Part 12

Nothing satisfactory on record. Said to have been a violent maniac. He was kept naked on loose straw. Since that time it is said he was improved by a seton; but still he was to the last a stupid, heavy, idiotical looking man, and in reality was so. {168} That he was less dirty, and kept himself dressed, was owing to better habits, into which proper management had gradually moulded him. But his mind was irrecoverably gone; he was motionless and silent, unless spoken to, or urged to some action. His replies were merely monosyllabic, and these only correct when they referred to something he had formerly best known; he was, however, drilled into some degree of usefulness, in helping about the wash-house. He was removed by his friends in April, 1821.

[Picture: No. 20 page 168]

_No._ 21.—_Admitted_ 1801.

Nothing on record.—He was one of those who was formerly kept naked on loose straw. He has been for years, for the most part, in a moping, poring, and solitary looking state; yet he has had occasional seasons of excitement, when the disposition towards furious revenge seemed to possess him, so much so, that he would, unprovoked, place his back against a corner of the wall in the attitude of self-defence, shaking his doubled fists in a daring and threatening manner. Though these effervescences of his spirits occur as frequently as ever, yet the malicious disposition seems dying away, and instead of which he will, at these periods, sing a little comic air, and give other indications of his mind being happy and full of good-nature, as much so as the little mind he possesses will enable him to be, if, indeed, beings in such a state can be said to have minds at all; for what an appalling difference between them and minds enriched with laborious habits of reading and reflection!

OBSERVATION XI.

In addition to the observations already made on former and present treatment, it is only justice further to say, that amongst recent patients, I have scarcely seen (if indeed I have seen) one instance of continued revenge. Their spirits exhibit themselves in good or ill-nature, according to the direction that is given them, and even in the old cases, as in the one above stated, it appears simply the remains of their former usage; so that if their minds are still agitated in some sort with feelings of revenge, it is only like the sea which will fluctuate awhile after the storm has ceased; but the winds are hushed, and every wave becomes less and less, until it subsides into a calm.

_No._ 22.—_Admitted_ 1801.

Nothing on record.—I have been informed, that his mind was instantly wrecked by the female of his heart unexpectedly marrying another the very day previous to that on which she had promised to be made his own for ever. He was an idiot, who could barely answer in a low whisper, and to a few very simple questions, “yes” or “no.” He was old, and pale, and thin—had a long face—his head hanging forwards—his stare was ludicrously vacant and goggling—his lower jaw fallen, and saliva flowing over his large hanging lip—though he generally stood quietly in a corner with his face to the wall, yet sometimes he would for some hours together make a strange and disagreeable noise—what was still more disgusting about him, he had the sickening habit of bringing up his food and regorging it, yet, in other respects he was not a dirty patient—perhaps because having been with a better class, he had received more attention.—He had this singular fancy, that if he had one or fifty pieces of bread and butter, he would eat, or secrete, or pocket them all, except one. He gradually declined from old age, and died in December, 1821.

_No._ 23.—_Admitted_ 1801.

No statement of his case. It is reported that he was a clever man, a hard student, fond of political subjects, and that speculations on the national debt were the cause of his insanity.—This report receives a colouring of probability from two large trunks full of books now in the Asylum belonging to him, almost wholly on subjects of political science, among which is a large collection of pamphlets on the national debt, and it is apparently confirmed by the nature of his hallucination; only I cannot trace the report to any certain source. It is certain he was Superintendant of the Police at Bombay.

His appearance and manners are very peculiar, and very difficult to describe. He holds his head forwards and obliquely upwards in a calculating position; moving his hands in different directions, and working with his fingers like unto one gathering something in the air.—At times he extends and stretches his hands higher than his head, moving and working them in the same manner: he will hold his face directly upwards—open and shut his mouth in a gaping and catching style, as if he were feeding on air; repeating these operations, and intermingling them with a strange gurgling noise in his throat—almost always muttering to himself as if he held busy converse with his own thoughts, with visible appearances of pleasure or anger on his countenance, occasioned by his imaginary operations being successful or otherwise.

Though he is sometimes as immoveable as a statue, yet he is for the most part moving about, and has a singular mode of treading with his feet like one who has been accustomed to a tread-mill, lifting them higher than necessary, and setting them down cautiously,—sometimes pulling off his shoes—sometimes, however, quickening all his motions, as if something required extraordinary haste and dispatch; and thus he marches about like some star-gazer treading on precious and frail materials; seldom more than a few moments in one place, and in all his movements in different rooms and parts and corners of his gallery, stairs, and airing court, and in all his operations and mutterings it is evident that he, in his imagination, is performing some essential part of his _mighty task of paying the national debt_, for when any of his operations or mutterings are interrupted, like one whose studies are suddenly broken in upon at some unlucky moment, he seems vexed and unhinged; sometimes bursting into a violent passion, when he is most eloquent in the use of scurrilous epithets (a proof that to use abusive epithets requires very little mind) calling the person who has impeded him in his great work, low-bred, mean, dirty scoundrel, rascal, villain, thief, vagabond, madman; accusing him of being the cause of the loss of many millions to the nation, threatening him with the direst punishment, particularly that he shall be whipped in the air. He is otherwise remarkably quiet and inoffensive, and uniformly intent upon this object, except that sometimes, as already stated, he appears unhinged and irritable by the unsuccessful issue of his calculations, and is then more liable to take offence, especially at any disrespectful deportment towards him, for it must be observed that he is still very fond of his title and of that deference due to a man of rank. Occasionally, like some alchemist of old, he fancies that some äerial being, which he calls the clown of the air, plagues him in various strange ways and interrupts his operations, for which mischievous interference he, in his way, severely scolds him.

The politeness which may be traced in his manners, is evidently the result or remains of his old habits, as he is so absorbed in abstract speculations that all attention to himself or external objects is utterly excluded; he is always solitary, but it is like the solitariness of one whose intense studies allow him no time for fellowship or the exercise of social feelings, so much so, that notwithstanding a consciousness of kind and respectful treatment towards him, he scarcely yet seems to know the name of his attendant.

Although his system is delicately susceptible of changes of temperature, he scarcely ever notices it himself; and when roused to pay attention to his feelings, he says that it is the clown in the air that has teased him with the iron ague.

He has been subject to occasional attacks of asthma, brought on, apparently, by exposure to cold in the night time, during these operations, (for he frequently jumps out of his bed to carry on this great patriotic duty.)

Though he can, if properly roused and managed, still answer questions much more correctly than all these appearances would indicate, yet it is evident that his mind is gradually declining, from age, exertion, and the nature of his case; he is an object of interest and sympathy, and nothing can exceed the way in which it is shewn towards him by his attendant.

OBSERVATION XII.

The correspondence between the insane state and the previous character and habits are in most cases, and certainly in this, very striking. On this subject I refer to the Essay on the Changes and Correspondence between the previous Natural Character, and that which they exhibit in their Insane State.

There is another fact in this last case, which may conveniently serve the purpose of introducing some observations ON THE EFFECTS OF HEAT AND COLD AND THE STATE AND CHANGES OF TEMPERATURE IN INSANE PERSONS, which may be considered as an Appendage to the remarks made in Observation V. and IX.

The fact to which I allude in this case is this, viz. that his system “is delicately susceptible of changes of temperature, but that he himself scarcely ever notices it.”

When the hallucinations of the insane are purely intellectual, and wholly and intensely occupy the attention, the generation of animal heat appears less than usual; and decidedly less than in those cases where the aberrations of the mind are connected with the stimulus of selfish and exciting passions,—hence the system is cold. But this arises rather from defective quantity of heat, than from any irregularity in its distribution; and thus, while the mind, from its state of abstraction, either disregards, or is wholly unconscious of exposure to the cold, the body is very sensibly and strongly affected by it.

In the last stages of gradual decay of mind, the changes and disturbances in the quantity, state, and diffusion of heat, resemble that observable in paralytics; there is great insensibility to heat and cold, and the infliction of pain; and, previous to the period of their dissolution, the slightest pressure, even so slight as to give no pain, produces ulcerations, which rapidly degenerate into gangrenous ulcers.—In old torpid cases of neglect—cases of suspension of mind; and in cases of pure mental abstraction, it is deficient in quantity, although equable in its diffusion.

In all these cases, as well as in cases of over activity of mind, especially during violent paroxysms, there is a general loss, or want, of consciousness to the usual impression of the corporeal system. Sometimes, however, this consciousness is on some points morbidly acute, indicated by strange sounds, and sights, desires, or aversions, &c., according to the parts or organs affected. In fact, it is this undue concentration of energy, which abstracts or confuses, rather than destroys the proper diffusion of consciousness.

Hence the insane, during violent paroxysms, bear the want of sleep and food, resist the action of severe cold, and the effects of large doses of strong medicines. In most cases their minds are so absorbed or suspended during their paroxysms that passing and external events are wholly excluded, and though some few, after their recovery, vividly remember their dreadful dreams; to others, all has been a blank, and they feel just as a person feels respecting that section of the country in which he happens to sleep as he travels; but all these things, (which I intend shall be noticed more particularly hereafter,) are not peculiar to the insane, as has been held by some; they are equally the case with patients during the paroxysms and delirium in the inflammatory stage of fevers. Indeed, the same principle is exemplified in the cases of men of spirit or energy, who, during the excitement produced by the achievement of some difficult enterprise, bear the want of food and sleep, and resist the effects of cold and exhaustion, to an extent which would seem to have exempted them from the common laws of humanity, and these are the incidents in life which are never forgotten; but then, as with the insane, this extraordinary expenditure of the cerebral energy leaves the system exhausted, and it requires all our art and care to recover the enfeebled powers. It is this critical period of convalescence which is so important, and so difficult in the management of the insane.

I further observe, that the variation of temperature of the system, observed during paroxysms of insanity, is more like that produced by the passions in a state of excitement than that which accompanies inflammatory fever. It appears to fluctuate in quantity, and to be tumultuous in its distribution, in proportion as the exciting and depressing passions are active and contending with each other. In proof of the truth of this, I need only mention that every thing which excites the malignant passions, or produces misery and distraction of mind, increases these appearances. I allude not merely to the expression of the countenance, but to the absolute heat of different parts of the system,—of different parts of the head in particular, of which they complain and to which they point distinctly, being often sensible to the external touch of another. It is to be remarked, that the changes and unequal diffusion of heat in other parts of the body correspond with the general and particular state of the mind: indeed the condition, (as it regards health or disease) of each part of the bodily system, directly or indirectly, corresponds with, and indicates states of the mind: but this truth requires more than an observation to do it justice; I make the remark, however, in the mean time, because there is no better guide to us in our treatment than this knowledge, and it explains this temperature as one of the corresponding effects. And though I shall not now enter on the medical nature of the treatment these indications afford us, neither is it necessary to say what kind of moral treatment they point out to us as our wisest course to pursue. In all such cases, and indeed in every case, we ought always to be anxious not only to keep our sympathies alive, but, in order that we may never fail rightly to direct them, we must also possess ourselves of a thorough knowledge of the mind, and its individual peculiarities.—To give settled calmness and tranquillity to the distracted mind, and bloom to the wild and faded countenance, ought not to be considered matters of trifling importance.

OBSERVATION XIII. ON THE EFFECTS OF INTENSE STUDY, AND GENERAL INTEMPERANCE OF MIND.

Though the effect of intense study and general intemperance of mind, may be better illustrated by many cases than by the preceding, yet for the sake of the moral deducible from the combined view of this part of the subject, and the preceding observations on the distribution of animal heat, I am tempted briefly to glance at the important reflections included within it; intending to resume a more elaborate consideration of its merits when I come to the Essay on the Causes which produce Insanity.

In those cases where intense study has been considered as the exciting cause of insanity, I have almost always been able, on closer investigation, to trace it rather to the intemperate feelings and sentiments of the mind, combined with the injudicious mode of procedure and irregular habits attending it. In young students, these studies are blamed; but, alas! how often have I ascertained that much greater and more decided causes (_secret and wicked causes_) have long been exercising the most baneful influence. In cases of regular and well-balanced exertion, however severe, the effects were rather a general depression and weakness of the whole nervous system than absolute derangement, producing either debility or suspension of mind, but which for its restoration required only cessation from accustomed exertions. Calmness and tranquillity, combined with innocent diversions and general attention to hygeian rules, invariably effected a cure.

I am the more particular on this point, as some authors on the subject of insanity seem almost to discourage all mental exertion whatever; whereas, we should never lose an opportunity of repeating the common observation, that the judicious exercise of mind, as well as body, is equally conducive to health and strength, as it is to mental improvement and worth. Rightly to apportion and conjoin the exercise of the feelings and understanding, as well as of the corporeal frame, constitutes the whole of Physiology as applied to health. When the civil duties of life are performed from right motives, we then are obedient to the first law of nature, as well as of the Decalogue: then all is healthy co-operation—all portions of the system have their fair proportion of exercise—none are over-worked, neither in the individual nor in the mass—neither in body nor in mind, as we at present see to be the case, singly and collectively: everywhere the effect is similar, destructive alike of all healthy, mental, and corporeal energy, and of all the sweet ties and charities of life which bind families and societies together.

It is remarked by Dr. Arnold and Dr. Penel, that most mathematicians and philosophers have not only lived to an advanced age, but have enjoyed good health, and have been exempt from mental diseases. Perhaps the number of such men vouchsafed to the world, has been too inconsiderable to enable us to form any correct comparative estimate between them and the rest of mankind, yet reason proclaims it true; and as far as medical statistics furnish us with facts, they all tend to confirm the truth. Certain it is, that nothing conduces so much to health and long life as conduct, well regulated, and a mind habitually preserved in a state of intellectual calmness.

Such exercise of the reflective faculties not merely subjugates, but virtually diminishes the energy of the passions; for reflection convinces that every improper gratification must produce dangerous consequences. The very exertion of thought on subjects of exact enquiry, by appropriating the vital energies to its more exalted purposes, abstracts as much from the strength of the passions and propensities as it adds might to the powers of reason and conscience to subdue and control them. On the contrary, persons with vacant and ill-regulated minds, (instead of possessing the passport to the wise and good, whose habits create in the social circle cheerfulness and felicity, and from thence diffuse these blessings to others around them,) fly, when unoccupied, to those who expend the energies of their existence in senseless follies or sensual gratifications. The virtuous man has an ever-living zeal about him, which benevolence warmly inspires, and truth calmly regulates. There is no destructive warfare among the powers of his mind, as is the case with those whose zeal is _generated by pride_, _and nourished by malignity_, but his more noble faculties take the lead in activity, and superintend the whole; all are cheered and invigorated by the co-operation and harmony that reigns among them. It is wonderful how with this proper balance and use of the faculties they stimulate each other, and keep the mind alive;—“Peace is within these walls, prosperity within these palaces.” Such a one alone possesses his soul with the full use of its instruments of operation. Where the powers of body mind are well balanced—every thing is in its place—every part subservient to every other—all reduced to practice—then the mental and corporeal powers wear well—age brings few diseases, and no apprehensions—our peace of mind becomes more settled—our wisdom greater—our friendships more valuable, and we come to the grave in a full age, like a shock of corn in its season. To say, that knowledge is power, is only to assert half the truth: it is knowledge combined with moral worth, or as Solomon more beautifully expresses it, “Wisdom is Strength.”—Without virtue, knowledge is ruinous and destructive; with it, the progress of improvement and happiness is illimitable,—here providence smiles—there she frowns; this is equally applicable to individuals as well as nations. History is but one large commentary on this truth, and when men (indeed such a period appears now to dawn) have learned wisdom by the severe lessons of providence, then the Rise and Progress, not “the Decline and Fall, of Empires,” will be the title of the volumes of some future historian.

Were it not for the vast importance of the subject, this might seem the place to introduce some observations on that most grievous error so common among religious persons, of supposing that God requires, on sacred matters, the abnegation of reason—of that reason which distinguishes men, and without which there is no distinction between us and brutes;—it is not merely our will, or affections, or instincts, but this will combined with the superadded attribute of our own understanding which makes us men, and makes us even images and likenesses, (so far as the will and understanding are united, and exist in perfection,) of our Maker! These doctors teach their hearers to dethrone reason, in order, as they say, that the Gospel, the grace, the wisdom, the justice, and goodness of God, may be exalted thereon. They call all this a reasonable and acceptable service. Strange paradox! Wonderful perversion, that a view so contradictory and false can be enforced with a fiery zeal that proves it is believed, embraced, and retained under the influence of the fear, (and not the conviction in the understanding,) that it is essential to their salvation! yet I know this doctrine is the main branch, or the first fruits of that grand fundamental error which is called in the strong prophetic language of Scripture, “the abomination which maketh desolate.”—Some of the effects are, separating faith from charity, truth from goodness, _the will from the understanding_; and all that God hath, according to the laws of order in the Creation ordained to be joined together, it tears asunder, throwing the mind into a dislocated and distracted state, destructive alike of its peace, and of the bonds which preserve society together:—madness, wickedness, infidelity, and anarchy are the fruits which it produces.

If people are destroyed for lack of knowledge—if to hate the light is a proof of deeds being evil—if the fear of the Lord is the beginning of wisdom—if this knowledge is the continent in the mind for the reception of every other what shall we say of those who teach—that this—the first, the best, the godlike gift of the Creator, must be sacrificed in order to embrace the view of religion which they propose? I cannot use stronger language than I have used already, but repeat that mental alienation is one of the dreadful consequences of that doctrine which is emphatically called the ‘abomination which maketh desolate;’—of that doctrine, whose fruits are bitter, and which fills the mind with doubt, gloom, and misery.

When the only true basis of religious knowledge is removed, and insane notions occupy its place, what desolation follows!