Essay on the Classification of the Insane
Part 13
At present, however, I will not enter into a clear and full explanation of this momentous subject; but I trust hereafter I shall be able show, that I am fully prepared to prove these assertions, and, moreover, to prove that, besides the extremes of pride and presumption, despair and misery, with endless indications that it is not according to the wisdom which cometh from above, it is the most common and frightful cause of the most incurable forms of insanity which I have found in lunatic asylums, I repeat, however, that so important and awfully true are these facts in my estimation, that I cannot remain contented with simply making these slight allusions to them, and I therefore intend hereafter to attack the error with all the force which my conception of its magnitude and baneful influence can inspire. Oh! that I could attack it with such effect that it would be rooted up for ever—so that it would no longer exist as the cause, (as it has hitherto been,) of gloom, misery, and desolation to minds of the most gentle, amiable, and acute construction. Such would not be the case did mankind behold the delightful harmony which exists between revealed truth and the constitution of the human mind. I see no lines and separations in knowledge, but behold in each part a portion of one grand whole. Science, intelligence, wisdom, and religion, are all ONE, and woe to the man who separates them!
O that mankind knew these glorious truths, which are everywhere most beautifully held forth to our view—not only knew these things, but knew also the happiness of making all this knowledge increase the well being and happiness of others around them! Then would the world possess the channels for the right influx of the inspiration of the heart; and then would that true and steady light be received into the understanding which would prevent it from falling into the mazes and darkness of error, or into actual evils and miseries of heart and of life.
Then, indeed, would the fire of Divine Love purify the earth of the human mind;—then would the oil of charity be the fuel on the altar of every heart;—then would the light of Divine Wisdom ascend into understanding, there to remain a sun without clouds for ever.
_No._ 24.—_Admitted_ 1802.—_Aged_ 25.
Nothing on record. She was brought up tenderly and respectably: her health was rendered delicate by close confinement at her needle-work, and her fondness for reading and writing. She was from home when her mind received a severe shock by the unexpected intelligence of her father having put an end to his own existence. Soon after this a grievous disappointment completed the overthrow of her mind. Before her father’s death, it was generally supposed he was wealthy: she was then engaged to one who had secured her affections; after her lover knew of her father’s death, and the involved state of his affairs, he still continued to profess his attachment, and held out the prospect of speedily fulfilling his promise of marriage;—she believed him, until she happened accidentally in company to cast her eye on the announcement of his marriage to another, when she shuddered and shrieked, and exclaimed “Wretch!” and from that moment she was insane, and has been so ever since. Her lucid intervals are considerable; yet she always retains so painful a recollection of this fact, that though fond of talking of all other occurrences of her former life, she studiously evades all conversation, or any question that at all alludes to this; so much so, that from this fact, as well as some others, I think it highly probable that even her present less violent, and less frequent paroxysms, are partly brought on by associations which awaken the same agony of mind and feelings of indignation as she then suffered. When highly excited, she will, like one who has received some extreme provocation, (her face red and swoln with rage) burst forth into the most violent passion, using the most scurrilous language; sometimes it is maniacal fury; at other times, only like one excessively angry, venting feelings by a hearty scolding; at others, she is only perverse and sulky, and frequently merely odd and flighty. All these symptoms for the most part occur, more or less, at certain periods, (see Observation V. and Essay on Atmospherical Influence,) but now they are something less violent at all times, and sometimes, for many months in succession, so slight that strangers could not perceive them, when she continues conversable and pleasant. She is very agreeable and useful in the house, which she considers her home. Perhaps this improvement may be attributed partly to the application of the medical swing—partly to the greater mildness of her present attendant: she is made happy by a little attention, and often visits her friends in York. Her natural talents are good, and improved by reading; her disposition is friendly and benevolent, but hasty, credulous, and incautious.
_No._ 25.—_Admitted_ 1803.—_Aged_ 28.
Nothing satisfactory on record. I have been informed by his family and friends, that he was a proud, passionate, spoiled child, and that the immediate exciting causes of his derangement were these. Through the interest of an elder brother, he expected to obtain a most lucrative and respectable situation in the East Indies, but it was discovered on his examination that he did not possess the requisite qualifications, consequently, he was not merely disappointed, but his pride was doubly mortified by being reduced to the necessity of undertaking the management of a common farm; there, with several other causes, these things operating on a spirit ill prepared for any adverse wind or the common storms of life, soured his temper; and at last produced so exasperated and violent a state of mind, that his mother, sisters, and friends, were compelled on account of various outrageous acts of passion to confine him.
[Picture: No. 25 page 190]
It is said that he was so violent after this, that it was deemed necessary to punish him, by chaining him for years, at times, to another patient; and yet, notwithstanding this treatment, it is evident from the remark of an old journal he then wrote, that he possessed a considerable proportion of mind; there are many excellent reflections on general subjects, joined, it is true, with what must appear to others, trivial observations, on the conduct of the attendants in the house. About two years ago he was subject to maniacal fits of outrageous passion, when his manner was proud and stalking, his voice loud and blustering, and his language contemptuous and imperative; calling the house his own; commanding every one of us as his servants, in grand style. The mention of a single fact, out of an immense number, will be sufficient to characterise his spirit and manners. Often have I seen him look at the patients with ineffable arrogance and contempt, and say, in a style which no acting could imitate, “Take this dog out of my sight.”
This violence and noise was so exciting to others, and unhappy for himself, that after various attempts by methods of kindness and argumentation, he was, without any previous threat, taken to the medical swing, where I told him that I was sorry to be obliged to apply so severe a medicine, but that I was certain from his conduct lately he must be very unwell, and that this would cure him, and more to the same purpose. Since this time, I have never heard any noise, or seen any violence about him. The name of the swing, after this, was enough to check him; but now even this was not necessary, and his seasons of excitement have from self restraint disappeared; and he is now, though an old incurable case, much more social than he was. In fact, he appears affable to me, and in some measure, even is so to the patients around him. He is fond of whist, and has very much improved in the game; and when I add to this, that reading the newspapers, walking, taking large quantities of snuff, and laying leaning on his arm, fill up his time, and that he is a dark, cadaverous, sulky, proud, gaunt looking man, all the house will know him. {192}
_No._ 26.—_Admitted_ 1806—_Aged_ 45.
There was nothing on record; nor have I been able to obtain any information about her previous history, except that she was a charwoman. Her appearance was rather respectable, her manners and conversation were distinguished by sort of bravado air of pride, very often extremely wild and extravagant; she was particularly fond of boasting of and displaying herself as being or doing something great and wonderful,—a general, lord mayor, king, &c.—always a male, and had a full beard on the upper lip, and her voice was more like that of a man than a woman. When addressed as a female, she immediately said she was a man, or a woman turned into one. She was very fond of decorating herself in a fantastic style. When provoked, she swore and talked most brutishly and strangely. She was removed May 15th, 1822—much in the same state, except that latterly she was worse, and not so useful in the laundry as she had heretofore been.
_No._ 27.—_Admitted_ 1806.—_Aged_ 36.
Nothing on record about her, but report says, 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 one _almost_ shivering 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.
OBSERVATION XIV.
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 susceptible and 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.
_No._ 28.—_Admitted_ 1806.—_Aged_ 23.
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.
[Picture: 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 material views 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.
_No._ 29.—_Admitted_ 1808.—_Aged_ 47.
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 former times 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 artificial drain 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.
OBSERVATION XVIII.
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, one thing 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.
_No._ 30.—_Admitted_ 1808.—_Aged_ 47.
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 the length 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.
OBSERVATION XIX.
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 can bring forth, for the purpose of enforcing this first, this inmost, this greatest, grandest principle involving the happiness and well-being of the world.
_No._ 31.—_Admitted_ 1808.—_Aged_ 30.
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.
[Picture: 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 activity of 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 grandeur and 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.