In the autumn of 1824, he walked about a hundred miles to see me, and not finding my place of residence, he called on a medical acquaintance, to whom his description of my kindness and attention, and their happy influence upon himself, were so powerful and eloquent, that this new and accidental medical acquaintance, became from that time to the present, my first and warmest medical friend in encouraging me to establish myself in my present residence, and to whom I have to attribute the origin of all my success; so that this recovered patient’s gratitude, who followed me unexpectedly, was the first step in my progress, and was the _sole_ foundation of every thing which I have done or exists in this place. It was my only introduction. I may be permitted, therefore, to acknowledge my great obligations to the warm-heart friendship of the person, of whose melancholy state I have just given a general description, as well as, the medical friend to whom I have alluded. _No._ 195, _admitted October_ 27_th_, 1821. This case, I shall hereafter show, was apparently saved by this separation from former associates, at this critical period of convalescence, and he was one who required very superior and intellectual attention. He was a young man of some talents, and of various pursuits and acquirements, by far too many to be perfect in any one. Born with a large proportion of the family failing, his vanity had been fed by flattery and example, so much so, that it might be said he was bred in vanity’s hot-house; and ultimately, from over excitation, and too little collision with the world, he fancied himself a second Crichton. Of course with such an estimate of himself, it could not be otherwise but that he was constantly meeting with disappointments and mortifications, on his entrance into his profession, and the real business of life. From these causes, as well as from an increase at this time, of parental embarrassments and mortifications, (and home had always been an atmosphere of perpetual storms), from an hereditary scrofulous habit, and from his self-made morbid state, his mind was at last overwhelmed. But it is not my intention to enter into all the details of his history, further than to prove that the causes which produced his disease, and the form his insanity assumed, perfectly corresponded with each other.