MEDICAL SUPERSTITION AND INSANITY

The history of medicine is conjoined with the evolution of theology to an extent which makes them almost inseparable, and this may best be seen from a study of the management of the insane, which is a continuous record of cruelty based upon medico-theological superstition. Perhaps the most heartrending chapter of unphilosophical theology teems with the narration of thousands of unfortunate beings murdered, tortured, and mishandled by the finesse in the interpretation of Biblical texts. The greatest triumph of modern medicine has consisted in unfettering the views of effete centuries, born of superstition and misconception, and in placing the treatment of the insane upon a humane, often even a curative, plane. As other afflictions of humanity were attributed to the agency of evil spirits, this was particularly the case with insanity; for if the evil one found it an easy task to control the corporeal acts of humanity, his power over the mental functions of the person afflicted was even greater. Hence, it was not the person who acted, but the evil spirit in him. Thus, the devil and his minions were the specific pathogenic agents.

This conception was not universal, for history shows us that clear thinkers, far in advance of their times, had an almost correct view of the nature of insanity—namely, that it was due to an affection of the mind. Among such men were Hippocrates, AretÆus, Soranus, Galen, Aurelianus, etc., and some of the Mohammedan physicians. These apostles of science taught that insanity was a disease of the brain, and the most efficient remedy, mild, palliative treatment.

The belief which had flourished in most of the Oriental religions from remote antiquity, that the power of evil demons was the active cause of disease, particularly that lunacy was due to diabolic possession, became rooted in the early Christian Church and flourished for eighteen centuries, each leaf of this malignant plant representing countless unfortunates sacrificed to superstition. Later it was thought that the moon had a direct influence upon perturbation of the mind; hence, the term “lunacy” developed.

These doctrines gained special credence in the first centuries after Christ by the dissemination under the Church Fathers of the story of the miracles which they claimed had been performed by Jesus of Nazareth. Did not the Savior cast out devils? Did He not cure madness? The very word “epilepsy” shows by its derivation, ?p?????? (to seize upon), that possession was the presumable nature of the malady.

The noble work accomplished by the “pagan” pioneer alienists was discredited or forgotten, and the Church originated a process by which the possessed were to be treated. This method of treatment was derived purely from theologic sources, tempered with sufficient dogma. At first the treatment was gentle, in accordance with the spirit of the great physicians of antiquity, and if the afflicted one was not violent he was permitted to attend public worship. Sacred salves and holy water, the breath or the spittle of the officiating priest, the touching of relics, or a visit to holy places, were the principal therapeutic agents employed. These methods, even if they did no good (sometimes merely the consolation of a kind word from the priest had a beneficial effect), certainly did no harm, even tho such practises were factors in the spread of superstition.

This mild form of treatment did not, however, long continue. Soon measures were directed toward driving out the evil spirit from the possessed. This was attempted in various ways; first, by exorcism, in the period of Justin Martyr, and continued up to almost recent times (see Lecky, “History of European Morals”). “From the time of Justin Martyr for about two centuries, there is, I believe, not a single Christian writer who does not solemnly and explicitly assert the reality and frequent employment of this power.”

One of the chief attributes of the devil was pride, therefore attempts were made by exorcism to pierce this vulnerable point in the armor of the evil one, and the foulest, vilest epithets were used to attain this end. It is impossible to-day to print these expressions, even in a work of scientific character, and it is better, perhaps, to refer such as are especially interested in them to the Manuale Benedictionum, by the Bishop of Passau, published in 1849, and similar works. Adjuvants to this form of treatment consisted in “frightening” the devil by long words, difficult to pronounce, commonly derived from Oriental languages, by the administration of malodorous and filthy “drugs,” and similar practises.

It was claimed that many devils were thus driven out, and the annals of the Church contain numerous records of persons cured in this manner. “The Jesuit Fathers at Vienna, in 1583, glorified in the fact that in such a contest they had cast out twelve thousand, six hundred and fifty-two living devils” (White). The prevalence of these ideas to such a degree in the minds of the people may be noted from the fact that, in the churches themselves, such scenes are carved in stone and depicted on canvas. Medieval drama teemed with similar conceptions, and this condition of affairs prevailed for over one thousand years, unfortunately not in this harmless manner, but supplemented by great cruelty, which forms, perhaps, the most terrible chapter in the history of medical superstition.

The subtleties of theologic interpretation soon evolved a more comprehensive method of dealing with the “possessor” and the possessed. As an appeal to pride was ineffectual and noxious drugs unavailing, it was found necessary to whip the devil out, or the unfortunate individuals were imprisoned, and as a refinement of this treatment they were even tortured. Thus the jailer for a long time played the part of a specialist in lunacy, with the clergy in consultation. Places in which the insane were confined were known as “fool towers” and “witch towers.”

This state of things was not altered with the dawn of the Reformation. The writings of Luther conclusively show his ideas in regard to possession and witchcraft, and these views under Calvin reached enormous development. Even Cotton Mather, in many respects far in advance of his times, and who himself had known persecution, was not emancipated from these delusions, and Salem has many a story to tell of possession and witch-baiting. It is true we may quite properly consider these views as the thought of the times, but, in many other respects, Luther, Calvin, and Mather were in advance of their period, and, therefore, a justification for their actions is not quite apparent. Marcus Aurelius also was much superior to his age, yet was grateful to his teachers that they taught him to disregard superstition in all its various forms.

It is not unlikely that conditions of this kind frequently led to epidemics—if not of actual insanity, at least to hysteria—which not rarely developed in cities, nunneries, and monasteries; thus the epidemics in Erfurt in 1237, in the Rhine countries in 1374, and many others (see Hirsch).

It is rather remarkable that while such views and practises prevailed in the Christian Church, the followers of Mohammed not only held different views, but adopted a mode of treatment of the insane which laid the foundation of modern therapeutics in diseases of the mind. In the twelfth century, in Bagdad, a palace called the “Home of Mercy” was built, in which the insane were confined, examined every month, and released as soon as they had recovered. An asylum in Cairo was founded in 1304, while the first Christian asylum expressly for the mad is noted in 1409 (Lecky).

But science fought its way through the barriers of ignorance, misdirected zeal, and superstition. Altho there were physicians and “magicians,” who conformed to the views of the Church, the seed sown by the earlier schools of medicine slowly but surely began to put forth shoots, and the result was a tree of knowledge, the fruit of which may be observed in every modern insane asylum of the world, where the unfortunate sufferer is treated with kindness and skill, which, fortunately, often results in cure.

Scientific reason frequently rebelled against the “insane superstition,” at first mildly, but constantly increasing in strength, until an effectual protest was finally raised by John Weir, of Cleves, who was soon followed by Michel de Montaigne. And now a battle royal was waged between the adherents of theology and the disciples of the “resurrected” truth, and once more in the history of the world was demonstrated the correctness of the saying, that “truth crushed to earth shall rise again.” All over the world the warfare was carried, and at the end of the eighteenth century new champions arose—Jean Baptiste Pinel in France, and William Tuke in England. Their followers are legion, and in the book of life, in letters of gold, many a name has been written of those who trod in the footsteps of these pioneers. Theology no longer interferes in the treatment of the insane; in fact, it would be manifestly unjust not to mention that many Christian theologians subsequently joined in the noble work of lunacy reform, and aided progress greatly.

How great this progress in the treatment of the insane can best be appreciated by some of the older physicians in practise to-day. Who does not remember the chains, the strait-jacket, the dark locked cells of the insane asylum? These conditions existed not very many years ago, and altho the novels of Charles Reade are no doubt greatly exaggerated in regard to the conditions he portrayed in insane asylums, yet more than a grain of truth is probably contained in them. The books did much to bring about reforms in England and elsewhere.

Modern alienists have wrought wonders; their successful operations are not published in the daily press, but any visitor who knows what an insane asylum was fifty years ago, and who spends a few hours in a modern hospital for the treatment of lunatics, will observe what appears but little short of the miraculous. Imagine two thousand or more insane persons dining in a large hall, upon the table a tablecloth, and the insane using knife and fork in a decorous manner, and when the visitor is told that the “violent ward” is also present, and is asked to single these out from among the many, and fails (as he invariably does), the results attained by science, above all other measures, are strikingly apparent.

[200]
[201]