Physician and patient

by Worthington Hooker

Anything which causes an undue excitement in the mind has a tendency to produce insanity. A too exclusive and prolonged attention to one subject has this effect. It is in this way in part that ultraism acts as a cause of this disease. The brain becomes wearied out and weakened by one kind of effort, just as the muscles of the school boy’s arm are tired out, when, as a punishment, he is compelled to hold with outstretched arm any heavy article for some considerable length of time. A wearied and weakened brain, when the infliction which produces this result, is frequent and long continued, is apt to become diseased; and one of the diseases to which it is thus made liable is insanity.

It is said that insanity is hardly known among the savage and uncivilized. There are two reasons for this. They are the intellectual torpor, and the physical vigor, which result from the habits of the savage. Wild passion, it is true, sometimes lashes his mind into fury, but it easily subsides into its usual repose, and the firm fibres of the brain and nerves suffer no injury from the shock. So also in countries which are ruled by despotic governments, the mental torpor which prevails makes insanity a rare disease.

As the intellectual torpor and the physical vigor of savage life prevent the occurrence of insanity; so on the other hand, the intellectual activity and the physical debility of civilized life conduce to its existence. Mental excitement combined with luxury and effeminacy is a prolific source of this disease. In this age, and especially in this nation, the mental activities in every department of effort are so lively, and have so little intervals of relaxation, that the wear and tear of brain in all this conflict produce an unusual amount of insanity, greater as is shown by statistics, than in any other country in the world.

It is not strange that the excitement which is created in the mind by the stirring motives presented by religion, should sometimes occasion mental derangement. The struggle which it often awakens against the passions, and propensities, and errors, which have accumulated in amount and force by long indulgence in sin, must render persons of considerable nervous susceptibility liable to this disease. But in such cases religion acts only as the exciting cause, while the predisposing causes have been exerting their influence through a long series of years. And it is to be remembered, that though, even when it is properly taught and enforced, it may occasionally act as the exciting cause of insanity, its general influence tends to remove the predisposing causes to which I have alluded, and its universal prevalence would be attended by their entire removal. It is also to be remembered, that of all those cases which are charged to religion by an indiscriminating public, and by the enemies of Christianity, in very few of them is the insanity produced by the proper presentation of religious truth, while in the great majority of them it owes its origin to the wild vagaries and the rash measures of the errorist, the ultraist, and the fanatic.

A fruitful source of insanity is to be found in a general debilitated condition of the system, which may be induced by a great variety of causes. Such a condition is commonly characterized by a morbid nervous irritability, which, with the aid of concurring causes, often produces mental derangement. A very large proportion of the inmates of our Insane Retreats present this condition of system. Their physical and mental energies have both been exhausted by incessant toil, and care, and anxiety from year to year, and long continued ill-health has at length resulted in insanity. I may remark that we see, in the loss of physical vigor as a cause of insanity, the chief reason why there are more females than males among the insane.

As intemperance combines so many of the agencies which tend to produce insanity, it is justly considered as one of the most prolific sources of this disease. Strong drink exerts its destructive influence upon the whole man, mental, moral, and physical. It dethrones the reason, and inflaming the passions, gives them the supremacy. It creates a morbid excitement throughout the whole nervous system, and especially in the brain, the great central organ of this system, and the instrument of the mind. It affects other organs also, and particularly the stomach, which sympathizes so readily with the brain, that its disorders, as is known to every one, have a great influence upon that organ. Strong drink, therefore, acting in these different ways upon the system, not only expends the vital power rapidly, bringing on premature old age, but it makes its deposites of disease here and there in the various organs, which seriously embarrass them in the performance of their functions. With such an impaired and diseased state of the system, and with the constant excitement to which both body and mind are subjected, it is no wonder that the intemperate are peculiarly liable to insanity.

In looking at the causes of insanity we readily discover the reason why children are so seldom insane, though, from the liveliness of their sympathies, they are much more apt to be temporarily deranged by disease than adults are, as we see in the paroxysms of fever. The brain and nervous system require a long series of influences to bring them into such a state, as renders them liable to that class of diseases, which we include under the name of insanity. This state is an accumulated result of the action of predisposing causes, continued for some length of time, perhaps during all the previous life of the patient. But the derangement of the child ceases with the temporary disease which causes it. Its organs, not being incumbered with any accumulations of disease, return readily to the performance of their healthy functions; and its nervous system not having been shattered with repeated attacks of sickness, and not having experienced the wear and tear of trouble and toil, resumes at once its usual free and easy and buoyant condition.

But, though insanity is not a common disease in the early years of life, the foundations are often laid for it in this forming period. The intellectual is often cultivated at the expense of the physical, thus inducing that debilitated, and at the same time irritable state of system, which you have seen is one of the prominent causes of insanity. The passions, instead of being curbed by reasonable restraints, are left to run riot. False views of life are permitted, with all the bewitching fascinations which genius and fancy and wit can furnish, to stamp their impress upon the mind, and through it upon the brain during the impressible period of its growth. Luxury too pampers the appetites, and gives to them a supremacy, which debases and impairs alike the physical and the mental powers. When the child therefore becomes the man, it is not strange that the predisposition, thus formed within him by this moral and physical training, should become more and more developed amid the stirring and troublous scenes of active life, till at length, through the agency of some exciting cause, insanity appears as the accumulated result of all these evil influences. Education then, using the word in its widest sense, has much to do with the production of insanity when it is directed by wrong principles; and, on the other hand, it can be made under proper management, to exert a powerful influence in the prevention of this disease.

Let me now call the attention of the reader to a few considerations in regard to the forms and the signs of insanity.

In some cases the symptoms of this disease are from the first of so marked a character that no one can mistake the nature of the malady. But in other cases its signs are for a long time indistinct, and no period can be accurately fixed upon as marking the commencement of the disease. Such cases are apt to be very obstinate, and the longer they continue without proper treatment, the more difficult is it to effect a cure. And delay is so common on the part of friends in relation to such cases, that many of them, in which an early adoption of the proper course would have resulted in an entire restoration to health, become incurable before anything effectual is done. In order that cases of this character should not be thus neglected, the community need to be enlightened in regard to them.