gress unobserved, owing to this condition of vital and organic insensibility. The lungs, stomach, liver, kidneys, heart, bladder, and intestines have occasionally exhibited after death serious lesions, the existence of which was never suspected during the life of the patient. Organic structures appear in insanity to undergo important and often unobserved material modifications; hence the grave necessity of watching closely the pathological state of the insane, with the view of detecting, at the earliest possible period, the presence of certain physical complications often seriously interfering with the mental recovery of the patient, and proving perilous to his life.

I have known patients suffering from active inflammation of the pleura as well as lungs, repudiate all idea of indisposition. A gentleman, who had a large calculus in his bladder, declared that it gave him no kind of uneasiness. Had he been sane, exhibiting an abnormal degree of sensibility, I am satisfied his agony would have been intense. I have witnessed operations of a very painful character performed upon the insane without giving rise to any apparent disturbance of their sensibility.

I have not yet referred to the anesthesia of the insane resulting from the pre-occupation or intense absorption of the imagination, in some fearful hallucination of the mind, or all-engrossing monomaniacal illusion of the senses. I have no doubt that much of the apparent physical insensibility of the insane arises from this cause. Insanity often effectually masks and obscures all evidence. of organic sensibility, the greater malady effectually paralysing the functions of the sensor nerves.

When Lear, Kent, and the Fool are standing alone on the wild heath, exposed to the raging of the pitiless storm, Kent affectionately and feelingly implores the

king to seek shelter in an adjoining hovel from the "tyranny of the open night." In answer to this appeal, Lear exclaims:

"Thou think'st 'tis much, that this contentious storm
Invades us to the skin: so 'tis to thee;

But where the greater malady is fixed,

The lesser is scarce felt ;

The tempest in my mind

Doth from my senses take all feeling else
Save what beats there."

Analogous psychical and physical phenomena are exhibited in certain conditions of morbid exaltation of the conscience in connexion with the religious and superstitious observances of barbarous and uncivilized nations. Persons have been known, after having excited themselves to the highest pitch of enthusiastic ecstasy, to burn, cut, and maim their bodies in the severest possible manner, without exhibiting the slightest symptom of sensibility.*

* Mr. Catlin, in his “Notes on the North American Indians,” vol. ii. p. 170, refers (and the facts he records afford a good illustration of the effects of intense mental preoccupation in blunting the sensibility), to the self-imposed tortures of the Mandan Indians for the purpose of qualifying themselves for the honoured rank of warriors. "One at a time of the young fellows already emaciated with fasting, and thirsting, and waking, for nearly four days and nights, advanced from the side of the lodge, and placed himself on his hands and feet, or otherwise, as best adapted for the performance of the operation, where he submitted to the cruelties in the following manner. One inch or more of the flesh of each shoulder was taken up between the finger and thumb by the man who held the knife in his right hand, and the knife, which had been ground sharp at both edges and then hacked and notched with the blade of another to make it produce as much pain as possible, was forced through the flesh below the fingers, and being withdrawn, was followed by a splint or skewer from the other, who held a bundle of such in his left hand, and was ready to force them through the wound. There were then two cords lowered down from the top of the lodge, which were fastened to these splints or skewers, and they instantly began to haul him up : he was thus raised until his body was just suspended from the ground where he rested, until the knife and a splint were passed through the flesh or integuments in a similar manner on each arm below the shoulder, below the elbow, on the thighs, and below the knees. In some instances they remained in a reclining posture on the ground, until this painful operation was finished, which was performed in all instances exactly on the same parts of

VITIATED SENSATION.-In the incipient stage of various forms of cerebral disease, the sensibility is not only heightened, impaired, and paralysed, but it shows marked evidence of being vitiated. The patient complains of the existence of pricking sensations in various parts of the body, as well as of the existence of formication, particularly at the extremities of the fingers and toes. For some time previously to the development of well-marked symptoms of cerebral disease, a patient remarked that everything he touched was extremely cold. In some cases a gritty body like that of sand, and a piece of cloth, appeared to be interposed between the patient's fingers and whatever they came in contact with. Other invalids have affirmed, that whatever they touched felt like a piece of velvet. Andral notices this phenomenon.* Six weeks before a paralytic attack, a patient complained of one-half of the scalp feeling like a piece of leather. In the case of a gentleman who died of apoplexy, there was for some time previously to his illness a feeling in both hands as if the skin were covered with minute and irritating particles of dust or sand. He repeatedly complained of this symptom, and was frequently observed to wash his hands with the view of removing the imaginary annoyance. Impairment of sensibility in the

the bodies and limbs, and which, in its progress, occupied some five or six minutes.

"Each one was then instantly raised with the cords, until the weight of his body was suspended by them, and then, while the blood was streaming down their limbs, the bystanders hung upon the splints each man's appropriate shield, bow, quiver, &c., and in many instances the skull of a buffalo, with the horns on it, was attached to each lower arm and each lower leg, for the purpose, probably, of preventing, by their great weight, the struggling which might otherwise take place to their disadvantage whilst they were hung up. When these things were all adjusted each one was raised higher by the cords, until these weights all swung clear from the ground. The unflinching fortitude with which every one of them bore this part of the torture surpassed credibility,"

He terms it the "velvet-like sensation" accompanying the alterations of sensation preceding attacks of paralysis and softening.

arm, preceded first by a feeling of intense cold in the part, and subsequently of numbness, followed this perverted state of the sensation. The patient had also slight paroxysmal attacks of headache, and, occasionally, considerable confusion of thought. In another case, some time prior to a paralytic seizure, the patient imagined that he had extraneous particles of dirt and stones in his boots, or inside his stockings, irritating his feet, and interfering with his personal comfort, as well as freedom of locomotion. This perverted state of the sensation was observed for two months previously to his attack of acute cerebral disorder.

CHAPTER XXI.

Morbid Phenomena of the Special Senses.

THIS section of the subject will be considered in the following order :

a. Sight.

B. Hearing.
7. Taste.

8. Touch.

e. Smell.

In estimating the value of all morbid evidences of the special senses supposed to be symptomatic of brain disease, we must carefully consider their normal state, making proper allowances for any previously existing idiosyncrasies in their mode of action. The sense of vision, of hearing, &c., is occasionally seen extraordinarily acute. I have known individuals in whom the sense of smell and taste was so exquisitely developed, that certain substances and odours produced a severe degree of mental torture, when brought in contact with the gustatory and nasal organs. The slightest particle of ipecacuanha has caused violent vomiting in certain nervous temperaments. In other instances, the smell of rhubarb has produced a severe action upon the bowels, and the faintest odour of aloes has affected, in a marked manner, the lower portion of the bowels. It is literally true that a person may,

"Die of a rose in aromatic pain,"