_Galvanism applied to the cure of melancholy madness._
Hospitals for lunatics present a spectacle which must excite
compassion in every breast not void of humanity, as they are in
general crowded with unfortunate beings, useless to themselves and
dangerous to others; while little hope is left of their being ever
restored to society. This is the case in particular with persons
subject to melancholy madness; on some of whom I tried last year the
effects of Galvanism. In consequence of a long series of painful and
disagreeable experiments made on myself, I was induced to entertain
great hopes from this remedy. I applied it to my ears and to different
parts of the head, in order that I might form a just estimation of its
power and influence on the brain. It is well known that the strength
and energy of the operations of the mind depend on the state of the
functions of the brain. It is well known also, that a violent fall, or
strong impression on the head, has often occasioned great variations
in the intellectual faculties. By such accidents some have entirely
lost the power of imagination; while, on the other hand, some have
acquired very great talents, or emerged from a state of complete
stupidity. These considerations gave me reason to hope that the power
of Galvanism might perhaps be able to produce a salutary change in the
brain in cases of melancholy madness. I communicated my thoughts on
this subject to the physicians who superintend the hospital for
lunatics at Bologna. They approved of my ideas, and gave me every
assistance in their power to enable me to prosecute my researches. In
their presence, and under their direction, I administered Galvanism to
several lunatics, applying it different ways; and the result was the
complete cure of two who had laboured under melancholy madness. As the
method I followed in both cases was nearly the same, I shall here give
a description of it, as it may serve as a general rule for the
administration of this remedy under similar circumstances.
Louis Lanzarini, of a phlegmatic temperament, twenty-seven years of
age, and a farmer by profession, fell into a state of deep melancholy,
which first announced itself by an attack of fever; in consequence of
which he was conveyed to the public hospital of St. Ursula on the 17th
of May 1801. When he arrived there, he began to complain of the
treatment he had received, and to show great uneasiness; by which
means his melancholy increased so much, that it at length degenerated
into real stupidity. While in this state, Professors Gentilli and
Palazzi were so kind as to allow me to administer Galvanism to him;
which I did in the presence of these physicians, and of several
medical students who attended the hospital.
I had provided for this purpose a pile composed of eighty pieces of
silver and zinc, and I at first administered the Galvanism gradually,
forming the arc by means of the hands. Lanzarini, in a state of the
utmost dejection, viewed the apparatus and the company present with
his eyes fixed and motionless. When interrogated by the physicians and
myself in regard to the origin of his malady, he gave laconic and
confused answers, which seemed to indicate a great degree of stupidity
and derangement. I first moistened his hands, and formed an arc with
the pile at different heights, to accustom him to endure the action of
the apparatus. No change, however, was produced in the patient by this
operation. I then repeated the experiment, placing his hands,
moistened with salt water, at the bottom of the pile; and conveying an
arc from the summit of the pile to different parts of his face,
moistened with the same solution. A change was soon observed in the
patient’s countenance, and his whole demeanour seemed to indicate that
the degree of his melancholy was somewhat lessened. The experiment was
repeated several times with the same success; which seems to prove
that Galvanism absolutely exercises an action in such diseases. The
patient being interrogated next day, asserted that he had felt no
inconvenience from the application of the Galvanism; and this account
was confirmed by the keepers, who had been desired to give a report of
the least change that might take place. Similar results were obtained
by gradually administering the action of the pile with greater force
for several days successively, and we soon began to observe that it
produced a very striking effect. The patient, on touching the
apparatus, seemed to acquire new spirits; a smile appeared on his
countenance, and a complete change took place in his eyes as well as
in every feature of his face. Instead of showing any aversion to the
pile, he readily obeyed whenever he was called to undergo the
operation; and his whole conduct indicated that he found relief from
the influence of the unknown agent which it excited. He began to
converse with more readiness, sometimes respecting the machine, and
sometimes on the flash of light which appeared in his eyes when the
arc was applied; and on that account we conceived the most flattering
hopes of a complete cure. The result of this operation induced me to
administer the Galvanism even to the substance of the brain; being
convinced, as I have already remarked, that the Galvanic fluid by this
method of application exercises its action with greater energy. I
communicated my design to the Professors of the hospital, and with
their approbation began to try the effects of a pile composed of
fifteen plates of copper and zinc. I formed an arc from one of the
hands to one of the ears, and then from one ear to another, having
first moistened them with a solution of muriate of soda. I increased
the number of plates of which the pile was composed, and found that
the patient was always more or less affected with a momentary
impression exceedingly painful, which however seemed in the end to
produce a good effect. When Galvanism was administered in this manner,
I did not neglect to continue the application of the other method at
the same time; and I found that the progress of the cure became more
rapid. But as I observed that the action of Galvanism on the ears was
sometimes too violent, we thought proper to apply it in a more
moderate and less dangerous manner. Several persons having been
induced through curiosity to try this action, the result, besides a
violent commotion of the whole substance of the brain against the
skull, was a state of watchfulness which continued several days
running, and which I experienced myself as well as others. We then
conceived the idea of shaving the head above the suture of the
parietal bone (Plate III. fig. 3.); and having moistened the shaven
part with salt water, a piece of gold or silver coin was placed over
it. The patient then touched with one of his hands the bottom of the
pile, and at the same time an arc was established from the summit of
the pile to the metallic armature placed on the head. By this
arrangement the action of the Galvanism was rendered more moderate;
the patient endured it for a long time, and seemed to be greatly
relieved by it. I have always united this method with external
application to different parts of the face, and have observed such
sudden changes in the looks as seemed to announce a considerable
abatement of the disease. Some of the physicians of Bologna,
Professors Brugnatelli and Zola of Pavia, and several other
foreigners, examined and confirmed the permanency of this effect. The
patient, therefore, not only got the better of his melancholy, but
began to relish his food, and at length recovered so much strength
that the physicians of the hospital thought nothing further was
necessary to complete the cure.
No other remedy besides Galvanism was administered to him, lest the
effects should be so confounded as to render it impossible to tell to
which the cure ought to be ascribed. Two days, however, before he left
the hospital a little blood was taken from him; as it was conceived
that this operation might contribute to render the cure more certain.
On his leaving the hospital I carried him to my house, that he might
be fitted by proper nourishment for resuming his former occupations.
He remained with me eight days in the quality of a domestic, during
which time he was exceedingly tractable, and performed his duty with
great care and attention. I had several conversations with him, in the
course of which I learned that his father, Fabian Lanzarini, had been
attacked by the same disease, and that he had been admitted into the
same hospital, where he died on the 12th of June 1790. By inspecting
the registers of the hospital, I found this account to be perfectly
correct.
Agreeably to the principles already established, in regard to the
treatment of madness, I advised Lanzarini to spend the rest of his
life at a distance from his native country, lest, having continually
before his eyes those objects which had occasioned his disease, it
might recur with double violence. But though he had given me several
proofs of his docility, I found it impossible to persuade him to make
this sacrifice. A kind of _nostalgia_, perhaps, attached him to his
former master, to whom he returned, after paying a visit to the curé
of the parish. The latter, when he first saw him, imagined he had run
away from the hospital; but by his conversation he was soon convinced
of his being completely cured. After this period, I obtained a regular
report respecting his behaviour and the state of his health, from the
above curé, and from the person who had paid all the expenses of his
residence in the hospital; and I learned, with great satisfaction,
that he continued to enjoy good health, and to exercise his usual
employment.
By the same treatment I cured, of a similar disorder, Charles Bellini,
a labourer, who was restored to society in a shorter space of time,
because the affection was not so violent as in the preceding case. The
phænomena which took place when the patient was subjected to the
action of the pile, when the Galvanism was applied to the brain, and
during the whole progress of the cure, were nearly the same. I must,
however, freely acknowledge, that two cures are not sufficient to
establish the application of Galvanism as an universal remedy in such
cases. But on this account it ought not to be rejected: at any rate it
deserves further examination; for it is well known that all remedies
require certain conditions before they can perform their effect. I
have therefore several times found it impossible to obtain the same
result in other patients afflicted with melancholy madness, to whom I
administered Galvanism; and in cases of raving madness I have even
found it dangerous. In some instances, melancholy madness derives its
origin from a certain general constitution of the animal machine, or
from some great alteration in the brain; and it is evident that in
such cases the action of Galvanism would be of no avail. But if the
derangement of the intellectual functions depend only on some humour
intercepted between the membranes and other parts of the brain, there
is reason to hope that Galvanism, if prudently administered, may be
attended with great benefit. The real cases in which it may be
administered with success, can be ascertained only by experience. I
must observe also, that the method of administering it is not yet
reduced to that state of simplicity, which is necessary before it can
be brought into regular use in large hospitals. The physicians, under
whose care they are placed, have in general a great deal of private
practice, and cannot conveniently attend to operations which require a
continued labour for several months. Besides, the novelty of the
remedy is sufficient to excite a clamour against it, and to awaken the
prejudice of the assistants, who will even wish to proscribe it before
it has been tried. For this reason, I think it necessary here to
request, that those who preside over establishments destined for the
reception of such patients would turn their attention to this subject,
and endeavour to reduce the method of applying Galvanism to the utmost
simplicity of which it is susceptible, in order that it may be fit for
being introduced into large hospitals. As the patient often shows an
aversion to this strange remedy, it will be necessary to encourage him
by every means possible. Sometimes on observing the flash of light,
when the Galvanism is communicated, he cries out and is frightened;
imagining that he sees a devouring fire ready to consume him, and on
this account refuses to submit again to the operation. It will,
therefore, be proper to conceal from him the apparatus, or to make a
person show him the pile some time before as an object of amusement,
and in this manner to prepare him for receiving its action. It will be
of benefit also sometimes to modify the action of the pile, and to
render it more moderate by a different method of application. In the
case of female patients I have found the result the same, when the
Galvanism, instead of being applied directly to the interior part of
the ears, was directed externally to the gold pendents (Plate III.
fig. 4.).
By considering the course generally pursued in curing melancholy
madness, hints may be suggested for an useful application of Galvanism
in that disease, and data may be obtained sufficient to establish the
different modes of application best fitted to the different cases.
These ideas have engaged a good deal of my attention; and when I have
finished the observations I have been for some time collecting, I
flatter myself that I shall be able to communicate to the public some
interesting information on the subject.
In some cases of madness, as I found it impossible to apply Galvanism
to the hands, which were confined, I employed the action of an arc
directed to the mouth (Plate III. fig. 2.), while another proceeded to
one of the ears; or I applied a piece of money to the head, and
communicated the Galvanism by the method already described (Plate III.
fig. 3.).
It will even be necessary to try the effect of the Galvanic current,
sometimes continued, and sometimes interrupted by means of the
apparatus employed for diseases of the organs of hearing. It will be
proper, in many cases, to combine moral with physical treatment, and
not to neglect the other methods already known and practised, which
may be used as very convenient auxiliaries.