I mention such cases, because I shall hereafter do all I can to draw attention to similar mental states, as the common causes of insanity. That almost all cases _begin in this way_, but that they are disguised or kept from our view, with those who possess self control, until (unless the tendency be cured by such efforts to disguise it) they at last burst forth into some form of insanity; and indeed insanity itself may be defined generally, the uncontrolled over-excitement, imbecility, suspended or paralysed state of one or more of the mental functions, arising from some previous faulty state of action. I shall have to show hereafter how all these cases might in their incipient and curable stage have their specific modes of moral and medical treatment applied in order to counteract and cure them; and by this method incurable cases would be almost unknown. At the same time let it be observed, that such treatment requires much more delicate and intellectual attention than is in the power of those who for the most part live amongst the insane, and, have the direct and important management of them; and that, in justice to ourselves, I have a right to assert, that where such treatment has existed, and does exist, it is not a matter which money can remunerate, and that in this case there was no pecuniary reward. It was no such inducement that had any influence in regulating the conduct which we pursued with such unwearied diligence; and not merely was there no pecuniary reward, but even gratitude was wanting for a time; for this attention was so delicate, that she was always made to feel she was the person conferring rather than receiving favours; so that when she was relieved from her depressed state, and it was superseded by the excitement of the exhilirating passions, her self esteem dwelt only on the favours she imagined she had been conferring. _She was useful_, but her usefulness was more for her own good than for ours. Indeed, we paid the price of patient endurance to a degree and extent which can never be conceived or known, still less was she in a state to perceive or appreciate our motives, therefore she conceived, and was confirmed in the impression that she was actually the person to whom obligation and gratitude were due. This impression was the last remains of her disease, or of that over-excitement of the exhilirating passions, which with the longer-continued paroxysms of the over-excitement of the depressing passions, constituted the character of her case; and she left us, not merely before the “high state” had solely subsided, but at the very time when we felt it to be our duty to restrain and subdue it, and of course when she felt most mortified, and was least able to perceive and appreciate our motives, but which she has since done to our entire satisfaction.