CHAPTER IV. Confessions of Patients after Recovering from Insanity; or, the Condition of the Mind when in a state of Aberration. THE autobiography of the insane, embodying a faithful record of the state of the intellect, emotions, and instincts, whilst fading into a condition of alienation, as well as an accurate account of the condition of the mind after its complete subjugation by disease, proceeding from the pens of persons who have passed through the terrible ordeal of insanity, opens a new, and profoundly interesting page, in the history of the pathology, as well as philosophy, of the human mind. It may be asked, is it possible for the insane, accurately to describe the state of their mind, during a paroxysm of mania? Can they have any recollection of their incoherent ramblings, wild and fanciful imaginations, horrible and frightful hallucinations? In many cases, such is the fact. Insanity does not invariably overthrow, and alienate, all the powers of the understanding. It is often a mixed condition, a combined state of reason, and insanity. This idea does not at all militate against the view, that I have elsewhere propounded, respecting partial insanity, using this phrase in its strictly legal acceptation. The mind is one and indivisible." A part of the intellect cannot be affected, without, to a certain extent, influencing and modifying the whole of the operations of thought; never. theless, there are in derangement of the mind occasional lucid moments, when the patient is conscious of his state of disorder, and is able to describe his sensations clearly to those about him. Again, after recovery, patients who have passed through acute attacks of insanity, are occasionally able to recollect, with remarkable clearness, everything that occurred during their long, and painful illness. Patients, however, have frequently very confused and incorrect notions of events that have transpired, in connexion with themselves as well as with others, whilst insane. We are bound, therefore, to exercise extreme caution in admitting and acting upon evidence of this character, particularly if it materially affects the motives, and compromises the actions, of others. With a view of analysing the phenomena of morbid thought, I have often requested patients to detail the actual operations of the mind during the incipient, as well as advanced stages, of its disorders. In many cases, I have not been able to obtain any trustworthy representation of facts; in other instances, the patients could not, without considerable and painful revulsion of feeling, revert, even for a single moment, to the past. In a few instances I have had no difficulty in persuading patients not only to talk about their past condition, but to write, with great minuteness, an account of their sensations, mental and bodily, whilst insane. I cannot, without a violation of good faith, and a breach of professional confidence, publish some of these remarkable confessions. I may, however, revert to them in general terms. Before doing so, I would briefly refer to the fallacy pervading all the poetic, dramatic, and artistic descriptions of insanity, save and excepting our own illustrious, and immortal Shakspeare, whose wonderfully truthful delineations of the different types of disordered mind, embodied in passages of rare and matchless beauty, must ever entitle him to the distinction of holding the foremost rank among the most eminent psychologists that have conferred lustre on the annals of this, or any other country. The descriptions of insanity proceeding from the pens of novelists, as well as of poets, constitute, unquestionably, strikingly clever and graphic melo-dramatic sketches; but I hope, the accomplished writers to whom I refer, will not be offended by my suggesting, that their portraits of insanity, do not exactly correspond with the character of the disease, as exhibited in modern times. Thanks to the immortal PINEL, who effected a great revolution in the moral treatment of the insane, a lunatic asylum no longer resembles a bastile surrounded by high serrated walls, and protected by iron-barred windows. We are not shocked at the sight of the straw bed upon which "Poor Tom" of former days, was in the habit, like a wild animal, of crouching, with little or no covering to protect him from the cold, during the most inclement seasons of the year. We cease to observe the dens in which lunatics were formerly caged like ferocious beasts; we no longer witness the iron chains with which their attenuated and palsied limbs, were frequently manacled. The sense of hearing is not pained by the wild and unearthly wailings of bitter anguish, caused by the whip of the keeper, as it fell unmercifully across the back of the unruly and excited patient. Thank God! Pinel, and those who have followed humbly in his wake, have given the death-blow to such brutal proceedings, and to such horrible barbarities. Pari passú with a liberal, and enlightened recognition, of the great principles of treatment, which the genius of the illustrious Frenchman conceived, and boldly carried into effect, has the character of insanity been altogether deprived of many of its most painful and repulsive features. The modern principles of moral treatment, based upon kindness, gentleness, and E soothing tenderness, have very materially modified the manifestations of insanity. In estimating the circumstances, that have led to the great improvement that has taken place in the condition of the insane, in modern times, I am bound to refer, not only to the abolition, thanks to Dr. Conolly, of the severer forms of mechanical restraint, but to the progress made in the pathology as well as therapeutics of insanity. Compare for one moment the opinion entertained by medical men of great distinction, and of high professional eminence, who flourished and ruled despotic, about sixty years ago, with the enlightened views that are, in the present day, almost universally, adopted and acted upon. I refer to the principles of treatment as enunciated by the celebrated Dr. Brown (author of the "Bruonian theory" of medicine) who, for a short period, entered the arena, and successfully contested, with the illustrious Dr. Cullen, the sovereignty of the medical republic. Dr. Brown when speaking of his method of curing mania, observes: "The patient should be struck with fear and terror, and driven in his state of insanity, to despair. As a remedy against the great excitement of the organs of voluntary motion, the labour of draft cattle should be imposed upon him, and assiduously continued. The diet should be the poorest possible, and his drink only water. In water, as cold as possible, the patient should be immersed, and kept under it, covered all over, for a long time, till he is near killed!" It is evident that Dr. Cullen himself, entertained the most unenlightened views with regard to the treatment of insanity, for, he says, when speaking of the management of lunatics, "in most cases it has appeared to be necessary to employ a very constant impression of fear to inspire them with the awe and dread of some particular persons, this awe and dread is therefore by one means or other to be acquired, sometimes it may be "* It is necessary to acquire it by STRIPES and BLOWS.' clear, that these notions were at that time generally prevalent, for I find in Burnst the following passage, "Any person may justify confining and beating his friend being mad, in such manner as is proper in such circumstances.' But COLLINS ventures to expound much more monstrous views, in regard to the insane, than the three authorities previously mentioned, for he asserts, that "furious madmen may be legally despatched by private men!" Whilst contemplating such barbarous, and inhumane principles, we are not astonished to hear the solemn protest, which the illustrious Lord Erskine, when Lord Chancellor, considered it necessary to make, in behalf of the insane. "I consider," says "I consider," says this renowned judge, "the various trusts with which I am invested, in a manner, as nothing when compared with the sacred duty of protecting those who are visited with mania; it is as much a disease as any other with which it pleases GOD to afflict mankind, and I am sure it is always exasperated in its symptoms, and frequently rendered incurable by unkind and rigorous treatment." How different are the modern views, with regard to the medical, and moral, treatment of insanity! To these humanizing and enlightened principles (so successful in the cure of the malady) we may undoubtedly, in a measure, trace the great alteration that has happily been effected in the features of the disease. Kind, gentle, considerate, and affectionate treatment, has disarmed insanity of many of its repulsive, and most odious characteristics. With these preliminary remarks, I proceed to a consideration of the incipient symptoms of insanity, as de * Dr. Cullen's "First Lines." |