Madness and Morals

Ideas on Insanity in the Nineteenth Century

Vieda Skultans

• Publisher: Routledge
• Year: 2022
• ISBN:
  9781000580167
• Edition: 1
• Topic: Psychology
• Subtopic: Social Psychology
• Index: Psychology

First published in 1975, Madness and Morals presents the major preoccupations of nineteenth century society concerning insanity, its problems, and implications. In the introduction to the collection, Vieda Skultans traces developments and changes in the ideas about the insane and their treatment during the nineteenth century. She shows that two contrasting themes dominated writing on the subject: the relative weight to be attributed to physical and moral causes of insanity; and the emphasis on hereditary endowment or the 'tyranny of organization'. The eighty years covered by this book produced a wide and varied literature on insanity, and the psychiatric texts reproduced, by English writers in the field are grouped under three sections: Outlines of Insanity; Psychiatric Romanticism; and Psychiatric Darwinism. These are written by physicians, administrators of the asylums and hospitals, editors of specialist publications, and others with wide experience in the field. These writings have a special relevance to the social history of the nineteenth century, for they demonstrate how psychiatric thinking reflects the contemporary moral outlook, forming a part of the total social fabric of society. This book will be useful for scholars and researchers of mental health, psychology, and psychiatry.

PART ONE OUTLINES OF INSANITY

DOI: 10.4324/9781003283522-2

Chapter I Ci^© Causes and Prevalence

DOI: 10.4324/9781003283522-3

1. John Haslam, The Nature of Madness

(Excerpt from Observations on Madness and Melancholy, London: Callow, 1810, pp. 15-16.)

Madness being the opposite to reason and good sense, as light is to darkness, straight to crooked, &c. it appears wonderful that two opposite opinions could be entertained on the subject: allowing each party to possess the ordinary faculties common to human beings in a sound and healthy state, yet such is really the fact: and if one party be right, the other must be wrong: because a person cannot correctly be said to be in his senses and out of his senses at the same time.

But there is considerable difficulty and some danger in applying logic to facts. Every person who takes the degree of Doctor becomes, in consequence of taking such degree, a learned man; and it is libellous to pronounce him ignorant. It is true, a Doctor may be blind, deaf and dumb, stupid or mad, but still his Diploma shields him from the imputation of ignorance.* It has also not unfrequently occurred, that a man who has been dubbed a Doctor of Medicine at Leyden, Aberdeen, or St. Andrews, and whose Diploma sets forth his profound learning, accomplishments, and competence to practise on the lives of His Majesty’s good and faithful subjects, has been found incapable of satisfying the gentlemen in Warwick Lane that he possessed the common rudiments of his profession, and has been by them accordingly rejected; so that learning in many instances appears to be local.

* The feeblest intellect I ever commiserated was a Doctor of Laws from the University of Glasgow.

2. Alexander Morison, Moral Causes of Insanity

(Excerpt from Outlines of Mental Diseases, Edinburgh: MacLachlan & Stewart, 1824, pp. 66-71.)

With regard to the influence of Seasons, it appears that Spring and Summer are more conducive to Mania—Autumn to Partial Insanity with Depression—and Winter to Dementia.

The heat in summer produces exacerbation in many cases of insanity, and increases the tendency to suicide.

With respect to Age.

Infants are nearly exempted, although children under ten years of age occasionally exhibit symptoms of general and of partial insanity. It is sometimes coincident with rapid growth—and with the efforts of the constitution in establishing the menstrual discharge.

In old age, the first appearance of insanity (Dementia excepted) is rare, although instances have occasionally occurred in persons whose age has exceeded 80, and even 100. It is, however, most prevalent between the ages of 25 and 40.

Sex.—In some countries, as in Great Britain and France, there are more females insane than males; but this is not the case in all. Females are exposed to exciting causes from which males are exempted, as

The puerperal state, which seems to give a predisposition to insanity, and frequently calls it into action, when there is hereditary disposition; this cause acts more extensively in the higher than in the lower classes.

The critical period of female life also frequently leads to the development of insanity.

In the treatment of mental disease, it has been observed that there is a beneficial influence exerted by one sex over the other.

With regard to the influence of occupation and condition in life, in the production of insanity, it may be observed, that professions requiring great mental exertion, and those which lead to hazardous speculations, are more liable to insanity than others; persons who are most independent, in consequence of their rank and fortune, are comparatively speaking, more subject to it than the middle class. This may be accounted for in part by intermarriages and excesses.

Education conducted with too great severity may lead to insanity; but the opposite extreme is a more common cause of it— an education not conducted on the principle of bringing the inclinations and affections under the control of religious and moral principles, and of repressing ideas of hurtful tendency, but encouraging false and romantic notions, and ideas above the rank in life.

The minds of some have likewise been weakened by terrifying tales in early life.

Excess of ignorance, and excess of study, both tend to weaken the mind, particularly the latter, when directed to a few ideas. The consequences of this excess of study, or of application to business, are—an irritable state of body and of mind—restless nights—febrile symptoms—diminished power of attention—confusion of ideas—and, if persisted in, insanity.

The predominant ideas of the times, whether religious or political, have great influence in producing mental disorder.

With regard to the influence of religion, although excessive devotion, and contrition or remorse of conscience may occasionally lead to insanity, especially in melancholy dispositions, doubt of doctrines previously professed in general precedes madness from religion: the mind, in suspense as to what regards eternal salvation, is easily overset.

Religion has less influence in this respect in the warmer climates, and in the Catholic countries, than in the temperate climates, and in countries where latitude of religious opinion is permitted; free governments, and political commotions, being favourable to the production of insanity, while despotic governments are not.

The emotions of mind produced by ardent and ungratified desires—by domestic troubles—and by the affections and passions —are frequent causes of insanity.

Some of the latter, as terror, anger, and passions produced by reverse of fortune, act immediately; but more commonly the action is gradual and continued, as that of grief, love, jealousy, disappointed pride, shame, the struggle between religious and moral principles and passions, &c.

3. Alexander Morison, Increase in Insanity

(Excerpt from Outlines of Mental Diseases, Edinburgh: MacLachlan & Stewart, 1824, pp. 74-5.)

This leads to the question, whether insanity is on the increase or decrease? The former is said to be the case in this country, as both public and private establishments for the reception of the insane have increased. There can be little doubt that Insanity increases with civilization: in proof of which we find the number of insane stated to be very small in South America, and among the Indian tribes, &c. and to be very considerable in China.

It is therefore probable, that the increasing civilization and luxury of this country, co-operating with hereditary disposition, tends rather to increase the numbers in proportion to the population.

4. George Man Burrows, Insanity: Disease of the Nerves or Blood?

(Excerpt from Commentaries on Insanity, London: Underwood, 1828, p. 109.)

Most nosologists class insanity among the neuroses; and hence it has been popularly received as a disease exclusively of the nerves.

Let us examine if there be not ground to assume, that the disorders of the sanguiferous system have as great, or greater influence in originating insanity, than those of the nervous system.

Some authors advert to certain anomalies in the circulation in cases of insanity, especially in the earlier stages of the malady. But whether prepossessed with the opinion, that it be a disease only of the intelligent or thinking principle, or a disorder solely of the nerves themselves, as the instruments of this intelligent principle, I cannot decide; but it is clear such phenomena are rather incidentally than specially noticed.

The late Dr. Caleb Parry is an exception. He has exhibited, in a full and perspicuous manner, the disorders of the sanguiferous system, and their influence on health; and he especially applies his reasoning to prove the specific effects of such disorders on the operations of the mind.

5. George Man Burrows, Brain, Heart and Will

(Excerpt from Commentaries on Insanity, London: Underwood, 1828, pp. 112-13.)

Physiological experiments prove that an animal can live without a brain, but not without a heart; and in the instance of an acephalous child, we see the animal functions may be carried on without the former. Daily experience proves, that the brain, the seat of the sensorium, sustains great injuries and mutilations without injury to the intellectual functions. Life, therefore, it appears, as well as mind, is more dependent on the movements of the circulation than on the functions of the nerves.

Still, a disorder of the nerves may be, and frequently is, the immediate cause of insanity; for a violent moral impression being made on any of the senses, is first carried to the brain, which immediately acts synchroneously with the heart, and re-acts on the brain; and the last action may remain after the other has ceased. The same is seen in many morbid affections: the original induces a second affection, which is sympathetic; and the latter will continue long after the primary cause is removed.

Intense thought or abstraction exercises a powerful influence on the circulation. Great calculators have been known to pass days and nights without sleep, from having been deeply engaged in some intricate calculations. This want of sleep results from a preternaturally increased action of the vessels which supply the brain; and this action, if not relieved, soon runs on to delirium. Such pursuits being the effect of volition, may be suspended ere they proceed to this extremity.

All passions and emotions are said to be modifications of the will; and whenever the will stimulates the brain to violent exertion, the actions of the heart are always responsive, with a force proportionately augmented or diminished, according to the nature of the impression. Thus, joy, anger, desire, &c. increase the energy of the heart, and accelerate the circulation, and in excess super-induce apoplexy, palsy, mania, &c.; while, on the contrary, fear, horror, &c. diminish the action of that organ, and retard, or rather reflect, the current of blood on the large vessels, occasioning asphyxia, syncope, &c. But in this latter case, when the heart recovers its force, such a degree of re-action is produced, as sometimes either proves fatal to life, or otherwise deranges the intellectual faculties. Therefore, whether the impetus of the circulation be augmented or lessened; whether the blood, propelled by the heart, excite the brain, or the former be excited by the nervous influence of the latter,—still, if life be not extinguished in the conflict, the loss of reason is a frequent effect.

Whenever either of these important organs is preternaturally excited, the relation is so intimate, that a reciprocal and powerful action must be produced. The consequences are obvious; for, agreeably to a law of nature, extended as well to intellectual as to corporeal powers, when over-exerted, a state of relaxation or rest must follow, or a lesion of that power so over-exerted will ensue.

Even when the stimulus which has proved an exciting cause is withdrawn, or ceases to act before any lesion takes place, the extraordinary energy induced is necessarily succeeded by a state of diminished sensibility and weakness, or of collapse, subversive of the mind. It is in this way, probably, that moral or affective causes act on the nervous system.

6. George Man Burrows, Moral Causes of Insanity as they Affect Different Social Classes

(Excerpt from Commentaries on Insanity, London: Underwood, 1828, pp. 9-10,18-20.)

The moderns divide the causes of insanity into moral and physical.

Every impression on the sensorium, through the external senses, and every passion in excess, may become a moral cause of insanity. Thus all, however opposite, act as exciting causes, and will produce this result: joy and grief, anger and pain, love and hatred, courage and fear, temperance and ebriety, repletion and inanition, application and indolence, may have the same effect. Vices, also, which occasion changes in the physical constitution, act as remote moral causes, and induce mental derangement.

All impressions that affect the feelings are conveyed to the sensorium, and operate according to the degree of constitutional susceptibility, and the nature and force of the impression. The action of the heart is correspondent with this impression, and re-acts on the brain and nervous system. Hence there are two impressions: the one primitive, affecting the sensorium; the other, consecutive, but simultaneously affecting the heart. Thus the nervous and vascular systems are both implicated; and in this manner moral impressions become causes of insanity. The moral cause, therefore, is always the remote cause; the physical, the proximate, or that state of the cerebral functions which immediately precedes the peculiar action denominated maniacal.

The influence of the passions on the operations of the mind is a subject which, to be examined as its merits, demands ‘the eye of a natural historian, and the spirit and impartiality of a philosopher.’ No author has discussed it with greater ability than Sir Alex Crichton.

The effect of intense emotions or passions, often repeated or long continued, not only disturbs the functions, but will occasion lesions of the brain. It is easy, says this author, to conceive, that an affection or change of structure of this organ does occur from an external impression being communicated to it by the nerves; but the effect on the mind produced by this impression on the brain, is what we cannot explain.

Many structural and functional diseases, which are ascribed to physical causes only, may be clearly traced to emotions of the mind.

Thus the heart, stomach, liver, intestines, kidneys, &c. are often violently acted upon by external impressions; but the effect is modified or altered, according to the force of the exciting cause, or the temperament of the person acted upon; and it commonly ceases with the cause that gave rise to it.

The upper classes, who are supposed to be most subject to maladies of the nervous system, have also been deemed almost exclusively liable to insanity. This, however, is a vulgar error, which an inspection of any of the pauper asylums for the insane instantly refutes. Habitual luxury, and the vices of refinement, are peculiar to the rich; and, consequently, a greater degree of susceptibility and irritability is superinduced. The lower orders, who ought more generally to be exempt from the concomitant of wealth and indolence, that is, disease, unhappily provoke it by their excesses; and thus voluntarily ingraft on themselves the evils which, from their condition, they might otherwise escape.

If, therefore, the nervous system be immediately acted upon, through greater susceptibility in the upper classes, from luxury, an equal susceptibility to morbid affections of the viscera is induced in the lower classes, though more slowly and remotely, from intemperance.

The moral causes of insanity will naturally affect the rich and educated differently to the poor and uneducated. Indeed it will be found, that the former, with the exception of hereditary insanity, are most frequently deranged from affective or moral causes, while the latter are principally so from physical causes.

Extensive as I conceive the influence is of moral causes in the production of insanity, I cannot assign it so wide a scope as many foreign writers.

I entertain very strong doubts of the fidelity of the catalogue of moral causes which they enumerate with so much affectation of minute accuracy. For, although very inquisitive on this point in every case on which I am consulted, yet it very frequently happens, that I can trace no moral cause at all. The majority originate in direct physical causes, which the privations and consequent misery, the poor suffer in all countries, as well as their vices, greatly multiply.

A recent English author, going to the other extreme, asserts, that he never could trace, in several hundred cases, more than one originating in a moral cause. The necessary inference is, that he could have made no...

Table of contents

• Cover
• Half Title
• Title
• Copyright
• Original Title
• Original Copyright
• Contents
• Biographical Notes
• Introduction
• PART ONE OUTLINES OF INSANITY
• PART TWO PSYCHIATRIC ROMANTICISM
• PART THREE PSYCHIATRIC DARWINISM
• Index