CASES OF INSANE CHILDREN.

In the month of March, 1799, a female child, three years and a quarter

old, was brought to the hospital for medical advice. She was in good

bodily health, and born of sane and undiseased parents. The mother, who

attended, stated that her husband's parents and her own had never been in

the slightest degree afflicted with mania, but that she had a brother who

was born an ideot. She related that her child, until the age of two years

and a half, was perfectly well, of ordinary vivacity, and of promising

talents; when she was inoculated for the small pox. Severe convulsions

ushered in the disease, and a delirium continued during its course. The

eruption was of the mild kind, and the child was not marked with the

pustules. From the termination of the small-pox to the above date, (nine

months) the child continued in an insane state. Previously to the

small-pox, she could articulate many words, and use them correctly for the

things they signified: but since that time she completely forgot her

former acquisitions, nor ever attempted to imitate a significant sound.

Whatever she wished to perform, she effected with promptitude and

facility. She appeared anxious to possess every thing she saw, and cried

if she experienced any disappointment; and on these occasions she would

bite, or express her anger by kicking or striking. Her appetite was

voracious, and she would devour any thing that was given to her, without

discrimination; as fat, raw animal food, or tainted meat. To rake out the

fire with her fingers was a favourite amusement, nor was she deterred from

having frequently burned them. She passed her urine and faeces in any place

without restraint; but she could retain a considerable quantity of the

former before she discharged it. Some cathartic remedies were ordered for

her, with an emetic occasionally, and she was brought to the hospital

every fortnight, but she did not appear in any degree amended. On June 22

she was admitted a patient, and continued in the hospital until the middle

of October, when she was attacked with an eruptive fever, and consequently

discharged. During this time little progress was made, although

considerable pains were bestowed. She became more cunning, and her taste

appeared improved. The cathartic medicine, which she drank at first

without reluctance, became afterwards highly disgusting, and when she saw

the basket which contained it, she endeavoured to escape and hide

herself. To particular persons she was friendly, and felt an aversion to

others. She was sensible of the authority of the nurse who attended her,

and understood by the tone of her voice whether she were pleased or

offended. The names of some things she appeared to comprehend, although

they were extremely few; when the words, dinner, cakes, orange, and some

more were mentioned, she smiled, and appeared in expectation of receiving

them. By great attention and perseverance on the part of the nurse, she

was brought to evacuate her faeces and urine in a night stool.

After the elapse of three years I was informed that the child had made no

intellectual progress.

W. H. a boy, nearly seven years of age, was admitted into the Hospital,

June 8th, 1799. His mother, who frequently visited him, related the

following particulars respecting his case.--She said that, within a month

of being delivered of this child, she was frightened by a man in the

street, who rudely put his hand on her abdomen. When the child was born it

was subject to startings, and became convulsed on any slight

indisposition. When a year old, he suffered much with the measles: and

afterwards had a mild kind of inoculated small-pox. At this age she

thought the child more lively than usual, and that he slept less than her

other children had done. At two years, the mother perceived he could not

be controled, and therefore frequently corrected him.

There was a tardiness in the developement of his physical powers. He was

fifteen months old before he had a tooth, and unable to go alone at two

years and a half: his mind was equally slow; he had arrived at his fourth

year before he began to speak; and, when in his fifth, he had not made a

greater proficiency in language than generally may be observed in children

between two and three years. When admitted into the hospital, he wept at

being separated from his mother, but his grief was of very short

continuance. He was placed on the female side, and seemed highly delighted

with the novelty of the scene: every object excited his curiosity, but he

did not pause or dwell on any. He was constantly in action, and rapidly

examined the different apartments of the building. To the patients in

general he behaved with great insolence--he kicked and spat at them, and

distorted his face in derision; but, on the appearance of the nurse, he

immediately desisted, and assured her he was a very good boy. Great, but

ineffectual, pains were taken, to make him understand the nature of

truth,--he could never be brought to confess any mischief he had

committed, and always took refuge in the convenient shelter of a lie. In a

short time he acquired a striking talent for mimickry, and imitated many

of the patients in their insane manners; he generally selected, for his

models, those who were confined, as he could practise from such with

impunity.

In about three months he had added considerably to his stock of language,

but, unluckily, he had selected his expressions from those patients who

were addicted to swearing and obscene conversation. To teach him the

letters of the alphabet had many times been endeavoured, but always

without success; the attempt uniformly disgusted him: he was not to be

stimulated by coaxing or coercion; his mind was too excursive, to submit

to the painful toil of recording elementary sounds; but it may rather be

inferred that he did not possess a sufficient power of attention to become

acquainted with arbitrary characters.

He was in good health, his pulse and bowels were regular, and his appetite

was keen, but not voracious. One circumstance struck me, as very peculiar,

in this boy,--he appeared to have very incorrect ideas of distance: he

would frequently stretch out his hand, to grasp objects considerably

beyond his reach, but this referred principally to height: he would

endeavour to pluck out a nail from the ceiling, or snatch at the moon. In

October he became unwell, and, at the mother's request, was discharged

from the hospital.

In September 1805, I again saw the boy: he was then thirteen years of age,

had grown very tall, and appeared to be in good health. He recollected me

immediately, and mentioned the words, school Moorfields, nasty physic. On

meeting with some of the female patients, he perfectly remembered them,

and seemed for the moment, much pleased at the renewal of the

acquaintance. By this time, he had made comparatively, a great progress in

language; he knew the names of ordinary things, and was able to tell

correctly the street in which he resided, and the number of his house. His

mother informed me that he was particularly fond of going to church,

although he was unable to comprehend the purpose for which he went: when

there, he conducted himself with great order and decorum, but was disposed

to remain after the congregation had dispersed. To shew how little he

understood, why he frequented a place of worship: his mother once took him

to church on Sacrament-sunday, and fearful of disturbing the persons

assembled, by compelling him to return home, allowed him to be a

spectator of those solemn administrations. The only reflexion he made on

the subject, but in disjointed expressions, was, that he thought it

extremely hard, that the ladies and gentlemen should eat rolls and drink

gin, and never ask him to partake. In his person he was clean, and dressed

himself with neatness. Having been taught when in the hospital to use a

bowl for his necessary occasions, he obstinately continued the same

practice when he returned home, and could never be persuaded to retire to

the closet of convenience; but the business did not terminate here, when

he had evacuated his intestines into the bowl he never failed to paint the

room with its contents. To watch other boys when they were playing, or to

observe the progress of mischief, gave him great satisfaction: but he

never joined them, nor did he ever become attached to any one of them. Of

his mother he appeared excessively fond, and he was constantly caressing

her: but in his paroxysms of fury he felt neither awe nor tenderness, and

on two occasions he threw a knife at her. Although equally ignorant of

letters, as when discharged from the hospital, he took great delight in

having gilt books; indeed every thing splendid attracted his attention,

but more especially soldiers and martial music. He retained several tunes,

and was able to whistle them very correctly. The day on which I last saw

him his mind was completely occupied with soldiers; when questions were

put to him, if he answered them it was little to the purpose, generally he

did not notice them, but turned round to his mother and enquired about the

soldiers.

The defect of this lad's mind, appeared to be a want of continued

attention to things, in order to become acquainted with their nature; and

he possessed less curiosity than other children, which serves to excite

such attention: and this will in some degree explain, why he had never

acquired any knowledge of things in a connected manner. His sentences were

short, and he employed no particles to join them together. Although he was

acquainted with the names of many things, and also with expressions which

characterize passion, he applied them in an insulated way. For instance,

if a shower fell, he would look up and say, "rains;" or when fine, "sun

shines." When in the street he would pull his mother, to arrest her

attention, and point to objects, as a fine horse, or a big dog; when he

returned home he would repeat what had attracted his notice, but always

speaking of himself in the third person. "Billy see fine horse, big dog,

&c."[12] Of circumstances boldly impressed, or reiterated by habit, his

memory was retentive, but as his attention was only roused by striking

appearances, or loud intonations, ordinary occurrences passed by

unobserved.

In the month of July 1803, my opinion was requested respecting a young

gentleman, ten years of age, who was sent here, accompanied by a kind and

decent young man, to take care of him. Previously to his arrival I had

corresponded respecting his case with a very learned and respectable

physician in the country, under whose care the boy had been placed. From

the information furnished by this gentleman, and that which was collected

from the keeper, I believe the former history of his case is correctly

given.

The parents are persons of sound mind, and they do not remember any

branches of their respective families to have been (in any manner)

disordered in their intellects. The subject of the present relation was

their eldest son; the second child was of a disposition remarkably mild;

and the youngest, a boy, about two years and a half, was distinguished by

the irritability and impatience of his temper. At the age of two years,

the subject of the present relation, became so mischievous and

uncontroulable, that he was sent from home to be nursed by his aunt. In

this situation, at the request of his parents, and with the concurrence of

his relation, he was indulged in every wish, and never corrected for any

perverseness or impropriety of conduct. Thus he continued until he was

nearly nine years old, the creature of volition and the terror of the

family. At the suggestion of the physician, whom I have before mentioned,

and who was the friend of his parents: a person was appointed to watch

over him. It being the opinion of the doctor that the case originated in

over indulgence and perverseness; a different system of management was

adopted. The superintendant was ordered to correct him for each individual

impropriety. At this time the boy would neither dress nor undress himself,

though capable of doing both; when his hands were at liberty, he tore his

clothes: he broke every thing that was presented to him, or which came

within his reach, and frequently refused to take food. He gave answers

only to such questions as pleased him, and acted in opposition to every

direction. The superintendant exercised this plan for several months, but

perhaps not to the extent laid down; for it may be presumed, that after a

a few flagellations his humanity prevailed over the medical hypothesis.

When he became the subject of my own observation, he was of a very healthy

appearance, and his head was well formed; this was also the opinion of

several gentlemen, distinguished for their anatomical knowledge, to whom

the boy was presented. His tongue was unusually thick, though his

articulation was perfectly distinct. His countenance was decidedly

maniacal.[13] His stature, for his age, was short, but he was well

compacted, and possessed great bodily strength. Although his skin was

smooth and clear, it was deficient in its usual sensibility; he bore the

whip and the cane with less evidence of pain than other boys. Another

circumstance convinced me of this fact. During the time he resided in

London he was troubled with a boil on his leg; various irritating

applications were made to the tumor, and the dressings were purposely

taken off with less nicety than usual, yet he never complained. His pulse

was natural, and his bowels were regular. His appetite was good, but not

inordinate, and he bore the privation of food for a considerable time

without uneasiness. Although he slept soundly, he often awoke as if

suddenly alarmed, and he seemed to require a considerable duration of

sleep.

He had a very retentive memory, and had made as great proficiency in

speech as the generality of boys of his own age. Few circumstances

appeared to give him pleasure, but he would describe very correctly any

thing which had delighted him. As he wanted the power of continued

attention, and was only attracted by fits and starts, it may be naturally

supposed he was not taught letters, and still less that he would copy

them. He had been several times to school, and was the hopeless pupil of

many masters, distinguished for their patience and rigid discipline; it

may therefore be concluded, that from these gentlemen, he had derived all

the benefits which could result from privations to his stomach, and from

the application of the rod to the more delicate parts of his skin.

On the first interview I had with him, he contrived, after two or three

minutes acquaintance, to break a window and tear the frill of my shirt. He

was an unrelenting foe to all china, glass, and crockery ware, whenever

they came within his reach he shivered them instantly. In walking the

street, the keeper was compelled to take the wall, as he uniformly broke

the windows if he could get near them, and this operation he performed so

dextrously, and with such safety to himself, that he never cut his

fingers. To tear lace and destroy the finer textures of female ornament,

seemed to gratify him exceedingly, and he seldom walked out without

finding an occasion of indulging this propensity. He never became attached

to any inferior animal, a benevolence so common to the generality of

children: to these creatures his conduct was that of the brute: he

oppressed the feeble, and avoided the society of those more powerful than

himself. Considerable practice had taught him that he was the cat's

master, and whenever this luckless animal approached him he plucked out

its whiskers with wonderful rapidity; to use his own language, "_I must

have her beard off_." After this operation, he commonly threw the creature

on the fire, or through the window. If a little dog came near him he

kicked it, if a large one he would not notice it. When he was spoken to,

he usually said, "I do not choose to answer." When he perceived any one

who appeared to observe him attentively, he always said, "Now I will look

unpleasant." The usual games of children afforded him no amusement;

whenever boys were at play he never joined them: indeed, the most singular

part of his character was, that he appeared incapable of forming a

friendship with any one: he felt no considerations for sex, and would as

readily kick or bite a girl as a boy. Of any kindness shewn him, he was

equally insensible; he would receive an orange as a present, and

afterwards throw it in the face of the donor.

To the man who looked after him, he appeared to entertain something like

an attachment: when this person went out of the room, and pretended that

he would go away, he raised a loud outcry, and said, "what will become of

me, if he goes away; I like him, for he carries the cane which makes me a

good boy:" but it is much to be doubted, whether he really bore an

affection for his keeper; the man seemed to be of a different opinion, and

said, when he grew older he should be afraid to continue with him, as he

was persuaded the boy would destroy him, whenever he found the means and

opportunity.

Of his own disorder he was sometimes sensible: he would often express a

wish to die, for he said, "God had not made him like other children;" and

when provoked, he would threaten to destroy himself.

During the time he remained here, I conducted him through the hospital,

and pointed out to him several patients who were chained in their cells;

he discovered no fear or alarm; and when I shewed him a mischievous maniac

who was more strictly confined than the rest, he said, with great

exultation, "this would be the right place for me." Considering the

duration of his insanity, and being ignorant of any means by which he was

likely to recover, he returned to his friends, after continuing a few

weeks in London.

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