faid to be of more frequent occurrence now than heretofore, and in this country more than in any other part of Europe. This pofition, which is not, we believe, allowed by the phyficians to our two great inflitutions for the reception of infane patients in London, is confidered by Dr. Cox as an acknowledged fact, and the reafon he thinks fufficiently obvious. "Early diffipation," he says, " unrestrained licentiousness, habitual luxury, inordinate tafte for fpeculation, defective fyftems of education, laxity of morals, but more especially promifcuous intermarriages, where one or both of the parties have hereditary claims to alienation of mind, are fufficient to explain the lamentable fact." P. 1. But it is evident that scarcely any of these causes will apply to the major part of the perfons who are inmates at Bethlehem, St. Luke's, or Hoxton; particularly to the females, who equal the number of males in those receptacles. The most frequent caufes of infanity, which the author afterwards recognifes, are immoderate and habitual drinking, religion, love, long and intense application to one object or course of study, and a difpofition derived from parents, which probably originated in one of thefe caufes. Of the manner in which these causes act, in producing the disease, little fatisfactory is known, as on examining the brains of perfons who had died infane, in Tome of them no marks of difeafe have been obferved; while, on the other hand, that organ has been found much injured, in fubjects who, while living, had fhown no fymptoms of alienation of mind. "Infants have been born," he says, "without brain, and adults almoft completely deprived of it by difeafe, yet the faculties faid to depend on the integrity of this organ, did not appear to fuffer." P. 8. That infants have been born without brain is true, but as they never live in that state more than a few hours, no proof can be drawn from them, that the faculties fuppofed to depend on the integrity of that organ would not have been wanting. The The author next gives a defcription of the fymptoms ufu. ally attendant on infanity, and marks those which give more o lefs hope of a favourable termination of the disease, and then proceeds to lay down general rules for the treatment of infane parients, which he confiders under the heads of medical, and moral treatment. In the one, we are to be guided by the conftitution and habit of body of the patient; in the other, by the difpofition of mind, and the nature of the hallucination. On the medical treatment he is, in this part, concife, only recommending that the ftomach and bowels be properly cleanfed, with which the cure fhould in all cafes begin. This fubject is refumed towards the latter part of the work, where the author examines the medicines commonly employed for the purpose. On the moral treatment he is more diffufe, but not always, we think, intelligible; indeed he complains of the difficulty of be ing explicit. "The effence of management refults from experience, addrefs, and the natural endowments of the practitioner, and turns principally on making impreflions on the fenfes. It is impoffible to exhibit a fet of invariable rules in this department of our curative attempts; the methods had recourse to, and the conduct of both medical and other attendants must be regulated by the circumftances of the cafe." This is perhaps as much as could be faid on the fubject. It is from experience, not precept, we must acquire knowledge of the method of managing infane perfons. In examining the moral means, as the author calls them, which he recommends in changing the concatenation of ideas, fome of them appear to us too whimsical, abfurd, or even too dangerous to be admitted. "Where there is no obvious corporeal indifpofition, it certainly," he fays, "is allowable to try the effect of certain deceptions, contrived to make ftrong impreffions on the fenfes, by means of unexpected, pnufual, Ariking, or apparently fupernatural agents; fuch as after waking the party from fleep, either fuddenly, or by a gradual process, by imitated thunder, or foft mufic, according to the peculiarity of the cafe, combating the erroneous deranged notion either by fome pointed featence, or figns executed in phofphorus upon the wall of the bedchamber, or by fome tale, affertion, or reafoning; by one in the cha racter of an angel, prophet or devil." P. 28. The author knows that perfons have been fometimes frightened out of their wits, and thence feems to think it not irrational to fuppofe their wits may be frightened back again. Among the caufes of infanity, Dr. C. has very properly mentioned drinking immoderately of fermented, intoxicating liquors; this perhaps led him to propofe, in fome cafes, where ftimulants were fuppofed to be wanting, keep ing the patient, for days in fucceffion, in a state of intoxica tion." P. 42. The ftramonium, thorn-apple, is faid to deprive perfons who eat of it of their reafon; it was on that account that a German philofopher, about fifty years ago, was induced, he faid, to try its effects in curing infanity, and, as we are told, with furprising fuccefs, many patients being reftored to reafon by its agency; but we have never heard of any other physician ufing it under stars equally propitious. Among the agents to be reforted to under this head, the author reckons mufic, in which he seems to have much faith; he certainly describes the effects of it upon his patients, in a manner truly poetical. "The power of harmony over fome human conftitutions," he fays, "is not eafily conceived or defcribed. 1 have seen it rouze from a moft lethargic ftate, and divert the mind from the fubject of its deepest contemplation. In a military maniac, I once witneffed the notes of a thrill fife managed with fome addrefs, firft waken attention, then occafion intereft, as was obvious by his animated looks and beating time; and at length, by varying the air according to the effects, produce the most pleafing fenfations, as he afterwards informed me, brought back fome very impreffive recollections, excited entire new trains of thought, and feemed to correct the error of intellect; though he had not left his bed for fix weeks, nor spoken a single word during that time, and been supported entirely by force, he now arofe, dressed himself, and without any other remedy but gentle tonics, returned to his former habits of neatnefs and rationality, advancing gradually to perfect recovery." P. 53. Such power has mufic; who will hereafter doubt of its foftening rocks, and bending knotted oaks ? There are many other cafes related in the courfe of this volume, as evidences of the advantages of the methods recommended, but they are in general too loosely put together to answer the intended purpofe; we are neither told how long the patients had been ill previous to their being fubmitted to the author's care, nor how long they were fubjected to his treatment, before they recovered. But this was neceffary, as many perfons recover from infanity, only on being reftricted from the courfes that occafioned the complaint, without taking any kind of medicine. No names alfo are given of any medical affiftant who had feen any of the patients, either previous to, or during the cure; not even the name of the furgeon who cured the wound in the patient, who had caftrated himself; nor any statement of the proportion of patients who recovered, out of a given number that were under cure; and yet that was neceffary to enable the reader to form an eftimate of the value of the methods propofed. There have been two fales, we will obferve, of hypochondriacal patients, who who caftrated themselves, recorded; the one in the fecond volume of Medical Communications, the other in Dr. Heberden's Commentaries. Swinging, particularly whirling the patients rapidly round, until they become dizzy and fick, is another of the remedies which in the hands of the prefent author appears to have been very efficacious in the cure of infane patients. "It proves," he fays, "a mechanical anodyne. After a very few circumvolutions, I have witneffed the foothing, lulling effects, when the mind has become tranquillized, and the body quiefcent; a degree of vertigo has often followed, and this been fucceeded by the moft refreshing flumbers: an object the most desirable in every cafe of madness, and with the utmoft difficulty procured. Maniacs in general are not fenfible to the action of the common ofcillatory swing, though it affords an excellent mode of fecure confinement, and of harmlefs punishment; and I have met with a few inftances where the circulating, in both the horizontal and perpendicular poftures, produced no effect. The valuable properties of this remedy are not confined to the body, its powers extend to the mind. Conjoined with the paffion of fear, the extent of its action has never been accurately afcertained; but I am of opinion it might afford relief in fome very hopelefs cafes, if employed in the dark where from unufual noifes, fmells, or other powerful agents acting forcibly on the fenfes its efficacy might be amazingly increafed." P. 104. The digitalis alfo receives high commendation from this author, there being few cafes, he fays, in which it may not be advantageoufly ufed. It flands next in his lift of medicines to emetics. Then follow purging, bathing, bliftering, fetons, the application of rubefacients, &c. to each of which the author gives its appropriate portion of praifes. The volume concludes with directions for the conduct of phyficians when called upon judicially to give an opinion whether a perfon is affected with infanity; or, being fo, whether during the lucid intervals he is competent to alienate his property, make a will, &c. points certainly of great importance, to be clearly defined and fettled, if they are capable of being fo. Our readers will fee there is much curious matter contained in this volume; and if the author's zeal has not led him fometimes into error, our refources in curing infanity are more numerous and efficacious than has been generally fuppofed. Hitherto however, neither digitalis, fwinging, nor any other of the means here recommended, for they have all been tried, have fucceeded with other practitioners to the degree they are here supposed to have done. They must therefore be fubjected to more numerous trials, before it would be proper to give a decifive opinion of their powers. ART, ART. XI. To Marry or not to Marry. A Comedy in Five Ads., As performed at the Theatre-Royal, Covent-Garden. By Mrs. Inchbald. 8vo. 2s. 6d. Longman and Co. 1805. IT T certainly is not very creditable to the prefent ftate of the drama in this country, that in our progress through four and twenty volumes, fo few theatrical productions have appeared which were deemed worthy of a place anong our principal' and leading articles. It certainly does not arile from too critical a faftidioulness on our part, as the public appear to have gone hand in hand with us, and have been able to endure the reprefentation of very few productions of the kind, beyond. the fleet period of a few evenings. Among the authors however of this defcription, we have always pronounced Mrs. Inchbald deferving of much commendation. If we have not often been tranfported with the brilliant fallies of her wit, we have never been offended with any violation of dramatic confiitency or propriety. If we have not been ele-vated by the inventive powers of her genius, we have always been fatisfied, and occafionally more than fatisfied, with the correctness of her fentiments, the decorum of her ftyle, the truth of her characters, and the great felicity of her design. Perhaps the taste of the times may require an accommodation on the part of the author, to which the powers of the mind must fometimes be directed in oppofition to the better feelings of the judgment. But we proceed to give the outline of the ftory of this Comedy. Sir Ofwin Mortland avows a diflike to marriage, and a fondnefs for ftudious retirement-Whilft purfuing this bent of his nind, his uncle Lord Danberry importunes him to marry Lady Sufan Courtly. In the interval a young lady rather cu rioully intrudes herfelf, uninvited, into Sir Olwin's family, on a vilit to his fifter, Mrs. Sarah Mortland. With this lady, Sir Ofwin falls inftantaneously and violently in love. Upon this circumftance the whole of the plot hinges, for this young lady turns out to be the daughter of Lavenstorth, Sir Ofwin's bitter and determined enemy. The denoument may eafily be ima gined, the enemies are reconciled, and the lovers married. We give the following specimen of the dialogue: "Mrs. Sarah. Your guardian has fent me a letter by this Mr. Willowear, in which he informs me, that your real name is Lavensforth, and that you are the daughter, the only child of Sir Ofwin's inveterate enemy. By this intelligence your guardian conceives you will imme diately |