At a time when the provisions for the care and treatment of pauper lunatics are almost completed in compliance with the legislative enactments of 1845, cavillings are heard, not as to minor details or local discrepancies, but against the first lines, the root and trunk-growth of the scheme. County asylums have arisen in every shire, attended in many instances by their satellite borough institutions, and some men, not ignorant on these matters, have looked on, and pronounced the arrangements to be good, very good; some, perhaps prejudiced, or short-sighted, or inexperienced, have gone so far as to say, that in no country in the world could similarly well ordered provisions for the maintenance and recovery of the poor insane be found, as we see raised at distances of twenty or thirty miles apart, over the length and breadth of this favored land of ours. Each institution a ready recipient of every needy being, whose taint, or toil, or trouble, or perhaps vice, if this precedes insanity, has reduced him to knock at the friendly door. Once admitted—every one who has bowels that can be sympathetically affected by the miseries of others, to a sufficient degree to induce him to care for, and to look into the plans adopted for the amelioration of the afflicted, can satisfy himself of the real good offered, and the benefit likely to be conferred by admission into one of these havens of rest. He will find within a well-planned building, divided into separate compartments exactly suitable for almost every phase of the disease to be treated; every arrangement for ventilation, warmth, and cleanliness; means for the regular elaboration and punctual distribution of a carefully devised dietary, every thing ready to hand; every appliance that modern notions suggest for the medical and moral treatment of the insane, and for the individual and personal and separate watching, nursing, and complete and effectual treatment of each unfortunate inmate.

Epilepsy, says Aræteus, “is an illness of various shapes, and horrible;” and Hippocrates, who existed five hundred years before him, in one of his terse aphorisms, states that those fits “which come on after twenty-five years of age, for the most part terminate in death.’” Lucretius, who lived in an age intervening between these two distinguished physicians, has with marvellous power pourtrayed the fearful symptoms of this apalling malady. Although a poet, and not a physician, his lines are equal in accuracy of delineation to those of the greatest pathologist.

Living in what may be said to be in a country which forms the link between civilisation and barbarism, so favored by nature, so neglected by man, where we have constantly so much before us to admire and so much to condemn, we have naturally been led to enquire into the condition of the poor lunatic in this city of the Sultan, into the state of him, whom mental and bodily disease has overtaken in its worst form; whom the public in some countries are disposed to honour as a gifted being, and whom in others they are inclined to look upon as the especial object of divine vengeance and torture.

A Report read before the Association of Medical Superintendents of American Institutions for the Insane at the Annual Meeting, 1857. From the American Journal of Insanity.