Religio Psycho-Medicine
17 & Art. II.? :Author: W. A. P. Browne, LL.D., formerly .Medical Commissioner in Lunacy, Scotland.
” For as though there were a metempsychosis, and the soul of one man passed into another, opinions do find, after certain revolutions, men and minds like those that first begat them.” Page 14, Religio Medici. By Sir Thomas Browne, Knt., M.D. Ed. 1754.
Except in the title, motto, and certain of the sentiments of this essay, I can claim no kindred with my illustrious namesake. It is not my wish to imitate even his excellences and peculiarities, so that I deprive myself of the charm of his quaint egoism which casts his ethics into the mould of a narrative.
Neither does it fall within the compass of my design to record mv personal experience, to sketch the likeness of a typical reverential alienist, or to imply that all, or many, or any indivi- dual among my fellow-labourers have been led by intellect or sentiment to the impressions or conclusions described. Guided by humbler aspirations, my purpose is to describe the varied cir- cumstances in the daily walk of a psychologist, which are calculated to create feelings or convictions of veneration, faith, piety, and the adoption of those principles and practices which have actuated those engaged in similar duties, and have been tested in the con- sciousness, and have proved the support and solace of succeeding generations of minds of every calibre and character.
The admission of a lunatic into an asylum, when stript of legal formalities and medical testimony, is a most sad and solemn event. There was a tyrannical custom in old pagan Athens, whereby ob- noxious persons?obnoxious sometimes from qualities which the possessor held to be merits?were sent into banishment, a relic or shadow of which is still detectable in expulsion from clubs and communities, for reasons which are unreasonable to the sufferer; but true ostracism reappears in branding and banishing the lunatic upon grounds which are to him unknown or unintelligible.
He becomes an exile, an expiator, a captive. An exile in being- deprived of all rights, privileges, enjoyments?civil social, domestic-which he cannot conceive that lie has rightfully for- feited ; and by the act of those of his own household, of those whom he loved and trusted, of the very guardians of that law and liberty under which he lived. An expiator, in that he bears or may bear the blight and burden of errors, eccentricities, vices of ancestors in centuries long past the taint of a corrupted constitution which he did not corrupt, but which, in blind ignorance of all the laws involved in hereditary tendencies and intermarriage, he has unwittingly and innocently, contributed to deteriorate ; and thrust forth, like the scapegoat of old, into a desert with an abiding curse from which he cannot escape, and which he may have perpetuated to a wide and widening circle. A captive for long?it may be for ever?in what he regards, notwithstanding its amenities, as a prison ; among companions whom he loathes, or at least loves not, and with surroundings foreign to his nature and habits, incompatible with his prospects and desires, and where no ray of comfort from the future can penetrate through bolts, bars, administrative vigilance and management. This doom may, too, be inflicted when he is in a mental sleep or hybernation, dimly conscious that he suffers, but by what or whose instrumentality he cannot guess; or in a waking dream, where grotesque and hideous shapes crowd in upon his fancy or his folly; or in a fervid and frenzied delirium, which mis- interprets every object and event into malignant persecution or conspiracy; or in that partial insanity which permits of clear though perverted moral vision of the capacity to see realities, but to see them through a medium of suspicion, misery, and misinterpretation. He is thus left alone, his solitude disturbed by the sense of desertion, by fears or forebodings under which, and in the darkness or twilight which broods over him, he must grope around for some half-meaning, some hope, some stay on which to lean. That stay is generally his physician, who may be viewed and repelled as a dictator, an interested party, or a demon, but who is generally addressed as a court of appeal, hailed as a friend and a just arbiter of destiny, and whose kind words, deeds, sympathy are sought for and solicited as the balm, almost the elixir of life and consolation. He must have a frivolous or flinty nature who could deny such a boon, who could reject the overtures of the desolate or despairing, and fail to recognise in his charge one of those beings upon w;hom what are called the inscrutable sentences of fate have fallen, as one isolated from all and everything save the utterances and impulses of that spiritual influence which constitutes him what he is, which forms a link between his past and his future, and which may yet be evolved into the glories and gladness of intelligence and peace. It ought not to be merely a happy accident, but a triumph of moral treatment, when the physician becomes the confidant and confessor of his patient, oftentimes his penitent. The relations of the superintendent with the mem- bers of an insane community differ widely from those of a physician with his patients. The connection must be long, and may be for a lifetime. The tie is rather that between a counsellor, a companion, a friend with a child or ward, than of an invalid with a guide as to drugs and dietetics. The alienist has not only the health and restoration of those intrusted to his charge in his hands, but their comfort, happi- ness, resignation, almost their immortal peace ; and it is note- worthy that the powers and responsibilities and usefulness of such a moral director increase in the same ratio as the years, helplessness, and hopelessness of his pupils, penitents, and pa- tients. There is a daily, almost hourly, communion between the parties. The guardian and custodian is supreme ; the ward and captive depends in all things upon the will, the wisdom, the affectionate care or the caprice of his adviser. Even where this official potentate is not clothed by delusion, depression, unfounded fear, with the imaginary qualities of a god, a tyrant, a persecutor; even where the actual qualities of such a ruler are, or approach to, judicious benevolence, delicate forbearance, attention, and sleepless watchfulness; the ruled must seek and obtain the gratification of every whim or wish, however important or in- ? significant?his liberty of action, even of thought?from this source. The patient is in many senses a climber, a parasite, deriving nourishment and life from the support to which it clings. In strength and excitement, the guardian must restrain ; in weakness, waywardness, exhaustion, and the expiring fires of hope, he must support, soothe, solace ; and when physical death impends, his duty is to impart the viaticum of a happier issue. It is then, when standing face to face with the last manifestations of a soul trembling on the brink not only of eternity, of a passage from suffering, and sorrow and decay, to immortality ; but from the clouds of confusion, and it may be the terrors of mental disease, to everlasting light and order?from moral death, which may have lasted half a century, to a new birth of powers and feelings in their original, or even in augmented freshness and fulness?that the psychologist feels and believes this cannot be the end, the close. But sometimes, shortly be- fore that sunset, as physical strength declines?but not because it declines?there is a sudden and brief sunrise or euthanasia, which is popularly but beautifully called ” a lightening before death,” when the mists of disease pass away, when the patient awakes as if from a long sleep, as the buds and bulbs burst forth in spring prematurely, and in despite of cold and tempest; and the spirit shines out in its original light and powers, ignorant of obscuration, and joining together the links in the chain of memory which insanity had broken asunder. I have watched such Phenomena in several, but not many cases for hours, even days?and have seen in it that which was inexplicable, if not supernatural. Sir Thomas Brown says (Religio Medici, p. 208) : ” Thus it is observed, that men sometimes, upon the hour of their departure, do speak and reason about them- selves. For then the soul, being more freed from the liga- ments of the body, begins to reason like herself, and to discourse in a strain above mortality.” A witness to such scenes feels that the belief in immortality is not merely an in- tuition, but a part of his mental constitution ; but that these necessitate the exist ence of a Creative energy, which connects the primal feeling of personality with all mental manifestations; which unites in consciousness the otherwise distinct and isolated impressions of the senses, and the succession and recollection of ideas which regulates our perceptions and our conscience; of a process, or a Person, by which, or by whom, the mental process may be purified and perfected when soiled, or sin or sorrow- stricken, restored when broken or bruised ; and of an indwelling Spiritual influence which shall act, not by molecular changes, but by that quickening, enlightening and moral influence which all feel, which none can call into activity or resist.
But it is not only when the spirit is departing, whatever may be its destiny, that the physician listens to outpourings from the distempered heart. At all seasons he is called upon to listen to confidences which may contain long narratives of misspent lives, misapplied opportunities, wasted frames, fortunes, faculties, misadventures, misfortunes, tragedies. His penitents may con- fess crimes and atrocities which were never committed, but to the commission of which the dark design, or the desire or temptation or tendency, may have previously existed and been cherished, and may still linger and lurk, as a morbid memory or a delusion, far down in the mysterious intricacies of outraged feelings and propensities or of perverted conscience. But it may be that real atrocities are revealed, or those obscene impulses, obscure perversions, and impotency or impairment of the senti- ment of responsibility which occupy the border-land between derangement and crime, and so mingled with monstrous pre- tensions, absurd delusions as to Divine power and privileges, invulnerability, with the personification of Buddha, Confucius, St. Francis Xavier, the last avatar of Johanna Southcote, that the auditor stands aghast, detects his own inability to discrimi- nate between what is true and what is false, between the sins of the sane man and the offences of the maniac, and willingly admits that Omniscience alone could establish such a distinction, and restore the mental chaos to order, and unity, and peace. But besides what is voluntarily exposed, psychologists must become vivisectors. The minute anatomy of our mental and moral nature is exposed and palpitating before them. What- ever may have been hidden by cunning, caution, conventionality, is revealed; what may be called the topography of motive, and impullse, and conduct is mapped out, the function of each part and portion of our spiritual system is detected or discovered.
The real origin, root, and ramifications of every thought, fancy, folly, glowing imagination or delirious conception, may be traced. What is sound and sane may be separated from what is diseased and decayed, and the whole machinery of conscious- ness becomes palpable to the experimenter. Much more is seen, explained, and understood, than the sufferer himself con- ceived or suspected, and his memory and his hopes become more the property of those who listen, than of him who speaks. But more than this, the alienist penetrates beneath the surface of present conditions and experiences: by employing reason or remonstrance, fear, fancy, love, those moral electroids, he may so stimulate the inner and deeper strata of our nature, as to demonstrate the capacities which still linger, and so rouse those which are still dormant or suspended, as to bring into activity and movement the very mainsprings of action and passion. And this examination may be conducted for years. The nudification and the shame which attends the exposure even of what is natural and unsullied, may be one of the sources of that an- tagonism or antipathy which the recovered lunatic sometimes feels toward those under whose care and by whose aid he has been restored, and towards those who poured into his wounds oil and wine, and into his ears the healing balm of the good time coming here and hereafter, and who, it may hap, obtained a clearer con- ception of his future risen condition, of his salvation from the impure and the perishable, in performing these very acts of be- nevolence and by their results.
But these ministers of a godly mission must be consolers as well as scrutators. They must so frame and co-ordinate their manners, expressions, moral tone, to the wants, the poverty, the feebleness, the fancies of those who depend upon them, that their approach must have in it the sound, the promise, the prognostic of medicine, of cure. Their look must convey a message from the highest intelligence and sympathy, and their prescriptions must convey the tonic of hope, the training and rehabilitation suggested by reason and religion, as well as the drugs which their bodily system may require.
One of these remedies is the operation of sacred services, the external ordinances, as well the general influence of the faith of civilisation.
Two thoughts occur, when numbers of the insane are seen together. There is first the similarity of misfortune?they are all shorn, stricken down, half men, quarter men, or dwarfed to littleness or nothingness?and there is, secondly, the dissimilarity of their deprivation: they differ as much as other men, allied only by mental blindness of different kinds and degrees. They are solitary, extruded from the community, from kindred, home; they can find, nor form, no new ties or affections; they live in their own selfishness or darkness; they are shut out alike from the time that is and the time that is to be, and from all that is real, practical, useful; they subsist in a world not of their own creation, but called into existence by occult and therefore mys- terious circumstances, and yet in which there moves and rules a God. It is instructive and impressive to see this crowd, in such institutions as Han well and Colney Hatch, where many hundreds assemble together?the sexes, as in primitive times being kept apart?bow down in worship. Other assemblies may comprehend wide diversities in opinion, coldness, doubt or denial; but here imaginary but sincere and self-convinced angels, apostles, principalities, powers, even deities, kneel calmly down, some guided by the teachings in childhood ; some awed by the silence around, but the majority acknowledging, faintly and feebly it may be, but consciously, that natural or revealed divinity which dwells within the conscience, which is never obliterated even by disease, which acts independently of the will, and at moments when the mind is least prepared for such action, and now to calm the moral, as in former times was calmed the physical storm. The most distinguished of modern philosophers and sceptics, Jouffroy, in some respects the co- thinker of Sir William Hamilton, murmured when dying, ” Systems! One page of the Catechism is worth them all.” That Satan or his satellites, that demoniacs or demiurges, that fallen angels, or lost and despairing souls, should bow down before the shrine of ” the Mighty and Marvellous ” is conceivable as an act of allegiance or fear; but that gods, divinities of all ranks, ages, pretensions, should recognise and affect to worship, in any form or under any relation, Him whose powers and very name they have arrogated and appropriated, is explicable, but barely explicable, as an indelible instinct of human nature which compels our sentiments to love, respect, and adore what our intellect may dispute or deny. The physician who, apart, wit- nesses such a spectacle, may seek a solution of the long-con- tinued composure and respect in the overmastering power of habit, or of imitation, or in that reverence which tends to revere what others revere; but he may penetrate deeper, and find in that submission,silence,and solemnity?a sunbeam from onhigh?that affluence of inner life and love and light which may be traced among the shadows of the afflicted and stricken mind, as clearly perhaps as in the clear perspective of the robust intelligence. The long-sustained attention should be accepted as a proof that there is something infused, added to the subjective, the personal visions and vagaries of the worshipper. He might continue to maintain attention for an hour or more; he might join in prayers, read or oral, in music or psalmody, and display a calm and propriety rarely attainable under different, and never, with- out such addition, under such trying circumstances. But the impulse of the witness may be to kneel beside his charges, in the hope or conviction that the different degrees of devotional feeling, of reasonable or unreasoning intercommunion with the unseen, the sense and sound of supplication, may ascend to the source of health and beneficence. Many of these sufferers pray without ceasing. The prostration of the religious melancholia, the ex- tasy, self-contemplation, and aspiration of the theomaniac are not now under consideration. But there are conditions where there can be no suspicion as to sincerity, where the pious feel- ings and acts are in themselves sane, and only because of their excess and the exclusion of objective realities insane, and where we are surprised into the belief that we have to deal with a pure and elevated spirit rather than with a monomaniac.
Many years ago a gardener was under my care. His attitude was that of profound reverence ; his upward look was intently fixed upon the sky; the only words he uttered, ejaculatively, were ” Bless the Lord,” ” Bless the Heavens’ Grod,” and the only words he ever read, when a Bible was placed in his hands, were ” Bless the Lord, 0 my soul” and this audible adora- tion was persevered in articulately while subjected to the shower bath, and murmured when the head and face were en- veloped in plaster of Paris, in the process of taking a cast of the head. The whole moral and mental life of this poor man was concentrated in worship. In what did this devotee differ from St. Simon Stylites, or from those whose lips never uttered aught but consecrated words, and of whose sanctity and of whose com- munion with the object of prayer there can be no doubt ? In mediaeval times?a.d. 500-1500?the insane were in- trusted to religious recluses, or to conventual seclusion. It is probable that this step was taken partly in consequence of the lack of other custodians and accommodation, because monks and ministers of religion were the best cultivated moral teachers of the time, and because the presence or proximity of what was sacred was esteemed sanitary and life-restoring. Precisely three hundred years ago, it would appear that St. Vincent de Paul, that ” friend of the poor, and steward of Providence,” struck by the neglected state of those of imperfect or perverted intellect, admitted members of this class into his community, recom- mending them to the prayers and care of his associates, and proclaiming that such superintendence was not sought for by thern, but imposed by God.1 Beyond the effect, the cethos of solemn rites, of the regular performance of duties consecrated by authority, long usage, and their consoling power, and of a calm and contemplative, pure and benignant religious life, it would be difficult to determine precisely, amid accounts of gro- tesque mismanagement, what system of treatment, if any, was pursued; but it is certain that lunatics were admitted to church during the celebration of the sacred offices, and I have seen on the Continent a chapel containing a recess separated from the body of the edifice by a curtain, where even epileptics, and maniacs liable to sudden outbursts of fury, were placed during service. How far a sense of duty, or a hope of benefit, dictated this arrangement, was not ascertained. At no very distant period, and perhaps still in conjunction with therapeutic agents, the inhabitants of the insane colony of Grheel, were present at mass. Many knelt and prayed under the relic of St. Dymphna, and those in the first or agitated state of their malady, were chained in the covered niches formed in the outer wall of the church, but near to the holy precincts in the interior. I do not know whether these unfortunates were, or could be, admitted to confession and communion, either there or elsewhere, and can appreciate difficulties in such a step.
That somewhat similar relations continued recently, perhaps still continue to exist, between the insane and sanctified objects, may be gathered from the following anecdote, where a pious or holy person, not a priest, exercised supreme power in virtue of her office and attributes. Not very many years ago, we visited the asylum at Mareville, subsequently the scene of the labours of Archambaud, Morel, and Renaudin, but then under the superin- tendence?and wefearwemust add, the mismanagement?of about twenty Sisters, as the community was merely visited by a medical officer who resided in Nancy. But the religious element, or the power which personal piety or official sacredness confer, shone forth in various ways through the ignorance and superstition around. One illustration of this lingers most lovingly in memory. In passing, with the sister who acted as guide, through a remote ward, we heard cries and sounds of strife. We quickly reached a small paved court surrounded by buildings, in which two male lunatics were engaged in a furious, and what might have proved fatal struggle. The Sister advanced fear- lessly to part the combatants. In a moment strife was over. One of the men rushed to the most retired part of the yard, and crouched, shame or awe-stricken, in the corner. The other, per- haps the aggressor, knelt penitently down, kissed the Sister’s skirt, and at once obeyed her command to follow us. That such patients were admitted to the ceremonial of Benediction, which is in a sense sacramental, cannot be doubted. But in this respect the Anglican practice is more logical and beneficent, as, if grace in any degree or form be imparted in the Sacrament, independently of the will of the communicant, the benefit should be afforded to those of imperfect and impaired mind, as well as to those of imperfect or impaired morals. It is matter for regret that such ordinances are not more generally accessible in asylums, and as an argument for their catholicity, it should be kept in mind that in Broadmoor patients are admitted to such privileges :
judiciously selected individuals, doubtless, but unavoidably pa- tients in whom crime has been associated with insanity, or insanity with crime. That a school of theology, very dif- ferent from that to which allusion has just been made, has directed its exertions to the religious condition of the insane, and has entertained ardent anticipations that dogmatic teaching as well as objective worship might elevate and enlighten that condition, may be learned from the works of Cheyne, Bingham, and essays in connection with Earlswood Asylum,* which, in addition, show how greatly widened may be the operation of such agencies in the alleviation of alienation.
Since the Reformation, priestly ministrations have been spasmodically extended to lunatics, but their recognition as an element in the system of moral treatment and reculture is con- temporaneous with the present century. This recognition is due almost exclusively to the action of medical men. It may be true that the majority of our collaborateurs introduced wor- ship as a remedy, restorative, as a means of assimilating the cloistered life to the habits and customs of rational society, but many co-operated from higher aims and motives?from a desire to point to God as the Father and the Physician of the victim of mental, as well as moral diseases, as able and willing to heal wounds and woes which they failed to alleviate or cure, and of pouring down balm and blessings upon those who can scarcely ask for them, understand them, or feel them; and acting, coming, going, how and whence and whither we know not, but which exert an influence similar to that of physical means, and quite as explicable as the therapeutic operation of any drug whatever. The efficacy may consist in a process similar to the solace and support derived from commonplace sources of distraction, occu- pation, amusement. But this is a presumption as gratuitous as that the Divine Power should be directly exerted in calming the troubled conscience, or rehabilitating the enfeebled conscious- ness ; or that the humble, perhaps cloudy faith of the participant placed him in closer relation to the Giver of Health. It is perfectly true that one of the great revolutions in psychology originated, and that very recently, in the conviction that aliena- tion is a disease of the body. The dogma was sound, and has been pregnant with incalculable benefits in establishing a ra- tional treatment, in emancipating the lunatic from the perse- cution instigated by false views, fear, and from the bonds and brutality to which ignorance and pusillanimity resorted. The principle appeared to involve two cognate opinions ; first, that mind was something superadded to body, and disturbed, not in its nature but in its manifestations, through the instrumentality of bodily disease; and secondly, that mind was a mere function of body, and became diseased with, as well as through, the structure of the organisation, and could be reached and restored solely through these structures. The tendency to materialism created by the latter proposition unfortunately prevailed for a long time. But the adoption of what has been vaguely called moral treatment, as co-ordinate with anodynes and anaphrodi- siacs, portends a change of creed?has, indeed, already conceded the question at issue, has sacrificed scepticism before the invin- cible truth, that the emotions and intelligence can be influenced through other avenues than the stomach, or even the external senses. The impalpables of light, perhaps coloured light, tem- perature, motion, beauty, faith, even force of character, depending neither upon bulk nor bearing, because it is recognised by the blind, have been despised and neglected, because misinterpreted or misapplied. That faith can remove mountains is certain. Whether the removal of the burdens and blots upon our nature be the effect of this sentiment excited in the mind, or of the Divine Law, Will, Power, by which that sentiment has been so excited in the mind, may remain inscrutable, but that hope heals is patent even to the vulgar eye. The modus operandi of faith is not one whit more obscure than that of any tonic or opiate, and I do not shrink from reliance upon the reality of cures resulting from the ashes of St. Dymphna, the prayers of the Cure D’Ars, even from the manifestations of the mesmerist, more than from those which obviously flow from the moral qualities of a physician, from the word in season, from the inspiring prognosis. But dare we affirm that the finger of (rod, of Om- nipotence, guides the invisible as well as the visible agent, acts by a law which we have not discovered, as well as by a law the existence of which we have imagined and defined ?
There is a reaction between the physician and his patient: the religious influence which may calm the lunatic- elevates his attendant; and the result is not merely a fraternal tie of mutual benefit but of mutual belief, and the leader is led by the tie and the teaching by means of which he has endeavoured, and perhaps succeeded, in raising the mental status of his charge. He has created a reasoning and responsible being, and loves it.
For you must lovo him, ere to you He -will seem worthy of your lovo. But there are cold, obdurate, unlovable companions. Some so sublimated as to soar above, some so degraded as to sink beneath the gospel of loving mercy, doing justly and walking humbly: transcendentalists who embrace all truth, who have solved all problems, who share in the Divine essence. There are Nebuchadnezzars, who creep, grovel, feed on foul garbage ; Lycanthropes, who have either indulged the appetites of can- nibals, or dream that they have fed in charnel houses; many who seem reduced to the level of the beasts that perish, or of molluscs who have never lived within the pale of reason; and yet these outcasts may be seen ” seated, clothed,” and though not in their right mind, soothed or subdued by words or tones which speak of peace and hope.
At no moment does a physician feel himself so insignificant as when confronted with a madman, whether he be animated with the malignity and violence of diabolical possession?for there is possession, it maybe of a demon, it may be of an inborn desire?or it may be the torments of imaginary sorrows, sins, sufferings; or the soul may be darkened or dulled by the sense- less, hopeless, idealess night of fatuity. He knows the fabled omnipotence of love and sympathy even over the cold and hardened heart, but now they fall as inert as the snow-flakes upon the frozen earth. Hitherto he may have boasted of pain- quelling morphia, of mind and motion-coercing chloroform, of the intoxicating joys of hachisch, and of the thousand panaceas and drug weapons which the tradition and experience of two thousand years have accumulated against the fury or folly or feebleness of poor suffering humanity; but he recoils less in Nullifidianism than in doubt and perplexity as to their appro- priateness, trustworthiness, and actual effect. He has before him two roads by which his object, the removal of disease, may theoretically be reached, the external senses by which moral agents may travel, and the nutritive and assimilative functions which may convey physical agents into the system. But with whatever wisdom these instruments may be applied, however triumphant they may have seemed to be, he is conscious that neither by his eye nor his art can he trace their course, track what may be called their physiological footsteps through various structures to the diseased or disorganised spot, or, what is more essential, to the delusion or delirium which he seeks to combat. He feels that there is a chasm, a void; and even when his random or empirical effort may appear to succeed, may appear to restore sanity and serenity, suddenly as the lightning in the storm, slowly as the sun from eclipse, or imperceptibly as the spring- tide warms and wakes the sleeping flowers to renewed life, he dares not say nor believe that his was the design or the act, nor even was the blind, although assuredly benevolent instrument in accomplishing it.
There are hospitals in which drugs, the materia mecLica, and mechanical resources are eschewed. There are nullifidian super- intendents who trust exclusively to nutrition, exercise, cheerfulness, in the establishment of an abstraction which they call physical health, and, through such instrumentality, sound reason. But physical health may be attained without its concomitant. And what is this cheerfulness but the moral agent acting under the forms of distractions, occupation, religious impressions, &c., act- ing upon our spiritual being ?
There are minds easily satisfied as to the mode in which such agents, whether moral or material, travel to and act upon the cen- tral intelligence. Such messages, whether transmitted along the sympathetic from the body itself, or by the external senses from the outer world, are supposed to move with measurable rapidity along nervous tracks, converging towards ganglia, we might almost call them manufactories; where the impressions grow into, are changed into sensations, where these sensations become instincts, ascend into what are technically called higher strata, are resolved into ideas and emotions, prompt or pass into volitions which ultimately issue as missives along the motor tracks, awakening or co-ordinating muscular action; all or many of such stages being at different times within the region of con- sciousness, in other words, known’ to the Ego. What first strikes a non-metaphysical thinker is to inquire what are the vehicles by which such impressions are carried within the cognisance of intellect; and the answer is, molecules. The second difficulty presented is, what psychical state or recep- tivity is affected by sensation ; and the answer is?vague but correct?the mind. The third difficulty is, what constitutes the unifying process by which impressions from the skin, eye, ear, for examples, are formed into a whole, a unit, representing a given object. The fourth enigma is, in what consists the change by which a sensation is elevated into a sentiment, or any other mental condition ; what or who transmutes, what is transmuted, and in what way can such a succession of states produce the feeling of personal identity, the faculty of willing, which seems to precede all other mental acts. The notion of molecules?for upon the existence and laws of such atoms the whole chain of mental acts attempted to be traced depends?is a mere figment devised for the convenience of scientific specula- tions ; an imaginary basis upon which is placed an imaginative hypothesis. The roots by which increment to intelligence is secured are as distinct as the roads or rivers upon a map, but all else between sights, sounds, &c., and the mind, the spirit, the ego, is enveloped in mist or in utter darkness.
It is both solemn and saddening to mingle with hundreds of individuals bereft, and partly bereft, of reasoning powers. They may rave, riot, they may be exuberant in joy or plunged in dejection ; but while so torn and travestied, there remains in them the visible stamp and type?unless they are and act as automata?of an original nature, which bears characters written by no evolution, no historic or hereditary process, by no personal error or effort, but dates from that primeval moment when identity, self-consciousness, and faith, or continuity of life and mind, were imparted to the soul, not created by it.
By the impassable gulf which separates mental conditions from cerebral changes, more than by the vast and vital destruction of cerebral substance, which is represented by no appreciable mental change, and is compatible with life and thought and comparative health, the physician is perplexed when gazing upon the ruins which he cannot repair, and which seem irreparable, to discover that some essential faculty or combination of faculties remains unscattered, though perhaps not untouched, by the dilapidation and destruction around. The perpetuity of delusions under varying and unallied morbid mental states, even although the sufferer should pass through the states of mania, melan- cholia, to dementia, has been speculatively discussed. But we are not aware that due attention has been directed to these almost inexplicable phenomena, the survival of unimpaired volition amid great intellectual decay, of the power to will, to think, and act in a particular manner, that manner, in fact, which the actor, though morbidly impelled, wishes; and we are certain that the importance of the permanence and natural operation of personal identity in the most disturbed and degraded mind has been underrated by philosophers, if it has been estimated by them at all. This continued sway of the valid ego is not met merely in the fatuous, who continues to be in his own conscious- ness what he has always been since childhood, long after he has been shorn of all the attributes which constituted him what he was in the sight of others. It is even more conspicuous, because in striking contrast and contradiction to the morbid characteristics with which it is associated, when it is manifested in monomaniacs and maniacs, firmly and sincerely entertaining the conviction that they are saints, sovereigns, even the Saviour. In hundreds of such transformations, if they may be so called, which I have examined, I have never encountered a single exception to the retention of personal identity, to the apparently irreconcilable proposition, that while A. B. proclaimed himself Julius Caesar he thought and acted as A. B., recollected the events in the history of A. B., recognised and admitted the relationships and ties of A. B., although, notwithstanding all this, he might adhibit to any document requiring his signature, the words Julius Coesar. I have said that such incompatible conditions are almost in- explicable ; they have, however, a prompt solution by one of two modes: either they demonstrate that certain mental powers, not emotive, are above, apart from, independent of material organs, and remain intact after the destruction of such organs; or that they have been primarily rendered invulnerable and inviolable by God, for the preservation of the individual. When the body is broken down piecemeal by palsy?when por- tions are separated from self?when it is divided, halved, there is no partition, no bisection of the Concrete Ego. The living half may drag along the cold, senseless corpse-companion, now beyond the influence of will, consciousness, almost of animal life, yet the personality survives the partial death, intact and entire. Nor does this individualism contract into a mere point; it expands around in likings and dislikings; upwards in prayer and communion with what is stronger, kinder, better ; onwards, unto the hope of a resurrection, not of a moiety, but of original unity, and into an eternity of an unmutilated, pain- less life. It wakes and watches in sleep both when the surround- ings consist of the parti-coloured patchwork of which dreams consist; of the wild, incongruous unrealities which fancy or excess may body forth; of even those combinations of recollected images which memory faithfully, though fantastically, photo- graphs. The dreamer is ever the hero of, his own story, the victim of his own sufferings, the fugitive from his own fears. The Somnambulist, the Second-Sight Seer, the Sot, undergo no metempsychosis, no dualism, but continue, in trance, in vision, in orgies, the same mysterious self. Through the crucible of insanity no one passes unchanged. The form, the bril- liancy, the ductility of the product differs from the original.
Even when these signs are absent the casual observer, in- capable of defining the alteration, sees that the cured patient is not himself. But revolutions, graver and deeper, and detectable even by the sufferer, such as the deletion of the inventive and poetic faculty in Eobert Hall; of entire languages; of acquirements and of sentiments, such as affection; of habits, such as perseverance; which are better appreciated by the maimed and mutilated mind itself, than by bystanders, have been recorded, where the personality and spontaneity remain as distinct and continuous as previous to the invasion of disease. The same remark is applicable to cases in which some quality has been added, by or subsequent to mental disease, such as excitability, a tendency to intemperance, to immorality, to untruthfulness, where the individual has under- gone a momentous deterioration in character, and where his feeling of identity is in all respects the same. (To be continued.)
Disclaimer
The historical material in this project falls into one of three categories for clearances and permissions:
Material currently under copyright, made available with a Creative Commons license chosen by the publisher.
Material that is in the public domain
Material identified by the Welcome Trust as an Orphan Work, made available with a Creative Commons Attribution-NonCommercial 4.0 International License.
While we are in the process of adding metadata to the articles, please check the article at its original source for specific copyrights.