staid long enough, and accordingly removed him. In a few days, he became so excited and violent, as to frighten his family, and at the end of three weeks he was brought to us again. He improved for a season, then became stationary, and he seems now to be sinking into an incurable form of insanity.— A young man was brought to the Hospital in a state of high maniacal excitement, which gradually passed off, and in three months' time, he had become perfectly quiet, docile, and disposed to labor. His friends, visiting him about this time, and finding him at work, came to the conclusion that, if he were well enough to work, he was well enough to go home, and obtained his discharge. In ten days, he was returned, having been so excited and wild, that he was caged the greater part of the time he was absent; and, although he finally recovered, it was full three months before he had regained the ground he lost. Another, admitted shortly after the latter, and in a similar condition, was removed under similar circumstances. His friends could not comprehend why he might not work as well, and improve as fast, at home, as with us, and he too was removed. In about a month, he was returned worse than when he entered at first, having been caged most of the time; and now, five months afterwards, he has but slightly improved.

"If minor degrees of improvement are so much misapprehended, it is not strange that convalescence should often be mistaken for entire and permanent cure. In the course of a single short interview, the patient manifests no sign of mental aberration, nor undue exhilaration of spirits, and in every respect appears like himself when well. It is impossible to convince the friends that the mind, though sound, is not strong, and cannot be exposed to causes of excitement without great danger of a relapse. Relying with presumptuous confidence on their own sagacity, our advice is listened to like a tale that is told, and forthwith the patient is removed. For a few days, or weeks, they rejoice in the course they have taken; but, in a large portion of cases, the sight of old friends, exciting conversation, and the revival of old associations, prove too much for the mind, in its weakened condition, and soon the derangement returns in all its original severity. If we are entitled to any confidence at all, we claim it in regard to our opinions on this point. If the friends are better judges than we are as to the most proper time for removing a patient, then are they also more competent to direct the management of the case in its previous stages. Since, however, the latter are immediately intrusted to our management, what can be more inconsistent and absurd, than the idea that, in the latter stage of the disease, no further dependence need be placed on our judgment? The fact is, that the convalescent stage is that in which there is most liability to mistake; and in nothing is the judgment of the physician more closely exercised, than in determining when convalescence ends, and perfect recovery is established. On a point so important and delicate as this, we conceive that our ampler means of information render our opinion worthy of some consideration. If incorrect, it can, at the worst, merely occasion a few days' or weeks' unnecessary detention; and every one must know how much less an evil it is, to keep a patient too long, than to remove him too soon.

"We would take the opportunity of saying a few words on a subject somewhat akin to the latter in its consequences,- we mean the visits of friends to patients. On no point have we found so little disposition to acquiesce in our views as this. With amazing confidence, the friends persist in declaring how sure they are that their visits cannot hurt the patient; and many a time have we been obliged to permit an interview under the painful conviction, that, in all probability, it would aggravate the mental disorder. We certainly do not covet the trouble of objecting to such visits; but since we so frequently see their mischievous effects, it becomes our duty to prevent them, if possible, by plainly stating our reasons therefor, though at the risk of giving offence. In old cases, where we have no hope of cure, we have never discouraged them; and in recent cases, before the period of high maniacal excitement is finished, or symptoms of improvement have appeared, we have not thought it worth

while to offer much opposition; for though they may sometimes temporarily increase the excitement, yet the patient is too much under the influence of disease to be deeply affected. But from the period when the cloud that obscures the mental vision begins to disperse, and the mind is struggling into a dim consciousness of its true condition, to that when the stage of convalescence is firmly established, any intercourse with friends is liable to be followed by injurious effects. It would seem as if, while the mind is in this transition state, if we may so call it, emerging from the darkness and confusion of disease into the clear atmosphere of health, the sight of near friends, by suddenly recalling a crowd of painful associations, or too rudely awakening the domestic affections, produced a degree of nervous excitement, that the brain, in its weakened, irritable condition, is unable to bear. None but those engaged in the care of the insane, can conceive how seriously they may sometimes be affected by the slightest circumstance that acts upon the moral affections. If the mention of a familiar name can agitate the whole frame, and the sight of a bundle of old clothes from home give rise to the most distressing emotions, it may be easily conceived, if one will but consider the matter, how much risk is run by interviews with friends. I do not mean that they always prove injurious; but, as they do so in the larger proportion of cases, and we have not always the means of distinguishing between them beforehand, it becomes our duty to discountenance them in all. It must be considered, too, that the evil is greatly aggravated by the conversation of the friends who, instead of cheering and encouraging the patient by inspiring him with hopes of a seasonable recovery, and representing things as going on smoothly at home, oftentimes, by some strange obliquity of judgment, talk of nothing but misfortunes and grievances, and such like disagreeable subjects, that should be kept as far as possible from his thoughts. This is a matter we cannot control, and the general promises of friends to abstain from all topics that might unpleasantly affect the feelings, we have found, by painful experience, are little to be relied on. If it is as much as a patient can bear to meet his friends, and hear only cheerful intelligence, it may well be conceived that, when their communications awaken the most painful emotions, the mind must inevitably stagger under the shock. The letters of friends are liable to the same objections, unless they are of a cheering character; and, even then, there are cases where they had better be withheld. When judiciously written, however, they often prove highly beneficial—sometimes, even, in cases where a personal interview might have been hazardous."

MORAL AND RELIGIOUS INSTRUCTION IN INSANE ASYLUMS.

Dr. Ray, superintendent of the Insane Hospital in Maine, says, in his report. dated December 31, 1841,

"In pleasant weather, a number of our male patients have attended church in the village; and on Sabbath evenings, we have had a religious service, which has generally been conducted by some clergyman in the vicinity. About three fourths of our patients have usually attended; and though some of them, no doubt, have been little improved thereby, yet I have no hesitation in saying that, on the whole, the effect of the service has been highly beneficial. It is well to permit the insane to continue their usual customs, duties, and modes of life, just so far as they are compatible with the police of the institution, and with the means made use of for their recovery. Generally speaking, the more they are suffered to act like other men, the more they will strive to become like them. To attend divine service on the Sabbath, is one of those observances of ordinary life which a large portion of them are anxious

to maintain, and to some it is a source of heartfelt joy. Many attend merely to change the scene, without caring for the religious influences of the occasion; but, even with such, it is not without its benefits. It serves as a powerful motive to self-control; and it is curious how admirably some control themselves there who never do it any where else. This is something gained; and if it constituted the principal benefit of religious services, this would be a sufficient inducement for continuing them. To that class of patients to whom the earth seems a sterile promontory, and this brave o'erhanging firmament to be nothing but a foul and pestilent congregation of vapors,' the services of the Sabbath are sometimes directly beneficial. Cheering views of divine Providence, and exhibitions of the parental character of God, are, in some instances, as efficient as any means we have to encourage and confirm the desponding spirit. Convalescent patients, softened by sickness, and penetrated by a sense of divine goodness, are in just that condition of mind to be favorably affected by the truths of religion. To the clergymen of this vicinity, Doctor Tappan, Messrs. Warren, Barnard, Jenne, and Freeman, of Augusta; Cole, Thurston, Butler, Gunnison, and Adlam, of Hallowell; Messrs. Adams of Portland, and Sewall of Baltimore, Md., our thanks are due for the cheerfulness and promptness with which they have always complied with our request to officiate for us."

Dr. Rockwell, superintendent of the Vermont Asylum for the Insane, says, in his report, dated October 1, 1841, —

"The effects of our religious exercises have been very beneficial. All who are in a proper condition attend them, and to many they are a source of the greatest comfort. We have had religious exercises from the commencement of our operations. In no instance do we recollect of their being injurious to any individual; and to many they have been of great benefit."

Dr. Woodward, superintendent of the State Hospital at Worcester, says, in his report, dated November 30, 1841,

"In November, 1837, the Hospital chapel was dedicated for religious worship. Since that time, there have been in the Hospital 845 patients, of whom 797 have attended religious worship on the Sabbath, more or less, and 48 have failed to attend.

"Of the 399 patients who have been in the Hospital the past year, 373 have attended these exercises, and 26 have not attended.

"Of the 232 patients that are now in the Hospital, 214 have attended the religious services, and 18 have not attended. In this number are included 6 recent cases, that will probably all attend when they shall be able to exercise sufficient self-control, leaving but 12 old cases that are not in a condition to attend the chapel. Some of these remain in the house in consequence of their liability to epilepsy, some from continued excitement, and some from habits of negligence and want of regard to personal decency.

"There have been regular services in the chapel every Sabbath of the past year, and all parts of the service have been performed which are customary in the New England churches.

"A respectable choir of singers has always been in attendance, consisting of persons employed in the institution, and patients, accompanied by from two to four musical instruments. Their performance has been good at all times, and has never been interrupted by disturbance or discord. Much credit is due to those members of the family who have assisted in this pleasant and very desirable part of religious worship.

"Sacred music is one of the safest and most sane. Its influence on the feelings is soothing. the mind from its reveries, and prepares for the place.

salutary exercises for the inIt awakens attention, diverts accompanying duties of the

"During the last year, the Rev. George Allen has officiated as chaplain of the Hospital. The services of the house have always been conducted by him with solemnity and discretion, and the influence of religious teaching has never been better. He is judicious in the selection of his subjects, and appropriate and solemn in the application of religious truth, and has never failed to interest his hearers, while he has been sufficiently guarded not to offend them. "His mode of preaching has shown that any topic, discussed with prudence, is as suitable for our congregation as for others, and that the insane bear instruction and reproof as well as other religious assemblies. With few exceptions, they are attentive listeners, always wide awake, and they carry much of the influence of the Sabbath into the ensuing week. They often recollect the texts of both services, and will repeat many of the leading thoughts of the sermon many days after.

"On the day following the last Sabbath, as an experiment, I inquired the place of the text, chapter, verse, &c., of eight or ten patients, some of whom are generally so much excited, and others so much abstracted, that I would not have believed that they gave the least attention to the services; yet, to my surprise, all knew the place of the texts and the subjects of the discourses. One woman, who had recently come into the Hospital, had not only recollected the place of the text, but, after her return to her room, had surrounded with the mark of a pen, the portion of the verses principally used in the discourse; another had turned down the leaf of her Bible to the text.

"The good order and solemnity of our chapel exercises have been the subjects of frequent remark and cominendation by strangers and visitors; and all who witness them cannot fail to be impressed with the propriety and peculiar fitness and value of religious services for the insane.

"These exercises are very acceptable to a large proportion of the inmates of the Hospital. They generally attend voluntarily; and those who are required to attend are of that class who are equally opposed to any thing else that requires an effort.

"The preparation for attendance in the chapel, the assembling together, the music before service, the solemn exercises of the place, and the topics of conversation to which all these operations lead, with the variety they afford, and the pleasure they give, make the Sabbath, to many, the most interesting day of the week. Instead of the dread with which its dull monotony was formerly contemplated, it is hailed as a day of gratification and delight by many members of our family.

"Besides the religious services of the Sabbath, there is a prayer-meeting on Saturday evening, and a Bible class on the Sabbath, which many of the patients attend.

"The change of public sentiment with regard to religious instruction for the insane, has been great for the last few years. When this Hospital was erected, it was not contemplated, and no provision was made for assembling together for this purpose. This is the only institution of the kind in the country, so far as my knowledge extends, which has a chapel set apart for religious worship.

"In many of the institutions, religious meetings are regularly held on the Sabbath, and this practice is being extended through most of the Asylums in the country.

"For four years we have tried this experiment fairly, admitting to the exercise all patients who were in a situation to attend. Here are collected the excited maniac, the gloomy melancholic, the anxious inquirer after truth, those who imagine themselves guilty of the unpardonable sin, the gods, saviors, and prophets, the infidel, the scoffer, and yet we have found no injury arise from such attendance, and no disposition to disturb the quiet and solemnity of the place.

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"By our whole moral treatment, as well as by our religious services, we inculcate all the habits and obligations of rational society. We think the in

sane should never be deceived; all their delusions and false impressions of character should be discouraged by removing, in the kindest manner, every badge of honor and distinction which they are disposed to assume, and by directing their attention to other subjects of interest. They may be held responsible for their conduct so far as they are capable of regulating it. By encouraging self-control, and respect for themselves and others, we make them better men, more orderly and reasonable, before any impression is made upon their delusions. To aid this, it is easy to see how useful must be that religious instruction which points out their duty to themselves and to their fellow-men, and their responsibility to God.

"The evils that we at first anticipated do not accompany these salutary influences. There is certainly a choice of subjects for their consideration, but the range is much wider than we at first supposed; and, whatever is the topic of discourse, the service is seldom objectionable to any one, and usually acceptable to all."

Dr. Bell, of the McLean Asylum at Charlestown, Mass., conducts a religious service himself, every evening in the week, Sundays excepted, when he sometimes gets the assistance of a clergyman from the neighborhood. Besides, many of the patients attend worship, every Sabbath, in churches of their own choice, in Cambridge, Charlestown, and Boston. Dr. Bell speaks, in his last report, of "a proper participation in the services of religion as being among the moral means of the highest utility to the insane.

Dr. Butler, superintendent of the Lunatic Asylum at South Boston, conducts a religious service himself, every evening, for the benefit of his household and the patients, assembled together; and he is generally able to obtain the assistance, on the Sabbath, of some one of the many ministers in Boston. Dr. Butler says, in his last report,

"The extended experience of the year has abundantly confirmed all that was stated in the last report, in respect to the influence of religious services. Simply considered as remedial and disciplinary measures, I would on no consideration dispense with their assistance. We trust they have a higher and more extensive influence. The expression of grateful obligation which has come to us from many of our inmates, is due to those clergymen to whose acceptable services, gratuitously performed, we have owed the privilege of listening, for nearly every Sabbath of the year, to the preaching of the gospel. "The spacious room in the third story of the east building, which has been vacant, is now being prepared for a chapel - an excellent accommodation, that the increased number of our attendants on public worship renders very desirable."

Dr. Brigham, superintendent of the Retreat at Hartford, Conn., says, in his report for 1841,

"Religious services have been continued during the past as in preceding years. Every evening, the patients and attendants assemble, when a hymn is sung, and a portion of Scripture read, and prayer offered by the chaplain. On Sunday, he preaches to the assembled household. On these occasions, from two thirds to three fourths of our patients assemble, and several assist us in singing. Rarely is there any disturbance. I have frequently witnessed, with pleasure and surprise, those who were constantly in motion and noisy