The science and practice of medicine in relation to mind : the pathology of nerve centres and the jurisprudence of insanity, being a course of lectures delivered in Guy's Hospital

Front matter

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i« iNCONcaU'lTY OF DrESS.

THE SCIENCE AND PRACTICE

Preface

These Lectures were first delivered in Guy's Hospital in the summer of i86g. They have of necessity been considerably modified since that time, and are now published as they were delivered in the summer of 1873, and are in a great measure, a record of personal observation.

I have striven, as far as possible, to teach simply what I know of my own knowledge, as I believe that the most successful teaching is that which is based upon personal experience.

In collecting materials in the first instance, I had recourse to every available work and pamphlet on the subject of insanity, and I availed myself of the successful labour of numerous cultivators of mental science. The Journal of Mental Science, offered a wide field wherein I found vast masses of information ; and the admirable handbooks of Drs. Bucknill and Tuke, of Griesinger, (translated by Dr. Lockhart Robertson and Dr. Rutherford,) the Lectures of Dr. Blandford and the excellent Work of Dr. Maudsley, were all on my desk whilst preparing these lectures. I must here acknowledge my indebtedness to the several authors, and, generally.

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to any whose name I may have inadvertently omitted to note.

The pathological anatomy, which forms a considerable part of the practical teaching, is almost entirely new. In delivering the lectures it was illustrated by a large collection of microscopical and other preparations and drawings, plates of some of which I have inserted ; they were drawn with the utmost care from the microscope, and are faithful representations of the morbid appearances. I • would take this opportunity of thanking my friend. Dr. Lockhart Clarke, to whose patient teaching I owe whatever of success I may have achieved in making microscopical preparations, and also in describing and demonstrating nerve-tissue, for the great assistance he has from time to time so liberally aftbrded me.

I have given the pathology of nerve centres a prominent place in this work, because I felt that the only successful manner in which mind could be studied, was in its relation to organization, and that the surest means of comprehending abnormal conditions of mind, was by gaining a good knowledge of the abnormal tissues upon which it depended.

Pathology is a progressive science, and nervous pathology is yet in its infancy. I think, nevertheless, that my descriptions of morbid structures

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will bear the test of the most severe criticism. But facts in pathology, as in every other science, must be collected before we can generalise and draw inferences from them, and I therefore ask for my descriptions, nothing more than that they be received as a record of facts and observation.

I have included in the last lecture some suggestions for a natural classification of insanity. It will, I think, be found to be purely scientific. I have endeavoured to render it simple, and at the same time comprehensive.

To my erudite friend. Dr. Diamond of Twickenham, my best thanks are due, not only for many useful hints, but for his liberality in placing at my disposal, his valuable collection of photographic negatives, some of which have been reproduced by a new process of litho-photography. The work was executed by Mr. Briggs of Baker Street.

I have to ofi"er my best thanks to Dr. Stocker of Peckham House, to whom I am indebted for the opportunity he has afi'orded me of practically instructing my class in his Asylum.

The excellent arrangement of Peckham House, which has lately been reconstructed, afiorded the students the best possible opportunities of observing insanity, and the benefit of a well-ordered asylum in the treatment of insane patients.

Finally, I have to thank my friend Dr. Moxon for

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his kindness in assisting me in correcting many of these sheets as they passed through the press, and for the manv vakiable sucfq-estions he made to me whilst the work was in progress.

26 Upper George Street,

Bryanston Square, W.

January, 1874.