Contents -BIBLIOGRAPHIC RECORD

S. Austin Allibone, comp. Prose Quotations from Socrates to Macaulay. 1880.

Insanity

“I have,” said Dr. Allen, “been a practising physician for nearly thirty years. I have had some experience in cases of insanity, having been for ten years medical superintendent of the Kentucky Lunatic Asylum, and during that time had over two thousand crazy people under my charge. I have heard the hypothetical case read by Mr. Phelan. I am here as an expert, and before answering the question would like to say that the more I studied the question of insanity the less I understood it; and if you ask me where it begins and where it ends, neither I nor any physician in the world could tell you: in fact, on occasions like this, lawyers make fools of themselves in trying to make asses of doctors.”

Insanity, as well as delirium, may be considered as divisible into two kinds; one of which may be called ideal, and the other notional insanity.

Ideal insanity is that state of mind in which a person imagines he sees, hears, or otherwise perceives, or converses with, persons or things which either have no external existence to his senses at the time, or have no such external existence as they are then conceived to have; or, if he perceives external objects as they really exist, has yet erroneous and absurd ideas of his own power, and other sensible qualities:—such a state of mind continuing for a considerable time, and being unaccompanied with any violent or adequate degree of fever.

Notional insanity is that state of mind in which a person sees, hears, or otherwise perceives external objects, as they really exist, as objects of sense; yet conceives such notions of the powers, properties, designs, state, destination, importance, manner of existence, or the like, of things and persons, of himself and others, as appear obviously, and often grossly, erroneous, or unreasonable, to the common sense of the sober and judicious part of mankind. It is of considerable duration; is never accompanied with any great degree of fever, and very often with no fever at all.

Mad is one of those words which mean almost everything 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.

I always expected with impatience the accession of the paroxysms [of insanity], since I enjoyed during their presence a high degree of pleasure. They lasted ten or twelve hours. Everything appeared easy to me. No obstacles presented themselves either in theory or practice. My memory acquired, all of a sudden, a singular degree of perfection: long passages of Latin authors occurred to my mind. In general, I have great difficulty in finding rhythmical terminations; but then I could write in verse with as much facility as in prose. I was cunning, malicious, and fertile in all kinds of expedients.

Oppression makes wise men mad; but the distemper is still the madness of the wise, which is better than the sobriety of fools.

Ever, as before, does madness remain a mysterious, terrific, altogether infernal boiling up of the nether chaotic deep, through this fair painted vision of creation, which swims thereon, which we name the real.

There can be no doubt that many a man has been saved from an attack of mental disease by the resolute determination of his will not to yield to his morbid tendencies. But if he should give way to them and dwell upon his morbid ideas, instead of resisting them, they come at last to acquire a complete mastery over him; his will, his common sense, and his moral sense at length succumb to their domination.

When a man mistakes his thoughts for persons and things, he is mad. A madman is properly so defined.

Insanity is, in a person awake, a false or mistaken judgment of things which, as occurring most frequently in life, are those about which the generality of men form the same judgment, and particularly is the malady evinced when the judgment of the individual is very different from what he had himself before usually formed of the same object.

Insanity consists in such false perceptions of the relations of things as lead to irrational emotions or actions. Melancholy is partial insanity, without indigestion; mania is universal insanity.

If the raving be not directed to a single object, it is mania, properly so called; if to one object, it constitutes monomania.

In some, perhaps in many, cases the human mind is stormed in its citadel, and laid prostrate under the stroke of frenzy: these unhappy sufferers, however, are not so much considered by physicians as maniacs, as in a state of delirium from fever. There, indeed, all the ideas are overwhelmed, for reason is not merely disturbed, but driven from her seat. Such unhappy patients are unconscious, therefore, except at short intervals, even of external objects, or at least are wholly incapable of understanding their relations. Such persons, and such persons alone (except idiots), are wholly deprived of their understandings, in the Attorney-General’s sense of that expression. But these cases are not only extremely rare, but can never become the subjects of judicial difficulty. There can be but one judgment concerning them. In other cases Reason is not driven from her seat, but Distraction sits down upon it along with her, holds her trembling upon it, and frightens her from her propriety. Such patients are victims to delusions of the most alarming description, which so overpower the faculties, and usurp so firmly the power of realities, as not to be dislodged and shaken by the organs of perception and sense: in such cases the images frequently vary, but in the same subjects are generally of the same terrific character. Delusion, therefore, where there is no frenzy or raving madness, is the true character of insanity; and where it cannot be predicated on a man standing for life or death for a crime, he ought not, in my opinion, to be acquitted: and if courts of law were to be governed by any other principle, every departure from sober rational conduct would be an emancipation from criminal justice.

Fixed seriousness heats the brain in some to distraction, and causeth an aching and dizziness in sounder heads.

Read Haslam on insanity. This dreadful visitation he ascribes not to a false perception, or morbid intensity, but to a wrong association of ideas. There surely, however, must be more in it than this. I once asked a professional gentleman, who had particular opportunities of experience on the subject, whether he always found the brain of maniacs in a preternatural or disordered state. He said that he frequently, perhaps generally, did; but that in many cases where the faculties were most completely deranged, that organ had every appearance of being in a perfectly sound and healthy condition.

On the approach of mania, they first become uneasy, are incapable of confining their attention, and neglect any employment to which they have been accustomed. They get but little sleep; they are loquacious, and disposed to harangue and decide promptly and positively upon every subject that may be started. Soon after, they are divested of all restraint in the declaration of their opinions of those with whom they are acquainted. Their friendships are expressed with fervency and extravagance; their enmities with intolerance and disgust. They now become impatient of contradiction, and scorn reproof. For supposed injuries they are disposed to quarrel and fight with those about them. They have all the appearance of persons inebriated; and those who are unacquainted with the symptoms of approaching mania generally suppose them in a state of intoxication. At length suspicion creeps upon the mind: they are aware of plots which had never been contrived, and detect motives that were never entertained. At last the succession of ideas is too rapid to be examined: the mind becomes crowded with thoughts, and confusion ensues. Those under the influence of the depressing passions will exhibit a different train of symptoms. The countenance wears an anxious and gloomy aspect; and they are little disposed to speak. They retire from the company of those with whom they formerly associated; seclude themselves in obscure places, or lie in bed the greater part of their time. Frequently they will keep their eyes fixed to some objects for hours together, or continue them an equal time “bent on vacuity.” They next become fearful, and conceive a thousand fancies; often recur to some immoral act which they have committed, or imagine themselves guilty of crimes which they never perpetrated; believe that God has abandoned them, and with trembling await his punishment. Frequently they become desperate, and endeavour by their own hands to terminate an existence which appears to be an afflicting and hateful encumbrance.

Insane people easily detect the nonsense of other madmen.

All power of fancy over reason is a degree of insanity.

High spirits, as they are generally termed, are the first symptoms of this kind of disorder [insanity]: they excite a man to take a larger quantity of wine than usual (for those who have fallen under my observation, in this particular, have been naturally very sober); and the person thus affected, from being very abstemious, reserved, and modest, shall become quite the contrary: drink freely, talk boldly, obscenely, swear, sit up till midnight, sleep little, rise suddenly from bed, go out a hunting, return again immediately, set all the servants to work, and employ five times the number that is necessary: in short, everything he says or does betrays the most violent agitation of mind, which it is not in his power to correct, and yet, in the midst of all this hurry, he will not misplace one word, or give the least reason for any one to think he imagines things to exist that really do not, or that they appear to him different from what they do to other people. They who see him but seldom, admire his vivacity, are pleased with the sallies of his wit and the sagacity of his remarks: nay, his own family are with difficulty persuaded to take proper care of him, until it becomes absolutely necessary, from the apparent ruin of his health and fortune.

The physician should never deceive them [the insane] in anything, but more particularly with regard to their distemper; yet, as they are generally conscious of it themselves, they acquire a kind of reverence for those who know it, and by letting them see that he is thoroughly acquainted with their complaint he may very often gain such an ascendant over them that they will readily follow his directions.

Of what is the most subtile folly made, but of the most subtile wisdom? As great friendships spring from great enmities, and vigorous healths from mortal diseases, so from the rare and quick agitations of our souls proceed the most wonderful and most deprav’d frenzies; ’tis but a half turn of the toe from the one to the other. In the actions of mad men we see how infinitely madness resembles the most vigorous operations of the soul. Who does not know how indiscernible the difference is betwixt folly and the elevations of a spritely soul, and the effects of a supream and extraordinary vertue? Plato says that melancholick persons are the most capable of discipline, and the most excellent, nor indeed is there any so great a propension to madness. Great wits are ruin’d by their own proper force and quickness.

The characteristic symptom of human madness is the rising up in the mind of images not distinguishable by the patient from impressions on the senses.

What, I may be asked, is my test of insanity? I have none. I know of no unerring, infallible, and safe rule or standard, applicable to all cases. The only logical and philosophic mode of procedure in doubtful cases of mental alienation is to compare the mind of the lunatic at the period of his suspected insanity with its prior natural and healthy condition; in other words, to consider the intellect in relation to itself, and to no artificial a priori test. Each individual case must be viewed in its own relations. It is clear that such is the opinion of the judges, notwithstanding they maintained, as a test of responsibility, a knowledge of right and wrong. Can any other conclusion be drawn from the language used by the judges when propounding in the House of Lords their view of insanity in connection with crime? “The facts,” say they, “of each particular case must of necessity present themselves with endless diversity and with every shade of difference in each case; and it is their duty to declare the law upon each particular case, upon facts proved before them; and after hearing arguments of counsel thereon, they deem it at once impracticable, and at the same time dangerous to the administration of justice if it were practicable, to attempt to make minute applications of the principles involved in the answers given by them to the questions proposed.” This is a safe, judicious, and philosophic mode of investigating these painful cases; and if strictly adhered to, the ends of justice would be secured, and the requirements of science satisfied.