Curiosities of Medical Experience Part 20

According to our ingenious author, drunkenness is the chief cause of suicide in England, Prussia, and Germany; love and gambling in France; whilst bigotry, or the fear of dying without having received the sacrament, he supposes, prevents it in Spain, where, comparatively speaking, suicide is seldom heard of.

The same remark may apply to Italy, where a Roman lady, having heard of such an action, exclaimed, "_Dev' essere un forestiere; gli Italiani non sono tanto matti_." She was right, the suicide was a melancholy German tailor.

In India, where the doctrine of predestination is generally prevalent, it is calculated that in one year there were forty suicides in a population of 250,000, twenty-three of which were females.

Arntzenius quotes Gall's opinion, that suicide arises from too great a predominance of the organ of cautiousness. Combe and other phrenologists are of opinion, that with this predominance a deficient development of hope and a large destructiveness must be conjoined.

It has been remarked that in Spain and Portugal, where insanity is comparatively rare, malconformation of the brain and consequent idiotism are very frequent.

Since the peace it may be more difficult to arrive at any conclusion on the subject of increase of lunacy, founded on the admission of lunatics into public and private establishments, since emigration has carried so many families and operatives of every description abroad, many of whom, from various disappointments and vexations, might have been predisposed to insanity.

It appears that in 1836 there existed in England and Wales 6402 lunatics, 7265 idiots--13,667 lunatics and idiots. Of paupers alone, or lunatics and idiots, there were 1.00098 of the total population, or 1 in 1024.

However, according to the most probable calculation, the number of lunatics in England amounts to about 14,000, out of which about 11,000 are paupers. Idiots are nearly as numerous as lunatics. Sir A. Halliday states the former to amount to 5741, and the latter to 6806. To this it must be observed that many harmless idiots are allowed to remain in their usual residence. In Wales it appears that idiots are to lunatics in the proportion of seven to one. The difficulty of obtaining any certain information on this subject, however, is such, that it is scarcely possible to decide the question with any chance of a probable certainty.

In regard to the prevalence of lunacy in other countries, the following are curious statistical statements:

In Spain, in 1817, according to the report of Dr. Luzuriaga, there only existed in the asylums of Toledo, Granada, Cordova, Valencia, Cadiz, Saragossa, and Barcelona, 509 lunatics--only fifty were in the hospitals of Cadiz, sixty in that of Madrid, and thirty-six in the kingdom of Granada.

In Italy, in twenty-five asylums in Turin, Genoa, Milan, Brescia, Verona, Venice, Parma, Modena, Bologna, Ferrara, Florence, Sienna, Lucca, and Rome, Mr. Brierre only found 3441 patients. The population of these parts of Italy amounting to about 16,789,000 inhabitants, which gives one lunatic to 4879 persons.

Scott, who accompanied Lord Macartney's emba.s.sy to China, observed that very few insane persons were to be found there. Humboldt states that madness is rare amongst the natives of South America. Carr made the same remark in Russia. In Spain and Italy, religious melancholy, and that most vexatious species of insanity called _erotomania_, are the more common.

In the savage tribes of Africa and America insanity is very rare. Dr.

Winterbotham affirms, that among the Africans near Sierra Leone, mania is a disease which seldom if ever occurs. Idiotism was likewise a rare phenomenon among them. Among the negro slaves in the West Indies it is scarcely known, and during three years' residence in the Bahamas, only one case of monomania fell under my observation. Amongst the native races of America it scarcely exists. From these observations we may conclude, with Esquirol, that insanity belongs almost exclusively to civilized races of men, that it scarcely exists among savages, and is rare in barbarous countries. To what circ.u.mstance are we to attribute this exemption?

Possibly it may be attributed to simplicity in living, which predisposes to less disease and morbid varieties of organization, and to the absence of that refined education which exposes man to the artificial wants and miseries of high civilization. It is moreover probable that the constant occupation which the existence of the savage requires to satisfy his absolute necessities, does not leave him leisure time to ponder over gloomy ideas and fict.i.tious sufferings. In addition to these circ.u.mstances, Dr. Pritchard has justly remarked, that we might also conjecture that congenital predisposition is wanting in the offspring of uncivilized races. The same author admits the probability of the brain receiving a different development in the progeny of cultivated races, or of those whose mental faculties have been awakened.

Various professions have been supposed to exercise much influence on the intellectual faculties. The following observations at the Salpetriere during one year may tend to ill.u.s.trate this subject:

Field labourers 43 Servants 51 Needlework women 85 Cooks 16 Shopkeepers 21 Pedlars 16 Shoemakers 8 House-painters and varnishers 5 Housekeepers 192 Women of the town 33

In Mr. Esquirol's establishment:

Farmers 3 Military men 33 Seamen 3 Merchants 50 Students 25 Clerks in public offices 21 Engineers 2 Lawyers 11 Chemists 4 Physicians 4 Artists 8

According to the prevalence of the ideas connected with their former pursuits do we observe the hallucination of these unfortunate persons to be of a different character. Dr. Abercrombie relates the case of a Scotch clergyman, who was brought before a jury to be what is called in Scotland _cognosced_, or declared incapable of managing his affairs. Amongst the acts of extravagance alleged against him was, that he had burnt his library. When he was asked by the jury what account he would give of this part of his conduct, he replied in the following terms: "In the early part of my life I had imbibed a liking for a most unprofitable study, namely, controversial divinity. On reviewing my library, I found a great part of it to consist of books of this description, and I was so anxious that my family should not be led to follow the same pursuits, that I determined to burn the whole." He gave answers equally plausible to questions which were put to him respecting other parts of his conduct; and the result was, that the jury found no sufficient ground for cognoscing him; but in the course of a fortnight from that time, he was in a state of decided mania.

What a school of humility is a lunatic asylum! What a field of observation does it not present to the philosopher who ranges among its inmates! We find the same aberrations that obtain in society; similar errors, similar pa.s.sions, similar miserable self-tormenting chimeras, empty pride, worthless vanity, and overweening ambition. There we

See that n.o.ble and most sovereign reason, Like sweet bells jangled, out of tune and harsh.

Each madhouse has its G.o.ds and priests, its sovereigns and its subjects, terrific mimicry of worldly superst.i.tions, pomp, pride, and degradation!

There, tyranny rules with iron sway, until the keeper's appearance makes tyrants know there does exist a power still greater than their own. In madhouses egotism prevails as generally as in the world, and nothing around the lunatic sheds any influence unless relating to his wretched self. In this struggle between the mind and body, this constant action and reaction of the moral and the corporeal energies, when reason has yielded to the brute force of animal pa.s.sions, and the body with all its baseness has triumphed over the soul, one cannot but think of Plutarch's fanciful idea, that, should the body sue the mind for damages before a court of justice, it would be found that the defendant had been a ruinous tenant to the plaintiff.

In many cases of insanity we observe a singular fertility of glowing imagination and a vivacity of memory which is often surprising. Dr. Willis mentions a patient who was subject to occasional attacks of insanity, and who a.s.sured him that he expected the paroxysms with impatience, as they proved to him a source of considerable delight. "Every thing," he said, "appeared easy to me. No obstacles presented themselves either in theory or in practice. My memory acquired of a sudden a singular degree of perfection. Long pa.s.sages of Latin authors occurred to my mind. In general I have great difficulty in finding rhythmical terminations, but then I could write verse with as much facility as prose."

Old a.s.sociations thus recalled into the mind are often mixed up with recent occurrences, in the same manner as in dreaming. Dr. Gooch mentions a lady who became insane in consequence of an alarm of fire in her neighbourhood. She imagined that she was transformed into the Virgin Mary, and that a luminous halo beamed round her head.

It is said that the Egyptians placed a mummy at their festive board, to remind man of mortality. Would not a frequent visit to a lunatic asylum afford a wholesome lesson to the reckless despot, the proud statesman, and the arbitrary chieftain? There they might converse with tyrants, politicians, and self-created heroes, in all the naked turpitude of the evil pa.s.sions, who in their frantic gestures would show them that which they wish to be--that which the world considers they are! Often would they hear the maniac express the very thoughts that ruffle their own pillows, until the dreaded bell that announces the doctor's visit, and which with one loud peal destroys his fond illusions, herald of that knell which sooner or later must call them from the busy world they think their own.

How beautifully has Filmer expressed the madman's fears!

See yon old miser laden with swelling bags Of ill-got gold, with how much awkward haste He limps away to shelter! See how he ducks, And dives, and dodges with the G.o.ds; and all Only in hope to avoid, for some few days Perhaps, the just reward of his own sad extortions.

The hot adulterer, now all chill and impotent With fear, leaps from the polluted bed, And crams himself into a cranny!

There mighty men of blood, who make a trade Of murder, forget their wonted fierceness; Out-nois'd, they shrink aside, and shake for fear O' th' louder threat'nings of the angry G.o.ds.

Whatever may be the nature of insanity or our fallacious views regarding it, it is a matter of great consolation to find that our mode of treating it is at last founded on rational and humane principles. The unfortunate lunatic is no longer an object of horror and disgust, chained down like a wild beast, and sunk by ignorance or avarice, even below the level of that degradation in the scale of human beings, to which it had pleased Providence to reduce him,--we no longer behold him rising from his foul and loathsome bed of straw, scantily covered with filthy tatters, his hair and beard wild and grisly--his eyes under the influence of constant excitement, darting menacing looks--the foam bubbling through his gnashing teeth--clanking his fetters with angry words and gestures, threatening heaven and earth--gazed at with dismay, through ma.s.sive bars--the very female seeming of doubtful s.e.x:

Her unregarded locks Matted like fury-tresses, her poor limbs Chain'd to the ground; and stead of those delights Which happy lovers taste, her keeper's stripes, A bed of straw, and a coa.r.s.e wooden dish Of wretched sustenance.[18]

Now, the unfortunate persons are restored to social life as much as their sad condition allows; they enjoy every comfort that can solace them in their lucid intervals, when their hallucinations cease; in illness they are treated with kindness and liberality, and in health, their former a.s.sociations with the busy world, are recalled by labour, voluntarily performed or stimulated by the incentive of some additional comfort. No coercion is resorted to, except to prevent the furious maniac from injuring himself and others, and then, such means are adopted that restrain his violence without a painful process. Even the straight waistcoat, which impedes respiration, is generally banished in all well-regulated establishments, and belts, sleeves, and m.u.f.fs, which merely secure the hands, without preventing a free motion of the articulations, are usually resorted to. To such an extent is healthy occupation carried on in lunatic asylums, that at this moment at Hanwell, out of upwards of 600 inmates under my care, 421 are at work and distributed as follows:

_Males._

57 Working in the garden and grounds.

53 Handicrafts at various trades.

38 a.s.sistants in the wards.

28 Picking coir, or the external fibre of the cocoa-nut, for stuffing mattresses, &c.

2 Clerks in the office.

---- 178 ----

_Females._

120 At needlework.

2 Making brushes.

21 In the kitchen and dairy.

21 a.s.sisting in the wards.

26 Picking coir.

30 Working in the garden.

23 In the laundry.

---- 243 ----

Hanwell may be said to be an asylum for incurables, since it is doomed to receive old cases that scarcely ever afford a chance of recovery; to which are added a large proportion of the idiots and epileptics of Middles.e.x, whose families cannot support them.

Let us hope from this gradual amelioration in the condition of this illfated cla.s.s of our fellow-creatures, that every inst.i.tution, both public and private, will shortly be conducted upon a similar plan, having sufficient grounds attached to it, to give occupation to such of their inmates as may still be able to enjoy some share, however trifling it may be, of the blessings of this life.

LEPROSY.

Bontius informs us that this disease was observed on the banks of the Ganges, where it was known by the name of _Cowrap_. Kaempfer noticed it in Ceylon and j.a.pan. In Sumatra, whole generations are infected with both leprosy and elephantiasis; and those who are labouring under the latter disease, although it is not contagious, are driven into the woods.

Christopher Columbus found lepers in the island of Buona Vista in 1498, and frictions of turtle blood were used to relieve them.

In our days it is a disease of rare occurrence, at least in Europe; yet it was observed at Vetrolles and Martignes, in France, in 1808, and at Pigua and Castel Franco, in Italy, in 1807. The elephantiasis still prevails in our West India colonies, more especially that species which is called "elephant leg," and which is not uncommon at Barbadoes, St. Christopher, and Nevis. Parsons, in his Travels in Asia and Africa, informs us that a similar complaint exists on the coast of Malabar, where it is called the "Cochin leg." The Hindoo physicians treat it with pills of a.r.s.enic and black pepper.

A curious species of leprosy appeared in Rome under the reign of Tiberius, which was brought thither from Asia. The eruption first broke out upon the chin, whence it was called _Mentagra_, and is thus alluded to by Martial:

Non ulcus acre, pustulaeve lucentes; Nec triste mentum, sordidive lichenes.