Part 1 (1/2)
Observations on Madness and Melancholy.
by John Haslam.
Preface.
_The alarming increase of Insanity, as might naturally be expected, has incited many persons to an investigation of this disease;--some for the advancement of Science, and others with the hope of emolument._
_More than ten years having elapsed since the publication of the ”Observations on Insanity,” a trifle, which the Profession has held in greater estimation than its intrinsic merits could justify: the present work is modestly introduced to the public notice, as a corrected copy of the former, with considerable additions, which the extensive scope of Bethlem Hospital would have furnished more liberally to a more intelligent observer._
_To have taken a comprehensive survey of the human faculties in their sound state; to have exhibited them impaired by natural decay, and transformed by disease, would have implied an ability to which I cannot pretend; would have required many volumes to unfold, and perhaps more patience than any rational experience could have attributed to the reader.
The contents of the following pages are therefore to be considered as an abbreviated relation, and condensed display of many years observation and practice, in a situation affording constant opportunities and abundant supplies for such investigations._
_It is natural to presume, that amongst my professional acquaintance the subject of Insanity must have been frequently introduced as a topic of discourse; and I am ready to acknowledge, that I have often profited by their remarks and suggestions: but I should be ungrateful were I not to confess my particular obligations to my esteemed friend, Anthony Carlisle, Esq. Surgeon to the Westminster Hospital, for many corrections, and some communications, which I shall ever value as judicious and important._
BETHLEM HOSPITAL, NOV. 21, 1808.
CHAPTER I.
DEFINITION.
There is no word in the English language more deserving of a precise definition than madness: and if those who have treated on this subject have been so unfortunate as to disagree with each other, and consequently have left their readers to reconcile their discordant opinions; yet it must be confessed that considerable pains have been bestowed, to convey a clear and accurate explanation of this term. Although this contrariety of sentiment has prevailed concerning the precise meaning of the word madness, medical pract.i.tioners have been sufficiently reconciled as to the thing itself: so that when they have seen an insane person, however opposite their definitions, they have readily coincided that the patient was mad.
From this it would appear that the thing itself, is, generally speaking, sufficiently plain and intelligible; but that the term which represents the thing is obscure. Perhaps, we might be somewhat a.s.sisted, by tracing back this word, in order to discover its original meaning, and shewing from its import the cause of its imposition.
If the reader, as is now the custom, should turn to Johnson's Dictionary for the meaning and etymology of this word, he will find that the Doctor has derived it both from the Anglo-Saxon gemaad and the Italian _matto_; but without giving any meaning as the cause of its employment.
The word is originally Gothic, and meant anger, rage, [Gothic: Mod].
[Mod]. It is true that we have now controverted the o, into a, and write the word mad: but mod was anciently employed.
”Yet sawe I MODNESSE laghyng in his _rage_.”
_Chaucer. Knight's Tale, fol. 1561, p. 6._
There is so great a resemblance between anger and violent madness, that there is nothing which could more probably have led to the adoption of the term. Dr. Beddoes, who appears to have examined the subject of insanity with the eye of an enlightened philosopher, is decidedly of this opinion, he says, HYGEIA, _No. 12, p. 40_, ”Mad, is one of those words which mean almost every thing and nothing. At first, it was, I imagine, applied to the transports of rage; and when men were civilized enough to be capable of insanity, their insanity, I presume, must have been of the frantic sort, because in the untutored, intense feelings seem regularly to carry a boisterous expression.”
MAD is therefore not a complex idea, as has been supposed, but a complex term for all the forms and varieties of this disease. Our language has been enriched with other terms expressive of this affection, all of which have a precise meaning. Delirium, which we have borrowed from the latin, merely means, _out of the track_, de lira, so that a delirious person, one who starts out of the track regularly pursued, becomes compared to the same deviation in the process of ploughing. _Crazy_, we have borrowed from the French _ecrase_, crushed, broken: we still use the same meaning, and say that such a person is crack'd. Insane, deranged, or disarranged,[1]
melancholic, out of one's wits, lunatic, phrenitic, or as we have corrupted it, frantick, require no explanation. _Beside one's self_ most probably originated from the belief of possession by a devil, or evil spirit.
The importance of investigating the original meaning of words must be evident when it is considered that the law of this country impowers persons of the medical profession to confine and discipline those to whom the term mad or lunatic can fairly be applied. Instead of endeavouring to discover an infallible definition of madness, which I believe will be found impossible, as it is an attempt to comprise, in a few words, the wide range and mutable character of this Proteus disorder: much more advantage would be obtained if the circ.u.mstances could be precisely defined under which it is justifiable to deprive a human being of his liberty.
Another impediment to an accurate definition of madness, arises from the various hypotheses, which have been entertained concerning the powers and operations of the human mind: and likewise from the looseness and unsettled state of the terms by which it is to be defined.
Before treating of the intellect in a deranged state, it will perhaps be expected that some system of the human mind, in its perfect and healthy condition, should be laid down. It will be supposed necessary to establish in what sanity of intellect consists, and to mark distinctly some fixed point, the aberrations from which are to const.i.tute disease.
To have a thorough knowledge of the nature, extent, and rect.i.tude of the human faculties, is particularly inc.u.mbent on him who undertakes to write of them in their distempered state; and, in a legal point of view, it is most important that the medical pract.i.tioner should be enabled to establish the state of the patient's case, as a departure from that which _is_ reason.
The difficulty of proposing a satisfactory theory of the human mind, must have been felt by every person, who has touched this delicate string since the days of Aristotle, and failure must be expected in him who attempts it: yet the endeavour is laudable, and miscarriage is not linked with disgrace. Every contribution, to ill.u.s.trate what are the powers of mind we possess; how we are acted upon by external circ.u.mstances in the acquisition of knowledge; and concerning the manner in which we use this knowledge for the purposes of life; ought to be candidly received.