Probably the worst thing in the world for those who have any inherited tendency to disequilibration of mind is to have an occupation in life which involves strains and stresses of emotion. The gambler, the speculator, the man who risks his all on some attempt to make a great deal of money, are much more prone to develop insanity than those who have occupations in life at which they work from day to day for a moderate wage, and who get their joy in life out of the fulfillment of domestic duties. Almost needless to say religion has always discouraged gambling and such speculation as resembles it very closely, and the whole tendency of religious influence is to make people so satisfied with their lot in life that they will not take the risks which involve the [{213}] vehement mental emotions so likely to disturb those with inherited predispositions toward irrationality. Undoubtedly religion has in this way saved a great many men from serious developments in mental alienation which might have come had they felt themselves free to take up the riskier avocations in life from which they were deterred by the feeling of religious disapproval.
After the tendency to exaggeration of the ego and delusions of grandeur, the most common symptom of incipient insanity is delusion of persecution. As regards this, once more, the religious feeling of trust in Providence and the conviction that God will somehow take care of them keeps many people from allowing their delusions of persecution to manifest themselves so soon or so violently as would otherwise be the case. Only comparatively rarely do religious minded people in the midst of their delusions of persecution commit crimes, being deterred therefrom by the underlying consciousness of the wrongness of their acts in taking judgment on their persecutors into their own hands, even though they may have yielded to a belief in their delusions. It is true that a certain number of religious-minded people do commit crime under the influence of delusions, but these are rarer than the cases which occur in people who have never had any sense of religious morality.
In a word religion has meant a very great deal for the limitation of insanity and the tendency to it, for putting off its development and giving patients years of sanity they might not otherwise have enjoyed, and it has had a very definite effect in limiting the crimes consequent upon insanity. It has a very marked tendency to create the atmosphere of placid trust and confidence which means so much for the preservation of sanity. Far from being [{214}] a provocative of irrational tendencies it soothes patients' minds, prevents them from running into such excesses of emotion as are dangerous for mental balance, and it predisposes those who allow themselves to be deeply influenced by it to live such quiet satisfied lives without inordinate ambition and disordered desires as make for health of mind and body during prolonged life.
It has often been said that religion unfortunately proved harmful to insanity and the insane in the old medieval days, because ecclesiastics, sometimes for the sake of the fees that they might secure for exorcisms, taught very generally the doctrine that the insane were possessed of the devil, and that the one thing to do for them, besides exorcising the evil spirit, was to chain them up and keep them in manacles in dungeons until there was assurance that they had been released from the devil that had gained possession of them.
In spite of the fact that this is a rather common teaching in medical books and is frequently asserted even by physicians and sometimes indeed by specialists in nervous and mental diseases who are supposed to know the subject on which they discourse, there is very little foundation for this prevalent impression. Undoubtedly there was the belief in the possibility of possession by the devil and some such modern scientific minds as Alfred Russel Wallace and Professor Barrett of Trinity College, Dublin, have reverted to that belief because of their studies in spiritism and some of the curious results that follow from overdevotion to the cult of spirits. There was, however, a very definite recognition of the fact during the later Middle Ages that the insane were just ailing persons who had to be taken care of, properly treated, kept from hurting themselves or others, just as delirious individuals [{215}] would have to be guarded, but who must be looked upon as sick in mind, just as a number of people were sick in body and with more than a hint that the bodily condition had more to do with the insanity than anything else. I have discussed the subject at some length in my volume on "Medieval Medicine" recently published in London. [Footnote 7] Paul of Aegina wrote in the seventh century of melancholy as a primary affection of the brain to be treated with frequent baths and a wholesome and humid diet, together with suitable exhilaration of mind and without any other remedy unless when from its long continuance the offending humor is difficult to evacuate, in which case we must have recourse to more complicated and powerful plans of treatment. Paul was a very popular author much read in the Middle Ages.
[Footnote 7: Black. 1920.]
The Church's view of the subject of insanity is very well expressed in Bartholomew's Encyclopedia. This was a work written particularly for the information of the clergymen of the time, in order to explain to them all references in Scripture and to give them such details of knowledge as were necessary for preaching and for the teaching of their flocks. Bartholomew was very widely read and went through many editions before printing, was put into print very early, and some of the editions are among the greatest of bibliophilic treasures. Bartholomew, usually called the Englishman—his Latin name of Bartholomaeus Anglicus is well known—boiled down all the knowledge of insanity into a single paragraph. He has nothing at all to say of possession by the devil, and his discussion of the whole subject of madness is as modern as can be.
The causes of insanity which this clergyman writer [{216}] of the middle of the thirteenth century enumerates are those which psychiatrists of the present day are insisting on. The symptoms of infection, considering the brevity of the passage, are very well and clearly described, and the treatment suggested is the very latest in modern practice and consists of improvement of nutrition and the diversion of the insane. With all our supposed advance in knowledge no physician, even of the twentieth century, could have expressed the whole subject of insanity any better than Bartholomew did. This paragraph is a complete refutation of the objections that the Church by its insistence on diabolical possession as the principal cause of insanity did a great deal of harm. Bartholomew said:
"Madness cometh sometime of passions of the soul, as of business and of great thoughts, of sorrow and of too great study, and of dread: sometimes of the biting of a wood (mad) hound, or some other venomous beast; sometimes of melancholy meats, and sometimes of drink of strong wine. And as the causes be diverse, the tokens and signs be diverse. For some cry and leap and hurt and wound themselves and other men, and darken and hide themselves in privy and secret places. The medicine of them is, that they be bound, that they hurt not themselves and other men. And namely, such shall be refreshed, and comforted, and withdrawn from cause and matter of dread and busy thoughts. And they must be gladded with instruments of music, and some deal be occupied."