Читать книгу Chapters in the History of the Insane in the British Isles - Daniel Hack Tuke - Страница 6

"They bryng mad men on fuit and horsse,

And byndes theme to Saint Mangose Crosse."

To this cross (at Lotherwerd, now Borthwick, county Edinburgh), says an old writer, Jocelin, a monk of Furness, "many labouring under various disorders, and especially the furious and those vexed with demons, are bound in the evening; and in the morning they are often found sane and whole, and are restored to their liberty."[42]

The resort to pillars of churches is illustrated by what an Augustine Canon of Scone says, in a work on the rule of his foundation (Paris, 1508), for he protests against the desecration of churches, with the exception of curing lunatics in the way I have just described, as being bound to the church pillars.

Nearly a hundred years after Dr. Borde wrote, that remarkable work was published, "The Anatomy of Melancholy," by Burton. Some quaint lines and a rough engraving on the title-page illustrate but too well the treatment of the insane familiar to him, although not a physician; it seems worse, instead of better, than that of the doctor of St. Giles.

"But see the madman rage downright

With furious looks, a ghastly sight!

Naked in chains bound doth he lie

And roars amain, he knows not why."

The first edition of Burton's work was published in 1621, five years after the death of Shakespeare, who speaks, in "As You Like It" (Act iii. sc. 2), of madmen deserving "a dark house and a whip," and in "Twelfth Night" makes Sir Toby say of Malvolio (Act iii. scene 4), "Come, we'll have him in a dark room and bound." The medical treatment of melancholia contained in Burton consists mainly of herbs, as borage, supposed to affect the heart, poppies to act on the head, eupatory (teazel) on the liver, wormwood on the stomach, and endive to purify the blood. Vomits of white hellebore or antimony, and purges of black hellebore or aloes, are prescribed.

The famous "Herbal" of Gerarde, published in 1597, gives various remedies for madness, but they are, unfortunately, copied for the most part from Dioscorides, Galen, and other ancient writers. They are so far of interest that they show what was accepted as the best-known drug practice at the time in England in mental disorders. Under "A Medicine against Madnesse" we have rhubarb and wild thyme, the latter being "a right singular remedie to cure them that have had a long phrensie or lethargie." He is here only following Aetius, and when he says, "Besides its singular effects in splenetical matters, it helpeth any disease of melancholy," he appears to follow Galen. Feverfew is said to be "good for such as be melancholike, sad, pensive, and without speech." Syrup made of flowers of borage "comforteth the heart, purgeth the melancholy, and quieteth the phrenticke or lunaticke person." Hellebore, of course, has its virtues recognized. Black hellebore, or the Christmas rose, "purgeth all melancholy humors, yet not without trouble and difficultie, therefore it is not to be given but to robustious and strong bodies as Mesues teacheth. It is good for mad and furious men, for melancholy, dull, and heavy persons, for those that are troubled with the falling sickness (epilepsy)," and "briefely for all those that are troubled with blacke choler, and molested with melancholy."[43]

Gerarde strongly commends "that noble and famous confection Alkermes, made by the Arabians," containing the grains of the scarlet oak (Ilex coccigera). "It is good against melancholy deseases, vaine imaginations, sighings, griefe and sorrow without manifest cause, for that it purgeth away melancholy humors" (p. 1343). Poultices applied to the head, of mustard and figs, are recommended for epilepsy and lethargy. Gerarde adopts from Apuleius the virtues of double yellow and white batchelor's buttons, hung "in a linnen cloath about the necke of him that is lunaticke, in the waine of the moone, when the signe shall be in the first degree of Taurus or Scorpio."

Such are the principal remedies for insanity given by Gerarde, original and second hand.

Returning to Burton, it should be said that among the causes of the disease he distinctly recognizes the same uncanny influence that his contemporaries Coke and Hale regarded as a legal fact—I mean witchcraft. After saying that "many deny witches altogether, or, if there be any, assert that they can do no harm," of which opinion, he adds, "is our countryman (Reginald) Scot (of Kent),[44] but of the contrary opinion are most lawyers, physicians, and philosophers," he proceeds, "They can cause tempests, etc., which is familiarly practised by witches in Norway, as I have proved, and, last of all, cure and cause most diseases to such as they hate, as this of Melancholy among the rest."[45]

It may be asked, What was the medical knowledge or practice at the time of Coke and Hale, to which they would turn for direction when insanity came before them in the courts of law? and I think a correct reply would be best obtained by taking this wonderful book of Burton's, the works of Sir Thomas Browne, who gave evidence before Hale, and what may be called the case-book of the celebrated Court physician, Sir Theodore de Mayerne. A Genevese, he settled in England in 1606, and was regarded as the highest authority in mental and nervous affections. A medical work of his was translated into Latin by Bonet. Mayerne's treatment was certainly of a somewhat cumbrous character, and his patients must have had an unusual and commendable amount of perseverance if they pursued it thoroughly. The drugs probably cured in part, at least, from the duty entailed upon the patients of collecting the numerous herbs which were ordered for the composition of the mixture, and Sir Theodore truly and naïvely remarks to one of his patients, "It will take some time before you have mixed your medicine." It is clear that he was under the influence of the old belief in the connection between the liver and insanity, and the paramount importance of getting rid of the black bile. Of one case he asserts that the root of all the griefs wherewith the patient has been afflicted is a melancholy humour, generated in the liver and wrought upon in the spleen. This humour is stated to be mixed in the veins, and so extended to the brain, which this offensive enemy of nature doth assault as an organical part. Hence, he says, it happens that the principal functions of the soul do act erroneously. His treatment consisted of emetics, purges, opening the veins under the tongue, blisters, issues, and shaving the head, followed by a cataplasm upon it, the backbone anointed with a very choice balsam of earthworms or bats. One prescription for melancholia contains no less than twenty-seven ingredients, to be made into a decoction, to which is to be added that sine quâ non, the ever precious hellebore. Other remedies were prescribed; in some cases the "bezoartick pastills," composed of an immense number of ingredients, including the skull of a stag and of a healthy man who had been executed. The commentary triumphantly made by this lover of polypharmacy in the case in which this medicine was administered, runs thus:—"These things being exactly performed, this noble gentleman was cured." With certain modifications, the general treatment here indicated was that in fashion at the period to which I refer, and was based on a strong conviction of the presence of certain peccant humours in the body, affecting the brain, which required elimination.

Mayerne, of whom there is a portrait in the College of Physicians, was physician to more crowned heads than has fallen to the lot of probably any other doctor, namely, Henry IV. of France, James I. of England, his queen, Anne of Denmark, Charles I., and Charles II. He introduced calomel into practice. Dying in 1654/5, he was buried in the church of St. Martin's-in-the-Fields, where a monument was erected to his memory.[46]

The royal author of the book on Demonology (first published in 1597)—the high and mighty Prince James—gives sundry learned reasons why witches are not to be regarded as mad, and why, therefore, the plea of insanity should be rejected in the legal tribunals. Written in the form of a dialogue between Philomathes and Epistemon, the latter, who personates the king, says, "As to your second reason (that Witchcraft is but very melancholique imagination of simple raving creatures), grounded upon Physicke, in attributing the confessions or apprehensions of Witches to a natural melancholique humour, any one that pleased physikally to consider upon the natural humour of Melancholy, according to all the physicians that ever writ thereupon, shall find that that will be over short a cloake to cover their knavery with."[47]

James is very wroth with Reginald Scot and Wierus[48] for their opposition to the prevalent belief, and urges, as proof of the existence of witches ("which have never fallen out so clear in any age or nation"), daily experience and their confessions. Reginald Scot had dared to write, in his "Discovery of Witchcraft" (1584): "Alas, I am sorry and ashamed to see how many die who being said to be bewitched, only seek for magical cures, whom wholesome diet and good medicines would have recovered.... These affections tho' they appear in the mind of man, yet are they bred in the body and proceed from the humour which is the very dregs of the blood; nourishing those places from whence proceed fear, cogitations, superstitions, fastings, labours, and such like."

It is striking to observe how much more enlightened this writer was than a physician to whom I have already referred, Sir Thomas Browne. His famous sentence, in which he gives full credence to witches, makes us obliged to admit that when so distinguished a man entertained such superstitious notions, we cannot be much surprised if contemporary judges regarded many of the really insane as witches, although they had before them the enlightened opinions of Reginald Scot.

The history of incubi, or "night-comers," is doubtless, to a large extent, a narrative of the hallucinations, delusions, and automatic thoughts of the insane, although to what extent would be a difficult question to determine, because some were assuredly frightened into the confessions which they made; and, further, it is hard to say how much of a certain belief was due to the current popular ignorance and credulity, and how much to actual mental disease. Still the ignorant opinions of an age find their nisus and most rapid development in persons of weak or diseased mind, and they form the particular delusion manifested; and at a period when witches are universally believed in, there must be some reason why one believes he or she has had transactions with Satan, and another does not believe it. It is, indeed, impossible to read the narratives of some of the unfortunate hags who were put to death for witchcraft, without recognizing the well-marked features of the victims of cerebral disorder. In this way I have no doubt a considerable number of mad people were destroyed. Their very appearance suggested to their neighbours the notion of something weird and impish; the physiognomy of madness was mistaken for that of witchcraft, while the poor wretches themselves, conscious of unaccustomed sensations and singular promptings, referred them to the agency of demons. Strangely enough, even an inquisitor—Nider, who died in 1440—gives many instances of persons whose symptoms he himself recognized as those not of possession, but of madness.

It is hardly necessary to say that the treatment of the unfortunate lunatics and epileptics who were judged to be witches by James I. was nothing else than death, and he thus coolly comments on this punishment: "It is commonly used by fire, but that is an indifferent thing, to be used in every country, according to the law or custom thereof."[49]

I cannot pass from this subject without doing honour to two men who abroad, no less than Reginald Scot in Britain, opposed the immolation of lunatics—Wierus, physician to the Duke of Cleves, who wrote a remarkable work in 1567, and appealed to the princes of Europe to cease shedding innocent blood; and Cornelius Agrippa,[50] who interfered in the trial of a so-called witch in Brabant, having sore contention with an inquisitor, who through unjust accusations drew a poor woman into his butchery, not so much to examine as to torment her. When Agrippa undertook to defend her, alleging there was no proof of sorcery, the inquisitor replied, "One thing there is which is proof and matter sufficient; for her mother was in times past burnt for a witch." When Agrippa retorted that this had reference to another person, and therefore ought not to be admitted by the judge, the inquisitor was equal to the occasion, and replied that witchcraft was naturally engrafted into this child, because the parents used to sacrifice their children to the devil as soon as they were born. On this Agrippa boldly exclaimed, "Oh, thou wicked priest, is this thy divinity? Dost thou use to draw poor guiltless women to the rack by these forged devices? Dost thou with such sentences judge others to be heretics, thou being a greater heretic than either Faustus or Donatus?" The natural consequence was that the inquisitor then threatened to proceed against the advocate himself as a supporter of witches; nevertheless, he continued his defence of the unhappy woman, who, whether a lunatic or not, was delivered, we read, by him "from the claws of the bloody monk, who, with her accuser, was condemned in a great sum of money, and remained infamous after that time to almost all men."

Scot, who cites this case, shows great familiarity with examples of melancholy and delusion, and from his work have been derived many of the best known illustrations of the latter, including the delusions of being monarchs, brute beasts, and earthen pots greatly fearing to be broken. The old story of the patient who thought Atlas weary of upholding the heavens and would let the sky fall upon him, is narrated by this author, as well as that of the man who believed his nose to be as big as a house.

It comes then, to this—to revert to the question, what was the medical knowledge or practice at the time of Coke and Hale, to which they would turn for direction when insanity came before them in the Courts of Law? —that when the lawyers went to the doctors for light they got surprisingly little help. They had better have confined themselves to reading the old Greek and Roman books on medicine, of which the medical practice of that period was but a servile imitation, and not have added, from their belief in witchcraft, the horrible punishment of lunatics, which in our country extended over the period between 1541 and 1736, when the laws against witchcraft were abolished. The last judicial murder of a witch in the British Isles (Sutherlandshire) was in 1722.

Leaving now the insane who were punished as witches, I pass on to remark that in Percy's "Reliques of Ancient English Poetry," it is stated that the English have more songs and ballads on the subject of madness than any of their neighbours. "Whether," the writer proceeds, "there be any truth in the insinuation that we are more liable to this calamity than other nations,[51] or that our native gloominess hath peculiarly recommended subjects of this class to our writers, we certainly do not find the same in the printed collections of French and Italian songs." Half a dozen so-called mad songs are selected. These refer to much the same period as that we have been considering; and, in fact, we come upon the "Old Tom of Bedlam," or Cranke or Abram man, who "would swear he had been in Bedlam, and would talk frantickly of purpose," so notorious in connection with the beggary which endeavoured to make capital out of the asylum most familiar to our ancestors of the sixteenth and seventeenth centuries. In this light the Bedlam beggars appear in "King Lear"—

"The country gives me proof and precedent

Of Bedlam beggars, who, with roaring voices,

Stick in their numb'd and mortify'd bare arms

Pins, wooden pricks, nails, sprigs of rosemary;"

and these enforce their charity by lunatic "bans," that is, by licences to beg under the badge of the Star of Bethlehem.

Some doggerel from the most ancient of the Percy "Reliques" will serve for a sample of the rest:

"Forth from my sad and darksome cell,

Or from the deepe abysse of Hell,

Mad Tom is come into the world againe,

To see if he can cure his distemper'd braine."

Tom appears to have brought away with him some of his fetters, then sufficiently abundant in Bedlam:

"Come, Vulcan, with tools and with tackles,

To knocke off my troublesome shackles."

This method of treatment—by fetters—has not, it may be well to state, survived, like immersion, in the practice of the present Master of Bedlam.

We learn from Shakespeare how "poor Tom that eats the swimming frog, the toad, the tadpole, the wall-newt and the water [newt]; ... swallows the old rat, and the ditch-dog;" and "drinks the green mantle of the standing pool," was "whipped from tything to tything, and stocked, punished, and imprisoned....

Mice, and rats, and such small deere

Have been Tom's food for seven long yeare."[52]

Whipping-posts were very common in the reign of Henry VIII., and we suppose long before; certainly also much later. About the middle of the seventeenth century an old poet, John Taylor, once a waterman on the Thames, and hence called the "Water Poet," wrote:

"In London, and within one mile, I ween,

There are of jails and prisons full eighteen,

And sixty whipping-posts and stocks and cages."

The whipping-post was sometimes called the "tree of truth." There is a curious passage in Sir Thomas More's works, in which he orders a lunatic to be bound to a tree and soundly beaten with rods.

"There was a tree in Sir Thomas More's garden, at which he so often beat Lutherans, that it was called the 'tree of troth,'" says Burnet. This was not the tree at which he had the poor lunatic flogged, for he says that was in the street.

"It was a good plea in those days to an action for assault, battery, and false imprisonment, that the plaintiff was a lunatic, and that therefore the defendant had arrested him, confined him, and whipped him."[53]

Whipping-posts may still be seen in some villages in England, in the vicinity of stocks. Of course they were largely employed for idle vagabonds, but many really insane people suffered. The following item from the constable's account at Great Staughton, Huntingdonshire, illustrates the custom of whipping wandering lunatics:—"1690/1. Paid in charges, taking up a distracted woman, watching her and whipping her next day, 8s. 6d."[54]

Let me here refer for a moment to the "brank."

The "brank" or "scold's bridle" was very probably used in former days for lunatics—an instrument of torture which has received much elucidation from my friend Dr. Brushfield, the late medical superintendent of Brookwood Asylum. Indeed, it is certain that it, or a similar gag, called the "witch's bridle," was employed for these unfortunate suspects, of whom so many, as we have good reason to conclude, were insane or hystero-epileptics. In the church steeple at Forfar one was preserved, within recent times, with the date 1661.[55] Archdeacon Hale many years ago suggested that the "brank" was used to check noisy lunatics of the female sex; and in reference to this, Dr. Brushfield remarks: "Medical officers of asylums can always point out many female patients who, if they had been living a couple of centuries back, would undoubtedly have been branked as scolds. One of the female lunatics in the Cheshire Asylum gave me, a few days since, a very graphic account of the manner in which she had been bridled some years ago whilst an inmate of a workhouse."[56]

No doubt, in addition to branks and whipping-posts, the pillory and stocks, and probably the ducking-stool, were made use of for unruly and crazy people, who nowadays would be comfortably located in an asylum.

What now, let us ask in conclusion, are the practical inferences to draw from the descriptions which I have given respecting the popular and medical treatment of lunatics in the good old times in the British Isles?

In the first place, we see that the nature of the malady under which the insane laboured was completely misunderstood; that they often passed as witches and possessed by demons, and were tortured as such and burnt at the stake, when their distempered minds ought to have been gently and skilfully treated. Some, however, were recognized by the monks as simply lunatic, and were treated by the administration of herbs, along with, in many instances, some superstitious accompaniment, illustrating, when successful, the influence of the imagination.

Further, the medical treatment, so far as it made any pretension to methods of cure, was either purely empirical, or founded upon the one notion that descended from generation to generation from the earliest antiquity—that there was an excess of bile in the blood, and that it must be expelled by emetics or purgatives.

Again, there was the more violent remedy of flagellation, one always popular and easy of application; equally efficacious, too, whether regarded as a punishment for violent acts, or as a means of thrashing out the supposed demon lurking in the body and the real cause of the malady. And there was, of course, as the primary treatment, seclusion in a dark room and fetters.

To anticipate what belongs to subsequent chapters, we may say here that when the insane were no longer treated in monasteries, or brought to sacred wells, or flogged at "trees of truth," they fared no better—nay, I think, often worse—when they were shut up in mad-houses and crowded into workhouses. They were too often under the charge of brutal keepers, were chained to the wall or in their beds, where they lay in dirty straw, and frequently, in the depth of winter, without a rag to cover them. It is difficult to understand why and how they continued to live; why their caretakers did not, except in the case of profitable patients, kill them outright; and why, failing this—which would have been a kindness compared with the prolonged tortures to which they were subjected—death did not come sooner to their relief.