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!
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.