Physicians From Scotland

"The first natural group is obviously “Idiocy”, including Imbecility under all its various forms and degrees, until we come down, or up rather, to the mere mild Dundrearyism of an effete and degenerate race. To this class must be referred a large number of cases of “moral idiocy and imbecility”, many of which at present get mixed up, by our present mode of classification, among the Insane, as Monomaniacs of various kinds. Such are many cases, familiar to all of you, of congenital moral perversion, instinctive cruelty, and destructiveness and theft. Many of our most noted Kleptomaniacs have had the tendency from childhood, and have been “moral imbeciles”. In fact, as far as a I know, all of them have been so ; when we meet with Kleptomania in cases of Insanity” it is only as one of many other symptoms, as when we find it associated, as often do, with General Paralysis. I would refer all those cases of Insanity, which are hut the development and aggravation of a congenital moral perversion, or want of balance, to the class of congenital moral imbeciles."

"The next point which has struck me in my experience, both in respect to others and myself, whether as regards cases placed under our care, or cases in regard to which were asked to give our opinion in consultation, is the mode in which we all very soon come to look at any new case. We do not ask ourselves, nor do we seek to determine by the questions we put to the patient or his friends, what the nosological name of his particular form of Insanity is. What we are solicitous to know is the “natural history” of the disease before us, and its cause. Is it a Congenital disease? It is one associated with Epilepsy caused by masturbation, by paturation, or protracted lactation, or some other debilitating cause, or by hard drinking? Is it a case of orgnaic Brain disease, or General Paralysis? Is it one connected with Phthisis-with the critical period, or with the atheromatous vessels of the brain of the Senile Dement? Such are the kind of questions we seek to solve, in order to form a diagnosis of the nature of the case, and in order to enable us to answer the anxious inquiries of friend as to its probable termination ; and such instinctively and practically are the data upon which we classify the cases, which are placed under our case, in our own minds. Why, then, should we adopt another ground of classification in our tables and text-books? And why should we perpetuate a nomenclature so indefinite and conventional, and which has no other foundation upon which to rest than an imperfect, of not an obsolete, system of psychology? Were our physiology of the Brain as perfect as that of the Lungs-were we able to predicate what particular portion of the Brain was affected in each case of Insanity-I cannot see how our present mode of classifying the varieties of the disease (according to the character of the mental symptoms) would ever be one of practical utility. We do not classify the various disease in which delirium is present by the character of the mental affection l we do not describe acute or violent delirium, or muttering delirium, or fugacious and wandering delirium, or coma, as “diseases” ; we describe the diseases upon which they depend, of some of which we know as little as we do of Insanity, but of which we know at least the natural history,- the origin, course, and probable termination ; and we describe, accordingly, inflammatory fewer, typhus and typhoid fevers, phthisis, uraemic poisoning, and the other diseases of which these different forms of delirium are only symptoms. Why should we proeed upon another principle in regard to Insanity? Why should we attempt to group and classify the varieties of Insanity by the “mental” symptoms, and not, as we do in other disease, by the “bodily disease” of which those mental perversions are but the signs?"

"At one point I thought of directing your attention to the medico-legal relations of Insanity, with a special reference to the oproprium which has so often been thrown upon medical witnesses for the unseemly differences and contradictions displayed by them in our courts of law in questions as to the existence of Imbecility and Insanity. I have strong conviction that these differences and contradictions are entirely due to the “lawers”, and the very imperfect and erroneous legal defintions of Idiocy and Insanity, and nor to the “Doctors”. And I think we ought, both as individuals and as an Association, to use all our energies and influence to bring about a revision of the legal distinctions regarding Insanity, so as to get their distinctions and definitions in conformity with ours, or, more correctly speaking, in conformity with nature and facts;-with those descriptions and distinctions which we have derived from the careful study of mental disease. Let the legal responsibility, or legal capacities of each class so recognized, be at the same time fixed and determined by law, and then-and then only-will the greater part of the difficulties and discrepancies of medical testimony entirely disappear."

"The next natural order is doubtless Senile Insanity, occasionally commencing in the form of Mania, more frequently in the form of Melancholia, but most frequently during its whole course presenting the well known features of Dementia, in all its degrees, from simple impairment of the memory down to total Fatuity ; and de- pendent, I believe, upon an atheromatous condition of the vessels of the Brain, and the consequent changes which take place in the nutritive and reparative processes of the cerebral tissues. This form of Insanity I hope to see fully described in an early number of the Journal by my friend Dr Yellowlees."

"My proposition, then, is this-that we ought to classify all the varieties of Insanity to use a botanical term, in their natural orders or families; or, to use a phrase more familiar to the Physician’s er, that we should group them in accordance with the “natural history” or each. Now, I observe, in starting, that wherever we have a very “distinct” natural history of any form of Insanity, we at present always refer it to its natural order, without reference to the character of the mental disorder. All our Epileptics are classified “as such”, whether they are demented or Monomaniacs, or subject to paroroxyms of Acute Mania. It is Insanity with epilepsy. “Puerperal Mania” forms a distinct group whether the patient is maniacal, suicidal, or melancholic. “General Paralysis” afford another group, and none of us ever think of referring a General Paralytic to any other group than that of the natural family to which he belongs, whether is maniacal a man of exalted wealth and rank, a melancholic, or a dement. Is it not possible to extend the same rational and practical method of classification to all the other varieties of Insanity? I do think it can be done, at least to a very great extent; and I do think that this is, in the present state of our knowledge, the only rational and really practical basis of classification."

"The second natural group appears to me to be the Epileptics. Epilepsy is emphatically a disease of childhood, and when it is established at that period, it arrests the development of the Brain, and is associated with Idiocy and Imbecility. In other cases, we have it associated with maniacal paroxysms, Monomania, or Dementia, or total Fatuity. All the cases, whatever the mental symptoms may be, or however they may vary, as they often do, during the progress of the disease, still they form a distinct natural family, of which the epileptic seizures are the most prominent symptoms, and the causes of that state of the nervous system which conditions the mental derangement with which each case is complicated."

"From my own personal experience, then, and from what I have observed in the practical experience of others-of the many distinguished and talented young men who have studies Insanity under my care,-it has always struck me, that the moment they came into actual persona contact with the insane, all their preconceived notions of Insanity derived from our systematic works were found to be vague, misty, and purely conventional descriptions of what they actually saw. Acute Mania, instead of being the frightfully agonizing picture drawn by Chiauggi, was only presented to them in the transient and babbling excitement of a harmless and frightened, but dirty unifying, and destructive patient. The gradations between Acute Mania and Mania, and Chronic Mania and Dementia have osme degree of noise and destructiveness, they found to be so gradual, that it was very difficult, and, in fact, only a conventional matter to say where the one beganand the other ended. In “Idiots” and “Dements” they found every degree of mental impairment-from simple loss of memory and slight childishness, to total fatuity, and obliteration of all the mental faculties. Among the so-called “Monomaniacs”, thy found very few who were “Monomaniacs” at all : most of them were insane on severalsubjects, although presenting some more “salient” feature”, such as the fear of poison, hanging, or eternal damnation, or the belief of exalted rank or enormous wealth or power. Many of them had no delusions at all; and gradually we began to discover that the “Moral Insanity”,which was confined to our text-books to a few cases of homicidal and suicidal impulse, ran through every variety of Insanity as at present classified,-so that we found Acute Mania and Chronic Mania, and Melancholia and Monomania or Self-esteem or Pride, and of Fear, all existing without any delusions."

"The third natural family I would assign to the Masturbators. Although I designate this family by the cause only which originates the Insanity, yet I think it cannot be denied that that vice produces a group of symptoms which are quite characteristic and easily recognised, and give to the cases a special natural history ; — the peculiar imbecility and shy habits of the very youthful victim ; the suspicion, and fear, and dread, and suicidal impulses, and palpitations, and scared look, and feeble body, of the older offenders, passing gradually into Dementia or Fatuity, with other characteristic features familiar to all of you, and which I do not stop to enlarge on, — all combine to stamp and define this as a natural order or family."

"The Insanity of the critical period of life is a form very familiar to us ; and I have no doubt you have recognised a critical period in the male sex as well as in the female, — a period of life at which, in many men, great disturbance of the normal state of the feelings and emotions is experienced, in some instances amounting to an insanity of the same type as that generally met with in females at their critical period — namely, a monomania of fear, despondency, remorse, hopelessness, passing occasionally into Dementia. This variety I would designate as Climacteric Insanity. There is a form of Insanity common to females, different from Hysterical Mania, or Nymphomania, and which, I think, is commonly associated with Ovarian disease, sometimes with uterine disease, and of which one of the most common symptoms is a sexual hallucination, — the belief that certain persons visit them and co- habit with them during the night, and other similar delusions. This form might be denominated Utero-mania, or Ovario-mania. It is, I think, par excellence the Insanity of old maids."

"Next comes a well-known group, but with protean lineaments, yet familiar to all of us, cases of Hysterical Mania. I need not weary you by an attempt to describe its varied features, from cases of singular moral perversion, living without food, giving birth to mice and toads, passing all sorts of curious things with the urine, up through the long and singular forms it presents with varied sexual and erotic symptoms, until we find it presenting a truly maniacal aspect. You must know them all, and yet you recognise in all with readiness the Hysteria, which characterises every variety, and makes your prognosis and treatment so different from what, in the absence of that significant mark, it would have been. This is certainly a well-marked natural order."

"I would strongly press upon you this view of the subject, — one to which I have already referred, that this is, in fact, the stand- point from which we all instinctively view a case of Insanity, when called upon as practical men to form a diagnosis, or offer a prognosis, upon any case submitted to us for the first time. We ask ourselves, is this a case of congenital moral perversion or intellectual deficiency? Is it one connected with masturbation, with pubescence, with hysteria, with phthisis, with drinking, with uterine disease, with brain disease, and so forth ? If this is true, surely this is at least the practical basis upon which to form a Classification of the Insane; and if not the most scientific, it is certainly more so than the present poor, uncertain, and conventional one, or perhaps than any one which can be founded upon a physiological or psychological basis, in our present very imperfect knowledge of the physiology of the Brain. It has this especial merit, at least — that it ever keeps before us the all-important principle, that Insanity is a disease of the body, whether it be of some remote organ sympathetically acting on the mind, or of the material organ of the mind itself."

"Some Physiologists will have it that the Stomach is a Mill;—others, that it is a fermenting Vat;—others, again, that it is a Stew-pan;—but in my view of the matter, it is neither a Mill, a fermenting Vat, nor a Stew-pan—but a STOMACH, gentlemen, a STOMACH."

"Let me tell you, my young doctor friends, that a cheerful face and step, and neckcloth and kindly joke, a power of exciting, a setting a-going, a good laugh, are stock in our trade not to be despised. The hearty heart does good like a medicine."

"From the facts I have adduced in the course of this paper I must come to the conclusion that the theory which makes all the languages of Europe and Asia, from Bengal to the British Islands, however different in appearance, to have sprung from the same stock, and hence, all the people speaking them, black, swarthy, and fair, to be of one and the same race of man, is utterly groundless, and the mere dream of learned men, and perhaps even more imaginative than learned. I can by no means, then, agree with a very learned professor of Oxford, that the same blood ran in the veins of the soldiers of Alexander and Clive as in those of the Hindus whom, at the interval of two-and-twenty ages, they both scattered with the same facility. I am not prepared, like him, to believe that an English jury, unless it were a packed one of learned Orientalists, with the ingenious professor him- self for its foreman, would, "After examining the hoary documents of language," admit "the claim of a common descent between Hindu, Greek, and Teuton," for that would amount to allowing that there was no difference in the faculties of the people that produced Homer and Shakespear, and those that have produced nothing better than the authors of the Mahabharat and Ramayana; no difference between the home-keeping Hindus, who never made a foreign conquest of any kind, and the nations who discovered, conquered, and peopled a new world."

"When Mr. Canning made his celebrated boast in Parliament, that he had created the republics of Mexico and Peru, Columbia, Bolivia, and Argentine, I made, to some friends, the remark, that to create races of men was beyond his power, and that the result of his measure would merely be to precipitate that return, sure to come at last, the return to the aboriginal Indian population, from whom no good could come, from whom nothing could be expected; a race whose vital energies were wound up; expiring: hastening onwards also to ultimate extinction."

"[T]he Dutch families who settled in Southern Africa three hundred years ago, are now as fair, and as pure in Saxon blood, as the native Hollander; the slightest change in structure or colour can at once he traced to intermarriage. By intermarriage an individual is produced, intermediate generally, and partaking of each parent; but this mulatto man or woman is a monstrosity of nature — there is no place for such a family: no such race exists on the earth, however closely affiliated the parents may be. To maintain it would require a systematic course of intermarriage, with constant draughts from the pure races whence the mixed race derives its origin. Now, such an arrangement is impossible. Since the earliest recorded times, such mixtures have been attempted and always failed; with Celt and Saxon it is the same as with Hottentot and Saxon, Caffre and Hottentot. The Slavonian race or races have been deeply intercalated for more than twice ten centuries with the South German, the pure Scandinavian, the Sarmatian, and even somewhat with the Celt, and with the Italian as conquerors: have they intermingled? Do you know of any mixed race the result of such admixture? Is it in Bohemia? or Saxony? or Prussia? or Finland?"

"The source of all evil lies in the race, the Celtic race of Ireland. There is no getting over historical facts. Look at Wales, look at Caledonia; it is ever the same. [...] The race must be forced from the soil; by fair means, if possible; still they must leave. The Orange club of Ireland is a Saxon confederation for the clearing the land of all Papists and Jacobites; this means Celts. If left to themselves, they would clear them out, as Cromwell proposed, by the sword; it would not require six weeks to accomplish the work. But the Encumbered Estates Relief Bill will do it better."

"But the land of Egypt still abounds with its ancient monuments; the race was quite peculiar, and was, I think, African, or at least allied to the African races. The mouth and lips all but prove this. Nevertheless, their identity with a great section of the present Jewish race cannot be doubted; the young Jew of London or Amsterdam might readily sit for a likeness of the bust of Amenoph."

"From what we know of living anthropoids, we may infer that the chief mental activities of the group will be three in number—namely, those concerning with mating, maternity, and social behaviour. Each group will be attached to a territory and maintain its isolation."

"We have to face the fact that we are the descendants of apelike ancestors. The truth, at first sight, is often ugly and repulsive to our personal feelings, but when it is the truth, its ultimate effects on us are always salutary. ... ... Man's brain does not stand as a thing apart; it is the culmination of an ascending series. There is no part of it and no function manifested by it that cannot be traced to humble beginnings lower in the animal scale. And what we postulate for man's brain we must in all justice apply to that of the ape, the dog, and all other beasts."

"In all the medical schools of London a notice is posted over the door leading to the dissecting room forbidding strangers to enter. I propose, however, to push the door open and ask the reader to accompany me within, for, if we are to understand the human body; it is essential that we should see the students at work."

"Now we proceed to consider the oldest race of great stature that has yet been discovered, one which flourished in the south of France when the last of the cold periods was lifting from Europe. The first examples of this race were discovered in 1868, when a railway was being constructed in the valley of the Vézère, a tributary of the Dordogne. A cutting made in the débris at the foot of the limestone cliffs which flank the valley of the Vézère at Cro-Magnon, brought to light the skeletons of a man, of a woman, and part of the skull of a third individual. Hence this ancient type or race is usually named Cro-Magnon."

"If we harden our hearts to the suffering of the creatures, we must by an immutable law harden our hearts to our brother and sister, and this can never lead to ideal conditions. The adoption of this vegetarian way of life, if the food is balanced, will lead to a new, better, higher, and more noble rhythm of living."

"A vegetarian diet, Latto believes, promotes endurance. … Despite the number of patients he must treat, Dr. Latto still finds time to serve as president of the two vegetarian societies … and to lecture on the salutary benefits of a vegetarian diet all over England and Europe—testimony in itself to the stamina that such a diet provides."

"I sat through the first act and heard my lovely lines falling like cold porridge on a damp mattress."

"I met Dr. Gordon Latto, who had become so impressed by the efficacy of nature cure methods that he had switched over almost completely from his orthodox practice to natural healing. He said that he could stop the gallstone from forming, but that I must go on a strict vegetarian diet for a year, besides knocking off drink and tobacco (which he said was worse than drink). This was a tough regime; the gallstones could not survive it. I did, however, and at the end of the period I found that I was also cured of smoking, and that the vegetarian diet suited me so well that I have preferred it ever since."

"So I read about various aspects of vegetarianism—the scientific aspect, the humane aspect, the ethical aspect, and the economic aspect. The more I studied, the more convinced I became that it was a logical procedure, that it would help humanity, that it would lessen the suffering of the animals, and that it would help this country."

"Vegetarianism is harmless enough though it is apt to fill a man with wind and self-righteousness."

"To see the Convulsions, Agonies and Tortures of a poor Fellow-Creature, whom they cannot restore nor recompense, dying to gratify Luxury, and scratch callous and rank Organs, must require a rocky Heart, and a great Degree of Cruelty and Ferocity. I cannot find any great Difference on the Foot of natural Reason and Equity only, between feeding on human Flesh, and feeding on brute animal Flesh, except Custom and Example. I believe some rational Creatures would suffer less in being fairly butcher'd, than a strong Ox, or red Deer; and in natural Morality and Justice, the Degrees of Pain here, make the essential Difference; for as to other Differences, they are relative only, and can be of no Weight with an infinitely perfect Being. Did not Use and Example weaken this Terror, and make the Difference, Reason alone could never do it."

"I should be writing a third paper on the Nerves, but I cannot proceed without making some experiments, which are so unpleasant to make that I defer them. You may think me silly, but I cannot perfectly convince myself that I am authorised in nature, or religion, to do these cruelties—for what?—for anything else than a little egotism or self-aggrandisement; and yet, what are my experiments in comparison with those which are daily done? and are done daily for nothing. So my employment is, correcting the press of my new edition of the Anatomy, and writing notes for my Physiology, which I mean to make an additional volume to the Anatomy."

"In concluding these papers, I hope I may be permitted to offer a few words in favour of anatomy, as better adapted for discovery than experiment. … Experiments have never been the means of discovery; and a survey of what has been attempted of late years in physiology, will prove that the opening of living animals has done more to perpetuate error, than to confirm the just views taken from the study of anatomy and natural motions."

"The present volume, introductory to a series of works in more ample detail, is submitted to the public as a specimen of the manner in which the author conceives technological subjects should be discussed."

"Being advised by his medical friends to try the effects of travelling, with light intellectual exercise, he left London in the latter end of last summer, and spent several months in wandering through the factory districts of Lancashire, Cheshire, Derbyshire, &c., with the happiest results to his health; having everywhere experienced the utmost kindness and liberality from the mill-proprietors."

"Manufacture is a word, which, in the vicissitude of language, has come to signify the reverse of its intrinsic meaning, for it now denotes every extensive product of art, which is made by machinery, with little or no aid of the human hand; so that the most perfect manufacture is that which dispenses entirely with manual labour."

"Great Britain may certainly continue to uphold her envied supremacy, sustained by her coal, iron, capital, and skill, if, acting on the Baconian axiom, " Knowledge is Power," she shall diligently promote moral and professional culture among all ranks of her productive population."

"of the body was immediately agitated with convulsive movements resembling a violent shuddering from cold. ... On moving the second rod from hip to heel, the knee being previously bent, the leg was thrown out with such violence as nearly to overturn one of the assistants, who in vain tried to prevent its extension. The body was also made to perform the movements of breathing by stimulating the phrenic nerve and the diaphragm. When the supraorbital nerve was excited 'every muscle in his countenance was simultaneously thrown into fearful action; rage, horror, despair, anguish, and ghastly smiles, united their hideous expressions in the murderer's face, surpassing far the wildest representations of Fuseli or a Kean. At this period several of the spectators were forced to leave the apartment from terror or sickness, and one gentleman fainted.'"

"The present is distinguished from every precenn hvjh vding age by an universal ardour of enterprise in arts and manufactures. Nations convinced at length that war is always a losing game, have converted their swords and muskets into factory implements, and now contend with each other in the bloodless but still formidable strife of trade. They no longer send troops to fight on distant fields but fabrics to drive before them those of their old adversaries in arms, and to take possession of a foreign mart. To impair the resources of a rival at home, by underselling his wares abroad, is the new belligerent system, in pursuance of which every nerve and sinew of the people are put upon the strain."

"There are only two ores of tin: the peroxide, tin-stone, or Cassiterite; and tin pyrites, sulphide of tin, or Stannine: the former of which alone has been found in sufficient abundance for metallurgical purposes."

"Another forerunner of modern organization theorists was Andrew Ure, a professor of chemistry. An enthusiastic proponent of “the factory system,” Ure (1835) took a step beyond Adam Smith. Whereas Smith’s pin factory was solely an example of division of labor, Ure pointed out that a factory poses organizational challenges. He asserted that every factory incorporates “three principles of action, or three organic systems”: (a) a “mechanical” system that integrates production processes, (b) a “moral” system that motivates and satisfies the needs of workers, and (c) a “commercial” system that seeks to sustain the firm through financial management and marketing. Harmonizing these three systems, said Ure, was the responsibility of managers."

"The difficulties which Arkwright encountered in organizing his factory system, were much greater than is commonly imagined. In the first place, he had to train his work-people to a precision in assiduity altogether unknown before, against which their listless and restive habits rose in continual rebellion; in the second place, he had to form a body of accurate mechanics, very different from the rude hands which then satisfied the manufacturer; in the third, he had to seek a market for his yarns; and in the fourth, he had to resist competition in its most odious forms. From the concurrence of these circumstances, we find that so late as the year 1779, ten years after the date of his first patent, his enterprise was regarded by many as a doubtful novelty."

"One event has been adduced in evidence of the uncertainty of his condition, which ought to excite interest in his behalf. He parted from his wife in 1779, because she would not agree to join him in converting some landed property into money, for the sale of which her consent was required by law. The property was worth, it is said, little more than four hundred pounds. Mrs. Arkwright entertained a high esteem for her husband, and always spoke of him with respect; yet she preferred separating from him, to the chance of being beggared by placing her dowry in so precarious a concern as she then thought the water-spinning frame to be. For some years after this event she lived altogether upon her own means. Mr. Arkwright was justly indignant at this want of sympathy in one so nearly related to him, and in consequence allowed her only thirty pounds a year, out of his own pocket, even when he had realized great opulence. These particulars are given by Mr. Guest on the authority of Sir Richard Arkwright’s niece, probably a disappointed and prejudiced person"

"The final tin-dip is useful to remove the marks of the brush, and to make the surface uniformly bright."

"The processes that may be employed, to give to portions of inert matter, precise movements resembling those of organized beings, are innumerable, as they consist of an indefinite number and variety of cords pulleys, toothed-wheels, nails, screws, levers, inclined-planes, as well as agencies of air, water, fire, light, &c., combined in endless modes to produce a desired effect Ingenuity has been long exercised on such combinations, chiefly for public amusement or mystification, without any object of utility."

"A mechanical manufacture being commonly occupied with one substance, which it conducts through metamorphoses in regular succession^ may be made nearly automatic; whereas a chemical manufacture depends on the play of delicate affinities between two or more substances, which it has to subject to heat and mixture under circumstances somewhat uncertain, and must therefore remain, to a corresponding extent, a manual operation."

"The stanniferous small veins, or thin flat masses, though of small extent, are sometimes very numerous, interposed between certain rocks, parallel to their beds, and are commonly called tin-floors."

"It is in a cotton mill, however, that the perfection of automatic industry is to be seen; it is there that the elemental powers have been made to animate millions of complex organs, infusing into forms of wood, iron, and brass an intelligent agency."

"Of the early management pioneers, history has provided us with the best records for four men: Robert Owen, Charles Babbage, Andrew Ure, and Charles Dupin... Ure knew the French engineer and management writer Charles Dupin, and when Dupin visited Great Britain in 1816–1818, Ure escorted him around the Glasgow factories. Dupin commented that many of the managers of these factories were Ure’s own students."

"How fortunate we didn't have these animal tests in the 1940s, for penicillin would probably not have been granted a licence, and possibly the whole field of antibiotics might never have been realised."

"One sometimes finds what one is not looking for."

"When I woke up just after dawn on September 28, 1928, I certainly didn’t plan to revolutionize all medicine by discovering the world’s first antibiotic, or bacteria killer, ... But I guess that was exactly what I did."