tween these two methods in which excito-secretory action may be originated; and in the course of the present paper, we have quoted freely from Henle and older writers, as well as from Drs. Claude Bernard and Brown-Séquard, many instances of the production of both altered function and changed tissue, by irritations made in the cerebro-spinal centres; but inasmuch as since then, we have observed some ingenuous misapprehension on this point, we here formally reaffirm the difference between the two kinds of acts, which we have termed excito-secretory. The one is the result of an impression made upon a cerebro-spinal centre, from which impression or irritation, the ganglionic system is excited to the performance of all, or any one, of its various kinds of acts. The other, which we have termed reflex excito-secretory, is, as we have said, a more recondite process, and comprehends, not only a cerebrospinal centre, but also a sensitive cerebro-spinal nerve, implanted into that centre, which, having received the peripheral impression, acts centripetally in transmitting it to the cerebro-spinal centre, from which point, the two excito-secretory processes present no difference in their mode of manifestation.

Isolated and unclassified facts illustrating the general notion of the influence of the cerebro-spinal nervous centres upon the organs, have been occasionally referred to for a long time, in various relations in the explication of morbid phenomena; but, as we have seen,' even these views have never exerted much influence in pathology, nor ever became at all prominent in physiology. They certainly suffered much neglect, and being denied by the best authorities, were seldom ever appealed to in medical investigations. But on the establishment of the truth of the more comprehensive doctrine of reflex excito-secretory action, these scattered facts and older views gain a new importance by the clear illumination of the present light, which this more recent function is enabled to reflect back upon them, and they now lend their aid in the elucidation of phenomena which before, did not come within their scope.

The awakening and entire reconstruction of an old and imper

See page 605, quotation from Copeland's Dictionary of Practical Medicine. The cause of the failure of these views, was the non-existence or rather non-establishment at the time of their suggestion, of the science of reflex nervous action. "Their success only began to be possible" on Dr. Marshall Hall's announcement of excitomotory action in 1837. This is the acknowledged epoch of the discovery of reflex nervous action. Former facts were but the prelude to that epoch. See History of Discovery, everywhere.

fect doctrine, by the subsequent independent origination of a new and more complete one, is certainly not without precedent in the history of inductive science. In our own department, Sir Charles Bell's discovery of sensitive and motor nerves, reminded us that Herophilus had surmised the same, in the remote and almost forgotten past; yet, Sir Charles Bell's distinct and clear enunciation of the two functions was the starting-point of a new epoch in the history of physiology. Even the sublime and immeasurable law of gravitation was darkly foreshadowed in the epicycular theory of Hipparchus, ages before.

It was the observation of Mersenne,' that in a number of cords stretched with an unequal degree of tension, only those will respond to another cord sounded near them, which happen to be strung to a nearly similar note; otherwise, unless skilfully touched themselves, they never yield harmonious strains. So these older facts of science-observed, and accurately recorded, long ago, they have lain still and silent, like the carefully strung, but unwaked cords of a neglected harp-the dust of ages has accumulated upon them; no hand disturbs, no kindred note calls forth an answering vibration-motionless and mute they sleep, yet holding a potential, though unstirred melody. But now, a kindred note is sounded very near them, in the distinct and clear enunciation of some general principle-and they awake-slowly at first, and in dull vibrations, then-in a confused and jarring clamor of discord; but, as the dust becomes fully shaken off, by the constant sounding of the appealing note, their response becomes clearer and more genial, till, as with Newton's law, they all together swell into an anthem, which, blending with a still yet higher harmony, makes up that which binds earth to heaven-THE HARMONY OF INFINITE TRUTH.

I 1636.

REPORT

ON

MORAL INSANITY IN ITS RELATIONS TO

MEDICAL JURISPRUDENCE.

BY

D. MEREDITH REESE, M. D., LL.D., ETC.,

OF NEW YORK.

REPORT ON MORAL INSANITY.

THERE is no single topic in the whole range of medical inquiry, which has so strong claims upon the earnest attention and painstaking investigation of our profession, as the subject of Insanity in the various phases it assumes, all of which are included under the generic name. Happily for us, and for the interests of humanity, many of the mightiest minds which have ever been enrolled among physicians, in our own, and other countries, and in each succeeding generation, have consecrated their genius and intellect to this exclusive field of research. And hence, confessedly obscure as are the morbid phenomena of mind, in their etiology and causation, when latent, or even overt disease has begun its ravages upon the brain; yet there is no department of organic or functional malady to which our race is liable, upon which greater light has been thrown, or greater improvements made, than in the prophylaxis, diagnosis, therapeutics, and moral management of insanity. The present century, especially, has been signalized by an entire revolution in the theory and practice in this department, and honorable to our profession, and challenging the admiration of the world, for the philanthropic results which have followed.

It is not our province or purpose, however, to discuss this general subject of Medical Psychology, which, in its varied and multiform aspects, would be a task, indeed, for any but an acknowledged expert, who has made the selection of this department for special study and exclusive practice, and even he would require longer time and an ampler space than has been awarded to the author of the present paper, which must, of necessity, be brief.

"Moral insanity" is the theme which has been assigned to us, and to this alone our inquiries and observations will be directed. And with the view to greater perspicuity, we propose to consider and discuss the following questions, viz:—