Insanity: Its Causes and Prevention

by Henry Putnam Stearns

And in the history of the world, thus far, there has never appeared any high states of civilization without these unequal and inharmonious developments. No peoples have as yet ever learned the art of living under the conditions of civilization without them; no peoples have ever passed from the community of interests and possessions, which exists so largely in savage life, up to those conditions which pertain to civil life, except with attendant results similar to those already indicated; and these results are plainly those which tend largely toward the development of mental disease.

If the views presented in the preceding chapter and also in this, in reference to the tendency of insanity to increase, and which statistics appear to confirm, are correct, we perceive at once how important, in relation to both political economy and the future health and happiness of society, becomes the problem of this disease.

As a subject of science and philanthropy, it has for some years engaged the study and interest of many who have been desirous more fully to understand its bearing in both these respects; but in the no distant future, it will become the disease of paramount importance and interest to legislators and political economists; and as there exist reasons for supposing that, under the changing conditions of our modern civilization, it will more surely tend to invade the homes of many who have heretofore been exempt, and will in the future even more surely than in the past, affect all ranks and conditions of society, the increasing importance of making its causes a subject of investigation, and of endeavoring to prevent its increase, even in a limited degree, becomes at once apparent.

It may be remarked at the outset that many of the exciting causes of insanity are uncontrollable. We can do little, or nothing, toward changing or modifying the demands which are made upon us by the business operations of the present; nor toward modifying those great activities which are so loudly calling for development and conduct in life; we cannot do much toward changing the unequal conditions which pertain so largely in relation to property, occupations, and modes of living; or in avoiding the sufferings which result from the bereavements and disappointed expectations of life; we cannot, nor is it desirable, in all respects, if we could, do much to promote community of interests in property. But it is important to bear in mind that, after all, the prime condition of insanity lies, to a large extent, back of these exciting causes. Thousands have passed through such conditions and experiences, have suffered from disappointment and failure in respect to their plans and purposes; have endured exposures and hardships all their lives; all, without becoming insane, and thousands more will continue to do so in the future. It is evident, therefore, that there must exist back of these experiences, a state of the nervous system which renders it susceptible of the disease. This, it is, which is the prime factor in the problem of insanity; and it becomes of the first importance to discover, so far as we may be able to do so, in what this predisposing tendency may consist, or, at least in what ways, or through the operation of what causes, it more especially tends to come into existence and operation to so large an extent at the present time, and by what means it maybe avoided.

In this study we are proceeding along the same road we follow in investigations concerning other diseases. In a philosophical sense, there lies back of all manifestation of diseased action, an antecedent condition, which is the soil from which morbid actions spring. There exist the scrofulous, the phthisical, the gouty, the rheumatic diatheses, and, hence, the question of heredity is of the utmost importance in reference to many forms of disease.

“To many intents and purposes, we are born one generation at least, and generally more, before we come into the world. The soil whence the protoplasm of our grandfathers was formed, has a large significance in reference to ourselves. We limp, because they were gouty; we groan with rheumatic pains, because they slept in damp rooms; the neuralgic twinges of their fifth pair of nerves extend over into ours. The acid of the grapes, which our fathers ate, has acted on the enamel of our bicuspids and molars. That intangible tendency to weakness, to unhealth, so indefinable, so delicate, so inappreciable to our senses, is yet the mightiest factor in our being, and measures the amount of our physical pains and sufferings with a greater delicacy than we have been wont to think. It is the match, which needs only to be rubbed,—or the tinder waiting for the spark,—or the acid for the alkali.

On no other theory are we able to explain the effects, or absence of effect, from the exciting causes of disease. For instance: in one case cold produces neuralgia, in another rheumatism, in another pneumonia, in yet another bronchitis, and in the fifth person no morbid action at all. Now in these several persons there must have existed a primary or induced condition of the several parts affected, of such a nature, that a common cause, acting upon all alike, yet produced widely different results.

“Again, two persons may be exposed to the same atmospheric conditions, or be brought within a similar miasmatic influence, resulting in the one case in fever; in the other, in nothing. The miasm or poison was doubtless present in both systems alike, and, perhaps, in similar quantity, and yet in one case with no appreciable effect, and in the other, creating an illness which may continue for weeks or months. It is evident that there must have been, in the last case, a condition of the system which rendered the action of the miasm possible, and without which, it would have been entirely, or nearly, inert. In fact, strictly speaking, this cause, or antecedent condition, is rather a part of the disease itself, and cannot, in fairness, be separated from it. For, if disease be abnormal action, either in the structure or function of an organ, whether sufficient to be recognized or not, subjectively or objectively, then this weakness, inherited or acquired, becomes the chief factor, and those changes, which are sufficiently gross to be observed by our senses, and which we are accustomed to term disease, are only the remaining factors of it.”[3]

I apply the same course of reasoning in relation to that necessarily antecedent condition of the brain, which renders it especially liable to become diseased through the operation of those ordinary exciting causes, which, to a greater or less extent, surround the lives of all persons, and which we term the Insane Diathesis. It becomes necessary, therefore, to study this peculiar condition of the brain, first, as to its nature, and, second, as to some of those causes which tend especially to create it.