Nothing on record about her, but reportsays, that others in the family are insane; and that the exciting cause, in her case, was the loss of some money she had saved in service as a cook.
She is at present in a state of imbecility of mind, and she looks a quiet, timid, silent, motionless, stupid creature, sitting continually in the same posture, like onealmostshivering with cold. Although extremely peaceable and timid, yet her mind is irritable, wanting, however, courage for retaliation, so that when provoked, she looks angry, but walks away: she never speaks unless spoken to, and then her answers are short, but mostly correct, though it is evidently all force work. This has been for years her state, or rather debility, with scarcely any perceptible changes, except that her mind appears gradually sinking. She was formerly more conversable, and would have done something at her needle, but at present she is always idle, and has latterly, from inaction, become less cleanly in her person.
Her habits of saving (if the report be true) prove her love of money, the loss of which would of course, be felt in proportion as she valued it; and, with her exceedingly susceptibleand delicate mind, it must have been overpowering; hence, as in all hereditary cases, there was something discoverable in the natural disposition which rendered the exciting cause more efficient, and we find benevolence, caution, and consciousness large, and self-esteem and combativeness defective.
There is nothing on record, but I have been informed that the cause was religious controversy, resulting from association with the followers of Johanna Southcote.[195]He was the son of a respectable country wright and joiner, and had a decent ordinary education.
No. 28 page 195
His present state of mind presents a strange mass of confusion from which nothing can be drawn or collected, except that from his fondness for drawing houses, and different things connected with building, and from his muttering to himself (for he declines all conversation with others) something about measurement, the square being so much, &c. some traces of his former habits of life, may be remarked and determined: the strange and absurd materialviews of the coming new order of things, betray the view which did (and I am told, still,) belong to that sectarian delusion. He is chiefly distinguished by his unsocial habits, and by the singular practice of always cramming a part of his meat, and sometimes other things, into his ears, shoes, breeches, and different parts of his dress.
Once for all, I must say of these old cases, since there is no book or documents concerning them, that the origin, nature, and progress of the disease cannot now be known except from enquiries directly made, either by writing, or of such friends as may occasionally visit them; and with many of these lower class of patients, it cannot of course surprise us that they should not have any friends to visit them after such a lapse of time. This is more likely to be the fact when the character of the case is of a more revolting nature—as is very singularly so of the one I am about to describe. Yet she has had visitors, from whom, however, I was not able to gather any information upon which I could depend; her insanity was said to be hereditary, she having a sister who is insane.
She is one of those old cases which, in formertimes in this institution, were kept naked in loose straw and not allowed seats; and hence she now, from this deprivation, sits huddled up, resting on her calves, when worn out by her violence, curled up like an urchin in a corner in a sort of dog sleep, the slightest noise instantly rousing her, when she starts into her strangely agitated state,—shaking her head and gnashing her teeth, and uttering horrible curses with a sort of barking, hoarse, and hideous gutteral sound, apparently against some object present to her imagination; in this violence she formerly continued, sometimes for weeks, latterly only for days, with the most part only for hours, with scarcely any intermission. In fact, she was in appearance and manner the most brutal and blasphemous demon—no imagination can picture any thing at all equal to the awful reality; and yet it is a remarkable fact, that, some years since, her intellect was restored by a very decided physical cause, the breaking of her leg; when, during the process of the bone uniting, her reason returned: her manners were mild, grateful, and affable, and the tone of her voice was soft and sweet; and again, when her leg was healed, she relapsed into the same violent state. It has continued, excepting a short convalescence during an attack of dysentery: and this is now more than seven years ago; and after which, an artificialdrain was kept open, but with no apparent benefit; the dysenteric attack was also imitated, but with no further benefit or effect than its mere physical depressing influence at the time. It is worthy of notice, that when taken to the swing[198]a second time, she talked more sensibly, refrained from swearing, promised to behave better, and in a sweet tone begged not to be swung: since this time, she has been less violent, has shaken her head and sworn less than before; indeed she has a more good-natured manner, and very often expends her excitement in mirthful dancing and singing, and generally seizes my hand, that I may dance with her.
Though the doctrine of Demons, or being possessed, has been discarded; yet, in my opinion, it deserves a more serious consideration than medical men imagine:—it involves the true theory of mind and matter, their connection with each other, and the principles on which this connection depends, and by which it is regulated. I shall leave this question for the present, with the intention of returning to it at some future opportunity. However, onething this case serves to prove and illustrate, which is, that whatever mysterious link the mind may constitute in the order of being, it is certain that this is according to or dependant on the physical condition of the material organs through which this connection operates, so that the physical reasoning on disordered and diseased organization remains precisely the same, whether we admit or deny that the visible, and invisible world subsist together and are in indissoluble connection.
I have not been able to obtain a very accurate or full history of this old and incurable case. He was a clergyman of the Church of England. He had been a hard reader and distinguished student at Cambridge, and he now gives proof of his having been an excellent classic. It is said, that after he had obtained a small vicarage, although not an immoral man, he was gay and expensive in his habits. After the age of thirty, he hastily married an exceedingly beautiful girl of about sixteen years of age, but who was uneducated and from a low station of life. Afterwards discovering her deficiencies as a companion, his love cooled into indifference, and his naturally proud, impatient,and uncontrollable temper was made worse; he treated her harshly, their quarrels became habitual, and they lived in hatred, misery, and distraction together.
In this state of his disappointed affections he was seduced into various intrigues. Shame, conscience, and loss of character, quarrels with his parishioners, aggravated at the same time by a fall from his horse on his head, increased his natural irratibility of temper, and so mortified his pride, that he became desperate and attempted suicide. After this he had a regular paroxysm of maniacal violence, which subsided, although it has returned with considerable increasing intervals up to this time.
During his lucid intervals, he will talk of the harshness with which he was used, when it was first considered necessary to remove him from home; and there is no doubt there is some truth in his statements: at the same time it seems right to observe that, if in any instance it can be excusable to allow our natural feelings for a moment to overcome us, this was one of such cases. The proud, malignant, and contemptuous manner displayed in his violence, was irritating in the extreme.
About eight years ago, he continued for some time in a perfect state of convalescence, and when the paroxysm returned, its violence and duration appeared in proportion to thelength of intermission. These paroxysms and intervals of convalescence have since preserved the same ratio to each other. It is remarkable that the last interval of convalescence, commencing about five years ago, continued for more than three years, which I attribute to the absence of causes of irritation, more delicate and attentive treatment, and constant resources of various amusements. During the whole of this time, he could not be persuaded to leave the place; he said “It would not do;” that he “should soon be worse than ever.” The name of home and his wife seemed to make him shudder; and when asked if he should not like to go, he shook his head, turned away, and said nothing; but he evidently painfully felt the association of old exciting causes.
It ought, however, to be mentioned that during the whole of this time he would frequently exhibit signs of great uneasiness and irritability, would pace the gallery or airing court, in quick and hurried steps, and afterwards call his attendants to play a game at whist or backgammon: at these times he was in the habit of chewing orange-peel, which he constantly carried in his pocket for that purpose, and afterwards he would say his troubles were overcome. He has since had a return of his insanity, from which he never perfectly recovered; I have since understood that he is dead.
The most obvious remark suggested by this case is, that, like many old cases, when once an irritable habit is established in any part of the mind, how easily the mere association of old existing causes will overturn the balance and introduce a relapse into the same state: no exciting causes can have more power to do this, than the constant painful state of mind which ill-assorted and unhappy marriages produce; and therefore, the next most obvious remark suggested by this case, is the evil which arises from the whole mind being ultimately disagreeably affected by the contraction of hasty, mistaken, and ill-assorted matrimonial connexions. As the sublime principle of rightly-constituted and spiritual or mental marriage is involved in the consideration of such cases; and as, from the want of a proper understanding of this principle being duly impressed upon mankind, the evils and miseries which the parties bring upon themselves and entail upon their offspring in the world, are so numerous and so frightful, and so frequently the cause of the most terrible forms of insanity, I shall, in an after part of this work, endeavour to embody in an essay expressly on this subject, all the arguments which I canbring forth, for the purpose of enforcing this first, this inmost, this greatest, grandest principle involving the happiness and well-being of the world.
He is a surgeon, and was formerly in great repute as a successful practitioner, as well as a lecturer on anatomy, surgery, and the practice of physic.
No. 31 page 203
He was very studious, and chiefly during the night, though his sleep was already sufficiently broken by his professional labour. As a young student he was ambitious to excel, as he would often say, “I employed my time well, that it might serve me in after life; and it did so.”
His mind is naturally one of much greater activity than power, hence his harassing day and night practice and preparation for lecturing induced a morbid state of mind, in which condition a fever in his family occurred. Rapidly and unexpectedly, four male children, a niece, and a maid-servant, were the victims, and this completed the wreck of his overworked, active, and feeling mind.
His present state is most interesting and singular, and very difficult to describe. His activityof mind, prodigious command of words, and most animated and graceful manner, excite the greatest surprise; and even in his present deranged and deluded condition, with his varied stores of information, these exhibitions are mistaken for the remnants of versatility of genius; yet, as I have already said, it is most true that his mind was not naturally one of so much power as it was of amazing ambition and activity.
He will suddenly rush into some of his anatomical, surgical, and medical lectures, going through different parts of the human body, operations, and practice. His lectures on the circulation of the blood, seem to have been most strongly impressed upon his memory. At other times, his eloquence is displayed in imitations of various celebrated characters. If they are ancients, and he be asked, how can this be? since they lived two thousand years ago, he says: “Yes, but I died and rose again in the world.” And thus, he imagines himself every character he personifies, and that at that time he was alive, and afterwards died, again reappearing in such another character. In this way having passed through numberless transmigrations, he was Adam, Abel, or Melchisadeck, Abraham, Isaac, and Jacob, Moses, Joshua, Samson, Goliah, David, and Solomon. Solomon had great attractions: frequently describing, with great animation, his state of grandeurand enjoyment. In the same way he was Aristotle, Pythagoras, Confucius, Plato, Zoroaster, Pliny, Ptolemy, Cicero, Demosthenes, and particularly Homer, Mahomet, and even our Saviour, &c. All these he will still personate, and make speeches differing in manner and matter, and suitable in some measure to each of them.
In medicine, all the list of celebrated men are claimed as the same transmigration of his soul. He lifted up the serpent. He was Hypocrates, Celsus, Galen, Paracelsus, Stahl, Van Helmont, Boerhave, Cullen. In anatomy, surgery, chemistry, and natural philosophy, it was the same. The whole list of celebrated medical men is monopolized by this mania of transmigration.
He always addressed strangers as contemporaries, saying, “Good God! you were alive at such a time: I knew you well; you were with me when I conquered at the plains of Marathon! or, you met me at such a place when I was singing the Iliad, as old Homer,” and so on. All this with such a fascination of look, manner, and address, that he arrests and amuses every one, especially strangers. He frequently talks with imaginary, and especially angelic beings, which he does with a manner and expression that prove he believes he beholds their actual presence.
He had a peculiarly bright and glistening eye,indicative of the secret and destructive habit so dreadfully fatal to the insane.
It appeared to me, since amidst all this strange confusion and delusion, his intellectual powers were still in existence, that if his understanding could be constantly occupied, this confused condition might in time be corrected, and his mind restored to a right state: for this purpose I undertook to make him translate a French work, while I wrote from his dictation, at the same time checking and controlling his wild starts into all these vagaries. In this manner we nearly finished an important medical work together, and he was evidently much improved by the exercise; the task was however so amazingly arduous, that in the midst of my other duties I was obliged to discontinue it, and he then relapsed into his former state.
The effect, however, was sufficiently decided to prove a fact of very great importance, and many such facts having since occurred, which further tend to confirm that many cases which are generally given over as incurable, may be cured by a well-directed exercise of the understanding, by which it is at once strengthened, and the mind drawn and excluded from the exercise of its insane feelings and hallucinations. In some cases I have made them translate a work on the nature and effects oftheir secret vice, and it has silently checked this habit, and at last restored them.
Here I close my description of these old cases, conceiving I have given a sufficient number for the purpose I had in view, that of exhibiting a fair average picture of the state and character of the old insane. After one general abstract observation on the whole essay, I shall afterwards, and following this last case, make my next essay on the origin and nature of disease in general, and of insanity in particular: and which I shall do as preliminary to the more intimate and direct investigation of the causes and nature of insanity; and especially the direct consideration of the cause to which I have alluded in this case, because it is one of the most general and most fatal causes of insanity, and a cause, which if not removed, inevitably renders them incurable. Such was the habit of the person whose case obliged me very reluctantly to assume a defensive attitude, and refute falsehood by a statement of the truth, or otherwise I should have continued silently to proceed in the path of duty, without obtruding our own secret exertions on the notice of the public, as it may appear that I have done in this essay, as well as in those which are to follow, written, as they will be, in some measureon the same principle, for the truth should not suffer from diffidence, any more than it ought to be brought into disrepute by vain ostentation; still, I am quite certain, that I am actuated by no feelings incompatible with charity and justice.
The concluding general observations on this Essay and its Appendix, are, that the one principal object I have had constantly in view, has been the removal of the erroneous impressions and prejudices which exist almost universally against the insane, as if they alone were all furious wild beasts or infernal demons, and which have hitherto excited and still continue to excite a spirit and conduct toward them, productive of a baneful and injurious influence.
So long as these prejudices exist in the mind, even the soothing treatment which is now so much the boast of the age, assumes a spirit and manner, perhaps as galling and injurious to the afflicted as was, undoubtedly, the heartless tyranny of former times.
I deprecate that altered tone of voice and manner which implies in every word and action, that they are considered either as children, or as beings wholly bereft of rationality.
In the system (which I have in some degree stated and explained) of receiving and treating them as visitors, even as though they were stillrational, and of course observing towards them the same polite and delicate attentions as are practised in well-bred society, the same irresistible effects which precept and example always produce in every sphere, in proportion as they are exercised in sincerity and truth, will be found to be produced also on them; and hence we may easily perceive how it comes to pass that we have so much greater dependence on their attachment, good conduct, fidelity, and honour, than is generally imagined to be possible, and why, consequently, the greater liberty which is given them is seldom or never abused; and, as cause and effect increase each other, it is evident that this system, by exciting and exercising the higher feelings and moral principles of the mind, produces, (as will be seen from the tables I shall hereafter introduce) a much greater proportion of cures than has hitherto been the case. It is much more conducive to cure than the system of perfect separation and exclusion from any association. This truth is another important reason for being anxious, from the best of motives, to remove these baneful prejudices which have hitherto made a marked moral line of distinction between diseases of the brain, and other parts of the system, exclusively and absurdly making the former a proof of some shameful criminality. And though this greater degree of well-judgedliberty (not indiscriminate) appears alarming to those who retain the usual worldly prejudices against the insane, it is in reality attended with much less of danger or of any thing to excite the fears of others, than most assuredly is a contrary system.
I am now enabled, from nearly twenty years’ experience, to say this with confidence; and I am the more anxious to impress this on the world, in order that I may not be obliged, from too great a deference to its fears and prejudices, to abridge the exercise of this influence, so far as to lessen the happy effects of a system which theory and feeling have suggested and compelled me to pursue, and which increased knowledge and experience have confirmed and justified.
Our fears and prejudices create and realize that which would otherwise have no existence. We often blame effects of which we ourselves are the cause. This is one principal, if not the only, source of all our complaints and all our troubles. Servants, children, families, sects, parties, nations, and even the insane, are more or less good or bad in their conduct and character, in proportion as our principles and conduct towards them are under the influence of a wrong spirit or a right one.
Such are our views, and I trust it will be seen (the experimental part at least,—thetheory will be explained in due course) that we have endeavoured, however imperfectly, to reduce them to practice.
Wherever natural and spiritual good exist, there we shall behold those best fruits of charity, of which the vine and fig-tree are beautifully appropriate emblems.
I trust that what I have advanced will be considered less as a personal boast than as an explanatory statement, suggested by recognised evils, and enhanced by candour and conviction. Although past conduct is the best guarantee for the future, yet it is by no means an infallible security; and it altogether ceases to be the test of any security, the moment boasting, pride, or self-confidence exclude a higher and better dependence.
THE END.
DEAN AND MUNDAY, PRINTERS,THREADNEEDLE-STREET.
[vi]For the present I shall defer the publication of these Tables.
[xiii]Inferno, c. iii. 9.
[xv]See page 211.
[26]A Case and Observations being mislaid when printing, accounts for the error in the number of this observation.
[5]See hereafter, Divisions of Insanity.
[16]See Divisions of Insanity. See also No. 131.
[18]See No. 71, 81, 88, 105, 145, 146, 175, 208, 339, 374, 375, 376, 379, 380.
[20]See Essay on a Knowledge of the Human Mind, unfolding the universal principles of generalisation, where I shall show that these words are not mere figures of speech, but that they each express a truth which every fact in medicine demonstrates.
[22]It is worthy of remark, that these are those who are always ailing, and their complaints correspond with their faulty state of mind.
[27]See the cases mentioned in Mr. Harris’s and Mr. Balle’s affidavits,—in Allen v. Dutton.
[28]See Dr. Birkbeck’s affidavit, in AllenversusDutton.
[36]She knew me at York, when she was at the Retreat.
[55]Inferno, c. iii. 9.
[57]See No. 427.
[80]See 395 and 396.
[95]See Case No. 85.
[96]I have hitherto had but one out of 600—and he had secreted a rope, and effected his purpose, the day after his arrival by pretending to retire to a place of convenience.—I confess I would rather not state this, as it may look like boasting; but so far from this, I am sure my feelings are only those of gratitude. A suicide of a most determined character was so delicately watched, that for six months he did not ascertain that he had any loss of liberty, or was in a place of this description, but merely with kind friends of his parents.
[99a]This evil is prominently seen to result from all modes of charity that are not secret, or have not their origin or are not done in the spirit of kindness, as well as from all punishments that are too severe and unnecessarily degrading in their nature.
[99b]See case No. 6, in the Appendix.
[102]See Essay on Forbearance.
[114a]The organs[114d]of self esteem and benevolence, are well developed, cautiousness defective; indeed, the whole head agrees admirably with what I should conceive his character has been; and from what I have seen and heard characterizes the family.
[114b]He repeats, most correctly, almost the whole of Goldsmith’s Description of the taking of Quebec.—These cases were written in 1821. See Essay on Atmospheric Influence.
[114c]His friends, though rich, from caprice, only allow him a very coarse dress: in other respects, they are exceedingly attentive and kind to him.
[114d]I think, in the present state of this science, the word—organ objectionable, and merely to say, they are external forms representative of internal states of mind; at the same time, I believe most firmly, that mind can only act through organic forms created expressly for specific uses, and even though this admits that the manifestation depends on organic structure, yet it is best not to appear hasty, and on this account also, I am not satisfied that the present names and divisions, are those which time will determine, and which in nature are true.
[115]There is some partial or general defect, which renders the operations or manifestations of mind imperfect: whether this defect, and consequent imperfection in the manifestation of mind, arose in the first place from bad habits, producing disorganization, or disorganization bad habits, or from both, is not now the question. It is, however, I believe, (the evidence on which this belief is founded, will be stated hereafter,) generally the first.
[116]His head, upon the whole, is well formed, except that there is a slight degree of irregularity, one side being more developed than the other.—Cautiousness and benevolence are most prominent.—Since this was written, two members of his family have been insane.
[117]See Table. I shall have occasion again to refer to this fact, and have, therefore, very briefly noticed it in this place. That the middling class are more torpid, is certain, whether wholly from their treatment, or partly that their minds had been of a more composed habit, or that their insanity had not arisen from violent excitements, are interesting questions to the Medical Physiologist, and Moral Philosopher,—which will be considered in another place.—See Mr. Jona. Gray’s History of York Asylum.
[119a]See Observation 12.
[119b]There is a remarkable correspondence between the kind of mind he exhibits, and the configuration of his head. It is very large and smooth, with self-esteem, love of approbation, large; firmness, full; combativeness, defective.
[121a]See Observation 12.
[121b]His head is small, particularly his forehead, where the reflective organs are defective; but individuality, combativeness, and amativeness are full; self-esteem, defective.
[122a]In this case, the organ of benevolence was exceedingly prominent, and combativeness equally defective; indeed his whole head corresponded most exactly with his character, and was a good one, except that one side was more developed than the other.
[122b]His head is well formed,—benevolence, and the organs of social feelings, particularly full, with combativeness, very defective; ideality, very full.
[123]That he has been thousands of miles in a minute; very busy relieving, saving, burying, or getting out of the way, (as he calls it,) thousands of people that have been burned in some great fire—starved in masses of ice many miles thick—or drowned in some dreadful shipwreck, &c., &c.; some of them uncles or aunts of those he is conversing with at the time, &c., &c.
[133a]Armies sustain immense fatigues during the excitement of a campaign; but when the excitement is over, a prevailing epidemic will often attack, subdue, and sometimes almost annihilate them.
[133b]In 1759, a typhus prevailed in Bethlem, and from its state at that time, we cannot wonder at this fact. Dr. Wright, of Bethlem, says, they have had this year a severe erysipelis attacking a great number.
It was observed of the plague of 1707, that persons excluded in religious retirement, escaped the disease, and so did prisoners and all others kept from the air abroad.
[134]Sydenham thought “there was some secret inexplicable alteration in the bowels of the earth.”
[135]See Dr. Hawkin’s most valuable work on Medical Statistics.
[141]Take no pleasure in the folly of an idiot, nor in the whims and fancies of a lunatic, nor in the phrensy of a drunkard; make them the object of thy love and pity, not of thy pastime: when thou, alas! beholdest them, behold how thou art indebted to Him who suffered thee not to be like them!—Retrosp. Rev. p. 185.
[142]See Observation on Dæmonology.
[143]See pages 17 and 18.
[145a]It is a principle throughout nature, that changes, and the repetition of changes give, in proportion to their repetition, a greater aptitude to their periodical recurrence.—Wine merchants say, that wine always undergoes a slight change on the annual recurrence of the original season of its fermentation.
[145b]See pages 16, 17, & 18.
[147]See Haslam on Madness, page 236.
[151]Pinel, p. 10.
[152]This was written in 1822.
[153]In seeing the patients bathe, I have been struck with the beautiful sleekness and clearness of their skins. Many of them, however, retain marks of scrofula.
[154a]See No. 30.
[154b]Since the above was written, the disease of the skin was much relieved by Ung. Hydr. Nitrat.
[155]Her head is generally good, indicating a peaceable, good-natured being. Combativeness, defective; benevolence and philoprogenitiveness, full.
[156a]His organ of destructiveness is very full, and the wound has been directly there.
[156b]Firmness is very full, and combativeness rather so.
[159]His head corresponds with his character: no combativeness, destructiveness, or caution; but self-esteem, hope, friendship, and benevolence, full.
[160]I shall hereafter make some observations on the peculiarities of character in females contra-distinguished from that of males.
[162]Pride, benevolence, hope, combativeness, and amativeness, full; caution, conscientiousness, and veneration, partly defective.
[164]Philoprogenitiveness is singularly full, so is combativeness and firmness.
[165a]He had the most immense organ of destructiveness and firmness I ever saw, and was remarkably defective in the social feelings and sentiments, but he had some benevolence.
[165b]His attendant says, he would have resisted harsh treatment to the very last effort that life would allow him.
[168]His head was an immense smooth round mass, such as is common to Epileptics, and powerful but sluggish minds.
[192]Self-esteem, love of approbation, firmness, and amativeness, are very full; caution, causality, combativeness, are next in order; veneration, rather defective.
[195]For remarks on religious controversy, see Essay on ‘Truth contrasted with Error.’
[198]This I have never used since, now sixteen years ago. It is now, under better management, wholly unnecessary, and worse than useless.