Insanity Part 3

In short, there may exist not only a difference in the const.i.tution of the different organs of the body, but these natural conditions are more or less changeful in their states, within certain limits, while still in a state of health. There may exist a condition of over-activity, or of under-activity, in any or all portions of the body, and from the operation of causes, the nature of which we are entirely ignorant, and concerning which persons do not much care, so long as they do not experience so much discomfort as to be unfitted for their usual occupations and pleasures.

Such experiences are common with many persons, who yet remain in a condition of health.

Pa.s.sing now to the conditions of the mental side of the human system, we find, in what are called healthy states, that there exists as broad a diversity of character as in the physical. While some apprehend any thing a little abstruse with great difficulty, or fail to do so at all, others understand it with a readiness which we are accustomed to call intuition; while many occurrences seem merely to impinge upon and glance off the minds of some persons never to be remembered again, they pa.s.s from the minds of others only after long years, or remain through life.

Some persons always look upon and judge of occurrences and results in an unusual way. They are odd or singular in their mental const.i.tution, and are accustomed to do odd and out-of-the-way things just as naturally as others would do the same things in such a manner as to attract no attention. Some persons see, hear, taste, touch, and smell so much more quickly and delicately than others, that we must conclude there exists a radical difference in the perfection of the organization of the nerve-cells of these various organs of special sense.

Again, there are periods in the experience of some persons, when they see, hear, touch, taste, and smell with much greater readiness and delicacy than at other times, even in a state of so-called health. Musical sounds are more delicate and pleasing; harsh and rough sounds are more harsh and rough; certain articles of food produce a keener sense of relish, and colors a greater sense of pleasure: all of which would indicate temporary changes in the structure or function of the nerve element comprising these special organs of sense.

The same is true to even a larger extent of the emotional nature. Persons, in certain states of the nervous system, are pleased with persons, objects, and sensations, which afford them no pleasure at other times; they are displeased and pained, while in other conditions, with sentiments which would at other times produce no such effect. They sometimes feel that the world and its possessions and pleasures are so great and grand that they can never leave them, and the thought of doing so causes the keenest anguish; while in another state all these pleasures and possessions appear as empty and valueless as a bubble of air, and the thought of leaving them, and throwing off the burdens and cares of life, which are usually so much enjoyed, seems almost pleasurable.

Again, some persons have periods of being irritable, restless, nervous; they cannot bear much; little incidents which, in other conditions of the nervous system, they would think little or nothing of, turn them into a pa.s.sion of excitement, which can hardly be controlled for the time being.

In other states they may long to weep, or to be in solitude where they cannot be disturbed; or they may shout, and laugh, and talk, while thoughts come coursing through the brain so fast that words fail in their expression.

The same changes occur among the impulses; these are at times almost irresistible. Nearly every one, while standing on a high cliff or house-top, has felt an impulse to jump off or push his friend off, reckless of the consequences.

In the usual condition of the nervous system persons love their children and relatives, and are ready to do and suffer and at times even to die for them, if need be, while at other times all these sentiments fade away, so that they are unconscious of them, and even the opposite sentiment of dislike or hatred takes their place.

Periods of mental lethargy come over many persons at times, so that they care neither to talk nor engage in any of their usual intellectual or physical pursuits; and such stimuli as are usually sufficient to rouse the brain into action appear to have very little effect. They feel and say that there is a state of only partial brain-activity. At other times the brain acts with the greatest freedom; occurrences which took place long years before, and which, perhaps, have not been thought of since, come back with all the freshness of yesterday. Thoughts come rapidly. Keen flashes of wit, bright scintillations of thought, forms of expression of unusual felicity, pour forth spontaneously, while the mind apprehends and retains many kinds of knowledge with the greatest readiness. Similar variations take place in reference to courage and its opposite, timidity; truthfulness and suspicion; and, in fact, the whole range of mental endowments.

Now all this grand play of diverse emotions and conditions in the psychical functions takes place in a state of health; still, there can be no doubt that it comes from an unstable condition of the nervous elements of the brain, or from changes produced in some manner in these varied and delicate structures. It may be from varying states which are constantly occurring in the blood, in the processes of reception and elimination; or from those delicate chemical operations which must be forever going on in the nerve elements of the brain hemispheres, affecting their recipient and sensitive capacities; or it may be from other unknown causes: and these changes occur much more readily and frequently in some persons than in others.

Bearing in mind, now, these conditions of the physical and mental systems, the tendencies to which are inherited, and more or less changeful in character, we may proceed a step farther.

This unstable condition, both physical and mental, may exist not only as an inherited condition, but it may be produced, or become greatly increased by causes external to the system, which are brought into contact so as to influence it.

A few ill.u.s.trations may serve to make this more clear:

1. When a person who has not been accustomed to use the muscles of the arm in active and vigorous exercise, lifts, or makes a strong effort to lift, a heavy weight, if the effort is continued any considerable length of time, two conditions result therefrom:

First, a state of tremulousness, or spasm of the arm, hand, and especially of the fingers. The largest effort the individual can make toward controlling this irregularity of movement, is insufficient, and these parts remain in a condition of more or less spasmodic action, until the nervous energy is restored.

Second, there results a sensation of pain, more or less severe, according to the time the exertion has continued. This would indicate positive injury, to some extent, in the nerve filaments of the muscles which have been so unusually exercised. The degree of effect will be dependent upon the condition of the nerves of the hand and arm at the time the effort is made, and upon the amount of force expended.

If the effort is repeated soon, there will result a similar condition, and ultimately the nerve would cease to respond to the call for action in any degree,--the arm would be paralyzed.

2. All are more or less familiar with that condition which is usually termed the _writer's cramp_. Sometimes persons of a peculiar nervous organization, who have been accustomed to spend many hours a day in the mechanical process of writing, experience such a loss of nervous energy that the arm fails to respond to the will power. There results spasmodic and irregular movements in the arm, and more especially in the fingers, indicating that some morbid condition of the median nerve has been produced. If the case is neglected, and the exciting causes continue in operation, after awhile the nerve will become less and less responsive to the call of the will, and the arm may become seriously affected, after a longer or shorter period of more or less pain. In this case, as in the former one, there may exist all degrees of impairment of nerve function, from that of slight unsteadiness or instability, up to entire failure.

3. The condition of the nervous system in ch.o.r.ea presents another ill.u.s.tration. Between the ages of ten and fifteen years, in some children, there may occur such changes in the condition of the nervous element, from the altered character of the blood, as to render it more or less unstable in some portion. One arm or one leg, or a hand, or some of the muscles of the face or neck, cannot be kept long at rest by any effort which can be exerted by the individual, and this may be so slight as scarcely to attract attention, or it may be so great as to cause extreme suffering for a long time, and ultimately destroy life.

Now the primary condition in the above cases is one of _instability of nerve function_. Such a change has occurred in the elemental tissue of the nerve, as to injure its power of activity so far as it is under the control of the will. The nerve has been stimulated to over-activity, or its energy impaired by other causes arising within the system itself.

These ill.u.s.trations have related to those portions of the nervous system which are more immediately connected with motion, and which, consequently, are located in the muscular system. If, now, we pa.s.s from these portions of the nervous system up to its grand centre, or that part of it whose function is connected with mental operations, we shall find similar effects resulting from like causes.

If a person experiences a sudden mental shock, occasioned, it may be, by sad intelligence of some kind, or if he pa.s.ses suddenly through some great personal peril, or if he has made unusual mental effort in some abstruse study, or in the conduct of business, which has been long protracted, he becomes conscious of what is called mental fatigue. The brain refuses to respond to any calls which may be made upon it for further action, or partially refuses; it becomes confused and bewildered, and unsteady in its action; it is difficult to force it to further application, or to connected lines of thought, and if, by a strong effort of the will, this is done during a short time, it is inclined soon to wander from the subject, and there exists a more or less distinctly recognized sensation of pain as well as inability to regulate its action.

In this case, also, as in the others, there may result any degree of effect, from a sensation of fatigue up to mental spasm, and the amount will depend on the condition of the brain during the time the effect continues, and its intensity. The two conditions of instability and pain may be less marked in the case of the brain than in the nerves of motion, but there can be little doubt there has resulted something of a similar character in both.

Precisely in what this change which has taken place consists, may not be easily determined. There may have occurred actual lesion of nerve element, or only impairment or exhaustion of functional power without lesion; probably the latter condition only, in the primary stages of the operation. Certain portions of the brain have been over-stimulated in action, and consequently their power of normal activity and stability is impaired, as was seen in the cases of nerves distributed to the muscles of the arm and other portions of the body.

II. Again, if the arm or hand of a vigorous person, which has long been trained to make either large efforts, or the more delicate movements, or again, to make but little effort in any direction, be placed in splints, or be suspended in a sling so that there is little or no activity for a few weeks, more or less, there results a failure of nerve-function; and there may be any degree of impairment, from that of slight degree, such as may be evinced by spasm, to that of paralysis.

The same is true in reference to any portion of the nervous system which can be placed in a state of inactivity.

A few sentences of recapitulation in our process of reasoning will now be in order.

1. We have seen that imperfection and instability of nerve-function may be inherited; that weakness, or impairment, exists with many persons from the time of birth, which affects more or less the functions of the various portions of the nervous system; and that this is seen not only in the mechanical operations of the hand and arm, in the execution of all the more delicate movements of which it may be susceptible, but also in the mental operations. By no possible amount of training can the nerves of the arm in certain persons be educated to do the finer portions of mechanism, any more than can their brains be educated to continuous or concentrated thought on the solution of problems in the higher mathematics; that the broadest diversity as to strength and steadiness of nerve-function exists from the period of childhood to old age: while the nerves and brains of some bear long-continued and large effort without disturbance or failure of function, these portions of the system in others soon manifest the effects of such treatment, and ere long break down; and there may exist any degree of difference, from the manifestations of genius, to those of imbecility.

2. We have also observed that disturbance and imperfection of nerve-function may be produced in all persons by the action of causes operating from without upon the nervous system, and that the results may be similar in character, whether there has been too great or too little exercise of function.

It will further be observed, that we have in a definite and somewhat continuous line pa.s.sed from the production of disturbance and irregularity of the function of simple motion in the hand and arm, up to the more complicated and less understood activities of the hemispheres of the brain. We have seen that there exists at least a similarity in the exhibition of failure in the functions of execution in both cases, whether acquired or inherited.

I think there can be little doubt that there exists some such condition of that portion of the brain which is concerned in mental operations, as I have in a somewhat crude manner attempted to ill.u.s.trate, which is the primary condition in a large number of persons who become insane.

Precisely in what it may consist during the earlier stages we may not be able to explain. There doubtless is no change which can be termed _organic_ in either the nerve cell or any other portion of the substance of the brain during the primary stages of this failure in function, but rather an exhaustion or lack in functional power, which after a longer or shorter period _may_ lead to organic change of structure.

Now we have only to suppose a person with a nervous system so const.i.tuted that these conditions, which I have described as temporarily occurring with many persons from exciting causes, are permanent, though in a latent state, and we have that peculiar organization which we term _The Insane Diathesis_. That is, we have a nervous system so sensitively const.i.tuted, and illy adjusted with its surroundings, that when brought in contact with unusually exciting influences, there may occur deranged instead of natural mental action, and it becomes more or less continuous instead of evanescent.

The mind pa.s.ses from the control of the will, and wanders. .h.i.ther and thither, or persistently holds on in one channel of thought. Its action may become spasmodic and irregular in all degrees from slight aberrations, or excitement, up to incoherence and mental spasm; or from slight degrees of depression, down to almost inactivity and dementia: in short, such abnormal conditions of mental activity as const.i.tute insanity.

The husband hates his wife, and the wife her husband; the parent his child, and the child the parent. We have the person, whose brain is so perverted in its action that he feels no pleasure and experiences no satisfaction in life, but hates it, and longs to throw off its burdens and cares, and leaves no effort untried to accomplish it; while another is so filled with joyous emotion, his brain is so excited in functional activity, that he can neither eat nor sleep, but ideas flow forth in one constant stream of words--words; bright visions appear on every side, and his life is worth a thousand worlds. Or, we may have any other of the ten thousand perverted mental activities which attend the "mind diseased."

"And he * * * (a short tale to make) Fell into a sadness; then into a fast; Thence into a watch; thence into a weakness; Thence into a lightness; and by this declination Into a madness, whereon he now raves And we all mourn for."

In the above view, there does not appear to be any well-defined, sharply bounded line between what is termed normal and abnormal mental activity in its primary stage. The one insensibly merges into the other, while both depend upon the physiological condition of the brain for the time being.

When that portion of it which is immediately concerned in thought is in what is termed a healthy state, that is, a condition in which its involuntary functions are normally performed and under the control of the will, then we have healthy mind; and, _vice versa_, when it varies from this condition, either from the effect of influences which have been inherited or acquired, then we have for the time, abnormal mind. Thousands are born into the world with brains so const.i.tuted as to become easily deranged by external influences and experiences, and thousands more attain to such conditions of the brain, from the frictions of life, and abuse of its enjoyments and requirements.

If these views, in relation to the princ.i.p.al condition of insanity, are correct, it is evident that the question of largest interest in relation to its _prevention_, relates, not so much to the long catalogue of exciting or secondary causes, as to the avoidance of such courses of life, habits, and tendencies of society, as specially a.s.sist to develop and perpetuate this diathesis. It now becomes necessary to suggest and discuss, more or less fully, some of the influences which are in operation in modern modes of education and habits of life, and which have a special tendency to create this condition of the brain. I shall first refer to some points in connection with present methods of education as related to the young.

CHAPTER V.

THE INFLUENCE OF EDUCATION.

The highest conception of an education would include the idea of its being symmetrical; that is, that the psychical and physical should be trained together and in harmony; that the system should be considered and educated as a whole, the brain not being stimulated in its cultivation at the expense of the body, or neglected while the latter is in process of development. If both are educated together, and with due proportion of attention to the laws of development and growth of each, then they will be in the most favorable condition to withstand the effects of the wear and tear which come in the lives of all.

That the courses of education at present pursued in the larger number of our select and common schools, especially those located in cities and large towns, are of this character, will hardly be claimed by persons who study educational systems and processes from a physiological and sanitary point of view.

At five or six years of age, and while for some years the system must be in the formative, growing period of its existence, the child is confined five hours a day on a hard seat or chair, in a room often illy ventilated and irregularly heated. During the larger portion of this time he or she is expected to have the mind occupied in study, or recitation, which is quite equivalent to study. In addition to this, after the child arrives at the age of ten or twelve years, tasks of such extent and difficulty are imposed, that it becomes necessary to study one or two hours during the evening. I think that most persons, with much experience in intellectual occupations, will agree with me, that six hours a day are quite enough for an adult mind to be occupied, with advantage, in study. I am confident it will be found that our most successful clergymen, lawyers, and _litterateurs_, though at times a more protracted period of mental effort may be necessary, yet, as a rule, do not spend a longer period daily in intellectual efforts.

Yet in the education of our little children, we find that both teachers and parents, in their blind ambition to hurry them forward, conspire in imposing tasks of such a character and magnitude as to require longer hours of study than we know to be best for the adult brain.[4]

I believe, however, that the largest mischief does not come from the length of time occupied in confinement and study, great as this may be. A still larger defect in the system lies in the multiplicity of the subjects studied and the lack of sufficient individuality in its administration.

In the graded schools children are parcelled out in numbers ranging from forty to sixty in one room, and put under the charge of one teacher. The system is too purely a mechanical one; all must come in, go out, rise up and sit down, study, and recite in very large cla.s.ses. There is no room or time for individuality in any department of study, and very little in any recitation. Each one goes on with the whole, or he drops out and back, while the half-exhausted teacher has neither time nor opportunity to bestow the little attention and aid which would often be of so much value.

No teacher can do even half justice to any such number of children, and I presume it is not expected he will. His task appears to be to find that in some way or other the pupil seems to be able to recite his lesson, and if not, that he work at it until he does; and if the unfortunate one fails, see that he goes back to a lower cla.s.s. Now, doubtless, one or two out of every five of these fifty or sixty children will be able to press on with comparative ease and health through all the studies which all are expected to master, but for the other three or four of the five, there exists a large tendency toward confusion of mind and imperfect knowledge, rather than those clear conceptions and definite understanding which tend to give vigor and strength of brain.