In this confusion and clashing of opinions, when unfortunately each theorist views, or fancies that he views, functional or organic derangements sufficiently evident (in his eyes at least) to support his doctrine, it is no easy matter to come to a fair conclusion. It can only be observed, that, as the wonderful sympathies of the brain with other organs especially the viscera of the abdomen, are universally acknowledged, the morbid condition in which the brain is occasionally found may have arisen from a primary morbid condition of some other organ. Hence it is difficult to say whether insanity is most generally a primary or a secondary affection. Physical causes act both upon the brain and the abdominal system. Concussion and compression of the brain will occasion nausea, vomiting, and hepatic affections, and the presence of worms in the intestines will excite convulsions and epilepsy. In regard to moral causes, they may also act directly or indirectly upon the brain, or the parts that sympathize with it. Sudden or violent emotions are known to produce an immediate effect upon our digestive functions, which may in turn by their sympathetic connexion act upon the brain and the mind, although the connexion between brain and mind is not yet proved in any conclusive manner. However, in a practical point of view, whatever discrepancy of opinion may prevail on this subject, I think it will be found advisable to consider most, if not all recent cases of insanity, as arising from physical causes, and therefore to submit the patient to such a medical treatment in addition to moral aid, as the prevalence of morbid symptoms of local derangement are more or less evident. My own experience has fully convinced me that a morbid condition of the cerebral organ, and the viscera of the thorax and abdomen, are invariably met with, and must have proved of sufficient importance to develop symptoms which the slightest observations might have detected. How far the organic derangement may have been either the cause or the result of insanity I am not prepared to say, but they have generally borne the appearance of having originated in undue excitement. On this most important subject I feel much gratification in quoting the following opinion of the experienced Pinel: "It appears in general that the primitive seat of insanity is in the region of the stomach and intestinal canal, and it is from this central part that mental aberration is propagated as by irradiation." Esquirol is of opinion that insanity arises from a lesion of the vital functions of the brain, and not unfrequently from a disturbance in the various points of sensibility in different parts of the system.